{"title":"Disease Severity in Respiratory Syncytial Virus Infection: Role of Viral and Host Factors","authors":"J. Legg","doi":"10.5772/intechopen.88782","DOIUrl":"https://doi.org/10.5772/intechopen.88782","url":null,"abstract":"Respiratory syncytial virus (RSV) is not only a major cause of severe lower respiratory tract infection (LRTI) in infancy but is increasingly recognised as an important pathogen in later life. RSV infection is associated with a wide spectrum of disease ranging from asymptomatic infection to life-threatening bronchiolitis and pneumonia. Research has demonstrated that there exists a complex interplay between viral and host factors that determines the severity of disease following RSV infection. Several factors determine RSV virulence including the infective properties of individual strains and viral load (VL). Disease outcome from RSV infection is also impacted considerably by a variety of host factors with the host immune response increasingly recognised as pivotal. This chapter outlines our current understanding of these factors and provides an oversight of their relative importance.","PeriodicalId":366789,"journal":{"name":"The Burden of Respiratory Syncytial Virus Infection in the Young","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124156170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Shafique, M. Zahoor, Muhammad Arshad, B. Aslam, A. Siddique, M. Rasool, M. Qamar, M. Usman
{"title":"Hurdles in Vaccine Development against Respiratory Syncytial Virus","authors":"M. Shafique, M. Zahoor, Muhammad Arshad, B. Aslam, A. Siddique, M. Rasool, M. Qamar, M. Usman","doi":"10.5772/INTECHOPEN.87126","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.87126","url":null,"abstract":"Respiratory syncytial virus (RSV) infection is a major cause of severe respiratory disease in infants and young children worldwide and also forms a serious threat for the elderly. Vaccination could significantly relieve the burden of the RSV disease. However, unfortunately there is no licensed vaccine available so far. This is partly due to disastrous outcome of a clinical trial of formalin-inactivated RSV (FI-RSV) in children in 1960s; leading to enhanced respiratory disease upon natural infection. These findings contributed significantly to the delay of RSV vaccine development. Other key obstacles in development of RSV vaccine such as a peak of severe disease at 2–3 months of age, challenging biochemical behavior of key vaccine antigens and dependence on animal models that may not truly reflect human disease processes. These challenges could be overcome through maternal immunization, structure-based engineering of vaccine antigens, the design of a novel platform for safe infant immunization, and the development of improved animal models. Currently, several vaccine candidates are in pre-clinical and clinical trials targeting the diverse age groups; young children or older adults from the infection or can reduce incidence, mortality and morbidity among the RSV infected individuals.","PeriodicalId":366789,"journal":{"name":"The Burden of Respiratory Syncytial Virus Infection in the Young","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132103236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Respiratory Syncytial Virus Infections among Children with Congenital Heart Disease","authors":"Maja Daurach, I. Michel-Behnke","doi":"10.5772/intechopen.85552","DOIUrl":"https://doi.org/10.5772/intechopen.85552","url":null,"abstract":"Infants and children suffering from congenital heart disease represent a patient cohort particularly at risk for severe RSV infections. Most notably the complication rates in lower respiratory tract infections due to RSV among patients with congenital heart disease are significantly higher compared to other patient collectives. Predisposing factors are altered lung mechanics caused by either increased or decreased pulmonary blood flow, both resulting in a ventilation/ perfusion mismatch causing decreased pulmonary compliance and higher airway resistance. Randomized controlled trials have shown that immunoprophylaxis with palivizumab is beneficial for CHD patients. Guidelines from different national societies suggest administration of palivizumab for infants with CHD in young age injected monthly throughout the RSV season, if the CHD is considered hemodynamically significant.","PeriodicalId":366789,"journal":{"name":"The Burden of Respiratory Syncytial Virus Infection in the Young","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128523156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Resolving the Debate on RSV Prophylaxis in Late Preterm Infants","authors":"B. Paes, B. Rodgers-Gray, X. Carbonell-Estrany","doi":"10.5772/INTECHOPEN.85073","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85073","url":null,"abstract":"There is still active debate in the scientific literature about the importance of providing respiratory syncytial virus (RSV) prophylaxis to late preterm infants born at 33–35 weeks’ gestational age (wGA). The American Academy of Pediatrics and the Canadian Paediatric Society position statements only advocate for RSV prophylaxis for infants <30 wGA. Several publications prove the contrary, reporting substantial morbidity and even mortality in older GA infants, following RSV infection. Consequently, other Societies, such as from Spain and Italy, have differ-ent criteria, and include as candidates 30–32 wGA infants and 33–35 wGA infants with risk factors for severe RSV disease. This chapter will systematically examine the current evidence for RSV prophylaxis in both early and late preterm infants 29–35 wGA and the cost-effectiveness of this strategy with the use of risk scoring tools. The authors will attempt to reconcile the misconception that late preterm infants do not merit RSV prophylaxis and hopefully resolve the long-standing debate that currently exists in many countries worldwide.","PeriodicalId":366789,"journal":{"name":"The Burden of Respiratory Syncytial Virus Infection in the Young","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130766599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RSV: Available Prophylactic Options and Vaccines in Clinical Trials","authors":"D. Linfield, F. Rezaee","doi":"10.5772/INTECHOPEN.84851","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84851","url":null,"abstract":"Respiratory syncytial virus (RSV) is the leading cause of serious lower respiratory infection (ALRI)-related hospitalization in children worldwide, and a source of morbidity and mortality in high-risk adults. There are strong associations between RSV, persistent wheezing and childhood asthma. Despite extensive research, no effective treatment is available aside from supportive care. The trial of a formalin-inactivated RSV vaccine in the 1960s resulted in priming the severe illness upon natural infection. Palivizumab, a monoclonal antibody approved for RSV prophylaxis in high-risk infants, has only moderately decreased hospital admissions due to RSV infection. Live-attenuated, vector, and protein-based vaccine candidates are being investigated in many clinical trials. Developing a vaccine remains challenging due to finding the right balance between adequate immunogenicity and attenuation of vaccine. Here we review the clinical significance of RSV in infants, young children, high-risk adults, elderly population, pregnant women; clinical manifesta-tions and consequences of RSV infection; the pharmacologic strategies currently available, the current stages of RSV vaccine clinical trials, different strategies, and major hurdles in the development of an effective RSV vaccine.","PeriodicalId":366789,"journal":{"name":"The Burden of Respiratory Syncytial Virus Infection in the Young","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115534887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}