Infections With Respiratory Syncytial Virus (Rsv) And Human Metapneumovirus The

Infections caused by the respiratory syncytial virus and human metapneumovirus the lead to seasonal diseases of the lower respiratory tract, particularly in infants and young children. The disease may be asymptomatic, light or heavy run and lead to bronchiolitis and pneumonia. The diagnosis is usually made clinically, but also a clinical laboratory confirmation is possible. Treatment is supportive.

Respiratory syncytial virus (RSV) is a DNA virus that belongs to the pneumovirus. So far, the subtypes A and B have been identified. RSV is ubiquitous; nearly all children are infected up to 4 years. Outbreaks occur in temperate climates annually in winter or early spring. Since the immune response to RSV does not protect against reinfection, the disease rate in all exposed individuals is about 40%. Nevertheless, antibodies against RSV reduce the severity of the disease. RSV is the most common cause of infections of the lower respiratory tract in young infants and is responsible in the US for> 50,000 hospitalizations annually among children under the age of 5 years.

Infections caused by the respiratory syncytial virus and human metapneumovirus the lead to seasonal diseases of the lower respiratory tract, particularly in infants and young children. The disease may be asymptomatic, light or heavy run and lead to bronchiolitis and pneumonia. The diagnosis is usually made clinically, but also a clinical laboratory confirmation is possible. Treatment is supportive. Respiratory syncytial virus (RSV) is a DNA virus that belongs to the pneumovirus. So far, the subtypes A and B have been identified. RSV is ubiquitous; nearly all children are infected up to 4 years. Outbreaks occur in temperate climates annually in winter or early spring. Since the immune response to RSV does not protect against reinfection, the disease rate in all exposed individuals is about 40%. Nevertheless, antibodies against RSV reduce the severity of the disease. RSV is the most common cause of infections of the lower respiratory tract in young infants and is responsible in the US for> 50,000 hospitalizations annually among children under the age of 5 years. A similar, but independent virus is the human metapneumovirus (hMPV). The seasonal epidemiology of hMPV appears to be similar to that of RSV, but the incidence of infection and disease appears to be significantly lower. Symptoms and signs The clinical manifestations of RSV and hMPV infections is similar. The most noticeable clinical syndromes are bronchiolitis (bronchiolitis) and pneumonia (overview of pneumonia (pneumonia)). These diseases begin characteristically with symptoms of upper respiratory tract and fever and progress over several days to dyspnea, coughing, wheezing and rattling in Brustauskultation. Apnea may represent <6 months, the initial symptom of RSV infection in infants. In healthy adults and older children, the disease is usually mild and can also run asymptomatic or manifest itself as not feverish flu infection. However, can develop a serious illness in the following patients: patients who are <6 months old, the elderly or immunocompromised individuals patients who have an underlying cardiopulmonary disease diagnosis Clinical evaluation Sometimes rapid antigen tests of nasal swab, Reverse -Transkriptase-PCR (RT-PCR) or viral culture suspicion of infection with respiratory syncytial virus (RSV) and possibly also with the human Metapneumovirush (hMPV) is in infants and young children with bronchiolitis or pneumonia during the RSV season , Since antiviral treatment is not generally recommended, a specific virological diagnosis to therapy management is not required. However, a clinical laboratory diagnosis may be useful in hospital hygienic point of view, to allow a cohort isolation of children who are infected with the same virus. There are rapid antigen detection tests with high sensitivity for RSV and other respiratory viruses for use in children available; to nasal swab or Nasaltupfer be used. These tests are less sensitive in adults. Molecular diagnostic tests such as RT-PCR were improved in terms of sensitivity and are currently widely available as single or multiplex assays. Treatment Supportive treatment The treatment of RSV and hMPV infections carried supportive and includes, if necessary, the administration of O2 and of liquid (bronchiolitis). Corticosteroids and bronchodilators are generally not helpful and are not currently recommended. Antibiotics should be reserved for patients with fever, evidence of pneumonia on chest radiograph and with suspected bacterial coinfection. The administration of palivizumab (monoclonal antibody against RSV) is not an effective treatment. Inhaled ribavirin, an antiviral substance with activity against RSV, has only a small effect, are potentially toxic to medical personnel and except for infections severely immunocompromised patients no longer recommended. Prevention contact precautions (eg. As hand washing, gloves, isolation) are important, especially in hospitals. Passive immunization with palivizumab reduced the incidence of hospitalization for RSV in infants at high risk. This is cost-reducing only for those infants who are at high risk, having to be hospitalized. These include infants who are with hemodynamically significant congenital heart disease are <1 year old <1 year old with chronic lung disease of premature infants (gestational age <32 weeks, 0 days with the need for O2 therapy for at least 28 days after birth) a due date have <29 weeks of gestation and who are at the start of RSV season <1 year old in the second year of life have chronic lung disease of premature infants and received within 6 months of the RSV season treatment (treatment with chronic corticosteroids or diuretics or continuing need an O2 therapy) prophylaxis can be also considered for infants in the first year of life, have the anatomical lung abnormalities, which limit the ability to effectively clear the upper respiratory tract infants who neuromuscular e rkrankungen have children <24 months, which have a profound immunodeficiency The i.m. Palivizumab dose is 15 mg / kg. The first dose is given just before the usual onset of the RSV season (in North America in early November). The following doses are given at one-month intervals over the entire duration of the RSV season (usually a total of 5 doses). Summary RSV and hMPV usually cause bronchiolitis, but also pneumonia can occur. The diagnosis is made clinically in general, but it can also be used rapid antigen tests and molecular tests (eg., PCR). Treatment is supportive. Corticosteroids, bronchodilators and palivizumab are not recommended. Inhaled ribavirin may be useful for RSV, but only in severely immunocompromised patients. Passive immunization with palivizumab, which is carried out just before and during the RSV season, reduced the incidence of hospitalization in infants at high risk.

Health Life Media Team

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