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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infants often develop reactive airway disease after respiratory syncytial virus (RSV) bronchiolitis. Cysteinyl-leukotrienes (cys-LT) are released during RSV infection and may contribute to the inflammation. We hypothesized that a cys-LT receptor antagonist would ameliorate reactive airway disease subsequent to RSV bronchiolitis. One hundred and thirty infants who were 3 to 36 months old, hospitalized with acute RSV bronchiolitis, were randomized into a double-blind, parallel comparison of 5-mg montelukast chewable tablets or matching placebo given for 28 days starting within 7 days of symptom debut. Infants with a suspected history of asthma were excluded. One hundred sixteen infants provided diary card data for the treatment period. Median age was 9 months. Infants on montelukast were free of any symptoms on 22% of the days and nights compared with 4% of the days and nights in infants on placebo (p = 0.015). Daytime cough was significantly reduced on active treatment (p = 0.04). Exacerbations were significantly delayed from montelukast compared with placebo (p < 0.05). In conclusion, cys-LT antagonist treatment reduces lung symptoms subsequent to RSV bronchiolitis.
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PMID:A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. 1516 15

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection (LRTI) in young children worldwide. Approximately half of all LRTI-associated hospitalizations are caused by bronchiolitis, with RSV accounting for 50%-80% of all bronchiolitis cases. Bronchiolitis is an infection of the bronchial and bronchiolar epithelial cells, with subsequent inflammation and edema resulting in airway obstruction. This process manifests clinically as cough, wheezing, tachypnea, and respiratory distress. Because of the association between bronchiolitis and RSV infection, bronchiolitis is a good indicator of RSV disease; therefore, prevention strategies for RSV should reduce the rate of bronchiolitis. Rates of bronchiolitis-associated hospitalization for American Indian/Alaska Native (AI/AN) children are approximately twice that for the general population of U.S. children. This report describes the first estimate of rates of outpatient bronchiolitis-associated visits and updates rates of bronchiolitis-associated hospitalizations in these populations. Rates of bronchiolitis-associated outpatient visits and hospitalizations were higher for AI/AN children than for other U.S. children, and hospitalization rates for both groups increased during 1990-2000. This report underscores the high burden of bronchiolitis and the need for effective prevention programs for AI/AN communities.
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PMID:Bronchiolitis-associated outpatient visits and hospitalizations among American Indian and Alaska Native children--United States, 1990-2000. 1289 58

Respiratory syncytial virus (RSV) causes significant respiratory disease in children worldwide. For the study of severe RSV disease seen in preterm infants, a suitable animal model is lacking. The novel hypothesis of this study was that preterm lambs are susceptible to bovine RSV (bRSV) infection, an analogous pneumovirus with ruminant host specificity, and that there would be age-dependent differences in select RSV disease parameters. During RSV infection, preterm lambs had elevated temperatures and respiration rates with mild anorexia and cough compared to controls. Gross lesions included multifocal consolidation and atelectasis with foci of hyperinflation. Microscopic lesions included multifocal alveolar septal thickening and bronchiolitis. Immunohistochemistry localized the RSV antigen to all layers of bronchiolar epithelium from a few basal cells to numerous sloughing epithelia. A few mononuclear cells were also immunoreactive. To assess for age-dependent differences in RSV infection, neonatal lambs were infected similarly to the preterm lambs or with a high-titer viral inoculum. Using morphometry at day 7 of infection, preterm lambs had significantly more cellular immunoreactivity for RSV antigen (P <0.05) and syncytial cell formation (P <0.05) than either group of neonatal lambs. This work suggests that perinatal RSV clearance is age-dependent, which may explain the severity of RSV infection in preterm infants. The preterm lamb model is useful for assessing age-dependent mechanisms of severe RSV infection.
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PMID:Reduced clearance of respiratory syncytial virus infection in a preterm lamb model. 1555 38

