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Could preventive intranasal interferon lower the morbidity in children prone to respiratory illness?
R M Douglas1, B Moore, H B Miles
1National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.
Insights
Intranasal interferon may not significantly reduce respiratory illness in children prone to severe infections. These children often introduced viruses, and rhinovirus infections had minimal impact on their overall respiratory morbidity.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) hospitalization in infancy is linked to later respiratory morbidity.
- Intranasal interferon has shown promise in preventing rhinovirus infections within families.
Purpose of the Study:
- To evaluate the effectiveness of intranasal interferon as a contact prophylaxis for respiratory illness in children with a history of severe RSV infections.
- To determine if this preventive strategy could substantially reduce respiratory morbidity in this high-risk pediatric population.
Main Methods:
- A prospective virological and epidemiological study of 127 children aged 4-9 years over a seven-month winter period.
- Monitoring of illness introduction within households and assessment of respiratory morbidity associated with specific viral infections, particularly rhinovirus.
Main Results:
- Children with a history of severe RSV infections were more likely to introduce respiratory illnesses into the household.
- Rhinovirus infections, potentially preventable by interferon, were associated with only a minor reduction in lower respiratory morbidity.
- Rhinoviruses were found to be a less significant contributor to the overall respiratory illness burden in these children.
Conclusions:
- Contact prophylaxis with intranasal interferon is unlikely to substantially decrease the burden of respiratory illness in children with a history of severe RSV infections.
- The study highlights that these children are often the source of illness introduction and that rhinovirus plays a minor role in their overall respiratory morbidity.
Abstract:
Recent studies have demonstrated that rhinovirus infections can be prevented in the family setting through use of intranasal interferon sprays which are commenced when another family member develops a cold. One hundred and twenty-seven children aged 4-9 years who had been hospitalized during their first year of life for severe infections caused by respiratory syncytial virus were studied virologically and epidemiologically during a seven-month period which included the winter months. The hypothesis was that a significant part of their respiratory morbidity would be preventable by a contact prophylaxis approach using intranasal interferon. However, the findings suggest that a preventive approach of this kind would not substantially reduce the burden of respiratory illness in these children because: the target children themselves more often introduced illness into the family than did other household members; rhinovirus infections preventable by interferon were associated with little lower respiratory morbidity; and rhinoviruses were minor contributors to the total respiratory illness burden in these respiratory illness-prone children.