Maternal Effects of Respiratory Syncytial Virus Infection during Pregnancy

Wheeler, Sarahn M.; Dotters‐Katz, Sarah K.; Heine, R. Phillips; Grotegut, Chad A.; Swamy, Geeta K.

doi:10.3201/eid2111.150497

Cited by 44 publications

(45 citation statements)

References 23 publications

(20 reference statements)

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“…There, children die in excess of 20‐fold more than in industrialized nations . Neonatal deaths (0‐28 days) are frequent, particularly early after birth . And the proportion of deaths in the post‐neonatal period (29‐364 days) is higher than in industrialized countries .…”

Section: Respiratory Diseases Are a Leading Cause Of Mortality In Youmentioning

confidence: 99%

“…Neonatal deaths (0‐28 days) are frequent, particularly early after birth . And the proportion of deaths in the post‐neonatal period (29‐364 days) is higher than in industrialized countries . Pneumonia and diarrhea are responsible for most fatalities during post‐neonatal infancy and early childhood …”

Section: Respiratory Diseases Are a Leading Cause Of Mortality In Youmentioning

confidence: 99%

“…Numerous multicenter collaborations advance to clarify the role of the pathogen in long term morbidity (ie,: asthma) and infant mortality . Recent reports are describing the consequences of infection in pregnant women . Recently, Shi et al estimated that a successful maternal or newborn immunization strategy, with 80% protection and near universal coverage, could prevent 22 000 RSV‐associated fatalities a year.…”

Section: The Futurementioning

confidence: 99%

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Respiratory syncytial virus is an “opportunistic” killer

Caballero

Polack

2018

Pediatric Pulmonology

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Respiratory syncytial virus (RSV), responsible for more than three million yearly hospitalizations and up to 118 000 deaths in children under 5 years, is the leading pulmonary cause of death for this age group that lacks a licensed vaccine. Ninety‐nine percent of deaths due to the virus occur in developing countries. In‐hospital RSV fatalities affect previously healthy term infants in association with bacterial sepsis, clinically significant pneumothoraxes and, to a lesser extent, comorbid conditions. Community deaths affect low‐income children from socially vulnerable families and appear to be as frequent as inpatient fatalities. In industrialized countries, RSV deaths occur almost exclusively in children with premorbid conditions.In a sense, RSV is an “opportunistic” killer. It needs a synergistic premorbid, medical practice‐related, infectious, or social co‐factor to cause a fatal outcome. But while the complex problems associated with these co‐factors await solutions, candidate vaccines, long‐lived monoclonal antibodies and antivirals against RSV are under clinical evaluation. It seems reasonable to predict that the landscape of RSV infections will look different in the next decade.

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Section: Respiratory Diseases Are a Leading Cause Of Mortality In Youmentioning

confidence: 99%

Section: Respiratory Diseases Are a Leading Cause Of Mortality In Youmentioning

confidence: 99%

Section: The Futurementioning

confidence: 99%

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Respiratory syncytial virus is an “opportunistic” killer

Caballero

Polack

2018

Pediatric Pulmonology

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“…One woman did report symptoms of LRTI during hospitalization for fever and uterine contractions and was found to have PCRconfirmed RSV several days after hospital discharge. She, like those in the case-series by Wheeler et al, reported co-morbidities that may have put her at risk for a more serious illness [13].…”

Section: Discussionmentioning

confidence: 69%

“…Maternal RSV infection has not been well defined, both in regards to rate of infection and consequences of infection. A case-series study was the first to describe severe RSV infection during pregnancy: two of the three cases were hospitalized and required mechanical ventilation [13]. In addition, several large prospective maternal cohort studies of influenza-like illness (ILI) evaluated during influenza vaccine trials have described maternal RSV infection incidences of 3.9/1000 person-years in Nepal, 5.3/1000 person-months in South Africa, and 0.3/1000 persondays in Mongolia [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and outcomes of respiratory syncytial virus infection in pregnant women

Hause

Avadhanula

Maccato

et al. 2019

Vaccine

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a b s t r a c tObjective: To describe the clinical presentation and laboratory diagnosis of pregnant women with respiratory syncytial virus (RSV) infection. Methods: Pregnant women in their second and third trimester were enrolled during the course of routine prenatal care visits when they were asymptomatic within the preceding two weeks (healthy controls) or when they reported symptoms of acute respiratory illness (ARI) of 7 days of duration (cases). Clinical outcomes were assessed at enrollment and two weeks after. Re-enrollment was allowed. Nasalpharyngeal secretions were evaluated for respiratory pathogens by real-time reverse transcription polymerase chain reaction (PCR). Sera were tested for RSV-specific antibody responses by Western Blot, microneutralization assay, and palivizumab competitive antibody assay. Results: During the 2015-2016 respiratory virus season, 7 of 65 (11%) pregnant women with ARI at their initial enrollment and 8 of 77 (10%) pregnant women with ARI during the study period (initial or reenrollment) had PCR-confirmed RSV infection. Four (50%) PCR-confirmed RSV ARI cases reported symptoms of a lower respiratory tract illness (LRTI), one was hospitalized. Combining PCR and serology data, the RSV attack rate at initial enrollment was 12% (8 of 65), and 13% (10 of 77) based on ARI episodes. Among healthy controls, 28 of 88 (32%) had a Western Blot profile suggestive of a recent RSV infection either in the prior and/or current season. Conclusion: RSV had an attack rate of 10-13% among ambulatory pregnant women receiving routine prenatal care during the respiratory virus season. The serology results of healthy controls suggest a potentially higher attack rate. Future studies should be aware of the combined diagnostic strength of PCR and serology to identify RSV infection. As maternal RSV vaccine candidates are evaluated to protect young infants, additional priority should be placed on outcomes of pregnant women.

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