Interview with Prof Luc J.I. Zimmermann
Prof. Zimmermann, in adults, how does a typical course of infection with RSV look like and how frequent is it?
RSV infections are very common, and, just like the influenza virus, RSV appears during flu season, in the coldest and wettest months of the year. In healthy adults, an RSV infection shows only mild symptoms similar to the common cold, like a running nose or a sore throat, and normally does not need to be treated. However, in other patient groups like preterm babies, an RSV infection can actually become rather threatening.
Why are preterm babies more at risk for serious complications from RSV infections?
The lungs are one of the last organs to develop as a baby is growing inside the womb. This means that when a baby is born preterm, even if it is only a few weeks too early, the lungs are not fully developed. Secondly, full-term babies get antibodies from their mothers during pregnancy, which help to fight RSV and other viruses, but when babies are born too early, they do not get enough of these antibodies before birth.
How is the virus transmitted to another person and how can we avoid infections?
To prevent an infection should be indeed our first priority. As for all viruses, RSV is also transmitted by droplets from one person to another, e.g. if an infected person sneezes and another person inhales the droplets, or if a person touches a surface that was recently touched by an infected person. Just remember the general and well-known hygiene rules against infections: Wash your hands frequently and thoroughly, do not share objects with others, avoid crowds, do not shake hands, and, if possible, stay home when you have cold-like symptoms.
It is often said that washing hands is the single most powerful measure of all to prevent infections, so can you please explain what needs to be observed when washing hands, especially when there is a baby at risk?
Washing hands with soap and water is the best way to reduce the number of germs on them. We recommend wetting the hands first, then lathering the hands with sufficient soap and scrubbing also the back of your hands, between your fingers, and under your nails. Rinse well and dry your hands with a clean towel or air-dry them.
So far, there is no vaccine available against an RSV infection. Can you tell us something about the current status regarding the development of a potential vaccine?
First of all, it is great news that it is increasingly recognized that RSV is not only a danger to our most vulnerable patients, but that it also represents a massive health burden on a global scale. It is correct, there is no vaccine available yet, but currently a number of different approaches and vaccine candidates are being tested so hopefully an effective vaccine will be on the market at some point soon.
Currently the only available medication is palivizumab, can you tell us what it is?
Palivizumab is not a vaccine, but a preventive medication based on monoclonal antibodies. It is applied by a series of injections that need to be given monthly, but only during the flu season. Palivizumab can help to prevent an infection but can also mitigate illness caused by an RSV infection.
In what cases should palivizumab be considered?
Palivizumamb should be considered if your baby is born too early, suffers from chronic lung disease, congenital heart disease or immunodeficiency disease. Guidelines on precise indications are currently not the same in every country and they are recently revised in many of them. It would be useful to streamline these guidelines in Europe.
Special thanks to Prof. Luc Zimmermann for his support and advice.
The topic “Respiratory syncytial virus (RSV)” was supported by AbbVie until 2020.