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Pediatric Cardiology

, Volume 17, Issue 3, pp 163–168 | Cite as

Respiratory syncytial virus infection in children with congenital heart disease: A review

  • D. E. Fixler
Original Articles

Abstract

This paper reviews recent changes in morbidity and mortality of respiratory syncytial virus (RSV) infection in infants with congenital heart disease. Mortality since the late 1970s has declined substantially, from approximately 37% to 3%. Although the frequency of admission to intensive care units has declined from approximately 60% to 30%, the frequency for mechanical ventilatory support has not changed significantly. Because mortality dropped prior to the widespread use of ribavirin, it is difficult to ascribe the improvement to this therapy. In infants with congenital heart disease (CHD), nosocomial infection remains a significant problem, accounting for approximately 33% of the RSV cases. Some authors report significant reductions in hospital-acquired RSV by use of gloves and gowns for contacts with infectious cases. Efforts at primary prevention have encountered problems with development of an RSV vacine. Preliminary data from studies of passive immunization using immune globulins with high RSV antibody titers suggest that this therapy may reduce the severity of RSV infection in infants with serious heart disease.

Key words

Respiratory syncytial virus Congenital heart disease RSV vaccines RSV passive immunization 

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References

  1. 1.
    Albert RK, Condie F (1981) Hand-washing patterns in medical intensive-care units.N Engl J Med 304: 1465–1466PubMedCrossRefGoogle Scholar
  2. 2.
    Bruhn FW, Yeager AS (1977) Respiratory syncytial virus in early infancy: circulating antibody and the severity of infection.Am J Dis Child 131: 145–148PubMedGoogle Scholar
  3. 3.
    Collins P, Davis A, Lubeck M, et al (1989) Evaluation of the protective efficacy of recombinant vaccinia viruses and adenoviruses that express respiratory syncytial virus glycoproteins. In:Modern Approaches to New Vaccines Including Prevention of AIDS, Abstracts of 1989 meeting, September 1989, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, p 26Google Scholar
  4. 4.
    Committee on Infectious Disease (1987) Ribavirin therapy of respiratory syncytial virus.Pediatrics 79:475–476Google Scholar
  5. 5.
    Garner JS, Simmons BP (1983) Guideline for isolation precautions in hospitals.Infect Control 4(Suppl):245–325PubMedGoogle Scholar
  6. 6.
    Glezen WP, Paredes A, Allison JE, Taber LH, Frank AL (1981) Risk of respiratory syncytial virus infection for infants from lowincome families in relationship to age, sex, ethnic group, and maternal antibody level.J Pediatr 98:708–715PubMedCrossRefGoogle Scholar
  7. 7.
    Glezen WP, Taber LH, Frank AL, Kasel JA (1986) Risk of primary infection and reinfection with respiratory syncytial virus.Am J Dis Child 140:543–546PubMedGoogle Scholar
  8. 8.
    Groothuis JR, Simoes EAF, Levin MJ, et al (1993) Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children.N Engl J Med 329:1524–1530PubMedCrossRefGoogle Scholar
  9. 9.
    Groothuis JR, Woodin KA, Katz R, et al (1990) Early ribavirin treatment of respiratory syncytial viral infection in high-risk children.J Pediatr 117:792–798PubMedGoogle Scholar
  10. 10.
    Hall CB (1992) Respiratory syncytial virus. In: Feigin RD, Cherry JD (eds)Textbook of Pediatric Infection Disease, 3rd edn, Saunders, Philadelphia, pp 1663–1756Google Scholar
  11. 11.
    Hall CB, McBride JT, Gala CL, Heldreth SW, Schnabel KC (1985) Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease.JAMA 254:3047–3051PubMedCrossRefGoogle Scholar
  12. 12.
    Hall CB, McBride JT, Walsh EE, et al (1983) Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection: a randomized double-blind study.N Engl J Med 308:1443–1447PubMedCrossRefGoogle Scholar
  13. 13.
    Hemming VG, Prince GA, London WT, et al (1988) Topically administered immunoglobulin reduces pulmonary respiratory syncytial virus shedding in owl monkeys.Antimicrob Agents Chemother 32:1269–1270PubMedGoogle Scholar
  14. 14.
    Hemming VG, Prince GA, Rodriguez W, et al (1988) Respiratory syncytial virus infections and intravenous gamma-globulins.Pediatr Infect Dis J 7(Suppl):103–506Google Scholar
  15. 15.
    Hemming VG, Rodriguez W, Kim HW, et al (1987) Intravenous immunoglobulin treatment of respiratory syncytial virus infections in infants and young children.Antimicrob Agents Chemother 31:1882–1886PubMedGoogle Scholar
  16. 16.
    Henderson FW, Collier AM, Clyde WA Jr, Denny FW (1979) Respiratory syncytial virus infections, reinfections and immunity: a prospective longitudinal study in young children.N Engl J Med 300:530–534PubMedCrossRefGoogle Scholar
  17. 17.
    Hughes JH, Mann DR, Hamparian VV (1988) Detection of respiratory syncytial virus in clinical specimens by viral culture, direct and indirect immunofluorescence, and enzyme immunoassay.J Clin Microbiol 26:588–592PubMedGoogle Scholar
