1 : Respiratory Syncytial Virus: Microbe for All Ages, Mimic of Maladies Many

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Respiratory syncytial virus (RSV) was discovered more than 4 decades ago. Infants who have been hospitalized with RSV bronchiolitis have been well described as having a predilection to experience recurrent wheezing. The majority of these children appear to be clinically normal for years but are at risk for having abnormal lung function later in life. An increase in asthma among children in the United States and some other countries has been documented, and the morbidity associated with asthma has risen disproportionately in certain lower-income and minority populations, the same groups who are most likely to acquire RSV infection early and more severely. Of increasing importance is RSV's ability to become an opportunistic pathogen in immunocompromised patients. A study by researchers indicates the significance RSV as a cause of admissions for lower respiratory tract disease in previously healthy adults of all ages. In this study of community-acquired lower respiratory tract infections in individuals 18 years of age or older, RSV caused 4% of the admissions. The first means of prophylaxis was only recently made available with the 1996 licensure of high-titered polyclonal RSV immunoglobulin to RSV, which is administered intravenously once a month. The currently available technology and candidate vaccines, although not yet perfected for use in infants, may be suitable and rapidly developed for varied older populations at risk for RSV illness and its complications.

Citation: Hall C. 2000. Respiratory Syncytial Virus: Microbe for All Ages, Mimic of Maladies Many, p 1-15. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch1
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Image of Figure 1.
Figure 1.

Patterns of reported cases of bronchiolitis in relation to activity of RSV in Monroe County, New York. Data obtained from a weekly community surveillance program for infectious diseases. Reprinted from ( ) with permission of the publisher.

Citation: Hall C. 2000. Respiratory Syncytial Virus: Microbe for All Ages, Mimic of Maladies Many, p 1-15. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch1
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Image of Figure 2.
Figure 2.

Clinical manifestations of RSV infection in 74 adults ranging from 20 to 62 years of age. Adapted from ( ) with permission of the publisher. White bars, percentage of all subjects with documented RSV infection; black bars, percentage of those subjects with RSV infection who also had had previous RSV infection within 6 months.

