Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T11:11:03.722Z Has data issue: false hasContentIssue false
  • English
  • Français

Infection by the respiratory syncytial virus in infants and young children at high risk

Published online by Cambridge University Press:  03 May 2005

Damien Bonnet ,
Achim A. Schmaltz  and
Timothy F. Feltes
Damien Bonnet
Affiliation:
Paediatric Cardiology, Hôpital Necker-Enfants-Malades, Paris, France
Achim A. Schmaltz
Affiliation:
Clinic for Paediatric Cardiology, University Hospital Duisburg-Essen, Germany
Timothy F. Feltes
Affiliation:
Section of Pediatric Cardiology, Ohio State University and The Heart Center at Children's Hospital, Columbus, Ohio, United States of America
Get access Rights & Permissions [Opens in a new window]

Abstract

The respiratory syncytial virus is the most common cause of infection of the lower respiratory tract in infants and young children, and is the leading cause of hospitalisation and death due to viral illness during the first year of life. In otherwise healthy infants, the virus usually causes only mild respiratory illness, but premature babies and infants with chronic lung disease, those with congenitally malformed hearts, or those who are immunodeficient, are at increased risk of serious illness, hospitalisation, and death. Recent infection with the virus is also associated with increased postoperative complications after corrective surgery for congenitally malformed hearts. No effective vaccine is currently available, and treatment is limited to supportive therapy. Prevention in groups deemed to be at high-risk, therefore, is essential. In addition to measures for control of infection, prophylactic immunotherapy is indicated in selected patients. Palivizumab (Synagis®) is a monoclonal antibody indicated for the prevention of serious viral disease of the lower respiratory tract in premature infants, those with chronic lung disease, and those with haemodynamically significant congenital cardiac lesions. Palivizumab is given intramuscularly, usually as a monthly injection during the so-called “season”. In a recent international, randomised, double-blind, placebo-controlled trial in 1,287 children less than or equal to 2 years old with haemodynamically significant congenital cardiac malformations, prophylaxis achieved a relative reduction of 45 per cent in the incidence of antigen-confirmed viral-related hospitalisation, and reduced the duration of hospital stay by 56 per cent. National and international guidelines, therefore, now recommend routine prophylaxis in the first year of life in children with haemodynamically significant congenital cardiac disease.

