The impact of prophylaxis on paediatric intensive care unit admissions for RSV infection: a retrospective, single-centre study

Butt, Michelle; Symington, Amanda; Janes, Marianne; Elliott, LouAnn; Steele, Susan M.; Paes, Bosco

doi:10.1007/s00431-010-1376-3

Cited by 13 publications

(25 citation statements)

References 51 publications

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“…It is generally prescribed for individuals with predetermined risk factors, and as stated earlier, risk factors are identified in only a fraction of susceptible children. In developing countries, constraints in infrastructure and funding further impede access [32]. Clearly, further development of RSV vaccines and therapies is warranted, and novel successful products could have an enormous positive impact on human health.…”

Section: Respiratory Syncytial Virus: the Diseasementioning

confidence: 99%

Respiratory syncytial virus vaccine development

Hurwitz¹

2011

Expert Review of Vaccines

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Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract viral disease in infants and young children. Presently, there are no explicit recommendations for RSV treatment apart from supportive care. The virus is therefore responsible for an estimated 160,000 deaths per year worldwide. Despite half a century of dedicated research, there remains no licensed vaccine product. Herein are described past and current efforts to harness innate and adaptive immune potentials to combat RSV. A plethora of candidate vaccine products and strategies are reviewed. The development of a successful RSV vaccine may ultimately stem from attention to historical lessons, in concert with an integral partnering of immunology and virology research fields.

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Section: Respiratory Syncytial Virus: the Diseasementioning

confidence: 99%

Respiratory syncytial virus vaccine development

Hurwitz¹

2011

Expert Review of Vaccines

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“…Following the universal use of palivizumab prophylaxis, the majority of RSV‐related hospital admissions now occur in term infants [Prais et al, ; Butt et al, ; Kusuda et al, ]. There is very little information on risk factors that accurately identify healthy term infants who are at highest risk for severe RSV lower respiratory tract infection [Bont and Houben, ; Houben et al, ].…”

Section: Introductionmentioning

confidence: 99%

“…At the time of admission for RSV‐related illness, term infants have an overall comprehensive severity index which is not indifferent to their preterm counterparts [Horn and Smout, ]. Term infants also suffer major complications related to RSV infection including hospitalization, respiratory failure, intensive care admission, mechanical ventilation, prolonged duration of hospital stay, and death [Horn and Smout, ; Willson et al, ; Prais et al, ; Butt et al, ]. Moreover, costs for the hospitalization of term infants with RSV illness approximate US$8,000–10,000 per admission [Willson et al, ; Makari et al, ].…”

Section: Introductionmentioning

confidence: 99%

Value of a risk scoring tool to predict respiratory syncytial virus disease severity and need for hospitalization in term infants

Mosalli

Moez

Janish

et al. 2015

Journal of Medical Virology

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Several environmental and demographic risk factors have been validated and are used to determine the risk of acquiring severe respiratory syncytial virus (RSV) infection and subsequent hospitalization in late preterm infants born at 33-35 weeks gestational age. The applicability of the same composite model of risk factors in the term population has not been fully explored. The primary objective of this pilot study was to establish whether a risk scoring tool (RST), could predict the severity of RSV infection in term, RSV-positive infants who were hospitalized. A retrospective observational study was conducted in a pediatric unit, over 2 RSV seasons (2011-2013). A convenient sample of 72 children was selected out of a total of 111 RSV-positive cases after exclusions. The RST was applied and a score of respiratory disease severity was determined for each patient. Demographic characteristics were analyzed by standard descriptive methods, χ(2) analysis was utilized for categorical data and ANOVA for comparison between the clinical severity groups and the RST score. A P-value <0.05 was considered significant. Sixty per cent (n = 43) of all infants scored in the low-risk category compared to 26% (n = 19) in the moderate and 14% (n = 10) in the high-risk groups. RST scores were also inconsistent with disease severity. Mean (SD) RST scores for those with mild, moderate, and severe illness were 47.8 [16.4], 41.1 [20.39] and, 41.7 [19.8], respectively (P = 0.17). In conclusion, the RST did not predict accurately the clinical severity of RSV bronchiolitis in term infants nor did it correlate with risk for RSV-related hospitalization.

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“…Due to drug and administration costs, current recommendations from the American Academy of Pediatrics and the Canadian Pediatric Society state that only very high risk populations (e.g., extreme prematurity, moderate prematurity with multiple additional risk factors, congenital heart disease requiring surgery) receive prophylaxis . Presently, more than half, and up to 90% of children, who develop severe RSV and bronchiolitis do not fall into a very high risk group . There remains considerable interest in the identification of RSV risk factors that are either modifiable, lead to novel interventions, or improve the accuracy of clinical prediction tools.…”

Section: Introductionmentioning

confidence: 99%