ESPID Reports and Reviews CONTENTS RSV--More Questions 32nd Annual Meeting of ESPID

EDITORIAL BOARD

Co-Editors: Delane Shingadia and Irja Lutsar Board Members David Burgner (Melbourne, Australia) Luisa Galli (Florence, Italy) Cristiana Nascimento-Carvalho (Bahia, Brazil) Ville Peltola (Turku, Finland)

Nicole Ritz (Basel, Switzerland) Ira Shah (Mumbai, India) Matthew Snape (Oxford, UK) George Syrogiannopoulos (Larissa, Greece)

Tobias Tenenbaum (Mannhein, Germany) Marc Tebruegge (Southampton, UK) Marceline van Furth (Amsterdam, The Netherlands) Anne Vergison (Brussels, Belgium)

RSV—Still More Questions Than Answers Louis Bont, MD, PhD,* Eugenio Baraldi, MD, FCCP,† Brigitte Fauroux, MD, PhD,‡ Anne Greenough, MD, FRCPCH,§ Terho Heikkinen, MD, PhD,¶ Paolo Manzoni, MD, PhD,║ Federico Martinón-Torres, MD, PhD,** Harish Nair, MD, PhD,††‡‡ and Nikolaos G. Papadopoulos , MD, PhD§§¶¶, on behalf of ReSViNET RECENT ADVANCES Respiratory syncytial virus (RSV) infection is the leading cause of hospitalization for acute respiratory infection among infants1 and an important etiology of lower respiratory infection in young children and the elderly.2 By the end of the second year of life, most children have experienced at least 1 episode of RSV infection, and repeat infections with RSV are common. Approximately Accepted for publication August 21, 2014. From the *Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; †Women’s and Children’s Health Department, Unit of Respiratory Medicine and Allergy, Padova, Italy; ‡Necker Pediatric University Hospital, Paris Descartes University, Paris, France; §Division of Asthma, Allergy and Lung Biology, King’s College, London, United Kingdom; ¶Department of Paediatrics, University of Turku and Turku University Hospital, Turku, Finland; ║S. Anna Hospital, Neonatal Intensive Care Unit, Torino, Italy; **Hospital Clínico Universitario de Santiago de Compostela, University of Santiago, La Coruña, Spain; ††Center for Population, Health Sciences, The University of Edinburgh, Medical School, Midlothian, United Kingdom; ‡‡Public Health Foundation of India, New Delhi, India; §§Manchester Children’s Hospital, Manchester, United Kingdom; and ¶¶Pediatric Clinic, University of Athens, Athens, Greece. The authors have no conflicts of interest related to the paper to disclose. Address for correspondence: Louis Bont, MD, PhD, Room KE 04.133.1, Wilhelmina Children’s Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands. E-mail: [email protected]; [email protected] Copyright © 2014 by Lippincott Williams & Wilkins ISSN: 0891-3668/14/3311-1177 DOI: 10.1097/INF.0000000000000535

1–3% of all healthy term infants are admitted to hospital for lower respiratory tract infection (LRTI) due to primary RSV infection,1 and this admission rate can increase to and above 10% in high risk populations. Risk factors for severe RSV disease include bronchopulmonary dysplasia, birth at less than 36 weeks gestation, clinically significant congenital heart disease, Down syndrome, neuromuscular disease and severe immunosuppression. Long-term respiratory morbidity associated with RSV LRTI includes recurrent wheeze and an increased risk of developing asthma. There is no vaccine or antiviral treatment against RSV available. Passive immunization with palivizumab, a humanized antibody against the RSV fusion glycoprotein, is used for prevention of RSV-related hospitalization in prematurely born infants and children with congenital heart disease. Supportive care consists of oxygen and fluid supplementation. Further airway support is provided preferentially by noninvasive ventilatory assistance. The interest in RSV research has increased dramatically in the past decade. In 2013, there were more annual publications (343 PubMed publications) than ever before (240 publications in 2007). Four major breakthroughs have boosted RSV research during the last decade. First, RSV has been reported to be a major cause of death in the world during infancy.3 Annual RSV-related deaths have been estimated at 253,000, accounting for up to 6.7% of the mortality in children aged

RSV--still more questions than answers.

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