Current strategies in the prevention of respiratory syncytial virus disease.
Infants infected with respiratory syncytial virus (RSV) develop both upper and lower respiratory tract infections resulting in laryngotracheobronchitis, bronchiolitis and pneumonia. Premature infants of less than 32 weeks' gestation and those with underlying chronic lung disease are particularly susceptible and incur significant morbidity and mortality following hospitalisation. Conservative RSV prevention strategies focus on the interruption of transmission by proper hand-washing techniques and reducing exposure to potential environmental risk factors. Major challenges have impeded the development of an RSV vaccine but a licensed product may be expected in the near future. Prophylaxis with a humanised mouse monoclonal antibody (palivizumab) has been effective in reducing the rate of RSV hospitalisation in high-risk premature infants in phase II-IV trials and is available for use within internationally approved guidelines. Experimental studies evaluating the use of palivizumab in patients with congenital heart disease, those with cystic fibrosis and immunosuppressed bone marrow transplant recipients are well underway, the results of which are eagerly awaited.
Paes
B A
BA
Department of Pediatrics (Neonatal Division), The Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada. paes@mcmaster.ca
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D000069455:Palivizumab; D016032:Randomized Controlled Trials as Topic; D018357:Respiratory Syncytial Virus Infections / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D012136:Respiratory Syncytial Viruses
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D000069455:Palivizumab