Respiratory Syncytial Virus and Mortality Among Children Aged 5 Years or Younger

Findings from a recent study indicate that acute lower respiratory infections caused by respiratory syncytial virus (RSV) are responsible for a substantial global mortality rate among children aged 5 years or younger.

“We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV,” the authors wrote.

The authors estimated that in 2015, RSV-associated acute lower respiratory infection would result in a total of 118,200 deaths worldwide among children aged 5 years or younger. In this study, the authors looked to provide an updated estimation of RSV-associated deaths that did not occur in a hospital and information on RSV disease burden in narrow age brackets.

Expanding on 317 studies from their previous review, the authors obtained data on neonates to children aged 5 years with RSV as primary infection with acute lower respiratory infection from 481 studies. From their findings, they estimated that there were 3.6 million RSV-associated acute lower respiratory infection hospital admissions globally in 2019 (uncertainty range, 2.9-4.6 million). Of those reported cases, 39% had occurred in infants aged 6 months or younger.

Using the data, the authors estimated in neonates to children aged 5 years, there were 26,300 RSV-associated acute lower respiratory infection hospital deaths and 101,400 deaths overall, including community deaths, globally.

For neonates to infants aged 6 months, there were 13,300 RSV-associated acute lower respiratory infection hospital deaths and 46,700 overall deaths.

The authors also reported that RSV-associated acute lower respiratory infections and deaths had occurred across all age ranges in low- and middle-income countries, 95% and 97% respectively.

“Most of the striking gap between in-hospital and community deaths in low-income settings can be explained by the poor access to care, cost of care, and limited beds in hospitals during an RSV epidemic,” the authors concluded. “Another explanation is that some of the RSV deaths might be in children with rapidly progressive illness who, initially, do not appear to be severely ill.” 

—Jessica Ganga

Reference:

Li Y, Wang X, Blau DM, et al; RESCEU investigators. Global, regional, and national burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399(10340):2047-2064. doi:10.1016/S0140-6736(22)00478-0