Early life respiratory syncytial virus disease—a preventable burden

Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract infection (LRTI), and mortality in infants, predominantly in those younger than 6 months. 1 Li Y Wang X Blau DM et 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. Lancet. 2022; 399: 2047-2064 Summary Full Text Full Text PDF PubMed Google Scholar The predominant burden of severe illness occurs in full-term infants, although children born premature or those with underlying conditions such as cardiac or chronic lung disease are vulnerable to developing more severe disease. 1 Li Y Wang X Blau DM et 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. Lancet. 2022; 399: 2047-2064 Summary Full Text Full Text PDF PubMed Google Scholar , 2 Wang X Li Y Shi T et al. Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019: a systematic review and meta-analysis of aggregated and individual participant data. Lancet. 2024; 403: 1241-1253 Summary Full Text Full Text PDF Scopus (0) Google Scholar The burden is highly skewed to low-income and middle-income countries (LMICs), in which RSV-associated infant mortality rates are much higher than in high-income countries, in part due to a lack of access to care, with an estimated 70% of RSV-associated deaths occurring outside a health facility. 1 Li Y Wang X Blau DM et 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. Lancet. 2022; 399: 2047-2064 Summary Full Text Full Text PDF PubMed Google Scholar Effectiveness and impact of universal prophylaxis with nirsevimab in infants against hospitalisation for respiratory syncytial virus in Galicia, Spain: initial results of a population-based longitudinal studyNirsevimab substantially reduced infant hospitalisations for RSV-associated LRTI, severe RSV-associated LRTI requiring oxygen, and all-cause LRTI when given in real-world conditions. These findings offer policy makers and health authorities robust, real-world, population-based evidence to guide the development of strategies for RSV prevention. Full-Text PDF