Michael Marcus, MD Pediatric Pulmonary Director of Pediatric Pulmonary at Maimonides Medical Center Fellowship:Children’s Hospital of Philadelphia
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Male Speaker: If a certain group, you heard about, what group of that be the most risky group? Is that big babies, little babies, what group is that? Dr. Grimmy: Well, certainly there are children who have greater risks of having serious problems when they develop RSV infection. And we have characterized those children into certain groups. The groups that are at the greatest risk are babies who had been born prematurely. Babies born prematurely have lungs which are either not fully developed at birth, or have lung development after birth which is slightly different than a full-term baby. This difference of lung development makes these children at significantly greater risk for having wheezing and more serious problems, whey they get their RSV infection. Male Speaker: This tiny prematures like maybe 30, 32 weeks really at high risk. Is there anything we can do, so they don't get so sick? Dr. Grimmy: Certainly. There are number of different strategies that we use. The first of course, is to try to minimize the risk of getting that infection at the earliest age. So we want minimal exposure to other children who may be carriers of the virus. We want to make sure that anybody who touches or handled these children, wash their hands properly and otherwise are not sick. Once we take these usual precautions to minimize exposure, the next thing we do is to immunize these patients with a new vaccine which prevents the serious form of the RSV infection. This vaccine is called Synagis, and is required to be given once a month throughout the high risk time of year, that is from October to March, in the East coast. In other areas of the country the risky time of year maybe slightly different. But generally, we give this vaccination once a month for five to six month period during this high risk period, to minimize the seriousness of RSV infection if the premature infants contracted. Male Speaker: When you say premature, how premature the child has to be to be considered to get this vaccine? Dr. Grimmy: Any premature child can be considered for this vaccine, and then there are various risk factors which we factor in to decide which child actually gets it or not. But the starting point is always prematurity, all by itself. The more premature the child is, the greater their risk and so the greater likelihood is that they would qualify. Children that are near term, 34 to 36 weeks would need several other risk factors before they would be required to get RSV Synagis vaccination.
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