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, Volume 54, Issue 6, pp 867–884 | Cite as

Prevention and Treatment Recommendations for Respiratory Syncytial Virus Infection

Background and Clinical Experience 40 Years After Discovery
  • Martin G. Ottolini
  • Val G. Hemming
Disease Management

Summary

Though 40 years have passed since its discovery, respiratory syncytial virus (RSV), one of the most ubiquitous viruses known, continues to evade most of our efforts to prevent or treat the clinical disease it causes. Long recognised as the most common cause of lower respiratory tract infections in virtually all children in the first 2 years of life, it has been increasingly recognised as a cause of more serious disease in several ‘high risk’ populations. These populations include infants with cardiac or pulmonary disease and infants and adults with immunodeficiencies, particularly those undergoing bone marrow transplantation.

Early attempts to immunise children with a simple formalin-inactivated vaccine led to severe disease in vaccinated children who subsequently were infected with RSV from the community. Other vaccine constructs have failed for a variety of reasons, although surface glycoprotein subunit vaccines may hold promise. For years, ribavirin, a synthetic nucleoside analogue administered by constant aerosol, has been felt by many to lead to more rapid improvement in clinical disease caused by RSV, but it is still unclear whether its benefits are truly significant.

An intravenous immunoglobulin product prepared from donors screened for the presence of high titres of RSV neutralising antibody (known as RSVIG) appears to be well tolerated and relatively effective in protecting high-risk infants against serious RSV disease, although therapeutic use has proven less dramatic. At least one monoclonal antibody undergoing current testing may prove easier to use in similar immunoprophylactic use. Results on the use of corticosteroids as supportive therapy have not been conclusive.

In short, RSV will continue to be a challenge for clinicians and researchers well into the next century.

Keywords

Respiratory Syncytial Virus Respiratory Syncytial Virus Infection Severe Respiratory Syncytial Virus Respiratory Syncytial Virus Disease Severe Respiratory Syncytial Virus Infection 

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References

  1. 1.
    Collins PL, McIntosh K, Chanock RM. Respiratory syncytial virus. In: Fields BN, Knipe DM, Howley PM, et al., editors. Fields virology. 3rd ed. Philadelphia: Raven, 1996: 1313–49Google Scholar
  2. 2.
    Hall CB. Respiratory syncytial virus. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone, 1995: 1501–19Google Scholar
  3. 3.
    Glezen WP, Denney FW. Epidemiology of acute lower respiratory disease in children. N Engl J Med 1973; 288: 498–505PubMedGoogle Scholar
  4. 4.
    Ottolini MG, Hemming VG. Respiratory syncytial viral infection: an old problem presents new challenges. Infect Med 1994; 11: 342–60Google Scholar
  5. 5.
    Bruhn FW, Mokrohinfski ST, McIntosh K. Apnea associated with respiratory syncytial virus infection in young infants. J Pediatr 1977; 90: 382–6PubMedGoogle Scholar
  6. 6.
    Parrot RH, Kim HW, Arrobio JI, et al. Epidemiology of respiratory syncytial virus in Washington, D.C.: II. Infection and disease with respect to age, immunologic status, race, and sex. Am J Epidemiol 1973; 98: 289–300Google Scholar
  7. 7.
    Beem M. Repeated infections with respiratory syncytial virus. J Immunol 1967; 98: 115–22Google Scholar
  8. 8.
    Glezen WP, Taber LH, Frank AL, et al. Risk of primary infection and reinfection with respiratory syncytial virus. Am J Dis Child 1986; 140: 543–6PubMedGoogle Scholar
  9. 9.
    Hall CB, Walsh EE, Long CE, et al. Immunity to and frequency of reinfection with respiratory syncytial virus. J Infect Dis 1991; 163: 693–8PubMedGoogle Scholar
  10. 10.
    Wellever RC, Wong DT, Sun M, et al. The development of respiratory syncytial virus-specific IgE and the release of histamine in nasopharyngeal secretions after infection. N Engl J Med 1981; 305: 841–6Google Scholar
  11. 11.
    Englund JA, Sullivan CJ, Jordan MC, et al. Respiratory syncytial virus in immunocompromised adults. Ann Intern Med 1988; 109: 203–8PubMedGoogle Scholar
  12. 12.
    Harrington RD, Hooton TM, Hackman RC, et al. An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis 1992; 165: 987–93PubMedGoogle Scholar
  13. 13.
    Whimbey E, Champlin RE, Englund JA, et al. Combination therapy with aerosolized ribavirin and intravenous immunoglobulin for respiratory syncytial virus disease in adult bone marrow transplant recipients. Bone Marrow Transplant 1995; 16: 393–9PubMedGoogle Scholar
  14. 14.
    Morris JA, Blount RE, Savage RE. Recovery of cytopathic agent from chimpanzees with coryza. Proc Soc Exp Bio Med 1956; 92: 544–9Google Scholar
  15. 15.
    Chanock RM, Finberg L. Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA): II. Epidemiologic aspects of infection in infants and young children. Am J Hyg 1957; 66: 281–90PubMedGoogle Scholar
  16. 16.
    Chanock RM, Kim WH, Vargosko AJ, et al. Respiratory syncytial virus: I. Virus recovery and other observations during 1960 outbreak of bronchiolitis, pneumonia and minor respiratory diseases in children. JAMA 1961; 176: 647–57PubMedGoogle Scholar
  17. 17.
    Beem M, Wright FH, Hamre D, et al. Association of the chimpanzee coryza agent in acute respiratory disease in children. N Engl J Med 1960; 263: 523–30PubMedGoogle Scholar
  18. 18.
    Kim HW, Arrobio JO, Brandt CD, et al. Epidemiology of respiratory syncytial virus infection in Washington, D.C.: I. Importance of the virus in different respiratory tract syndromes and temporal distribution of infection. Am J Epidemiol 1973; 98: 216–25PubMedGoogle Scholar
  19. 19.
    Belshe RB, Richardson LS, London WT, et al. Experimental respiratory syncytial virus infection of four species of primates. J Med Virol 1977; 1: 157–62PubMedGoogle Scholar
  20. 20.
    Prince GA. The pathogenesis of respiratory syncytial virus infection in infant ferrets [dissertation]. Los Angeles (CA): Univ of California at Los Angeles, 1975Google Scholar
  21. 21.
    Munoz JL, McCarthy CA, Clark ME, et al. Respiratory syncytial virus infection in C57BL/6 mice; clearance of virus from lungs with virus specific cytotoxic T cells. J Virol 1991; 65: 4494–7PubMedGoogle Scholar
  22. 22.
    Prince GA, Jenson AB, Horswood RL, et al. The pathogenesis of respiratory syncytial virus infection in cotton rats. Am J Pathol 1978; 93: 771–92PubMedGoogle Scholar
  23. 23.
    Hall CB, Walsh EE, Long CE, et al. Immunity to and frequency of reinfection with respiratory syncytial virus. J Infect Dis 1991; 163: 693–8PubMedGoogle Scholar
  24. 24.
    MacDonald NE, Hall CB, Suffin SC, et al. Respiratory syncytial viral infections in infants with congenital heart disease. N Engl J Med 1982; 307: 397–400PubMedGoogle Scholar
  25. 25.
    Hall CB, Douglas RG. Modes of transmission of respiratory syncytial virus. J Pediatr 1981; 99: 100–3PubMedGoogle Scholar
  26. 26.
    Hall CB, Geiman JM, Douglas RG. Control of nosocomial respiratory syncytial viral infections. Pediatrics 1978; 62: 728–32PubMedGoogle Scholar
  27. 27.
    Coates HV, Kendrick L, Chanock RM. Antigenic differences between two strains of respiratory syncytial virus. Proc Soc Exp Biol Med 1963; 112: 958–64PubMedGoogle Scholar
  28. 28.
    Coates HV, Ailing DW, Chanock RM. An antigenic analysis of respiratory syncytial virus isolates by a plaque reduction neutralization assay. Am J Epidemiol 1966; 83: 299–313PubMedGoogle Scholar
  29. 29.
    Fernie GF, Gerin JL. Immunochemical identification of viral and nonviral proteins of the respiratory syncytial virus virion. Infect Immun 1982; 37: 243–9PubMedGoogle Scholar
  30. 30.
    Collins PL, Wertz GM. Gene products and genome organization of human respiratory syncytial (RS) virus. In: Lerner RA, Chanock RM, Brown F, editors. Modern approaches to vaccines. Cold Spring Harbor: Cold Spring Harbor Laboratory, 1989: 297–310Google Scholar
  31. 31.
    Johnson PR, Olmsted RA, Prince GA, et al. Antigenic relatedness between glycoproteins of human respiratory syncytial virus subgroups A and B: evaluation of the contributions of F and G glycoproteins to immunity. J Virol 1987; 61: 3163–6PubMedGoogle Scholar
  32. 32.