Respiratory syncytial virus (RSV) infection is now recognised as a significant problem in elderly adults. Epidemiological evidence indicates the impact of RSV in older adults may be similar to non-pandemic influenza, both in the community and in long-term care facilities. Attack rates in nursing homes are approximately 5-10% per year with significant rates of pneumonia (10-20%) and death (2-5%). Estimates using US health care databases and viral surveillance results over a 9-year period indicate that RSV infection causes approximately 10,000 all-cause deaths annually among persons >64 years of age. In contrast, influenza A accounted for approximately 37,000 yearly deaths in the same age group. The clinical features of RSV infection may be difficult to distinguish from those of influenza but include nasal congestion, cough, wheezing and low-grade fever. Older persons with underlying heart and lung disease and immunocompromised patients are at highest risk for RSV infection-related pneumonia and death. Diagnosis of RSV infection in adults is difficult because viral culture and antigen detection are insensitive, presumably because of low viral titres. The combination of serology and reverse transcriptase polymerase chain reaction assay offers the best sensitivity and specificity for the diagnosis of RSV but unfortunately these techniques are not widely available; consequently, most adult RSV disease goes unrecognised. Although treatment of RSV infection in the elderly is largely supportive, early therapy with ribavirin and intravenous gamma-globulin improves survival in immunocompromised persons. An effective RSV vaccine has not yet been developed. Therefore, prevention of RSV is limited to standard infection control practices, such as hand washing and the use of gowns and gloves.
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PMID:Respiratory syncytial virus infection in elderly adults. 1603 73

The objective of the study was to determine the morbidity of influenza and respiratory syncytial virus (RSV) infection in the 0-19 years of age group with influenza-like illness among the outpatient cases. From 20 January to 31 March 2003 a total of 123 subjects with upper respiratory tract infection attended Yunus Emre Health Center. Ninety-one subjects fit the case definition of influenza-like illness, which consisted of acute fever of more than 38 degrees C, cough, and sore throat. After obtaining their consent, nasal swabs were taken for isolation of influenza and RSV. Of these, 10 were influenza A virus, 6 were influenza B virus and 20 were RSV. All of influenza virus A was typed as subtype H3N2. The rates of influenza virus among 5-9 and 1-4 years of age groups and of RSV among 1-4 years of age group were high. The average number of absentee days of schoolchildren with influenza was 3.33 days and of those with RSV infection was 1.43 days; this rate was calculated as 2.25 days for the influenza-like illness. Continuous surveillance and influenza vaccination for target groups are recommended for beneficial effects of reducing influenza morbidity and mortality in the community.
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PMID:Influenza and respiratory syncytial virus morbidity among 0-19 aged group in Yunus Emre Health Center. 1636 39

Human metapneumovirus (hMPV) is a recently described member of the Paramyxoviridae family/Pneumovirinae subfamily and shares many common features with respiratory syncytial virus (RSV), another member of the same subfamily. hMPV causes respiratory tract illnesses that, similar to human RSV, occur predominantly during the winter months and have symptoms that range from mild to severe cough, bronchiolitis, and pneumonia. Like RSV, the hMPV virus can be subdivided into two genetic subgroups, A and B. With RSV, a single monoclonal antibody directed at the fusion (F) protein can prevent severe lower respiratory tract RSV infection. Because of the high level of sequence conservation of the F protein across all the hMPV subgroups, this protein is likely to be the preferred antigenic target for the generation of cross-subgroup neutralizing antibodies. Here we describe the generation of a panel of neutralizing monoclonal antibodies that bind to the hMPV F protein. A subset of these antibodies has the ability to neutralize prototypic strains of both the A and B hMPV subgroups in vitro. Two of these antibodies exhibited high-affinity binding to the F protein and were shown to protect hamsters against infection with hMPV. The data suggest that a monoclonal antibody could be used prophylactically to prevent lower respiratory tract disease caused by hMPV.
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PMID:Isolation and characterization of monoclonal antibodies which neutralize human metapneumovirus in vitro and in vivo. 1687 37

Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections (LRTIs) (e.g., bronchiolitis and pneumonia) among young children in the United States. RSV also causes severe respiratory disease and a substantial number of deaths among older adults and persons with compromised respiratory, cardiac, or immune systems. RSV is transmitted person to person through close contact or inhalation of large droplets from a sneeze or cough; infection also can occur through contact with fomites (i.e., contaminated surfaces or objects). In temperate climates, peak RSV activity typically occurs during the winter. This report presents preliminary data on RSV activity reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS) for the weeks ending July 8-November 18, 2006, indicating the onset of the 2006-2007 RSV season, and summarizes RSV trends during July 2005-June 2006. Health-care providers should consider RSV in the differential diagnosis for persons of all ages with LRTIs and implement appropriate isolation precautions to prevent nosocomial transmission from RSV-infected patients. Immune prophylaxis should be considered for certain infants and young children at high risk for complications from RSV infection (e.g., certain premature infants or infants and children with chronic lung and heart disease).
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PMID:Brief report: respiratory syncytial virus activity--United States, 2005-2006. 1713 23

