scholarly journals Respiratory Syncytial Virus Infection in High-risk Infants – an Update on Palivizumab Prophylaxis

2014 ◽  
Vol 8 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Bernhard Resch
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Rare Diseases ◽  
Gestational Age ◽  
Meta Analysis ◽  
Infants And Children ◽  
High Morbidity ◽  
Syncytial Virus ◽  
Economic Analyses ◽  
High Risk Infants

Morbidity due to respiratory syncytial virus (RSV) disease is still high in infants and children worldwide during the first two to five years of life. Certain categories of high-risk infants with increased morbidity and mortality attributed to RSV disease have been identified and are included in national recommendations for prophylaxis with the monoclonal RSV antibody palivizumab. Most guidelines recommend palivizumab for preterm infants born less than or equal to 32 weeks gestational age with or without bronchopulmonary dysplasia, those born between 33 and 35 weeks gestational age with additional risk factors, and infants and children with hemodynamically significant congenital heart disease. Over the last years several rare diseases have been identified demonstrating high morbidity associated with RSV disease, thus, extension of guidelines for the prophylaxis with palivizumab for these patients with rare diseases including children with malignancy, congenital and acquired immune deficiency, Down syndrome, neuromuscular impairment, cystic fibrosis, congenital diaphragmatic hernia and other severe respiratory disease is increasingly discussed. Efficacy of palivizumab prophylaxis is documented by meta-analysis, and different economic analyses demonstrate cost-effectiveness of palivizumab for the most common indications during the first RSV season.

scholarly journals Impact of the Withdrawal of Palivizumab Immunoprophylaxis on the Incidence of Respiratory Syncytial Virus (RSV) Hospitalizations Among Infants Born at 33 to 35 Weeks’ Gestational Age in the Province of Quebec, Canada: The RSV-Quebec Study

2020 ◽  
Author(s):  
Jesse Papenburg ◽  
Isabelle Defoy ◽  
Edith Massé ◽  
Georges Caouette ◽  
Marc H Lebel
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Lower Respiratory Tract ◽  
Primary Outcome ◽  
Birth Month ◽  
Syncytial Virus ◽  
High Risk Infants ◽  
The Impact

Abstract Background Infants born at 33–35 completed weeks’ gestational age (wGA) aged <6 months at the start of or born during respiratory syncytial virus (RSV) season and classified as moderate/high risk of severe RSV disease were included in a palivizumab RSV prophylaxis program in the province of Quebec, Canada, until 2014–2015. We assessed the impact of withdrawal of this indication on lower respiratory tract infection (LRTI)/RSV hospitalizations (H) in this population. Methods We conducted a 4-year, retrospective, cohort study in 25 Quebec hospitals (2 seasons with and 2 without palivizumab prophylaxis for moderate- to high-risk infants). Our primary outcome was LRTI/RSV-H incidence. We compared LRTI/RSV-H incidence before (2013–2015; seasons 1 + 2 [S1/2]) and after (2015–2017; S3/4) the change in indication. Results We identified 6457 33–35 wGA births. LRTI/RSV-H occurred in 105/3353 infants (3.13%) in S1/2 and 130/3104 (4.19%) in S3/4. Among LRTI/RSV-H, 86.4% were laboratory-confirmed RSV-H. Adjusting for sex, wGA, and birth month, S3/4 was significantly associated with increased LRTI/RSV-H incidence (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.04–1.76) but not with laboratory-confirmed RSV-H (aOR, 1.19; 95% CI, 0.90–1.58). Mean duration of LRTI/RSV-H was 5.6 days; 22.6% required intensive care unit admission. Comparing S3/4 with S1/2, infant percentage with LRTI/RSV-H classified as moderate/high risk increased from 27.8% to 41.9% (P = .11). Conclusions In a province-wide study, we observed a significant increase in LRTI/RSV-H incidence among infants born at 33–35 wGA in the 2 years after withdrawal of RSV prophylaxis.

scholarly journals A Decade of Respiratory Syncytial Virus Epidemiology and Prophylaxis: Translating Evidence into Everyday Clinical Practice

2011 ◽  
Vol 18 (2) ◽  
pp. e10-e19 ◽  
Author(s):  
Bosco A Paes ◽  
Ian Mitchell ◽  
Anna Banerji ◽  
Krista L Lanctôt ◽  
Joanne M Langley
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Health Care Professionals ◽  
Burden Of Illness ◽  
Scientific Evidence ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Tract Disease ◽  
High Risk Infants ◽  
Long Term Impact

Respiratory syncytial virus (RSV) is a common infection in infancy, with nearly all children affected by two years of age. Approximately 0.5% to 2.0% of all children are hospitalized with lower respiratory tract disease, of which 50% to 90% have bronchiolitis and 5% to 40% have pneumonia. Morbidity and mortality are highest in children with nosocomial infection and in those with underlying medical illnesses such as cardiac and chronic lung disease. Aboriginal children residing in remote northern regions are specifically considered to be at high risk for hospitalization due to RSV infection. Thorough hand washing and health education are the principal strategies in primary prevention. In the absence of a vaccine, palivizumab prophylaxis is currently the best intervention to reduce the burden of illness and RSV-related hospitalization in high-risk children. Health care professionals should provide palivizumab prophylaxis cost effectively in accordance with recommendations issued by pediatric societies and national advisory bodies.The present article reviews the epidemiology of RSV infection and the short- and long-term impact of disease in high-risk infants and special populations. Prevention strategies and treatment are discussed based on the existing scientific evidence, and future challenges in the management of RSV infection are addressed.

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