{"id":10006,"date":"2017-05-04T00:00:00","date_gmt":"2017-05-03T22:00:00","guid":{"rendered":"https:\/\/inovie.fr\/lsprovence-v2\/actualites\/2017\/05\/04\/virus-respiratoire-syncytial-humain\/"},"modified":"2017-05-04T00:00:00","modified_gmt":"2017-05-03T22:00:00","slug":"virus-respiratoire-syncytial-humain","status":"publish","type":"post","link":"https:\/\/labosud-provencebiologie.fr\/general\/2017\/05\/04\/virus-respiratoire-syncytial-humain\/","title":{"rendered":"LE VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS)"},"content":{"rendered":"

VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS)<\/h1>\n

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A l\u2019origine d\u2019une des principales causes des broncho-pneumopathies aigues virales chez les enfants dans le monde, le virus respiratoire syncytial humain (VRS) est aussi responsable de la bronchiolite du nourrisson. Le VRS est \u00e0 l\u2019origine d\u2019\u00e9pid\u00e9mies qui s\u00e9vissent chaque ann\u00e9e entre octobre et avril, responsable \u00e9galement de pneumopathies chez les personnes \u00e2g\u00e9es et les immunod\u00e9prim\u00e9s.
\nIl s\u2019agit d\u2019un virus \u00e0 ARN, envelopp\u00e9 donc fragile et sensible alors aux agents physiques et chimiques. Le r\u00e9servoir de virus est essentiellement constitu\u00e9 par les enfants et les adultes r\u00e9infect\u00e9s de mani\u00e8re asymptomatique.<\/p>\n

La transmission est inter-humaine globalement similaire \u00e0 celle d\u2019autres virus notamment grippaux ou pseudogrippaux. Cette transmission peut \u00eatre directe par les secr\u00e9tions respiratoires (gouttelettes de Pfl\u00fcgge), la conjonctive et les muqueuses nasales repr\u00e9sentant alors la porte d\u2019entr\u00e9e, ou indirecte manuport\u00e9e.<\/p>\n

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Clinique<\/span><\/h2>\n

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Apr\u00e8s une incubation de 2 \u00e0 6 jours, dans un contexte f\u00e9brile souvent mod\u00e9r\u00e9, les manifestations cliniques apparaissent touchant la sph\u00e8re ORL \u00e0 l\u2019origine de rhinites, otites (\u00be des otites virales de l\u2019enfant sont li\u00e9es au VRS), sinusites, laryngites mais aussi des conjonctivites. Puis le tractus respiratoire inf\u00e9rieur est lui aussi atteint avec bronchites et pneumopathies.
\nLa dur\u00e9e de contagiosit\u00e9 d\u00e9pend de l\u2019\u00e2ge du patient : pendant 3 semaines chez les jeunes enfants (< 6 mois), 3 \u00e0 7 jours chez l\u2019adulte, et dans tous les cas cette contagiosit\u00e9 est maximale d\u00e8s le d\u00e9but de l\u2019infection.
\nChez le nourrisson l\u2019aspect le plus typique de la maladie est la bronchiolite se traduisant par une polypn\u00e9e, une toux souvent associ\u00e9e \u00e0 des troubles digestifs. Cette bronchiolite pouvant \u00eatre \u00e0 l\u2019origine d\u2019insuffisance respiratoire n\u00e9cessitant l\u2019hospitalisation chez les nourrissons ayant une pathologie cardio-respiratoire associ\u00e9e.<\/p>\n

Le VRS est \u00e9galement impliqu\u00e9 dans le d\u00e9clenchement des crises d\u2019asthme, de ph\u00e9nom\u00e8ne d\u2019hyperr\u00e9activit\u00e9 bronchique ou de manifestations respiratoires r\u00e9cidivantes.\"\"
\nLes enfants plus grands et les adultes ne sont g\u00e9n\u00e9ralement que rarement infect\u00e9s par le VRS mais peuvent contaminer les enfants en bas \u00e2ge et les nouveaux n\u00e9s.
\nChez les personnes \u00e2g\u00e9es ou fragilis\u00e9es (BPCO, asthme, insuffisance cardio-respiratoire) le VRS est \u00e0 l\u2019origine de pneumopathie interstitielle pouvant \u00e9ventuellement se compliquer de pneumopathie bact\u00e9rienne aggravant alors le pronostic.
\nOn ne note pas de risque particulier chez la femme enceinte<\/p>\n