Citation: Hall C. 2000. Respiratory Syncytial Virus: Microbe for All Ages, Mimic of Maladies Many, p 1-15. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 4. ASM Press, Washington, DC. doi: 10.1128/9781555816971.ch1
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1. Aguinaga, O. I.,, P. A. Arnedo,, J. Bellido,, J. Bellido,, G. F. Guillen,, and V. M. M. Suarez. 1999. The prevalence of asthma-related symptoms in 13-14-year old children from 9 Spanish populations. The Spanish Group of the International Study of Asthma and Allergies in Childhood. Med. Clin. 112:171175.
2.American Academy of Pediatrics Committee on Infectious Diseases. 1998. Prevention of respiratory syncytial virus infections: indications for use of palivizumab and update on the use of RSVIGIV. Pediatrics 102:12111216.
3. Armstrong, D.,, K. Grimwood,, J. B. Carlin,, R. Carzino,, J. Hull,, A. Olinsky,, and P. D. Phelan. 1998. Severe viral respiratory infections in infants with cystic fibrosis. Pediatr. Pulmonol. 26:371379.
4. Bowden, R. A. 1997. Respiratory virus infections after marrow transplant: the Fred Hutchinson Cancer Research Center Experience. Am J. Med. 102:2730.
5. Chanock, R. M., and R. H. Parrott. 1965. Acute respiratory disease in infancy and childhood: present understanding and prospects for prevention. Pediatrics 36:2139.
6. Collins, P. L.,, K. McIntosh,, and R. M. Chanock,. 1996. Respiratory syncytial virus, p. 13131315. In B. N. Fields,, D. M. Knipe,, and P. M. Howley (ed.), Fields Virology. Lippincott-Raven Publishers, Philadelphia, Pa.
7. Couch, R. B.,, J. A. Englund,, and E. Whimbey. 1997. Respiratory viral infections in immunocompetent and irnmunocompromised persons. Am. J. Med. 102:29.
8. Crain, E. F.,, K. B. Weiss,, P. E. Bijur,, M. Hersh,, L. Westbrook,, and R. E. Stein. 1993. An estimate of the prevalence of asthma and wheezing among inner-city children. Pediatrics 94:356362.
9. Dowell, S. E.,, L. J. Anderson,, H. E. Gary, Jr.,, D. D. Erdman,, J. F. Plouffe,, T. M. File, Jr.,, B. J. Marston,, and R. F. Breiman. 1996. Respiratory syncytial virus is an important cause of community-acquired lower respiratory infection among hospitalized adults. J. Infect. Dis. 174:456462.
10. Englund, J. A.,, L. J. Anderson,, and F. S. Rhame. 1991. Nosocomial transmission of respiratory syncytial virus in immunocompromised adults. J. Clin. Microbiol. 29:115119.
11. Englund, J. A.,, P. A. Piedra,, and E. Wbimbey. 1997. Prevention and treatment of respiratory syncytial virus and parainfluenza viruses in irnmunocompromised patients. Am. J. Med. 102:6170.
12. Englund, J. A. 1999. Prevention strategies for respiratory syncytial virus: passive and active immunization. J. Pediatr. 135:S38S44.
13. Falsey, A. R.,, C. K. Cunningham,, W. H. Barker,, R. W. Kouides,, J. B. Yuen,, M. Menegus,, L. B. Weiner,, C. A., BonviUe,, and R. F. Betts. 1995. Respiratory syncytial virus and influenza A infection in the hospitalized elderly. J. Infect. Dis. 172:389394.
14. Falsey, A. R.,, and E. E. Walsh. 1997. Safety and immunogenicity of a respiratory syncytial virus subunit vaccine (PFP-2) in the institutionalized elderly. Vaccine 10:11301132.
15. Falsey, A. R. 1998. Respiratory syncytial virus infection in older persons. Vaccine 16:17751778.
16. Garcia, R.,, I. Raad,, D. Avi-Said,, G. Bodey,, R. Champlin,, J. Tarrand,, L. A. Hill,, J. Umphrey,, J. Neumann,, J. A. Englund,, and E. Whimbey. 1997. Nosocomial respiratory syncytial virus infections: prevention and control in bone marrow transplant patients. Infect. Control Hasp. Epidemial. 18:412416.
17. Glezen, W. P.,, L. H. Taber,, A. L. Frank,, and J. A. Kasel. 1986. Risk of primary infection and reinfection with respiratory syncytial virus. Am. J. Dis. Child. 140:543546.
18. Groothius, J. R.,, E. A. Simoes,, M. J. Levin,, C. B. Hall,, C. E. Long,, W. J. Rodrigquez,, J. Arrorio,, H. C. Meissner,, D. R. Fulton,, R. C. Welliver, et al. 1993. Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children. The Respiratory Syncytial Virus Immune Globulin Study Group. N. Engl. J. Med. 329:15241530.
