Pediatric Infectious Disease

Register      Login

VOLUME 2 , ISSUE 4 ( October-December, 2020 ) > List of Articles


Respiratory Syncytial Virus

Mallavalli Surendranath

Keywords : Monoclonal antibody palivizumab, Respiratory infection, Respiratory syncytial virus, Respiratory syncytial virus protein F

Citation Information : Surendranath M. Respiratory Syncytial Virus. Pediatr Inf Dis 2020; 2 (4):146-151.

DOI: 10.5005/jp-journals-10081-1272

License: CC BY-NC 4.0

Published Online: 20-02-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Respiratory syncytial virus (RSV) is one of most common cause of lower respiratory tract infection in infants less than 2 years of age and sometimes in elderly people. Bronchiolitis is the common presentation. Severe infection is seen in high-risk infants and preterm infants. More than 90% of mortality due to RSV infection occurs in developing countries. At present, no specific drug is available for treatment. Prevention of RSV infection can be done by giving palivizumab, which is a monoclonal antibody developed against RSV fusion protein. Phase 3 clinical trials are done with nanoparticle RSV protein F vaccine for pregnant mothers to protect the infant through transplacental transfer of RSV antibodies. Clinical trials are going on for live attenuated RSV vaccine, vector-based vaccines, chimeric vaccine, and subunit vaccine.

