Respiratory Syncytial Virus Resurgence in Italy: The Need to Protect All Neonates and Young Infants

Abstract

Respiratory syncytial virus (RSV) is the most prevalent cause of viral respiratory infections in children up to the age of 2 years and causes a wide range of clinical manifestations [...]

The assessment of future RSV immunizations: How to protect all infants?

“…In 2021, following the removal of lockdown measures, uncommon resurgences during spring and summer were first reported in southern hemisphere countries such as Australia ( 24 ). Similar trends were then observed in some northern hemisphere countries, such as France, Spain, Germany and the UK ( 25 ).…”

Out-of-Season Epidemic of Respiratory Syncytial Virus during the COVID-19 Pandemic: The High Burden of Child Hospitalization in an Academic Hospital in Southern Italy in 2021

“…Maternal immunization during the third trimester of pregnancy could increase the amount of anti-RSV antibodies passed from the mother to the infant. The passive immunization of infants using this strategy is advisable, as any RSV vaccine in infants would not protect them from infection during the first weeks of life when the risk of hospitalization for RSV is higher [ 11 , 41 ].…”

“…In temperate regions of the Northern Hemisphere, RSV typically peaks in the winter months every year [ 4 , 10 ]. In Italy, the annual outbreak usually occurs from late fall to early spring, peaking in January-February [ 10 , 11 ]. Both subtypes of RSV (A and B) co-circulate during annual outbreaks, although one subtype usually predominates each year.…”

Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis

“…In this regard, future studies should guarantee a more accurate reporting on two substantial issues represented by risk factors for severe and complicated RSV infections, including [ 46 , 47 , 48 ]: infants either born at ≤35 weeks of Gestational Age (wGA); children < 2 years of age with chronic lung disease of prematurity (CLD) or hemodynamically significant congenital heart disease (CHD). Moreover, while new preventive options for RSV infections are increasingly made available [ 49 , 50 , 51 , 52 , 53 ], including extended half-life recombinant mAb (e.g., nirsevimab), future studies should more accurately highlight whether or not FS may represent a proxy for treatment failures. As most of RSV cases usually occur at community level, failing to obtain a proper microbiological diagnosis [ 3 , 54 ], if further studies will confirm the association between FS and a more invasive RSV infection pattern, identifying incident cases of FS among children having received previous prophylaxis would help to properly characterize a subset of treated individuals who did not benefit from the delivery of mAb, requiring improved preventive and clinical interventions [ 50 , 55 , 56 , 57 , 58 , 59 ].…”

“…Even though the estimates were reasonably free from small study effects and publication bias, it should be stressed that RSV has been often and improperly regarded as a somewhat “minor” pathogen, and also medical professionals still fail to understand the severity of RSV infections in infants and adults [ 60 , 61 , 62 ]. Therefore, the large majority of incident cases simply remains undiagnosed [ 5 , 52 , 53 , 63 ]. As a consequence, we cannot rule out that our estimates might have been affected by a resulting overestimation, particularly in studies based on records from PICU, where a higher share of complicated cases of RSV infections are reasonably included [ 16 , 29 , 33 ].…”