<\/h3>\n

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Diagnostic<\/span><\/h2>\n

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Le laboratoire Labosud-Provence-Biologie dispose d\u2019un test immunochromatographique de diagnostic rapide du virus respiratoire syncytial (VRSTOP\u00aeoptima)<\/strong>.
\nCe test r\u00e9alis\u00e9 \u00e0 partir d\u2019\u00e9couvillonnage nasal poss\u00e8de une excellente sensibilit\u00e9 et sp\u00e9cificit\u00e9 et va permettre en 10 mn de d\u00e9tecter la pr\u00e9sence du VRS. Il est pris en charge par l\u2019assurance maladie.
\nIl sera int\u00e9ressant compte tenu de la similitude des sympt\u00f4mes d\u2019effectuer \u00e9galement un test de d\u00e9pistage de la grippe afin de prendre les mesures pr\u00e9ventives chez les patients \u00e0 risque et isoler le sujet source..
\nD\u2019autres techniques diagnostiques sont possibles : immunofluorescence, culture virale ou amplification g\u00e9nique (RT-PCR) mais n\u00e9cessitent un \u00e9quipement particulier et un d\u00e9lai plus important.<\/p>\n

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Traitement<\/span><\/h2>\n

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Il existe un traitement prophylactique par des anticorps monoclonaux anti-VRS (palivizumab SYNAGIS\u00ae) qui diminue la fr\u00e9quence des hospitalisations. Mais le co\u00fbt \u00e9lev\u00e9 du traitement en limite l\u2019utilisation aux pr\u00e9matur\u00e9s (<32 semaines d\u2019am\u00e9norrh\u00e9e), aux enfants de moins de 3 mois et aux enfants de moins de 2 ans avec dysplasie broncho-pulmonaire ou atteints d\u2019une cardiopathie cong\u00e9nitale avec perturbations h\u00e9modynamiques.
\nIl n\u2019y a pas actuellement de vaccin disponible contre le VRS.
\nEn cas de pr\u00e9sence de sujet \u00e0 risque dans l\u2019entourage du sujet expos\u00e9, m\u00eame asymptomatique, il faudra \u00e9viter les contacts rapproch\u00e9s pendant huit jours.<\/p>\n

L\u2019immunit\u00e9 naturelle provoqu\u00e9e par une infection ant\u00e9rieure n\u2019est ni durable ni compl\u00e8te et des infections intercurrentes arrivent fr\u00e9quemment pendant les 3 premi\u00e8res ann\u00e9es de la vie.<\/p>\n

<\/h5>\n
Pour en savoir plus:<\/span><\/h5>\n

 <\/p>\n

Bronchiolite. Aide-m\u00e9moire. InVS, 2015 (http:\/\/www.invs.sante.fr\/Dossiers-thematiques\/Maladies-infectieuses\/Infections-respiratoires\/Bronchiolite\/Aide-memoire<\/a>). Zandotti C, Pozzetto B – Virus respiratoire syncytial. In: Pozzetto B (Ed) – Infections nosocomiales virales et \u00e0 agents transmissibles non conventionnels. Montrouge : Edition John Libbey Eurotext ; 2001 : 214-221 Survenue de maladies infectieuses dans une collectivit\u00e9. Conduites \u00e0 tenir. Haut Conseil de la Sant\u00e9 Publique (HCSP), 2012 (http:\/\/www.hcsp.fr\/explore.cgi\/avisrapportsdomaine?clefr=306<\/a>).<\/em><\/p>\n

Dr Pierre Hance<\/p>\n

 <\/p>\n

\u00a0Retrouvez sur ce lien l’ensemble de nos bulletins d informations m\u00e9dicales au format PDF<\/a><\/h5>\n","protected":false},"excerpt":{"rendered":"

VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS)     A l\u2019origine d\u2019une des principales causes des broncho-pneumopathies aigues virales chez les enfants dans le monde, le virus respiratoire syncytial humain (VRS) est aussi responsable de la bronchiolite du nourrisson. Le VRS est … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":27,"featured_media":10011,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_links_to":"","_links_to_target":""},"categories":[284],"tags":[],"acf":[],"yoast_head":"\nLE VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS) - Labosud Provence<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/labosud-provencebiologie.fr\/general\/2017\/05\/04\/virus-respiratoire-syncytial-humain\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LE VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS) - Labosud Provence\" \/>\n<meta property=\"og:description\" content=\"VIRUS RESPIRATOIRE SYNCYTIAL HUMAIN (VRS)     A l\u2019origine d\u2019une des principales causes des broncho-pneumopathies aigues virales chez les enfants dans le monde, le virus respiratoire syncytial humain (VRS) est aussi responsable de la bronchiolite du nourrisson. 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