PDF Share
  1. Shi T, McAllister DA, O'Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet 2017;390(10098):946–958. DOI: 10.1016/S0140-6736(17)30938-8.
  2. Maitreyi RS, Broor S, Kabra SK, et al. Rapid detection of respiratory viruses by centrifugation enhanced culture from children with lower respiratory tract infections. J Clin Virol 2000;16(1):41–47. DOI: 10.1016/S1386-6532(99)00075-X.
  3. Broor S, Parveen S, Bharaj P, et al. A prospective three-year cohort study of epidemiology and virology of acute respiratory infections of children in rural India. PLoS ONE 2007;2(6):e491. DOI: 10.1371/journal.pone.0000491.
  4. Krishnan A, Kumar R, Broor S, et al. Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children. J Glob Health 2019;9(1):010433. DOI: 10.7189/jogh.09.010433.
  5. Broor S, Praveen S, Maheswari M. Respiratory syncytial virus infections in India: epidemiology and need for vaccine. Indian J Med Microbial 2018;36(4):458–464. DOI: 10.4103/ijmm.IJMM_19_5.
  6. Taleb SA, Al Thani AA, Al Ansari K, et al. Human respiratory syncytial virus: pathogenesis, immune responses, and current vaccine approaches. Eur J Clin Microbiol Infect Dis 2018;37(10):1817–1827. DOI: 10.1007/s10096-018-3289-4.
  7. Babu BVS, Gunasekaran P, Venkataraman P, et al. Prevalence and molecular characterization of circulating respiratory syncytial virus (RSV) in Chennai, South India during 2011-2014. Biosci, Biotech Res Asia 2016;13(2):1055–1062. DOI: 10.13005/bbra/2132.
  8. Haider MSH, Khan WH, Deeba F, et al. BA9 lineage of respiratory syncytial virus from across the globe and evolutionary dynamics. PLoS 2018;13(4):e0193525. DOI: 10.1371/journal.pone.0193525.
  9. Welliver RC, Checchia PA, Bauman JH, et al. Fatality rates in published reports of RSV hospitalisation among high-risk and otherwise healthy children. Curr Med Res Opin 2010;26(9):2175–2181. DOI: 10.1185/03007995.2010.505126.
  10. Shi T, Balsells E, Wastnedge E, et al. Risk factors for respiratory syncytial virus associated with lower respiratory infections in children under five years: systematic review and meta-analysis. J Glob Health 2015;5(2):020416. DOI: 10.7189/jogh.05.020416.
  11. Sahu M, Kori BK, Sahare L, et al. Respiratory syncytial virus in children with influenza like illness. Indian Pediatr 2015;52(4):339–340. DOI: 10.1007/s13312-015-0635-9.
  12. Kliegman RM, Crowe JE. Nelson text book of pediatrics. 20th ed., ch. 260 pp. 1606–1609.
  13. Zhang N, Wang L, Deng X, et al. Recent advances in the detection of respiratory virus infection in human. J Med Virol 2020;92(4):408–417. DOI: 10.1002/jmv.25674.
  14. Zhang L, Mendoza-Sassi, Wainwright C, et al. Cochrane review 21 December 2017.
  15. Wang Z-Y, Li X-D, Fu. X-Q. Efficacy of 3% hypertonic saline in bronchiolitis: a meta analysis. Exp Ther Med 2019;18(2):1338–1344. DOI: 10.3892/etm.2019.7684.
  16. Linfield DT, Rezaee F. RSV: available prophylactic options and vaccines in clinical trials. Burd Respirat Syncyt Virus Infect Young Old 2019. DOI: 10.5772/Intechopen.84851.
  17. Arasaratnam R. ALS-008176 for respiratory syncytial virus infection. N Engl J Med 2016;374(14):1391. DOI: 10.1056/NEJMc1516110.
  18. German P, Xin Y, Chien JW, et al. Phase 1 first-in-human, single-and multiple-ascending dose and food effects studies to assess the safety, tolerability and pharmacokinetics of presotovir for treatment of respiratory syncytial virus infection. J Clin Pharmacol 2018;58(8):1025–1034. DOI: 10.1002/jcph.1112.
  19. Karron RA, Buchhoiz UJ, Collins PL. Live attenuated respiratory syncytial virus vaccines. Curr Top Microbiol Immunol 2013;372:259–284.
  20. McFarland EJ, Karron RA, Muresan P, et al. Live-attenuated respiratory syncytial virus vaccine candidate with deletion of RNA synthesis regulatory protein M2-2 is highly immunogenic in children. J Infect Dis 2018;217(9):1347–1355. DOI: 10.1093/infdis/jiy040.
  21. Higgins D, Trujillo C, Keech C, PATH. Advances in RSV Vaccine Research and Development- A Global Agenda. WHO.
  22. RSV vaccine and mAb snap shot.
  23. Muňoz FM, Swamy GK, Hickman SP, et al. Safety and immunogenicity of a respiratory syncytial virus fusion (F) protein nanoparticle vaccine in healthy third-trimester pregnant women and their infants. J Infect Dis 2019;220(11):1802–1815. DOI: 10.1093/infdis/jiz390.
  24. IAP Text book of vaccines. 2nd ed., 2020. pp. 630–649.
  25. Arankelle VA, Kulkarni R, Malshe N, et al. Seroepidemiology of respiratory syncytial virus in western part of India with special reference to appropriate age for infant vaccination. J Med Virol 2019;91(8):25489.
  26. Kim HW, Canchola JG, Brandt CD, et al. Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. Am J Epidmiol 1969;89(4):422–434. DOI: 10.1093/oxfordjournals.aje.a120955.
  27. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guidelines: the diagnosis, management and prevention of Brochiolitis. Pediatrics 2014;134(5):e1474–e1502. DOI: 10.1542/peds.2014-2742.
  28. Griffin MP, Khan AA, Esser MT, et al. Safety, tolerability and pharmacokinetics of MED18897, the respiratory syncytial virus perfusion F-targeting monoclonal antibody with an extended half life in healthy adults. Antimicrob Agents Chemother 2017;61(3):e01714–e01716. DOI: 10.1128/AAC.01714-16.
  29. Domachowske JB, Khan AA, Esser MT, et al. Safety and tolerability and pharmacokinetics of MED18897, an extended half life single dose respiratory syncytial virus perfusion F targeting monoclonal antibody administered as a single dose to healthy preterm infants. Pedatr Infect Dis J 2018;37(9):886–892. DOI: 10.1097/INF.0000000000001916.
  30. Clinical Ph2b to evaluate safety and efficacy of MED18897. Available from: https://clinlical
  31. Clinical A study to evaluate safety and efficacy of MED18897 for prevention of medically attended RSV LRTI in healthy late preterm and term infants. Available from: https://clinlical
  32. Clinical A study to evaluate safety and efficacy of MED18897 for prevention of medically attended respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in high risk children. Available from: https://clinlical
  33. Alansari K, Toaimah FH, Almatar DH, et al. Monoclonal antibody treatment of RSV bronchiolitis in young infants: a randomised trial. Pediatrics 2019;143(3):e20182308. DOI: 10.1542/peds.2018- 2308.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.