19. Groothuis, J. R.,, S. J. King,, D. A. Hogerman,, P. R., Paradiso,, and E. A. Simoes. 1998. Safety and immunogenicity of a purified F protein respiratory syncytial virus (PFP-2) vaccine in seropositive children with bronchopulmonary dysplasia. J. Infect. Dis. 177:467469.
20. Hall, C. B.,, R. G. Douglas, Jr.,, J. M. Geiman,, and M. K. Messner. 1975. Nosocomial respiratory viral infections. N. Engl. J. Med. 293:13431346.
21. Hall, C. B.,, J. M. Geiman,, R. Biggar,, K. E. Kotok,, P. M. Hogan,, and G. R. Douglas, Jr. 1976. Respiratory syncytial virus infections within families. N. Engl. J. Med. 294:414419.
22. Hall, C. B. 1983. The nosocomial spread of respiratory syncytial virus infections. Ann. Rev. Med. 34:311319.
23. Hall, C. B.,, K. R. Powell,, K. C. Schnabel,, C. L. Gala,, and P. H. Pincus. 1988. The risk of secondary bacterial infection in infants hospitalized with respiratory syncytial viral infection. J. Pediatr. 113:266271.
24. Hall, C. B.,, E. E. Walsh,, K. C. Schnabel,, C. E. Long,, K. M. McConnQchie,, S. W. Hildreth,, and L. J. Anderson. 1990. The occurrence of groups A and B of respiratory syncytial virus over 15 years: the associated epidemiologic and clinical characteristics in hospitalized and ambulatory children. J. Infect. Dis. 162:12831290.
25. Hall, C. B.,, E. E. Walsh,, C. E. Long,, and K. C. Schnabel. 1991. Innnunity to and frequency of reinfection with respiratory syncytial virus. J. Infect. Dis. 163:693698.
26. Hall, C. B. 1999. Respiratory syncytial virus: a continuing culprit and conundrum. J. Pediatr. 135:S5S7.
27. Hall, C. B.,, and C. A. McCarthy,. 1999. Respiratory syncytial virus, p. 17821801. In G. L. Mandell,, J. E. Bennett,, and R. Dolin (ed.), Principles and Practice of Infectious Diseases, 5th ed. Churchill Livingstone Inc., New York, N.Y.
28. Hall, C. B., Respiratory syncytial virus. In A. J. Zuckerman,, J. E. Banatvala,, and J. R. Pattison (ed.), Principles and Practice of Clinical Virology, 4th ed., in press. John Wiley & Sons Ltd., Chichester, England.
29. Han, L. L.,, J. P. Alexander,, and L. J. Anderson. 1999. Respiratory syncytial virus pneumonia among the elderly: an assessment of disease burden. J. Infect. Dis. 179:2530.
30. Henderson, F.W,, A. M. Collier,, W. A. Clyde, Jr.,, and F. W. Denny. 1979. Respiratory syncytial virus infections, reinfections, and immunity. A prospective, longitudinal study in young children. N. Engl. J. Med. 300:530534.
31. Hiatt, P. W.,, S. C. Grace,, C. A. Kozinetz,, S. H. Raboudi,, D. G. Treece,, L. H. Taber,, and P. A. Piedra. 1999. Effects of viral lower respiratory tract infection on lung function in infants with cystic fibrosis. Pediatrics 103:619626.
32. Hussell, T.,, L. C. Spender,, A. Georgiou,, and P. J. Openshaw. 1996. Thl and Th2 cytokine induction in pulmonary T cells during infection with respiratory syncytial virus. J. Gen. Virol. 77:24472455.
33.IMpact-RSV Study Group. 1998. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 102:531537.
34.Institute of Medicine Committee on Issues and Priorities for New Vaccine Development. 1988. Prospects for immunizing against respiratory syncytial virus, p. 397409. In New Vaccine Development, Establishing Priorities, vol. I. National Academy of Sciences Press, Washington, D.C.
35. Kapikian, A. Z.,, R. H. Mitchell,, R. M. Chanock,, R. A. Shredoff,, R. A., and C,. E. Stewart. 1969. 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. 89:405421.
36. Kattan, M. 1999. Epidemiologic evidence of increased airway reactivity in children with a history of bronchiolitis. J. Pediatr. 135:S8S13.
37. Larsen, G. L.,, and G. N. Colasurdo. 1999. Neural control mechanisms within airways: disruption by respiratory syncytial virus. J. Pediatr. 135:2127.
38. Ljungman, P. 1997. Respiratory virus infections in bone marrow transplant recipients: the European perspective. Am. J. Med. 102:4447.
