Apnea associated with respiratory syncytial virus infection in young infants

Effect of Respiratory Syncytial Virus on Apnea in Weanling Rats

“…The susceptibility to apnea and apnea-related mortality during the early phase of the infection suggests that RSV can produce serious disruption of the neural control of breathing even when the infection is still confined to the upper airways, which provides a rationale to the clinical observation that apnea is frequently the presenting symptom of the infection and typically precedes the appearance of coryza, cough, or wheezing (3,4). Furthermore, our findings provide a pathophysiologic basis to several parallels that have been drawn between RSV infections and SID, such as the high incidence in winter months, the occurrence in young infants 2-4 mo of age, the increased risk for premature-born infants, and the frequent report of upper respiratory tract symptoms in the days preceding SID (31).…”

“…Apnea related to respiratory infections in infants is also seen with other viruses (3,33), but the proportion of patients who develop this complication is much smaller than with RSV. A retrospective study of hospitalized infants who were Ͻ6 mo of age found that the combined incidence of apnea associated with respiratory viruses other than RSV (including influenza, parainfluenza type 3, and rhinovirus) was 8.8% compared with 20.4% in the RSV group (3).…”

“…Adenovirus was chosen because it is a common respiratory pathogen, potentiates airway neurogenic inflammation in our model in a manner similar to RSV (22), and has not been associated with the development of apnea in infants (3).…”

“…Although most infections have a mild course, RSV can cause severe respiratory compromise, especially in patients with underlying cardiorespiratory conditions, and predisposes to the development of childhood asthma (2). Apnea can be the presenting sign of this infection, and its incidence varies between 16 and 25% of infected infants, with a particularly high risk associated with young age (Ͻ3 mo) and prematurity (3)(4)(5). Because of its ability to interfere with ventilatory control, it has been suggested that RSV infection may also be a precipitating factor in cases of sudden infant death (SID) (6)(7)(8), yet the pathophysiology of apnea associated with RSV infection remains unclear, and no specific prophylaxis or treatment is currently available to protect infants from this complication.…”

Respiratory Syncytial Virus Infection Reinforces Reflex Apnea in Young Lambs

“…Prolonged apnea is believed to be a crucial part of the pathophysiology of SIDS (5). RSV is known to cause apnea among approximately 20% of hospitalized infants under 1 y of age (6,7). Prematurity and young age are risk factors for the development of apnea during this infection.…”