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      27 June 2024

      Respiratory syncytial virus (RSV) is a common, highly contagious seasonal virus that affects the respiratory system, causing cold-like symptoms.1,2 In healthy adults, RSV infections usually go away on their own within a week or two.3 However, RSV can lead to more severe illnesses like bronchiolitis or pneumonia, with infants, young children and older adults being the most at risk.1-3 Diagnostic testing and epidemiology play a critical role in helping to manage RSV, reducing the magnitude of infection within a community by limiting infectious interactions.

      RSV impact, symptoms and seasonality

      RSV Infection significantly impacts at-risk populations in the US, causing substantial hospitalizations annually.4 It leads to an estimated 58 000–80 000 hospitalizations among children younger than five years old and 60 000–160 000 hospitalizations among adults aged 65 and older.4 It’s the most common cause of bronchiolitis and pneumonia in children younger than one year old and is more common in male infants and children.3,5

      Common RSV symptoms include coughing, sneezing, wheezing, a runny nose, fever and decreased appetite. In very young infants, symptoms can include breathing difficulties, irritability, and decreased activity, appearing within four to six days of infection.3 

      RSV peaks seasonally - in the northern hemisphere from September to January, and in the southern hemisphere from March to June. In tropical and subtropical regions, RSV seasons vary and studies show peaking either with the rainy season or with higher temperatures.6

       

      How can RSV be treated and prevented?

      Because RSV is a virus with no specific treatment currently available, supportive care is the most common form of treatment. Patients are advised to rest, drink plenty of fluids and manage symptoms like fever and pain with over-the-counter medications. Although not routinely done, antiviral medication may also be given as a treatment option in some cases.3

      In severe cases requiring hospitalization, treatments may include intravenous fluids, humidified oxygen and sometimes mechanical ventilation.7

      Prevention of RSV is better than treatment in at-risk groups. The following vaccination options are available:
      • A vaccine for adults over 60 was approved in the US and Europe in 2023.8,9 
      • Monoclonal antibodies (mAbs) that provide passive immunization are available to protect infants and young children.10
      • A maternal vaccine can be given between weeks 32 and 36 of pregnancy.8

      To prevent severe RSV disease in infants, the Centers for Disease Control and Prevention (CDC) recommends either maternal RSV vaccination or infant RSV immunization with mAbs.8

       

      The role of epidemiology and diagnostic testing in RSV prevention and management

      Epidemiology, the study of disease in populations, is critical for disease surveillance, outbreak investigation and risk factor identification. Understanding the risk factors of infectious diseases like RSV helps to guide disease control measures, informing public health interventions.11

      In vitro diagnostic (IVD) tests can be used to detect RSV and other respiratory diseases12,13 and can also be used in the surveillance and monitoring of RSV.14 Timeous testing improves early detection, and can help prevent the spread of this infectious illness.14

      “Diagnosis is a driver of patient, financial and health systems impact, and a critical enabler of universal health coverage.” 
      – World Health Organization15a

      IVD testing isn’t only used to diagnose individuals – it also plays a critical role in epidemiology and public health surveillance, especially when documenting the infection rates in populations and helping to predict emerging epidemics.16

      “Diagnostic tests are increasingly important around the world as a first defense against the spread of many diseases … In vitro diagnostics are also the first line of defense against the possibility of the reemergence of eradicated diseases."

      – World Health Organization15b

      Learn more about Medix Biochemica’s work and find the IVD products to meet your needs.

       

      New RSV research and developments

      Promising therapeutics – mAbs and RSV

      Research suggests that the mAbs motavizumab, nirsevimab and palivizumab are all associated with substantial benefits in the prevention of RSV infection in infants and children.7 Nirsevimab in particular was shown to be highly (90%) effective in preventing RSV-related hospitalizations during its first season in use, according to 2024 CDC data.18 Studies have also examined the possibility of using palivizumab to treat acute infection, but results were not significantly different to that of the placebo group.19 Further research into mAbs and RSV is needed to confirm the safety and cost-effectiveness of various therapeutics.17 

      New tools – AI and RSV

      In 2022, a machine learning algorithm was developed to assist with the early prediction of RSV infections in hospitalized pediatric patients. This could be a cost-effective and very useful tool to help healthcare practitioners to quickly identify patients who have RSV so that early intervention can be implemented and spread of infection can be contained.20

      In 2023, an AI trained to predict flavonoids with potential anti-RSV activity produced results with accuracy of more than 83%. This tool could be used to accelerate studies to find new RSV treatments.21

       

      RSV IVD raw materials from Medix Biochemica

      Medix Biochemica produces the raw materials needed to develop IVD tests for RSV, including antibodies, antigens, and related biospecimens.22 Our commitment to quality empowers our customers to create sensitive and reliable RSV testing products, assisting with diagnosis to enable timely treatment, help prevent the spread of RSV and ultimately reduce the burden of this common disease.

      For example: A recent study by Medix Biochemica allowed for the identification of several NP-hRSV-specific recombinant rabbit mAbs. Several pairs of mAbs were identified as being able to detect RSVs from native lysates. This work presents new high-potential mAbs with diagnosis applications.23 Discoveries like this will enable more effective diagnosis and management of RSV in the future.

      Download Infectious Diseases Catalog

      References: 

      1. Learn about respiratory syncytial virus infection (RSV). Centers for Disease Control and Prevention. Accessed May 27, 2024. https://www.cdc.gov/rsv/index.html.
      2. Start of the respiratory syncytial virus (RSV) season (alert to clinicians). NICD. Accessed May 27, 2024. https://www.nicd.ac.za/start-of-the-respiratory-syncytial-virus-rsv-season-alert-to-clinicians/.
      3. Symptoms and care for RSV. Centers for Disease Control and Prevention. Accessed May 28, 2024. https://www.cdc.gov/rsv/about/symptoms.html.
      4. Hamid S. Seasonality of respiratory syncytial virus - United States, 2017–2023. MMWR Morb Mortal Wkly Rep. 2023;72. doi:10.15585/mmwr.mm7214a1.
      5. Suss RJ, Simões EAF. Respiratory syncytial virus hospital-based burden of disease in children younger than 5 years, 2015-2022. JAMA Network Open. 2024;7(4):e247125. doi:10.1001/jamanetworkopen.2024.7125.
      6. Staadegaard L, Caini S, Wangchuk S, et al. Defining the seasonality of respiratory syncytial virus around the world: national and subnational surveillance data from 12 countries. Influenza Other Respir Viruses. 2021;15(6):732-741. doi:10.1111/irv.12885.
      7. Respiratory syncytial virus (RSV) - diagnosis & treatment. Mayo Clinic. Accessed May 28, 2024. https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/diagnosis-treatment/drc-20353104.
      8. RSV (respiratory syncytial virus) immunizations. Centers for Disease Control and Prevention. Accessed May 28, 2024. https://www.cdc.gov/vaccines/vpd/rsv/index.html.
      9. Venkatesan P. First RSV vaccine approvals. Lancet. 2023;8(4):e577. https://doi.org/10.1016/S2666-5247(23)00195-7.
      10. Healthcare providers: RSV immunization for children 19 months and younger. Centers for Disease Conrtol and prevention. Accessed June 3, 2024. https://www.cdc.gov/vaccines/vpd/rsv/hcp/child.html
      11. Bartlett PC, Judge LJ. The role of epidemiology in public health. Rev Sci Tech. 1997;16(2):331-336. doi:10.20506/rst.16.2.1020.
      12. Onwuchekwa C, Atwell J, Moreo LM, et al. Pediatric respiratory syncytial virus diagnostic testing performance: a systematic review and meta-analysis. The J Infect Dis. 2023;228(11):1516. doi:10.1093/infdis/jiad185.
      13. Jullien S, Fitzgerald F, Keddie S, et al. Diagnostic accuracy of multiplex respiratory pathogen panels for influenza or respiratory syncytial virus infections: systematic review and meta-analysis. BMC Infect Dis. 2022;22:785. doi:10.1186/s12879-022-07766-9.
      14. Rohr UP, Binder C, Dieterle T, et al. The value of in vitro diagnostic testing in medical practice: a status report. PLoS One. 2016;11(3):e0149856. doi:10.1371/journal.pone.0149856.
      15a. In vitro diagnostics. Overview. World Health Organization. Accessed May 28, 2024. https://www.who.int/health-topics/in-vitro-diagnostics#tab=tab_1.
      15b. In vitro diagnostics. Impact. World Health Organization. Accessed May 28, 2024. https://www.who.int/health-topics/in-vitro-diagnostics#tab=tab_2.
      16. Stevenson M. A situation analysis of the state of supply of in vitro diagnostics in low-income countries. Glob Public Health. 2020;15(12):1836-1846. doi:10.1080/17441692.2020.1801791.
      17. Sun M, Lai H, Na F, et al. Monoclonal antibody for the prevention of respiratory syncytial virus in infants and children. JAMA Netw Open. 2023;6(2):e230023. doi:10.1001/jamanetworkopen.2023.0023.
      18. Moline HL, Tannis A, Toepfer AP. Early estimate of nirsevimab effectiveness for prevention of respiratory syncytial virus–associated hospitalization among infants entering their first respiratory syncytial virus season — new vaccine surveillance network, October 2023–February 2024. MMWR Morb Mortal Wkly Rep. 2024;73. doi:10.15585/mmwr.mm7309a4.
      19. Gatt D, Martin I, AlFouzan R, Moraes TJ. Prevention and treatment strategies for respiratory syncytial virus (RSV). Pathogens. 2023;12(2):154. doi:10.3390/pathogens12020154.
      20. Tso CF, Lam C, Calvert J, et al. Machine learning early prediction of respiratory syncytial virus in pediatric hospitalized patients. Front Pediatr. 2022;10:886212. doi:10.3389/fped.2022.886212.
      21. Lopes BRP, Albertini TT, Costa MF, et al. The use of artificial intelligence in predicting respiratory syncytial virus-inhibiting flavonoids. Braz J Biol. 2023;83:e270776. doi:10.1590/1519-6984.270776.
      22. Search results for: “RSV”. Medix Biochemica. Accessed May 29, 2024. https://www.medixbiochemica.com/catalogsearch/result/index/?q=rsv.
      23. Baurand P, Balland J, Galli E, et al. New anti-RSV nucleoprotein monoclonal antibody pairs discovered using rabbit phage display technology. Antibodies 2023;12:73. https://doi.org/10.3390/antib12040073.