Respiratory syncytial virus infection in children with congenital heart disease: a review.
This paper reviews recent changes in morbidity and mortality of respiratory syncytial virus (RSV) infection in infants with congenital heart disease. Mortality since the late 1970s has declined substantially, from approximately 37% to 3%. Although the frequency of admission to intensive care units has declined from approximately 60% to 30%, the frequency for mechanical ventilatory support has not changed significantly. Because mortality dropped prior to the widespread use of ribavirin, it is difficult to ascribe the improvement to this therapy. In infants with congenital heart disease (CHD), nosocomial infection remains a significant problem, accounting for approximately 33% of the RSV cases. Some authors report significant reductions in hospital-acquired RSV by use of gloves and gowns for contacts with infectious cases. Efforts at primary prevention have encountered problems with development of an RSV vaccine. Preliminary data from studies of passive immunization using immune globulins with high RSV antibody titers suggest that this therapy may reduce the severity of RSV infection in infants with serious heart disease.
Fixler
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Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75235-9063, USA.
D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003428:Cross Infection / Q000150:complications / Q000517:prevention & control; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009017:Morbidity; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D012136:Respiratory Syncytial Viruses / Q000276:immunology; D012254:Ribavirin / Q000627:therapeutic use; D015996:Survival Rate; D014765:Viral Vaccines / Q000627:therapeutic use
D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D014765:Viral Vaccines; D012254:Ribavirin