RSV infection in infants and young children. What's new in diagnosis, treatment, and prevention?
RSV is the most important respiratory pathogen in infants and young children. About 1% of primary RSV infections result in hospitalization. The virus is spread by large droplets of secretions or contact with contaminated secretions. Infants infected with RSV may demonstrate poor feeding, rhinorrhea, apnea, lethargy, wheezing, and respiratory distress. Diagnosis may be made by clinical signs and symptoms (especially those observed during epidemics), by chest radiographs showing hyperinflation, or by rapid antigen detection with immunofluorescence of nasopharyngeal aspirates. Risk factors for severe disease accompanied by complications include chronic heart disease, chronic lung disease, immunodeficiency, HIV, and prematurity. Immunity is incomplete and of short duration, and reinfection is common. Treatment remains supportive and consists of oxygen administration, hydration, and diligent monitoring. Use of corticosteroids, bronchodilators, antibiotics, and ribavirin is controversial and is dependent largely on physician preference. Use of ribavirin should be reserved for patients who have severe underlying conditions associated with increased mortality rates. Intravenous RSV Ig has been replaced by palivizumab, which is generally recommended for infants at high risk for severe RSV, including those with a history of prematurity and those with chronic lung disease.
Baker
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Department of Pediatrics, Penn State Geisinger Health System, Danville, USA.
Ryan
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D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005440:Fluid Therapy / Q000379:methods; D006760:Hospitalization; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D007223:Infant; D000069455:Palivizumab; D011322:Primary Prevention / Q000379:methods; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy* / Q000635:transmission; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D013256:Steroids
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D001993:Bronchodilator Agents; D013256:Steroids; D012254:Ribavirin; D000069455:Palivizumab