Respiratory syncytial virus kills 100,000 under-fives every year

Respiratory syncytial virus is killing 100,000 children under the age of five every year worldwide, new figures reveal as experts say the global easing of coronavirus restrictions is causing a surge in cases.

RSV is the most common cause of acute lower respiratory infection in young children. It spreads easily via coughing and sneezing. There is no vaccine or specific treatment.

RSV-attributable acute lower respiratory infections led to more than 100,000 deaths of children under five in 2019, according to figures published in the Lancet. Of those, more than 45,000 were under six months old, the first-of-its-kind study found.

More children are likely to be affected by RSV in the future, experts believe, because masks and lockdowns have robbed children of natural immunity against a range of common viruses, including RSV.

“RSV is the predominant cause of acute lower respiratory infection in young children and our updated estimates reveal that children six months and younger are particularly vulnerable, especially with cases surging as Covid-19 restrictions are easing around the world,” said the study’s co-author, Harish Nair of the University of Edinburgh. “The majority of the young children born in the last two years have never been exposed to RSV (and therefore have no immunity against this virus).”

The figures in the Lancet include data from 113 studies. Around the globe in 2019, there were 33m RSV-associated acute lower respiratory infections in children aged under five, leading to 3.6m hospital admissions, 26,300 in-hospital deaths, and 101,400 RSV-attributable deaths. This accounts for about one in 50 – or 2% – of annual deaths from any cause in this age range.

For infants under six months old, there were 6.6m RSV-associated acute lower respiratory infection episodes globally in 2019. There were 1.4m hospital admissions, 13,300 hospital deaths, and 45,700 overall deaths attributable to RSV.

Overall, 97% of RSV deaths in children under five occurred in low- and middle-income countries.

Earlier this year a UK charity warned parents of young children to be on the alert for signs of RSV after a sharp rise in cases. The British Lung Foundation said an estimated 1,000 children had needed hospital care for the condition in England alone in just three months.

In some cases, RSV can lead to bronchiolitis, an inflammatory infection that can make it hard to breathe. The early symptoms are similar to those of a common cold but can develop over a few days into a high temperature, a dry and persistent cough, difficulty feeding, and wheezing.