Practical recommendations for the detection of pediatric respiratory syncytial virus infections

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Abstract
In a private clinic-hospital setting, respiratory syncytial virus (RSV) was isolated from infants more frequently and sooner from nasal washes (84%; 4.2 days) than from throat swabs (45%; 5.5 days) or nasopharyngeal swabs (39%; 5.7 days). Immunofluorescence (IF) of nasal wash cells identified 72% of the infants with virus isolations from nasal washes < 1 day. The combination of isolation and IF on nasal wash specimens is thus recommended for optimal detection of RSV-infected infants. IF of respiratory tract cells was also useful for monitoring the presence of RSV antigen in intubation secretions during ribavirin antiviral therapy. RSV infectivity was maintained in phosphate-buffered saline at room temperature for 6 h. Transport and inoculation of specimens in < 6 h yielded RSV isolates from 50% of sampled infants during the 2 RSV seasons examined. For optimal RSV isolation, inoculation of HEp-2 tubes .ltoreq. 4 days old is recommended. Replacing medium after 3 days as compared with 7 days did not increase recovery of RSV and provided little practical reduction in time to detection of cytopathology.