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.

Download full-text


Available from: Robert Welliver, Oct 29, 2015
  • Source
    • "We defined viral coinfection as the detection of other viral agents by PCR testing on the same specimen that detected HMPV. Patients with chronic medical conditions associated with increased morbidity and mortality with viral respiratory illness were identified23416]. These conditions included chronic pulmonary conditions, cyanotic heart disease, prematurity , immunocompromised state, neuromuscular disorders , and hemoglobinopathies. "
    [Show abstract] [Hide abstract]
    ABSTRACT: . Human metapneumovirus (HMPV) is a paramyxovirus from the same subfamily as respiratory syncytial virus (RSV) and causes similar acute lower respiratory tract infection. Albuterol in the setting of acute RSV infection is controversial and has not yet been studied in HMPV. We sought to determine the frequency of albuterol use in HMPV infection and the association between albuterol administration and patient outcomes. Methods . We conducted a retrospective cohort study identifying all patients hospitalized in a tertiary care children’s hospital with laboratory-confirmed HMPV infection between January 2010 and December 2010. Results . There were 207 patients included in the study; 57% had a chronic medical condition. The median hospital length of stay was 3 days. Only 31% of patients in the study had a documented wheezing history, while 69% of patients received at least one albuterol treatment. There was no difference in length of stay between patients who received albuterol and those who did not. Conclusion . There is a high frequency of albuterol use in children hospitalized with HMPV infection. As with RSV, evidence may not support routine use of bronchodilators in patients with acute HMPV respiratory infection. Research involving additional patient outcomes and illness severity indicators would be useful in future studies.
    Full-text · Article · Jan 2016 · International Journal of Pediatrics
    • "RSV infections in Turkey usually occur as well-defined community outbreaks during winter and early spring [6]. Risk factors for severe RSV bronchiolitis include prematurity with or without chronic lung disease (CLD), congenital heart disease (CHD), Down syndrome, neuromuscular disorders and immunodeficiencies [2,3,7,8]. Other risk factors for hospitalization include male sex, siblings living in the household, daycare attendance and exposure to tobacco smoke [9,10]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs). Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip�-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions. Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW 42500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU. Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU.
    No preview · Article · Sep 2015
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Mar 2014 · Journal of Advanced Nursing
Show more