Respiratory syncytial virus (RSV) is a common respiratory virus. Since RSV-infected cells will fuse together to form a large cell structure similar to "synocytes", it is vividly given the name of the respiratory "synocyte" virus.
It is understood that respiratory syncytial virus is the main pathogen of respiratory diseases in infants and young children around the world. Worldwide, almost all children have been infected with RSV before the age of 2. Research shows that in 2015, about 33.1 million children around the world were infected with RSV and more than 3.2 million children were hospitalized due to infection. In my country, among acute respiratory infections in children under 5 years old, 46.9% are caused by viral infections, of which RSV composition ratio reaches 25.7%, exceeding rhinovirus, parainfluenza virus and influenza virus, and are the first viral pathogen that causes acute lower respiratory tract infections in children.
A few days ago, "Children" breathing, protecting together - 2022 Education and Popular Science Event for Lower Respiratory Diseases in Infants and Children was held in Beijing. Zhang Lingli, deputy secretary-general of the Chinese Preventive Medicine Association, pointed out in the event that respiratory syncytial virus is the most common viral pathogen that causes acute lower respiratory tract infection in children under 5 years old worldwide, and is also the primary cause of hospitalization for acute lower respiratory tract infection in infants and young children under 1 year old, seriously endangering the health of infants and young children. Respiratory syncytial virus infection not only aggravates the original chronic respiratory disease, but also may cause recurrent asthma, leaving behind sequelae, and has a great impact on children's health around the world and a burden of disease. However, respiratory syncytial virus is still relatively unfamiliar to most parents and has not attracted enough attention from the whole society. Therefore, it is very important to carry out popular science work on the prevention of respiratory syncytial virus disease.
"When talking about acute lower respiratory tract infection in children, pediatricians have endless topics." Zeng Mei, director of the Department of Infectious Diseases at the Pediatric Hospital Affiliated to Fudan University, said that from a global perspective, the vast majority of severe RSV infections occur in developing countries. It is particularly important to emphasize that among the people affected by RSV, the most vulnerable baby is the most vulnerable baby. Among them, the number of infections under 6 months old accounts for about 50% of the total number of RSV infections, and 75% of the age of infection occurs under 1 year old.
According to Zhang Yan, director of the Measles Department of the Institute of Virus Disease Prevention and Control of the Chinese Center for Disease Control and Prevention, because respiratory syncytial virus is highly contagious, it will also cause outbreaks in specific populations. Some literature shows that outbreaks mainly occur in people with low immune function such as pediatric wards, neonatal intensive care units, nursing homes, transplant departments and cancer centers. "We have also been exposed to a severe pneumonia incident caused by respiratory syncytial virus infection that broke out in the confinement center. At that time, there were 21 newborns in the confinement center, 19 of which were healthy full-term babies, but the last 16 were hospitalized due to respiratory syncytial virus infection, and 7 were intubated in the ICU ward for intubation. So you can see that after the outbreak of respiratory syncytial virus infection, it can lead to more serious public health events." But it is gratifying that in recent years, the emergence of long-acting human monoclonal antibodies has brought light to the prevention and control of respiratory syncytial virus. It is understood that the research and development of long-acting human monoclonal antibodies in China has entered the third phase of clinical trials. Recent research on the effectiveness and safety of RSV prevention in infants and young children will be carried out in many places, and clinical recruitment work will be launched soon.
Xie Zhengde, director of the Infection and Virus Research Office of Beijing Children's Hospital Affiliated to Capital Medical University and Beijing Institute of Pediatrics Research, proposed that for the prevention of any infectious disease, there are two main categories:
The first category is general prevention. Generally speaking, it is called non-pharmaceutical intervention measures, such as wearing masks, washing hands, ventilation in the room, maintaining a certain degree of social distance, etc. Since many respiratory viruses are transmitted through droplets, relatively safe social distance is needed. General prevention is useful for most pathogens. At the same time, you must develop good hygiene and living habits, wear a mask in crowded places, especially in winter, and wash your hands in time after you go home.
The second category is special prevention, which is divided into two categories: passive immunity and active immunity.Passive immunity is to inject monoclonal antibodies or specific immunoglobulins into the human body. After the virus invades the human body, the antibody neutralizes the virus and will not get sick. Passive immune drugs include immunoglobulins and monoclonal antibodies. Immunoglobulins are prepared through the blood. For example, if you are infected with measles, specific antibodies against measles may be isolated from the blood, and the preparation of immunoglobulins can prevent measles in other people. Human-derived, synthetic monoclonal antibodies mainly target a specific virus, such as RSV and rabies virus. Another type of specific immunity is vaccines, which allows the body's immune cells to actively produce antibodies to prevent diseases.
Xie Zhengde emphasized that since the RSV vaccine is still under intensive development, it will take some time to be applied to clinical practice, so parents should understand the local RSV epidemic season so that targeted prevention can be done. For example, the north may start to increase RSV in September, and the epidemic season will generally last until March and April of the second year. At the same time, if you have a baby at home, adults may carry viruses when they go home. If you don’t wash your hands, you will have close contact with your children, which will easily spread the virus to your children, so your family should do a good job of health management. When holding a baby in winter, especially a few months old, it is best to wear a mask and wash your hands. If your family has symptoms of respiratory infection, such as sneezing, runny nose, or slight pharynx discomfort, it is best to stay away from the baby.
In addition, from a clinical point of view, it is important to identify RSV infection. If it cannot be identified in a timely manner, there is a problem of excessive use of antibiotics or other antiviral drugs, but not all medical institutions have the ability to detect respiratory syncytial virus. Zeng Mei reminded that wheezing is the most typical feature of children infected with respiratory syncytial virus. The younger the age, the more severe the wheezing, and 50% of children may have fever. (Guangming Daily All-Media Reporter Tian Yating)