39. MacDonald, N. E.,, N. Wolfish,, P. McLaine,, P. Phipps,, and E. Rossier. 1986. Role of respiratory viruses in exacerbations of primary nephrotic syndrome. J. Pediatr. 108:378382.
40. Mahant, S.,, J. L. Robinson,, and E. E. L. Wang. 1997. Hospital morbidity in patients with RSV lower respiratory illness (LRI) and underlying heart disease: analysis of PICNIC RSV database. Pediatr. Res. 41(no. 4, pt. 2):78A.
41. Martinez, F. D. 1994. Role of viral infections in the inception of asthma and allergies during childhood: could they be protective? Thorax 49:11891191.
42. Martinez, F. D. 1995. Viral infections and the development of asthma. Am. J. Respir. Crit. Care Med. 151:16441648.
43. Martinez, F. D.,, A. L. Wright,, L. M. Taussig,, C. J. Holberg,, M. Halonen,, W. J. Morgan, and Group Health Medical Association. 1995. Asthma and wheezing in the first six years of life. N. Engl. J. Med. 332:133138.
44. Mazzuli, T.,, T. C. T. Peret,, A. McGeer,, D. Cann,, K. S. MacDonald,, R. Chua,, D. D. Erdman,, and L. J. Anderson. 1999. Molecular characterization of a nosocomial outbreak of human respiratory syncytial virus on an adult leukemia/lymphoma ward. J. Infect. Dis. 180:16861689.
45. Morris, J. A.,, R. E. Blount,, and R. E. Savage. 1956. Recovery of cytopathogenic agent from chimpanzees with coryza. Proc. Soc. Exp. Biol. Med. 92:544549.
46. Neuzil, K. M.,, J. E. Johnson,, Y. W. Tang,, J. P. Prjeels,, Saloui, M.,, N. Gar,, and B. S. Graham. 1997. Adjuvants influence the quantitative and qualitative immune response in BALB/c mice immunized with respiratory syncytial virus FG subunit vaccine. Vaccine 15:525532.
47. Noble, v.,, M. Murray,, M. S. Web,, J. Alexander,, A. S. Swarbrick,, and A. D. Milner. 1997. Respiratory status and allergy nine to ten years after acute bronchiolitis. Arch. Dis. Child. 76:315319.
48. Paradiso, P. R.,, S. W. Hildreth,, D. A. Hogerman,, D. J. Speelman,, E. B. Lewin,, J. Oren,, and D. H. Smith. 1994. Safety and immunogenicity of a subunit respiratory syncytial virus vaccine in children 24 to 48 months old. Pediatr. Infect. Dis. J. 94;13:792798.
49. Piedra, P.,, S. Grace,, A. Jewell,, S. Spinelli,, D. Bunting,, D. A. Hogerman,, F. Malinoski,, and P. W. Hiatt. 1996. Purified fusion protein vaccine protects against lower respiratory tract illness during respiratory syncytial virus season in children with cystic fibrosis. Pediatr. Infect. Dis. J. 15:2331.
50.PREVENT Study Group. 1997. Reduction of respiratory syncytial virus hospitalization among premature infants and infants with bronchopulmonary dysplasia using respiratory syncytial virus immune globulin prophylaxis. Pediatrics 99:9399.
51. Renzi, P. M.,, J. P. Turgeon,, J. P. Yang,, S. P. Drblik,, J. E. Marcotte,, L. Pedneault,, and S. Spier. 1997. Cellular inununity is activated and a Th-2 response is associated with early wheezing in infants after bronchiolitis. J. Pediatr. 130:584593.
52. Russo, M. J.,, K. M. McConnochie,, J. T. McBride,, P. G. Szilagyi,, A. M. Brooks,, and K. J. Roghmann. 1997. Increase in admission threshold explains stable asthma hospitalization rates. Pediatrics 104:454462.
53. Shay, D. K.,, R. C. Holman,, R. D. Newman,, L. L. Liu,, J. W. Stout,, and L. J. Anderson. 1999. Bronchiolitis-associated hospitalizations among U.S. children, 1980-1996. JAMA 782:14401446.
54. van Schaik, S. M.,, D. A. Tristram,, I. S. Nagpal,, K. M. Hintz,, R. C. Welliver,, and R. C. Welliver. 1999. Increased production of IFN-gamma and cysteinyl leukotrienes in virus-induced wheezing. J. Allergy Clin. Immunol. 103:630636.
55. Walsh, E. E.,, A. R. Falsey,, and P. A. Hennessey. 1999. Respiratory syncytial and other virus infections in persons with chronic cardiopulmonary disease. Am. J. Resp. Crit. Care Med. 160:791795.
56. Welliver, R. C. 1999. Immunologic mechanisms of virus-induced wheezing and asthma. J. Pediatr. 135:S14S19.
57. Whimbey, E.,, J. A. Englund,, and R. B. Couch. 1997. Community respiratory virus infections in immunocompromised patients with cancer. Am. J. Med. 102:1018.

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