Interpretation of "Expert recommendations for the prevention of common respiratory viral infections in neonates": problems faced by respiratory syncytial virus infection in neonates

CHENG Chen; WANG Ya-Juan; SHI Yuan

doi:10.7499/j.issn.1008-8830.2409033

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Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (1) : 26-32. DOI: 10.7499/j.issn.1008-8830.2409033

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Interpretation of "Expert recommendations for the prevention of common respiratory viral infections in neonates": problems faced by respiratory syncytial virus infection in neonates

CHENG Chen, WANG Ya-Juan, SHI Yuan

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Abstract

Neonates are susceptible to respiratory viral infections, with outbreaks reported in areas with a high population of neonates, such as postpartum care centers and neonatal wards. While specific antiviral drugs are currently available for influenza, symptomatic supportive treatment remains the primary approach for respiratory syncytial virus (RSV), making prevention particularly important. The article closely follows the "Expert recommendations for the prevention of common respiratory viral infections in neonates" and provides an in-depth interpretation of recent breakthroughs in RSV prevention. It discusses the physiological and immunological characteristics of neonates, the disease burden and transmission routes of RSV infection, the main clinical manifestations and long-term effects of RSV infection in neonates, as well as specific preventive measures against RSV and practical recommendations and prevention experiences for RSV from abroad to lay a foundation for RSV prevention and control in neonates in China.

Key words

Respiratory syncytial virus / Disease burden / Passive immunization / Monoclonal antibody / Neonate

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CHENG Chen, WANG Ya-Juan, SHI Yuan. Interpretation of "Expert recommendations for the prevention of common respiratory viral infections in neonates": problems faced by respiratory syncytial virus infection in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(1): 26-32 https://doi.org/10.7499/j.issn.1008-8830.2409033

References

1 Hall CB, Weinberg GA, Blumkin AK, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age[J]. Pediatrics, 2013, 132(2): e341-e348. PMID: 23878043. DOI: 10.1542/peds.2013-0303.
2 Guan X, Gao S, Zhao H, et al. Clinical characteristics of hospitalized term and preterm infants with community-acquired viral pneumonia[J]. BMC Pediatr, 2022, 22(1): 452. PMID: 35897053. PMCID: PMC9325944. DOI: 10.1186/s12887-022-03508-7.
3 中国妇幼保健协会新生儿保健专业委员会. 新生儿常见呼吸道病毒感染预防的专家建议[J]. 中国当代儿科杂志, 2024, 26(8): 789-794.
4 Bush D, Juliano C, Bowler S, et al. Development and disorders of the airway in bronchopulmonary dysplasia[J]. Children (Basel), 2023, 10(7): 1127. PMID: 37508624. PMCID: PMC10378517. DOI: 10.3390/children10071127.
5 Lambert L, Sagfors AM, Openshaw PJM, et al. Immunity to RSV in early-life[J]. Front Immunol, 2014, 5: 466. PMID: 25324843. PMCID: PMC4179512. DOI: 10.3389/fimmu.2014.00466.
6 Reis J, Shaman J. Simulation of four respiratory viruses and inference of epidemiological parameters[J]. Infect Dis Model, 2018, 3: 23-34. PMID: 30839912. PMCID: PMC6326234. DOI: 10.1016/j.idm.2018.03.006.
7 Kaler J, Hussain A, Patel K, et al. Respiratory syncytial virus: a comprehensive review of transmission, pathophysiology, and manifestation[J]. Cureus, 2023, 15(3): e36342. PMID: 37082497. PMCID: PMC10111061. DOI: 10.7759/cureus.36342.
8 Caini S, Casalegno JS, Rodrigues AP, et al. Change in age profile of respiratory syncytial virus disease over the course of annual epidemics: a multi-national study[J]. J Infect, 2024, 88(5): 106154. PMID: 38583722. DOI: 10.1016/j.jinf.2024.106154.
9 浙江省疾病预防控制中心, 浙江省传染病疫苗与预防控制研究重点实验室, 国家儿童医学中心（上海）复旦大学附属儿科医院, 等. 人呼吸道合胞病毒感染监测与防控专家共识（2023年）[J]. 中华临床感染病杂志, 2023, 16(5): 337-353. DOI: 10.3760/cma.j.issn.1674-2397.2023.05.002.
10 Griffiths B, Riphagen S, Lillie J. Management of severe bronchiolitis: impact of nice guidelines[J]. Arch Dis Child, 2020, 105(5): 483-485. PMID: 30472669. DOI: 10.1136/archdischild-2018-315199.
11 Lu L, Yan Y, Yang B, et al. Epidemiological and clinical profiles of respiratory syncytial virus infection in hospitalized neonates in Suzhou, China[J]. BMC Infect Dis, 2015, 15: 431. PMID: 26470889. PMCID: PMC4608146. DOI: 10.1186/s12879-015-1155-x.
12 Savi? N, Jankovi? B, Mini? P, et al. Clinical characteristics of respiratory syncytial virus infection in neonates and young infants[J]. Vojnosanit Pregl, 2011, 68(3): 220-224. PMID: 21524004. DOI: 10.2298/vsp1103220s.
13 Glezen WP, Taber LH, Frank AL, et al. Risk of primary infection and reinfection with respiratory syncytial virus[J]. Am J Dis Child, 1986, 140(6): 543-546. PMID: 3706232. DOI: 10.1001/archpedi.1986.02140200053026.
14 Cohen C, Kleynhans J, Moyes J, et al. Incidence and transmission of respiratory syncytial virus in urban and rural South Africa, 2017-2018[J]. Nat Commun, 2024, 15(1): 116. PMID: 38167333. PMCID: PMC10761814. DOI: 10.1038/s41467-023-44275-y.
15 Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010[J]. Lancet, 2012, 380(9859): 2095-2128. PMID: 23245604. PMCID: PMC10790329. DOI: 10.1016/S0140-6736(12)61728-0.
16 Rha B, Curns AT, Lively JY, et al. Respiratory syncytial virus-associated hospitalizations among young children: 2015-2016[J]. Pediatrics, 2020, 146(1): e20193611. PMID: 32546583. DOI: 10.1542/peds.2019-3611.
17 Lively JY, Curns AT, Weinberg GA, et al. Respiratory syncytial virus-associated outpatient visits among children younger than 24 months[J]. J Pediatric Infect Dis Soc, 2019, 8(3): 284-286. PMID: 30840770. DOI: 10.1093/jpids/piz011.
18 Gelber SE, Ratner AJ. Hospital-acquired viral pathogens in the neonatal intensive care unit[J]. Semin Perinatol, 2002, 26(5): 346-356. PMID: 12452507. PMCID: PMC7133582. DOI: 10.1053/sper.2002.36268.
19 Fodha I, Landolsi N, Vabret A, et al. Epidemiology and clinical presentation of respiratory syncytial virus infection in a Tunisian neonatal unit from 2000 to 2002[J]. Ann Trop Paediatr, 2004, 24(3): 219-225. PMID: 15479571. DOI: 10.1179/027249304225018966.
20 Wang B, Song J, Song J, et al. An outbreak of severe neonatal pneumonia caused by human respiratory syncytial virus BA9 in a postpartum care centre in Shenyang, China[J]. Microbiol Spectr, 2022, 10(4): e0097422. PMID: 35863015. PMCID: PMC9430609. DOI: 10.1128/spectrum.00974-22.
21 国家儿童健康与疾病临床医学研究中心, 中华医学会儿科学分会感染学组, 上海市医学会感染病分会, 等. 儿童呼吸道合胞病毒感染临床诊治中国专家共识（2023年版）[J]. 临床儿科杂志, 2024, 42(1): 1-14. DOI: 10.12372/jcp.2024.23e1129.
22 Kenmoe S, Atenguena Okobalemba E, Takuissu GR, et al. Association between early viral lower respiratory tract infections and subsequent asthma development[J]. World J Crit Care Med, 2022, 11(4): 298-310. PMID: 36051944. PMCID: PMC9305678. DOI: 10.5492/wjccm.v11.i4.298.
23 Coutts J, Fullarton J, Morris C, et al. Association between respiratory syncytial virus hospitalization in infancy and childhood asthma[J]. Pediatr Pulmonol, 2020, 55(5): 1104-1110. PMID: 32040885. PMCID: PMC7187471. DOI: 10.1002/ppul.24676.
24 Berdnikovs S, Newcomb DC, Hartert TV. How early life respiratory viral infections impact airway epithelial development and may lead to asthma[J]. Front Pediatr, 2024, 12: 1441293. PMID: 39156016. PMCID: PMC11327159. DOI: 10.3389/fped.2024.1441293.
25 Fikenzer S, Uhe T, Lavall D, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity[J]. Clin Res Cardiol, 2020, 109(12): 1522-1530. PMID: 32632523. PMCID: PMC7338098. DOI: 10.1007/s00392-020-01704-y.
26 Mejias A, Rodríguez-Fernández R, Oliva S, et al. The journey to a respiratory syncytial virus vaccine[J]. Ann Allergy Asthma Immunol, 2020, 125(1): 36-46. PMID: 32217187. PMCID: PMC7311299. DOI: 10.1016/j.anai.2020.03.017.
27 Rossey I, Saelens X. Vaccines against human respiratory syncytial virus in clinical trials, where are we now?[J]. Expert Rev Vaccines, 2019, 18(10): 1053-1067. PMID: 31587585. DOI: 10.1080/14760584.2019.1675520.
28 PATH. RSV vaccine and mAb snapshot [EB/OL]. (2024-09-18) [2024.09.04]. https://www.path.org/our-impact/resources/rsv-vaccine-and-mab-snapshot/.
29 Vekemans J, Moorthy V, Giersing B, et al. Respiratory syncytial virus vaccine research and development: World Health Organization technological roadmap and preferred product characteristics[J]. Vaccine, 2019, 37(50): 7394-7395. PMID: 29395536. DOI: 10.1016/j.vaccine.2017.09.092.
30 U.S. Food and Drug Administration. FDA approves first vaccine for pregnant individuals to prevent RSV in infants[EB/OL]. (2023-08-21)[2024-09-04]. https://www.fda.gov/news-events/press-announcements/fda-approves-first-vaccine-pregnant-individuals-prevent-rsv-infants.
31 American Academy of Pediatrics Committee on Infectious Diseases, American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection[J]. Pediatrics, 2014, 134(2): 415-420. PMID: 25070315. DOI: 10.1542/peds.2014-1665.
32 McLellan JS, Chen M, Joyce MG, et al. Structure-based design of a fusion glycoprotein vaccine for respiratory syncytial virus[J]. Science, 2013, 342(6158): 592-598. PMID: 24179220. PMCID: PMC4461862. DOI: 10.1126/science.1243283.
33 European Medicines Agency. Beyfortus [EB/OL]. (2024-10-16) [2024-12-05]. https://www.ema.europa.eu/en/medicines/human/EPAR/beyfortus.
34 Hammitt LL, Dagan R, Yuan Y, et al. Nirsevimab for prevention of RSV in healthy late-preterm and term infants[J]. N Engl J Med, 2022, 386(9): 837-846. PMID: 35235726. DOI: 10.1056/NEJMoa2110275.
35 Domachowske J, Madhi SA, Sim?es EAF, et al. Safety of nirsevimab for RSV in infants with heart or lung disease or prematurity[J]. N Engl J Med, 2022, 386(9): 892-894. PMID: 35235733. DOI: 10.1056/NEJMc2112186.
36 Jones JM, Fleming-Dutra KE, Prill MM, et al. Use of nirsevimab for the prevention of respiratory syncytial virus disease among infants and young children: recommendations of the advisory committee on immunization practices—United States, 2023[J]. MMWR Morb Mortal Wkly Rep, 2023, 72(34): 920-925. PMID: 37616235. PMCID: PMC10468217. DOI: 10.15585/mmwr.mm7234a4.
37 Centers for Disease Control and Prevention. Respiratory syncytial virus (RSV) immunizations [EB/OL]. (2024-09-04) [2024-09-04]. https://www.cdc.gov/vaccines/vpd/rsv/index.html.
38 Fleming-Dutra KE, Jones JM, Roper LE, et al. Use of the Pfizer respiratory syncytial virus vaccine during pregnancy for the prevention of respiratory syncytial virus-associated lower respiratory tract disease in infants: recommendations of the advisory committee on immunization practices—United States, 2023[J]. MMWR Morb Mortal Wkly Rep, 2023, 72(41): 1115-1122. PMID: 37824423. PMCID: PMC10578951. DOI: 10.15585/mmwr.mm7241e1.
39 Child and Adolescent Immunization Schedule by Age[EB/OL].(2024-11-21)[2024-12-05]. https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html.
40 Meeting of the Advisory Committee on Immunization Practices(ACIP) June26-28,2024. Meeting Summary. [EB/OL]. (2024-09-12)[2024-12-05]. https://www.cdc.gov/acip/downloads/minutes/summary-2024-06-26-28-508.pdf.
41 Ezpeleta G, Navascués A, Viguria N, et al. Effectiveness of nirsevimab immunoprophylaxis administered at birth to prevent infant hospitalisation for respiratory syncytial virus infection: a population-based cohort study[J]. Vaccines (Basel), 2024, 12(4): 383. PMID: 38675765. PMCID: PMC11054679. DOI: 10.3390/vaccines12040383.
42 Ministerio de Sanidad. Recomendaciones de utilización de nirsevimab para la temporada2024-2025 en Espa?a[EB/OL]. (2024-04-02) [2024-09-04]. https://www.sanidad.gob.es/areas/promocionPrevencion/vacunaciones/comoTrabajamos/docs/Nirsevimab.pdf.
43 Centers for Disease Control and Prevention. RSV immunization guidance for infants and young children[EB/OL].(2024-08-30)[2024-09-04]. https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/infants-young-children.html.