Respiratory syncytial virus (RSV) is
Respiratory syncytial virus (RSV), a negative-sense, singlestranded RNA (ssRNA) virus of the Paramyxoviridae family, is one of the most important respiratory pathogens of young children worldwide (1). Epidemiological studies have shown that RSV infects almost all children in the United States by the age of 3, producing primarily upper respiratory tract infections and otitis media (2). In a small subset of immunologically naive or predisposed infants, RSV infection produces a more severe, lower respiratory tract infection (LRTI), an event that accounts for over 3 million hospitalizations and about 200,000 deaths (3, 4). Importantly, there are no effective vaccines or treatments available (2).In seasonal epidemics, RSV is spread via large droplets and self-inoculation (3). Once infected, RSV replicates in the nasal mucosa intraepithelial bridges into the lower respiratory tract or by free virus in respiratory secretions binding to epithelial cilia (5, 6). In the lower airway, RSV replicates primarily in epithelial cells, where it generates bronchial inflammation, epithelial necrosis, sloughing, peribronchial mononuclear cell infiltration, and submucosal edema producing obstructive physiology (7-9). The pathogenesis of LRTI involves an interplay between viral inoculum, host factors, and immune response and is not fully understood (10). Children with bronchiolitis present symptoms at times