RSV is the leading cause of bronchiolitis and lower respiratory tract infections in young children and can lead to severe illness in infants.
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The respiratory syncytial virus (RSV) is making its presence felt as the official season commenced in the second week of March, following a notable delay compared to historical patterns.
Experts are sounding the alarm, reminding healthcare professionals to brace for a potential influx of cases among young children.
RSV is notoriously known as the leading cause of bronchiolitis and lower respiratory tract infections in infants, posing a severe health risk for vulnerable populations. This highly contagious virus primarily spreads through respiratory droplets, making it essential for parents and caregivers to take precautionary measures.
This year, the RSV season began in week 11 (starting March 10, 2025) when the three-week moving average of the detection rate in children under five years old remained above 15% for consecutive weeks in public hospitals.
The onset of this year's RSV season is approximately four weeks later than the historical average, which often starts in mid-February, coming just ahead of the influenza surge.
While most infants affected by RSV experience mild symptoms and do not require hospitalisation, certain groups are at a higher risk for severe illness. Infants under six months are particularly vulnerable, with symptoms such as apnoea, difficulty feeding, and severe respiratory distress being indicators of potential hospitalisation.
Moreover, children with underlying health conditions, such as chronic lung disease, congenital heart disease, or neurological disorders, face increased risks.
As healthcare providers gear up for the RSV season, they are reminded to remain vigilant and consider RSV in their differential diagnoses for severe respiratory illnesses in children. Symptoms in very young infants may manifest as irritability and decreased activity, making early diagnosis crucial.
Parents and caregivers can implement several preventative measures to protect infants from RSV. Isolating children exhibiting influenza-like symptoms and promoting proper sneeze and cough hygiene can significantly reduce the spread of the virus.
Healthcare professionals are advised to ensure that children remain at home during illness to prevent further transmission.
For infants at high risk of severe RSV, the monthly administration of the monoclonal antibody palivizumab has been proven effective, although its high cost and requirement for injections limit accessibility for many families.
Despite recent advancements in maternal vaccines and long-acting monoclonal antibodies for RSV prevention in countries such as the USA and Europe, South Africa has yet to see these innovative products made available.
As clinicians and paediatric units prepare for the anticipated rise in admissions, it is imperative they allocate adequate resources to cater to the influx of RSV cases. Regular monitoring of RSV circulation in the community is critical, with weekly reports accessible from the National Institute for Communicable Diseases (NICD).
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