Department of General Paediatrics, Perth Children's Hospital, Hospital Avenue.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
Curr Opin Infect Dis. 2023 Dec 1;36(6):522-528. doi: 10.1097/QCO.0000000000000967. Epub 2023 Oct 13.
Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies.
An initial reduction of RSV disease observed with NPIs, and subsequent global resurgence was associated with a collapse in genetic diversity. A lack of immunity is suggested to have contributed to the resurgence of RSV cases experienced post COVID-19. The median age of children admitted with RSV increased during the resurgence, likely secondary to the expanded cohort of RSV-immune naive children. The pandemic also played a role in increased community awareness, which can be utilized as part of a coordinated public health effort to introduce prevention strategies. Further education on signs and symptoms of RSV is still required.
mAbs and maternal vaccines targeting RSV have the potential to reduce paediatric morbidity, however this new era of RSV prevention will require ongoing research to facilitate community awareness and engagement, and better respiratory surveillance. Tackling the global burden of RSV will require a coordinated effort and measures to ensure access and affordability of new prevention strategies.
目的综述：呼吸道合胞病毒（RSV）仍然是全球范围内导致死亡率和发病率的主要原因。与 COVID-19 相关的非药物干预（NPI）扰乱了 RSV 的季节性。我们回顾了 RSV 的季节性、分子流行病学、临床表现和社区认知，以为未来的预防策略提供信息。
最新发现：NPI 最初观察到 RSV 疾病减少，随后全球反弹与遗传多样性的崩溃有关。缺乏免疫力可能导致 COVID-19 后 RSV 病例的反弹。RSV 住院患儿的中位年龄在反弹期间增加，可能是由于 RSV 免疫幼稚儿童的扩展队列所致。大流行也在提高社区认知方面发挥了作用，这可以作为引入预防策略的协调公共卫生努力的一部分。仍需要进一步教育 RSV 的症状和体征。
总结：针对 RSV 的 mAbs 和母体疫苗有可能降低儿科发病率，但 RSV 预防的新时代将需要持续的研究来促进社区的认知和参与，并加强呼吸监测。要应对 RSV 的全球负担，需要协调一致的努力，并采取措施确保新的预防策略的可及性和可负担性。
