Acute lower respiratory tract disease is a major culprit that seriously threatens the life and health of infants and young children. Recently, in the "Children" breathing and protection of the common science activities of 2022 Infant and Toddler Lower Respiratory Disease Education and Science , experts remind that respiratory syncytial virus (RSV) is the most common viral pathogen in acute lower respiratory tract infection in infants and young children. parents should understand the dangers and prevention methods of respiratory syncytial virus infection, and jointly protect the health of the baby.
About 33.1 million children under 5 years old are infected with RSV
Deputy Secretary-General of the Chinese Preventive Medicine Association Zhang Lingli
Deputy Secretary-General of the Chinese Preventive Medicine Association Zhang Lingli said that pneumonia is the number one "killer" for the health of children under 5 years old in the world, and the main pathogens of pneumonia include bacteria, viruses, mycoplasma, etc. Among them, RSV is the most common viral pathogen that causes acute lower respiratory tract infection in children under 5 years old worldwide. RSV infection not only aggravates the original chronic respiratory disease, but also may cause repeated asthma, leaving behind sequelae, and has a great impact on the health of children around the world and a burden of disease. It is worth noting that compared with Streptococcus pneumoniae, RSV is still relatively unfamiliar to most parents and has not attracted enough attention from the whole society. Therefore, it is very important to carry out popular science work related to RSV.
Director of the Department of Infectious Diseases at the Pediatric Hospital of Fudan University Zeng Mei
Respiratory syncytial virus (RSV) is a very common negative sense single-strand RNA virus. Since cells infected with RSV fuse together to form a large cell structure called syncytial, it is called respiratory syncytial virus. Zeng Mei, director of the Department of Infectious Diseases at the Pediatric Hospital of Fudan University, pointed out that about 33.1 million children under the age of 5 are infected with RSV every year worldwide, of which about 10% of infants and young children are hospitalized, resulting in nearly 60,000 children under the age of 5 die due to RSV infection. Among children under 5 years old in China, there are about 2.58 million cases of RSV infection every year, most of which occur in infants and young children.
In 2021, the Chinese Center for Disease Control and Prevention released a 11-year monitoring data on respiratory infectious diseases in the authoritative journal Nature Communications. After conducting etiology and epidemiological studies on more than 230,000 acute respiratory infection cases from 277 sentinel hospitals nationwide, the detection rate of RSV is as high as 25.7%, higher than influenza (14.2%) in children under the age of 5.
Chinese Center for Disease Control and Prevention
Direction Prevention and Control
Direction Prevention and Control
"Global, RSV is mainly prevalent in winter and spring in the cold and temperate areas; in tropical and subtropical areas, the infection rate in the wet rainy season has increased significantly. In our country, winter and spring are the peak of epidemics in the northern region, and in the southern region, winter or wet rainy season are its peak of epidemics. There will also be detection at other times." Zhang Yan, director of the Measles Department of the Institute for Virus Disease Control and Prevention of the Chinese Center for Disease Control and Prevention, said that in terms of population distribution, RSV not only infects infants and young children, but also in other age groups, but infants and young children are high-risk groups, and the clinical manifestations after infection are generally more serious. Older children and adults do not experience obvious clinical symptoms or have mild clinical manifestations after infection, but they may transmit the virus to small babies. There is currently no effective vaccine or specific therapeutic drugs for RSV. The burden of disease caused by RSV infection is very serious worldwide, and it consumes a large amount of medical and health resources every year, which poses a great burden on society and families. China is one of the countries with the largest number of RSV infections in the world, and it is urgently needed to effectively solve clinical unmet needs.
