Current research on respiratory viral infections: Fourth International Symposium

The IV International Symposium on Respiratory Viral Infections was successful in summarizing the recent advances in respiratory virus research. Advances in the understanding of the epidemiology and pathogenesis of RSV, influenza, parainfluenza, and adenovirus were discussed. It is clear that there is emerging evidence that the 1918 influenza virus is derived from an avian precursor but that it probably adapted to humans soon before the pandemic. The introduction of novel strains of influenza from the region around Hong Kong are concerning and may result in a future pandemic. Influenza vaccine has been proven to be cost-effective in most patient populations. Several studies how shown that respiratory viral infections can be differentiated by clinical presentation and that rapid diagnostic tests are aiding in the diagnostic process. Respiratory viruses have clearly been implicated in the pathogenesis and frequency of AOM. The hMPV has recently been discovered and appears to be a common pathogen in man. Our understanding of this virus is in its infancy and future studies on its epidemiology, pathogenesis, prevention, and management will likely be presented at future meetings. There have been many advances in the field of respiratory viral vaccinology over the past year. An RSV vaccine has been studied in adults and appears to be safe and immunogenic. A parainfluenzavirus 3 vaccine is also under development and appears to be safe and immunogenic. Influenza vaccines have been found to be cost-beneficial in most patient populations and can therefore be recommended in most patients as long as the vaccine availability permits complete vaccination of high-risk patients. Several intranasal influenza vaccines are either approved or far along in their development. The past year has been marked by the availability of new antiviral agents. The Flunet® represents a novel dimer of zanamivir that has pharmacokinetic properties in animals that suggests it can be administered once-a-week. Several RSV fusion inhibitors, such as VP14637, have been developed. This class of agents is highly potent against both RSV-A and B strains and is currently undergoing early clinical trials. Two new classes of anti-picor-navirus agents has been tested. The capsid-binder pleconaril is well tolerated and effective therapy of rhinovirus colds. The picornavirus protease inhibitor ruprintrivir is currently being investigated as a highly potent, peptidomimetic, irreversible 3C protease inhibitor. The drug performed well in experimental human rhinovirus infections but did not result in significant differences in the treatment of natural infections. It is still being investigated in different settings and with novel formulations.