Although we spend most of our time talking about COVID-19, we should not forget about Respiratory syncytial virus (RSV). How common is hospitalization for RSV and what predicts worse illness?
To answer those questions, Rha et al (10.1542/peds.2019-3611) share with us an update estimating the prevalence of RSV in 7 US children’s hospitals around the country from November 2015 to June 2016. The authors share data on 2,969 children hospitalized for acute respiratory illness in these hospitals, of which 1043 (35%) tested positive for RSV. As expected, most of these children were less than 2 years of age, and half of the sample were less than 6 months of age with the highest rates of hospitalization in infants less than 1 month of age. What is most notable, however, is that 2/3 of those hospitalized had no underlying co-morbid condition or history of preterm birth.
So what can we do about the high prevalence rates in otherwise healthy infants who are not preterm? To answer that question, we asked Dr. Octavio Ramilo and Asuncion Mejias from Nationwide Children’s Hospital to comment on preventive strategies we might consider to further reduce the prevalence of this illness (10.1542/peds.2020-1727). Drs. Ramilo and Mejias also point out the limitations of this study in regard to missing cases that might have been hospitalized outside the study period, and just as importantly missing outpatient cases that may alter the overall prevalence rates of this virus as reported in this study of inpatients only. Drs. Ramilo and Mejias raise as many questions as they answer about next steps in prevention, and whether prevention strategies should be targeted to the various higher risk demographic factors shared in the Rha et al study.
Both this study and commentary are nothing to sneeze at and will bring you up to speed on where we need to direct our preventive measures in the office and in the lab at curtailing the prevalence of RSV in our communities. As to whether RSV becomes a factor in worsening the clinical course of a child who is also COVID-19 positive, we look forward to such a study coming our way in the year ahead.