Keywords

Monoclonal antibodycongenital heart diseaseprematurityhospitalisationpalivizumab
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 3 , June 2005 , pp. 256 - 265
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis-associated hospitalizations among US children, 1980–1996. JAMA 1999; 282: 1440–1446.Google Scholar
Leader S, Kohlhase K. Respiratory syncytial virus-coded pediatric hospitalizations, 1997 to 1999. Pediatr Infect Dis J 2002; 21: 629–632.Google Scholar
Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003; 289: 179–186.Google Scholar
Morris JA, Blount RE Jr, Savage RE. Recovery of cytopathogenic agent from chimpanzees with coryza. Proc Soc Exp Biol Med 1956; 92: 544–549.Google Scholar
Chanock R, Roizman B, Myers R. Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA). I. Isolation, properties and characterization. Am J Hyg 1957; 66: 281–290.Google Scholar
Ogra PL. Respiratory syncytial virus: the virus, the disease and the immune response. Paediatr Respir Rev 2004; (Suppl A): S119–S126.Google Scholar
Black CP. Systematic review of the biology and medical management of respiratory syncytial virus infection. Respir Care 2003; 48: 209–231; discussion 231–233.Google Scholar
Blydt-Hansen T, Subbarao K, Quennec P, McDonald J. Recovery of respiratory syncytial virus from stethoscopes by conventional viral culture and polymerase chain reaction. Pediatr Infect Dis J 1999; 18: 164–165.Google Scholar
Simoes EA. Immunoprophylaxis of respiratory syncytial virus: global experience. Respir Res 2002; 3 (Suppl 1): S26–S33.Google Scholar
Glezen WP, Taber LH, Frank AL, Kasel JA. Risk of primary infection and reinfection with respiratory syncytial virus. Am J Dis Child 1986; 140: 543–546.Google Scholar
Donati D, Cellesi C, Rossolini A, et al. Serological diagnosis of respiratory viral infections. A five-year study of hospitalised patients. New Microbiol 1998; 21: 365–374.Google Scholar
Weigl JA, Puppe W, Schmitt HJ. Incidence of respiratory syncytial virus-positive hospitalizations in Germany. Eur J Clin Microbiol Infect Dis 2001; 20: 452–459.Google Scholar
Greenough A, Cox S, Alexander J, et al. Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child 2001; 85: 463–468.Google Scholar
Greenough A, Alexander J, Burgess S, et al. Health care utilisation of prematurely born, preschool children related to hospitalisation for RSV infection. Arch Dis Child 2004; 89: 673–678.Google Scholar
Meissner HC, Welliver RC, Chartrand SA, et al. Immunoprophylaxis with palivizumab, a humanized respiratory syncytial virus monoclonal antibody, for prevention of respiratory syncytial virus infection in high risk infants: a consensus opinion. Pediatr Infect Dis J 1999; 18: 223–231.Google Scholar
Simoes EA. Environmental and demographic risk factors for respiratory syncytial virus lower respiratory tract disease. J Pediatr 2003; 143 (Suppl): S118–S126.Google Scholar
Fixler DE. Respiratory syncytial virus infection in children with congenital heart disease: a review. Pediatr Cardiol 1996; 17: 163–168.Google Scholar
Berner R, Schwoerer F, Schumacher RF, Meder M, Forster J. Community and nosocomially acquired respiratory syncytial virus infection in a German paediatric hospital from 1988 to 1999. Eur J Pediatr 2001; 160: 541–547.Google Scholar
Lanari M, Rossi GA, Merolla R, di Luzio Paparatti U. High risk of nosocomial-acquired RSV infection in children with congenital heart disease. J Pediatr 2004; 145: 140; author reply 140–141.Google Scholar
Nosocomial infection with respiratory syncytial virus. Lancet 1992; 340: 1071–1073.
Heerens AT, Marshall DD, Bose CL. Nosocomial respiratory syncytial virus: a threat in the modern neonatal intensive care unit. J Perinatol 2002; 22: 306–307.Google Scholar
Thwaites R, Piercy J. Nosocomial respiratory syncytial virus infection in neonatal units in the United Kingdom. Acta Paediatr Suppl 2004; 93: 23–25.Google Scholar
MacDonald NE, Hall CB, Suffin SC, Alexson C, Harris PJ, Manning JA. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med 1985; 307: 397–400.Google Scholar
Welliver RC. Review of epidemiology and clinical risk factors for severe respiratory syncytial virus (RSV) infection. J Pediatr 2003; 143 (Suppl): S112–S117.Google Scholar
Boyce TG, Mellen BG, Mitchel EF Jr, Wright PF, Griffin MR. Rates of hospitalization for respiratory syncytial virus infection among children in Medicaid. J Pediatr 2000; 137: 865–870.Google Scholar
Gilchrist S, Torok TJ, Gary HE Jr, Alexander JP, Anderson LJ. National surveillance for respiratory syncytial virus, United States, 1985–1990. J Infect Dis 1994; 170: 986–990.Google Scholar
Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med 2000; 161: 1501–1507.Google Scholar
