Snodgrass - Respiratory Syncytial Virus Bronchiolitis in...

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    Respiratory Syncytial Virus Bronchiolitis in Infants Amanda Snodgrass Dr. Bill Grimes, Advisor Spring 2006
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Objectives Mechanisms involved in RSV  infection and severity Risk factors for severe RSV infection Prophylaxis and treatment of RSV Morbidity and Mortality
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Case Study
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RSV Facts Most common cause of  in children under 1  25-40% of children  develop bronchiolitis or  pneumonia during first  RSV infection 31/1,000 under 1 yr. are  hospitalized with RSV 2% will die
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Presentation Cold-like sx Audible wheezing SOB Anorexia Poor sleeping Irritability  Vomiting Choking
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Pathophysiology Negative-strand RNA virus Family  Paramyxoviridae RSV season late fall to early spring Peak in January/February Incubation 4-5 days, LRI between days  5-7
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Severity of RSV Infection is Determined By: Inhibition of certain interferons Involvement of innate immune system Interleukins and chemokines Coinfection with other respiratory viruses
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Inhibition of Interferons Interferons believed to have antiviral  properties Inhibition of IFN-gamma causes  enhanced IgE production
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Innate Immune System Activation contributes to inflammation  RSV-F glycoprotein may inhibit T-cell  activation RSV-infected CD8+ cells unable to  release IFN-gamma
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Infection induces expression Chemokines mimic RSV glycoproteins neutrophils IL-8 levels positively associated with  severity
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Coinfection Rhinovirus contributes to increased  severity in children with bronchiolitis Metapneumovirus (hMPV) enhances or  mimics symptoms of RSV bronchiolitis required amission to PICU
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Risk Factors
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Snodgrass - Respiratory Syncytial Virus Bronchiolitis in...

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