Respiratory syncytial virus is known to be especially dangerous for premature and medically fragile children. (National Institute of Allergy and Infectious Diseases)

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ATLANTA – It is estimated that 1 in 1 of the deaths of healthy children under the age of 5 worldwide is now due to a common virus. Increase in the USRespiratory syncytial virus, or RSV. And in high-income countries, one in 56 healthy, full-term babies will be hospitalized with RSV, according to the researchers’ estimates.

The virus is known to exist Especially dangerous for premature and medically fragile infants, but “results in a significant burden of disease among infants worldwide,” the study’s authors wrote Thursday in The Lancet Respiratory Medicine.

Other studies have previously examined the number of children hospitalized with RSV, but the new study is one of the first to look at the numbers in healthy children.

“This is a very low-risk baby being treated in the hospital, so in reality, the numbers are actually a lot higher than some people think,” said study co-author Dr. Louis Bont, professor of pediatric infectious diseases. Wilhelmina Children’s Hospital at Utrecht University in the Netherlands. Bont is the founding chair of the RSVnet Foundation, a non-profit organization dedicated to reducing the global burden of RSV infection.

In the year The estimates are based on an analysis of the number of RSV cases in 9,154 infants born between July 2017 and April 2020 who were followed for the first year of life. The children received care at health centers across Europe.

‘No intensive care unit’

About 1 in 1,000 children in the study were admitted to the intensive care unit for mechanical ventilatory support. This care is very important: the risk of death is high in parts of the world where there is a lack of hospital services.

“Most deaths from RSV occur in developing countries,” Bont said. “Mortality is rare in the developed world, and if it does occur, it’s almost exclusively in those with severe infectious diseases. But in most parts of the world, there are no intensive care units.”

Globally, RSV is the second leading cause of death in children’s first year of life, after malaria. Between 100,000 and 200,000 children die from the virus each year, Bont said.

Permanent lung damage

Dr. Christina Dieter, MD, chair of pediatrics at the University of Nevada, Reno, and a pediatrics specialist, said the virus is still highly pathogenic, and even hospitalization can cause serious complications. Critical care in the pediatric medical team.

“This trauma, such as psychosocial, emotional issues after hospitalization, or having more vulnerable lungs — you may develop asthma later, for example if you have a very serious infection at a young age — can permanently damage your lungs,” said Dieter, who was not involved in the new study. It’s an important virus in our world and something we really need to focus on. “The pediatric ICU is kind of bread and butter.”

Health care providers know that November through March is the traditional “virus season” and should plan for RSV and other respiratory problems.

Dr. Nicholas Holmes, senior vice president and chief operating officer at Rady Children’s Hospital in San Diego, said officials are confident there are always enough respiratory therapists and medical staff available.

Even then, officials at the largest pediatric hospital on the West Coast had to get creative to keep up with the patient load, he said.

“The sickest of sick children.”

“One thing we’ve implemented recently to help is that a lot of clinics have licensed nurses or therapists or physicians like myself in non-clinical roles in the organization. So we’re engaging licensed staff to provide support and advocacy. We’re bridging that gap and giving our nurses, physicians on the direct line of patient care. to support,” Holmes said.

On Wednesday, Holmes said he spent an hour and a half in the emergency room instead of doing his usual work through the hospital’s Helping Hands program. Check in on families and patients by giving out blankets and fruit pops. If a child is sick and needs immediate medical attention, it gives him the opportunity to see problems and notice the nurses.

“This allows the nursing team in the unit to focus on the sickest children,” Holmes said.

Although there is no specific treatment for RSV in healthy children, recent developments in vaccination and treatment mean that help can be provided in overcrowded hospitals.

There is only one. Monoclonal antibody therapy Pre-existing conditions or premature births. It’s been around since 1998 and has made a big difference, Dieter says.

‘Swamp in RSV patients’

“Once you start receiving that, the number of premature babies drops dramatically,” she says. “At this point, it’s very rare to put a baby on a ventilator for RSV. This small, vulnerable group is well protected with those shots, and yet we still have thousands of babies coming in who don’t receive it. They still need shots, and often supportive care.” , are managed without respiratory support.

There are things parents of infants can do to prevent RSV, says Dr. Priya Soni, assistant professor of pediatric infectious diseases at Cedars-Sinai Medical Center. These are the simple behaviors that everyone knows about during the Covid-19 pandemic: wash your hands well, stay home if you’re sick, and practice hygiene.

“The virus is a little bit tougher on hard surfaces, so cleaning those areas properly and washing hands goes a long way against RSV, as well as limiting a child’s overall exposure to contagious respiratory infections and spots,” Soni said. Involved in the new study.

The study’s findings on the number of children who contract RSV in the first months of life shows how important it is to have a vaccination strategy for pregnant women, she said.

“Anything we can do to close that gap for young infants in the first six months of life, who may be most susceptible to RSV infection, will help,” Sonny said.

In the US, four RSV vaccines are close to being reviewed by the FDA. They are in more than a dozen trials worldwide. A prophylactic treatment for lower respiratory tract infections caused by RSV received approval from the European Commission last week.

These developments could be game-changing, say experts.

“Every pediatrician I know is always working very, very hard at Christmas time. We are always overwhelmed with RSV patients every year,” Bont said. “This or next year may be the last time we really see that because it can really prevent most serious infections.”

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