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

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Respiratory Syncytial Virus: Microbe for All Ages, Mimic of Maladies Many, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816971/9781555811976_Chap01-1.gif /docserver/preview/fulltext/10.1128/9781555816971/9781555811976_Chap01-2.gif


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
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


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
Permissions and Reprints Request Permissions
Download as Powerpoint
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
Permissions and Reprints Request Permissions
Download as Powerpoint


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: 171 175.
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: 371 379.
4. Bowden, R. A. 1997. Respiratory virus infections after marrow transplant: the Fred Hutchinson Cancer Research Center Experience. Am J. Med. 102: 27 30.
5. Chanock, R. M., and R. H. Parrott. 1965. Acute respiratory disease in infancy and childhood: present understanding and prospects for prevention. Pediatrics 36: 21 39.
6. Collins, P. L.,, K. McIntosh,, and R. M. Chanock,. 1996. Respiratory syncytial virus, p. 1313 1315. 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: 2 9.
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: 356 362.
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: 456 462.
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: 115 119.
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: 61 70.
12. Englund, J. A. 1999. Prevention strategies for respiratory syncytial virus: passive and active immunization. J. Pediatr. 135: S38 S44.
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: 389 394.
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: 1130 1132.
15. Falsey, A. R. 1998. Respiratory syncytial virus infection in older persons. Vaccine 16: 1775 1778.
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: 412 416.
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: 543 546.
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: 1524 1530.
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: 467 469.
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: 1343 1346.
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: 414 419.
22. Hall, C. B. 1983. The nosocomial spread of respiratory syncytial virus infections. Ann. Rev. Med. 34: 311 319.
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: 266 271.
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: 1283 1290.
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: 693 698.
26. Hall, C. B. 1999. Respiratory syncytial virus: a continuing culprit and conundrum. J. Pediatr. 135: S5 S7.
27. Hall, C. B.,, and C. A. McCarthy,. 1999. Respiratory syncytial virus, p. 1782 1801. 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: 25 30.
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: 530 534.
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: 619 626.
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: 2447 2455.
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: 405 421.
36. Kattan, M. 1999. Epidemiologic evidence of increased airway reactivity in children with a history of bronchiolitis. J. Pediatr. 135: S8 S13.
37. Larsen, G. L.,, and G. N. Colasurdo. 1999. Neural control mechanisms within airways: disruption by respiratory syncytial virus. J. Pediatr. 135: 21 27.
38. Ljungman, P. 1997. Respiratory virus infections in bone marrow transplant recipients: the European perspective. Am. J. Med. 102: 44 47.
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: 378 382.
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: 1189 1191.
42. Martinez, F. D. 1995. Viral infections and the development of asthma. Am. J. Respir. Crit. Care Med. 151: 1644 1648.
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: 133 138.
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: 1686 1689.
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: 544 549.
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: 525 532.
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: 315 319.
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: 792 798.
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: 23 31.
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: 584 593.
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: 454 462.
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: 1440 1446.
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: 630 636.
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: 791 795.
56. Welliver, R. C. 1999. Immunologic mechanisms of virus-induced wheezing and asthma. J. Pediatr. 135: S14 S19.
57. Whimbey, E.,, J. A. Englund,, and R. B. Couch. 1997. Community respiratory virus infections in immunocompromised patients with cancer. Am. J. Med. 102: 10 18.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error