Stein RT, Sherrill D, Morgan WJ, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet 1999; 354: 541–545.Google Scholar
Sigurs N. Epidemiologic and clinical evidence of a respiratory syncytial virus-reactive airway disease link. Am J Respir Crit Care Med 2001; 163: S2–S6.Google Scholar
Piedimonte G. The association between respiratory syncytial virus infection and reactive airway disease. Respir Med 2002; 96 (Suppl B): S25–S29.Google Scholar
Openshaw PJ, Dean GS, Culley FJ. Links between respiratory syncytial virus bronchiolitis and childhood asthma: clinical and research approaches. Pediatr Infect Dis J 2003; 22 (Suppl): S58–S64; discussion S64–S65.Google Scholar
Peebles RS Jr, Hashimoto K, Graham BS. The complex relationship between respiratory syncytial virus and allergy in lung disease. Viral Immunol 2003; 16: 25–34.Google Scholar
Hall CB, Hall WJ, Gala CL, MaGill FB, Leddy JP. Long-term prospective study in children after respiratory syncytial virus infection. J Pediatr 1984; 105: 358–364.Google Scholar
Feltes TF, Groothuis JR. Acute and long-term effects of infection by the respiratory syncytial virus in children with congenital cardiac malformations. Cardiol Young 2005; 15: 266–273.Google Scholar
Wang EE, Law BJ, Stephens D. Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) prospective study of risk factors and outcomes in patients hospitalized with respiratory syncytial viral lower respiratory tract infection. J Pediatr 1995; 126: 212–219.Google Scholar
Horn SD, Smout RJ. Effect of prematurity on respiratory syncytial virus hospital resource use and outcomes. J Pediatr 2003; 143 (Suppl): S133–S141.Google Scholar
Weisman LE. Populations at risk for developing respiratory syncytial virus and risk factors for respiratory syncytial virus severity: infants with predisposing conditions. Pediatr Infect Dis J 2003; 22 (Suppl): S33–S37; discussion S37–S39.Google Scholar
Carbonell-Estrany X, Quero J. Hospitalization rates for respiratory syncytial virus infection in premature infants born during two consecutive seasons. Pediatr Infect Dis J 2001; 20: 874–879.Google Scholar
Liese JG, Grill E, Fischer B, et al. Incidence and risk factors of respiratory syncytial virus-related hospitalizations in premature infants in Germany. Eur J Pediatr 2003; 162: 230–236.Google Scholar
American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Prevention of respiratory syncytial virus infections: indications for the use of palivizumab and update on the use of RSV-IGIV. Pediatrics 1998; 102: 1211–1216.
Navas L, Wang E, de Carvalho V, Robinson J. Improved outcome of respiratory syncytial virus infection in a high-risk hospitalized population of Canadian children. Pediatric Investigators Collaborative Network on Infections in Canada. J Pediatr 1992; 121: 348–354.Google Scholar
La Via WV, Marks MI, Stutman HR. Respiratory syncytial virus puzzle: clinical features, pathophysiology, treatment, and prevention. J Pediatr 1992; 121: 503–510.Google Scholar
Hoffman JI. Incidence of congenital heart disease: I. Postnatal incidence. Pediatr Cardiol 1995; 16: 103–113.Google Scholar
Meissner HC, Welliver RC, Chartrand SA, Fulton DR, Rodriguez WJ, Groothuis JR. Prevention of respiratory syncytial virus infection in high risk infants: consensus opinion on the role of immunoprophylaxis with respiratory syncytial virus hyperimmune globulin. Pediatr Infect Dis J 1996; 15: 1059–1068.Google Scholar
Wren C, O'Sullivan JJ. Survival with congenital heart disease and need for follow up in adult life. Heart 2001; 85: 438–443.Google Scholar
Wang EE, Law BJ, Robinson JL, et al. PICNIC (Pediatric Investigators Collaborative Network on Infections in Canada) study of the role of age and respiratory syncytial virus neutralizing antibody on respiratory syncytial virus illness in patients with underlying heart or lung disease. Pediatrics 1997; 99: E9.Google Scholar
Cabalka AK. Physiologic risk factors for respiratory viral infections and immunoprophylaxis for respiratory syncytial virus in young children with congenital heart disease. Pediatr Infect Dis J 2004; 23 (Suppl): S41–S45.Google Scholar
Duppenthaler A, Ammann RA, Gorgievski-Hrisoho M, Pfammatter JP, Aebi C. Low incidence of respiratory syncytial virus hospitalisations in haemodynamically significant congenital heart disease. Arch Dis Child 2004; 89: 961–965.Google Scholar
Moler FW, Khan AS, Meliones JN, Custer JR, Palmisano J, Shope TC. Respiratory syncytial virus morbidity and mortality estimates in congenital heart disease patients: a recent experience. Crit Care Med 1992; 20: 1406–1413.Google Scholar
Khongphatthanayothin A, Wong PC, Samara Y, et al. Impact of respiratory syncytial virus infection on surgery for congenital heart disease: postoperative course and outcome. Crit Care Med 1999; 27: 1974–1981.Google Scholar