  18. 18.
    Kapikian AZ, Mitchell RH, Chanock RM, Shevdoff RA, Stewart CE (1969) 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 89:405–421PubMedGoogle Scholar
  19. 19.
    Kellogg JA (1991) Culture vs direct antigen assays for detection of microbial pathogens from lower respiratory tract specimens suspected of containing the respiratory syncytial virus.Arch Pathol Lab Med 115:451–458PubMedGoogle Scholar
  20. 20.
    Kim HW, Arrobio JO, Brandt CD, et al (1973) Safety and antigenicity of temperature-sensitive (TS) mutant respiratory syncytial virus (RSV) in infants and children.Pediatrics 52:56–63PubMedGoogle Scholar
  21. 21.
    Kim HW, Canchola JG, Brandt CD, et al (1969) Respiratory syncytial virus disease in infants despite prior administration of an antigenic inactivated vaccine.Am J Epidemiol 89:422–434PubMedGoogle Scholar
  22. 22.
    Kim HW, Leikin SL, Arrobio J, et al (1986) Cell-mediated immunity to respiratory syncytial virus induced by inactivated vaccine or by infection.Pediatr Res 10:75–78Google Scholar
  23. 23.
    Lamprecht CL, Krause HE, Mufson MA (1976) Role of maternal antibody in pneumonia and bronchiolitis due to respiratory syncytial virus.J Infect Dis 134:211–217PubMedGoogle Scholar
  24. 24.
    Leclair JM, Freeman J, Sullivan BF, Crowley CM, Goldmann DA (1987) Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions.N Engl J Med 317:329–334PubMedCrossRefGoogle Scholar
  25. 25.
    MacDonald NE, Hall CB, Suffin SC, et al (1982) Respiratory syncytial viral infection in infants with congenital heart disease.N Engl J Med 307:397–400PubMedCrossRefGoogle Scholar
  26. 26.
    McIntosh K (1993) Respiratory syncytial virus—successful immunoprophylaxis at last.N Engl J Med 329:1572–1574PubMedCrossRefGoogle Scholar
  27. 27.
    Meert K, Heidemann S, Lieh-Lai M, Sarnaik AP (1989) Clinical characteristics of respiratory syncytial virus infections in healthy versus previously compromised host.Pediatr Pulmonol 7:167–170PubMedGoogle Scholar
  28. 28.
    Meissner HC, Fulton DR, Groothuis JR (1993) Controlled trial to evaluate protection of high risk infants against respiratory syncytial virus disease by using standard intravenous immune globulin.Antimicrob Agents Chemother 37:1655–1658PubMedGoogle Scholar
  29. 29.
    Moler FW, Khan AS, Meliones JN, et al (1992) Respiratory syncytial virus morbidity and mortality estimates in congenital heart disease patients: a recent experience.Crit Care Med 20:1406–1413PubMedCrossRefGoogle Scholar
  30. 30.
    Murphy BR, Graham BS, Prince GA, et al (1986) Serum and nasal-wash immunoglobulin G and A antibody response of infants and children to respiratory syncytial virus F and G glycoproteins following primary infection.J Clin Microbiol 23:1009–1014PubMedGoogle Scholar
  31. 31.
    Navas L, Wang E, de Carvalho V, et al (1992) Improved outcome of respiratory syncytial virus infection in a high-risk hospitalized population of Canadian children.J Pediatr 121:348–354PubMedGoogle Scholar
  32. 32.
    Ogilvie MM, Vathenen AS, Radford M, Codd J, Key S (1981) Maternal antibody and respiratory syncytial virus infection in infancy.J Med Virol 7:263–271PubMedGoogle Scholar
  33. 33.
    Olsen MA, Shuck KM, Sambol AR (1993) Evaluation of Abbott TestPack RSV for the diagnosis of respiratory syncytial virus infections.Diagn Microbiol Infect Dis 16:105–109PubMedCrossRefGoogle Scholar
  34. 34.
    Parrott RH, Kim HW, Arrobio JO, et al (1973) Epidemiology of respiratory syncytial virus infection in Washington, DC. II. Infection and disease with respect to age, immunologic status, race and sex.Am J Epidemiol 98:289–300PubMedGoogle Scholar
  35. 35.
    Prince GA, Hemming VG, Horswood RL, Chanock RM (1985) Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat.Virus Res 3:193–206PubMedCrossRefGoogle Scholar
  36. 36.
    Smith DW, Frankel LR, Mathers LH, et al (1991) A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial infection.N Engl J Med 325:24–29PubMedCrossRefGoogle Scholar
  37. 37.
    Stretton M, Ajizian SJ, Mitchell I, Newth CJL (1992) Intensive care course and outcome of patients infected with respiratory syncytial virus.Pediatr Pulmonol 13:143–150PubMedGoogle Scholar
  38. 38.
    Tristam DA, Welliver RC, Mohar CK, et al (1993) Immunogenicity and safety of respiratory syncytial virus subunit vaccine in seropositive children 18–36 months old.J Infect Dis 167:191–195Google Scholar
  39. 39.
    Ward KA, Lambden PR, Ogilvie MM, Watt PJ (1983) Antibodies to respiratory syncytial virus polypeptides and their significance in human infection.J Gen Virol 64:1867–1876PubMedCrossRefGoogle Scholar
  40. 40.
    Wright PF, Shinozaki T, Fleet W, et al (1976) Evaluation of live, attenuated respiratory syncytial virus vaccine in infants.J Pediatr 88:931–936PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1996

Authors and Affiliations

  • D. E. Fixler
    • 1
  1. 1.Department of PediatricsUniversity of Texas Southwestern Medical CenterDallasUSA

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