Respiratory syncytial virus infection cases in congenital heart disease patients

Purpose : Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients. Methods : On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients. Results : During the winter season, RSV caused 20–0% of LRI admissions in children. In patients with completely repaired simple left to right (L–R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L–R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course. Conclusion : To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.

[1]  K. Henrickson,et al.  Diagnostic Assays for Respiratory Syncytial Virus Disease , 2007, The Pediatric infectious disease journal.

[2]  D. Noyola,et al.  Impact of respiratory syncytial virus on hospital admissions in children younger than 3 years of age. , 2007, The Journal of infection.

[3]  A. Leventhal,et al.  Elimination of Hepatitis A Infection Outbreaks in Day Care and School Settings in Southern Israel After Introduction of the National Universal Toddler Hepatitis A Immunization Program , 2007, The Pediatric infectious disease journal.

[4]  A. Bruu,et al.  Respiratory syncytial virus infections in congenital heart defects--hospitalizations and costs. , 2006, Acta paediatrica.

[5]  D. Fixler,et al.  Respiratory syncytial virus infection in children with congenital heart disease: A review , 1996, Pediatric Cardiology.

[6]  W. Mahle,et al.  Economic Analysis of Palivizumab in Infants With Congenital Heart Disease , 2004, Pediatrics.

[7]  D. Noyola,et al.  Viral etiology of lower respiratory tract infections in hospitalized children in Mexico , 2004, The Pediatric infectious disease journal.

[8]  M. Rennels,et al.  Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. , 2003, Pediatrics.

[9]  R. Welliver Review of epidemiology and clinical risk factors for severe respiratory syncytial virus (RSV) infection. , 2003, The Journal of pediatrics.

[10]  K.,et al.  Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease. , 2003, The Journal of pediatrics.

[11]  J. Towbin,et al.  Detection of viruses in myocardial tissues by polymerase chain reaction. evidence of adenovirus as a common cause of myocarditis in children and adults. , 2003, Journal of the American College of Cardiology.

[12]  B. Paes Current strategies in the prevention of respiratory syncytial virus disease. , 2003, Paediatric respiratory reviews.

[13]  H. Meissner Selected populations at increased risk from respiratory syncytial virus infection , 2003, The Pediatric infectious disease journal.

[14]  P. Piedra Clinical experience with respiratory syncytial virus vaccines , 2003, The Pediatric infectious disease journal.

[15]  R. A. Blackwood,et al.  Case report of Staphylococcus aureus endocarditis after navel piercing. , 2003, The Pediatric infectious disease journal.

[16]  H. Jafri Role of chemokines in respiratory syncytial virus disease. , 2002, The Pediatric infectious disease journal.

[17]  T. Braciale,et al.  RSV-induced immunopathology: dynamic interplay between the virus and host immune response. , 2002, Virology.

[18]  P. Openshaw,et al.  Immunopathogenesis of vaccine-enhanced RSV disease. , 2001, Vaccine.

[19]  J. Mills,et al.  Preventive and therapeutic strategies for respiratory syncytial virus infection. , 2001, Current opinion in pharmacology.

[20]  M. Pérez-Ruiz,et al.  Rapid Detection of Respiratory Viruses by Shell Vial Assay Using Simultaneous Culture of HEp-2, LLC-MK2, and MDCK Cells in a Single Vial , 1999, Journal of Clinical Microbiology.

[21]  L. Wright,et al.  Prevention of Respiratory Syncytial Virus Infections: Indications for the Use of Palivizumab and Update on the Use of RSV-IGIV , 1998, Pediatrics.

[22]  E. Simões,et al.  Respiratory syncytial virus immune globulin for prophylaxis against respiratory syncytial virus disease in infants and children with congenital heart disease , 1998 .

[23]  L. Wright,et al.  Respiratory syncytial virus immune globulin intravenous: Indications for use , 1997 .

[24]  K. Kawazoe,et al.  Cardiopulmonary bypass and cellular immunity: changes in lymphocyte subsets and natural killer cell activity. , 1993, The Annals of thoracic surgery.

[25]  D. Mulder,et al.  Effect of cardiopulmonary bypass on circulating lymphocyte function. , 1992, The Annals of thoracic surgery.

[26]  R. Davey,et al.  Changes in lymphocyte subpopulations as a result of cardiopulmonary bypass. The effect of blood transfusion. , 1991, The Journal of thoracic and cardiovascular surgery.

[27]  Henry Nider,et al.  Report of the Committee on Infectious Diseases , 1989 .

[28]  C. Hall,et al.  Respiratory syncytial viral infection in infants with congenital heart disease. , 1982, The New England journal of medicine.

[29]  R. Chanock,et al.  An epidemiologic study of altered clinical reactivity to respiratory syncytial (RS) virus infection in children previously vaccinated with an inactivated RS virus vaccine. , 1969, American journal of epidemiology.

[30]  E. H. Lennette,et al.  Field evaluation of a respiratory syncytial virus vaccine and a trivalent parainfluenza virus vaccine in a pediatric population. , 1969, American journal of epidemiology.