Materiały źródłowe

• #1 UPDATE – 2022 Italian guidelines on the management of bronchiolitis in infants | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-022-01392-6

  Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. […] Because of the lack of effective treatment, the reduction of morbidity must rely on preventive measures. […] Environmental measures are crucial in preventing and limiting bronchiolitis spreading. […] The Italian Society of Neonatology (SIN) recommends palivizumab prophylaxis during RSV season (November-March) for infants of gestational age 29 weeks and age 12 months at the beginning of the epidemic season. […] The use of Palivizumab in preterm infants born after 29 weeks of gestation remains controversial due its high costs. […] Pharmacological prophylaxis of bronchiolitis is based on the prevention of RSV infection. […] Since there is no vaccine against RSV (i.e., the main aetiologic agent of bronchiolitis), environmental prophylaxis is crucial in preventing and limiting bronchiolitis spreading.

• #1 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Two monoclonal antibodies used for RSV prophylaxis in infants and young children are available in the United States. Nirsevimab is preferred but may not be available to some infants because of supply limitations; if it is not available, eligible high-risk infants and children should receive palivizumab. […] Nirsevimab a long-acting monoclonal antibody, is recommended for the prevention of RSV in the following infants and young children: All infants […] Children 8 months through 19 months of age who are at increased risk of severe RSV disease and who are entering their second RSV season. […] Only children who meet high-risk criteria should receive more than 1 dose of nirsevimab (1 dose in their first RSV season and 1 dose in their second RSV season). […] High-risk children 8 to 19 months of age include the following: Children with chronic lung disease of prematurity who required medical support any time during the 6-month period before the start of the second RSV season

• #1 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza — A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 — COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] Other measures — There are several other ways to prevent severe bronchiolitis:

• #2 Management of Bronchiolitis in Infants and Children: Summary – AHRQ Evidence Report Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11847/

  Bronchiolitis is the most common lower respiratory tract infection in infants. […] The relative severity of the disease among vulnerable subpopulations suggests that some infants and children may benefit from prophylactic therapy, although the cost-effectiveness of available interventions needs to be explored. […] The largest group of at-risk children are those born prematurely, who often have concurrent chronic lung disease (CLD). Palivizumab or RSVIG IV given on a monthly basis is effective for prophylaxis in high-risk infants and children who have underlying CLD or have been born prematurely and are less than 6 months of age. […] An effective vaccine would be a preferable strategy for prevention of RSV bronchiolitis in at-risk children compared to the passive immunity created by monthly injections of RSVIG.

• #2 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Children who are severely immunocompromised […] Children with cystic fibrosis who have severe lung disease or whose weight-for-length is less than the 10th percentile […] Children who are American Indian or Alaska Native. […] For eligible children, nirsevimab should be given shortly before the RSV season (typically from October through the end of March in most of the continental United States). […] Palivizumab, also a monoclonal antibody, decreases the frequency of hospitalization for RSV in high-risk infants. It should be used only in situations where nirsevimab is not available. […] The first dose of palivizumab is given just before the usual onset of the RSV season. Subsequent doses are given at 1-month intervals for the duration of the RSV season (usually a total of 5 doses).

• #2 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza – A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 – COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] There are several other ways to prevent severe bronchiolitis:

• #3 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  BRONCHIOLITIS PREVENTION […] Vaccines — Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV — There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy — A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection — Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus]) is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #3 Respiratory Syncytial Virus Bronchiolitis in Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p94.html

  Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. […] Infants at risk of severe lower respiratory tract infection should receive immunoprophylaxis with palivizumab (Synagis). Five doses provide six months of coverage, which is sufficient protection for the RSV season. […] In 2014, palivizumab prophylaxis guidelines were updated, with the goal of restricting its use to infants and children at greatest risk. […] Palivizumab (Synagis) is not recommended for otherwise healthy infants born at or after 29 weeks, 0 days’ gestation. Palivizumab is recommended in the first year of life for infants born before 29 weeks, 0 days’ gestation. Palivizumab is recommended in the first year of life for infants with hemodynamically significant heart disease. Palivizumab is recommended in the first year of life for preterm infants with chronic lung disease of prematurity (born before 32 weeks, 0 days’ gestation with an oxygen requirement of more than 21% for at least 28 days after birth). Palivizumab is recommended in the second year of life for children with chronic lung disease who require continued medical intervention (e.g., supplemental oxygen, chronic corticosteroid therapy, diuretics). Consider prophylaxis for infants younger than one year who have pulmonary abnormalities or neuromuscular disease that impairs the ability to clear upper airway secretions, or for children younger than two years who are profoundly immunocompromised.

