Questions
Respiratory syncytial virus — Questions
Study questions about Respiratory syncytial virus — exam-style, clinical-scenario and FAQ.
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2 questions: 0 MCQ, 2 written.
High prioritySAQDescribe the nature and the indications of palivizumab and nirsevimab. [4]
Model answer
Nature. Both are monoclonal antibodies against the respiratory syncytial virus (RSV) fusion (F) protein, giving passive protection. Palivizumab is given monthly through the RSV season; nirsevimab is engineered for a long half-life, so a single dose covers a whole season.
Indications. Prevention, not treatment, of severe RSV lower-respiratory-tract disease in infants: palivizumab for high-risk infants (prematurity, chronic lung disease, significant congenital heart disease), and nirsevimab for a broader infant population. Neither helps once RSV infection is established.
High priorityExam-styleComment on maternal vaccination as an approach to preventing respiratory syncytial virus (RSV) disease in early infancy. [10]
Model answer
A complete answer gives the rationale, the vaccine and its evidence, the alternative passive approach, and the caveats.
Rationale. RSV causes its most severe disease in the first months of life, before an infant can mount a good vaccine response. Maternal IgG crosses the placenta, so immunising the mother in pregnancy delivers protective antibody to the newborn at exactly the vulnerable time.
The vaccine. A recombinant pre-fusion F protein vaccine given in pregnancy (around 28 to 36 weeks) raises maternal neutralising antibody that is transferred to the fetus.
Evidence. Maternal vaccination reduces severe RSV lower-respiratory-tract disease in the first months of life.
The alternative. A long-acting monoclonal antibody given to the infant (nirsevimab) provides the same protection passively and directly, and is an option where maternal vaccination is not used.
Caveats. The timing window matters for adequate antibody transfer, preterm infants may receive less, and safety in pregnancy and around gestational age has been a focus of evaluation.