The Global Epidemiology of RSV in Community and Hospitalized Care (GERi) study
Rationale, study aims and research questions
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections in children. By the age of one, 60–70% of children have been infected by RSV (2%-3% of whom are hospitalized), and almost all children have been infected by two years of age. A global burden of disease study has recently shown that RSV is estimated to cause approximately 33.8 million new episodes of acute lower respiratory infections annually in children aged <5 years worldwide, resulting in 3.2 million hospital admissions and 59,600 in-hospital deaths in children aged <5 years in 2015. RSV is also recognized as a cause of illness in adults and high-risk adults, with a disease burden similar to that of seasonal influenza A.
To support optimal immunization strategies to prevent and control RSV in the future, it is critically important to understand who develops symptoms which lead to seeking healthcare and to identify which groups are at risk of more severe RSV infection requiring hospitalization or intensive care, as well as the impact on community care. There are currently approximately 60 RSV vaccine candidates and monoclonal antibodies that are in pre-clinical to phase III clinical trials, with potential target groups including elderly people, pregnant women and infants. An RSV vaccine is expected to enter the market in the coming years.
Knowledge about the spatio-temporal timing of RSV epidemics will be very important as this information will allow for the optimization of the delivery of vaccines (or monoclonal antibodies) in community and hospitalized care. RSV infection is not notifiable in all countries, but many countries have a long tradition of reporting laboratory-confirmed RSV infections through surveillance networks (often linked to influenza) that are already in place.
Whilst a fair amount is known about the epidemiology of RSV at country level, especially in the Northern Hemisphere, there is limited data on a global level and certain regions of the world (e.g. Central America, North Africa, Central Africa and the Middle East). In addition, very few studies have looked at the RSV burden (and spatio-temporal patterns) in the community versus hospitalized patients.
Updated: 5 November 2020