Editor's recommendation: A new study published in the journal Lancet estimates that in 2019, the acute lower respiratory tract infection of by respiratory syncytial virus (RSV) caused by deaths worldwide. The study, the first time to investigate the burden of RSV disease in the narrow age group, reported that more than 45,000 infants died under six months of age in 2019, and one-fifth of the total global RSV cases occurred in this age group.
Abstract: Acute lower respiratory tract infection caused by
respiratory syncytial virus (RSV) has largely caused the global burden of death in children with an estimated 50 deaths in children under 5 years of age and 28 deaths in children under 6 months of age.
In 2019, the deaths of more than 100,000 children under the age of 5 can be attributed to RSV, with nearly half (more than 45,000) occurring among children under 6 months of age. RSV is estimated to cause 3.6 million hospitalizations each year. 97% of child deaths caused by
RSV occur in low- and middle-income countries. The findings highlight the urgency of developing effective RSV vaccines and prioritizing strategies for the most vulnerable populations, such as passive immunization of (i.e., vaccination during pregnancy) for children under 6 months. A new study published in the journal Lancet estimated that in 2019, acute lower respiratory tract infection caused by RSV killed more than 100,000 children under the age of 5 worldwide. The study, the first time to investigate the burden of RSV disease in the narrow age group, reported that more than 45,000 infants died under six months of age in 2019, and one-fifth of the total global RSV cases occurred in this age group.
Co-author of this paper, Harish, University of Edinburgh, UK Nair said: "RSV is the main cause of acute lower respiratory tract infection in young children, and our latest estimates show that children 6 months and under are particularly vulnerable, especially as COVID-19 restrictions surges around the world, most young children born in the past two years have never been exposed to RSV (and therefore have no immunity to the virus). We estimate that narrow age ranges help prioritize population pipelines with numerous RSVs Vaccine candidates, including those who are pregnant, so children in the youngest age group can be protected, similar to the current strategy to offer pertussis vaccines, typhoid fever, tetanus and pregnant people. "The findings of this new study are roughly consistent with estimates from a previous 2015 study that concluded that children under the age of 5 have 33.1 million people infected with RSV each year, resulting in a total death toll of 118,200. However, these updated calculations for RSV mortality at the global, regional and national levels in 2019 include modeling data from more than 100 new studies, allowing researchers to provide estimates for a narrower age group—including infants between 28 days and 6 months old, the age range with the highest known RSV lethality, as well as community mortality (i.e., deaths not occurring in hospitals).
In 2019, 33 million acute lower respiratory tract infections related to RSV occurred in children under the age of 5 worldwide, resulting in 3.6 million admissions, 26,300 hospitalizations and 101,400 deaths due to RSV (including community deaths). At this age, one in every 50 deaths, or 2% of deaths per year for any cause.
In 2019, 6.6 million acute lower respiratory tract infections occurred in children under 6 months of age worldwide. At this age group, 1.4 million people are hospitalized, 13,300 die in hospitals, and 45,700 die from RSV, accounting for 2.1% of the death toll for any cause each year, accounting for one in 50.
According to estimates of in-hospital and overall RSV mortality rates, only 26% of globally, or about one-quarter of RSV-related deaths occur in hospitals. This is particularly evident in low- and middle-income countries where hospitalization and mortality rates for children under five are 1.4%, compared with 0.1% in high-income countries. Overall, 97% of RSV deaths in children under five years of age occur in low- and middle-income countries.
The study co-author, Nanjing Medical University and the University of Edinburgh, UK, pointed out: "Our study estimates that three-quarters of RSVs deaths occur outside hospitals. In low- and middle-income countries, this gap is even larger, especially among children under 6 months of age, more than 80% of deaths occur in the community.This reflects the fact that access to and providing hospital care in these areas remains limited. Early detection of cases in the community and referral of sick children, especially those with low peripheral blood oxygen saturation, and popularization of effective and affordable immunization programs will be crucial. "
The authors acknowledge that there are some limitations in this study. Differences in factors such as the study environment, exact case definitions of acute lower respiratory tract infection (ALRI), access to and seeking behaviors for health care, and qualifications for RSV testing may affect the estimates of mortality numbers generated in the model. Data divided by age are also limited by the data available in the study. In addition, all data were collected before the COVID-19 pandemic; it is unclear the long-term impact of the COVID-19 pandemic on the burden of RSV disease. Tina Hart of Vanderbilt School of Medicine, USA, was not involved in the study, and she wrote in a related comment: "The impact of these data cannot be underestimated." In low- and middle-income countries, the burden of respiratory aiqido virus infection in neonatal periods is high, highlighting the potential for passive immunization strategies to have meaningful effects on children’s health. Policymakers will benchmark the benefits of respiratory Aiqido virus prevention and other priority public health interventions. Accurate estimates of the impact of prevention are crucial to demonstrate investment cases for RSV prevention. ”
Source: The Lancet
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