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Lower airway disease caused by respiratory syncytial virus

The Indian Journal of Pediatrics volume 65, pages 355–362 (1998)Cite this article

Abstract

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract disease in infants and young children. Most infections due to RSV are mild and do not require hospitalization. RSV causes both upper respiratory tract infections as well as lower respiratory tract infections. Infants with underlying disease states like bronchopulmonary dyslasia, congenital heart disease and prematurity appear more prone to develop severe infection and have a higher incidence of hospitalization. The exact pathogenesis of RSV is not well understood. The mortality associated with primary RSV infection in healthy children is estimated to be between .005% to .02%. In hospitalized children the mortality rate is estimated to be from 1% to 3%. Several treatment modalities in the form of bronchodilators, corticosteroids, ribavirin, intravenous immune gammaglobulin and antibiotics are available. Studies have failed to show the true beneficial effect of any of the above treatment modalities. Supportive care is only needed. The best treatment is the supportive care in the form of oxygen and fluids and close monitoring of the vital signs including oxygen saturation.

References

  1. Ruuskanen O, Ogra PL. Respiratory syncytial virus.Curr Probl Pediatr 1993; 23 (2): 50–79.

    PubMed  Article  CAS  Google Scholar 

  2. State of Art; Pediatric Intensive Care. In: Brunow de Carvalho W, ed.5th Brazilian Congress of Pediatric Intensive Care.

  3. Hall CB. Respiratory syncytial virus. In: Feigin RD, Cherry JD, eds.Textbook of pediatric infections diseases. 2nd ed. Philadelphia: WB Saunders, 1987; 1653–1679.

    Google Scholar 

  4. Groothuis JR, Gutierrez KM, Lauer BA. Respiratory syncytial virus infection in children with bronchopulmonary dysplasia.Pediatrics 1988; 82: 199–203.

    PubMed  CAS  Google Scholar 

  5. Meert K, Heidemann S, Abella B,et al. Does prematurity alter the course of respiratory syncytial virus infection?Crit Care Med 1990; 18: 1357–1359.

    PubMed  Article  CAS  Google Scholar 

  6. Toms GL. Respiratory syncytial virus: virology, diagnosis and vaccination.Lung 1990; 168 (Suppl): 388–395.

    PubMed  Article  Google Scholar 

  7. Hall CB. Respiratory syncytial virus. In: Mandell GL, Douglas RG, Bennett JE, eds.Principles and practices of infections diseases. 3rd ed. New York. Churchill Livingston, 1990; 1265–1279.

    Google Scholar 

  8. Hall CB, McBride JR. Respiratory syncytial virus-from chimps with colds to conundrums and cures.N Engl J Med 1991; 325: 57–58.

    PubMed  CAS  Article  Google Scholar 

  9. Andreson LJ, Hendry RM, Pierik LT,et al. Multicentre study of strains of respiratory syncytial virus.J Infect Dis 1991; 163: 687–692.

    Google Scholar 

  10. Hall CB, Walsh EE, Long CE,et al. Immunity to and frequency of reinfection with respiratory syncytial virus.J Infect Dis 1991; 163: 693–698.

    PubMed  CAS  Google Scholar 

  11. McConnochie KM, Roghmann KJ. Parental smoking, presence of older siblings, and family history of asthma increase risk of bronchiolitis.Am J Dis Child 1986; 140: 806–812.

    PubMed  CAS  Google Scholar 

  12. Carlsen KH, Larsen S, Bjerve O,et al. Acute bronchiolitis: predisposing factors and characterization of infants at risk.Pediatr Pulmonol 1987; 3: 153–160.

    PubMed  Article  CAS  Google Scholar 

  13. Ogra PL, Patel JP. Respiratory syncytial virus infection and the immunocompromised host.Pediatr Infect Dis J 1988; 7: 246–249.

    PubMed  CAS  Article  Google Scholar 

  14. Pickens DL, Scheffi GL, Storch GA,et al. Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection.Pediatr Plumonol 1989; 6: 195–201.

    Article  CAS  Google Scholar 

  15. Halstead DC, Todd S, Fritch G. Evaluation of five methods for respiratory syncytial virus detection.J Clin Microbiol 1990; 28: 1021–1025.

