Welliver, R.C. Review of epidemiology and clinical risk factors for severe respiratory syncytial virus (RSV) infection. J. Pediatr. 143, S112−S117

Department of Pediatrics, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, and the Division of Infectious Diseases, Children's Hospital of Buffalo, New York 14222, USA.
Journal of Pediatrics (Impact Factor: 3.79). 12/2003; 143(5 Suppl):S112-7. DOI: 10.1067/S0022-3476(03)00508-0
Source: PubMed


Respiratory syncytial virus (RSV) infection is the most frequent reason for hospitalization of infants in developed countries. Premature birth without or, especially, with chronic lung disease of prematurity, congenital heart disease, and T-cell immunodeficiency are conditions that predispose to more severe forms of RSV infection. Incomplete development of the airway, damage to the airway, and airway hyperreactivity underlie the increased morbidity of RSV infection in prematurely born infants. Pulmonary hypertension and cyanosis are associated with worse outcomes in infants with congenital heart disease, and prolonged viral replication accounts for more severe illness in immunocompromised individuals.

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Available from: Robert Welliver, Oct 29, 2015
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    • "Epidemiological studies indicate that bronchiolitis is a leading cause of morbidity amongst infants less than one year of age in the developed world (Collins 2002, Langley et al 2003, Law & Carvalho 1993, Shay et al 1999, Welliver 2003). In 2005, it was estimated that 33.8 (95% CI 19.3-46.2) million new episodes of RSV associated respiratory infection occurred worldwide in children younger than five years with mortality rates ranging between 66 000 – 199 000 deaths (Nair 2010). "
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    ABSTRACT: To develop and validate a bronchiolitis severity scoring instrument for use by nurses and other healthcare professions. Bronchiolitis is a viral lower respiratory tract infection of infancy. In industrialized countries, admission rates have increased over the last decade with up to 3% of all infants born being admitted to hospital. A small number of these hospitalized infants will require admission to critical care for either invasive or non-invasive ventilation. During the seasonal epidemic, the number of unplanned admissions to critical care with bronchiolitis substantially increases. We will use a mixed methods study design. We will use scale development and psychometric methods to develop a scoring instrument and to test the instrument for content, construct and criterion validity and reliability in several different clinical locations. This study protocol has been reviewed and approved by the NHS National Research Ethics Service, January 2011. There is an urgent need to develop a valid and reliable severity scoring instrument sensitive to clinical changes in the infant, to facilitate clinical decision-making and help standardize patient care. Furthermore, a valid and reliable scoring instrument could also be used as a proxy patient-reported outcome measure to evaluate the efficacy of clinical interventions in randomized controlled trials.
    Journal of Advanced Nursing 03/2014; 70(10). DOI:10.1111/jan.12387 · 1.74 Impact Factor
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    • ". The study showed that 7% of infants with bronchiolitis were premature. A study conducted in Canada showed higher prevalence of 20%prematurity associated with bronchiolitis[13]. Inadequate defense against infection and incomplete development of the airway are probably the most important factors which explain the relation between prematurity and bronchiolitis. "
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    ABSTRACT: Background: Bronchiolitis is most commonly presents in infants aged three to six months. The objectives of this study were to determine the risk factors and clinical presentation of bronchiolitis in Sudanese children attending GaafarIbn A of Hospital for children in Khartoum. Methods: The study design was descriptive. All children less than two years of age admitted to the hospital during the study period with the criteria fulfilling the diagnosis of acute bronchiolitis were enrolled in the study. The sample size was taken as 100. Data were collected by a questionnaire and medical examination. Informants for the questionnaire were the children mothers. Data was analyzed by SPSS software. Results: Children aged 0-6, 7-12 and more than 12 months constituted 68%, 19% and 13% respectively. Most children (92%) had siblings and 78%lived in un crowded environment at home. As regards parental smoking, 36% of the parents were cigarette smokers. Results showed that 34% of children had a past history of hospitalization. Seven percent of the children were delivered as pre term. The most common clinical presentation of bronchiolitis were cough, wheeze and shortness of breath constituted 87%, 82% and 64% respectively. Conclusion: The risk factors for Bronchiolitis were young age (0-6 months), presence of a sibling, a history of hospital admission and paternal history of tobacco smoking. The most common clinical presentations were cough, wheeze and crepitation.
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    • "Pediatric patients at high risk of RSV morbidity and mortality include preterm infants, especially those with CLD, infants with CHD, neuromuscular diseases, cystic fibrosis, and congenital or acquired immunodeficiency [12] [13]. "
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    ABSTRACT: Monoclonal antibodies are widely used both in infants and in adults for several indications. Humanized monoclonal antibodies (palivizumab) have been used for many years for the prevention of respiratory syncytial virus infection in pediatric populations (preterm infants, infants with chronic lung disease or congenital heart disease) at high risk of severe and potentially lethal course of the infection. This drug was reported to be safe, well tolerated and effective to decrease the hospitalization rate and mortality in these groups of infants by several clinical trials. In the present paper we report the development and the current use of monoclonal antibodies for prophylaxis against respiratory syncytial virus.
    Clinical and Developmental Immunology 06/2013; 2013(3):359683. DOI:10.1155/2013/359683 · 2.93 Impact Factor
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