• IMMUNE NETWORK
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• v.15 no.2
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• pp.73-82
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• 2015

Respiratory syncytial virus (RSV) infection is recognized by the innate immune system through Toll like receptors (TLRs) and retinoic acid inducible gene I. These pathways lead to the activation of type I interferons and resistance to infection. In contrast to TLRs, very few studies have examined the role of NOD-like receptors in viral recognition and induction of adaptive immune responses to RSV. Caspase-1 plays an essential role in the immune response via the maturation of the proinflammatory cytokines IL-$1{\beta}$ and IL-18. However, the role of caspase-1 in RSV infection in vivo is unknown. We demonstrate that RSV infection induces IL-$1{\beta}$ secretion and that caspase-1 deficiency in bone marrow derived dendritic cells leads to defective IL-$1{\beta}$ production, while normal RSV viral clearance and T cell responses are observed in caspase-1 deficient mice following respiratory infection with RSV. The frequencies of IFN-${\gamma}$ producing or RSV specific T cells in lungs from caspase-1 deficient mice are not impaired. In addition, we demonstrate that caspase-1 deficient neonatal or young mice also exhibit normal immune responses. Furthermore, we find that IL-1R deficient mice infected with RSV exhibit normal Th1 and cytotoxic T lymphocytes (CTL) immune responses. Collectively, these results demonstrate that in contrast to TLR pathways, caspase-1 might not play a central role in the induction of Th1 and CTL immune responses to RSV.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.168-177
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• 2013

Purpose: To identify the clinical and epidemiological characteristics of human metapneumovirus infections (hMPV) in children compared to respiratory syncytial virus A (RSV A) and B (RSV B). Method: A retrospective review of medical records was performed in 36 patients with hMPV infection, 106 with RSV A infection, and 51 with RSV B infection, from September 2007 to July 2012. Results: The peak incidence of hMPV infection was observed in May, whereas for RSV infections in November and December. hMPV infection occurred in older patients compared to RSV A and B infection ($29.9{\pm}32.5$ months vs. $13.6{\pm}15.4$ months, P<0.001; $29.9{\pm}32.5$ months vs. $12.1{\pm}13.5$ months, P<0.001, respectively). hMPV infection was more often associated with fever compared to RSV A (97.2% vs. 67.9%, P<0.001), while wheezing was less frequent compared to RSV A and B infection (16.7% vs. 47.2%, P=0.001; 16.7% vs. 37.3%, P=0.037, respectively). hMPV infection was more often diagnosed as pneumonia compared to RSV A infection (72.2% vs. 50.0%, P=0.047) while bronchiolitis was less frequent than in RSV A (5.6% vs. 34.9%, P=0.001) or RSV B infection (5.6% vs. 29.4%, P=0.006). In addition, intravenous antibiotic was more often prescribed for patients with hMPV infection than those with RSV A and B (69.4% vs. 39.6%, P=0.002; 69.4% vs. 43.1, P=0.015, respectively). Conclusion: This study identified characteristics of hMPV infection compared to RSV A and B infection. Seasonality in spring, higher age group, and higher proportion of pneumonia in hMPV infections may be a useful guide for management of respiratory viral infections in children.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.400-408
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• 2018

Background : Palivizumab is an intravenous monoclonal antibody which is used in the prevention of respiratory syncytial virus (RSV) infection. It is currently recommended for infants who are at high-risk for RSV infections due to preterm birth or other medical conditions such as congenital heart disease. Palivizumab is a humanized monoclonal antibody directed against an epitope in the antigenic site A of the protein F of RSV particles. Palivizumab is given once a month via intramuscular (IM) injection throughout the duration of the RSV season. Since palivizumab is known to have preventive effects against RSV infection for children with older siblings, the insurance coverage for palivizumab was expanded in October 2016. Methods : The electronic medical records of children under 2 years old who have older siblings who visited or were admitted to the Severance Hospital from October 2015 to May 2016 and from October 2016 to May 2017 were reviewed retrospectively. The data were then divided into two groups depending on the pilivizumab administration. Results : A total of 67 patients were enrolled in this study. The effectiveness in the reduction of hospitalization was statistically significant (p=0.009). Palivizumab decreased respiratory symptoms such as cough, rhinorrhea, and fever in patients with older siblings (p 0.05). Conclusions : In this study, palivizumab administration was effective in preventing RSV infection in infants with older siblings. Expanding palivizumab-prophylaxis administration to infants with older siblings may be effective in the prevention of upper respiratory infections.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.91-96
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• 2007

