Skip to main content
Top
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Respiratory Syncytial Virus Infection | Research article

Incidence of respiratory syncytial virus infection in children with congenital heart disease undergoing immunoprophylaxis with palivizumab in Pará state, north region of Brazil

Authors: Roseane Porfírio de Souza, Andre Luis Ribeiro Ribeiro, Sílvio Augusto Fernandes de Menezes, Luiz Fernando Almeida Machado

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

Palivizumab prophylaxis for the human respiratory syncytial virus (HRSV) has been reported to reduce the risk of hospital admissions related to HRSV in children with congenital heart disease (CHD). These children are at high risk of developing severe lower respiratory tract infection (LRTI) due to HRSV infection. Our goal was to evaluate the incidence of HRSV infection in children with CHD after being submitted to immunoprophylaxis with palivizumab in Pará state, North region of Brazil.

Methods

A prospective and observational cohort study was performed in children ≤2 years of age with CHD who received palivizumab immunoprophylaxis between January 1 and June 31, 2016. A questionnaire about basic non-medical care measures was applied to parents/legal representatives. Data on patients’ demographic characteristics, household environment, and respiratory infections were evaluated. HRSV infection was determined by qPCR.

Results

There were 104 children enrolled in this investigation and the results showed a mean age of 10.6 months, an average weight of 7.3 kg and 3.5 doses of palivizumab per children during seasonality of HRSV. Respiratory infection was observed in 27.9% of cases, of which 9.6% were LRTI. No case of children who received palivizumab immunoprophylaxis and developed influenza-like symptoms tested positive for HRSV.

