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[Respiratory syncytial virus infections and preventive options]
P H Rothbarth1, J L Kimpen, J J Roord
1Laboratorium Microbiologie Twente Achterhoek, Enschede.
Insights
Respiratory syncytial virus (RSV) causes severe respiratory infections in young children. Palivizumab, a monoclonal antibody, significantly reduces hospitalizations in high-risk infants, offering crucial prevention for serious RSV disease.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Context:
- Respiratory syncytial virus (RSV) is a leading cause of pediatric respiratory infections, particularly bronchiolitis in infants.
- Approximately 2000 children in the Netherlands require hospitalization annually due to RSV.
- High-risk infants, including premature infants and those with congenital conditions, face severe RSV outcomes.
Purpose:
- To evaluate the efficacy of palivizumab for preventing serious respiratory syncytial virus (RSV) disease in high-risk children.
- To inform clinical practice regarding the use of palivizumab for RSV prevention in vulnerable pediatric populations.
Summary:
- Palivizumab, a monoclonal antibody, is administered monthly for five months during the RSV season.
- Clinical studies demonstrate that palivizumab significantly reduces RSV-related hospital admissions and hospital stay duration in high-risk children.
- Treatment is symptomatic for most RSV cases, with antivirals reserved for immunocompromised patients.
Impact:
- Palivizumab provides a vital preventive measure against severe RSV infections in at-risk infants.
- The use of palivizumab can decrease the burden on healthcare systems by reducing pediatric hospitalizations.
- This passive immunization strategy improves outcomes for infants susceptible to serious respiratory syncytial virus disease.
Abstract:
Respiratory syncytial virus (RSV) is the most prominent pathogen found in respiratory tract infections in children and the most important cause of bronchiolitis in the first two years of life. In the Netherlands approximately 2000 children are admitted each winter season. A serious course is mostly seen in children younger than 3 months, (ex-)prematures, children with bronchopulmonary dysplasia or congenital cardiac anomalies, children with cystic fibrosis younger then 2 years and children with impaired T cell immunity; such cases not rarely require intensive care. Treatment (fluid, nutrition, bronchodilator agents, corticosteroids, oxygen and ventilation) is usually symptomatic. Antiviral therapy is only indicated in immunodeficient patients. For prevention by passive immunization palivizumab was recently registered in the Netherlands, a monoclonal antibody against RSV that has to be administered intramuscularly from the start of the RSV season (15 mg per kg bodyweight once a month during five months). In a number of large-scale American multicenter studies both the number of hospital admissions related to RSV infection and the mean duration of hospital stay showed a statistically significant reduction in high-risk children who had been treated with palivizumab. Palivizumab appears to be indicated in children from the categories with an increased risk for serious RSV disease.