Purpose : This study was performed to evaluate a new rapid diagnostic kit (BIOLINE $RSV^{TM}$; Standard Diagnostics Inc., Yongin, Korea), a lateral-flow immunoassay, in the detection of respiratory syncytial virus (RSV) from the nasopharyngeal aspirates (NPA) of children with lower respiratory tract infections (LRTIs) in comparison with other diagnostic methods. Methods : Three hundred and nineteen NPAs were selected from a large pool of NPAs that had been obtained from children with LRTIs. All specimens had already been tested for RSV by culture and immunofluorescent (IF) test, and had been kept frozen. Tests with BIOLINE $RSV^{TM}$ were performed at least twice. All who conducted the experiments or interpreted the test results were blinded to the results of both culture and IF tests. Results : One hundred seven (97.3%) of 110 specimens that were positive for RSV by both culture and IF test, 29 (87.9%) of 33 that were positive by IF test only, 20 (76.9%) of 26 that were positive by culture only, and 140 (93.3%) of 150 that were negative by both methods were negative for RSV by BIOLINE $RSV^{TM}$. By combining the above results, the following 5 diagnostic values of BIOLINE $RSV^{TM}$ were determined in comparison with viral culture or IF test; sensitivity, 92.3% (156/169, 95% confidence interval [CI], 87.1-97.5%); specificity, 93.3% (140/150, 95% CI, 88.4-98.2%); positive predictive value, 94.0% (156/166, 95% CI, 89.5-98.5%); negative predictive value, 91.5% (140/143, 95% CI, 86.0-97.0%); and agreement, 95.9% (306/319, 95% CI, 92.1-99.7%), respectively. Conclusion : This study revealed that BIOLINE $RSV^{TM}$ demonstrated good sensitivity and specificity for the detection of RSV antigen from NPAs of children with LRTIs. Because of simple methods and quick results, this test may be useful for the diagnosis of RSV infection during the epidemic periods.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.10-17
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• 2015

Objectives: An outbreak of acute febrile illness occurred in the Republic of Korea Air Force boot camp from May to July 2011. An epidemiological investigation of the causative agent, which was of a highly infective nature, was conducted. Methods: Throat swabs were carried out and a multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify possible causative factors. Results: The mean age of patients who had febrile illness during the study period was 20.24 years. The multiplex RT-PCR assay identified respiratory syncytial virus (RSV) as the causative agent. The main symptoms were sore throat (76.0%), sputum (72.8%), cough (72.1%), tonsillar hypertrophy (67.9%), and rhinorrhea (55.9%). The mean temperature was $38.75^{\circ}C$ and the attack rate among the recruits was 15.7% (588 out of 3750 recruits), while the mean duration of fever was 2.3 days. The prognosis was generally favorable with supportive care but recurrent fever occurred in 10.1% of the patients within a month. Conclusions: This is the first epidemiological study of an RSV outbreak that developed in a healthy young adult group. In the event of an outbreak of an acute febrile illness of a highly infective nature in facilities used by a young adult group, RSV should be considered among the possible causative agents.

• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.29-32
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• 2020

As respiratory syncytial virus(RSV) is transmitted either via directly contact with an infected case or via indirectly contaminated fomites or skin, the major preventive measures are strict hand hygiene, early detection of transmitted sources, and rapid isolation of RSV patients. Especially early detection of hidden cases is the most critical control measure when an index case was notified in a postpartum center. The Guideline of Korea Centers for Diseases Control and Prevention defines potential contacts in an epidemiologic survey as admitted newborns, parents of index cases, center's workers, and visitors for 10 days before the first diagnosis day of index case. However, it needs to classify potential contacts in more detail in order to conduct a successful survey. Authors conducted to search related literatures and appraise the evidences. Firstly, potential contacts would be classified into RSV-related symptomatic contacts(SxC) and asymptomatic contacts. And then, mother, caring workers, and visitors of the index cases among asymptomatic contacts would be defined as the asymptomatic close contacts(ASCC). Finally, the rest would be defined as the asymptomatic regular contacts(ASRC). The defined test using reverse transcription-PCR is applied to SxC and ASCC, and decision of isolation or regular activities are made according to the results. The rapid antigen detection test kits are applied to ASRC. These suggestions might be helpful to detect hidden cases earlier and prevent a further infection.

