Viral and Host Factors in Human Respiratory Syncytial Virus Pathogenesis.

Human respiratory syncytial virus (RSV) was first isolated in 1956 from a laboratory chimpanzee with upper respiratory tract disease. RSV was quickly determined to be of human origin and was shown to be the leading worldwide viral agent of serious paediatric respiratory tract disease. In a 13-year prospective study of infants and children in the United States, RSV was detected in 43%, 25%, 11%, and 10% of paediatric hospitalisations for bronchiolitis, pneumonia, bronchitis, and croup, respectively. RSV is also a significant cause of morbidity and mortality in the elderly, with an impact approaching that of nonpandemic influenza virus. Although RSV has a single serotype, reinfection can occur throughout life. Strains circulate quickly around the earth. Neither a vaccine nor an effective antiviral therapy is available; however, infants at high risk for serious disease can receive passive immunoprophylaxis by a monthly injection of a commercial RSV-neutralising monoclonal antibody, palivizumab (Synagis), which provides a 55% reduction in RSV-associated hospitalisation. Journal of Virology. 2008;2040–55.