Syncytial Virus In Infants Research Articles

Midturbinate Swabs Are Comparable to Nasopharyngeal Swabs for Quantitative Detection of Respiratory Syncytial Virus in Infants.

Nasopharyngeal (NP) swabs are generally used to detect respiratory syncytial virus (RSV) in infants. However, midturbinate (MT) swabs may provide comparable results. In this study, we enrolled hospitalized infants aged <24 months with RSV and collected NP and MT swabs. The resulting viral loads measured by real-time reverse-transcription quantitative polymerase chain reaction were similar. Most parents preferred MT swabs over NP swabs.

DETECTION OF RESPIRATORY SYNCYTIAL VIRUS IN INFANTS AND YOUNG CHILDREN WITH CHEST INFECTION: A COMPARISON OF REVERSE TRANSCRIPTION-PCR TECHNIQUE TO CHROMATOGRAPHIC IMMUNOASSAY AND ENZYME LINKED IMMUNOSORBENT ASSAY

Background: Human respiratory syncytial virus (hRSV) is a major cause of viral lower respiratory tract infection among infants and young children less than 2 years old. Multiple methods are used for the laboratory diagnosis of hRSV infections, including chromatographic immunoassay, enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) technique for detection hRSV-antigens, hRSV-antibodies and hRSV-RNA, respectively. Objective: To compare the efficiency of three diagnostic methods in detection of hRSV in infants and young children with chest infection. Methods: This study included 100 hospitalized infants and young children (39 females and 61 males) aged from (1) month to (24) months, their mean age (6.87 ± 6.03) months, who required hospital admission at the Pediatric Department in Al-Imamein AL-Kadhimein Medical City Hospital, Central Teaching Pediatric Hospital, and Al-Kadhimiya Pediatric Hospital in Baghdad-Iraq. Samples were collected over a three-month winter period from January 2017 to April 2017. Fresh nasal swab specimens were collected and testes for hRSV antigens by using chromatographic immunoassay as a rapid test, in addition, nasopharyngeal/throat swabs specimens were processed for detection of hRSV-RNA by RT-PCR, both for direct detection. Also, ELISA was done to measure anti-hRSV IgM antibodies in serum for indirect detection of RSV infection. Results: hRSV was found to be positive in (27%), (56%) and (44%) of specimens by rapid chromatographic immunoassay, ELISA and RT-PCR technique, respectively. Comparing with RT-PCR, the sensitivity of rapid test was (59.09%) ranged from (44.41) to (72.31) and the specificity was (98.21%) ranged from (90.55) to (99.91) with likelihood ratio equal to (33.09), while the sensitivity of ELISA test was (75.61%) ranged from (60.66) to (86.17) and specificity was (59.62%) ranged from (46.07) to (71.84) with likelihood ratio equals to (1.87). Conclusion: The RT-PCR technique was more sensitive than antigen or antibody detection methods for the diagnosis of hRSV Keywords: hRSV, rapid chromatographic immunoassay, ELISA, RT-PCR Citation: Al-Shuwaikh AMA, Ali SH, Arif HS. Detection of respiratory syncytial virus in infants and young children with chest infection: a comparison of reverse transcription-PCR technique to chromatographic immunoassay and enzyme linked immunosorbent assay. Iraqi JMS. 2018; 16(3): 319-326. doi: 10.22578/IJMS.16.3.11

Palivizumab prophylaxis for respiratory syncytial virus in infants with cystic fibrosis: is there a need?

Respiratory syncytial virus (RSV) infection in cystic fibrosis (CF) infants is associated with significant morbidities. This study's objective is to evaluate the effectiveness and adverse events related to palivizumab (PVZ) in CF infants. Data on respiratory-related illness (RIH) and RSV hospitalizations (RSVH) were collected retrospectively in CF infants aged < 2years in Alberta, Canada, from 2000 to 2017. Logistic regression models were used to compare the odds of RSVH or RIH in PVZ infants from the Canadian registry of palivizumab (CARESS) versus untreated (UPVZ) infants from Alberta, after adjusting for potential confounders. Illness severity was compared between cohorts using χ2 and t tests. A total of 267 CF infants were included: 183 (PVZ) and 84 (UPVZ). A total of 53.3% were tested for RSV. Fifty-five infants experienced a RIH and 10 had a RSVH. The PVZ cohort experienced similar odds of RSVH but decreased odds of RIH versus UPVZ, adjusting for gestational age, birth weight, birth during RSV peak months, and presence of siblings (Exp(B) = 0.23 [0.11-0.49], p < 0.0005). In RSVH-related subjects, PVZ subjects experienced shorter length of overall stay (LOS; t = 2.39 [df = 7], p = 0.048). In those with a RIH, the PVZ group had shorter overall intensive care unit (t = 3.52 [df = 15], p = 0.003) and hospital LOS (t = 2.11 [df = 52], p = 0.04). No serious adverse events were related to PVZ. The odds of RSVH were similar between groups, but PVZ subjects had decreased odds of RIH. The low number of RSV tests performed may explain the similarity in RSVH rates. Significant differences in LOS may indicate decreased RSVH and RIH illness severity in the PVZ versus UPVZ groups.

Characterizing the risk of respiratory syncytial virus in infants with older siblings: a population-based birth cohort study.

From a population-based birth cohort of 245 249 children born in Western Australia during 1996-2005, we used linkage of laboratory and birth record datasets to obtain data including all respiratory syncytial virus (RSV) detections during infancy from a subcohort of 87 981 singleton children born in the Perth metropolitan area from 2000 to 2004. Using log binomial regression, we found that the risk of infant RSV detection increases with the number of older siblings, with those having ⩾3 older siblings experiencing almost three times the risk (relative risk 2·83, 95% confidence interval 2·46-3·26) of firstborn children. We estimate that 45% of the RSV detections in our subcohort were attributable to infection from an older sibling. The sibling effect was significantly higher for those infants who were younger during the season of peak risk (winter) than those who were older. Although older siblings were present in our cohort, they had very few RSV detections which could be temporally linked to an infant's infection. We conclude that RSV infection in older children leads to less severe symptoms but is nevertheless an important source of infant infection. Our results lend support to a vaccination strategy which includes family members in order to provide maximum protection for newborn babies.

Clinical Predictors of Critical Lower Respiratory Tract Illness Due to Respiratory Syncytial Virus in Infants and Children: Data to Inform Case Definitions for Efficacy Trials.

We analyzed data from 524 Argentinean infants hospitalized with lower respiratory tract illness (LRTI) due to respiratory syncytial virus (RSV) to inform selection of clinical end points for RSV vaccine efficacy trials. Cases of LRTI due to RSV that required a mask, continuous or bilevel positive airway pressure, or mechanical ventilation were classified as critical. Oxygen saturation of ≤90%, tachypnea, and tachycardia were each associated with an increased odds of critical LRTI due to RSV (adjusted odds ratios [ORs], 2.30 [95% confidence interval {CI}, 1.26-4.24; P = .007], 2.22 [95% CI, 1.19-4.16; P = .012], and 2.35 [95% CI, 1.22-4.50; P = .010], respectively). The odds of critical LRTI due to RSV increased substantially (OR, 8.57; 95% CI, 2.19-73.5; P = .001) among individuals with ≥2 indicators. Lower chest wall indrawing was not associated with critical disease.

Crawling with Virus: Translational Insights from a Neonatal Mouse Model on the Pathogenesis of Respiratory Syncytial Virus in Infants.

The infant immune response to respiratory syncytial virus (RSV) remains incompletely understood. Here we review the use of a neonatal mouse model of RSV infection to mimic severe infection in human infants. We describe numerous age-specific responses, organized by cell type, observed in RSV-infected neonatal mice and draw comparisons (when possible) to human infants.

Respiratory syncytial virus in infants: is maternal vaccination a realistic strategy?

Respiratory syncytial virus (RSV) remains an important cause of serious and sometimes fatal acute lower respiratory tract disease in infants, yet no effective antiviral treatment or vaccine for the prevention of RSV in early life is available. Vaccination of women during pregnancy is considered to be the most plausible strategy to provide direct RSV antibody protection to young infants during a period of greatest vulnerability. Interest in the development of RSV vaccines for immunization of women during pregnancy is high. Numerous studies are underway to better understand the epidemiology and impact of RSV disease in pregnant women and infants, as well as the role of maternal antibodies in the protection of infants against early and severe RSV disease, to identify and measure serologic correlates of protection to RSV in infants and develop well tolerated and immunogenic RSV vaccines for pregnant women. Studies of RSV vaccination in pregnancy are in progress, making maternal vaccination a realistic intervention for the protection of young infants against RSV disease in the near future. Maternal immunization with an immunogenic vaccine has the potential to substantially impact the morbidity and mortality of RSV-associated lower respiratory tract illness in infants worldwide.

Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection

ObjectiveTo characterize and compare clinical, epidemiological, and laboratory aspects ofinfants with acute lower respiratory infection (ALRI) associated with the detection of adenovirus(ADV) or respiratory syncytial virus (RSV). MethodsA preliminary respiratory infection surveillance study collected samples of nasopharyngeal aspirate (NPA) for viral research, linked to the completion of a standard protocol, from children younger than two years admitted to a university hospital with ALRI, between March of 2008 and August of 2011. Polymerase chain reaction (PCR) was used for eight viruses: ADV, RSV, metapneumovirus, Parainfluenza 1, 2, and 3, and Influenza A and B. Cases with NPA collectedduring the first 24hours of admission, negative results of blood culture, and exclusive detection of ADV (Gadv group) or RSV (Grsv group) were selected for comparisons. ResultsThe preliminary study included collection of 1,121 samples of NPA, 813 collected in thefirst 24hours of admission, of which 50.3% were positive for at least one virus; RSV was identifiedin 27.3% of cases surveyed, and ADV was identified in 15.8%. Among the aspects analyzed inthe Gadv (n = 58) and Grsv (n = 134) groups, the following are noteworthy: the higher meanage, more frequent prescription of antibiotics, and the highest median of total white blood cellcount and C-reactive protein values in Gadv. ConclusionsPCR can detect persistent/latent forms of ADV, an aspect to be considered wheninterpreting results. Additional studies with quantitative diagnostic techniques could elucidatethe importance of the high frequency observed.

The Real-Life Effectiveness of Palivizumab for Reducing Hospital Admissions for Respiratory Syncytial Virus in Infants Residing in Nunavut

BACKGROUND⁄ Nunavut has the highest hospitalization rates for respiratory syncytial virus (RSV) worldwide, with rates of 166 per 1000 live births per year <1 year of age. Palivizumab was implemented in Nunavut primarily for premature infants, or those with hemodynamically significant cardiac or chronic lung disease; however, the effectiveness of the program is unknown. The objective of the present multisite, hospital-based surveillance study was to estimate the effectiveness of palivizumab in infants <6 months of age in Nunavut for the 2009 and 2010 RSV seasons. Infants identified as palivizumab candidates who were <6 months of age were compared with all admissions for lower respiratory tract infection through multisite, hospital-based surveillance documenting the adequacy of palivizumab prophylaxis, admission for lower respiratory tract infection and the results of RSV testing. The OR for RSV admission in unprophylaxed infants was compared with those who were prophylaxed, and the effectiveness of palivizumab was estimated. Within the study cohort (n=101) during the two RSV seasons, five of the 10 eligible infants who did not receive adequate prophylaxis were admitted with RSV while two of the 91 infants <6 months of age eligible for palivizumab who were adequately prophylaxed were hospitalized with RSV (OR 22.3 [95% CI 3.8 to 130]; P=0.0005). The estimated effectiveness of palivizumab for the cohort was as high as 96%. Eight eligible infants were missed by the program and did not receive prophylaxis. Palivizumab was highly effective in reducing hospitalizations due to RSV infection in Nunavut. Further efforts need to be made to ensure that all eligible infants are identified.

Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection

Objectiveto characterize and compare clinical, epidemiological, and laboratory aspects of infants with acute lower respiratory infection (ALRI) associated with the detection of adenovirus (ADV) or respiratory syncytial virus (RSV). Methodsa preliminary respiratory infection surveillance study collected samples of nasopharyngeal aspirate (NPA) for viral research, linked to the completion of a standard protocol, from children younger than two years admitted to a university hospital with ALRI, between March of 2008 and August of 2011. Polymerase chain reaction (PCR) was used for eight viruses: ADV, RSV, metapneumovirus, Parainfluenza 1, 2, and 3, and Influenza A and B. Cases with NPA collected during the first 24hours of admission, negative results of blood culture, and exclusive detection of ADV (Gadv group) or RSV (Grsv group) were selected for comparisons. Resultsthe preliminary study included collection of 1,121 samples of NPA, 813 collected in the first 24hours of admission, of which 50.3% were positive for at least one virus; RSV was identified in 27.3% of cases surveyed, and ADV was identified in 15.8%. Among the aspects analyzed in the Gadv (n = 58) and Grsv (n = 134) groups, the following are noteworthy: the higher mean age, more frequent prescription of antibiotics, and the highest median of total white blood cell count and C-reactive protein values in Gadv. ConclusionsPCR can detect persistent/latent forms of ADV, an aspect to be considered when interpreting results. Additional studies with quantitative diagnostic techniques could elucidate the importance of the high frequency observed.

