title: Risk of respiratory syncytial virus infection in preterm infants: reviewing the need for prevention.
abstract: Premature infants are at substantial risk for a spectrum of morbidities that are gestational age dependent. Respiratory syncytial virus (RSV) infection is most common in the first two years of life with the highest burden in children aged <6 months. Preterm infants ≤35 weeks' gestation are handicapped by incomplete immunological and pulmonary maturation and immature premorbid lung function with the added risk of bronchopulmonary dysplasia. Superimposed RSV infection incites marked neutrophilic airway inflammation and innate immunological responses that further compromise normal airway modeling. This review addresses the epidemiology and burden of RSV disease, focusing on the preterm population. Risk factors that determine RSV-disease severity and hospitalization and the impact on healthcare resource utilization and potential long-term respiratory sequelae are discussed. The importance of disease prevention and the evidence-based rationale for prophylaxis with palivizumab is explored, while awaiting the development of a universal vaccine.
authors.affiliation: a Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Health Sciences Centre , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Haben Y
authors.initials: HY
authors.lastname: Abraha
authors.affiliation: a Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Health Sciences Centre , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lanctôt
authors.affiliation: b Division of Neonatology, Department of Pediatrics , McMaster University , Hamilton , Ontario , Canada.
authors.forename: Bosco
authors.initials: B
authors.lastname: Paes
mesh_terms: D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use; D001997:Bronchopulmonary Dysplasia / Q000150:complications; D003362:Cost-Benefit Analysis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology; D000069455:Palivizumab / Q000191:economics / Q000627:therapeutic use; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control*; D012136:Respiratory Syncytial Viruses / Q000472:pathogenicity*; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D000069455:Palivizumab
keywords: epidemiology; healthcare costs; outcomes; palivizumab; premature infant; prevention; respiratory syncytial virus; risk factors