Children under the age of 5 with an RSV Infection frequently revisit their primary care physician

Among children under the age of five who visited their general practitioner (GP) during the winter season with acute respiratory symptoms, one-third tested positive for the respiratory syncytial virus (RSV). Children with an RSV infection were sick for an average of 12 days and visited the GP or the primary care pediatrician an average of 2.4 times during their illness. This was studied across five European countries: the Netherlands, Belgium, England, Spain and Italy. Between these countries, the percentage of hospital admissions due to RSV infections varied significantly. In the Netherlands 4% of children were hospitalized following a GP visit, while in Belgium this figure was as high as 44%. These findings are part of the RSV ComNet study, conducted by Nivel in collaboration with UMC Utrecht, the Dutch National Institute for Public Health and the Environment and international partners.

A total of 3,414 children and their parents/caregivers participated in the study, including 331 children from the Netherlands. The study measured the disease burden of young children with an RSV infection who visited the general practitioner (GP) or primary care pediatrician. This disease burden included the course of the illness (symptoms, duration, and complications), the healthcare utilization (GP and emergency department visits, hospital admissions, and medication use), and the societal impact (work absence among parents/caregivers).

Young children’s healthcare utilization for RSV infection varies between countries

Although the disease course of children experiencing an RSV infection is similar in the five European countries, there are significant differences in healthcare utilization. In addition to variations in hospital admission rates, differences in GP/primary care pediatrician visits stand out. Children in the Netherlands visited the GP an average of 1.4 times, whereas in Spain this number was twice as high at 3.0 visits. Furthermore, clear differences are notable in the number of prescriptions for antibiotics and corticosteroids. In the Netherlands, 19% of children were prescribed antibiotics and no corticosteroids were prescribed. In Italy however, 32% of children received antibiotics and both inhaled corticosteroids and oral corticosteroids were prescribed relatively frequently (25% and 18%, respectively). In Spain we see that these prescription rates end up at 9% and 14%, respectively).

The disease burden for RSV in primary care is significant among infants and young children

Most children with an RSV infection who visited a primary care physician were otherwise healthy. Only 7% were born prematurely (before 37 weeks of gestation) and 2% had a serious underlying condition, such as a heart defect or Down syndrome. Infants were hospitalized more often (20%) than children aged 1 to 5 years (7%). The duration of illness was similar. Infants with an RSV infection visited the primary care physician an average of 2.7 times, slightly more often than children aged 1 to 5 years (2.1 times). Notably, primary care physicians prescribed medication more frequently to children aged 1 to 5 years (62%) than to infants (50%).

Parental work absence due to child care

The study shows that the impact of an RSV infection extends beyond the sick child. Nearly half of the parents (46%) reported taking at least one day off work to care for their child. On average, parents took 3 days of leave, including those who did not take any leave. However, there are differences between the countries: in Spain, parents took an average of 1.3 days off, in Belgium 4.1 days, and in the Netherlands, 3.0 days.

Societal impact of RSV infections in young children

RSV infections cause a significant disease burden on young children and have a broad impact on the healthcare system and society. The findings from this study can support policy making regarding the availability of new preventive measures against RSV. Starting in the fall of 2025, the preventive antibody ‘nirsevimab’ will be added to the Dutch National Immunization Program, providing protection for infants against RSV during their first winter season. Currently, no preventive measures or vaccines are available for children aged 1 to 5 years.

About the study

RSV ComNet is a clinical study conducted in five European countries (the Netherlands, Belgium, England, Spain and Italy). A nasal swab was taken from 3,414 children under the age of 5 with acute respiratory symptoms during a visit to their general practitioner or primary care pediatrician, and it was subsequently tested for RSV. If a child tested positive for RSV, parents were asked to complete two questionnaires (on day 14 and day 30 after the test). These questionnaires measured the disease burden of the RSV infection. The RSV ComNet study is the first international study on the disease burden of RSV in children under 5 years old in the primary care setting. The study was funded by Sanofi and AstraZeneca.