The high price of RSV hospitalizations on families and healthcare systems

In the world of respiratory infections, these past three years have been unprecedented.

Respiratory syncytial virus (RSV) took a backseat during the COVID-19 pandemic. Many public health measures put in place to prevent the spread of COVID-19, such as wearing masks and limiting public gatherings, meant RSV was circulating at historically low levels.[1-2]

However, data from multiple countries showed that RSV was making its comeback last winter – a strong comeback. [3-5] US data from Centers for Disease Control and Prevention indicated that the last RSV season brought a much higher rate of RSV-related hospitalization in infants than in any of the years during the pandemic, or even pre-pandemic.[5]

These higher rates of RSV-associated hospitalizations put significant stress on families and healthcare systems, demonstrating an urgent need to prepare for future winters.

More than “a cold”

RSV is a leading cause of hospitalization in infants under 12 months. [6-10]

While most cases of RSV infection lead to a mild illness, much like a cold, it can progress to more severe respiratory disease. If we look at the US data specifically, infants under 12 months of age are 16 times more likely to be hospitalized due to RSV than influenza and 72% of infants hospitalized with RSV are born at term and healthy.[8,11]

Admission to the hospital due to RSV is a very traumatic experience for families. For parents, it can be frightening when they understand that RSV is something more than a cold – for example, seeing their baby coughing so hard, that it starts vomiting, or breathing so hard that it looks like they are using their belly to help get air in and out of their lungs.?

Is a terrifying experience for parents, but imagine what it must be like for infants: the sights and sounds of medical equipment, the sterile environment and separation from familiar faces. Severe RSV can also lead to a long recovery period for infants, adding additional stress for their parents.[12]

Creating awareness

Historically, RSV has been described as the “invisible virus,” hiding in the shadows of better-known viruses like influenza. Recently though, RSV has had its time in the media spotlight, with more focus on its unprecedented impact on families, hospitals, and healthcare systems.

Continuing this momentum and proactively educating new and current parents about the risks of RSV are important steps we can take to improve awareness.

Additionally, continuing to advance RSV research and development to expand preventative options is a critical part of this momentum and the hope of a "new normal" for RSV disease.

References:

1.??????Bardsley M. et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis 2023; 23: 56–66. doi:10.1016.

2.??????Groves E. et al. The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: A population-based study. Lancet Reg Health Am. 2021 Sep;1:100015. doi: 10.1016/j.lana.2021.100015

3.??????European Centre for Disease Prevention and Control. Intensified circulation of respiratory syncytial virus (RSV) and associated hospital burden in the EU/EEA. Available at: https://www.ecdc.europa.eu/en/publications-data/intensified-circulation-respiratory-syncytial-virus-rsv-and-associated-hospital. Accessed: April 2023

4.??????European Centre for Disease Prevention and Control. Communicable Disease Threats Report: Week 48. Available from: https://www.ecdc.europa.eu/en/publications-data/communicable-disease-threats-report-27-november-3-december-2022-week-48?Accessed: April 2023

5.??????Centers for Disease Control and Prevention. RSV-NET Interactive Dashboard. Available from: https://www.cdc.gov/rsv/research/rsv-net/dashboard.html. Accessed April 2023.

6.??????Centers for Disease Control and Prevention. RSV in Infants and Young Children. Centers for Disease Control and Prevention. https://www.cdc.gov/rsv/high-risk/infants-young-children.html. Accessed: April 2023

7.??????Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr. 2003;143(5 Suppl): S127-S132. doi:10.1067/s0022-3476(03)00510-9.

8.??????Arriola CS, Kim L, Langley G, et al. Estimated burden of community-onset respiratory virus–associated hospitalizations among children aged <2 years in the United States, 2014-15. J Pediatric Infect Dis Soc. 2020;9(5):587-595.

9.??????Hall, C. B. et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 2013 Aug;132(2):e341-8. doi: 10.1542/peds.2013-0303.

10.??Gantenberg, J. R. et al. Medically Attended Illness due to Respiratory Syncytial Virus Infection Among Infants Born in the United States Between 2016 and 2020. The Journal of Infectious Diseases, Volume 226, Issue Supplement_2, 15 August 2022, Pages S164–S174, https://doi.org/10.1093/infdis/jiac185

11.??Zhou H. et al. Hospitalizations Associated With Influenza and Respiratory Syncytial Virus in the United States, 1993–2008. Clinical Infectious Diseases, Volume 54, Issue 10, 15 May 2012, Pages 1427–1436, https://doi.org/10.1093/cid/cis211

12.??Leidy, N. et al. The Impact of Severe Respiratory Syncytial Virus on the Child, Caregiver, and Family During Hospitalization and Recovery. Pediatrics 115 (6): 1536–1546. https://doi.org/10.1542/peds.2004-1149