RSV Overview
RSV
RSV is an enveloped, single-stranded RNA virus belonging to the family of paramyxoviridae and the only human pathogen in the genus pneumovirus. The virus can survive on fomites for 6 to 7 hours but does not survive well at temperatures ≥ 37° C. RSV is destroyed by slow freezing and thawing but remains stable if frozen rapidly.1
The infectivity of RSV is determined by two surface glycoproteins, G and F. The G protein enables the virus to attach itself to a host cell. The F protein promotes the fusion of the virus with the host cell as well as fusion of infected host cells with one another, which facilitates cell-to-cell transmission and syncytia formation. The F and G surface glycoproteins have also been identified as targets of anti-RSV antibodies, but only the F protein remains highly conserved across both major strains of RSV. The F protein, therefore, was determined to be the appropriate target of an anti-RSV monoclonal antibody.2
About the photograph: Electron photomicrograph of budding virion (129) used to indicate location and chain length of the RSV proteins (Peter Collins, 1989; Fields Virology, 2nd ed, 1990).
Important Safety Information
Synagis® (palivizumab) is indicated for the prevention of serious lower respiratory tract disease caused by respiratory syncytial virus (RSV) in pediatric patients at high risk of RSV disease and is administered by intramuscular injection. Safety and efficacy were established in infants with bronchopulmonary dysplasia (BPD), infants with a history of premature birth (≤35 weeks gestational age), and children with hemodynamically significant congenital heart disease (CHD). Synagis has been used in more than one million children in the U.S. since its introduction in 1998. The first dose of Synagis should be administered prior to commencement of the RSV season. Patients, including those who develop an RSV infection, should continue to receive monthly doses throughout the season.
Synagis should not be used in pediatric patients with a history of severe prior reaction to Synagis or its components. Cases of anaphylaxis were reported following re-exposure to Synagis and severe acute hypersensitivity reactions have also been reported on initial exposure or re-exposure. If a severe hypersensitivity reaction occurs, therapy with Synagis should be permanently discontinued. If milder hypersensitivity reactions occur, caution should be used on re-administration of Synagis. In post-marketing reports, cases of severe thrombocytopenia (platelet count <50,000/microliter) have been reported.
In clinical trials, the most common adverse events occurring at least 1% more frequently in Synagis-treated patients than controls were upper respiratory infection, otitis media, fever, and rhinitis. Cyanosis and arrhythmia were seen in children with CHD. There have also been post-marketing reports of injection site reactions.
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