According to the analysis, respiratory syncytial virus (RSV) caused more than 100,000 deaths in children under the age of 5 worldwide in 2019. Published online May 19th Lancet.
Researchers led by Dr. YouLi of the Department of Public Health, Nanjing Medical University in Nanjing, China, found that nearly half of them (more than 45,000) occurred in children under 6 months of age.
They estimated that RSV caused 1 in 50 deaths in children under 5 years of age and 1 in 28 deaths in children under 6 months of age.
In addition, according to the report, RSV is responsible for an estimated 3.6 million hospitalizations worldwide each year.
The authors state that this analysis is the first to screen the burden of RSV disease on a narrow age group.
The figures emphasize that almost all of the deaths (97%) were in low- and middle-income countries.
Message for prevention
Dr. Tina Hartart, a professor of allergy, lung, and emergency medicine at Vanderbilt University of Medicine in Nashville, Tennessee, did not participate in this study. Invitation commentary These findings are important in RSV prevention.
She noted that some of the most notable findings were high mortality rates in the 0-6 month age group: “Age to be vaccinated during pregnancy and immune protection at birth. It states that it is a layer.
Hartart, MD, co-authored with Dr. Justin R. Ortiz, MD, Vaccine Development and Global Health Center, University of Maryland School of Medicine, Baltimore, said: Medscape Medical News“RSV is a respiratory virus that infects almost all children by the age of 2-3, with the most common severe infections and deaths in the youngest infants. The most severe of these young infants. Anti-infection vaccines are one of the best ways to prevent these severe infections and death. “
The authors found that most deaths occur in low- and middle-income countries, but RSV is one of the most common reasons for infant hospitalization in the United States, with 1% to 3% of infants. Affects, half of which are maturity and healthy. Said Hartart.
It is also one of the most common causes of lower respiratory tract infections in young children in the United States, causing the most serious illnesses at extreme ages, and older people experience a serious morbidity of RSV.
Lee said Medscape Medical News The team wasn’t focused on reporting country-specific estimates in this work, Previous work released last yearBrought 98,000 to 155,000 RSV-related hospitalizations to children under the age of 5 in the United States in 2019. 65,000 to 86,000 were babies under the age of one.
Currently, according to him, the available RSV prophylaxis Palivizumab (Synagis), this is expensive and is only given to high-risk infants in high-income countries, including the United States.
“There are many promising RSV prophylaxis drugs that may target the general infant population as well as high-risk infants in late-stage clinical trials, such as maternal vaccines and monoclonal antibodies,” he said. “Estimating RSV-related disease burden helps predict the impact of future RSV immunization programs.”
Pandemic changing patterns
This study was completed prior to the COVID-19 pandemic, but it is not yet known how it will affect the disease burden of RSV in the long term.
However, according to Hartart, during the pandemic, the RSV circulation changed significantly in both intensity and timing, probably due to a combination of COVID and public health precautions.
“When people return to normal activity and the public health measures implemented to prevent the spread of COVID are mitigated, RSV circulation may increase and return to circulation during the winter. This is usually the case. influenza — From November to March, the temperate climate of the Northern Hemisphere. “
The paper’s co-authors, Harish Nair and PhD, collaborated with the Global Health Center at the University of Edinburgh’s Asher Institute in Edinburgh, Scotland, to ease COVID restrictions around the world, so their findings are particularly important. I said there is.
“”[T]The majority of infants born in the last two years have never been infected with RSV (and therefore are not immune to the virus), “Nair wrote.
Most deaths that occur outside the hospital
The challenge to reducing deaths under the age of 5 is that most (76%) of deaths occur outside the hospital.
The authors write that “for each in-hospital death of an acute lower respiratory tract infection associated with RSV, an additional 3 additional deaths due to RSV are estimated in the community.”
In low- and middle-income countries, the rate of death outside the hospital is even higher (81%).
This work is based on a previous review by a team that analyzed 317 studies. They updated their search with 113 new eligible studies and unpublished data from 51 papers published between January 1, 2017 and December 31, 2020.
The authors acknowledged several restrictions, including the study environment, definition of acute lower respiratory tract infections, access to healthcare, and differences in eligibility for RSV testing.
This study was funded by the European EU Innovative Pharmaceuticals Initiative Respiratory Syncytial Virus Consortium (RESCEU). Li reported grants from Wellcome Trust and WHO other than the submitted work. Hartert, Ortiz, and Nair do not disclose the relevant financial relationships.
Lancet. Published online on May 19, 2022. Full text, editorial
Marcia Frellick is a freelance journalist based in Chicago. She previously contributed to the Chicago Tribune, Science News, Nurse.com and was the editor of the Chicago Sun-Times, The Cincinnati Enquirer, and St. Cloud (Minnesota) Times. Follow her on her Twitter @mfrellick.
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