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RSV bronchiolitis in the first year of life is one of the most important risk factors for the subsequent development of asthma.² Researchers have demonstrated a 40% to 50% incidence of wheezing episodes and asthma associated with previous RSV bronchiolitis.³ The link between RSV bronchiolitis in infancy and respiratory abnormalities later in life has been attributed to both a direct effect of the RSV infection upon bronchial tissue and to an inherent genetic susceptibility to developing asthma.⁴

For those infants who are hospitalized with serious RSV infection, aggressive medical intervention and early treatment with VIRAZOLE® (ribavirin for inhalation solution, USP) may significantly improve pulmonary function post discharge.^1,5,6

In a prospective seven-year follow-up trial by Rodriguez et al, at the Children's National Medical Center in Washington, D.C., previously healthy, pre-term infants and infants with chronic pulmonary disease hospitalized with RSV bronchiolitis were followed to detect the development of subsequent reactive airway disease (RAD). Between years five and seven, 53% (7 of 13) of VIRAZOLE-treated patients showed normal or mildly abnormal pulmonary function tests (PFTs). In contrast, all placebo recipients (6 of 6) showed moderate to severe abnormalities in their PFTs (P=0.043). The investigators concluded that weighted severity scores suggest a long-term beneficial effect of VIRAZOLE therapy.¹ VIRAZOLE is the only anti-viral agent approved for treatment of hospitalized infants and young children with severe lower respiratory tract infections due to RSV.

Infants and children at higher risk for severe RSV infection include those less than six weeks of age, infants with a history of prematurity, those with congenital heart disease, chronic lung conditions or immunodeficiency. Other factors that may also contribute to increased risk of developing serious bronchiolitis are lower socioeconomic status, crowded living conditions, exposure to passive cigarette smoking and avoidance of breast feeding.^7-9

The most common adverse events attributed to VIRAZOLE in infants are rash, bronchospasm,  and reversible skin irritation.⁶ Sudden deterioration of respiratory function (bronchospasm) has been associated with initiation of aerosolized VIRAZOLE; respiratory function should be carefully monitored. For more information on safety in patients and health care personnel, see enclosed full Prescribing Information.

References

1. Rodriguez WJ, Arrobio J, Fink R, Kim HW, Milburn C. Prospective (7 yrs) follow up (FU) and pulmonary functions (PFT) from a placebo (P) controlled randomized trial of ribavirin (R) in RSV bronchiolitis (B). Pediatr Res. May 1996. Abstract.

2. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B, Björkstén B. Asthma and immunoglobulin E antibodies after respiratory syncytial virus bronchiolitis: a prospective cohort study with matched controls. Pediatrics. 1995;95(issue 4):500-505.

3. Sly PD, Hibbert ME. Childhood asthma following hospitalization with acute viral bronchiolitis in infancy. Pediatr Pulmonol. 1989;7:153-158.

4. Long CE, McBride JT, Hall CB. Sequelae of respiratory syncytial virus infections: a role for intervention studies. Am J Respir Crit Care Med. 1995;151:1678-1681.

5. Hiatt P, Treece D, Morris L, Taber L. Longitudinal pulmonary function (PF) following treatment with ribavirin in infants hospitalized with RSV bronchiolitis. Am J Respir Crit Care Med. 1994;149(4):A354. Abstract.

6. Janai HK, Marks MI, Zaleska M, Stutman HR: Ribavirin: adverse drug reactions, 1986 to 1988. Pediatr Infect Dis J. 1990;9(3):209-211.

7. Bar-on ME, Zanga JR. Bronchiolitis. Prim Care. 1996;23(4):805-819.

8. Holberg CJ, Wright AL, Martinez FD, Ray CG, Taussig LM, Lebowitz MD. Risk factors for respiratory syncytial virus-associated lower respiratory illnesses in the first year of life. Am J Epidemiol. 1991;133:1135-1151.

9. McConnochie KM, Roghmann KJ. Wheezing at 8 and 13 years: changing importance of bronchiolitis and passive smoking. Pediatr Pulmonol. 1989;6:138-146. Back to top