• #3 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #4 Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

  Respiratory syncytial virus can infect anyone. But premature babies and young infants, as well as older adults, with heart or lung disease or a weakened immune system are at higher risk of severe infection. […] Two main options exist to help prevent young infants from getting severe RSV. One is an antibody product given to the infant. The other is an RSV vaccine for pregnant people to help protect their baby from birth through 6 months of age. Both are approved by the U.S. Food and Drug Administration (FDA). You and your healthcare professional can discuss which option is best to protect your child. […] Antibody product called nirsevimab (Beyfortus). This antibody product is a single-dose shot given in the month before or during RSV season. It’s for babies younger than 8 months born during or entering their first RSV season. Nirsevimab also can be given to children 8 months through 19 months old who are at higher risk of severe RSV disease through their second RSV season. In the U.S., the RSV season typically is November through March, but it varies in Florida, Alaska, Hawaii, Puerto Rico, Guam and other U.S. Pacific island territories.

• #4 The RSV Prevention Divide | Think Global Health

  https://www.thinkglobalhealth.org/article/rsv-prevention-divide

  In 2023, to protect the country’s youngest and most vulnerable, the United States approved and recommended the RSVpreF vaccine for pregnant women and the monoclonal antibody (mAb) nirsevimab for infants under the age of 2. […] The vaccine reduces the odds of hospitalization during a newborn’s early months of life by 57%; the efficacy of the antibody is 80%. […] This inequity has RSV experts calling for increased access to preventive interventions in LMICs. […] „It almost physically hurts to see that we are implementing all these methods of preventing RSV, but only in the high-income countries,” says Jonne Terstappen, a clinician-investigator at the Wilhelmina Children’s Hospital who focuses on RSV vaccinations and mAbs for LMIC settings. „But that’s not where the majority of deaths occur.”

• #4 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #5 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  BRONCHIOLITIS PREVENTION […] Vaccines — Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV — There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy — A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection — Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus]) is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #5

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/RSV-When-Its-More-Than-Just-a-Cold.aspx

  There are new immunizations to protect babies from severe illness during RSV season. You can choose RSV immunization during pregnancy, or your baby can be immunized after they are born. Most infants will likely only need protection from either the maternal RSV vaccine or infant immunization, but not both. […] Pregnant people can receive the maternal RSV vaccine (Abrysvo) at 32 through 36 weeks of pregnancy if their baby will be born during RSV season. The vaccine is given from September through January and reduces the risk of RSV hospitalization for babies by 57% in their first six months after birth. […] For infants and some toddlers, an RSV immunization called nirsevimab (Beyfortus) can be given as an injection during or just before RSV season. Babies can get it at the hospital when they are born or at their checkup visit. Nirsevimab has been shown to be approximately 80-90% effective in preventing infants from being hospitalized with RSV.

• #5 How to prevent RSV and bronchiolitis in babies | Norton Children’s Louisville, Ky.

  https://nortonchildrens.com/news/rsv-bronchiolitis/

  Bronchiolitis is a common lower respiratory tract infection that often appears in children younger than 2 years old. […] Families can take preventive action to avoid infection and limit the spread of the virus: […] Good hand hygiene is the best form of defense against RSV and bronchiolitis. […] Disinfect household objects on a regular basis. […] Use caution when bringing the baby around others. […] Do not expose the baby to secondhand smoke. […] Breastfeeding can offer extra protection.

• #6

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/RSV-When-Its-More-Than-Just-a-Cold.aspx

  There are new immunizations to protect babies from severe illness during RSV season. You can choose RSV immunization during pregnancy, or your baby can be immunized after they are born. Most infants will likely only need protection from either the maternal RSV vaccine or infant immunization, but not both. […] Pregnant people can receive the maternal RSV vaccine (Abrysvo) at 32 through 36 weeks of pregnancy if their baby will be born during RSV season. The vaccine is given from September through January and reduces the risk of RSV hospitalization for babies by 57% in their first six months after birth. […] For infants and some toddlers, an RSV immunization called nirsevimab (Beyfortus) can be given as an injection during or just before RSV season. Babies can get it at the hospital when they are born or at their checkup visit. Nirsevimab has been shown to be approximately 80-90% effective in preventing infants from being hospitalized with RSV.

