Federico Martinón-Torres
Head of the Paediatrics Department of the Hospital Clínico Universitario de Santiago. Coordinator of the WHO Collaborating Centre for Vaccine Safety in Santiago de Compostela and member of the WHO-Europe Vaccine Advisory Committee.
RSV in infants is the equivalent of covid-19 in the elderly. It is by no means new to paediatricians, as it is the most common cause of hospitalisation in infants and one of the most prevalent conditions in paediatric care.
This work by a team led by a brilliant colleague, Harish Nair of the University of Edinburgh, updates previous work they have already published on the global dimension of this pathology. This update estimates that 100,000 children under 5 years of age die each year from RSV.
As always, 97% of these cases are in resource-limited countries. And almost three out of four deaths occur outside of hospital, which gives an idea of the drama in these countries.
RSV in infants is the equivalent of covid-19 in the elderly
In our environment, this pathology results in a non-negligible mortality rate and a huge number of hospitalisations. Of the three and a half million hospitalisations due to this pathology, a significant proportion occur in developed countries. The vast majority of these infections occur in otherwise healthy children with no identifiable risk factors.
The real way to tackle this global health problem is through prevention. This has not been possible until now, but it is foreseeable that in a short period of time we will have alternatives that will allow this. Evidence suggests that the latest generation of monoclonal antibodies work very well (preventing three out of four cases of RSV infection requiring medical attention).
Vaccines are also being developed for pregnant women so that, as we do for pertussis, by vaccinating the mother we can protect the newborn. The period when the highest number of cases accumulates is precisely in children under six months of age. This is the period of maximum risk that we want to block this pathology.
New prevention modalities must be incorporated as soon as possible
In conclusion, it is a very important global health problem that paediatricians have been aware of for a long time. This paper brings it up to date, telling us that it is everyone's problem and that the health authorities must actively monitor this pathogen, something that is not yet being done in our country.
It also reminds us that new prevention modalities must be incorporated as soon as possible, first for the youngest infants and bearing in mind that anyone can be infected by this virus.
The infection leads to the need for medical attention and hospitalisation in a high percentage of cases, especially in the youngest infants, but it also causes sequelae in the lung and can even lead to death, which is why it is, I insist, a tremendously serious pathology, which we must monitor, detect and, as soon as possible, prevent.