Durban — The respiratory syncytial virus (RSV) is said to be a major cause of respiratory illness and death in young infants, especially in low and middle-income countries.
According to research done by the University of the Witwatersrand (Wits), RSV is a common cause of hospitalisation in children under 5 years of age, and even more so in those younger than 6 months. However, vaccines administered to pregnant mothers to protect babies were proven to be effective.
RSV is highly contagious with transmission mainly by respiratory droplets.
A study conducted in 18 countries including South Africa, called Maternal Immunisation Study for Safety and Efficacy (Matisse) and led by researchers at the Wits Vaccines and Infectious Diseases Analytics Research Unit (Wits Vida), revealed that the vaccination of pregnant women was safe and reduced the risk of RSV-associated lower respiratory tract infection (LRTI) by 82% in infants aged through to 6 months old.
The director of Wits Vida, Professor Shabir Madhi, said the findings came at a time when RSV was back with a vengeance in South Africa, with paediatric wards being filled with children in whom illness could now be prevented with this new RSV vaccine.
Madhi said LRTI was the most common cause of hospitalisation and death in children from 1 to 59 months of age, particularly in low and middle-income countries.
“RSV is the most common cause of LRTI hospitalisation in children, occurring in some 30-80% of cases. Approximately two-thirds of children will be infected at least once by RSV in the first two years of life, a third of whom will develop LRTI.
“In 2019, it was estimated that there were 101 400 RSV-attributable deaths, 99% of which occurred in low-and middle-income countries and 50% of which were in children less than 6 months of age,” he said.
He added that there was currently no antiviral treatment for children with RSV infection and that management of RSV-LRTI was symptom based. He said that Palivizumab, a costly monoclonal antibody, was the only licensed effective strategy to reduce the risk of RSV-LRTI hospitalisation in South Africa.
“The Matisse study shows that the RSV prefusion F protein-based vaccine (RSVpreF) administered during the late second or third trimester of pregnancy may protect infants from severe RSV illness during the first few months of life – this would be particularly important in low-and middle-income countries, where the burden of RSV-associated lower respiratory tract illness is highest,” said Madhi.
However, the National Institute for Communicable Diseases (NICD) said the high costs of Palivizumab, which is administered monthly throughout the RSV season to infants and children at high risk of severe RSV disease, limited its potential use.
“Prevention of RSV illness includes the isolation of children with influenza-like symptoms. Sick children should not go to crèches or schools for a few days, and teaching children to practise sneezing and cough hygiene is important,” said the NICD.
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