Group- and Genotype-Specific Neutralizing Antibody Responses Against Respiratory Syncytial Virus in Infants and Young Children With Severe Pneumonia

The effect of genetic variation on the neutralizing antibody response to respiratory syncytial virus (RSV) is poorly understood. In this study, acute- and convalescent-phase sera were evaluated against different RSV strains. The proportion of individuals with homologous seroconversion was greater than that among individuals with heterologous seroconversion among those infected with RSV group A (50% vs 12.5%; P = .0005) or RSV group B (40% vs 8%; P = .008). Seroconversion to BA genotype or non-BA genotype test viruses was similar among individuals infected with non-BA virus (35% vs 50%; P = .4) or BA virus (50% vs 65%; P = .4). The RSV neutralizing response is group specific. The BA-associated genetic change did not confer an ability to escape neutralizing responses to previous non-BA viruses.

A review of cost–effectiveness of palivizumab for respiratory syncytial virus

Palivizumab prophylaxis has been demonstrated to reduce the number of hospitalizations attributable to respiratory syncytial virus in high-risk infants. However, as palivizumab acquisition costs are high, quantifying cost–effectiveness is important. The primary aim of this review was to examine the cost–effectiveness of palivizumab across numerous indications in high-risk infants and to report on factors that may impact outcomes. A systematic literature search was conducted to identify pharmacoeconomic analyzes of palivizumab compared to no prophylaxis for respiratory syncytial virus in infants and young children. A total of 28 articles met inclusion criteria and were subsequently assigned quality scores according to the Quality of Health Economic Studies criteria. Results varied according to perspective, input parameters, outcome measures, populations and base-case and sensitivity analyses. Overall, cost–effectiveness results were inconsistent. Some studies reported favorable outcomes, while others did not, or were inconclusive. Factors to consider in the interpretation of such economic evaluations are discussed.

Equal Virulence of Rhinovirus and Respiratory Syncytial Virus in Infants Hospitalized for Lower Respiratory Tract Infection

Respiratory syncytial virus (RSV) and rhinovirus (RV) are predominant viruses associated with lower respiratory tract infection in infants. We compared the symptoms of lower respiratory tract infection caused by RSV and RV in hospitalized infants. RV showed the same symptoms as RSV, so on clinical grounds, no difference can be made between these pathogens. No relation between polymerase chain reaction cycle threshold value and length of hospital stay was found.

Etiological diagnosis reduces the use of antibiotics in infants with bronchiolitis

OBJECTIVE:Acute bronchiolitis is a leading cause of infant hospitalization and is most commonly caused by respiratory syncytial virus. Etiological tests are not required for its diagnosis, but the influence of viral screening on the therapeutic approach for acute bronchiolitis remains unclear.METHODS:A historical cohort was performed to assess the impact of viral screening on drug prescriptions. The study included infants up to one year of age who were hospitalized for bronchiolitis. Virus screening was performed using immunofluorescence assays in nasopharyngeal aspirates. The clinical data were obtained from the patients' medical records. Therapeutic changes were considered to be associated with viral screening when made within 24 hours of the release of the results.RESULTS:The frequency of prescriptions for beta agonists, corticosteroids and antibiotics was high at the time of admission and was similar among the 230 patients. The diagnosis of pneumonia and otitis was associated with the introduction of antibiotics but did not influence antibiotics maintenance after the results of the virus screening were obtained. Changes in the prescriptions were more frequent for the respiratory syncytial virus patients compared to patients who had negative viral screening results (p = 0.004), especially the discontinuation of antibiotics (p<0.001). The identification of respiratory syncytial virus was associated with the suspension of antibiotics (p = 0.003), even after adjusting for confounding variables (p = 0.004); however, it did not influence the suspension of beta-agonists or corticosteroids.CONCLUSION:The identification of respiratory syncytial virus in infants with bronchiolitis was independently associated with the discontinuation of antibiotics during hospitalization.

