RSV on the rise, hospitals urged to prepare for paediatric admissions

Image source: Jean-Paul CHASSENET – 123RF.com

The NICD has since issued a warning to clinicians and hospitals to prepare for an uptick in paediatric admissions.

RSV, according to the public health institute, is the most common cause of bronchiolitis and lower respiratory tract infection (LRTI) among young children. It is highly contagious and transmits mainly by respiratory droplets.

Among children younger than five years old, the NICD found that the RSV detection rate is currently at moderate levels and continues to rise steeply.

“Compared to the circulation of RSV between 2014 and 2019, the detection rate of RSV appears to be rising more sharply in recent weeks, although within the range of what has been seen in the past,” the public health institute said.

Meanwhile, data on increased RSV circulation and increased severe RSV-associated illness, which includes hospitalisation among children who are under a year old from November to February have been reported in the northern hemisphere countries.

“It is possible that the RSV season in South Africa will follow a similar trend.”

Preparation

“Clinicians, paediatric hospitals and intensive care units are reminded to anticipate an increase in paediatric admissions during the 2023 RSV season.”

In addition, healthcare providers are encouraged to prepare and allocate adequate resources to respond to the surge in RSV cases.

Clinicians are also urged to consider RSV in differential diagnosis for severe respiratory illness, especially in young children.

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“The majority of infants with RSV-associated bronchiolitis do not require hospitalisation, but certain children are at risk of severe disease (hospitalisation).”

Meanwhile, infants younger than six months may develop severe diseases, such as hypoxia, severe respiratory distress, inability to feed or apnoea and may require hospitalisation.

“In very young infants, irritability, decreased activity, and breathing difficulties may be the only presenting symptoms.”

Risk factors for severe RSV-associated disease include prematurity, congenital heart disease, chronic lung disease of prematurity, neurological disease, immunodeficiency and lack of breastfeeding.

Prevention

Prevention measures include the isolation of children with influenza-like symptoms, NICD said.

It also discourages sick children from going to crèches or schools for a few days and encourages teaching children and adults alike to practice sneezing and cough hygiene.

The institute does not recommend the use of prophylactic antibiotics for children with upper respiratory tract infections.

“The monoclonal antibody, palivizumab, administered monthly throughout the RSV season to infants and children at high risk of severe RSV disease, is effective for prevention.

“However, high costs and the need for monthly intramuscular injections throughout the RSV season limit its use.”