National Surveillance For Respiratory Syncytial Virus, United States, 1985-1990

Gilchrist, Siobhan; Török, Thomas J.; Gary, Howard E.; Alexander, James P.; Anderson, Larry J.

doi:10.1093/infdis/170.4.986

Cited by 102 publications

(76 citation statements)

References 13 publications

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“…[10][11][12][13] Recommendations for the management of RSV infections in cancer patients include strict infection control measures, delay in the therapy for the underlying disease, and treatment with aerosolized ribavirin plus high-dose intravenous immunoglobulin (IVIG). [3][4][5][6][7][8][9]14 These strategies are associated with huge costs, toxicity, disruption of patient care activities, and delay in treating the underlying cancer.…”

Section: Introductionmentioning

confidence: 99%

The natural history of respiratory syncytial virus infection in cancer and transplant patients: implications for management

Anaissie

Mahfouz

Aslan

et al. 2004

Blood

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Respiratory syncytial virus (RSV) has been reported to cause severe morbidity and mortality among cancer patients receiving chemotherapy with or without autologous peripheral blood stem cell transplantation (APBSCT). However, little is known about the natural history of this infection in these patients, and current standard practice, aerosolized ribavirin plus intravenous immunoglobulin (IVIG), is extremely expensive, difficult to use, and not supported by controlled clinical trials. The purpose of this observational study was to determine the frequency, seasonality, morbidity, and mortality of RSV infection in a group of cancer pa- IntroductionRespiratory syncytial virus (RSV) is thought to cause rare but severe community and nosocomial respiratory infections in immunocompromised adults, including cancer patients, [1][2][3][4][5][6][7][8][9] and to occur almost exclusively during winter. [10][11][12][13] Recommendations for the management of RSV infections in cancer patients include strict infection control measures, delay in the therapy for the underlying disease, and treatment with aerosolized ribavirin plus high-dose intravenous immunoglobulin (IVIG). [3][4][5][6][7][8][9]14 These strategies are associated with huge costs, toxicity, disruption of patient care activities, and delay in treating the underlying cancer. 15,16 Furthermore, these recommendations were based on studies that did not evaluate a homogenous patient population and, most important, failed to include a control group whose respiratory cultures were negative for RSV. We have previously reported on 10 myeloma patients with positive respiratory tract cultures for RSV who successfully underwent autologous peripheral blood stem cell transplantation (APBSCT) without receiving RSV-specific therapy. 17 In this prospective observational study, we sought to determine the incidence and seasonality of RSV infection in a homogenous group of cancer patients not receiving RSV-specific therapy. We also determined the type of and risk for complications associated with RSV by including a control group whose respiratory cultures were negative for this virus. Patients, materials, and methodsCancer patients receiving cytotoxic chemotherapy, with or without APBSCT or allogeneic bone marrow transplantation (allo-BMT), were evaluated at the University of Arkansas for Medical Sciences in Little Rock. A written informed consent for specimen collection was obtained in keeping with institutional policies. This evaluation occurred over a period of 12 months (October 3, 1997, to October 14, 1998. Nasopharyngeal washings were collected into a sterile cup and transported on wet ice to the virology laboratory, generally within 2 hours. Bronchoalveolar lavage specimens and tissue obtained by open lung biopsy and autopsy were also collected for culture when available, with tissue specimens homogenized prior to culture inoculation. Specimens were inoculated into tubes containing human diploid embryonic lung (MRC-5) fibroblast cells and checked daily during the first week and ...

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Section: Introductionmentioning

confidence: 99%

The natural history of respiratory syncytial virus infection in cancer and transplant patients: implications for management

Anaissie

Mahfouz

Aslan

et al. 2004

Blood

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“…Several prospective studies have also indicated that lower respiratory tract RSV infections in hospitalised [8] and nonhospitalised [9] infants, result in an excess of recurrent lower respiratory tract symptoms in subsequent years. These symptoms decline progressively over the first decade of life but the cause for this excess morbidity remains unclear [10].There has been much speculation regarding the nature of the host/virus interaction [3,11] and more than 30 yrs ago it was proposed that RSV bronchiolitis is a consequence of a specific immunopathology.Despite much research to demonstrate this, no distinct immunopathological process has been identified. The current authors have shown that neutrophils are the predominant inflammatory cell in the upper and lower airway in RSV infections in infants, accounting for y80% of cells recovered from the tracts [12].…”

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confidence: 99%

“…Respiratory syncytial virus (RSV) is responsible for annual epidemics of respiratory disease affecting the whole population [1][2][3] and particularly infants of whom the majority are infected during their first winter [1,4,5]. Of these, 20-30% develop lower respiratory tract symptoms and 0.5-2% are hospitalised with RSV bronchiolitis [1,2,4,5].…”

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Neutrophil survival is prolonged in the airways of healthy infants and infants with RSV bronchiolitis

Jones¹,

Qui²,

Bataki³

et al. 2002

European Respiratory Journal

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Large numbers of neutrophils in the airway of infants infected by respiratory syncytial virus (RSV) are recruited by chemokines, such as interleukin-8, and specific inflammatory molecules can delay apoptosis increasing their longevity. The aim of this study was to investigate whether airway secretions in RSV bronchiolitis contain factors that influence neutrophil apoptosis.Nasal lavage fluid (NLF) was obtained from 24 infants with RSV bronchiolitis (31 infant controls and 12 adults). Neutrophils isolated from healthy adult volunteers were incubated with the NLF in Dulbecco modified Eagle medium (DMEM) for 24 h, and apoptosis and necrosis were quantified using Hoechst 33342 and propidium iodide viability dyes. The presence of putative factors that delay neutrophil apoptosis was investigated using inhibitors to leukotriene-B 4 , lipopolysaccharide and the IL-8 receptor CXCR2, and blocking antibodies to granulocyte-monocyte colony-stimulating factor. Characterisation of NLF involved tests of thermal instability, proteolysis, deoxyribonuclease digestion and molecular filtration.NLF from infants with RSV bronchiolitis and controls significantly delayed neutrophil apoptosis, whereas NLF from healthy adults did not. None of these inhibitor molecules blocked this delay in apoptosis but activity was heat liable and w3 kDa.The study showed that nasal lavage fluid from infants significantly delays neutrophil apoptosis. The speculation is that the prolonged survival of neutrophils in the infant airway contributes to the characteristic accumulation of neutrophils in the airways of infants with respiratory infections. Respiratory syncytial virus (RSV) is responsible for annual epidemics of respiratory disease affecting the whole population [1-3] and particularly infants of whom the majority are infected during their first winter [1,4,5]. Of these, 20-30% develop lower respiratory tract symptoms and 0.5-2% are hospitalised with RSV bronchiolitis [1,2,4,5]. It is increasingly recognised that RSV is a major cause of respiratory morbidity in the elderly [6,7]. Several prospective studies have also indicated that lower respiratory tract RSV infections in hospitalised [8] and nonhospitalised [9] infants, result in an excess of recurrent lower respiratory tract symptoms in subsequent years. These symptoms decline progressively over the first decade of life but the cause for this excess morbidity remains unclear [10].There has been much speculation regarding the nature of the host/virus interaction [3,11] and more than 30 yrs ago it was proposed that RSV bronchiolitis is a consequence of a specific immunopathology.Despite much research to demonstrate this, no distinct immunopathological process has been identified. The current authors have shown that neutrophils are the predominant inflammatory cell in the upper and lower airway in RSV infections in infants, accounting for y80% of cells recovered from the tracts [12]. These finding have been subsequently replicated by others [13]. Increased protease activity in airway secre...

