Raising awareness of respiratory syncytial virus in infants
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Building on our longstanding heritage as a leader in respiratory diseases, we are advancing the science of respiratory syncytial virus (RSV) to reduce the burden of this leading cause of childhood illness worldwide.
Lung infections due to RSV is a leading cause of hospitalisation in the first year of life, and RSV is the leading cause of lower respiratory tract infections (LRTIs) globally among infants and young children.1
RSV is estimated to be responsible for 33 million acute respiratory infections each year.2
Intensified circulation of respiratory syncytial virus (RSV) has been observed following the COVID-19 pandemic. Given the high prevalence of RSV and its potential severity in high-risk infant populations globally, it is more important than ever to educate parents and families in recognising this viral infection. We are focused on helping HCPs improve RSV care and management for infants and children worldwide.
RSV is a very common, contagious seasonal virus that is easily transmissible from person to person through respiratory droplets, for example through coughing or sneezing.3 While most babies with RSV will only experience mild, cold-like symptoms, serious cases of RSV can have a significant impact and even be life-threatening.3
At AstraZeneca, we want to ensure not only that infants around the world have access to currently available management options, but that we are also following the science and working tirelessly to achieve improved RSV care and management that involves prevention, diagnosis and earlier treatment.
Symptoms of RSV in infants
Respiratory syncytial virus (RSV) is a virus that infects the respiratory tract, commonly affecting children under two years of age.4 The symptoms of RSV vary depending on the age, health, and pre-existing health issues. Older children and adults may experience mild flu-like symptoms such as a runny nose, sore throat, cough, and fever. However, children and immunocompromised individuals may experience severe symptoms.5,6
It is important to recognise RSV symptoms in infants, as severe cases can lead to pneumonia, bronchiolitis, and in some cases, be life-threatening.6
RSV can be highly contagious as it is transmitted through mucus and saliva of infected individuals.7 RSV can survive on surfaces for several hours, which makes it easy for infants to contract if they touch contaminated objects and then touch their eyes, nose, or mouth. Once the virus enters the body, it infects the cells in the respiratory tract.7 RSV causes inflammation and swelling of the airways, making it difficult for air to flow in and out of the lungs. Infants are particularly at risk for RSV due to their smaller airways which are more susceptible to swelling and inflammation.5,6
RSV can cause a range of symptoms in infants, including coughing, wheezing, rapid breathing, runny nose, congestion, fever, and lethargy. In severe cases of RSV infection, infants may experience short, shallow, and rapid breathing.5 They may struggle to breathe, and it may appear that their chest muscles and skin pull inwards with each breath. Infants may also experience coughing, poor feeding, unusual tiredness, irritability, and cyanosis, a condition where the skin turns blue due to a lack of oxygen.6 Infants with RSV may also experience increased work of breathing, known as retractions, where they use their chest muscles to help them breathe.5,8
Symptoms of RSV in infants under six months of age can vary, with some infants having more subtle signs of RSV. Therefore, it is important to be on the lookout for any unusual behaviour in infants and to seek medical attention if an infant exhibits any symptoms of RSV, particularly if they have a fever or are struggling to breathe. Infants with severe symptoms may require hospitalisation for treatment, including oxygen therapy and intravenous fluids.4,5
Preventative measures to avoid infants contracting RSV6,9
- Practice frequent hand washing and encourage others to do the same.
- Use soap and water to wash your hands for at least 20 seconds, especially after blowing your nose, sneezing or coughing, before eating, after being in public places, and after changing diapers.
- Ensure that infants are kept away from individuals with a cold, fever, or runny nose.
- It's best to avoid crowded areas and young children during the RSV season.
- Clean and disinfect surfaces regularly to reduce the spread of the virus.
- When coughing or sneezing, make sure to cover your mouth and nose.
- Ensure that no one smokes around infants as exposure to second-hand smoke can worsen the symptoms of RSV.
- These measures can significantly reduce the likelihood of infants contracting RSV and other respiratory illnesses.
During the seasons when RSV is more prevalent, parents may want to take extra measures to protect children. Other respiratory illnesses like the flu and common cold can also affect infants. If you suspect that a child has RSV or any respiratory disease, contact your healthcare provider immediately.7
Advancing the science of RSV
There is currently no specific treatment for Respiratory syncytial virus (RSV), meaning that prevention is key for infants.4
Babies born prematurely or with health conditions are at high risk of developing severe RSV infection.3,10 However, any infant, even those born healthy and at term, can be hospitalised in their first RSV season.11,12 Many hospitalisations have been observed in previously healthy infants and half of them occur in older infants born outside of the RSV season.11,12,13,14
There have been decades of dedicated research into RSV. However, in the last 60 years of research, the scientific community has struggled to advance new therapeutic options in this field.15
Looking to the near future, there are therapeutic options that offer hope – with recent scientific advancements in the RSV field, families might soon start to see a range of different options offering immunity to all infants and therefore providing protection against RSV.
We have a long-standing partnership with Sanofi, encompassing many years of research and collaboration towards improving the medical community’s approach towards RSV management.15,16
The prevention of RSV morbidity and mortality remains a global health care priority.17 No parent or family should have to experience their child struggle with RSV infection, and it’s our responsibility as a scientific community to follow the science and develop new solutions. The progress that can be made when collaboration is valued and nurtured is illustrated by our partnership with Sanofi. We are jointly committed to help healthcare professionals improve care and management for RSV, a leading cause of childhood illness worldwide.
