Hall Caroline Breese
Departments of Pediatrics and Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA.
Infect Disord Drug Targets. 2012 Apr;12(2):92-7. doi: 10.2174/187152612800100099.
Respiratory syncytial virus (RSV) was first isolated from infants by Chanock and colleagues in 1957. However, control of this ubiquitous agent has yet to be achieved. RSV is recognized as the primary cause of hospitalization for acute lower respiratory tract illness (LRTI) among infants worldwide. Among children < 5 years old, annual hospitalization rates in the United States (US) is 3/1000 children, and rates in Canada and European countries are similar. In the US the hospitalization rate is 3 times higher than that from influenza or parainfluenza viral infections. Much less appreciated is the clinical and economic burden from RSV outpatients, as few have specific diagnostic testing. Nevertheless, RSV in the US is estimated to cause 1 of 334 hospitalizations, 1 of 38 emergency department visits, but 1 of 13 private practice visits. These outpatient children tend to have moderate to severe illness with approximately three-fourths manifesting labored respirations. RSV burden among outpatients, therefore, is considerable both in size and severity. The global burden of RSV infection is unknown as few studies are from developing countries. Estimates indicate about one-fourth of all acute LRTI occur among children < 5 years, and the greatest burden is among children in developing countries. Currently the only approved means of RSV prophylaxis is passive immunization with humanized F protein monoclonal antibody. Such prophylaxis, however, has limited availability, is expensive, and is recommended only for infants most at risk for severe RSV disease. Only widespread immunization of children is likely to diminish the current burden of RSV infection.
呼吸道合胞病毒（RSV）于1957年由查诺克及其同事首次从婴儿体内分离出来。然而，对这种普遍存在的病原体的控制尚未实现。RSV被认为是全球婴儿急性下呼吸道疾病（LRTI）住院治疗的主要原因。在5岁以下儿童中，美国的年住院率为每1000名儿童中有3例，加拿大和欧洲国家的住院率与之相似。在美国，住院率比流感或副流感病毒感染高出3倍。人们对RSV门诊患者的临床和经济负担了解较少，因为很少有人进行特异性诊断检测。然而，据估计，在美国，RSV导致每334例住院病例中有1例、每38例急诊就诊病例中有1例，但每13例私人诊所就诊病例中有1例。这些门诊儿童往往患有中度至重度疾病，约四分之三表现为呼吸费力。因此，RSV门诊患者的负担在规模和严重程度上都相当大。由于来自发展中国家的研究较少，RSV感染的全球负担尚不清楚。据估计，所有急性LRTI病例中约四分之一发生在5岁以下儿童中，最大负担在发展中国家的儿童中。目前，RSV预防的唯一批准方法是用人源化F蛋白单克隆抗体进行被动免疫。然而，这种预防方法可用性有限、成本高昂，且仅推荐给患严重RSV疾病风险最高的婴儿。只有对儿童进行广泛免疫才有可能减轻目前RSV感染的负担。
