Objective To understand the epidemiological, clinical, and genetic characteristics of respiratory syncytial virus (RSV) in Putuo district, Shanghai, 2020-2024.

Methods We conducted respiratory pathogen testing on 2,895 specimens from acute respiratory infection (ARI) cases which collected from three sentinel hospitals in Putuo district from 2020 to 2024. Multiplex real-time fluorescent PCR technology was used to detect the nucleic acid of corresponding pathogens. RSV-positive results with a CT value less than 28 were subjected to sequencing. Statistical analysis was conducted using SPSS 22.0 and WPS Office software.

Results The RSV detection rate among the 2,895 ARI cases was 1.80% (52/2,895), with respiratory syncytial virus type A (RSVA) accounting for 55.77% (29/52) and respiratory syncytial virus type B (RSVB) for 44.23% (23/52). The RSV detection rate in severe acute respiratory infection (SARI) cases was significantly higher than in influenza-like illness (ILI) cases, with a statistically significant difference (χ²=16.936, P<0.001). The highest detection rate was observed in the age group of 17 years, with a statistically significant difference (χ²=36.441, P<0.001). The clinical manifestations were fever accompanied by cough (χ²=15.956, P=0.001). RSV infections were most prevalent in winter and spring, with a more pronounced peak in spring (χ²=21.643, P<0.001). Co-infections were primarily with Staphylococcus aureus and Haemophilus influenzae. All 2023 cases belonged to the GA2 lineage, while the 2024 cases were predominantly GB5.

Conclusion  RSV infections are mainly concentrated in SARI cases and children. The main symptoms are fever accompanied by cough, and infections are most prevalent in spring.