Chapter 8 Paramyxoviruses.

The paramyxoviruses are a heterogeneous group of viruses causing a variety of clinical diseases in humans, animals, and birds. This chapter examines in more detail the structure and properties of the important human viruses in this group, namely measles, respiratory syncytial virus (RSV), mumps and parainfluenza viruses I-V. They are all enveloped, negative-stranded, riboviruses of helical symmetry. It is suggested that susceptible children, adolescents, and adults should be vaccinated against mumps, unless vaccination is contraindicated. Mumps vaccine can be of particular value to children approaching puberty and for adolescents and adults, especially males who have not had mumps in childhood. Ribavirin therapy may be particularly beneficial for children at risk for severe and often fatal RSV infection, such as infants with congenital heart disease. Attenuated measles vaccines have been developed empirically by selection of host range mutants, and are widely and successfully used throughout the world. Using the vaccine, some countries may soon eliminate measles as an endogenous virus but continued problems are anticipated, particularly in adults with viruses re-introduced by visitors from abroad. Basic studies on new antivirals are continuing (particularly with oligopeptides) but antiviral compounds are unlikely to have extended use in the clinic, except perhaps in tropical areas where the disease may be life threatening. However, a vaccination programme in these areas is preferable, and is an urgent need.