RSV infection in infants is mainly manifested in wheezing
After children are infected with RSV, upper respiratory tract infection symptoms including nasal congestion and runny nose will usually occur in the early stage, which is similar to the symptoms of a cold. As the condition progresses, children with RSV infection may develop lower respiratory tract infection, such as coughing, wheezing, and further aggravation may experience shortness of breath, difficulty in breathing, difficulty in feeding and mental depression.Here, Zeng Mei reminds: "There is a special feature of RSV infection in infants, which is mainly manifested by wheezing, not fever, especially for small babies. When wheezing occurs, the child is very painful. When he is panting, his face turns red. In severe cases, it will cause hypoxia, purple lips, and poor sleep at night. The symptoms of acute attacks usually last for one to two weeks before slowly relieving, which will cause physical and mental trauma to the children and parents. Some babies also have RSV infections accompanied by fever and obvious cough."
Zeng Mei said that infants and young children are infected with RSV for the first time, which will cause hypoxia attacks. Hypoxia will damage organ functions and even threaten their lives. There may be secondary severe bacterial infection after RSV infection, which will make it worse. "The risk of repeated wheezing attacks and asthma after infancy and early childhood RSV infection will significantly increase. Some children with severe RSV infection will have residual lung function impairment after surviving. Especially for babies with some chronic underlying diseases such as congenital heart disease, chronic lung disease, and backward nervous system development, they often have the highest risk of developing severe diseases. From the perspective of family and social burden and economic burden, the harm brought by RSV is very great."
At present, there is no specific medicine for RSV infection. The overall treatment is a comprehensive measure, mainly for symptomatic support for respiratory tract support. If bacterial infection is combined, antibacterial drugs are needed for children in time. In severe cases, ventilators are needed to help children through the most dangerous period.
Wearing a mask and washing hands frequently can help prevent RSV infection
Beijing Children's Hospital Affiliated to Capital Medical University,
Director of the Infection and Virus Research Office of Beijing Institute of Pediatrics Xie Zhengde
Director of the Infection and Virus Research Office of Beijing Institute of Pediatrics Xie Zhengde
Director of the Infection and Virus Research Office of Beijing Institute of Pediatrics Xie Zhengde reminded that RSV can be transmitted through droplets or through contact. Wearing a mask, washing hands frequently, ventilation in the room, and maintaining social distancing can help prevent RSV infection. Especially for young babies, adults may carry viruses when they go home. If they do not wash their hands and have close contact with their children, they may pass the virus to their children. Therefore, family members should do a good job in health management. When holding their children, especially babies a few months old, family members should wear masks and wash their hands. If your family has symptoms of respiratory infection, such as sneezing, runny nose, or slight pharynx discomfort, it is best to stay away from the baby, which can help the baby reduce contact with the virus.
Xie Zhengde pointed out that RSV was discovered in the 1950s, but no vaccine has been developed. At present, the research progress of long-acting monoclonal antibodies is the fastest. In June 2021, the World Health Organization (WHO) formulated the "Product Characteristics of the World Health Organization Recommended Monoclonal Antibodies for Passive Immunization in Respiratory Syncytial Virus Infection", giving priority to the use of passive immunoprecipitates and long-acting monoclonal antibodies to protect babies from RSV hazards. "The World Health Organization has put forward the vision of human monoclonal antibodies: First, it must be long-term. For example, my country's RSV northern epidemic season is mainly 5 months. Second, it is cheap and ordinary people can afford it." Xie Zhengde said.
Zhang Yan believes that if RSV can be prevented, it will reduce the disease burden, family and socio-economic burden caused by RSV infection, which will have a positive impact on the prevention and control of RSV and the global public health field, including reducing the rate of lower respiratory tract infection cases, hospitalization cases, and even deaths caused by RSV infection, so as to reduce the consumption of medical resources; at the same time, it can also reduce the outbreaks of people in specific places caused by RSV infection, including neonatal nursing centers, pediatric wards, etc.
Experts interact with the topic of respiratory syncytial virus prevention and treatment . It is understood that the research and development of long-acting human monoclonal antibody in China has entered the third phase of clinical trials. Recent research on the effectiveness and safety of RSV prevention in infants and young children will be carried out in many places, and clinical recruitment work will be launched soon. Please indicate the source for reprinting of
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text || Fan Hongbo
editing || Wan Tao
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