Skip to main content
SpringerLink
Log in

Infektionen durch RS-Viren

Respiratory syncytial virus infections

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Das respiratorische Synzytialvirus (RSV, „respiratory syncytial virus“) ist ein weltweit verbreitetes, saisonal auftretendes Atemwegspathogen und häufigster Erreger von Bronchiolitis und Pneumonie im Kindesalter. RSV betrifft alle Altersgruppen. In Risikopopulationen wie Frühgeborenen, Senioren über dem 65. Lebensjahr und Immundefizienten ist die Erkrankung mit signifikanter Morbidität und Mortalität assoziiert. Eine spezifische antivirale Therapie ist nicht verfügbar. Die Behandlung der RSV-Infektion basiert im Wesentlichen auf supportiven Maßnahmen mit Flüssigkeitszufuhr, Sauerstoffsupplementation und (nicht-)invasiven Beatmungsverfahren. Eine passive Immunisierung mit dem monoklonalen Antikörper Palivizumab zur Vermeidung von schweren Verläufen ist für Risikopatienten indiziert. Derzeit befinden sich zahlreiche neue aktive RSV-Vakzine und antivirale Substanzen in klinischer Testung, die in den nächsten Jahren Marktreife erlangen könnten.

Abstract

Respiratory syncytial virus (RSV) is a seasonally occurring, worldwide distributed airway pathogen and the most common cause for severe bronchiolitis and pneumonia in infants. The RSV affects all age groups but in premature infants, immunodeficient patients and older people over the age of 65 years it is associated with a significant morbidity and mortality. No specific antiviral treatment is so far available and RSV bronchiolitis treatment remains only supportive with oxygen and fluid supplementation and non(invasive) ventilation. A passive immunization with palivizumab, a monoclonal antibody administered during the RSV season, is indicated in high-risk patients for avoidance of severe courses. Currently, however, many novel active RSV vaccines and antiviral substances are being clinically tested and should become available in the upcoming years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD et al (2017) 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 390(10098):946–958. https://doi.org/10.1016/S0140-6736(17)30938-8

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hall CB, Weinberg GA, Blumkin AK, Edwards KM, Staat MA, Schultz AF et al (2013) Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 132(2):e341–e348. https://doi.org/10.1542/peds.2013-0303

    Article  PubMed  Google Scholar 

  3. Fleming DM, Taylor RJ, Lustig RL, Schuck-Paim C, Haguinet F, Webb DJ et al (2015) Modelling estimates of the burden of respiratory syncytial virus infection in adults and the elderly in the United Kingdom. Bmc Infect Dis 15:443. https://doi.org/10.1186/s12879-015-1218-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Falsey AR, Hennessey PA, Formica MA, Cox C, Walsh EE (2005) Respiratory syncytial virus infection in elderly and high-risk adults. N Engl J Med 352(17):1749–1759. https://doi.org/10.1056/NEJMoa043951

    Article  CAS  PubMed  Google Scholar 

  5. Obando-Pacheco P, Justicia-Grande AJ, Rivero-Calle I, Rodriguez-Tenreiro C, Sly P, Ramilo O et al (2018) Respiratory Syncytial Virus Seasonality: A Global Overview. J Infect Dis 217(9):1356–1364. https://doi.org/10.1093/infdis/jiy056

    Article  PubMed  Google Scholar 

  6. Jha A, Jarvis H, Fraser C, Openshaw PJM (2016) Respiratory syncytial virus. In: Hui DS, Rossi GA, Johnston SL (Hrsg) SARS, MERS and other viral lung infections. Wellcome trust-funded monographs and book chapters. Trust, Sheffield

    Google Scholar 

  7. Institut RK (2011) Respiratorische Synzytial-Viren (RSV). Epidemiol Bull 19(19):160–163

    Google Scholar 

  8. Agoti CN, Munywoki PK, Phan MVT, Otieno JR, Kamau E, Bett A et al (2017) Transmission patterns and evolution of respiratory syncytial virus in a community outbreak identified by genomic analysis. Virus Evol 3(1):vex6. https://doi.org/10.1093/ve/vex006

    Article  PubMed  PubMed Central  Google Scholar 

  9. Openshaw PJM, Chiu C, Culley FJ, Johansson C (2017) Protective and harmful immunity to RSV infection. Annu Rev Immunol 35:501–532. https://doi.org/10.1146/annurev-immunol-051116-052206

    Article  CAS  PubMed  Google Scholar 

  10. Meissner HC (2016) Viral bronchiolitis in children. N Engl J Med 374(1):62–72. https://doi.org/10.1056/NEJMra1413456

    Article  CAS  PubMed  Google Scholar 

  11. Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM et al (2015) Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med 373(5):415–427. https://doi.org/10.1056/NEJMoa1500245

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Branche AR, Falsey AR (2015) Respiratory syncytial virus infection in older adults: an under-recognized problem. Drugs Aging 32(4):261–269. https://doi.org/10.1007/s40266-015-0258-9

    Article  PubMed  Google Scholar 

  13. Harrington RD, Hooton TM, Hackman RC, Storch GA, Osborne B, Gleaves CA et al (1992) An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis 165(6):987–993

    Article  CAS  Google Scholar 

  14. Sigurs N, Aljassim F, Kjellman B, Robinson PD, Sigurbergsson F, Bjarnason R et al (2010) Asthma and allergy patterns over 18 years after severe RSV bronchiolitis in the first year of life. Thorax 65(12):1045–1052. https://doi.org/10.1136/thx.2009.121582

