Michael Marcus, MD., Director Pediatric Allergy & Pulmonary -Maimonides Medical Center . Fellowship:Children’s Hospital of Philadelphia
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Host: What is RSV? Michael Marcus: RSV is a virus which causes a lung disease called Bronchiolitis. Host: And what group is more likely to be exposed to it to get into trouble? Michael Marcus: Well, all children get exposed to RSV virus and in fact, old children get infected with RSV virus, but that's 25% of children who do get infected, get a much more serious disease called Bronchiolitis, but they have wheezing, difficulty breathing and a real risk for acquiring hospitalization. Children who have the highest risk of having the severe form of RSV infection are children who have been premature or children who have some other underlying lung problem, even before they are infected by the virus. Host: Is there any particular time of the year where it's more apt to be RSV around? Michael Marcus: Well, RSV season starts, for the most part, through the months of October, November, continues straight, straight though the winter months and tends to get less common as we get into the spring months of April and May. Host: If someone who is in South America would be in the same rule or different rules down there? Michael Marcus: It seems like in South America, the months are reverse. So where we are in our species is when they are not and vice versa. Host: New York would follow what we go through? Michael Marcus: New York follows our pattern, Australia follows South America's pattern and so it seems to be a Northern Hemisphere, Southern Hemisphere phenomenon. Host: Is it a occasional case found in the summer? Michael Marcus: You can always see a sporadic case and when we do surveillance in this area, you will pick up cases here and there through other times of the year, but the six months, all through winter and early spring, is the most common one. Host: Is a passive vaccine available for RSV? Michael Marcus: There is a new form of treatment available, called Synagis. This is a type of injection, not truly a vaccine, but a modifying antibody which is given to children on a once a month basis. By giving this vaccine, this injection on a once a month basis to children, it would provide them with extra protection so that if they do get infected by the virus, it would not be the most severe form of the infection. Host: There is also some indications to be a new improved version of this vaccine coming up? Michael Marcus: Well, there is a newer more important form of this injection which is still in development and clinical trials and expecting that those clinical trials should be completed over the next year or two and at that point, the data get submitted to the FDA for review. Host: It's a very expensive drug to give. So the drug companies have put some restrictions what they will cover for. What groups were they usually cover this vaccine on, packed drug for? Michael Marcus: This vaccine is quite expensive and estimates are anywhere from $500-1000 per dose and the doses are given once a month. Because of it's expense, the drug companies put on -- the insurance companies, not the drug company, but the insurance companies restrict the use of this vaccine to those that are in the highest risk population. In fact, restricting that use at this point, is also so supported by the American Academy of Pediatrics. That higher risk group includes children who are born premature. Children born at less than 32 weeks, certainly are at the highest risk and children born between 32 and 36 weeks of gestation are also considered at risk if they have another risk factor, such as other children in school bringing the vaccine, home to them, exposure to environmental pollutants or some other respiratory abnormality. Host: Well, what about the full term baby born with say, a Cystic Fibrosis would that be required condition? Michael Marcus: The studies looking at Cystic Fibrosis, children are still ongoing and the jury is out. My personal opinion is, I would like to see those children covered just because they do have lung disease, although, their lung diseas
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