{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:15Z","timestamp":1787022915233,"version":"build-2736575974"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,3,1]]},"abstract":"<jats:p>Objective.\u2003To determine the effects of age and respiratory syncytial virus (RSV) antibody status on frequency and severity of RSV infections in children with underlying heart or lung disease.<\/jats:p>\n                  <jats:p>Design.\u2003Cohort study conducted during two consecutive RSV seasons.<\/jats:p>\n                  <jats:p>Setting.\u2003Ambulatory patients at eight Canadian pediatric tertiary care centers.<\/jats:p>\n                  <jats:p>Methods.\u2003Subjects under 3 years old with underlying heart disease who were digoxin-dependent or had not received corrective cardiac surgery or with underlying lung disease were enrolled. Demographic information and an acute sera for RSV neutralizing antibody was obtained on enrollment. Weekly telephone follow-up consisting of a respiratory illness questionnaire was followed with a home visit to obtain a nasopharyngeal aspirate when there was new onset of respiratory symptoms. The specimen was used to detect RSV antigen. RSV illnesses were grouped as upper or lower respiratory tract infection (LRI) based on clinical and radiographic findings. RSV hospitalizations were considered to be those RSV infections that resulted in hospitalization.<\/jats:p>\n                  <jats:p>Results.\u2003Of 427 enrolled subjects, 160 had underlying lung disease only, 253 had underlying heart disease only, and 14 had both. Eleven percent and 12% of lung and heart disease groups, respectively, had an RSV LRI. Three percent and 6% of lung and heart disease groups, respectively, were hospitalized with RSV infection. A significant decrease in frequency of RSV LRI and RSV hospitalization occurred with increasing age, with a major drop in those older than 1 year vs those younger than 1 year. Acute sera were available from 422 subjects. Geometric mean RSV antibody titers demonstrated a U-shaped distribution with increasing age. The trend to lower antibody concentrations in premature infants did not reach statistical significance. The frequency of RSV infection and RSV LRI was lower in patients with antibody at a titer more than 100, although the difference for RSV hospitalization was not statistically significant. These differences remained significant after age adjustment.<\/jats:p>\n                  <jats:p>Conclusion.\u2003Both age and RSV antibody status impact on RSV illness and LRI. Reduction in illness frequency with increasing age may lead to more informed targeting of those children most likely to benefit from RSV immune globulin prophylaxis. respiratory syncytial virus, cohort study, passive prophylaxis, neutralizing antibody.<\/jats:p>","DOI":"10.1542\/peds.99.3.e9","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:40:17Z","timestamp":1092426017000},"page":"e9-e9","source":"Crossref","is-referenced-by-count":43,"title":["PICNIC (Pediatric Investigators Collaborative Network on Infections in Canada) Study of the Role of Age and Respiratory Syncytial Virus Neutralizing Antibody on Respiratory Syncytial Virus Illness in Patients With Underlying Heart or Lung Disease"],"prefix":"10.1542","volume":"99","author":[{"given":"Elaine E. L.","family":"Wang","sequence":"first","affiliation":[{"name":"From the Hospital for Sick Children and University of Toronto, Toronto, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Law","sequence":"additional","affiliation":[{"name":"Winnipeg Children\u2019s Hospital and University of Manitoba, Winnipeg; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan L.","family":"Robinson","sequence":"additional","affiliation":[{"name":"University of Alberta Hospital and University of Alberta, Edmonton;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Dobson","sequence":"additional","affiliation":[{"name":"British Columbia\u2019s Children\u2019s Hospital and University of British Columbia, Vancouver;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suliman","family":"al Jumaah","sequence":"additional","affiliation":[{"name":"From the Hospital for Sick Children and University of Toronto, Toronto, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Stephens","sequence":"additional","affiliation":[{"name":"From the Hospital for Sick Children and University of Toronto, Toronto, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franc\u0327ois D.","family":"Boucher","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universite\u0301 de Laval and L\u2019Universite\u0301 de Laval, Que\u0301bec City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"McDonald","sequence":"additional","affiliation":[{"name":"Montreal Children\u2019s Hospital and McGill University, Montreal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Alberta Children\u2019s Hospital and University of Calgary, Calgary; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noni E.","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario and University of Ottawa, Ottawa."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1997,3,1]]},"reference":[{"key":"2021120819165096400_B1","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1097\/00006454-199308000-00007","article-title":"Respiratory syncytial virus infections in hospitalized Canadian children: regional differences in patient populations and management practices.","volume":"12","author":"Law","year":"1993","journal-title":"Pediatr Infect Dis J."},{"key":"2021120819165096400_B2","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/S0022-3476(95)70547-3","article-title":"Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of morbidity and risk factors with RSV disease.","volume":"126","author":"Wang","year":"1995","journal-title":"J Pediatr."},{"key":"2021120819165096400_B3","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1056\/NEJM199311183292102","article-title":"Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children.","volume":"329","author":"Groothuis","year":"1993","journal-title":"N Engl J Med."},{"key":"2021120819165096400_B4","first-page":"463","article-title":"Respiratory syncytial virus (RSV) infection in preterm infants and the protective effects of RSV immune globulin (RSVIG).","volume":"95","author":"Groothuis","year":"1995","journal-title":"Pediatrics."},{"key":"2021120819165096400_B5","doi-asserted-by":"crossref","first-page":"169A","DOI":"10.1203\/00006450-199604001-01022","article-title":"Reduction of respiratory syncytial virus-associated hospitalization in children with premature birth and\/or bronchopulmonary dysplasia using monthly infusions of RSV immune globulin (RespiGam, RSV-IGIV).","volume":"39","author":"Connor","year":"1996","journal-title":"Pediatr Res."},{"key":"2021120819165096400_B6","first-page":"543","article-title":"Risk of primary infection and reinfection with respiratory syncytial virus.","volume":"140","author":"Glezen","year":"1986","journal-title":"Am J Dis Child."},{"key":"2021120819165096400_B7","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S0022-3476(81)80829-3","article-title":"Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level.","volume":"98","author":"Glezen","year":"1981","journal-title":"J Pediatr."},{"key":"2021120819165096400_B8","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1056\/NEJM197903083001004","article-title":"Respiratory-syncytial-virus infections, reinfections and immunity.","volume":"300","author":"Henderson","year":"1979","journal-title":"N Engl J Med."},{"key":"2021120819165096400_B9","first-page":"694","article-title":"State of the art: bronchopulmonary dysplasia: unresolved neonatal acute lung injury.","volume":"132","author":"O\u2019Brodovich","year":"1985","journal-title":"Am Rev Respir Dis."},{"key":"2021120819165096400_B10","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1056\/NEJM198412273112602","article-title":"Association of respiratory viral infections with pulmonary deterioration in patients with cystic fibrosis.","volume":"311","author":"Wang","year":"1984","journal-title":"N Engl J Med."},{"key":"2021120819165096400_B11","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1128\/jcm.22.6.1050-1052.1985","article-title":"Microneutralization test for respiratory syncytial virus based on an enzyme immunoassay.","volume":"22","author":"Anderson","year":"1985","journal-title":"J Clin Microbiol."},{"key":"2021120819165096400_B12","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1093\/infdis\/134.3.211","article-title":"Role of maternal antibody in pneumonia and bronchiolitis due to respiratory syncytial virus.","volume":"134","author":"Lamprecht","year":"1976","journal-title":"J Infect Dis."},{"key":"2021120819165096400_B13","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1203\/00006450-198309000-00014","article-title":"Cellular and humoral immunity in recurrent respiratory syncytial virus infections.","volume":"17","author":"Fernald","year":"1983","journal-title":"Pediatr Res."},{"key":"2021120819165096400_B14","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1056\/NEJM198806303182605","article-title":"An assessment of clinically useful measures of the consequences of treatment.","volume":"318","author":"Laupacis","year":"1988","journal-title":"N Engl J Med."},{"key":"2021120819165096400_B15"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/99\/3\/e9\/998323\/e9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/99\/3\/e9\/998323\/e9.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T15:00:57Z","timestamp":1638975657000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/99\/3\/e9\/67327\/PICNIC-Pediatric-Investigators-Collaborative"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,3,1]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1997,3,1]]},"published-print":{"date-parts":[[1997,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.99.3.e9","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1997,3,1]]}}}