    Cane PA, Pringle CR. Respiratory syncytial virus heterogeneity during a epidemic analysis by limited nucleotide sequencing (SH gene) and restriction mapping (N gene). J Gen Virol 1991; 72: 349–57PubMedGoogle Scholar
  33. 33.
    Anderson LJ, Hendry RM, Pierik LT, et al. Multicenter study of strains of respiratory syncytial virus. J Infect Dis 1991; 163: 858–61PubMedGoogle Scholar
  34. 34.
    Steinhoff MC. Viral vaccines for the prevention of childhood pneumonia in developing nations: priorities and prospects. Rev Infect Dis 1991; 13: S562–70PubMedGoogle Scholar
  35. 35.
    Quinlan KP, Hayani KC. Vitamin A and respiratory syncytial virus infection: serum levels and supplementation trials. Arch Pediatr Adolesc Med 1996; 150: 25–30PubMedGoogle Scholar
  36. 36.
    Beem MR. Repeated infections with respiratory syncytial virus. J Immunol 1967; 98: 1115–22PubMedGoogle Scholar
  37. 37.
    Abman SH, Ogle JW, Butler-Simon N, et al. Role of respiratory syncytial virus in early hospitalizations for respiratory distress of young patients with cystic fibrosis. J Pediatr 1988; 13: 826–30Google Scholar
  38. 38.
    Groothuis JR, Guiterrez KM, Lauer BA, et al. Respiratory syncytial virus infection in children with bronchopulmonary dysplasia. Pediatrics 1988; 82: 199–203PubMedGoogle Scholar
  39. 39.
    Fishaut M, Tubergen D, McIntosh K. Cellular response to respiratory viruses with particular reference to children with disorders of cell-mediated immunity. J Pediatr 1980; 96: 179–86PubMedGoogle Scholar
  40. 40.
    Delage G, Brocho B, Robillard L, et al. Giant cell pneumonia due to respiratory syncytial virus. Arch Pathol Lab Med 1984; 108: 623–5PubMedGoogle Scholar
  41. 41.
    Chandwani S, Borkowski W, Krasinski K, et al. Respiratory syncytial virus infection in human immunodeficiency virus-infected children. J Pediatr 1990; 117: 251–4PubMedGoogle Scholar
  42. 42.
    King JC, Burke AR, Clemens JD, et al. Respiratory syncytial virus illness in human immunodeficiency virus- and non-infected children. Pediatr Infect Dis 1993; 12: 733–9Google Scholar
  43. 43.
    Hertz MI, Englund JA, Snover D, et al. Respiratory syncytial virus-induced acute lung injury in adult patients with bone marrow transplants: a clinical approach and review of the literature. Medicine 1989; 68: 269–81PubMedGoogle Scholar
  44. 44.
    Harrington RD, Hooton TM, Hackman RC, et al. An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis 1992; 165: 987–93PubMedGoogle Scholar
  45. 45.
    Fouillard L, Mouthon L, Laporte J-P, et al. Severe respiratory syncytial virus pneumonia after autologous bone marrow transplantation: a report of three cases and review. Bone Marrow Transplant 1992; 9: 97–100PubMedGoogle Scholar
  46. 46.
    Englund JA, Anderson LJ, Rhame FS. Nosocomial transmission of respiratory syncytial virus in immunocompromised adults. J Clin Microbiol 1991; 29: 115–9PubMedGoogle Scholar
  47. 47.
    Peigue-Lafeuille H, Gazuy N, Mignot P, et al. Severe respiratory syncytial virus pneumonia in an adult renal transplant recipient: successful treatment with ribavirin. Scand J Infect Dis 1990; 22: 87–9PubMedGoogle Scholar
  48. 48.
    Whimbey E, Couch RB, Englund JA, et al. Respiratory syncytial virus pneumonia in hospitalized adult patients with leukemia. Clin Infect Dis 1995; 21: 376–9PubMedGoogle Scholar
  49. 49.
    Hall CB, Douglas RG, Geiman JM, et al. Nosocomial respiratory syncytial virus infections. N Engl J Med 1975; 293: 1343–6PubMedGoogle Scholar
  50. 50.
    Agah R, Cherry JD, Garakian AJ, et al. Respiratory syncytial virus (RSV) infection rate in personnel caring for children with RSV infections Am J Dis Child 1987; 141: 695–7PubMedGoogle Scholar
  51. 51.
