RESPIRATORY SYNCYTIAL VIRUS-INFECTION IN CHILDREN WITH CONGENITAL HEART-DISEASE - A REVIEW

This paper reviews recent changes in morbidity and mortality of respir atory syncytial virus (RSV) infection in infants with congenital heart disease. Mortality since the late 1970s has declined substantially, f rom approximately 37% to 3%. Although the frequency of admission to in tensive care units has declined from approximately 60% to 30%, the fre quency for mechanical ventilatory support has not changed significantl y. Because mortality dropped prior to the widespread use of ribavirin, it is difficult to ascribe the improvement to this therapy. In infant s with congenital heart disease (CHD), nosocomial infection remains a significant problem, accounting for approximately 33% of the RSV cases . Some authors report significant reductions in hospital-acquired RSV by use of gloves and gowns for contacts with infectious cases. Efforts at primary prevention have encountered problems with development of a n RSV vaccine. Preliminary data from studies of passive immunization u sing immune globulins with high RSV antibody titers suggest that this therapy may reduce the severity of RSV infection in infants with serio us heart disease.