Vaccine Has Potential for Prevention of Respiratory Papillomatosis (web article)

The arrival of an FDA-approved human papilloma virus (HPV) vaccine in summer 2006 is expected to not only decrease the incidence of cervical cancer and indicators of cervical cancer, but it will also positively impact a less known disease. The vaccine will reduce HPV genital warts and subsequently reduce the number of cases of juvenile onset recurrent respiratory papillomatosis in children born to mothers with HPV, according to Keerti V. Shah, MD, DrPH, lead author of the article and professor of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health. Shah and his colleagues addressed the topic in a review article in the December 2005 issue of Papillomavirus Report.

“This is an extremely frustrating disease. We know the cause and generally how it is transmitted. We also know that exposure is no more than a fraction of an hour up to a few hours, but we do not currently have an available strategy to prevent the disease,” said Shah.

Symptoms of juvenile onset recurrent respiratory papillomatosis include growth of benign papillomas in the respiratory tract, most of which occur in the first four years of life. Their recurrent nature, location in the airway and potential for complications, such as malignant conversion, make them a burden to those inflicted and their families, according to the article authors. The condition is caused by human papillomavirus types 6 and 11 (which also cause genital warts) and is transmitted when the baby passes through an infected birth canal.

Typically, the disease cannot be eliminated and doctors treat the benign growths to ensure that the airway is intact. Other than caesarean deliveries, which may protect at-risk newborns from neonatal HPV infection, mothers do not have many options for preventing juvenile onset recurrent respiratory papillomatosis in their children.

In women who have not previously been infected with HPV, the vaccine will reduce their risk of having a child with juvenile onset recurrent respiratory papillomatosis to practically zero. The authors also report that vaccinating children at birth may also prevent the disease in children exposed to HPV during birth.

The authors suggest that national surveillance be set up to monitor and investigate new cases of juvenile onset recurrent respiratory papillomatosis to assess vaccine effectiveness and to pinpoint weaknesses in the preventive strategy.

“Recurrent respiratory papillomatosis: bright prospects for vaccine-based prevention” was coauthored by Keerti V. Shah, Elizabeth R. Unger, Craig S. Derkay and Bettie M. Steinberg.