Diagnostic Testing for RSV

Overview

Clinical symptoms of RSV are nonspecific and can overlap with other viral respiratory infections, as well as some bacterial infections. Several types of laboratory tests are available for confirming RSV infection. These tests may be performed on upper and lower respiratory specimens.

The most commonly used types of RSV clinical laboratory tests are:

• Real-time reverse transcription-polymerase chain reaction (rRT-PCR), which is more sensitive than culture and antigen testing
• Antigen testing, which is sensitive in children but less sensitive in adults

Less commonly used tests include:

• Viral culture
• Serology, which is usually only used for research and surveillance studies

Some tests can differentiate between RSV subtypes (A and B), but the clinical significance of these subtypes is unclear. Consult your laboratorian for information on what type of respiratory specimen is most appropriate to use.

RSV testing for infants and young children

Both rRT-PCR and antigen detection tests are effective methods for diagnosing RSV infection in infants and young children. The sensitivity of RSV antigen detection tests generally ranges from 80% to 90% in this age group. Healthcare providers should consult experienced laboratorians for more information on interpretation of results.

RSV testing for older children, adolescents, and adults

Healthcare providers should use highly sensitive rRT-PCR assays when testing older children and adults for RSV. rRT-PCR assays are now commercially available for RSV. The sensitivity of these assays often exceeds the sensitivity of virus isolation and antigen detection methods. Antigen tests are not sensitive for older children and adults because they may have lower viral loads in their respiratory specimens. Healthcare providers should consult experienced laboratorians for more information on interpretation of results.