AI Article Synopsis
- The 2022 RSV epidemic in Sydney resulted in a significant increase in infections among infants, leading to high hospitalization rates and greater health impacts across various demographics.
- Researchers analyzed the genomic sequences of RSV from 264 infants and assessed the immune response in women of childbearing age to identify contributing factors for the surge.
- Findings indicated that the rise in cases was not linked to a new RSV strain or immune system changes due to the COVID-19 pandemic, highlighting the need for ongoing surveillance and research to combat RSV outbreaks and improve treatment strategies.
Article Abstract
Objectives: The 2022 seasonal respiratory syncytial virus (RSV) epidemic in Sydney, Australia saw an unprecedented number of RSV detections. We aimed to characterize genomic and immunologic factors associated with the surge in RSV cases.
Methods: Whole genome sequences of RSV were generated from 264 RSV-infected infants and linked to case-matched clinical data from the 2022 southern hemisphere RSV season. We then performed an immunologic analysis of baseline RSV-specific humoral immunity in women of childbearing age before and throughout the coronavirus disease 2019 pandemic.
Results: Clinical analysis revealed a high burden of disease across patients of all health backgrounds. More than one-half of RSV-related health care visits by infants resulted in hospitalization, and one-quarter required high-flow respiratory support or a higher level of care. Viral phylogenetic analyses revealed that 2022 Sydney RSV sequences were closely related to viruses that had been circulating globally since 2017, including those detected in recent US outbreaks. Nonsynonymous mutations within the palivizumab and nirsevimab binding sites were detected at low frequencies. There was no difference in baseline RSV-neutralizing antibody titers between 2020 and 2022.
Conclusions: Collectively, these findings suggest that neither the emergence of a novel RSV genotype nor hypothesized immune debt was associated with the surge of RSV cases and hospitalizations in 2022. Continued genomic and immunologic surveillance is required to further understand the factors driving outbreaks of RSV globally, and to inform guidelines for the rollout and ongoing use of recently developed immunotherapeutics and vaccines.
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| http://dx.doi.org/10.1542/peds.2023-063667 | DOI Listing |
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