New solutions in RSV prevention for high-risk children

Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and young children in Vietnam, leading to many serious and even life-threatening illnesses.

Medical news March 18: New solution in RSV prevention for high-risk children

Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and young children in Vietnam, leading to many serious and even life-threatening illnesses.

New solutions in RSV prevention for high-risk children

The above information was shared at the recent Symposium on “RSV Prevention for High-Risk Infants and Children”. At the event, more than 50 experts, doctors, and healthcare workers shared their experiences and discussed the effects of RSV on children and the role of RSV prophylaxis with monoclonal antibodies.

Infants, especially those with a history of malnutrition, a family history of allergies or asthma, frequent exposure to cigarette smoke, or living in crowded conditions, are at high risk of RSV infection.

According to medical experts, RSV is the cause of 50-90% of bronchiolitis cases and 5-40% of pneumonia cases in children. Most children are infected with RSV in the first two years of life, with a rate of up to 85-100%. In particular, up to 75-90% of children are infected in the first year, and about 0.5-2% of children have to be hospitalized for treatment.

According to estimates from the World Health Organization (WHO), in 2010, Vietnam recorded 498,411 cases of RSV infection in children aged 0-4 years, of which 57,086 cases were severe. Another study at the Pediatric Center, Hue Central Hospital showed that 23.33% of bronchiolitis cases in children were caused by RSV.

RSV season in the southern region of Vietnam usually lasts from May to November each year, and premature babies, under 24 months old, or those with congenital heart disease or pulmonary dysplasia are at high risk of contracting the disease.

Symptoms of RSV can be as mild as the common cold (stuffy nose, cough, runny nose), but can become severe and cause complications such as bronchiolitis or pneumonia.

Babies under 6 weeks of age or at high risk may experience symptoms such as fussiness, poor feeding, fatigue and difficulty breathing. If left untreated, RSV can cause acute respiratory distress, collapsed lungs, bacterial superinfection and other serious complications, even death.

The virus is easily transmitted through the eyes, nose or close contact with an infected person, through airborne droplets, saliva or mucus. Notably, the virus can survive up to 6 hours on surfaces and can survive in the bodies of children and immunocompromised people for up to 4 weeks.

Associate Professor, Dr. Vu Huy Tru, a pediatrician, said that in addition to personal hygiene measures such as regular hand washing and surface disinfection, immunoprophylaxis with monoclonal antibodies is an effective solution to reduce the risk of disease, especially in high-risk children.

Although RSV vaccines are still being researched, with 38 vaccines in development and 19 in clinical trials, there is currently no licensed vaccine to prevent RSV in children. However, passive immunotherapies, such as monoclonal antibodies, have proven effective in reducing the incidence of severe disease.

The monoclonal antibody Palivizumab, approved by the FDA in 1998, is one of the most effective prophylactic measures for children at high risk of RSV. Palivizumab, a human monoclonal antibody, helps block viral replication and reduces the risk of severe lower respiratory tract infections. The recommended dose is 1 dose per month (15 mg/kg) for 5 consecutive months during the RSV season.

RSV disease prevention is not a new problem, but with the development of modern medicine, early prevention can help create a protective shield for children, reduce the disease burden and improve the quality of life for children. With the help of measures such as monoclonal antibodies and prevention strategies, high-risk infants and young children can be protected from serious complications caused by RSV.

Unpredictable consequences of using transgender hormones

Th., 30 years old, had been injecting male hormones for a long time to transition. However, when she decided to stop using male hormones to perform in vitro fertilization (IVF) and get pregnant, Th.'s body suddenly suffered hormonal disturbances, leading to prolonged vaginal bleeding and fainting.

At the age of 20, Th. began receiving testosterone injections at a private clinic to transition. This hormone enhances male characteristics while reducing the production of estrogen, the hormone associated with female characteristics.

After about 2 months of use, Th. began to experience changes in her voice, stopped having periods, and developed masculine characteristics such as growing a beard. After 5 years of using hormones, Thoa underwent breast removal surgery to achieve the desired appearance.

After getting married, Th. and his wife, H., wanted to have children. However, Ha had thalassemia and was concerned about passing it on to their children, so the couple decided to use Th.’s eggs to create embryos from donated sperm, then transfer the embryos into H.’s uterus. Because Vietnamese law does not allow eggs from one woman to be used to give birth to another woman’s child, they decided to go abroad for IVF.

