Trivia about RSV

RSV bronchiolitis

Causes 50-90% of all bronchiolitis in the US

risk factor - young infants <1year ( esp 1-2month old)
                    congenital heart disease
                    premature babies
                    patients with chronic lung disease
                    neuro-muscular disease / congenital airway abnormalities

Rate of hsopitalization is almost 5% for every 100,000 children

 Risk of CPAP and mech ventilation with premature infants and patients with hemodynamically significant heart disease

 Treatments such as albuterol, racemic epinephrine has not shown to shorten the duration / change duration of hospitalization of infants with RSV bronchiolitis

 RSV infection is associated with some degree of myocardial injury as evidenced by increase in troponin I with RSV infections in patients ( Cardiac troponin i as a predictor of respiratory failure in children hospitalized with respiratory syncytial virus (RSV) infections: a pilot study - Checchia Paul et al)

 RSV prophylaxis with Palivizumab ( directly taken from the CDC website)

American Academy of Pediatrics (AAP) Guidelines for Infants and Children at Risk for Severe Illness Due to RSV Infection

According to the AAP1, palivizumab prophylaxis may be considered for the following infants and children
  • Infants born at 28 weeks’ gestation or earlier during RSV season, whenever that occurs during the first 12 months of life
  • Infants born at 29–32 weeks’ gestation if they are younger than 6 months of age at the start of the RSV season
  • Infants born at 32–35 weeks’ gestation who are younger than 3 months of age at the start of the RSV season or who are born during RSV season if they have at least one of the following 2 risk factors: 1) infant attends child care; 2) infant has a sibling younger than 5 years of age
  • Infants and children younger than 2 years with cyanotic or complicated congenital heart disease
  • Infants and children younger than 2 years who have been treated for chronic lung disease within 6 months of the start of the RSV season.
  • Infants born before 35 weeks of gestation who have either congenital abnormalities of the airway or neuromuscular disease that compromises handling of respiratory secretions
Consult the American Academy of Pediatrics Red Book (28th edition, 2009) for more specific and latest recommendations, including the length of prophylaxis.


RSV infection does predispose to long term wheezing with viral infections and predispose to asthma

Environmental smoke exposure increases the severity of the infection

 

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