New respiratory viruses in children 2 months to 3 years old with recurrent wheeze

Respiratory viruses are associated with respiratory exacerbations, more frequently Respiratory Syncytial Virus in infants and Rhinovirus in children. To evaluate the prevalence and epidemiological features of newer and traditional respiratory viruses in infants and young children with recurrent wheeze. Cross sectional, prospective and descriptive study. Patients with recurrent wheeze and risk factors for asthma, age 2 months to 3 years, hospitalized with bronchial obstruction were included. On admission a respiratory sample was obtained through a nasopharyngeal aspirate. Immunofluorescence was performed to detect Respiratory Syncytial Virus, Adenovirus, Parainfluenza 1, 2, 3 and Influenza A and B. Polymerase Chain Reaction was used to detect Rhinovirus, Enterovirus, Metapneumovirus, Bocavirus, Adenovirus and Coronavirus. 119 patients (61 female), age (x E DS) 1.5 E 0.9 years were included. Days on admission and on oxygen requirement were, respectively (x E DS): 6.3 E 2.9 y 4.4 E 2.7. One hundred and two (86%) positive cases were diagnosed. Fifty five percent of the viruses were detected by Immunofluorescence and 45% by Polymerase Chain Reaction. A single virus was present in 75% of the samples, 22% had a double co-infection and 3% a triple virus co-infection. Overall, the prevalence of detected respiratory viruses was: Respiratory Syncytial Virus 55 (43%); Rhinovirus 30 (23%); Metapneumovirus 13 (10%); Influenza A 8 (6%); Enterovirus 6 (5%); Bocavirus 6 (5%); Adenovirus 4 (3%); Coronavirus 3 (2%); Parainfluenza 1: 2 (1%); Influenza B, 1 (1%) and Parainfluenza 3: 1 (1%). Infants and young children with recurrent wheeze and risk factors for asthma hospitalized for bronchial obstruction present a high prevalence of respiratory viruses. Hospital admissions were more frequent during months of higher respiratory circulation.

EMLA Cream and Nitrous Oxide to Alleviate Pain Induced by Palivizumab (Synagis) Intramuscular Injections in Infants and Young Children

Palivizumab (Synagis [Abbot Laboratories, Kent, United Kingdom]) is recommended for the prevention of severe lower respiratory tract infections caused by respiratory syncytial virus in infants at high risk. These injections are very painful, and currently the use of analgesics is not systematic. The objective of this study was to compare the efficacy of EMLA with premixed 50% nitrous oxide/oxygen, used alone or combined with EMLA, for pain alleviation during palivizumab injections. This randomized, double-blind, multicenter study included children who were younger than 24 months. Each child randomly received during the first 3 monthly injections 3 different analgesic interventions: (1) EMLA: application of EMLA plus air inhalation; (2) nitrous oxide/oxygen: inhalation of 50/50 nitrous oxide/oxygen plus application of a placebo cream; and (3) nitrous oxide/oxygen plus EMLA: inhalation of 50/50 nitrous oxide/oxygen plus application of EMLA. Each child was his or her own control. Procedural pain was assessed through videotapes with the Modified Behavioral Pain Scale. The procedure itself was subdivided in 2 periods: (1) injection and (2) recovery (first 30 seconds after the removal of the needle). Modified Behavioral Pain Scale scores over time (injection and recovery periods) and among treatments were compared by repeated-measures analysis of variance. Fifty-five children were included. Mean +/- SD Modified Behavioral Pain Scale pain scores for EMLA, nitrous oxide/oxygen, and nitrous oxide/oxygen plus EMLA were, respectively, 9.3 +/- 1.0, 8.8 +/- 1.2, and 8.2 +/- 1.8 during the injection and 7.8 +/- 1.7, 7.4 +/- 1.9, and 6.9 +/- 2.4 during the recovery period. A significant time and treatment effect in favor of the combined nitrous oxide/oxygen plus EMLA was observed. The administration of 50/50 nitrous oxide/oxygen to infants and young children is effective in decreasing the pain associated with palivizumab intramuscular injections. The combined nitrous oxide/oxygen plus EMLA cream was more effective than either EMLA cream or nitrous oxide/oxygen alone.

Use of Palivizumab for Prevention of Hospitalization as a Result of Respiratory Syncytial Virus in Infants With Cystic Fibrosis

The Palivizumab Outcomes Registry collected data on 19,548 high-risk infants who received > or =1 dose of palivizumab and followed prospectively from 2000 through 2004. Ninety-one children with cystic fibrosis (CF) were identified who received palivizumab off label. None of the infants with CF who received prophylaxis was hospitalized as a result of respiratory syncytial virus lower respiratory tract infection. Evaluations of palivizumab use in infants with CF could be warranted.