• Clinical and Experimental Pediatrics
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• v.61 no.6
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• pp.180-186
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• 2018

Purpose: Despite the availability of molecular methods, identification of the causative virus in children with acute respiratory infections (ARIs) has proven difficult as the same viruses are often detected in asymptomatic children. Methods: Multiplex reverse transcription polymerase chain reaction assays were performed to detect 15 common respiratory viruses in children under 15 years of age who were hospitalized with ARI between January 2013 and December 2015. Viral epidemiology and clinical profiles of single virus infections were evaluated. Results: Of 3,505 patients, viruses were identified in 2,424 (69.1%), with the assay revealing a single virus in 1,747 cases (49.8%). While major pathogens in single virus-positive cases differed according to age, human rhinovirus (hRV) was common in patients of all ages. Respiratory syncytial virus (RSV), influenza virus (IF), and human metapneumovirus (hMPV) were found to be seasonal pathogens, appearing from fall through winter and spring, whereas hRV and adenovirus (AdV) were detected in every season. Patients with ARIs caused by RSV and hRV were frequently afebrile and more commonly had wheezing compared with patients with other viral ARIs. Neutrophil-dominant inflammation was observed in ARIs caused by IF, AdV, and hRV, whereas lymphocyte-dominant inflammation was observed with RSV A, parainfluenza virus, and hMPV. Monocytosis was common with RSV and AdV, whereas eosinophilia was observed with hRV. Conclusion: In combination with viral identification, recognition of virus-specific clinical and laboratory patterns will expand our understanding of the epidemiology of viral ARIs and help us to establish more efficient therapeutic and preventive strategies.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.193-200
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• 2000

Purpose : This study was designed and performed for evaluations of clinical manifestation and course of the children under 2 year of age with respiratory tract infection and positive respiratory syncytial virus(RSV) antigen. Methods : The selection criteria of the patients were children under 24 month-of-age, Clinical manifestation of respiratory tract infection, and positive RSV antigen that was detected by Vitek ImmunoDiagnostic Assay System(VIDAS) from nasal cavity. The additional laboratory and simple chest X-ray findings were reviewed from the chart of children who were admitted Wonkwang university hospital from October 1999 to March 2000. Results : Total number of patients enrolled on this study was 102. The 48(47%) children were RSV antigen positive by VIDAS method. Abnormal chest X-ray findings were noticed in 38 cases. The male to female sex ratio of 48 RSV antigen positive cases was 1.2 : 1. The mean and range of age was $10.2{\pm}5.9$ and 1.0~24 months. The peak outbreak of cases was noticed on November, 1999. All of the cases shows coughing but rale was audible in 30 cases(60%). Dyspnea, wheezing, and intercostal retraction were noticed 11(23%), 15(31%), and 10(21%) cases respectively. The most common chest X-ray finding was scattered patch infiltration that was noticed in 30 cases(63%). The mean total white blood cell counts in peripheral blood was $12,608{\pm}4,686/mm^3$. The mean blood level of IgA and IgE were $50.8{\pm}20.9$ and $72.1{\pm}98.3mg/dL$ respectively. The C-reactive protein was $16.0{\pm}18.5mg/L$. Total 5 cases need a mechanical respiraton. The duration of admission was under 7 days in 36 cases(75%). Conclusion : The RSV antigen was detected commonly in late fall and winter season. The severity of children under 2 years old with RSV respiratory tract infection take in some degree a gave courses.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.310.1-310.1
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• 2002

The fusion (F) protein of respiratory syncytial virus(RSV) is an important antigen in including cross-protective immunity with neutralizing activity. Two peptides homologous to amino acid 205-225(F/205-225) and 255-278 (F/255-278) of the F glycoprotein of RSV containing B cell and T cell epitope were synthesized and then conjugated with KLH. (omitted)

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.95-100
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• 2013

Background: This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. Methods: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. Results: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. Conclusion: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.