In 2023, after stopping male hormone injections, Th. was given estrogen and other medications to stimulate ovarian activity. After 8 months of treatment, Thoa had her period again and was stimulated for in vitro fertilization. At the end of 2023, Th. created 4 embryos and transferred them into H.'s uterus, helping the couple have a child together.

However, after completing her egg donation duty, Thoa began injecting testosterone to return to being a man. However, after several months of hormone use, Th.'s period did not stop but lasted for 7 to 10 days.

In October 2024, when her period lasted more than half a month, Th. went to the doctor and was diagnosed with endometriosis due to long-term use of male hormones, causing abnormal vaginal bleeding.

Thoa was admitted to the hospital in a state of fainting and vaginal bleeding. Ultrasound results showed that Th.'s uterus was as large as a 14-week fetus, with fibroids and endometriosis cysts in the muscle layer. Th. suffered from severe anemia, with hemoglobin index dropping to 3.9g/dl, which was very dangerous if not treated promptly. After receiving 4 units of packed red blood cells (equivalent to 1.4 liters of blood), Th.'s condition gradually stabilized.

Two days later, Th. underwent surgery to completely remove her uterus. After the surgery, Th. recovered and was able to continue taking male hormones more safely without worrying about affecting her uterus.

According to obstetrician Dr. Nguyen Thi Yen Thu, sudden hormonal changes can cause imbalances in menstrual regulation. Testosterone supplementation in women can cause the uterine lining to become thinner.

However, when the drug is stopped and estrogen is added to stimulate egg development, the uterine lining can proliferate again, leading to cell changes. If after egg retrieval, Thoa starts injecting testosterone again, the uterine lining will be suddenly inhibited, increasing the risk of bleeding and other serious complications.

Dr. Yen Thu explains that endometriosis, when combined with constant hormonal changes, can cause inflammation and bleeding. It is the rapid hormonal changes that affect blood clotting function, leading to uncontrolled bleeding.

MSc. Dr. Le Dang Khoa, Head of the Reproductive Support Unit, Tam Anh General Hospital, District 8, recommends that women who want to change gender should freeze their eggs before using male sex hormones to protect their future fertility. In addition, after egg stimulation, the body needs a rest period of about 3-6 months before continuing to use testosterone, to avoid serious complications.

In Vietnam, the Ministry of Health has not licensed gender reassignment therapy, so testosterone is only licensed for men to treat hypogonadism or delayed puberty. However, for those who want to change gender, hormone supplementation must be closely monitored by a specialist to minimize dangerous complications.

Rare Disease Treatment Saves Marriage

One typical case is patient HHL, 24 years old, married for 2 years. She came to the clinic because of fear during sex.

Ms. L. suffered from involuntary vaginal spasms, which caused severe pain and increased difficulties in the marital relationship. This prolonged condition made it impossible for her and her husband to get along, leading to constant conflicts, putting their marriage on the brink of collapse.

After examination, Ms. L. was diagnosed with "vaginismus" syndrome. In this case, the doctor at the center prescribed treatment using psychotherapy combined with sex therapy.

During the treatment, the patient was guided by a team of female doctors and nurses in vaginal muscle relaxation exercises and applied cognitive behavioral therapy to help her control her fear and anxiety. At the same time, methods such as genital desensitization and vaginal dilation were also performed to improve the condition.

After only 6 sessions of treatment, the results exceeded expectations. Ms. L. no longer felt pain or anxiety during sex, and the vaginal spasm did not recur. The patient's emotions were gradually adjusted, helping her feel more comfortable and her married life became more fulfilling.

According to Dr. Pham Minh Ngoc, Deputy Director of the Hanoi Center for Gender Medicine, there are currently four main methods in treating vaginismus syndrome. However, at the center, doctors mainly apply two main methods: psychotherapy and sex therapy, with a successful treatment rate of up to 90% after 4-6 treatment sessions.

Vaginismus is not a rare disease, but many women are still shy and embarrassed when facing this problem, leading to not daring to go to the doctor. This makes the disease more and more serious, seriously affecting the quality of life and family happiness. Early examination and treatment will help patients regain comfort and confidence, while improving the quality of married life.

Experts recommend that women with suspected symptoms of vaginismus should immediately go to specialized medical facilities for timely consultation and treatment to avoid prolonging the condition.

Source: https://baodautu.vn/tin-moi-y-te-ngay-183-giai-phap-moi-trong-du-phong-rsv-cho-tre-nguy-co-cao-d255643.html