    Isaacs D, Dickson H, O’Callaghan C, et al. Hand washing and cohorting in prevention of hospital acquired infections with respiratory syncytial virus. Arch Dis Child 1991; 66: 227–31PubMedGoogle Scholar
  52. 52.
    Krasinski K, LaCouture R, Holzman RS, et al. Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission. J Pediatr 1990; 116: 894–8PubMedGoogle Scholar
  53. 53.
    Guidry GG, Black-Payne CA, Payne DK, et al. Respiratory syncytial virus infection among intubated adults in a university medical intensive care unit. Chest 1991; 100: 1377–84PubMedGoogle Scholar
  54. 54.
    Takimoto CH, Cram DL, Root RK. Respiratory syncytial virus infections on an adult medical ward. Arch Intern Med 1991; 151: 706–8PubMedGoogle Scholar
  55. 55.
    Garvie DG, Gray J. Outbreak of respiratory syncytial virus in the elderly. BMJ 1983; 287: 1618–9Google Scholar
  56. 56.
    Zaroukian MH, Kashyap GH, Wentworth BB. Case report: respiratory syncytial virus infection. A cause of respiratory distress syndrome and pneumonia in adults. Am J Med Sci 1988; 295: 218–22PubMedGoogle Scholar
  57. 57.
    Kim WH, Canchola JG, Brandt CD, et al. Respiratory syncytial virus in infants despite prior administration of antigenic inactivated vaccines. Am J Epidemiol 1969; 89: 422–34PubMedGoogle Scholar
  58. 58.
    Kapikian AZ, Mitchell RH, Chanock RM, et al. An epidemiologic study of altered clinical reactivity to respiratory syncytial (RS) virus infection in children previously vaccinated with an inactivated RS virus vaccine. Am J Epidemiol 1969; 89: 405–21PubMedGoogle Scholar
  59. 59.
    Chanock RM, Kapikian AZ, Mills J, et al. Influence of immunologic factors in respiratory syncytial virus disease. Arch Environ Health 1970; 21: 347–55PubMedGoogle Scholar
  60. 60.
    Prince GA, Jenson AB, Hemming VG, et al. Enhancement of respiratory syncytial virus pulmonary pathology in cotton rats by prior intramuscular inoculation of formalin-inactivated virus. J Virol 1986; 57: 721–8PubMedGoogle Scholar
  61. 61.
    Murphy BR, Prince GA, Walsh EE, et al. Dissociation between serum neutralizing and glycoprotein antibody responses of infants and children who received inactivated respiratory syncytial virus vaccine. J Clin Microbiol 1986; 24: 197–202PubMedGoogle Scholar
  62. 62.
    Connors M, Kulkarni AB, Firestone CY, et al. Pulmonary histopathology induced by respiratory syncytial virus (RSV) challenge of formalin-inactivated RSV-immunized BALB/c mice is abrogated by depletion of CD4+ T cells. J Virol 1992; 66: 7444–51PubMedGoogle Scholar
  63. 63.
    Graham BS, Henderson GS, Tang YW, et al. Priming immunization determines T helper cytokine mRNA expression patterns in lungs of mice challenged with respiratory syncytial virus. J Immunol 1993; 151: 2032–40PubMedGoogle Scholar
  64. 64.
    McKay E, Higgins P, Tyrell D, et al. Immunogenicity and pathogenicity of temperature-sensitive modified respiratory syncytial virus in adult volunteers. Med Virol 1988; 25: 411–21Google Scholar
  65. 65.
    Belshe RB, Van Voris LP, Mufson MA, et al. Parenteral administration of live respiratory syncytial virus vaccine: results of a field trial. J Infect Dis 1982; 145: 311–9PubMedGoogle Scholar
  66. 66.
    Murphy BR. Enhanced pulmonary histopathology is observed in cotton rats immunized with formalin-inactivated respiratory syncytial virus (RSV) or purified F glycoprotein and challenged with RSV 3–6 months after immunization. Vaccine 1990; 8: 497–503PubMedGoogle Scholar
  67. 67.
    Neuzil KM, Graham BS, Priels JP, et al. Adjuvants influence RSV subunit vaccine response in BALB/c mice [abstract]. In: Abstracts of the 33rd annual Meeting of the Infectious Disease Society of America; San Francisco, 16–18 Sep 1995: 118Google Scholar
  68. 68.
    Patterson JL, Fernandez-Larsson R. Molecular mechanisms of action of ribavirin. Rev Infect Dis 1990; 12: 1139–46PubMedGoogle Scholar
  69. 69.
