Respiratory syncytial virus infection in adults.

doi:10.1055/S-0031-1283282

Journal Article•DOI•

Respiratory syncytial virus infection in adults.

01 Aug 2011-Seminars in Respiratory and Critical Care Medicine (Semin Respir Crit Care Med)-Vol. 32, Iss: 4, pp 423-432

TL;DR: The greatest promise for reducing the impact of RSV in adults may be through immunization, however, an effective vaccine for RSV is not currently available.

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Abstract: Respiratory syncytial virus (RSV), an enveloped RNA virus in the Paramyxovirus family, is the most important cause of lower respiratory tract infection in infants and young children, accounting for ~100,000 pediatric hospitalizations and 250 deaths annually in the United States. Despite primarily being recognized as a pediatric pathogen, RSV reinfection causes substantial disease in all adult populations, including healthy young persons, old and frail individuals, those with chronic obstructive pulmonary disease and immunocompromised patients. Most illnesses are mild in adults, but significant morbidity and mortality can develop. In contrast to infants, diagnosis of RSV infections is difficult due to low virus shedding, and optimal diagnosis requires molecular tests. Unfortunately, antiviral therapy is of limited benefit. Ribavirin and palivizumab are the only approved pharmacological agents for RSV treatment and prophylaxis, respectively, and are primarily used in infants; data regarding their usefulness in adults are limited. Currently, specific antiviral therapy is generally reserved for severely immunocompromised patients or severe respiratory failure. The greatest promise for reducing the impact of RSV in adults may be through immunization. However, an effective vaccine for RSV is not currently available.

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Journal Article•DOI•

Guidelines for the management of adult lower respiratory tract infections ‐ Full version

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Mark Woodhead¹, Francesco Blasi², Santiago Ewig, Javier Garau³, G. Huchon, Margareta Ieven, Åke Örtqvist⁴, Tom Schaberg, Antoni Torres³, G. H. M. van der Heijden⁵, Robert C. Read⁶, Th J M Verheij⁵ - Show less +8 more•Institutions (6)

Manchester Royal Infirmary¹, University of Milan², University of Barcelona³, Stockholm County Council⁴, Utrecht University⁵, Royal Hallamshire Hospital⁶

01 Nov 2011-Clinical Microbiology and Infection

TL;DR: This document is an update of Guidelines published in 2005 and now includes scientific publications through to May 2010 that provides evidence-based recommendations for the most common management questions occurring in routine clinical practice in the management of adult patients with LRTI.

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768 citations

Cites background from "Respiratory syncytial virus infecti..."

...However, the study by Falsey [328] clearly showed that rapid influenza testing leads to reduction in antibiotic use in hospitalized adults....
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...However, the study by Falsey [328] clearly showed that rapid influenza testing leads to reduction in antibiotic use in hospitalized adults....
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...Falsey [328] Impact of rapid diagnosis on management of adults hospitalized with influenza RCS 4A+...
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...Proposal to apply S. pneumoniae UAT in high-risk patients without demonstrative Gram stain result PCS 3A+ Ishida et al. [305] Value of S. pneumoniae UAT PCS 3A+ Stralin et al. [306] Value of S. pneumoniae UAT PCS 3A+ Andreo et al. [307] Value of S. pneumoniae UAT PCS 3A+ Ercis et al. [308] Value of S. pneumoniae UAT PCS 3A+ Genne et al. [309] Value of S. pneumoniae UAT PCS 3A+ Lasocki et al. [310] Value of S. pneumoniae UAT RCS 4A+ Leeming et al. [311] S. pneumoniae serotype specific EIA on urine sample PCS 3A+ Van der Eerden et al. [295] Value of S. pneumoniae UAT PCS 3A+ Korsgaard et al. [316] S. pneumoniae UAT more positive after antibiotic treatment PCS 3A+ Andreo et al. [307] S. pneumoniae UAT applicable on BAL PCS 3A+ Dominguez et al. [317] S. pneumoniae UAT applied on serum PCS 3A+ Ortega et al. [300] Relation between UAT and PSI PCS 3A+ Vazquez et al. [329] S. pneumoniae UAT not positive after S. pneumoniae vaccination PCS 3A+ Dirven et al. [319] Sensitivity of three UATs similar PCS 3A+ Guerrero et al. [320] Sensitivity of UATs different on unconcentrated samples, identical on concentrated samples PCS 3A+ Blazques et al. [325] Positivity of Legionella UAT related to severity of disease PCS 3A+ Kobashi et al. [312] Evaluating the use of a Streptococcus pneumoniae urinary antigen detection kit for the management of community-acquired pneumonia in Japan PCS 3A+ Oka et al. [313] The efficacy of high-dose penicillin for community-acquired pneumonia diagnosed by pneumococcal urine antigen test RCS 4A+ Smith et al. [314] Diagnosis of Streptococcus pneumoniae infections in adults with bacteraemia and community-acquired pneumonia: clinical comparison of pneumococcal PCR and urinary antigen detection PCS 3A+ Andreo et al. [315] Persistence of Streptococcus pneumoniae urinary antigen excretion after pneumococcal pneumonia PCS 3A+ Porcel et al. [318] Contribution of a pleural antigen assay (Binax NOW) to the diagnosis of pneumococcal pneumonia PCS 4A+ Olsen et al. [321] Comparison of the sensitivity of the Legionella urinary antigen EIA kits from Binax and Biotest with urine from patients with infections caused by less common serogroups and subgroups of Legionella RCS 4A+ Blanco et al. [322] Detection of Legionella antigen in non-concentrated and concentrated urine samples by a new immunochromatographic assay RCS 4A+ Diederen et al. [323] Evaluation of the Oxoid Xpect Legionella test kit for detection of Legionella pneumophila serogroup 1 antigen in urine RCS 4A+ Alvarez et al. [324] Impact of the Legionella urinary antigen test on epidemiological trends in community outbreaks of legionellosis in Catalonia, Spain, 1990–2004 PCS 3A+ Von Baum et al. [326] Community-acquired Legionella pneumonia: new insights from the German competence network for community acquired pneumonia PCS 3A+ Steininger et al. [327] Near-patient assays for diagnosis of influenza virus infection in adult patients RCS 4A+ Falsey [328] Impact of rapid diagnosis on management of adults hospitalized with influenza RCS 4A+ What can serological tests offer in the diagnosis of pneumonia?...
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Journal Article•DOI•

