{"id":1164,"date":"2012-11-01T00:00:57","date_gmt":"2012-11-01T07:00:57","guid":{"rendered":"http:\/\/rhochistj.org\/RhoChiPost\/?p=1164"},"modified":"2014-02-19T12:16:34","modified_gmt":"2014-02-19T19:16:34","slug":"prepared-rsv-season","status":"publish","type":"post","link":"https:\/\/rhochistj.org\/RhoChiPost\/prepared-rsv-season\/","title":{"rendered":"Are You Prepared for RSV Season?"},"content":{"rendered":"<p><span style=\"font-size: 11pt; line-height: 1.5em;\">By: Mahdieh Danesh Yazdi, Associate Student Editor<\/span><\/p>\n<p>&#8211;<\/p>\n<p>Many of us have prepared for influenza season by receiving the flu vaccine.\u00a0 (If you have not, please speak to your doctor or pharmacist soon! \u00a0Remember: even if you do not need it for your protection, get it for your patients\u2019 well-being).\u00a0 However, for the youngest members of our population, there is also another threat this season: respiratory syncytial virus (RSV).\u00a0 RSV is a single-stranded RNA virus that causes symptoms of the common cold such as fever, runny nose, coughing, and wheezing.<sup>1<\/sup>\u00a0 For older children and adults, it causes self-limiting sickness that resolves within a couple of weeks.<sup>1<\/sup>\u00a0 However, in younger children and infants, infection with this virus may cause a much more serious illness.\u00a0 In fact, it is a major cause of pediatric pneumonia and bronchiolitis.<sup>1<\/sup>\u00a0 This is especially true in infants and young children who have comborbidities such as congenital heart disease or immunosuppression.<sup>1<\/sup>\u00a0 There is currently no treatment specifically indicated for use against RSV and therapy usually involves supportive care.<sup>1<\/sup><\/p>\n<p>As with many other diseases of viral etiology, the best medical option is prevention.\u00a0 Non-pharmacologic prevention methods include minimizing sharing personal items and utensils between children, frequent hand washing, and avoiding contact with those who are sick.\u00a0 Currently, there is only one medication indicated for the prevention of RSV: palivizumab (Synagis<sup>\u00ae<\/sup>), a monoclonal antibody that works by preventing viral membrane fusion and blocking its entry to host cells.<sup>2<\/sup><\/p>\n<p>The American Academy of Pediatrics (AAP) has published guidelines for palivizumab in RSV prevention.<sup>3<\/sup>\u00a0 They recommend a 15 mg\/kg once monthly intramuscular injection for<sup>3<\/sup><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Infants &lt; 24 months of age with chronic lung disease requiring therapy in the past six months<\/li>\n<li>Infants &lt; 24 months of age with congenital heart disease +\n<ul>\n<li>Therapy OR<\/li>\n<li>Moderate to severe pulmonary hypertension OR<\/li>\n<li>Cyanotic heart disease<\/li>\n<li>Infants &lt; 12 months of age with airway abnormality or neuromuscular disease that would decrease one\u2019s ability to manage airway secretions<\/li>\n<li>Infants &lt; 12 months of age who were born at a gestational age \u2264 28 weeks<\/li>\n<li>Infants\u00a0 &lt; 6 months of age who were\u00a0 born at a gestational age of 29 to 31 weeks and 6 days<\/li>\n<li>Infants &lt; 3 months of age who were born at a gestational age of 32 to 34 weeks and 6 days +\n<ul>\n<li>Attends daycare<\/li>\n<li>Has one or more siblings &lt; 5 years of age in the same household (excluding multiple birth babies)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>The AAP recommends that infants receive these monthly injections during RSV season with a maximum of five injections.<sup>3<\/sup>\u00a0 The exception is in the case of infants &lt; 3 months of age who were born at a gestational age of 32 to 34 weeks (and 6 days) and either attend daycare or have one or more siblings who are &lt; 5 years of age in the same household.<sup>3<\/sup>\u00a0 These patients should receive a maximum of three injections.<sup>3<\/sup><\/p>\n<p>The common side effects of this drug include erythema and swelling at the injection site, fever, and rash.