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“…Worldwide, HRSV is the most common cause of bronchiolitis-associated hospitalizations in infants (18,25). HRSV is also a significant cause of excess morbidity and mortality in adult patients with compromised immune status and chronic inflammatory lung disease and in the elderly (10,12,13,37).…”

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Respiratory Syncytial Virus (RSV) Nonstructural (NS) Proteins as Host Range Determinants: a Chimeric Bovine RSV with NS Genes from Human RSV Is Attenuated in Interferon-Competent Bovine Cells

Bossert

Conzelmann

2002

J Virol

128

116

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Bovine respiratory syncytial virus (BRSV) escapes from cellular responses to alpha/beta interferon (IFN-␣Interferons (IFNs) are involved in mounting both innate and adaptive host immune responses. Genes encoding IFN-␣ and IFN-␤ are induced by virus infection or double-stranded RNA in many cell types, whereas IFN-␥ expression is restricted to activated T cells and natural killer cells. IFNs bind to independent cell surface receptors and activate distinct but related signal transduction pathways, culminating in the activation of an overlapping set of IFN-stimulated genes (ISGs) (23). A variety of ISGs code for enzymes with antiviral function, such as PKR, 2Ј-5Ј oligoadenylate synthetase, and Mx proteins. In addition, IFNs can inhibit cell growth and promote apoptosis, thereby restricting virus spread (19).To counteract IFN, viruses have evolved mechanisms that interfere with IFN induction or signaling or directly with the function of antiviral IFN-induced proteins. The speed and efficiency by which a virus circumvents IFN induction or IFN response are critical determinants for its ability to establish an infection, for its pathogenicity and host range as well as for its resistance to IFN treatment.Most members of the Paramyxoviridae family are able to affect IFN signaling using different mechanisms. Human parainfluenza virus 2 (hPIV2; genus Respirovirus) inhibits IFN signaling by degradation of STAT2 (40) whereas Sendai virus and simian virus 5 (SV5) (genera Respirovirus and Rubulavirus, respectively) do so by blocking STAT1 activation (16,24) or by promoting STAT1 degradation (8,9,15). A rather distinctive feature seems to apply to respiratory syncytial virus (RSV) of the Pneumovirus genus, as this virus, without affecting IFN signaling, was found to be highly resistant to the cellular response induced by exogenously added IFN (40).Human RSV (HRSV), the prototype of the Pneumovirus genus within the Pneumovirinae subfamily, is among the most important respiratory pathogens (5). Worldwide, HRSV is the most common cause of bronchiolitis-associated hospitalizations in infants (18,25). HRSV is also a significant cause of excess morbidity and mortality in adult patients with compromised immune status and chronic inflammatory lung disease and in the elderly (10,12,13,37). Since an effective vaccine for HRSV is not yet available, various alternative treatments such as the application of IFN-␣/␤ are being actively pursued. Sung et al. (32) reported that treatment of RSV-infected children with IFN did improve their clinical course. However, in clinical trials involving adult volunteers, recombinant IFN-2␣ did not prove to be effective as a therapeutic agent against RSV infection (21). The latter is supported by in vitro studies with both laboratory strains (1, 40) and clinical isolates of HRSV (unpublished results), which revealed a high intrinsic resistance of HRSV towards exogenously added recombinant IFN-␣/␤ in cell cultures. This applies also to the bovine counterpart of HRSV, BRSV, which causes severe losses in stock...

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National Surveillance For Respiratory Syncytial Virus, United States, 1985-1990

Cited by 102 publications

References 13 publications

The natural history of respiratory syncytial virus infection in cancer and transplant patients: implications for management

The natural history of respiratory syncytial virus infection in cancer and transplant patients: implications for management

Neutrophil survival is prolonged in the airways of healthy infants and infants with RSV bronchiolitis

Respiratory Syncytial Virus (RSV) Nonstructural (NS) Proteins as Host Range Determinants: a Chimeric Bovine RSV with NS Genes from Human RSV Is Attenuated in Interferon-Competent Bovine Cells

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