Featured Research

from universities, journals, and other organizations

Risk Factors For Severe RSV Infection In Immunocompromised Children Identified

Date:
February 8, 2008
Source:
St. Jude Children's Research Hospital
Summary:
Researchers have shown how to predict if a child who is infected with respiratory syncytial virus while being treated for cancer or another catastrophic disease is at high risk for developing severe infection. The finding will help clinicians improve guidelines for managing these infected children.

St. Jude Children's Research Hospital investigators and collaborators have shown how to predict if a child who is infected with respiratory syncytial virus (RSV) while being treated for cancer or another catastrophic disease is at high risk for developing severe infection. The finding will help clinicians improve guidelines for managing these infected children.

RSV is a common cause of pneumonia among infants, children and adults during winter, frequently causing fever, runny nose and coughs. It can be much more severe in patients who are undergoing cancer treatments and whose immune systems are suppressed. In these patients, the virus can move into the deep lung, causing pneumonia and other respiratory problems that can be fatal. However, it is difficult to predict which infected patient is likely to develop a serious lower respiratory tract illness and which one will continue to simply have a mild runny nose and cough.

The St. Jude team and collaborators found that if these children are under 2 years old and have very low levels of immune system cells in their blood called lymphocytes, they are at high risk for the RSV infection to become serious by moving into the lung. Such infections are especially dangerous because they can be fatal in some immunocompromised children, and there is no standard effective treatment for these infections, the researchers said. A report on the retrospective findings appears in the February issue of the journal "Pediatrics."

"The new information is important because it helps identify children who are most at risk for severe disease using easily available clinical information," said Aditya Gaur, M.D., assistant member of the St. Jude Department of Infectious Diseases and the paper's senior author. "This narrows down the patient population who needs to be considered for antiviral therapy, which is costly and often inconvenient to receive from a child's perspective. For example, one treatment for RSV infection is to have the child breathe an aerosolized form of the antiviral drug ribavirin for 12 to 18 hours, which is tough for the child and the parent."

The findings of this study require confirmation in prospective studies, Gaur said. Results of the study also help define which children should receive medications that can help prevent RSV infection.

Another significant finding was that--unlike some previous reports in immunocompromised adults with RSV--neutropenia is not a risk factor for lower respiratory track infection, Gaur said. Neutropenia is an abnormally low level of neutrophils, immune system cells that engulf and digest germs.

"This finding is important because with cancer patients, clinicians are used to identifying those at risk for bacterial and fungal infections based on a patient having neutropenia," Gaur said. This study shows that for RSV, which is a viral infection, lymphopenia and not neutropenia is what identifies children at risk.

Previous studies have shown that lower respiratory track infection, is more common in children whose immune system is suppressed, who are receiving chemotherapy or who have received a hematopoietic stem cell transplant (HSCT). However, while some studies report that lower respiratory track infection, due to RSV is fatal in 50 to 100 percent of infected adults, there is little information about this type of infection in immunocompromised children.

"We decided to analyze the course of RSV infection in children being treated for cancer to identify factors that could help us predict which ones were at highest risk for severe disease or death due to a lower respiratory tract infection with this virus," Gaur said. HSCT is the transplantation of special cells from the blood or bone marrow that can give rise to all the blood cells of the body (red and white cells and platelets).

The St. Jude team studied clinical and laboratory information from the records of 58 patients who had tested positive for RSV infection. Among these children, 23 (40 percent) had acute lymphoblastic leukemia, 11 (19 percent) had solid tumors and 24 patients (41 percent) had acute myeloid leukemia (AML), severe combined immunodeficiency syndrome (SCIDS), or had undergone bone marrow transplantation. RSV disease in these infected children was classified as upper respiratory track infection only or lower respiratory tract infection; and children with both upper and lower respiratory track infections, were defined as having lower respiratory track infection.

Overall, 16 (28 percent) of these children developed lower respiratory track infection, due to RSV. The frequency of this type of infection was highest (42 percent) in patients who had undergone HSCT or who had AML or SCIDS. Five patients (31 percent) with LRTI died, an overall mortality rate of 8.6 percent. All deaths occurred in lower respiratory track infection patients who were severely immunocompromised from their cancer, from chemotherapy or from the HSCT.

Other researchers include C. M. El Saleeby (formerly of St. Jude and now at MassGeneral Hospital for Children, Boston), G. W. Somes (Department of Preventive Medicine, University of Tennessee, Memphis) and J.P. DeVincenzo (Le Bonheur Children's Medical Center and University of Tennessee, Memphis).

This study was supported by the National Institutes of Health and ALSAC.


Story Source:

The above story is based on materials provided by St. Jude Children's Research Hospital. Note: Materials may be edited for content and length.


Cite This Page:

St. Jude Children's Research Hospital. "Risk Factors For Severe RSV Infection In Immunocompromised Children Identified." ScienceDaily. ScienceDaily, 8 February 2008. <www.sciencedaily.com/releases/2008/02/080204132525.htm>.
St. Jude Children's Research Hospital. (2008, February 8). Risk Factors For Severe RSV Infection In Immunocompromised Children Identified. ScienceDaily. Retrieved July 26, 2014 from www.sciencedaily.com/releases/2008/02/080204132525.htm
St. Jude Children's Research Hospital. "Risk Factors For Severe RSV Infection In Immunocompromised Children Identified." ScienceDaily. www.sciencedaily.com/releases/2008/02/080204132525.htm (accessed July 26, 2014).

Share This




More Health & Medicine News

Saturday, July 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins