Abstract

BackgroundRespiratory syncytial virus (RSV)‐associated acute lower respiratory infection is a common cause for hospitalization and hospital deaths in young children globally. There is urgent need to generate evidence to inform immunization policies when RSV vaccines become available. The WHO piloted a RSV surveillance strategy that leverages the existing capacities of the Global Influenza Surveillance and Response System (GISRS) to better understand RSV seasonality, high‐risk groups, validate case definitions, and develop laboratory and surveillance standards for RSV.MethodsThe RSV sentinel surveillance strategy was piloted in 14 countries. Patients across all age groups presenting to sentinel hospitals and clinics were screened all year‐round using extended severe acute respiratory infection (SARI) and acute respiratory infection (ARI) case definitions for hospital and primary care settings, respectively. Respiratory specimens were tested for RSV at the National Influenza Centre (NIC) using standardized molecular diagnostics that had been validated by an External Quality Assurance program. The WHO FluMart data platform was adapted to receive case‐based RSV data and visualize interactive visualization outputs.ResultsLaboratory standards for detecting RSV by RT‐PCR were developed. A review assessed the feasibility and the low incremental costs for RSV surveillance. Several challenges were addressed related to case definitions, sampling strategies, the need to focus surveillance on young children, and the data required for burden estimation.ConclusionsThere was no evidence of any significant adverse impact on the functioning of GISRS which is primarily intended for virologic and epidemiological surveillance of influenza.

Highlights

  • Respiratory syncytial virus (RSV) is an important cause of respira‐ tory infections, with the most severe infections occurring in young children, older adults, and adults with chronic co‐morbidities.[1,2] Acute lower respiratory infections due to RSV are among the most common causes of hospital admis‐ sion and hospital deaths in young children globally and are associated with a high hospitalization cost burden.[3,4] The overall number of deaths associ‐ ated with RSV is less certain but has been estimated to be between 94 600 and 149 400 deaths in young children globally.[5]

  • The overarching aim of the pilot was to build on the successful global influenza surveillance platform, Global Influenza Surveillance and Response System (GISRS), to obtain RSV surveillance data without having a negative impact on GISRS

  • A mid‐ term review assessed that it was feasible to leverage GISRS for RSV surveillance with little incremental cost without any significant ad‐ verse impact on the functioning of GISRS for influenza surveillance

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Summary

Introduction

Respiratory syncytial virus (RSV) is an important cause of respira‐ tory infections, with the most severe infections occurring in young children, older adults, and adults with chronic co‐morbidities.[1,2] Acute lower respiratory infections (bronchiolitis and pneumonia) due to RSV are among the most common causes of hospital admis‐ sion (estimated 3.2 million annually) and hospital deaths (estimated 59 600) in young children globally and are associated with a high hospitalization cost burden.[3,4] The overall number of deaths associ‐ ated with RSV is less certain but has been estimated to be between 94 600 and 149 400 deaths in young children globally.[5]. Several challenges were addressed related to case definitions, sampling strategies, the need to focus surveillance on young children, and the data required for burden estimation.

Results
Conclusion
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