This article explores the home health nurse's role in preventing respiratory syncytial virus (RSV) among premature infants. Thousands of children infected with RSV require hospitalization each year. Consistent contact with the infant alerts the nurse to subtle signs and symptoms of RSV infection, which may include nasal congestion, cough, low-grade fever, and malaise. By developing patient and caregiver trust, the home health nurse can implement an RSV prevention plan, leading to a decrease in hospitalization episodes of premature infants with RSV. Identification of patient risk factors contributing to RSV together with caregiver education is addressed in this article.
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PMID:Preventing respiratory syncytial virus in homebound premature infants. 1766 1

Respiratory syncytial virus (RSV) infection, a common lower respiratory infection in infants, is now recognized in the USA as a significant problem in elderly adults. RSV infection has rarely been reported in adults in Japan. Nasal samples from 77 patients with influenza-like illness (ILI) and negative for influenza in a rapid antigen detection kit were also tested by polymerase chain reaction (PCR) to identify RSV. A clinical trial was also conducted using a new antigen detection test kit for RSV based on immunochromatography. RSV was detected by nested RT-PCR in samples from nasal swabs of 10 patients--3 children and 5 adults--and nasal aspiration samples in 2 children. The frequency of RSV detection by nested RT-PCR in ILI patients with a negative response for influenza virus using the rapid detection kit was 27.3% (3/11) for children aged 0 to 1 year and 33.3% (2/6) for children aged 2-3 years. The frequency was 10% (1/10) for adults aged 30-39 years, 25% (1/4) for those aged 70-79 years, and 60% (3/5) for those aged 80-89 years. By month, the frequency was 25% (2/8) for December, 27.3% (6/22) for January, and 4.4% (2/45) for February. The main clinical symptoms of the 10 patients with RSV were: peak body temperature during the clinical course of 37.2-39.7 degrees C, cough, and rhinorrhea in 9. Stridor was observed in all five children, but not in the five adults. Clinical examination showed CRP to be 0.2-3.4 (mean 1.3) mg/dL and WBC to be 3070-8000 (mean 5584) /microL for nine patients. Lymphocytopenia was observed in the four adults from whom WBC fraction data was obtained. Chest X-ray was within normal limits. RSV was detected by the new rapid antigen detection kit in 9 of the 10 patients in whom RSV was detected by PCR, but not in any of the 67 patients in whom RSV was not detected. The diagnostic accuracy of the new antigen detection kit for RSV was thus excellent at 98.7% compared to PCR. RSV was detected from nasal swab specimens of a substantial number of elderly Japanese by PCR or the antigen detection kit.
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PMID:[Detection of respiratory syncytial virus with nested RT-PCR and a new rapid detection test kit in patients with influenza-like illness, including elderly adults]. 1830 71

Human metapneumovirus (hMPV) is genetically related to respiratory syncytial virus (RSV); both cause respiratory tract illnesses ranging from a mild cough to bronchiolitis and pneumonia. The F protein-directed monoclonal antibody (mAb) palivizumab has been shown to prevent severe lower respiratory tract RSV infection in animals and humans. We have previously reported on a panel of mAbs against the hMPV F protein that neutralize hMPV in vitro and, in two cases, in vivo. Here we describe the generation of hMPV mAb-resistant mutants (MARMs) to these neutralizing antibodies. Sequencing the F proteins of the hMPV MARMs identified several neutralizing epitopes. Interestingly, some of the epitopes mapped on the hMPV F protein coincide with homologous regions mapped previously on the RSV F protein, including the site against which the broadly protective mAb palivizumab is directed. This suggests that these homologous regions play important, conserved functions in both viruses.
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PMID:Identification of antibody neutralization epitopes on the fusion protein of human metapneumovirus. 1900


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