Antibody against this protein neutralizes RSV infectivity and blocks syncytial cell formation. The G protein is responsible for attachment. Most outbreaks peak between January and March in the Northern Hemisphere. Epidemics are associated with increased pediatric hospitalizations and deaths caused by lower respiratory tract illness. Essentially all children are infected within several years of birth.
Immunity is incomplete, and reinfections in children and adults are common.
Higher titers of circulating and mucosal antibody occur with successive infections and appear to be associated with milder illness. RSV appears to be spread by largeparticle aerosols during close personal contact and by hand contamination with selfinoculation of the eye or nose. RSV is a major nosocomial pathogen, and high attack rates occur during outbreaks in hospitals, transplantation units, day care centers, and geriatric homes. Illness rates are commonly 20 to 50 percent among hospital staff and patients during epidemics. In households, secondary infection occurs in about one third of adults.