    PubMed  CAS  Google Scholar 

  16. Paton AW, Paton JC, Lawrence AJ,et al. Rapid detection of respiratory syncytial virus in nasopharyngeal aspirates by reverse transcription and polymerase chain reaction amplification.J Clin Microbiol 1992; 30: 901–904.

    PubMed  CAS  Google Scholar 

  17. Kellogg JA. 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 1991; 115: 451–458.

    PubMed  CAS  Google Scholar 

  18. Gozal D, Colin AA, Jaffe M,et al. Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis.Pediatr Res 1990; 27: 204–220.

    PubMed  Article  CAS  Google Scholar 

  19. Van Steensel-Moll HA, Hazelzet JA, Van Der Voort E,et al. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus.Arch Dis Child 1990; 65: 1237–1239.

    PubMed  Google Scholar 

  20. Schuh S, Parkin P, Rajan A,et al. High versus low-dose, frequently administered, nebulized albuterol in children with severe, acute asthma.Pediatrics 1989; 83: 513–518.

    PubMed  CAS  Google Scholar 

  21. Wang EE, Milner R, Allen U,et al. Bronchodilators for treatment of mild bronchiolitis: a factorial randomized trial.Arch Dis Child 1992; 67: 289–293.

    PubMed  CAS  Article  Google Scholar 

  22. Tal A, Bavilski C, Yohai D, Bearman JE, Gorodischer R, Moses SW. Dexamethasone and salbutamol in the treatment of acute wheezing in infants.Pediatrics 1983; 71: 13–18.

    PubMed  CAS  Google Scholar 

  23. The American Academy of Pediatrics Committee on Infection Disease. Ribavirin therapy of respiratory syncytial virus.Pediatrics 1987; 79: 475–478.

    Google Scholar 

  24. American Academy of Pediatrics Committee on Infectious Diseases. Use of Ribavirin in treatment of respiratory syncytial virus infection.Pediatrics 1993; 92: 501–504.

    Google Scholar 

  25. Wald ER, Dashefsky B, Green M. Ribavirin: A case of premature adjudication?J Pediatr 1988; 112: 154–158.

    PubMed  Article  CAS  Google Scholar 

  26. Zucker AR, Meadwo WL. Pediatric critical care physicians attitude about guidelines for the use of Ribavirin in critically ill children with respiratory syncytial virus pneumonia.Crit Care Med 1995; 23 (4): 767–772.

    PubMed  Article  CAS  Google Scholar 

  27. Smith DW, Frankel LR, Mathers LH,et al. A controlled trial of aerosolized Ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection.N Engl J Med 1991; 325: 24–29.

    PubMed  CAS  Article  Google Scholar 

  28. Meert KL, Sarnaik AP, Gelmini MJ,et al. Aerosolized Ribavirin in mechanically ventilated infants with respiratory syncytial virus lower respiratory tract disease.Crit Care Med 1994; 22: 566–572.

    PubMed  Article  CAS  Google Scholar 

  29. Hemming VG, Prince GA, Groothuis JR, Siber GR. Hyperimmune globulins in prevention and treatment of respiratory syncytial virus infections.Clin Microbiol Rev 1995; 8 (1): 22–23.

    PubMed  CAS  Google Scholar 

  30. Groothuis JR, Simoes EAR, Levin MJ,et al. Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children.N Engl J Med 1993; 329: 1524–1530.

    PubMed  Article  CAS  Google Scholar 

  31. Groothuis JR, Simoes EAF, Hemming VG. RSV infection in preterm infants and the protective effects of RSV immune globulin (RSVIG).Pediatrics 1995; 95 (4): 463–467.

    PubMed  CAS  Google Scholar 

  32. Hall CB. Prospects for a RSV vaccine.Science 1994; 265 (5177): 1391–1394.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Critical Care, St. Mary’s Medical Centre, 558 05, Duluth, MN, USA

    Rahul Aggarwal MD, FCCM

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  1. Rahul Aggarwal MD, FCCM
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Aggarwal, R. Lower airway disease caused by respiratory syncytial virus. Indian J Pediatr 65, 355–362 (1998). https://doi.org/10.1007/BF02761127

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  • DOI: https://doi.org/10.1007/BF02761127

Key words

  • Respiratory syncytial virus (RSV)
  • Bronchopulmonary dysplasia (BPD)
  • Congenital heart disease (CHD)
  • Intravenous immune gammaglobulin (IVIG)