RSV and Influenza

Treatment and Prevention
  • Birgit von Hoersten
  • Mike Sharland
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 549)


Clinical and experimental studies have demonstrated that the pathophysiology of RSV infection is largely due to host responses rather than cytopathic effects of the virus. Therefore the use of anti-inflammatory agents such as steroids appears to be an attractive therapeutic option. This has been studied extensively and a recent meta-analysis concludes that the use of steroids does not reduce the length of stay in hospital by a clinically relevant time (Garrison et al., 2000). A further multicenter RCT study using intravenous Dexamethasone in patients admitted to PICU also did not demonstrate an effect in length of stay in hospital. A subgroup analysis of young infants with bronchiolitis suggested a reduction in duration of ventilation (van Woensel et al., 2003).


Respiratory Syncytial Virus Influenza Vaccine Acute Otitis Medium Respiratory Syncytial Virus Infection Swine Influenza 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Academy of Pediatrics (AAP) Committee on Infectious Diseases. (1997). Respiratory syncytial virus immune globulin intravenous: Indications for use. Pediatrics 99, 645–650.Google Scholar
  2. Bisgaard, H. for the Study Group on Montelukast and Respiratory Syncytial Virus. (2003). A randomized trial of Montelukast in respiratory syncytial virus postbronchiolitis. Am. J. Respir. Crit. Care Med. 167, 379–383.PubMedCrossRefGoogle Scholar
  3. Boivin, G., Hardy, I., Tellier, G., and Maziade, J. (2000). Predicting influenza infections during epidemics with use of a clinical case definition. Clin. Infect. Dis. 31, 1166–1169.PubMedCrossRefGoogle Scholar
  4. CDC. (2002). Expansion of eligibility for influenza vaccine through the Vaccines for Children Program [Notice to readers]. MMWR 51, 864, 865.Google Scholar
  5. Clark, S.J., Beresford, M.W., Subhedar, N.V., and Shaw, N.J. (2000). Respiratory syncytial virus infection in high risk infants and the potential impact of prophylaxis in a United Kingdom cohort. Arch. Dis. Child. 83, 313–316.PubMedCrossRefGoogle Scholar
  6. Cooper, N.J., Sutton, A.J., Abrams, K.R., Wailoo, A., Turner, D.A., and Nicholson, K.G. (2003). Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: Systematic review of randomised controlled trials. BMJ 326, 1235–1240.PubMedCrossRefGoogle Scholar
  7. Frank, A.L., Taber, L.H., Wells, C.R,. Wells, J.M., Geyen, W.P., and Predes, A. (1981). Patterns of shedding of myxoviruses and paramyxoviruses in children. J. Infect. Dis. 144, 433–441.PubMedCrossRefGoogle Scholar
  8. Garrison, M.M., Christakis, D.A., Harvey, E., Cummings, P., and Davis, R.L. (2000). Systemic corticosteroids in infant bronchiolitis: A meta-analysis. Pediatrics 105, e44.PubMedCrossRefGoogle Scholar
  9. Green Book. (1996). Chapter 20. Influenza. Available at
  10. Hall, C.B., Dolin, R., Gala, C.L., Markovitz, D.M., Zhang, Y.O., Madore, P.H. et al. (1987). Children with influenza A infection: Treatment with Rimantadine. Pediatrics 80, 275–282.PubMedGoogle Scholar
  11. Health Protection Agency Communicable Disease Surveillance Centre. (2003). Laboratory reports to CDSC of infections due to respiratory syncytial virus, England and Wales, by date of report 1990-2003 (four weekly). In Public Health Laboratory Service website [online]. Health Protection Agency, London [cited 31 July 2003]. Available at
  12. Hendrick, J.A., Barzilai, A., and Behre, U. (2000). Zanamivir for treatment of symptomatic influenza A and B infection in children five to twelve years of age: A randomized controlled trial. Pediatr. Infect. Dis. J. 19, 410–417.CrossRefGoogle Scholar
  13. Hoberman, A., Greenberg, D.P., Paradise, J.L., Rockette, H.E., Lave, J.R., Kearney, D.H. et al. (2003). Efficacy of inactivated influenza vaccine in preventing acute otitis media in children. JAMA 290, 1608–1616.PubMedCrossRefGoogle Scholar
  14. Izurieta, H.S., Thompson, W.W., Kramarz, P., Shay, D.K., Davis, R.L., DeStefano, F. et al. (2000). Influenza and the rates of hospitalisation for respiratory disease among infants and young children. N. Engl. J. Med. 342, 232–239.PubMedCrossRefGoogle Scholar
  15. Joffe, S., Ray, G.T., Escobar, G.J., Black, S.B., and Lieu, T.A. (1999). Cost-effectiveness of respiratory syncytial virus prophylaxis among preterm infants. Pediatrics 104, 419–427.PubMedCrossRefGoogle Scholar
  16. Joint Committee on Vaccination and Immunisation (JCVI), Department of Health. (2002). Minutes of the Meeting held on Friday 1 November 2002. Available at
  17. Kellner, J.D., Ohlsson, A., Gadomski, A.M., and Wang, E.E. (1996). Efficacy of bronchodilator therapy in bronchiolitis: A meta-analysis. Arch. Pediatr. Adolesc. Med. 150, 1166–1172.PubMedCrossRefGoogle Scholar
  18. Lasky, T., Terracciano, G.J., Magder, L., Koski, C.L., Ballesteros, M., Nash, D. et al. (1998). Guillain-Barre syndrome and the 1992-1993 and 1993-1994 influenza vaccines. N. Engl. J. Med. 339, 1797–1802.PubMedCrossRefGoogle Scholar
  19. Neuzil, K.M., Wright, P.F., Mitchel, E.F., and Griffin, M.R. (2000a). Burden of influenza illness in children with asthma and other chronic medical conditions. J. Pediatr. 137, 856–864.PubMedCrossRefGoogle Scholar
  20. Neuzil, K.M., Dupont, W.D., Wright, P.F., and Edwards, K.M. (2001). Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: The pediatric experience. Pediatr. Infect. Dis. J. 20, 733–740.PubMedCrossRefGoogle Scholar
  21. Neuzil, K.M., Meilen, B.G., Wright, P.F., Mitchel, E.F., and Griffin, M.R. (2000b). Effect of influenza on hospitalisations, outpatient visits, and courses of antibiotics in children. N. Engl. J. Med. 342, 225–231.PubMedCrossRefGoogle Scholar
  22. NICE. (2003). Guidance on the use of Zanamivir, Oseltamivir and Amantadine for the treatment of influenza. Technology Appraisal No. 58 National Institute of Clinical Excellence February 2003. Available at http://www. nice. org. uk/pdf/58_Flu_fullguidance.pdf
  23. Piedra, P.A. (2003). Clinical experience with respiratory syncytial virus vaccines. Pediatr. Infect. Dis. J. 22, S94–S99.PubMedGoogle Scholar
  24. Romero, J.R. (2003). Palivizumab prophylaxis of respiratory syncytial virus disease from 1998 to 2002: Results from four years of palivizumab usage. Pediatr. Infect. Dis. J. 22, S46–S54.PubMedGoogle Scholar
  25. The IMpact-RSV Study Group. (1998). Palivizumab, a humanized monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 102, 531–537.CrossRefGoogle Scholar
  26. Thomas, M., Bedford-Russel, A., and Sharland, M. (2000). Hospitalisation for RSV infection in ex-preterm infants—implications for use of RSV immune globulin. Arch. Dis. Child. 83, 122–127.PubMedCrossRefGoogle Scholar
  27. Tibby, S.M., Hatherill, M., Wright, S.M., Wilson, P., Postle, A.D., and Murdoch, I.A. (2000). Exogenous surfactant supplementation in infants with respiratory syncytial virus bronchiolitis. Am. J. Respir. Crit. Care Med. 162, 1251–1256.PubMedGoogle Scholar
  28. Torrence, P.F. and Powell, L.D. (2002). The quest for an efficacious antiviral for respiratory syncytial virus. Antivir. Chem. Chemother. 13, 325–344.PubMedGoogle Scholar
  29. Uyeki, T.M. (2003). Influenza diagnosis and treatment in children: A review of studies on clinically useful tests and antiviral treatment for influenza. Pediatr. Infect. Dis. J. 22, 164–177.PubMedGoogle Scholar
  30. van Woensel, J.B.M., van Aalderen, W.M.C., de Weerd, W., Jansen, N.J.G., van Gestel, J.P.J., Markhorst, D.G. et al. (2003). Dexamethasone for treatment of patients mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus. Thorax 58, 383–387.PubMedCrossRefGoogle Scholar
  31. Wainwright, C., Altamirano, L., Cheney, M., Cheney, J., Barber, S., Price, D. et al. (2003). A multicenter, randomized, double-blind, controlled trial of neblized Epinephrine in infants with acute bronchiolitis. N. Engl. J. Med. 349, 27–35.PubMedCrossRefGoogle Scholar
  32. Whitley, R.J., Hayden, F.G., Reisinger, K.S., Young, N., Dutkowski, R., Ipe, D. et al. (2001). Oral Oseltamivir treatment of influenza in children. Pediatr. Infect. Dis. J. 20, 127–133.PubMedCrossRefGoogle Scholar
  33. WHO. (2003). 56th World Health Assembly. Prevention and control of influenza pandemics and annual epidemics (agenda item 14.14). WHO, Geneva, 26 May 2003 (Draft A56/63). Available at http://www. who. int/bg/EB_WHA/PDF/WHA56/ea5663.pdf
  34. Zambon, M. and Hayden, F.G. (2001). Position statement: Global neuraminidase inhibitor susceptibility network. Antiviral. Res. 49, 147–156.PubMedCrossRefGoogle Scholar
  35. Zangwill, K.M. (2003). Cold-adapted, live attenuated intranasal influenza vaccine. Pediatr. Infect. Dis. J. 22, 273–274.PubMedGoogle Scholar
  36. Zeiger, R.S. (2002). Current issues with influenza vaccination in egg allergy. J. Clin. Immunol. 110, 834–840.CrossRefGoogle Scholar

Copyright information

© Science+Business Media New York 2004

Authors and Affiliations

  • Birgit von Hoersten
  • Mike Sharland

There are no affiliations available

Personalised recommendations