A comprehensive look at Respiratory Syncytial Virus (RSV): from pathogenesis to prevention

Respiratory Syncytial Virus (RSV) is a formidable respiratory pathogen that particularly affects infants and children. RSV presents with diverse clinical severity, most often causing mild upper airway symptoms but sometimes progressing to severe and potentially fatal lower respiratory tract disease. This virus has a major global public health impact and places a substantial strain on healthcare systems. RSV exhibits distinct seasonal trends that vary across geographic locations and climate zones, and recognizing these patterns and their determinants is essential for policymakers to schedule RSV immunization programs effectively. Increasing attention has been directed toward the evolving landscape of RSV vaccines, particularly regarding their potential to prevent infection and reduce disease severity, especially among vulnerable populations. Until now, three RSV vaccines, Arexvy, Abrysvo, and mRESVIA, have received approval from the FDA. In addition, monoclonal antibodies such as Nirsevimab and Clesrovimab prevent severe RSV disease and are recommended for infants. Given the significant global impact of RSV, this narrative review addresses its multifaceted aspects, including epidemiology and global impact, clinical manifestations, therapeutic strategies, vaccine development, and its emerging potential as an oncolytic agent.