Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors

Geoghegan, Sarah; Erviti, Anabella; Caballero, Mauricio T.; Vallone, Fernando; Zanone, Stella M; Losada, Juan Ves; Bianchi, Alejandra; Acosta, Patricio L.; Talarico, Laura; Ferretti, Adrián; Grimaldi, Luciano Alva; Sancilio, Andrea; Dueñas, Karina; Sastre, Gustavo; Rodríguez, Andrea; Ferrero, Fernando; Barboza, Edgar; Gago, Guadalupe Fernández; Nocito, Celina; Flamenco, Edgardo; Pérez, Alberto Rodríguez; Rebec, Beatriz; Ferolla, Fausto M; Libster, Romina; Karron, Ruth A.; Bergel, Eduardo; Polack, Fernando P.

doi:10.1164/rccm.201603-0658oc

Cited by 137 publications

(175 citation statements)

References 27 publications

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“…Moreover, attributing all fatalities with a clinical diagnosis of bronchiolitis to RSV is also troublesome. Symptoms of bronchiolitis can be elicited by a variety of viruses that co‐exist during the respiratory season and their individual case fatality ratios (CFR) remain unclear . RSV is a more frequent cause of severe LRTI in children than other respiratory pathogens, often detected in 50‐70% of hospitalizations, but it also may be less lethal .…”

Section: Challenges In Estimating Rsv Mortality Ratesmentioning

confidence: 99%

“…Home deaths occur in clinically frail infants with sick lungs or simply in those exhausted due to lack of medical care or oxygen supplementation. In many developing countries, the number of home deaths during the respiratory season significantly exceeds the number of hospital deaths . Finally, pathogens detected in the upper respiratory tract of deceased infants may not necessarily match those identified in the lungs, where more than one pathogen is routinely detected by molecular techniques during autopsies .…”

Section: Challenges In Estimating Rsv Mortality Ratesmentioning

confidence: 99%

“…RSV mortality in the developing world underscores the serious structural problems in public health services that govern the fate of many children worldwide . After all, why would otherwise an ailment not treated by specific medication kill children so asymmetrically?…”

Section: In‐hospital Mortality Due To Rsv In Developing Countriesmentioning

confidence: 99%

“…After all, why would otherwise an ailment not treated by specific medication kill children so asymmetrically? Answers highlight a critical problem often faced by families living in poverty: the limited specific expertise of those caring for acute medical emergencies in infants and young children.…”

Section: In‐hospital Mortality Due To Rsv In Developing Countriesmentioning

confidence: 99%

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Respiratory syncytial virus is an “opportunistic” killer

Caballero

Polack

2018

Pediatric Pulmonology

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Respiratory syncytial virus (RSV), responsible for more than three million yearly hospitalizations and up to 118 000 deaths in children under 5 years, is the leading pulmonary cause of death for this age group that lacks a licensed vaccine. Ninety‐nine percent of deaths due to the virus occur in developing countries. In‐hospital RSV fatalities affect previously healthy term infants in association with bacterial sepsis, clinically significant pneumothoraxes and, to a lesser extent, comorbid conditions. Community deaths affect low‐income children from socially vulnerable families and appear to be as frequent as inpatient fatalities. In industrialized countries, RSV deaths occur almost exclusively in children with premorbid conditions.In a sense, RSV is an “opportunistic” killer. It needs a synergistic premorbid, medical practice‐related, infectious, or social co‐factor to cause a fatal outcome. But while the complex problems associated with these co‐factors await solutions, candidate vaccines, long‐lived monoclonal antibodies and antivirals against RSV are under clinical evaluation. It seems reasonable to predict that the landscape of RSV infections will look different in the next decade.

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Section: Challenges In Estimating Rsv Mortality Ratesmentioning

confidence: 99%

Section: Challenges In Estimating Rsv Mortality Ratesmentioning

confidence: 99%

Section: In‐hospital Mortality Due To Rsv In Developing Countriesmentioning

confidence: 99%

Section: In‐hospital Mortality Due To Rsv In Developing Countriesmentioning

confidence: 99%

See 2 more Smart Citations

Respiratory syncytial virus is an “opportunistic” killer

Caballero

Polack

2018

Pediatric Pulmonology

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“…Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infection (LRTI) worldwide [1]. Historically known as a major cause of bronchiolitis in infants, RSV is now recognized as an important cause of morbidity in adults, particularly in the elderly and immunocompromised individuals [2].…”

Section: Introductionmentioning

confidence: 99%

Ongoing developments in RSV prophylaxis: a clinician’s analysis

Rezaee

Linfield

Harford

et al. 2017

Current Opinion in Virology

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Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children worldwide. Lower respiratory tract infection due to RSV is one of the most common causes of hospitalization for infants, especially those born premature or with chronic lung or heart disease. Furthermore, RSV infection is an important cause of morbidity in adults, particularly in the elderly and immunocompromised individuals. The acute phase of this infection is often followed by episodes of wheezing that recur for months or years and usually lead to a physician diagnosis of asthma. RSV was discovered more than 50 years ago, and despite extensive research to identify pharmacological therapies, the most effective management of this infection remains supportive care. The trial of a formalin-inactivated RSV vaccine in the 1960s resulted in priming the severe illness upon natural infection. Currently, Palivizumab is the only available option for RSV prophylaxis, and because of restricted clinical benefits and high costs, it has been limited to a group of high-risk infants. There are several ongoing trials in preclinical, Phase-I, -II, or -III clinical stages for RSV vaccine development based on various strategies. Here we review the existing available prophylactic options, the current stages of RSV vaccine clinical trials, different strategies, and major hurdles in the development of an effective RSV vaccine.

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