General prevention measures The main prevention measure is to avoid close contact with infected individuals. In community and daycare settings, careful hand washing can help reduce transmission. In hospital settings, strict adherence to infection control measures can help prevent the spread of<unk>  to high-risk individuals. Alcohol-based disinfectants are recommended for hand decontamination. Immunoprophylaxis Although there is currently no vaccine against<unk> , passive immunization is available to prevent<unk>  infection and hospitalization in the highest risk infants. Historically,<unk> -specific intravenous immunoglobin (IVIG) was used to provide passive immunity. This involved monthly administration of<unk> -neutralizing antibodies (or immunoglobins) from human donors recovering from the disease. While this transfer of antibodies was reasonably effective in providing short-term immunization to at-risk infants, it was limited by both its intravenous administration and cost.<unk> -IVIG has since been replaced with the use of a monoclonal antibody (MAb) that can be delivered through muscular injection. While several monoclonal antibodies have been developed for<unk>  prophylaxis, the most successful of these has been Palivizumab (brand name Synagis). Palivizumab is a monoclonal antibody directed against the surface fusion (F) protein of the<unk>  virus. It was licensed in 1998 and is effective in providing temporary prophylaxis against both<unk>  A and B. It is given by monthly injections, which are begun just prior to the<unk>  season and are usually continued for five months. Palivizumab has been shown to reduce both hospitalization rates and all-cause mortality in certain groups of high-risk children (such as those with chronic lung disease, congenital heart disease, and those born preterm). However, its cost limits its use in many parts of the world. More potent derivatives of this antibody have since been developed (including motavizumab) but were associated with considerable adverse events. The American Academy of Pediatrics (AAP 2014) recommends<unk>  prophylaxis with palivizumab during<unk>  season for: * Infants born at ≤28 weeks 6 days gestational age and <12 months at the start of<unk>  season * Infants <12 months old with chronic lung disease of prematurity * Infants ≤12 months old with hemodynamically significant congenital heart disease * Infants <24 months old with chronic lung disease of prematurity requiring medical therapy Per AAP guidelines, palivizumab prophylaxis may also be considered in infants with: * Congenital airway abnormality * Neuromuscular disorder * Cystic fibrosis * Severe immunocompromise * Recent or upcoming heart transplantation On 3 Mar 2022, results of the Phase III Melody trial of Nirsevimab, a "potential immunisation for...infants" were published in the New England Journal of Medicine. Vaccines Currently, there is no licensed vaccine to prevent infection by<unk> . There has been tremendous interest and research in<unk>  vaccine discovery, given the virus's significant disease burden and the relative lack of disease-specific therapies. However, vaccine development has faced significant obstacles that have blocked its progress. Among these are infant-specific factors, such as the immature infant immune system and the presence of maternal antibodies, which make infantile immunization difficult. Attempts to develop an<unk>  vaccine began in the 1960s with a formalin-inactivated vaccine that was developed for use in infants and children. While a similar method was used to create a safe and effective poliovirus vaccine, this vaccine resulted in a dangerous phenomenon that came to be known as vaccine-associated enhanced<unk>  disease (VAERD). In VAERD, the vaccinated infants went on to develop significantly worse<unk>  disease than non-vaccinated infants during subsequent natural infection. Some 80% of such children (vs. 5% of virus-exposed controls) were hospitalized, with two cases leading to death. This disaster led to extreme caution and hindered vaccine development for many years. A 2019 paper claimed that research toward vaccine development had greatly advanced over the preceding 5–10 years, with more than 30 candidates in some stage of development. The same study predicted that a vaccine would be available within 10 years. The types of vaccines currently in research fall into five broad categories: live-attenuated, protein subunit, vector-based, particle-based, and messenger RNA. Each targets different immune responses, and thus may be better suited to prevent disease in different at-risk groups. Live-attenuated vaccines have shown some success in<unk> -naive infants. Other vaccine candidates hope to target vulnerable populations across the lifespan, including pregnant women and the elderly.
Respiratory syncytial virus
Influenza A virus
Influenza B virus
Influenza D virus
Rhinovirus
Human parainfluenza viruses
Human coronavirus 229E
Cricket paralysis virus