An Outbreak of an Influenza‐Like Illness in a Nursing Home

Osterweil, Dan; Norman, Dean C.

doi:10.1111/j.1532-5415.1990.tb01425.x

Cited by 46 publications

(22 citation statements)

References 15 publications

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“…7 Among patients in hospitals and long-term care facilities, RSV infection has resulted in exacerbations of chronic lung disease in 5 to 50 percent of cases and a mortality rate reaching 20 percent. [62][63][64] The importance of RSV infection as a cause of hospitalization in previously healthy adults has been recognized more recently. Of 1195 adults admitted to a hospital with community-acquired pneumonia in Ohio, 4.4 percent had RSV infection.…”

Section: Reinfections In Previously Healthy Personsmentioning

confidence: 99%

Respiratory Syncytial Virus and Parainfluenza Virus

2001

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PATHOGENESISAfter an incubation period of two to eight days, RSV and parainfluenza virus replicate in the nasopharyngeal epithelium, with spread to the lower respiratory tract one to three days later. The characteristic inflammation of RSV bronchiolitis is necrosis and sloughing of the epithelium of the small airways, with edema, and increased secretion of mucus, which ob-The New England Journal of Medicine Downloaded from nejm.org at UNIVERSITY OF TENNESSEE -KNOXVILLE on September 15, 2014. For personal use only. No other uses without permission.

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Section: Reinfections In Previously Healthy Personsmentioning

confidence: 99%

Respiratory Syncytial Virus and Parainfluenza Virus

2001

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“…Interestingly, natural RSV infection does not confer lifetime immunity [10] and therefore individuals are repeatedly infected throughout life. Healthy adults develop cold-or flu-like symptoms whereas the elderly [11][12][13][14] and immunocompromised individuals [15,16] have increased risk of severe respiratory illness. Moreover, a recent study has indicated that RSV disease burden in the elderly is similar to that of nonpandemic influenza A [17].…”

Section: Introductionmentioning

confidence: 99%

Understanding respiratory syncytial virus (RSV) vaccine-enhanced disease

2007

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Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in infants and children worldwide. In addition, RSV causes serious disease in elderly and immune compromised individuals. RSV infection of children previously immunized with a formalin-inactivated (FI)-RSV vaccine is associated with enhanced disease and pulmonary eosinophilia that is believed to be due to an exaggerated memory Th2 response. As a consequence, there is currently no licensed RSV vaccine and detailed studies directed towards prevention of vaccine-associated disease are a critical first step in the development of a safe and effective vaccine. The BALB/c mouse model of RSV infection faithfully mimics the human respiratory disease. Mice previously immunized with either FI-RSV or a recombinant vaccinia virus (vv) that expresses the attachment (G) glycoprotein exhibit extensive lung inflammation and injury, pulmonary eosinophilia, and enhanced disease following challenge RSV infection. CD4 T cells secreting Th2 cytokines are necessary for this response because their depletion eliminates eosinophilia. Intriguing recent studies have demonstrated that RSV-specific CD8 T cells can inhibit Th2-mediated pulmonary eosinophilia in vvG-primed mice by as yet unknown mechanisms. Information gained from the animal models will provide important information and novel approaches for the rational design of a safe and efficacious RSV vaccine.

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“…RSV infections typically cause mild illness, however severe disease can occur and is often associated with symptoms such as bronchiolitis and wheezing [6]. Populations at greatest risk to develop severe disease after RSV infection include premature infants [7], persons with congenital heart disease [8][9][10], immunocompromised individuals [11,12], and the elderly [11,13,14]. Clinical studies have indicated that children that are hospitalized due to RSV-induced disease exhibit an increased incidence of asthma later in life as compared to children that experience a mild or asymptomatic RSV infection (recently reviewed in [15]).…”

Section: Introductionmentioning

confidence: 99%

Overcoming T-Cell-Mediated Immunopathology to Achieve Safe Respiratory Syncytial Virus Vaccination

Castilow

Varga

2008

Future Virol.

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SummaryRespiratory syncytial virus (RSV) is the leading cause of lower respiratory tract disease in young children. Premature infants, immunocompromised individuals, and the elderly exhibit an increased risk for the development of severe disease after RSV infection. Currently, there is not a safe and effective RSV vaccine available, in part due to our incomplete understanding of how severe immunopathology was induced following RSV infection of children previously immunized with a formalin-inactivated RSV vaccine. Much of our current understanding of RSV vaccine-enhanced disease can be attributed to the establishment of multiple mouse models of RSV vaccination. Studies analyzing the RSV-specific immune response in mice have clearly demonstrated that both CD4 and CD8 memory T cells contribute to RSV-induced immunopathology. In this review we will focus our discussion on data generated from the mouse models of RSV immunization that have advanced our understanding of how virus-specific T cells mediate immunopathology and RSV vaccine-enhanced disease.

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An Outbreak of an Influenza‐Like Illness in a Nursing Home

Cited by 46 publications

References 15 publications

Respiratory Syncytial Virus and Parainfluenza Virus

Respiratory Syncytial Virus and Parainfluenza Virus

Understanding respiratory syncytial virus (RSV) vaccine-enhanced disease

Overcoming T-Cell-Mediated Immunopathology to Achieve Safe Respiratory Syncytial Virus Vaccination

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