The end of the corona measures caused a very early, very severe RSV wave in small children. Researchers from Denmark have now found that unusual symptoms have also increased since the pandemic. What is known so far and two means that give hope.
Unusually early and unusually violent: The RSV wave has been going on in Germany since October. Numerous children are infected, many children’s hospitals are still working at the limit. RSV stands for the respiratory pathogen respiratory syncytial virus, which can be particularly dangerous for infants and small children.
Basically, the following applies to RSV: Almost all small children are infected in the first two years of life. It causes respiratory infections in both children and adults. The pathogen can cause bronchitis and pneumonia, especially in infants. The reason is the smaller airways, which can be further blocked by swelling of the mucous membrane. Premature babies and children with previous illnesses, such as those of the lungs or heart, are particularly at risk.
In order to determine whether an RSV infection is actually present, the doctor must take a smear test. The classic symptoms include
In chronically ill children and especially in infants in the first months of life, the infection can spread to the lower respiratory tract within one to three days and, according to the Robert Koch Institute (RKI), among other things
A new study from Denmark has now found other symptoms. Since the pandemic, more severe courses have also occurred in children without risk factors. The researchers name the following symptoms that had been unusual for RSV up until then:
So far, there is no concrete explanation for this. According to the researchers, however, more severe courses in older children could be due to a lack of initial infection or reduced immunity due to a lack of RS exposure. “This suggests that regular RS exposure in older children is important to maintain immunity at levels that protect against hospitalization,” the researchers explain.
They emphasize: Doctors should remain vigilant in older infants and children with RSV, as different treatment may be needed.
The researchers say the results could also play a role in the development of anti-RSV drugs. However, the mortality rate among older infants and children is “significantly lower”. Therefore, agents are particularly important for the youngest patients who are exposed to RSV infection for the first time.
Currently there are mainly therapeutic approaches. This means that sick people are only treated after an infection and are not protected in advance. Although there is a prophylactic approach – the monoclonal antibody palivizumab – it is very expensive and is only available to high-risk patients.
There are now two new drugs that promise progress: Nirsevimab, developed by Sanofi and Astrazeneca, and Pfizer’s RSVpreF vaccine. Nirsevimab is also a monoclonal antibody. It binds to the F protein of the virus and is intended to prevent its penetration into the body’s cells. It has just been approved by the EU Commission.
The results of an international study are remarkable: According to this, nirsevimab reduced the risk of medical treatment in infants by around 75 percent. The risk of hospital admission fell by 62 percent. Unlike palivizumab, the drug does not have to be administered monthly; once at the beginning of the RSV season is sufficient.
However, there are still open questions. “Due to the limited data and information, it is not yet possible to say whether we are getting into an area where one can discuss giving the drug to all newborns,” explained Johannes Liese, head of infectiology and immunology at the University Hospital in Würzburg “TIME”. Further studies are necessary. Sanofi, on the other hand, is confident. The company is targeting a launch for the 2023/24 RSV season.
The first vaccine against RSV is also in the starting blocks. Pfizer’s RSVpreF does not vaccinate the newborn, but the mother during pregnancy. The antibodies formed are passed on to the infant via the umbilical cord.
According to Pfizer, the vaccine reduced the risk of medical treatment to 81.8 percent (in the first 90 days) and 69.4 percent (up to six months). There are no safety concerns for pregnant women or infants.
However, official data and publications in specialist magazines are still pending. Both are planned. The US pharmaceutical giant is aiming for approval in the US by the end of the year, with Europe to follow.