The RSV season for 2023 started in week 6 (starting February 6th), with the detection rate of RSV currently at moderate levels and continuing to rise steeply among children under 5 years old. Reports of increased RSV circulation and severe RSV-associated illness have been published from the United States of America and Europe, and it is possible that the RSV season in South Africa will follow a similar trend. Clinicians and hospitals are reminded to anticipate an increase in paediatric admissions during the 2023 RSV season and allocate adequate resources to respond to the surge in RSV cases.
Infants aged under 6 months are at risk of developing severe disease requiring hospitalisation, and risk factors for severe RSV-associated disease include prematurity, congenital heart disease, chronic lung disease of prematurity, neurological disease, infants under 6 months, immunodeficiency, and lack of breastfeeding. Prevention measures include isolation of sick children, teaching sneeze and cough hygiene, and the use of prophylactic antibiotics is not recommended. The monoclonal antibody, palivizumab, administered monthly throughout the RSV season to infants and children at high risk of severe RSV disease, has been shown to be effective for prevention, but its high costs and the need for monthly intramuscular injections limit its use.
In South Africa, RSV is estimated to infect between 178,000 and 443,000 children under the age of five every year, making it the leading cause of LRTI in young children not just locally, but worldwide. Due to the COVID-19 pandemic and associated restrictions, the number of RSV cases among young children were dramatically lower in 2020 and 2021. However, it was correctly predicted that there would be substantial increases in RSV cases in 2022.