    Rodriguez WJ, Hall CB, Welliver R, et al. Efficacy and safety of aerosolized ribavirin in young children with influenza: a double-blind, multicenter, placebo-controlled trial. J Pediatr 1994; 125: 129–35PubMedGoogle Scholar
  70. 70.
    McClung HW, Knight V, Gilbert BE, et al. Ribavirin aerosol treatment of influenza B virus infection. JAMA 1983; 249: 2671–4PubMedGoogle Scholar
  71. 71.
    Conner E, Morrison S, Oleske J, et al. Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with human immunodeficiency virus infection. Antimicrob Agents Chemother 1993; 37: 532–9Google Scholar
  72. 72.
    Bernier R, Tremblay M, Tsoukas C, et al. Drug sensitivity of human immunodeficiency virus 1 isolates after ribavirin therapy. J Infect Dis 1997; 175: 176–8PubMedGoogle Scholar
  73. 73.
    McJunkin JE, Khan R, de los Reyes EC, et al. Treatment of severe La Crosse encephalitis with intravenous ribavirin following diagnosis by brain biopsy. Pediatrics 1997; 130: 261–6Google Scholar
  74. 74.
    Forni AL, Schluger NW, Roberts RB. Severe measles pneumonitis in adults: evaluation of clinical characteristics and therapy with intravenous ribavirin. Clin Infect Dis 1994; 19: 454–62PubMedGoogle Scholar
  75. 75.
    McCarthy AJ, Bergin M, De Silva LM, et al. Intravenous ribavirin therapy for disseminated adenovirus infection. Pediatr Infect Dis J 1995; 11: 1003–4Google Scholar
  76. 76.
    McCormick JB, King IJ, Webb PA, et al. Lassa fever: effective therapy with ribavirin. N Engl J Med 1986; 164: 1119–27Google Scholar
  77. 77.
    Connor J. Ribavirin pharmacokinetics. Pediatr Infect Dis J 1990; 9: S91–2PubMedGoogle Scholar
  78. 78.
    Hruska JF, Bernstein JM, Douglas RG, et al. Effects of ribavirin on respiratory syncytial virus in vitro. Antimicrob Agents Chemother 1980; 17: 770–5PubMedGoogle Scholar
  79. 79.
    Hall CB. Ribavirin: beginning the blitz on respiratory viruses? Pediatr Infect Dis J 1985; 4: 668–71Google Scholar
  80. 80.
    Virazole® product information/package insert. 1996 ICN Pharmaceuticals, Costa Mesa, CaliforniaGoogle Scholar
  81. 81.
    Hruska JF, Morrow PE, Suffin SC, et al. In vivo inhibition of respiratory syncytial virus by ribavirin. Antimicrob Agents Chemother 1982; 21: 125–30PubMedGoogle Scholar
  82. 82.
    Hall CB, Walsh EE, Hruska JF, et al. Ribavirin treatment of experimental respiratory syncytial virus infection. JAMA 1983; 249: 2666–70PubMedGoogle Scholar
  83. 83.
    Hall CB, McBride JT, Walsh EE, et al. Aerosolized treatment of infants with respiratory syncytial virus infection. N Engl J Med 1983; 308: 1443–7PubMedGoogle Scholar
  84. 84.
    Taber LH, Knight V, Gilbert BE, et al. Ribavirin aerosol treatment of bronchiolitis associated with respiratory syncytial virus infection in children. Pediatrics 1983; 72: 613–8PubMedGoogle Scholar
  85. 85.
    Hall CB, McBride JT, Gala CL, et al. Ribavirin treatment of respiratory syncytial virus infection in infants with underlying cardiopulmonary disease. JAMA 1985; 254: 3047–51PubMedGoogle Scholar
  86. 86.
    Barry W, Cockburn F, Cornall R, et al. Ribavirin aerosol for acute bronchiolitis. Arch Dis Child 1986; 61: 593–7PubMedGoogle Scholar
  87. 87.
    Rodriguez WJ, Kim HW, Brandt CD, et al. Aerosolized ribavirin in the treatment of patients with respiratory syncytial virus disease. Pediatr Infect Dis J 1987; 6: 159–63PubMedGoogle Scholar
  88. 88.
    Conrad DA, Christenson JC, Warner JL, et al. Aerosolized ribavirin treatment of respiratory syncytial virus infection in infants hospitalized during an epidemic. Pediatr Infect Dis J 1987; 6: 152–8PubMedGoogle Scholar
  89. 89.