LOWER RESPIRATORY TRACT INFECTION CAUSED BY RESPIRATORY SYNCYTIAL VIRUS IN INFANTS: THE ROLE PLAYED BY SPECIFIC ANTIBODIES

Respiratory syncytial virus (RSV) is a major etiological agent of lower respiratory tract infection in infants. Genotypes of this virus and the role of the infants' serum antibodies have yet to be fully clarified. This knowledge is important for the development of effective therapeutic and prophylactic measures. To evaluate the types and genotypes of RSV causing respiratory tract infection in infants, to analyze the association of subtype-specific serum antibodies with the occurrence of infection and to evaluate the presence of subtype-specific antibodies in the infants' mothers and their association with the profile of the childrens' serum antibodies. This was a prospective study on infants hospitalized with respiratory infection. Nasopharyngeal secretions were collected for viral investigation using indirect immunofluorescence and viral culture and blood was collected to test for antibodies using the Luminex Multiplex system. 192 infants were evaluated, with 60.9% having RSV (73.5%- A and 20.5% B). Six genotypes of the virus were identified: A5, A2, B3, B5, A7 and B4. The seroprevalence of the subtype-specific serum antibodies was high. The presence and levels of subtype-specific antibodies were similar, irrespective of the presence of infection or the viral type or genotype. The mothers' antibody profiles were similar to their infants'. Although the prevalence of subtype-specific antibodies was elevated, these antibodies did not provide protection independently of virus type/genotype. The similarity in the profiles of subtype-specific antibodies presented by the mothers and their children was consistent with transplacental passage.

Influenza and respiratory syncytial virus in infants and children: relationship with attendance at a paediatric emergency unit and characteristics of the circulating strains

A study was carried out on 2,696 Italian children, aged 0-14 years. The goals were: (1) to define the age-related impact of acute respiratory infections (ARI), measured as the risk of attendance at the Paediatric Emergency Room, (2) to better define the importance and proportion of influenza and respiratory syncytial virus (RSV) infections and (3) to acquire deeper knowledge of the influenza strains circulating in infants and children. A standardised emergency unit attendance risk (EUAR) was calculated, by age group for ARI. Specific EUARs were also calculated for the two pathogens. Pharyngeal swabs were tested by polymerase chain reaction (PCR) for influenza and RSVs. Isolation in Madine-Darby canine kidney cells (MDCK) and Hep cells, haemagglutination inhibition (HI) testing and HA1 gene sequence analysis were performed for influenza viruses. Most of the patients enrolled were aged 0-5 years, 1,139 (84.6%) and 1,061 (78.5%) in the two seasons, respectively. The most represented age class was that of 1 year olds (331 cases in 2001-2002 and 301 in 2002-2003). The highest EUAR for ARI was in patients aged 0-3 years (16.8 and 12.9 during the two seasons). The same was observed on calculating this risk by specific pathogens: 17.4 and 5.5 for influenza and 13.0 and 12.7 for RSV. Virological analysis was performed on 2,696 samples, 595 of which proved positive (22%). The highest number of isolates (326) came from patients aged 1-3 years. RSVs were more often identified than influenza viruses in infants aged up to 1 year (32 vs. 20 isolates). Of 265 strains isolated in 2001-2002, 103 were RSVs (87 type A, 16 B) and 162 were influenza (90 type A, 72 B). HI showed that influenza B viruses were related to two lineages, B/Victoria/2/87 (32%) and B/Yamagata/16/88 (68%). Of 330 strains isolated in 2002-2003, 102 were RSVs (91 type A, 11 B) and 228 were influenza viruses (220 type A, 8 B). A/H3N2 strains belonged to two clusters, A/Panama/2007/99-like and A/Fujian/411/02-like, a new variant. This paper discusses the possible role of the identified flu strains in determining EUARs among the population by age class.

Palivizumab in the prophylaxis of respiratory syncytial virus infection

Respiratory syncytial virus infection continues to be one of the most important health problems in infancy. Active prophylaxis against this infection (i.e., vaccination) is not available. Therefore, protection of high-risk infants is possible only by passive prophylaxis with specific antibodies. Palivizumab (Synagis®) and respiratory syncytial virus intravenous immune globulin are licensed by the US Food and Drug Administration for the prevention of severe lower respiratory tract infections caused by respiratory syncytial virus in infants with bronchopulmonary dysplasia, infants with a history of premature birth (≤35 weeks gestational age) and children with hemodynamically significant congenital heart disease. Palivizumab is a humanized monoclonal antibody produced by recombinant DNA technology, directed to an epitope in the A antigenic side of the F-protein of the respiratory syncytial virus. This review discusses the characteristics of this drug in detail.