Antiviral Natural Products and Herbal Medicines

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Liang Tzung Lin¹, Wen Chan Hsu², Chun Ching Lin²•Institutions (2)

Taipei Medical University¹, Kaohsiung Medical University²

01 Jan 2014-Journal of Traditional and Complementary Medicine

TL;DR: In this mini-review, a summary of the antiviral effects reported for several natural products and herbal medicines is summarized.

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377 citations

Cites background from "Respiratory syncytial virus infecti..."

...[146, 147] Currently, immunization against RSV is unavailable, and the few therapies that exist for the treatment of RSV infections such as palivizumab (monoclonal antibody against RSV fusion protein) and ribavirin (nucleoside analogue) are only moderately effective or limited in efficacy....
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Journal Article•DOI•

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

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Cameron D. Griffiths¹, Steven J. Drews¹, David J. Marchant¹•Institutions (1)

University of Alberta¹

01 Jan 2017-Clinical Microbiology Reviews

TL;DR: This article attempts to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.

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Abstract: SUMMARY Respiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission. Compounding the burden of acute RSV infections is the exacerbation of preexisting chronic airway diseases and the chronic sequelae of RSV infection. A mechanistic link is even starting to emerge between asthma and those who suffer severe RSV infection early in childhood. In this article, we discuss developments in the understanding of RSV replication, pathogenesis, diagnostics, and therapeutics. We attempt to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.

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332 citations

Cites background from "Respiratory syncytial virus infecti..."

...Antibodies to glycoproteins F and G are thought to be neutralizing in vitro and in animal models and are used as correlates of vaccine/ immune protection (212, 213)....
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Journal Article•DOI•

Respiratory syncytial virus-associated hospitalizations among infants and young children in the United States, 1997-2006.

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Lauren J. Stockman¹, Aaron T. Curns, Larry J. Anderson, Gayle Fischer-Langley•Institutions (1)

Centers for Disease Control and Prevention¹

01 Jan 2012-Pediatric Infectious Disease Journal

TL;DR: Respiratory syncytial virus hospitalization rates remained steady during 1997 to 2006 and were a substantial burden in the United States, especially among infants and young children.

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Abstract: Background Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract disease among young children in the United States. RSV-associated hospitalization increased among children in the United States during 1980 through 1996. In this study, we updated national estimates of RSV hospitalization rates among US children through 2006. Methods We conducted a retrospective analysis of hospital discharges for lower respiratory tract illness (LRTI) in children Results RSV-coded hospitalizations accounted for 24% of an estimated 5.5 million LRTI hospitalizations among children 1 year old (1.8 per 1000). An estimated 132,000 to 172,000 RSV-associated hospitalizations occurred annually in children Conclusion RSV hospitalization rates remained steady during 1997 to 2006 and were a substantial burden in the United States, especially among infants and young children. A safe and effective RSV vaccine is needed.

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303 citations

Journal Article•DOI•

Rates of Hospitalizations for Respiratory Syncytial Virus, Human Metapneumovirus, and Influenza Virus in Older Adults

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Kyle Widmer, Yuwei Zhu, John V. Williams¹, Marie R. Griffin, Kathryn M. Edwards, H. Keipp Talbot - Show less +2 more•Institutions (1)

Vanderbilt University Medical Center¹

01 Jul 2012-The Journal of Infectious Diseases

TL;DR: In adults aged ≥ 50 years, hospitalization rates for RSV and HMPV were similar to those associated with influenza, and compared with patients with confirmed influenza, patients with RSV were older and more immunocompromised.

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Abstract: Background. We performed a prospective study to determine the disease burden of respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) in older adults in comparison with influenza virus. Methods. During 3 consecutive winters, we enrolled Davidson County (Nashville, TN) residents aged ≥50 years admitted to 1 of 4 hospitals with acute respiratory illness (ARI). Nasal/throat swabs were tested for influenza, RSV, and HMPV with reverse-transcriptase polymerase chain reaction. Hospitalization rates were calculated. Results. Of 1042 eligible patients, 508 consented to testing. Respiratory syncytial virus was detected in 31 participants (6.1%); HMPV was detected in 23 (4.5%) patients; and influenza was detected in 33 (6.5%) patients. Of those subjects aged ≥65 years, 78% received influenza vaccination. Compared with patients with confirmed influenza, patients with RSV were older and more immunocompromised; patients with HMPV were older, had more cardiovascular disease, were more likely to have received the influenza vaccination, and were less likely to report fever than those with influenza. Over 3 years, average annual rates of hospitalization were 15.01, 9.82, and 11.81 per 10 000 county residents due to RSV, HMPV, and influenza, respectively. Conclusions. In adults aged ≥50 years, hospitalization rates for RSV and HMPV were similar to those associated with influenza.

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246 citations

Cites background from "Respiratory syncytial virus infecti..."

...(RSV) is a common virus in childhood, but it also has been reported as a cause of significant morbidity and mortality in the older adult population [1–4]....
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Respiratory syncytial virus infection in adults.

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