    Groothuis JR, Woodin KA, Katz R, et al. Early ribavirin treatment of respiratory syncytial viral infection in high-risk children. J Pediatr 1990; 117: 792–8PubMedGoogle Scholar
  90. 90.
    Smith DW, Frankel LR, Mathers LH, et al. A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection. N Engl J Med 1991; 325: 24–9PubMedGoogle Scholar
  91. 91.
    Meert KL, Sarnaik AP, Gelmini MJ, et al. Aerosolized ribavirin in mechanically ventilated children with respiratory syncytial virus lower respiratory disease: a prospective, double-blind, randomized trial. Crit Care Med 1994; 22: 566–72PubMedGoogle Scholar
  92. 92.
    Möhler FW, Steinhart CM, Ohmit SE, et al. Effectiveness of ribavirin in otherwise well infants with respiratory syncytial virus-associated respiratory failure. J Pediatr 1996; 128: 422–8Google Scholar
  93. 93.
    De Vincenzo JP, Leombruno D, Soiffer RJ, et al. Immunotherapy of respiratory syncytial virus pneumonia following bone marrow transplantation. Bone Marrow Transplant 1996; 17: 1051–6PubMedGoogle Scholar
  94. 94.
    Janai HK, Stutman HR, Zaleska M, et al. Ribavirin effect on pulmonary function in young infants with respiratory syncytial virus bronchiolitis. Pediatr Infect Dis J 1993; 12: 214–8PubMedGoogle Scholar
  95. 95.
    Ito S, Koren G. Exposure of pregnant women to ribavirin-contaminated air: risk assessment and recommendations. Pediatr Infect Dis J 1993: 12: 2–5PubMedGoogle Scholar
  96. 96.
    Shults RA, Baron S, Decker J, et al. Health care worker exposure to aerosolized ribavirin: biological and air monitoring. J Occup Environ Med 1996; 38: 257–63PubMedGoogle Scholar
  97. 97.
    Munzenberger PJ, Walker PC. Protecting hospital employees and visitors from aerosolized ribavirin. Am J Hosp Pharm 1994; 15: 823–6Google Scholar
  98. 98.
    Committee on Infectious Diseases. Ribavirin therapy of respiratory syncytial virus. Pediatrics 1987; 79: 475–7Google Scholar
  99. 99.
    Wald ER, Dashefsky B, Green M. In re ribavirin: a case of premature adjudication. J Pediatr 1987; 112: 154–8Google Scholar
  100. 100.
    Mohler FW, Sullivan BJ. Ribavirin for severe RSV infection [letter]. N Engl J Med 1991; 325: 1884–5Google Scholar
  101. 101.
    Committee on Infectious Diseases. Use of ribavirin in the treatment of respiratory syncytial virus infection. Pediatrics 1993; 92: 501–4Google Scholar
  102. 102.
    Wald ER, Dashefsky B. Ribavirin: red book committee recommendations questioned [letter]. Pediatrics 1994; 93: 672–3PubMedGoogle Scholar
  103. 103.
    Pon S, Notterman DA. Aerosolized ribavirin in mechanically ventilated children with respiratory syncytial virus lower respiratory disease [letter]. Crit Care Med 1994; 23: 787–8Google Scholar
  104. 104.
    Law BJ, Wang EEL, MacDonald N, et al. Does ribavirin impact on the hospital course of children with respiratory syncytial virus (RSV) infection? Pediatrics 1997; 99: 469–70Google Scholar
  105. 105.
    Committee on Infectious Diseases. Reassessment of the indications for ribavirin therapy in respiratory syncytial virus infections. Pediatrics 1996; 97: 137–40Google Scholar
  106. 106.
    McIntosh K, Kurachek SC, Cairns LM, et al. Treatment of respiratory syncytial viral infection in an immunodeficient child with ribavirin aerosol. Am J Dis Child 1984; 138: 305–8PubMedGoogle Scholar
  107. 107.
    Win N, Mitchell D, Pugh S, et al. Successful therapy with ribavirin of late onset respiratory syncytial virus pneumonitis complicating bone marrow transplantation. Clin Lab Haematol 1992; 14: 29–32PubMedGoogle Scholar
  108. 108.
    Suffin SC, Prince GA, Much KB, et al. Immunoprophylaxis of respiratory syncytial virus infection in the infant ferret. J Immunol 1979; 123: 10–4PubMedGoogle Scholar
  109. 109.
    Prince GA, Hemming VG, Horswood RL, et al. Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat. Virus Res 1985; 3: 193–206PubMedGoogle Scholar
  110. 110.