Increasing awareness to RSV
Increasing awareness of RSV is crucial in the quest to prevent the spread of the virus and to protect vulnerable populations. By educating families on the signs, symptoms, and ways of transmission of RSV, they can take steps to reduce the risk of infection. If nothing else, raising awareness can help promote good hygiene practices such as handwashing and covering sneezes, which can inadvertently limit the spread of RSV and other respiratory illnesses.9
Improving awareness among parents and caregivers is critical, as RSV is often connected to other conditions and can lead to long-term consequences such as wheezing and childhood asthma. It is important for parents and caregivers to be informed of these risks so they can take appropriate measures to protect their child, especially in the case of premature babies who are at higher risk of severe RSV infection.3,18 A 2018 poll revealed that awareness levels around RSV are lower than those for flu, making advocacy and information dissemination even more important.19
This year, ReSViNET are launching the first RSV surveillance dashboard to help simplify tracking changes in RSV seasonality globally. This is important because the pandemic disrupted the previous predictability of RSV seasonality and, in some cases, RSV circulation was more intense than it was pre-COVID.20,21,22
Improving care for infants
References
1. Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. Eur Respir J.2015;45(3):774-789.
2. You Li. E al,. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis [Internet]. Vol. 399. The Lancet; 2022.
3. Piedimonte G, Perez MK. Respiratory syncytial virus infection and bronchiolitis. Pediatr Rev. 2014;35(12):519-530. doi:10.1542/pir.35-12-519.
4. CDC. Symptoms and care [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2023 May]. Available from: https://www.cdc.gov/rsv/about/symptoms.html
5. Nall R, MSN, CRNA. RSV in babies: Symptoms, getting help, treatment [Internet]. Healthline. 2022 [cited 2023 May]. Available from: https://www.healthline.com/health/parenting/rsv-in-babies
6. Respiratory syncytial virus (RSV) [Internet]. Mayo Clinic. 2021 [cited 2023 May]. Available from: https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098
7. Watch your baby for signs of serious RSV symptoms [Internet]. Cleveland Clinic. [cited 2023 May]. Available from: https://my.clevelandclinic.org/health/diseases/8282-respiratory-syncytial-virus-in-children-and-adults
8. American Lung Association. RSV symptoms and diagnosis [Internet]. Lung.org. [cited 2023 May]. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv/symptoms-diagnosis
9. CDC. RSV prevention [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2023 May]. Available from: https://www.cdc.gov/rsv/about/prevention.html
10. Goldstein M, Phillips R, DeVincenzo JP, et al. National Perinatal Association 2018 Respiratory Syncytial Virus (RSV) Prevention Clinical Practice Guideline: an evidence-based interdisciplinary collaboration. Neonatology Today. 2017;12:1-14
11. Rha B et al. Respiratory Syncytial Virus–Associated Hospitalizations among Young Children: 2015–2016. pediatric. 2020;146(1):e20193611.
12. Arriola CS, Kim L, Langley G, Anderson EJ, Openo K, Martin AM, et al. Estimated Burden of Community-Onset Respiratory Syncytial Virus-Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. Journal of the pediatric Infectious Diseases Society. 2020;9(5):587-95.
13. Reeves RM, Hardelid P, Panagiotopoulos N, Minaji M, Warburton F, Pebody R. Burden of hospital admissions caused by respiratory syncytial virus (RSV) in infants in England: A data linkage modelling study. The Journal of infection. 2019;78(6):468-75.
14. Demont, C., Petrica, N., Bardoulat, I. et al. Economic and disease burden of RSVassociated hospitalizations in young children in France, from 2010 through 2018. BMC nfect Dis 21, 730 (2021).
15. Villafana T, et al. Passive and active immunization against respiratory syncytial virus for the young and old. Expert Rev Vaccines. 2017;16:1-39.
16. Respiratory Syncytial Virus Infection (RSV): Infants and Young Children. Centers for Disease Control and Prevention. https://www.cdc.gov/rsv/high-risk/infants-young-children.html Accessed May2023.
17. Mammas IN, et al. Update on current views and advances on RSV infection (Review). Int J Mol Med. 2020 Aug;46(2):509-520.
18. Fauroux B. The Burden and Long-term Respiratory Morbidity Associated with Respiratory Syncytial Virus Infection in Early Childhood. Infect Dis Ther. 2017; 6(2): 173–197.
19. National Coalition for Infant Health. RSV awareness: A national poll of parents & health care providers. https://www.infanthealth.org/new-blog/2019/5/rsv-awareness-a-national-poll-of-parents-amp-health-care-providers. Accessed May 2023
20. Eden J-S, Sikazwe C. Xie R, et al. Off-season RSV epidemics in Australia after easing of COVID-19 restrictions. Nature Communications. 2022; 13(2884).
21. Billard M-N et al. International changes in respiratory syncytial virus (RSV) epidemiology during the COVID-19 pandemic: Association with school closures. Influenza Other Resp. 2022;16(5): 926-936.
22. European Centre for Disease Prevention and Control. Intensified circulation of respiratory syncytial virus (RSV) and associated hospital burden in the EU/EEA. 12 December 2022. https://www.ecdc.europa.eu/en/publications-data/intensified-circulation-respiratory-syncytial-virus-rsv-and-associated-hospital Accessed May 2023.