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Respiratory syncytial virus infection in children with congenital heart disease: A review

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Abstract

This paper reviews recent changes in morbidity and mortality of respiratory syncytial virus (RSV) infection in infants with congenital heart disease. Mortality since the late 1970s has declined substantially, from approximately 37% to 3%. Although the frequency of admission to intensive care units has declined from approximately 60% to 30%, the frequency for mechanical ventilatory support has not changed significantly. Because mortality dropped prior to the widespread use of ribavirin, it is difficult to ascribe the improvement to this therapy. In infants with congenital heart disease (CHD), nosocomial infection remains a significant problem, accounting for approximately 33% of the RSV cases. Some authors report significant reductions in hospital-acquired RSV by use of gloves and gowns for contacts with infectious cases. Efforts at primary prevention have encountered problems with development of an RSV vacine. Preliminary data from studies of passive immunization using immune globulins with high RSV antibody titers suggest that this therapy may reduce the severity of RSV infection in infants with serious heart disease.

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References

  1. Albert RK, Condie F (1981) Hand-washing patterns in medical intensive-care units.N Engl J Med 304: 1465–1466

    Article  PubMed  CAS  Google Scholar 

  2. Bruhn FW, Yeager AS (1977) Respiratory syncytial virus in early infancy: circulating antibody and the severity of infection.Am J Dis Child 131: 145–148

    PubMed  CAS  Google Scholar 

  3. Collins P, Davis A, Lubeck M, et al (1989) Evaluation of the protective efficacy of recombinant vaccinia viruses and adenoviruses that express respiratory syncytial virus glycoproteins. In:Modern Approaches to New Vaccines Including Prevention of AIDS, Abstracts of 1989 meeting, September 1989, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, p 26

    Google Scholar 

  4. Committee on Infectious Disease (1987) Ribavirin therapy of respiratory syncytial virus.Pediatrics 79:475–476

    Google Scholar 

  5. Garner JS, Simmons BP (1983) Guideline for isolation precautions in hospitals.Infect Control 4(Suppl):245–325

    PubMed  CAS  Google Scholar 

  6. Glezen WP, Paredes A, Allison JE, Taber LH, Frank AL (1981) Risk of respiratory syncytial virus infection for infants from lowincome families in relationship to age, sex, ethnic group, and maternal antibody level.J Pediatr 98:708–715

    Article  PubMed  CAS  Google Scholar 

  7. Glezen WP, Taber LH, Frank AL, Kasel JA (1986) Risk of primary infection and reinfection with respiratory syncytial virus.Am J Dis Child 140:543–546

    PubMed  CAS  Google Scholar 

  8. Groothuis JR, Simoes EAF, Levin MJ, et al (1993) Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children.N Engl J Med 329:1524–1530

    Article  PubMed  CAS  Google Scholar 

  9. Groothuis JR, Woodin KA, Katz R, et al (1990) Early ribavirin treatment of respiratory syncytial viral infection in high-risk children.J Pediatr 117:792–798

    PubMed  CAS  Google Scholar 

  10. Hall CB (1992) Respiratory syncytial virus. In: Feigin RD, Cherry JD (eds)Textbook of Pediatric Infection Disease, 3rd edn, Saunders, Philadelphia, pp 1663–1756

    Google Scholar 

  11. Hall CB, McBride JT, Gala CL, Heldreth SW, Schnabel KC (1985) Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease.JAMA 254:3047–3051

    Article  PubMed  CAS  Google Scholar 

  12. Hall CB, McBride JT, Walsh EE, et al (1983) Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection: a randomized double-blind study.N Engl J Med 308:1443–1447

    Article  PubMed  CAS  Google Scholar 

  13. Hemming VG, Prince GA, London WT, et al (1988) Topically administered immunoglobulin reduces pulmonary respiratory syncytial virus shedding in owl monkeys.Antimicrob Agents Chemother 32:1269–1270

    PubMed  CAS  Google Scholar 

  14. Hemming VG, Prince GA, Rodriguez W, et al (1988) Respiratory syncytial virus infections and intravenous gamma-globulins.Pediatr Infect Dis J 7(Suppl):103–506

    Google Scholar 

  15. Hemming VG, Rodriguez W, Kim HW, et al (1987) Intravenous immunoglobulin treatment of respiratory syncytial virus infections in infants and young children.Antimicrob Agents Chemother 31:1882–1886

    PubMed  CAS  Google Scholar 

  16. Henderson FW, Collier AM, Clyde WA Jr, Denny FW (1979) Respiratory syncytial virus infections, reinfections and immunity: a prospective longitudinal study in young children.N Engl J Med 300:530–534

    Article  PubMed  CAS  Google Scholar 

  17. Hughes JH, Mann DR, Hamparian VV (1988) Detection of respiratory syncytial virus in clinical specimens by viral culture, direct and indirect immunofluorescence, and enzyme immunoassay.J Clin Microbiol 26:588–592

    PubMed  CAS  Google Scholar 

  18. Kapikian AZ, Mitchell RH, Chanock RM, Shevdoff RA, Stewart CE (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

    PubMed  CAS  Google Scholar 

  19. Kellogg JA (1991) Culture vs direct antigen assays for detection of microbial pathogens from lower respiratory tract specimens suspected of containing the respiratory syncytial virus.Arch Pathol Lab Med 115:451–458