    Hemming VG, Fischer GW, Prince GA. Giant cell pneumonia due to respiratory syncytial virus [letter]. Arch Pathol Lab Med 1985; 109: 213PubMedGoogle Scholar
  111. 111.
    Groothuis JR, Levin MJ, Rodriguez W, et al. Use of intravenous gamma globulin to passively immunize high-risk children against respiratory syncytial virus: safety and pharmacokinetics. Antimicrob Agents Chemother 1991; 35: 1469–73PubMedGoogle Scholar
  112. 112.
    Meissner HC, Fulton DR, Groothuis JR, et al. Controlled trial to evaluate protection of high-risk infants against respiratory syncytial virus disease by using standard intravenous immune globulin. Antimicrob Agents Chemother 1993; 37: 1655–8PubMedGoogle Scholar
  113. 113.
    Groothuis JR, Simoes EAF, Levin JJ, et al. Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children. N Engl J Med 1993; 329: 1524–30PubMedGoogle Scholar
  114. 114.
    PREVENT Study Group. Reduction of respiratory syncytial virus hospitalization among premature infants and infants with bronchopulmonary dysplasia using respiratory syncytial virus immune globulin prophylaxis. Pediatrics 1997; 99: 93–9Google Scholar
  115. 115.
    Simoes EAF, Sondheimer HM, Meissner HC, et al. Respiratory syncytial virus immunoglobulin as prophylaxis against respiratory syncytial virus in children with congenital heart disease [abstract no. 662]. Pediatr Res 1996; 39: 113AGoogle Scholar
  116. 116.
    Hemming VG, Rodriguez W, Kim HW, et al. Intravenous immunoglobulin treatment of respiratory syncytial virus infections in infants and young children. Antimicrob Agents Chemother 1987; 31: 1882–6PubMedGoogle Scholar
  117. 117.
    Rodriguez WJ, Gruber WC, Groothuis J, et al. Respiratory syncytial virus immune human globulin [RSVIg] as treatment of RSV lower respiratory tract infections [LRI] in children [abstract no. 1085]. Pediatr Res 1996; 39: 183AGoogle Scholar
  118. 118.
    Rodriguez WJ, Gruber WC, Welliver RC, et al. Respiratory syncytial virus (RSV) immune globulin intravenous therapy for RSV lower respiratory tract infection in infants and young children at high risk for severe RSV infections. Pediatrics 1997; 99: 455–61Google Scholar
  119. 119.
    Siber GR, Leszczynski J, Pena-Cruz V, et al. Protective activity of a human respiratory syncytial virus immune globulin prepared from donors screened by microneutralization assay. J Infect Dis 1992; 165: 456–63PubMedGoogle Scholar
  120. 120.
    American Academy of Pediatrics Committee on Infectious Diseases, Committee on Fetus and Newborn. Respiratory syncytial virus immune globulin intravenous: indications for use. Pediatrics 1997; 99: 645–50Google Scholar
  121. 121.
    Meissner HD, Groothuis JR. Immunoprophylaxis and the control of RSV disease. Pediatrics 1997; 100: 260–3PubMedGoogle Scholar
  122. 122.
    Cote PJ, Fernie BE, Ford EC, et al. Monoclonal antibodies to respiratory syncytial virus: detection of virus neutralization and other antigen-antibody systems using infected human and murine cells. J Virol Methods 1981; 3: 137–47PubMedGoogle Scholar
  123. 123.
    Taylor G, Stott EJ, Bew M, et al. Monoclonal antibodies protect against respiratory syncytial virus infection in mice. Immunology 1984; 52: 137–42PubMedGoogle Scholar
  124. 124.
    Anderson LJ, Hierholzer JC, Tsaou C, et al. Antigenic characterization of respiratory syncytial virus strains with monoclonal antibodies. J Infect Dis 1985; 151: 626–33PubMedGoogle Scholar
  125. 125.
    Hendry RM, Pierik LT, McIntosh K. Prevalence of respiratory syncytial virus subgroups over six consecutive outbreaks: 1981–1987. J Infect Dis 1989; 160: 185–90PubMedGoogle Scholar
  126. 126.
    Beeler J, van Wyke Coelingh K. Neutralization epitopes of the F glycoprotein of respiratory syncytial virus: effect of mutation upon fusion function. J Virol 1989; 63: 2941–50PubMedGoogle Scholar
  127. 127.
