Each year, Respiratory Syncytial Virus (RSV) results in millions of outpatient visits and hundreds of thousands of inpatient visits nationwide – and though the CDC anticipates lower-than-average hospitalization rates this year, infections are still a concern healthcare professionals and the public should pay close attention to.
Proper RSV testing is critical to the identification and mitigation of RSV in both children and adults. In this article, we’ll focus on what RSV is, what the common symptoms are, and the ideal swabs for testing. Join us as we discuss the proper swab materials and supplies for medical service providers to have on hand to diagnose RSV.
RSV (a.k.a. Respiratory Syncytial Virus), is a common respiratory virus that usually causes mild, cold-like symptoms. For those that become infected, most recover in a week or two, but RSV can be serious for some, especially infants and older adults.
RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than one year of age in the United States.
The virus spreads much like the common cold. It spreads through droplets from an infected person’s cough or sneeze. Individuals may also become infected when they share beverages or kiss someone who has RSV.
Vaccines have been proven to dramatically reduce the risk of severe infection and hospitalization in people most at risk. This includes seniors, individuals with underlying health conditions like asthma, and young children.
Though most infections are minor and are treatable at home, the New American Lung Association reports that 160,000 older adults are hospitalized with the virus each year. This trend is expected to continue in the year to come, while overall hospitalizations for upper respiratory conditions including RSV, the flu, and COVID-19 are projected to be lower than average.
We can attribute some of these lower rates to the fact that vaccinations have been proven to dramatically reduce the risk of severe infection and hospitalization in people most at risk. This includes seniors, individuals with underlying health conditions like asthma, and young children.
The CDC does report that just 24.4% of adults over 60 years of age have received the vaccine – so it’s clear that there is still work to be done to increase vaccination rates for public health safety and vigilance.
RSV can affect anyone, regardless of age, health, or occupation, but certain groups face a higher risk of contracting the virus than others.
So, who do we need to be extra vigilant for?
Infants, young children, older adults and pregnant women! It’s true that younger age groups are the most likely to contract RSV as their immune systems are still developing – but we should also be on the lookout for RSV in older adults, especially those with chronic medical conditions, and pregnant women who are at heightened risk.
Given that kids are the most likely to contract the virus, let’s dive a little deeper into why and how we can help support our littles.
Parents are particularly concerned about the spike in RSV because of its potential severity in infants and young children. RSV can be especially severe for children who:
Are born prematurely
Are six months of age or younger
Are less than two years old and have a chronic lung disease or congenital heart disease
Have a weakened immune system
Have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions
For those that contract RSV, most will get it by the time they are two years old. And for many of those children, symptoms can be mild. However, with cases on the rise, parents are on high alert for their families.
But, as we mentioned before, children aren’t the only ones potentially severely affected by an RSV infection. Older adults also represent an at-risk age group.
Older adults are at increased risk if they are:
65 years old or older
Have a chronic heart or lung disease
Have a weakened immune system
Though the virus commonly affects young children and older adults, it can also affect pregnant women at any stage of pregnancy. If contracted during pregnancy, RSV can result in the following complications:
Pre-term delivery
Preeclampsia (high blood pressure that can result in kidney damage or organ failure)
Sepsis
Respiratory failure
The FDA notes that getting vaccinated between 32 and 36 weeks can dramatically reduce the risk of complications from RSV.
The testing method may vary depending on the age of the patient. According to the CDC, both rRT-PCR and antigen detection tests are effective methods for diagnosing RSV infection in infants and young children. For older children and adults, the CDC recommends that healthcare providers use highly sensitive rRT-PCR assays.
For the most up-to-date information on testing for RSV, please visit the CDC's website.
There are two common methods for collecting specimens for RSV testing.
This is the most common way to collect a sample for RSV testing, especially for young children or infants. To perform a nasal aspirate test for RSV, a medical professional uses a saline solution (salt water) to flush out the nose and remove the solution with very gentle suction. The solution is then tested for the presence of RSV.
Similar to flu and COVID-19 testing, a nasal swab test can be used for RSV specimen collection and diagnosis. A specialty swab is inserted into the nose and twisted gently in order to collect specimens for diagnostic testing.