Conclusion

Although the lack of a control group doesn’t allow to affirm the effectiveness of HRSV passive immunization, the immunoprophylaxis with palivizumab appeared to be totally efficient in preventing respiratory infection by HRSV in children up to two years of age with CHD.
Literature
1.
go back to reference Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55.CrossRef Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55.CrossRef
2.
go back to reference Ferone EA, Berezin EN, Durigon GS, Finelli C, FelÌcio MC, Storni JG, et al. Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection. J Pediatr. 2014;90(1):42–9.CrossRef Ferone EA, Berezin EN, Durigon GS, Finelli C, FelÌcio MC, Storni JG, et al. Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection. J Pediatr. 2014;90(1):42–9.CrossRef
3.
go back to reference Law BJ, Langley JM, Allen U, Paes B, Lee DS, Mitchell I, et al. The Paediatric investigators collaborative network on infections in Canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation. Pediatr Infect Dis J. 2004;23(9):806–14.CrossRef Law BJ, Langley JM, Allen U, Paes B, Lee DS, Mitchell I, et al. The Paediatric investigators collaborative network on infections in Canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation. Pediatr Infect Dis J. 2004;23(9):806–14.CrossRef
4.
go back to reference MacDonald NE, Hall CB, Suffin SC, Alexson C, Harris PJ, Manning JA. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med. 1982;307(7):397–400.CrossRef MacDonald NE, Hall CB, Suffin SC, Alexson C, Harris PJ, Manning JA. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med. 1982;307(7):397–400.CrossRef
5.
go back to reference Zachariah P, Shah S, Gao D, Simões EA. Predictors of the duration of the respiratory syncytial virus season. Pediatr Infect Dis J. 2009;28(9):772–6.CrossRef Zachariah P, Shah S, Gao D, Simões EA. Predictors of the duration of the respiratory syncytial virus season. Pediatr Infect Dis J. 2009;28(9):772–6.CrossRef
6.
go back to reference Schmidt R, Majer I, García Román N, Rivas Basterra A, Grubb E, Medrano López C. Palivizumab in the prevention of severe respiratory syncytial virus infection in children with congenital heart disease; a novel cost-utility modeling study reflecting evidence-based clinical pathways in Spain. Health Econ Rev. 2017;7(1):47.CrossRef Schmidt R, Majer I, García Román N, Rivas Basterra A, Grubb E, Medrano López C. Palivizumab in the prevention of severe respiratory syncytial virus infection in children with congenital heart disease; a novel cost-utility modeling study reflecting evidence-based clinical pathways in Spain. Health Econ Rev. 2017;7(1):47.CrossRef
7.
go back to reference Reis J, Shaman J. Retrospective parameter estimation and forecast of respiratory syncytial virus in the United States. PLoS Comput Biol. 2016;12(10):e1005133.CrossRef Reis J, Shaman J. Retrospective parameter estimation and forecast of respiratory syncytial virus in the United States. PLoS Comput Biol. 2016;12(10):e1005133.CrossRef
8.
go back to reference Brasil. Ministério da Saúde. Nota Técnica Conjunta n° 05 de 09 de fevereiro de 2015. Estabelece a Sazonalidade do Vírus Sincicial Respiratório no Brasil e Oferece Esclarecimentos Referentes ao Protocolo de Palivizumabe. Brasília: Ministério da Saúde; 2015. Brasil. Ministério da Saúde. Nota Técnica Conjunta n° 05 de 09 de fevereiro de 2015. Estabelece a Sazonalidade do Vírus Sincicial Respiratório no Brasil e Oferece Esclarecimentos Referentes ao Protocolo de Palivizumabe. Brasília: Ministério da Saúde; 2015.
9.
go back to reference Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD. Bacic Vrca V, Barsic B. monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children. Cochrane Database Syst Rev. 2013;30(4):CD006602. Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD. Bacic Vrca V, Barsic B. monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children. Cochrane Database Syst Rev. 2013;30(4):CD006602.
10.
go back to reference da Saúde M. Portaria no 522, de 13 de maio de 2013. Aprova o protocolo de uso do palivizumabe. Diário Oficial da União. 2013;14:mai. da Saúde M. Portaria no 522, de 13 de maio de 2013. Aprova o protocolo de uso do palivizumabe. Diário Oficial da União. 2013;14:mai.
12.
go back to reference Broadbent L, Groves H, Shields MD, Power UF. Respiratory syncytial virus, an ongoing medical dilemma: an expert commentary on respiratory syncytial virus prophylactic and therapeutic pharmaceuticals currently in clinical trials. Influenza Other Respir Viruses. 2015;9(4):169–78.CrossRef Broadbent L, Groves H, Shields MD, Power UF. Respiratory syncytial virus, an ongoing medical dilemma: an expert commentary on respiratory syncytial virus prophylactic and therapeutic pharmaceuticals currently in clinical trials. Influenza Other Respir Viruses. 2015;9(4):169–78.CrossRef
13.
go back to reference van Elden LJR, van Loon AM, van der Beek A, Hendriksen KAW, Hoepelman AIM, van Kraaij MGJ, Schipper P, Nijhuis M. Applicability of a real-time quantitative PCR assay for diagnosis of respiratory syncytial virus infection in immunocompromised adults. J Clin Microbiol. 2003;41(9):4378–81.CrossRef van Elden LJR, van Loon AM, van der Beek A, Hendriksen KAW, Hoepelman AIM, van Kraaij MGJ, Schipper P, Nijhuis M. Applicability of a real-time quantitative PCR assay for diagnosis of respiratory syncytial virus infection in immunocompromised adults. J Clin Microbiol. 2003;41(9):4378–81.CrossRef
14.
go back to reference Freitas AR, Donalisio MR. Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations. Mem Inst Oswaldo Cruz. 2016;111(5):294–301.CrossRef Freitas AR, Donalisio MR. Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations. Mem Inst Oswaldo Cruz. 2016;111(5):294–301.CrossRef
15.
go back to reference Durigon GS, Oliveira DB, Felicio MC, Finelli C, Pereira MF, Storni JG, Caldeira RN, Berezin RC, Durigon EL, Berezin EN. Poor outcome of acute respiratory infection in young children with underlying health condition in Brazil. Int J Infect Dis. 2015;34:3–7.CrossRef Durigon GS, Oliveira DB, Felicio MC, Finelli C, Pereira MF, Storni JG, Caldeira RN, Berezin RC, Durigon EL, Berezin EN. Poor outcome of acute respiratory infection in young children with underlying health condition in Brazil. Int J Infect Dis. 2015;34:3–7.CrossRef
16.
go back to reference Gurgel RQ, Bezerra PG, Duarte Mdo C, Moura AÁ, Souza EL, Silva LS, Suzuki CE, Peixoto RB. Relative frequency, possible risk factors, viral Codetection rates, and seasonality of respiratory syncytial virus among children with lower respiratory tract infection in northeastern Brazil. Medicine (Baltimore). 2016;95(15):e3090.CrossRef Gurgel RQ, Bezerra PG, Duarte Mdo C, Moura AÁ, Souza EL, Silva LS, Suzuki CE, Peixoto RB. Relative frequency, possible risk factors, viral Codetection rates, and seasonality of respiratory syncytial virus among children with lower respiratory tract infection in northeastern Brazil. Medicine (Baltimore). 2016;95(15):e3090.CrossRef
17.
go back to reference Monteiro AI, Bellei NC, Sousa AR, dos Santos AM, Weckx LY. Respiratory infections in children up to two years of age on prophylaxis with palivizumab. Rev Paul Pediatr. 2014;32(2):152–8.CrossRef Monteiro AI, Bellei NC, Sousa AR, dos Santos AM, Weckx LY. Respiratory infections in children up to two years of age on prophylaxis with palivizumab. Rev Paul Pediatr. 2014;32(2):152–8.CrossRef
18.
go back to reference Kim AY, Jung SY, Choi JY, Kim GB, Kim YH, Shim WS, et al. Retrospective multicenter study of respiratory syncytial virus prophylaxis in Korean children with congenital heart diseases. Korean Circ J. 2016;46(5):719–26.CrossRef Kim AY, Jung SY, Choi JY, Kim GB, Kim YH, Shim WS, et al. Retrospective multicenter study of respiratory syncytial virus prophylaxis in Korean children with congenital heart diseases. Korean Circ J. 2016;46(5):719–26.CrossRef
19.
go back to reference Castillo LM, Bugarin G, Arias JC, Barajas Rangel JI, Serra ME, Vain N. One-year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America. J Pediatr. 2017;93(5):467–74.CrossRef Castillo LM, Bugarin G, Arias JC, Barajas Rangel JI, Serra ME, Vain N. One-year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America. J Pediatr. 2017;93(5):467–74.CrossRef
20.
go back to reference Andres S, Bauer G, RodrÌguez S, Novali L, Micheli D, FariÒa D. Hospitalization due to respiratory syncytial virus infection in patients under 2 years of age with hemodynamically significant congenital heart disease. J Pediatr. 2012;88(3):246–52.CrossRef Andres S, Bauer G, RodrÌguez S, Novali L, Micheli D, FariÒa D. Hospitalization due to respiratory syncytial virus infection in patients under 2 years of age with hemodynamically significant congenital heart disease. J Pediatr. 2012;88(3):246–52.CrossRef
21.
go back to reference Pongiglione G, Possidoni A, di Luzio Paparatti U, Costanzo AM, Gualberti G, Bonvicini M, et al. Incidence of respiratory disease during the first two†years of life in children with hemodynamically significant congenital heart disease in Italy: a retrospective study. Pediatr Cardiol. 2016;37(8):1581–9.CrossRef Pongiglione G, Possidoni A, di Luzio Paparatti U, Costanzo AM, Gualberti G, Bonvicini M, et al. Incidence of respiratory disease during the first two†years of life in children with hemodynamically significant congenital heart disease in Italy: a retrospective study. Pediatr Cardiol. 2016;37(8):1581–9.CrossRef
Metadata
Title
Incidence of respiratory syncytial virus infection in children with congenital heart disease undergoing immunoprophylaxis with palivizumab in Pará state, north region of Brazil
Authors
Roseane Porfírio de Souza
Andre Luis Ribeiro Ribeiro
Sílvio Augusto Fernandes de Menezes
Luiz Fernando Almeida Machado
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1681-6

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue