Respiratory syncytial virus (RSV): a scourge from infancy to old age

Abstract

Respiratory syncytial virus (RSV) is the most common single cause of respiratory hospitalisation of infants and is the second largest cause of lower respiratory infection mortality worldwide. In adults, RSV is an under-recognised cause of deterioration in health, particularly in frail elderly persons. Infection rates typically rise in late autumn and early winter causing bronchiolitis in infants, common colds in adults and insidious respiratory illness in the elderly. Virus detection methods optimised for use in children have low detection rate in adults, highlighting the need for better diagnostic tests. There are many vaccines under development, mostly based on the surface glycoprotein F which exists in two conformations (prefusion and postfusion). Much of the neutralising antibody appears to be to the prefusion form. Vaccines being developed include live attenuated, subunit, particle based and live vectored agents. Different vaccine strategies may be appropriate for different target populations: at-risk infants, school-age children, adult caregivers and the elderly. Antiviral drugs are in clinical trial and may find a place in disease management. RSV disease is one of the major remaining common tractable challenges in infectious diseases and the era of vaccines and antivirals for RSV is on the near horizon.

Epidemiology of Respiratory Syncytial Virus-Related Hospitalization Over a 5-Year Period in Italy: Evaluation of Seasonality and Age Distribution Before Vaccine Introduction

“…Lots of pharmaceutical companies are presently working on the development of new monoclonal antibodies and vaccines so that RSV infection could be prevented in the risk categories. Different vaccine strategies may be appropriate for heterogeneous target populations such as at-risk infants, school-age children, adult caregivers or the elderly [15]. It is important to carry out studies in different countries and involving the whole population to decide the right target for prevention strategies.…”

“…The global burden of disease caused by RSV has become increasingly recognized, leading to many clinical trials of vaccine candidates. Several RSV immunoprophylaxis and vaccine candidates, including live attenuated, subunit, particle-based and live vectored agents are currently in development [14,15]. Identifying the part of the population with a higher risk of developing respiratory diseases that require hospitalization and identifying the seasonal patterns of RSV is important when planning strategies for prevention such as vaccination or monoclonal antibodies use.…”

Minimal Elements Required for the Formation of Respiratory Syncytial Virus Cytoplasmic Inclusion Bodies In Vivo and In Vitro

“…The human respiratory syncytial virus (RSV) is the leading cause of severe respiratory tract infections in newborn children worldwide ( 1 ). It infects close to 100% of infants within the first 2 years, and it is the main cause of bronchiolitis.…”

Neutrophil-Airway Epithelial Interactions Result in Increased Epithelial Damage and Viral Clearance during Respiratory Syncytial Virus Infection

“…Respiratory syncytial virus (RSV) is the major viral cause of pulmonary disease in young infants and the elderly and is responsible for annual epidemics that cause considerable morbidity and mortality worldwide (1,2). A growing body of evidence suggests that the virus initiates infection by targeting human ciliated epithelium lining the nasopharynx (3)(4)(5)(6).…”