When speaking with healthcare professionals, most go with the nasopharyngeal swab approach — so for the sake of that, we will focus our information there.
Which leads us to…
To test for RSV, you’ll need to perform a nasal swab. We’re happy to provide a quick refresher for our healthcare partners – as you know, the process is pretty simple as long as you follow these five steps:
Wash your hands thoroughly. Put on gloves and any other necessary personal protection equipment and remove the swab from the package. Be sure to hold the swab by the handle. Do not touch the swab tip.
Tilt the patient’s head back slightly. Insert the swab into one nostril, following the floor of the nasal passage and back to the nasopharynx. For reference, the swab should go no deeper than half the distance between the nostrils and the ear.
Gently rotate the swab, holding it in place for a few seconds to collect sample material. Slowly rotate the swab as it’s being withdrawn.
Insert the swab into a vial containing 1-3 mL of viral transport media and break the swab handle at the breaking point.
Label the vial with appropriate patient information. Process it immediately as per standard laboratory procedures.
To help, we have this handy video to guide you along these steps:
Don’t have time to watch the video? No problem – download our specimen collection guide to take these steps with you on the go or post them in your office. Having these handy will also help set patient’s minds at ease when they come in for a nasal swab test!
Collecting samples the right way and making sure they’re viable is key in diagnosing RSV. To help, we’ve outlined some tips to keep in mind when using swabs to test patients:
Clear away excess mucus by having the patient blow their nose prior to the test. This can make it easier to collect the sample and may make the test more comfortable for the patient.
Always be gentle regardless of patient age. Use light pressure when swabbing the inside of the nostril.
Pay attention to the patient’s facial expressions. If they look uncomfortable or act like they’re in pain, try using less pressure.
If you’re testing an older child, tell them what they can expect during the test and walk them through the process. Often, this can help them stay calmer and be more cooperative as you swab their nose.
With young children, try to distract them by having a nurse or the child’s parent engage them in conversation. Move quickly and gently to minimize discomfort and use a swab specifically designed for a child. Larger swabs can increase discomfort.
RSV testing should be a fast and, ultimately, painless process. By using these steps, you help make that a reality for your patient!
RSV swabs are a type of medical-grade diagnostic swab designed to collect viral samples from a patient’s nose. Using specialty materials and fibers, the swab can collect, hold, and release viral material for more accurate testing.
RSV swabs are similar to flu swabs and COVID-19 swabs. In at-home test kits, these swabs are sometimes one and the same.
The foam used in Puritan’s RSV swab is designed to maximize comfort without compromising the quality of the specimen collection. It’s flexible, comes in different sizes to accommodate patients of all ages, and features a tapered handle for ease of use.
An RSV swab for infants and young children should feature a micro ultra-fine flocked tip material. Flocked swabs can provide superior collection and release of specimens. An infant swab will have a slightly smaller tip than adult versions, allowing for nasal specimen collection of RSV from small infant cavities.
Learn more about Puritan’s pediatric RSV swab here.
An RSV swab for adults should also feature a micro ultra-fine flocked tip material. Depending on the needs of the medical provider, different breakpoints in the swab tip are available, including 80mm and 100mm. The unique microstructure of the RSV swab tip is designed to enhance rapid absorption and quick release of biological specimens. And the mini flock tip is ideal for patient comfort during the swab test.
Learn more about Puritan’s RSV swabs.
An RSV universal transport medium (UTM) is designed for the sterile collection of viruses like RSV. Look for a universal transport medium that contains antimicrobial agents to minimize bacterial and fungal contamination. Your RSV UTM can also include glass beads to better release and disperse the sample into the medium during vortexing.
An RSV universal transport medium can be used in viral antigen tests, PCR, and rapid tests for RSV.
Learn more about Puritan’s RSV universal transport medium kits.
Puritan’s medical products are 100% USA-made. Our products for RSV testing are focused on both patient and provider comfort and ease. Our transport media uses premium medical-grade plastic components to improve product shelf life.
Contact our sales team to customize your order today.