Respiratory syncytial virus is the most important respiratory pathogen during the first year or two of life, being responsible, during winter epidemics, for about half of all bronchiolitis in infants. Parainfluenza viruses (especially type 3) and influenza viruses are the other major causes of this syndrome. The disease can develop with remarkable speed. Breathing becomes rapid and labored, and is accompanied by a persistent cough, expiratory wheezing, cyanosis, a variable amount of atelectasis, and marked emphysema visible by X-ray. The infant may die overnight, and hence RSV is one of the causes of unexplained "cot deaths," otherwise known as the sudden infant death syndrome (SIDS).
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