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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Respiratory syncytial virus bronchiolitis
Alexander K C Leung1, James D Kellner, H Dele Davies
1Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Canada. aleung@ucalgary.ca
Insights
Respiratory syncytial virus (RSV) causes bronchiolitis, a common reason for infant hospitalization and significant illness globally. Supportive care and hand-washing are key, with palivizumab offering protection for high-risk infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Respiratory syncytial virus (RSV) is the primary cause of bronchiolitis, leading to widespread infant hospitalizations and considerable mortality/morbidity, especially in developing nations.
- Nearly all children are infected by RSV by age two, with 80% of cases occurring in the first year of life.
- Infants under six weeks, premature infants, and those with cardiopulmonary disorders or immunodeficiency face higher risks for severe RSV bronchiolitis.
Purpose of the Study:
- To summarize the epidemiology, clinical presentation, and management of respiratory syncytial virus (RSV) bronchiolitis.
- To highlight preventative measures and therapeutic options for RSV infection in infants.
- To underscore the importance of supportive care and prophylactic interventions for high-risk populations.
Main Methods:
- Review of existing literature on respiratory syncytial virus (RSV) and bronchiolitis.
- Analysis of clinical manifestations, risk factors, and treatment strategies.
- Evaluation of the efficacy of palivizumab for prevention in high-risk infants.
Main Results:
- RSV bronchiolitis typically presents with cough, wheezing, and respiratory distress.
- Supportive care, including hydration, fever management, and oxygen therapy, forms the primary treatment.
- Meticulous hand-washing is crucial for preventing secondary transmission.
- Palivizumab prophylaxis demonstrates effectiveness in preventing severe RSV bronchiolitis in at-risk infants.
- The condition is generally self-limiting, with a mortality rate below 1%, primarily affecting high-risk individuals.
Conclusions:
- Respiratory syncytial virus (RSV) bronchiolitis is a significant pediatric respiratory illness requiring prompt supportive care.
- Preventative strategies, including hygiene and prophylactic palivizumab for high-risk infants, are vital.
- While typically self-limiting, severe outcomes and mortality are associated with specific risk factors, necessitating individualized management.
Abstract:
Respiratory syncytial virus, the most common cause of bronchiolitis, is the leading cause of infant hospitalization in developed countries and accounts for substantial mortality and morbidity in developing countries. Children at increased risk of developing severe bronchiolitis are those <6 weeks of age, those born prematurely and those with an underlying cardiopulmonary disorder or immunodeficiency. Approximately 80% of cases occur in the first year of life. By two years of age, virtually all children have been infected by at least one strain of the virus. Classically, respiratory syncytial virus bronchiolitis manifests as cough, wheezing and respiratory distress. The mainstay of treatment is supportive care, consisting of adequate fluid intake, antipyretics to control fever and use of supplemental oxygen if necessary. Frequent and meticulous hand-washing is the best measure to prevent secondary spread. Treatment of respiratory syncytial virus bronchiolitis beyond supportive care should be individualized. Palivizumab has been shown to be effective in preventing severe respiratory syncytial virus bronchiolitis in high-risk children when given prophylactically. In the majority of cases, the disease is usually self-limited. The mortality rate is <1% and occurs predominantly in children at high risk for severe disease.
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