    Article  PubMed  Google Scholar 

  15. Blanken MO, Rovers MM, Molenaar JM, Winkler-Seinstra PL, Meijer A, Kimpen JL et al (2013) Respiratory syncytial virus and recurrent wheeze in healthy preterm infants. N Engl J Med 368(19):1791–1799. https://doi.org/10.1056/NEJMoa1211917

    Article  CAS  PubMed  Google Scholar 

  16. Caliskan M, Bochkov YA, Kreiner-Moller E, Bonnelykke K, Stein MM, Du G et al (2013) Rhinovirus wheezing illness and genetic risk of childhood-onset asthma. N Engl J Med 368(15):1398–1407. https://doi.org/10.1056/NEJMoa1211592

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Oosterheert JJ, van Loon AM, Schuurman R, Hoepelman AI, Hak E, Thijsen S et al (2005) Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 41(10):1438–1444. https://doi.org/10.1086/497134

    Article  PubMed  Google Scholar 

  18. Brinkman F et al (2015) PCR-basierte Erregerdiagnosik. Pneumologe 12:464–473. https://doi.org/10.1007/s10405-015-0001-6

    Article  Google Scholar 

  19. Jartti T, Soderlund-Venermo M, Hedman K, Ruuskanen O, Makela MJ (2013) New molecular virus detection methods and their clinical value in lower respiratory tract infections in children. Paediatr Respir Rev 14(1):38–45. https://doi.org/10.1016/j.prrv.2012.04.002

    Article  PubMed  Google Scholar 

  20. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM et al (2014) Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 134(5):e1474–e1502. https://doi.org/10.1542/peds.2014-2742

    Article  PubMed  Google Scholar 

  21. Excellence NIfHaC (2015) Bronchiolitis in children: diagnosis and mangement. Nice guideline. http://nice.org.uk/guidance/ng9/. Zugegriffen: 05. März 2019

    Google Scholar 

  22. Weigt SS, Gregson AL, Deng JC, Lynch JP 3rd, Belperio JA (2011) Respiratory viral infections in hematopoietic stem cell and solid organ transplant recipients. Semin Respir Crit Care Med 32(4):471–493. https://doi.org/10.1055/s-0031-1283286

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fuehner T, Dierich M, Duesberg C, DeWall C, Welte T, Haverich A et al (2011) Single-centre experience with oral ribavirin in lung transplant recipients with paramyxovirus infections. Antivir Ther (Lond) 16(5):733–740. https://doi.org/10.3851/IMP1811

    Article  CAS  Google Scholar 

  24. DeVincenzo JP, Whitley RJ, Mackman RL, Scaglioni-Weinlich C, Harrison L, Farrell E et al (2014) Oral GS-5806 activity in a respiratory syncytial virus challenge study. N Engl J Med 371(8):711–722. https://doi.org/10.1056/NEJMoa1401184

    Article  CAS  PubMed  Google Scholar 

  25. DeVincenzo JP, McClure MW, Symons JA, Fathi H, Westland C, Chanda S et al (2015) Activity of oral ALS-008176 in a respiratory syncytial virus challenge study. N Engl J Med 373(21):2048–2058. https://doi.org/10.1056/NEJMoa1413275

    Article  CAS  PubMed  Google Scholar 

  26. Cunningham S, Rodriguez A, Adams T, Boyd KA, Butcher I, Enderby B et al (2015) Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet 386(9998):1041–1048. https://doi.org/10.1016/S0140-6736(15)00163-4

    Article  PubMed  PubMed Central  Google Scholar 

  27. Franklin D, Dalziel S, Schlapbach LJ, Babl FE, Oakley E, Craig SS et al (2015) Early high flow nasal cannula therapy in bronchiolitis, a prospective randomised control trial (protocol): A Paediatric Acute Respiratory Intervention Study (PARIS). Bmc Pediatr 15:183. https://doi.org/10.1186/s12887-015-0501-x

    Article  PubMed  PubMed Central  Google Scholar 

  28. Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP (2017) Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev 12:CD6458. https://doi.org/10.1002/14651858.CD006458.pub4

    Article  PubMed  Google Scholar 

  29. Liese J, Forster J (2018) S2k-Leitlinie „Leitlinie zur Prophylaxe von schweren Erkrankungen durch Respiratory Syncytial Virus (RSV) bei Risikokindern“. www.awmf.org/uploads/tx_szleitlinien/048-012l_S2k_Prophylaxe-von-schweren_RSV-Erkrankungen-Risikokindern-Palivizumab_2018-11.pdf. Zugegriffen: 05. März 2019

    Google Scholar 

  30. Mazur NI, Higgins D, Nunes MC, Melero JA, Langedijk AC, Horsley N et al (2018) The respiratory syncytial virus vaccine landscape: lessons from the graveyard and promising candidates. Lancet Infect Dis 18(10):e295–e311. https://doi.org/10.1016/S1473-3099(18)30292-5

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für pädiatrische Pneumologie, Allergologie und Neonatologie, Zentrum Kinderheilkunde und Jugendmedizin, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    M. Wetzke & N. Schwerk

Authors
  1. M. Wetzke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Schwerk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Wetzke.

Ethics declarations

Interessenkonflikt

M. Wetzke und N. Schwerk geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

T. Welte, Hannover

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wetzke, M., Schwerk, N. Infektionen durch RS-Viren. Pneumologe 16, 232–241 (2019). https://doi.org/10.1007/s10405-019-0252-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10405-019-0252-8

Schlüsselwörter

Keywords

Search

Navigation