Common (but not always considered) viral infections of the lower respiratory tract.

Viral lower respiratory tract infections continue to cause a great deal of morbidity and mortality in the United States and worldwide, despite advances in treatment options, chemoprophylaxis, and vaccine development. The availability of ribavirin has improved the outlook in high-risk patients who develop respiratory syncytial virus bronchiolitis while intensive efforts are continued to develop an efficacious and safe vaccine. Respiratory syncytial virus immunoglobulin may prove to be a useful tool in the armamentarium of the pediatrician to prevent or modify respiratory syncytial virus disease in individual patients. Influenza vaccination and chemoprophylaxis remain mainstays in the prevention of influenza disease in high-risk individuals. The availability of a vaccine for varicella and a wider dissemination of measles vaccine, particularly in developing nations, may well limit the adverse outcomes associated with pneumonias caused by these two viruses. The transplant patient and other immunocompromised patients will continue to challenge clinicians and scientists to provide innovative and effective therapies for viral infections. The exciting advances in clinical and research virology over the last decade offer much hope to practicing pediatricians who struggle with offering prevention strategies and treatment options for their patients. Viral lower respiratory tract infections will never be eliminated as a clinical problem, although the morbidity and mortality associated with them will continue to improve.