We completely agree with the authors that CE is a novel tool3, 4, 5 and 6 in assessing IBDU and should be used with caution, as there is not yet a histological confirmation available with the CE study. “
“Respiratory syncytial virus (RSV) remains one of the great threats to child health associated with considerable acute and long-term morbidity.1 RSV is the main cause of viral Proteasome inhibitor lower respiratory tract infection (LRTI) in young children in both developed and developing countries, and worldwide almost 34 million new cases occur every year. In the United States, RSV is the most common cause of hospitalization in infants.2 and 3 In the developing world RSV accounts for 3.4 million hospitalizations for LRTI in children < 5 years of
age.4 Nevertheless, the global burden of RSV extends well beyond hospitalization and into the outpatient setting.5 and 6 There are well-characterized risk factors for severe RSV disease including prematurity, chronic lung disease (CLD), congenital heart disease (CHD), trisomy find more 21, neuromuscular disorders or an immunocompromised state. In addition, recent studies have identified other conditions to be associated with an increased risk for severe RSV disease, such as chromosomal abnormalities or malformations
of the upper airway. In reality, pediatricians are well aware that any “non-previously healthy infant” is actually at higher risk for hospitalization and developing severe RSV disease.7, 8 and 9 To complicate matters further, the majority of children that are hospitalized for RSV LRTI do not have any identifiable risk factors for severe disease. Two recent large studies, Tau-protein kinase one retrospective and hospital-based, and the other one prospective
and population-based, showed that 73% to 79% of children < 2 years of age requiring hospitalization for RSV LRTI were previously healthy and had no risk factors for severe disease.9 and 10 In temperate climates, RSV infections predictably occur in outbreaks each year and last 4 to 6 months, starting from late fall through early spring, but they can vary considerably between regions within a country or state. These differences on RSV endemic activity have been attributed in part to the effect of latitude, UV-B radiation, relative humidity or temperature, and need to be further characterized.11 Despite the disease burden, an effective vaccine or specific therapy are lacking largely due to our limited understanding of the immune response to RSV and how it relates to disease severity. The only effective pharmacologic means of preventing RSV infection involves the administration of passive prophylaxis with palivizumab during the RSV season. Countries have used different approaches to define the onset and offset of the RSV season. In the United States the Center for Disease Control and Prevention (CDC) uses laboratory isolate data to define the seasonality of RSV, while in Canada the active RSV season is based on epidemiologic data (number of admissions for RSV within a week).