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Can Respiratory Syncytial Virus (RSV) be prevented and are there treatment options?
Respiratory Syncytial Virus (RSV) can be prevented through common hygiene practices that include:
- Frequent and thorough handwashing with soap and water;
- Covering sneezes and coughs with a tissue;
- Avoiding close contact with others when ill and staying away from individuals who are sick;
- Frequent sanitizing of surfaces that are touched often.
There are no specific treatments for RSV infection. Most infants, children, and healthy older adults who become infected will recover within one to two weeks without any medical intervention. The symptoms of RSV infection can be managed with over-the-counter pain and fever medication, fluid and rest.
In cases where breathing problems or dehydration occurs, or if complications such as bronchiolitis or pneumonia develop, hospitalization may be necessary. The CDC estimates that between one and two children out of 100 will require hospitalization for RSV infection, but that most recover fully with supportive care that may include oxygen, mechanical ventilation, and intravenous (IV) fluids. Children and adults who require hospitalization are typically discharged from the hospital within a few days.
Through a joint partnership, AstraZeneca and Sanofi have developed Beyfortus (nirsevimab-alip), a monoclonal antibody, for use in all infants for the prevention of RSV infection. Unlike a vaccine that stimulates the body to produce an immune response against a particular antigen, a monoclonal antibody is given in an effort to stop an infection. This drug received FDA approval for use in all infants up to 24 months of age by the FDA on July 17, 2023. The CDC recommends that all infants under eight months of age born during, or entering their first RSV season (late fall through early spring), receive a single dose of Nirsevimab. Infants and young children ages 8 through 19 months who are considered to be at an elevated risk of severe RSV illness are also recommended to receive a dose during their second RSV season.
Nirsevimab is an extended half-life potent recombinant human kappa monoclonal antibody that targets the prefusion RSV F protein. Company officials report that a single dose of Nirsevimab can offer rapid protection for the entire RSV season.
Findings from the Phase 2/3 study (Melody Study) on the use of Nirsevimab in preterm and high-risk infants reported that the incidence of medically attended RSV-associated lower respiratory illness was 70.1 percent lower in infants who received Nirsevimab versus those who received the placebo through 150 days. The study, however, reported that Nirsevimab had no impact on reducing hospitalization rates.
Twelve infants involved in the Nirsevimab clinical trials died, with two deaths reported from “unknown causes” but believed to be attributed to Sudden Infant Death Syndrome (SIDS). Ten deaths were reportedly linked to “underlying disease” and included cardiac disease, COVID, a tumor, pneumonia, a skull fracture, two from gastroenteritis, and two from unknown causes. The FDA, however, reported that no deaths appeared to be linked to Nirsevimab.
Infants who are considered to be at high risk for RSV can also be administered Synergis (palivizumab) , another monoclonal antibody, to prevent severe complications of RSV infection. This drug is injected intramuscularly (IM), and is recommended by the American Academy of Pediatrics to be given monthly, for five consecutive months, during the fall and winter months, or at any time during the year when RSV infections are similar to the fall and winter months. Palivizumab is not effective as a treatment for an infant experiencing an active RSV infection.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Respiratory Syncytial Virus (RSV) and the Respiratory Syncytial Virus (RSV) vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.