Prevention of respiratory syncytial virus infections

Abstract

Respiratory syncytial virus is the most important cause of viral lower respiratory illness in infants and children worldwide. By the age of 2 years, nearly every child has become infected with respiratory syncytial virus and re-infections are common throughout life. Most infections are mild and can be managed at home, but this virus causes serious diseases in preterm children, especially those with bronchopulmonary dysplasia. Respiratory syncytial virus has also been recognized as an important pathogen in people with immunossupressive and other underlying medical problems and institutionalizated elderly, causing thousands of hospitalizations and deaths every year. The burden of these infections makes the development of vaccines for respiratory syncytial virus highly desirable, but the insuccess of a respiratory syncytial virus formalin-inactivated vaccine hampered the progress in this field. To date, there is no vaccine available for preventing respiratory syncytial virus infections, however, in the last years, there has been much progress in the understanding of immunology and immunopathologic mechanisms of respiratory syncytial virus diseases, which has allowed the development of new strategies for passive and active prophylaxis. In this article, the author presents a review about novel approaches to the prevention of respiratory syncytial virus infections, such as: passive immunization with human polyclonal intravenous immune globulin and humanized monoclonal antibodies (both already licensed for use in premature infants and children with bronchopulmonary dysplasia), and many different vaccines that are potential candidates for active immunization against respiratory syncytial virus.

Incidence and clinical characteristics of the infection by the Respiratory Syncytial Virus in children admitted in Santa Casa de São Paulo Hospital

“…Mortality rates related to infections by RSV are indicated as less than 1% in healthy children population [22]. A study performed with hospital admitted children below 2 years old, in the rural region of Asia, has indicated a mortality rate related to RSV of 1.9% [30].…”

Respiratory syncytial virus as a trigger of a pulmonary hypertensive crisis after operative correction of aortic coarctation

“…2 In another series, also from São Paulo city, the respiratory syncytial virus was the most frequently isolated virus from children hospitalized for acute respiratory disturbances, being present in over half the children studied. 3 Infection by the virus can complicate the postoperative course subsequent to paediatric cardiac surgery, and it has been identified as the causal agent of up two-fifths of cases of pneumonia, from half to nine-tenths of the cases of bronchiolitis, and from one-tenth to one-third of instances of bronchitis occurring in young children. 1,4 Besides preterm infants, children under 6 months of age with immune deficiency, malignancies, chemotherapy, bone marrow or solid organ transplants, chronic pulmonary disturbances and congenital cardiac malformations are known to be at major risk from infection of the lower respiratory tract with this virus.…”

“…1,4 Besides preterm infants, children under 6 months of age with immune deficiency, malignancies, chemotherapy, bone marrow or solid organ transplants, chronic pulmonary disturbances and congenital cardiac malformations are known to be at major risk from infection of the lower respiratory tract with this virus. [3][4][5] The reported mortality of hospitalized patients is from 1 to 4.4%, and can be higher when associated with other agents such as adenovirus, pneumococcus, cytomegalovirus. and Pneumocystis carinii.…”

Respiratory Syncytial Virus: From Discovery to Treatment

“…Th e viral nucleocapsid, also known as core, is composed of structural proteins combined with the viral genome, which is a single RNA strand. It is capable to performing at least 10 diff erent types of proteins, most of them with structural function and two nonstructural proteins with still unknown function (Bricks 2001). Th e viral genome consists of 15222 nucleotides that in association with nucleocapsid proteins, form a ribonucleoprotein complex resistant to RNAse activity (Mohapatra & Lockey 2008).…”