Respiratory syncytial virus infection: Prevention
- Frederick E Barr, MD
Frederick E Barr, MD
- Robert H Fiser Professor and Chair of Pediatrics
- Arkansas Children's Hospital
- University of Arkansas for Medical Sciences
- Barney S Graham, MD, PhD
Barney S Graham, MD, PhD
- Deputy Director
- Viral Pathogenesis Research
- Bethesda, MD
- Section Editors
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
- George B Mallory, MD
George B Mallory, MD
- Section Editor — Pediatric Pulmonology
- Associate Professor of Pediatrics
- Baylor College of Medicine
Respiratory syncytial virus (RSV) causes acute respiratory tract illness in persons of all ages. Almost all children are infected by two years of age, and reinfection is common . The clinical manifestations vary with age, health status, and whether the infection is primary or secondary.
The prevention of respiratory syncytial virus infection will be discussed here. The epidemiology, microbiology, clinical manifestations, diagnosis, and treatment of RSV infection are discussed separately. (See "Respiratory syncytial virus infection: Clinical features and diagnosis" and "Respiratory syncytial virus infection: Treatment".)
Transmission of RSV is primarily by inoculation of nasopharyngeal or ocular mucous membranes after contact with virus-containing secretions or fomites. Direct contact is the most common route of transmission. The average duration of shedding is approximately 10 days. (See "Respiratory syncytial virus infection: Clinical features and diagnosis", section on 'Microbiology'.)
Prevention of RSV infection entails decreasing exposure to RSV and decreasing the risk of acquisition of infection and/or development of disease if exposure occurs. Strategies to decrease exposure and/or the risk of acquisition include [2,3]:
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- GENERAL MEASURES
- HEALTH CARE-ASSOCIATED INFECTION
- Immunoprophylactic agents
- - Palivizumab
- - Other agents
- Indications for palivizumab
- - Factors affecting decision
- - Bronchopulmonary dysplasia
- - Prematurity without BPD
- - Other potential target groups
- Congenital heart disease
- Neuromuscular disorder
- Pulmonary abnormalities
- Cystic fibrosis
- Immunocompromised host
- Down syndrome
- Alaska Native/American Indian
- Dose and schedule
- - Breakthrough RSV infection
- Home administration
- Adverse events
- VACCINE DEVELOPMENT
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS