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Respiratory syncytial virus infections in infants: quantitation and duration of shedding
Insights
Respiratory syncytial virus (RSV) shedding in hospitalized infants can last over 20 days. Younger infants and those with pneumonia shed more virus for longer durations.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) is a major cause of infant hospitalization.
- Understanding RSV shedding patterns is crucial for infection control and treatment.
Purpose of the Study:
- To determine the quantitative shedding patterns and duration of RSV in hospitalized infants.
- To identify factors influencing RSV shedding quantity and duration.
Main Methods:
- Daily nasal wash specimens were collected from hospitalized infants.
- Viral titers were measured using 50% tissue culture infective doses (TCID50).
- Data were analyzed to determine mean maximal titers, shedding duration, and influencing factors.
Main Results:
- Mean maximal RSV titer was 4.34 log10 TCID50/mL.
- Viral shedding persisted for a mean of 6.7 days (range: 1-21 days), with no consistent decline until after Day 6.
- Higher RSV quantities were shed by infants <1 month old and those with pulmonary consolidation.
- Longer shedding duration was observed in infants with lower respiratory tract disease.
Conclusions:
- RSV shedding in infants is variable and can be prolonged.
- Younger infants and those with severe disease shed more virus for longer.
- Findings inform infection control strategies and highlight the severity of RSV in vulnerable infants.
Abstract:
Infants hospitalized with respiratory syncytial virus infection were studied to delineate the quantitative shedding patterns and duration of shedding of RSV. Nasal wash specimens collected daily from 19 infants contained a mean maximal titer of 4.34 log10 50% tissue culture infective doses per milliliter. On admission, the mean titer was 4.14 log10 TCID50, with no consistent decline until after Day 6. The mean duration of shedding for 23 patients until they were virus negative was 6.7 days with a range of 1 to 21 days. Quantities of RSV shed were significantly greater in infants less than one month of age and in infants with evidence of pulmonary consolidation on chest roentgenogram. Shedding extended for a significantly longer time in infants with lower respiratory tract disease than in those with clinical manifestations limited to the upper respiratory tract.