Respiratory virus kills 100,000 children under the age of five

As COVID-19 and baboons shine the spotlight, new research highlights the devastating potential of another viral disease – respiratory syncytial virus (RSV) – that kills more than 100,000 children annually worldwide.

RSV is the most common cause of acute lower respiratory infection in infants and young children worldwide, but the disease burden is disproportionately high in developing countries, according to the Respiratory Syncytial Virus Consortium in Europe.

Lower respiratory infections affect the air passages below the larynx or larynx, including the trachea, or trachea, and the tiny alveoli in the lungs. They include acute bronchitis, bronchiolitis, and pneumonia.

“In low- and middle-income countries, the burden is likely to be greater due to overcrowding and poverty, and therefore mandatory passive immunization plays a key role in preventing acute RSV disease.”

Sushmita Roy Chowdhury, Director of Pulmonology, Fortis Hospital, Kolkata, India

Figures published in scalpel reveal that more than 95 percent of RSV-related acute lower respiratory tract infections and more than 97 percent of respiratory syncytial virus-attributable deaths, among children under 5, occur in low- and middle-income countries (LMICs).

“RSV is an important cause of death from lower respiratory infections in children, especially infants,” says Anand Krishnan, study author and professor in the Center for Community Medicine at All India Institute of Medical Sciences based in New Delhi.

“Despite this, there is very little routine testing for RSV in clinical settings even in phase III. [specialised health care] facilities, primarily where no specific treatment is available.”

Researchers from countries such as India, South Africa, the UK and the USA suggest that RSV plays an important role in the suffering and death of young children worldwide – particularly in the first six months of life and in low- and middle-income countries.

Internationally, RSV causes one in 50 deaths among children under five and one in 28 deaths among those aged 28 days to six months, they found.

Researchers analyzed 481 studies and estimated that in 2019, among children under five, there were 33 million episodes of acute lower respiratory infection associated with RSV, and 101,400 deaths were attributable to RSV. For infants aged 0 to six months, the estimated figures were 6.6 million and 45,700, respectively.

The study suggests that “the disproportionately high RSV burden in younger age groups in low- and middle-income countries warrants more comprehensive community case management and effective and affordable immunization programmes”.

There is no specific vaccine for RSV, but researchers are urging the implementation of passive immunization programs to combat the disease. Instead of a vaccine, which provides active immunity, in passive immunity, a person receives antibodies – proteins that the body produces in response to an invasion or a foreign antigen.

Researchers recommend that passive immunization programs to provide protection against RSV in the first 6 months of life can significantly reduce RSV burden. However, they say more data is needed on this approach.

The researchers were also surprised to find that hospital admissions up to six months of age was “consistently lower” in low- and middle-income countries than in high-income countries, “reflecting the fact that access and availability of hospital care remains limited in low- and middle-income countries.” , as they said. .

Experts say cases of RSV are likely to be on the rise as masks and lockdowns have reduced natural immunity against this and other common viruses.

Vaccine development was slow after an unsuccessful vaccine in the 1960s led to a lung infection during the first infection with natural RSV after vaccination, resulting in death in two cases, according to the World Health Organization.

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However, new understanding of the virus in recent years has led to several candidate vaccines undergoing development, and some may receive regulatory approval in the near future, says the UN health body.

“RSV-targeted interventions are likely to be an important component of strategies to reduce infant mortality globally, especially for low- and middle-income countries,” Krishnan says. “It is important that manufacturers as well as global health agencies keep this in mind as they make decisions about access and pricing for upcoming products.”

He adds that as newer biomedical interventions are in the pipeline, it is important that governments are prepared to make appropriate, evidence-based decisions for their deployment in these countries.

Sushmita Roy Chowdhury, MD, director of pulmonology at Fortis Hospital in Kolkata, India, says the study highlights “the staggering mortality risk from RSV.”

“In low- and middle-income countries, the burden is likely to be greater due to overcrowding and poverty, and therefore mandatory passive immunization plays a key role in preventing acute RSV,” she said. SciDev.Net . Network.

This piece was originally produced by the global office of SciDev.Net.

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