<sup>4<\/sup>\u00a0 It is important to keep in mind that injections of this drug may cause anaphylactic reactions in those with hypersensitivity to palivizumab or any component of the drug.<sup>4<\/sup><\/p>\n<p>RSV season varies yearly and based on region, but usually begins around November and ends in March or April.<sup>5<\/sup>\u00a0 Palivizumab is recommended to be given the month before or during RSV season; therefore, the first dose is usually provided between September and November.<sup>5<\/sup><\/p>\n<p>If you have a new baby in your household and he\/she meets the criteria above, speak to the pediatrician about RSV prevention for the infant.\u00a0 Since this virus is highly contagious and is of special concern in infants with other comorbidities, those working in a hospital setting must be wary of the threat RSV poses.\u00a0 Of course, if you are on rotations (within a pediatric or neonatal unit), be sure to screen patients to determine their eligibility for palivizumab.<\/p>\n<p><b><span style=\"text-decoration: underline;\">SOURCES:<\/span><\/b><\/p>\n<ol>\n<li>Rubin E, Gorstein F, Rubin R, Schwarting R, Strayer D.\u00a0 Rubin\u2019s Pathology: Clinicopathologic Foundations of Medicine.\u00a0 Fourth ed.\u00a0 Philadelphia, PA: Lippincottt Williams &amp; Wilkins;2005: 364.<\/li>\n<li>Synagis [package insert].\u00a0 Gaithersberg, MD: Medimmune, LLC; 2012.<\/li>\n<li>American Academy of Pediatrics.\u00a0 Respiratory Syncytial Virus.\u00a0 In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds.\u00a0 Red Book: 2009 Report of the Committee on Infectious Diseases.\u00a0 28th ed.\u00a0 Elk Grove Village, IL: American Academy of Pediatrics; 2009.<\/li>\n<li>Synagis [package insert].\u00a0 Gaithersberg, MD: Medimmune, LLC; 2012.<\/li>\n<li>CDC features page.\u00a0 Centers for Disease Control and Prevention Web site.\u00a0 <a href=\"http:\/\/www.cdc.gov\/Features\/dsRSV\/\" target=\"new\" class=\"external external_icon\">http:\/\/www.cdc.gov\/Features\/dsRSV\/.<\/a>\u00a0 Accessed Oct 30, 2012.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>By: Mahdieh Danesh Yazdi, Associate Student Editor &#8211; Many of us have prepared for influenza season by receiving the flu vaccine.\u00a0 (If you have not, please speak to your doctor or pharmacist soon! \u00a0Remember: even if you do not need it for your protection, get it for your patients\u2019 well-being).\u00a0 However, for the youngest members&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,5],"tags":[1822,343,95,197,2243,702,707,1160,15,163,13,2227,29,50,132,314,425,2251,39,2253,135,137,995,407,2261,14,725,208,101,363,968,1625,704,12,92,671,1736,99,146,187,33,2252,1882,1161,16,51,48,1061],"class_list":["post-1164","post","type-post","status-publish","format-standard","hentry","category-clinical","category-news-politics","tag-against","tag-and","tag-april","tag-book","tag-cdc","tag-children","tag-cold","tag-control","tag-disease","tag-dose","tag-drug","tag-ebola-virus-disease","tag-editor","tag-fever","tag-flu","tag-for","tag-fusion","tag-guidelines","tag-heart","tag-hypertension","tag-illness","tag-infection","tag-influenza","tag-injection","tag-lung","tag-medication","tag-mg","tag-monthly","tag-november","tag-of","tag-one","tag-or","tag-pediatric","tag-pharmacist","tag-pneumonia","tag-r","tag-respiratory","tag-september","tag-sickness","tag-side","tag-student","tag-symptoms","tag-synagis","tag-therapy","tag-treatment","tag-vaccine","tag-virus","tag-with"],"views":557,"_links":{"self":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/1164","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/comments?post=1164"}],"version-history":[{"count":0,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/1164\/revisions"}],"wp:attachment":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/media?parent=1164"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/categories?post=1164"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/tags?post=1164"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}