    Ora Vax reports results from phase III trial of HNK20 nosedrop for respiratory syncytial virus in infants [online]. Available from: http://www.oravax.com [Accessed 1997 Mar 19]
  128. 128.
    MedImmune Inc. Results from double-blind, placebo-controlled, phase 1/2 clinical trial of Medi-493 [online]. Available from: http://www.medimmune.com [Accessed 1997 Mar 20]
  129. 129.
    MedImmune Inc. Positive MEDI-493 Phase 3 Clinical Results [online]. Available from: http://www.medimmune.com. [Accessed 1997 Jul 16]
  130. 130.
    Oski FA, Salitsky S, Barness LA. Steroid therapy in bronchiolitis: a double blind study. Am J Dis Child 1961; 102: 759AGoogle Scholar
  131. 131.
    McGeorge M. Severe obstructive bronchiolitis in infancy: treatment with hydrocortisone. Clin Pediatr 1964; 3: 11–8Google Scholar
  132. 132.
    Sussman S, Grossman M, Magoffin R, et al. Dexamethasone in obstructive respiratory tract infections in children. Pediatrics 1964; 34: 851–5PubMedGoogle Scholar
  133. 133.
    Dabbous IA, Tkachyk JS, Stamm S. A double blind study on the effects of corticosteroids in the treatment of bronchiolitis. Pediatrics 1966; 37: 477–84PubMedGoogle Scholar
  134. 134.
    Connolly JH, Field CMB, Glascow JET, et al. A double blind trial of prednisolone in epidemic bronchiolitis due to respiratory syncytial virus. Acta Paediatr Scand 1969; 58: 116–20PubMedGoogle Scholar
  135. 135.
    Leer JA, Green JL, Heimlich EM, et al. Corticosteroid treatment in bronchiolitis. Am J Dis Child 1969; 117: 495–503PubMedGoogle Scholar
  136. 136.
    Tal A, Bavilski C, Yohai D, et al. Dexamethasone and salbutamol in the treatment of acute wheezing infants. Pediatrics 1983; 71: 13–8PubMedGoogle Scholar
  137. 137.
    Logsdon PJ, Middleton E, Caffey RG. Stimulation of leukocyte adenylate-cyclase by hydrocortisone and isoproterenol in asthmatic and non-asthmatic subjects. J Allergy Clin Immunol 1980; 66: 52Google Scholar
  138. 138.
    Springer C, Bar-Yishay E, Uwayed K, et al. Corticosteroids do not affect the clinical or physiological status of infants with bronchiolitis. Pediatr Pulmonol 1990; 9: 181–5PubMedGoogle Scholar
  139. 139.
    McGowan JE, Chesney PJ, Crossley KB, et al. Guidelines for the use of systemic glucocorticoids in the management of selected infections. J Infect Dis 1992; 165: 1–13PubMedGoogle Scholar
  140. 140.
    Roosevelt G, Sheehan K, Grupp-Phelan J, et al. Dexamethasone in bronchiolitis: a randomized controlled trial. Lancet 1996; 348: 292–5PubMedGoogle Scholar
  141. 141.
    Klassen TP, Sutcliffe T, Watters L, et al. Dexamethasone in salbutamol-treated inpatients with acute bronchiolitis: a randomized controlled trial. J Pediatr 1997; 130: 191–6PubMedGoogle Scholar
  142. 142.
    Kairys SW, Olmstead EM, O’Conner GT. Steroid treatment of laryngotracheitis: a meta-analysis of the evidence from randomized trials. Pediatrics 1989; 83: 683–93PubMedGoogle Scholar
  143. 143.
    Super DM, Cartelli NA, Brooks LJ, et al. A prospective randomized double-blind study to evaluate the effect of dexamethasone in acute laryngotracheitis. J Pediatr 1989; 115: 323–9PubMedGoogle Scholar
  144. 144.
    Klassen TP, Feldman ME, Watters LK, et al. Nebulised budesonide for children with mild-to-moderate croup. N Engl J Med 1994; 331: 285–9PubMedGoogle Scholar
  145. 145.
    Prince GA, Porter DD. Treatment of parainfluenza virus type 3 bronchiolitis and pneumonia in a cotton rat model using topical antibody and glucocorticosteroid. J Infect Dis 1996; 173: 598–608PubMedGoogle Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Martin G. Ottolini
    • 1
  • Val G. Hemming
    • 1
  1. 1.F. Edward Hébert School of MedicineUSAF (Retired), Uniformed Services University of the Health SciencesBethesdaUSA

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