    PubMed  CAS  Google Scholar 

  20. Kim HW, Arrobio JO, Brandt CD, et al (1973) Safety and antigenicity of temperature-sensitive (TS) mutant respiratory syncytial virus (RSV) in infants and children.Pediatrics 52:56–63

    PubMed  CAS  Google Scholar 

  21. Kim HW, Canchola JG, Brandt CD, et al (1969) Respiratory syncytial virus disease in infants despite prior administration of an antigenic inactivated vaccine.Am J Epidemiol 89:422–434

    PubMed  CAS  Google Scholar 

  22. Kim HW, Leikin SL, Arrobio J, et al (1986) Cell-mediated immunity to respiratory syncytial virus induced by inactivated vaccine or by infection.Pediatr Res 10:75–78

    Google Scholar 

  23. Lamprecht CL, Krause HE, Mufson MA (1976) Role of maternal antibody in pneumonia and bronchiolitis due to respiratory syncytial virus.J Infect Dis 134:211–217

    PubMed  CAS  Google Scholar 

  24. Leclair JM, Freeman J, Sullivan BF, Crowley CM, Goldmann DA (1987) Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions.N Engl J Med 317:329–334

    Article  PubMed  CAS  Google Scholar 

  25. MacDonald NE, Hall CB, Suffin SC, et al (1982) Respiratory syncytial viral infection in infants with congenital heart disease.N Engl J Med 307:397–400

    Article  PubMed  CAS  Google Scholar 

  26. McIntosh K (1993) Respiratory syncytial virus—successful immunoprophylaxis at last.N Engl J Med 329:1572–1574

    Article  PubMed  CAS  Google Scholar 

  27. Meert K, Heidemann S, Lieh-Lai M, Sarnaik AP (1989) Clinical characteristics of respiratory syncytial virus infections in healthy versus previously compromised host.Pediatr Pulmonol 7:167–170

    PubMed  CAS  Google Scholar 

  28. Meissner HC, Fulton DR, Groothuis JR (1993) Controlled trial to evaluate protection of high risk infants against respiratory syncytial virus disease by using standard intravenous immune globulin.Antimicrob Agents Chemother 37:1655–1658

    PubMed  CAS  Google Scholar 

  29. Moler FW, Khan AS, Meliones JN, et al (1992) Respiratory syncytial virus morbidity and mortality estimates in congenital heart disease patients: a recent experience.Crit Care Med 20:1406–1413

    Article  PubMed  CAS  Google Scholar 

  30. Murphy BR, Graham BS, Prince GA, et al (1986) Serum and nasal-wash immunoglobulin G and A antibody response of infants and children to respiratory syncytial virus F and G glycoproteins following primary infection.J Clin Microbiol 23:1009–1014

    PubMed  CAS  Google Scholar 

  31. Navas L, Wang E, de Carvalho V, et al (1992) Improved outcome of respiratory syncytial virus infection in a high-risk hospitalized population of Canadian children.J Pediatr 121:348–354

    PubMed  CAS  Google Scholar 

  32. Ogilvie MM, Vathenen AS, Radford M, Codd J, Key S (1981) Maternal antibody and respiratory syncytial virus infection in infancy.J Med Virol 7:263–271

    PubMed  CAS  Google Scholar 

  33. Olsen MA, Shuck KM, Sambol AR (1993) Evaluation of Abbott TestPack RSV for the diagnosis of respiratory syncytial virus infections.Diagn Microbiol Infect Dis 16:105–109

    Article  PubMed  CAS  Google Scholar 

  34. Parrott RH, Kim HW, Arrobio JO, et al (1973) Epidemiology of respiratory syncytial virus infection in Washington, DC. II. Infection and disease with respect to age, immunologic status, race and sex.Am J Epidemiol 98:289–300

    PubMed  CAS  Google Scholar 

  35. Prince GA, Hemming VG, Horswood RL, Chanock RM (1985) Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat.Virus Res 3:193–206

    Article  PubMed  CAS  Google Scholar 

  36. Smith DW, Frankel LR, Mathers LH, et al (1991) A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial infection.N Engl J Med 325:24–29

    Article  PubMed  CAS  Google Scholar 

  37. Stretton M, Ajizian SJ, Mitchell I, Newth CJL (1992) Intensive care course and outcome of patients infected with respiratory syncytial virus.Pediatr Pulmonol 13:143–150

    PubMed  CAS  Google Scholar 

  38. Tristam DA, Welliver RC, Mohar CK, et al (1993) Immunogenicity and safety of respiratory syncytial virus subunit vaccine in seropositive children 18–36 months old.J Infect Dis 167:191–195

    Google Scholar 

  39. Ward KA, Lambden PR, Ogilvie MM, Watt PJ (1983) Antibodies to respiratory syncytial virus polypeptides and their significance in human infection.J Gen Virol 64:1867–1876

    Article  PubMed  CAS  Google Scholar 

  40. Wright PF, Shinozaki T, Fleet W, et al (1976) Evaluation of live, attenuated respiratory syncytial virus vaccine in infants.J Pediatr 88:931–936

    Article  PubMed  CAS  Google Scholar 

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Fixler, D.E. Respiratory syncytial virus infection in children with congenital heart disease: A review. Pediatr Cardiol 17, 163–168 (1996). https://doi.org/10.1007/BF02505206

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