Respiratory syncytial virus (RSV) infects almost all children by two years of age, resulting in a large number of hospital admissions in infants. Reactive airway disease is more common after RSV infection, even in previously healthy children. Management of the acute infection is supportive, but preliminary evidence suggests surfactant administration to ventilated infants may be of benefit. Whether ribavirin or corticosteroids reduce respiratory morbidity after RSV infection remains controversial. Immunoprophylaxis reduces RSV admissions, Palivizumab, a humanized monoclonal antibody, is a more cost-effective prophylaxis than RSV immune globulin. Nevertheless, the cost of prophylaxis, unless only given to very high-risk infants, exceeds savings made in reducing admissions.
Children Nationwide Professor of Neonatology and Clinical Respiratory Physiology, Head of the Academic Department of Paediatrics, Guy's, King's & St Thomas' School of Medicine, King's College, London, UK.
Correspondence to Professor Anne Greenough, MD, FRCP, FRCPCH, DCH, Department of Child Health, 4th floor, Ruskin Wing, King's College Hospital, London SE5 9RS, UK; e-mail: firstname.lastname@example.org