More than 100,000 children died in 2019 from respiratory syncytial virus, study says

More than 100,000 children under the age of five died worldwide in 2019 from respiratory syncytial virus (RSV) infection, according to a study published in the scientific journal The Lancet.

THE study assessed the burden of disease in restricted age groups, reporting that there were more than 45,000 deaths in children under six months of age in 2019, with one in five of the total global cases of the disease occurring in this age group.

“RSV is the predominant cause of acute lower respiratory infection in young children and our updated estimates reveal that children aged six months and younger are particularly vulnerable, especially with cases increasing as Covid-19 restrictions are easing around the world. and the majority of young children, born in the last two years, have never been exposed to the virus,” says co-author of the article, Harish Nair, a researcher at the University of Edinburgh, UK.

According to the expert, the estimates help identify groups that should be prioritized when a vaccine against the virus is widely available, including pregnant women, so that children in the younger age groups can be protected.

Breakdown by age groups

The findings of this new study are in line with previous estimates from a 2015 study, which put the number of annual cases of RSV in children under five years old at 33.1 million, resulting in a total of 118,200 deaths.

However, these updated RSV mortality calculations at global, regional and national levels for the year 2019 include modeling data from over a hundred new studies, allowing researchers to provide estimates for narrower age groups – including 28 and older. days to six months, which is known to be the age group with the highest death rate from the virus – and community death rates (deaths that did not occur in a hospital).

In 2019, there were 33 million cases of RSV-associated acute lower respiratory infection in children under five years of age worldwide, leading to 3.6 million hospital admissions, 26,300 hospital deaths, and 101,400 deaths attributable to the virus overall (including community deaths). According to the study, RSV is responsible for one in 50 or 2% of annual deaths from any cause in this age group.

For children under six months of age, there were 6.6 million episodes of RSV-associated acute lower respiratory infection worldwide in 2019. There were 1.4 million hospital admissions, 13,300 hospital deaths, and 45,700 overall RSV-attributable deaths in this range age, representing one in 50, or 2.1% of annual deaths from any cause.

Based on estimates of in-hospital versus general RSV mortality rates, globally only 26%, or approximately one in four RSV-associated deaths, occur in a hospital.

Impacts for low- and middle-income countries

The study points out that the scenario is particularly evident in low- and middle-income countries, where the proportion of in-hospital mortality cases for children under five is 1.4%, compared to 0.1% in high-income countries. . Overall, 97% of RSV deaths in children under five years of age occurred in low- and middle-income countries.

“Our study estimates that three-quarters of RSV deaths are occurring outside the hospital setting. This gap is even greater in low- and middle-income countries, especially in children under six months, where more than 80% of deaths are occurring in the community. This reflects the fact that access and availability of hospital care is still limited in these regions,” says study co-author Xin Wang, from Nanjing Medical University in China and the University of Edinburgh.

The researchers advocate early case identification and referral for hospital admission of sick children, especially those with low blood oxygen saturation.

Among the limitations of the research, experts point to factors that can affect the estimates of mortality numbers produced in the modeling, including variations in factors such as study scenario, exact case definition for acute lower respiratory infection, access to health care and behavior of patients. search and eligibility for the VSR test.