207.4 📌 章末速蚘

  • RSV: ssRNA, Pneumoviridae, F + G surface proteins, prefusion F = vaccine/mAb target
  • #1 cause pediatric LRTI globally, universal childhood infection, re-infection lifelong
  • Infant bronchiolitis classic (apnea in preterm/<3mo)
  • Elderly + immunocompromise: severe pneumonia
  • Treatment: supportive (oxygen, HFNC, CPAP, ventilator); no routine bronchodilator/steroid/antibiotic
  • Prevention 2023-2024 game changer:
    • Nirsevimab (Beyfortus) — universal infants, single mAb dose
    • Maternal Abrysvo — 32-36 wk gestation
    • Adult vaccines: Arexvy, Abrysvo, mRESVIA mRNA (2024) for ≥ 60 yr
    • Palivizumab being replaced
  • Ribavirin limited efficacy (HSCT only)
  • 2024 ACIP universal infant nirsevimab + adult vaccines
  • 盧醫垫 hint: 老 + 慢病 push RSV adult vaccine; pediatric universal nirsevimab