Altman CA, Englund JA, Demmler G, et al. Respiratory syncytial virus in patients with congenital heart disease: a contemporary look at epidemiology and success of preoperative screening. Pediatr Cardiol 2000; 21: 433–438.Google Scholar
Tulloh RM, Feltes TF. The European Forum for Clinical Management: Prophyplaxis against the respiratory syncytial virus in infants and young children with congenital cardiac disease. Cardiol Young 2005; 15: 274–278.Google Scholar
Broughton S, Greenough A. Effectiveness of drug therapies to treat or prevent respiratory syncytial virus infection-related morbidity. Expert Opin Pharmacother 2003; 4: 1801–1808.Google Scholar
Kneyber MC, Moll HA, de Groot R. Treatment and prevention of respiratory syncytial virus infection. Eur J Pediatr 2000; 159: 399–411.Google Scholar
American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics 2003; 112: 1442–1446.
Kapikian AZ, Mitchell RH, Chanock RM, Shvedoff RA, Stewart CE. An epidemiologic study of altered clinical reactivity to respiratory syncytial (RS) virus infection in children previously vaccinated with an inactivated RS virus vaccine. Am J Epidemiol 1969; 89: 405–421.Google Scholar
Kahn JS. Respiratory syncytial virus vaccine development. Curr Opin Pediatr 2000; 12: 257–262.Google Scholar
Piedra PA. Future directions in vaccine prevention of respiratory syncytial virus. Pediatr Infect Dis J 2002; 21: 482–487.Google Scholar
Kneyber MC, Kimpen JL. Advances in respiratory syncytial virus vaccine development. Curr Opin Investig Drugs 2004; 5: 163–170.Google Scholar
Groothuis JR, Simoes EA, Levin MJ, et al. Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children. The Respiratory Syncytial Virus Immune Globulin Study Group. N Engl J Med 1993; 329: 1524–1530.Google Scholar
The PREVENT Study Group. Reduction of respiratory syncytial virus hospitalization among premature infants and infants with bronchopulmonary dysplasia using respiratory syncytial virus immune globulin prophylaxis. Pediatrics 1997; 99: 93–99.
Simoes EA, Sondheimer HM, Top FH Jr, et al. Respiratory syncytial virus immune globulin for prophylaxis against respiratory syncytial virus disease in infants and children with congenital heart disease. The Cardiac Study Group. J Pediatr 1998; 133: 492–499.Google Scholar
Krilov LR. Palivizumab in the prevention of respiratory syncytial virus disease. Expert Opin Biol Ther 2002; 2: 763–769.Google Scholar
Simoes EA, Groothuis JR. Respiratory syncytial virus prophylaxis – the story so far. Respir Med 2002; 96 (Suppl B): S15–S24.Google Scholar
Pollack P, Groothuis JR. Development and use of palivizumab (Synagis): a passive immunoprophylactic agent for RSV. J Infect Chemother 2002; 8: 201–206.Google Scholar
The IMpact-RSV Study Group. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 1998; 102: 531–537.
Carbonell-Estrany X, Giuffré L, Kimpen JL, et al. Guidelines for the use of Synagis® (palivizumab), a humanized monoclonal antibody, for the prevention of respiratory syncytial virus (RSV) disease in high-risk infants: a consensus opinion. Infect Med 1999; 16 (Suppl G): 29–33.Google Scholar
Feltes TF, Cabalka AK, Meissner HC, et al. Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease. J Pediatr 2003; 143: 532–540.Google Scholar
Roeckl-Wiedmann I, Liese JG, Grill E, Fischer B, Carr D, Belohradsky BH. Economic evaluation of possible prevention of RSV-related hospitalizations in premature infants in Germany. Eur J Pediatr 2003; 162: 237–244.Google Scholar
Canadian National Advisory Committee on Immunization. Statement on the recommended use of monoclonal anti-RSV antibody (palivizumab). Can Commun Dis Rep 2003; 29: 1–15.
Tulloh RM, Marsh M, Blackburn M, et al. Recommendations for the use of palivizumab as prophylaxis against respiratory syncytial virus in infants with congenital cardiac disease. Cardiol Young 2003; 13: 420–423.Google Scholar
Chantepie A; bureau de la Filiale de Cardiologie Pediatrique de la Societe Francaise de Cardiologie. Use of palivizumab for the prevention of respiratory syncytial virus infections in children with congenital heart disease. Recommendations from the French Paediatric Cardiac Society. Arch Pediatr 2004; 11: 1402–1405.
Schmaltz AA. Stellungnahme der Deutschen Gesellschaft für Pädiatrische Kardiologie zur RSV-Prophylaxe mit Palivizumab (Synagis®). Monatsschr Kinderheilkd 2004; 152: 222–223.Google Scholar
Suárez Cabrera P, Malo Concepción P, Maroto E, Santos de Soto J. Recomendaciones de la Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas para la prevención de la infección por virus respiratorio sincitial en pacientes con cardiopatía congénita. 2004; http://www.secardioped.org/