Abstract
The IV International Symposium on Respiratory Viral Infections was successful in summarizing the recent advances in respiratory virus research. Advances in the understanding of the epidemiology and pathogenesis of RSV, influenza, parainfluenza, and adenovirus were discussed. It is clear that there is emerging evidence that the 1918 influenza virus is derived from an avian precursor but that it probably adapted to humans soon before the pandemic. The introduction of novel strains of influenza from the region around Hong Kong are concerning and may result in a future pandemic. Influenza vaccine has been proven to be cost-effective in most patient populations. Several studies how shown that respiratory viral infections can be differentiated by clinical presentation and that rapid diagnostic tests are aiding in the diagnostic process. Respiratory viruses have clearly been implicated in the pathogenesis and frequency of AOM. The hMPV has recently been discovered and appears to be a common pathogen in man. Our understanding of this virus is in its infancy and future studies on its epidemiology, pathogenesis, prevention, and management will likely be presented at future meetings. There have been many advances in the field of respiratory viral vaccinology over the past year. An RSV vaccine has been studied in adults and appears to be safe and immunogenic. A parainfluenzavirus 3 vaccine is also under development and appears to be safe and immunogenic. Influenza vaccines have been found to be cost-beneficial in most patient populations and can therefore be recommended in most patients as long as the vaccine availability permits complete vaccination of high-risk patients. Several intranasal influenza vaccines are either approved or far along in their development. The past year has been marked by the availability of new antiviral agents. The Flunet® represents a novel dimer of zanamivir that has pharmacokinetic properties in animals that suggests it can be administered once-a-week. Several RSV fusion inhibitors, such as VP14637, have been developed. This class of agents is highly potent against both RSV-A and B strains and is currently undergoing early clinical trials. Two new classes of anti-picor-navirus agents has been tested. The capsid-binder pleconaril is well tolerated and effective therapy of rhinovirus colds. The picornavirus protease inhibitor ruprintrivir is currently being investigated as a highly potent, peptidomimetic, irreversible 3C protease inhibitor. The drug performed well in experimental human rhinovirus infections but did not result in significant differences in the treatment of natural infections. It is still being investigated in different settings and with novel formulations.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 227-278 |
| Number of pages | 52 |
| Journal | Antiviral Research |
| Volume | 55 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2002 |
Funding
Dr Jordan and I began a study of acute respiratory disease in the approximately 500 employees of the Eastern Regional Office of the State Farm Insurance Company. This work was supported by the Commission on Acute Respiratory Disease of the Armed Forces Epidemiology Board and the Vaccine Development Branch of the National Institutes of Allergy and Infectious Diseases. The insurance employees maintained daily symptom records and supplied specimens for viral culture and serology. The study eventually continued for 15 years. A nurse monitored the employees on a weekly schedule to ensure accurate recording of data. In this study, which employed cell culture for viral identification, rhinovirus accounted for 25% of colds, giving a rate of 0.77 rhinovirus colds per person per year ( Gwaltney et al., 1966 ). This attack rate was consistent with that of an earlier study of young adults conducted in Chicago by Dr Dorothy Hamre ( Hamre et al., 1966 ). The age-specific rates of infection were higher in children than in adults. A seasonal variation in rhinovirus attack rates was also observed in the Charlottesville population which resulted in a consistent large fall peak of illness associated with rhinovirus. Of interest, this yearly rhinovirus outbreak coincided in time with a recurrent peak of respiratory illness identified 20 years earlier by Dr Wade Hampton Frost, a graduate of the University of Virginia and the first Dean of the School of Public Health at Johns Hopkins University. Details of the daily symptom patterns of rhinovirus colds were also obtained from the insurance company data ( Gwaltney et al., 1967 ).
Keywords
- Antiviral
- Respiratory
- Treatment
ASJC Scopus subject areas
- Pharmacology
- Virology
