The first vaccine since the 1960s for a potentially life-threatening viral infection that hospitalizes 100,000 infants and preschoolers each year may be tested in susceptible babies in Baltimore by next winter.
Dr. Leonard Krilov, a New York pediatric infectious disease expert, said yesterday the University of Maryland Medical Center has applied for a National Health Institutes contract to be one of 10 to 20 centers to use the vaccine in clinical trials that for the first time would involve babies by 1992.
To date, the vaccine has only been tested for safety in adults and animals, he said. The 1960s vaccine was not successful.
Krilov was scheduled to meet with UM pediatricians in Baltimore today to discuss vaccine development and the viral infection, known as RSV or respiratory syncytial virus, the most frequent cause of lower respiratory tract disease in infants and young children.
"The severity of this disease is such that vaccine development, if safe, would be targeted for all babies," he said.
"In the U.S. alone in 1985 there were at least 4 million infections with RSV of which 100,000 would make the infants sick enough to require hospitalization," he said. "And of those, up to 5 percent do die from the viral infection.
There are babies, in addition to normal infants, who have a "very rough" time with this infection which may show up as pneumonia and bronchiolitis, an infection of the small airways entering the lungs, he said. In adults, however, RSV would be similar to a bad cold.
One of the reasons the UM Medical Center may be so interested in RSV is because it treats a large number of HIV-infected babies, who are among those at high risk for severe RSV infection or mortality, Krilov said.
Others at high risk include babies with congenital heart disease, born with underdeveloped lungs, less than six weeks old and who have had chemotherapy or recent transplant operations.
The risk of death among RSV-infected infants who have congenital heart disease is as high as 30 percent. It is suspected that children afflicted with RSV infections may develop pulmonary complications that persist for up to 10 years.
The incidence of RSV, first identified at the turn of the century, is not rising, according to Krilov, who is chief of pediatric infectious disease at North Shore University Hospital in Manhasset, N.Y.
"What is changing," he said, "is both our ability to recognize and diagnose the specific virus that causes this infection and the availability of the tests to do that."