RESEARCH ARTICLE


Epidemiology of Respiratory Syncytial Virus Infection in Preterm Infants



Bernhard Resch1, *, Stefan Kurath1, Paolo Manzoni2
1 Research Unit for Neonatal Infectious Diseases and Epidemiology, Division of Neonatology, Pediatric Department, Medical University Graz, Austria
2 Division of Neonatology and NICU, S. Anna Hospital. AO O.I.R.M-S. Anna, Torino, Italy


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© Resch et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Neonatology, Pediatric Department, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria; Tel: 0043 316 385 81134; Fax: 0043 316 385 2678; E-mail: bernhard.resch@medunigraz.at


Abstract

This review focuses on the burden of respiratory syncytial virus (RSV) infection in preterm infants with and without chronic lung disease (bronchopulmonary dysplasia, BPD). The year-to-year and seasonal variations in RSV activity are key aspects of RSV epidemiology, and knowledge/monitoring of local RSV activity is mandatory for guidance of prophylaxis with the monoclonal antibodies palivizumab and in the near future motavizumab. Morbidity expressed in rates of hospitalizations attributable to RSV illness revealed a mean of 10 percent in preterm infants without and 19 percent (p=0.016) with BPD. Mortality rates diverged widely, and case fatality rates have been reported to range from 0 to 12 percent. The typical clinical picture of lower respiratory tract infection is not different in term and preterm infants, but rates of apnoeas are significantly increased in preterms, ranging from 4.9 to 37.5 percent with decreasing rates observed in more recent studies. Until a RSV vaccine is developed and will be available, prophylaxis with palivizumab is the only preventative strategy other than hand hygiene and contact measures that significantly reduces RSV hospitalization rates in preterm infants both with and without BPD.

Keywords: Bronchopulmonary dysplasia, monoclonal antibodies, palivizumab, preterms, preventative strategy.