• #6 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #7 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Bronchiolitis prevention […] Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV – There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy – A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection – Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus] is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #7 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  However, a more convenient RSV-specific humanized mouse IgG1 monoclonal antibody preparation, palivizumab, was subsequently developed and FDA-approved in 1998 for prophylaxis for infants at high risk for RSV infection. […] In a multi-institutional, randomized, placebo-controlled study of 1502 high-risk preterm infants in 139 centers in the United States and Canada during the 1996-1997 RSV season, rate of hospitalization was reduced by 5.8% (10.6% in placebo vs. 4.8% in palivizumab group, P 0.001). […] Since palivizumab was licensed for RSV immunoprophylaxis, the recommendations for its use have become more restrictive as additional information became available regarding the epidemiology of RSV hospitalizations and the limited benefit of prophylaxis in selected patient populations. […] AAP guidance regarding palivizumab use is stratified according to risk and can be summarized as follows: Preterm infants born before 29 weeks of gestation, without chronic lung disease of prematurity or congenital heart disease and less than 12 months of age at the start of RSV season; those born on or after 29 weeks of gestation should NOT receive prophylaxis as their rate of hospitalization for bronchiolitis is not different from full-term infants.

• #7 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #8 Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

  Vaccine for pregnant people. The FDA approved an RSV vaccine called Abrysvo for pregnant people to prevent RSV in infants from birth through 6 months of age. A single-dose shot of Abrysvo can be given sometime from 32 weeks through 36 weeks of pregnancy during September through January in the U.S. […] Older adults have weaker immune systems, especially those with ongoing conditions, such as heart or lung disease. To help prevent RSV infection, the FDA approved RSV vaccines for adults age 60 and older. […] The CDC recommends that adults age 60 and older talk with their healthcare professional about getting an RSV vaccine, especially if they’re at higher risk of getting severe RSV. Two vaccines are available for this age group: Abrysvo and Arexvy. The CDC does not recommend one over the other. Each is a single-dose shot.

• #8 Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01460-0

  Severe acute viral bronchiolitis is a common cause of admissions to pediatric intensive care units (PICUs), resulting in a significant organizational burden each winter. […] The recent introduction of generalized neonatal prophylactic therapies using Nirsevimab, a monoclonal antibody targeting the respiratory syncytial virus (RSV), has significantly reduced consultations and hospitalizations. […] The introduction of generalized neonatal prophylaxis with Nirsevimab significantly impacts the burden of severe acute bronchiolitis in the PICU. […] Prophylactic administration of Nirsevimab, An anti-VRS monoclonal antibody, after delivery significantly affects the burden of severe acute viral bronchiolitis in pediatric intensive care. […] Our findings indicate a notable reduction in hospitalizations and PICU length of stay during the winter of 20232024 compared to 20222023, suggesting an effect of Nirsevimab generalized prophylaxis on the severe acute bronchiolitis PICU burden.

• #8 Bronchiolitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565

  Bronchiolitis happens when a virus infects the bronchioles, which are the smallest airways in the lungs. The infection makes the bronchioles swollen and irritated. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs. […] Because the viruses that cause bronchiolitis spread from person to person, one of the best ways to prevent infection is to wash your hands often. This is especially important before touching your baby when you have a cold, flu or other illness that can be spread. If you have any of these illnesses, wear a face mask. […] If your child has bronchiolitis, keep your child at home until the illness is past to avoid spreading it to others. […] To help prevent infection: Limit contact with people who have a fever or cold. If your child is a newborn, especially a premature newborn, avoid being around people with colds. This is especially important in the first two months of life.

• #9

  https://www.who.int/news-room/fact-sheets/detail/respiratory-syncytial-virus-(rsv)

  There are two licensed immunization products for prevention of RSV disease in young infants: a long-acting monoclonal antibody administered to infants soon after birth and a maternal vaccine given to pregnant women and persons in the latter part of pregnancy. […] Several immunization products are currently available to prevent severe RSV disease in infants and elderly adults. To protect infants, there is a vaccine given to pregnant women and persons late in pregnancy (WHO recommends third trimester vaccination, defined from 28 weeks gestational age in most settings). Maternal immunization allows transfer of antibodies against RSV through the placenta to the unborn baby, who is then protected for approximately 6 months after birth. […] Another immunization product to protect babies is a long-acting monoclonal antibody that targets the RSV virus. It is given as an intramuscular injection to protect against severe RSV lower respiratory tract infection lung disease during RSV infection. This product can be administrated to all neonates and infants entering their first RSV season. In addition, countries could consider administering monoclonal antibody to young children (up to 24 months) with high risk of severe RSV disease (e.g. chronic lung disease, congenital heart disease, immunocompromised) entering their second RSV season.

• #9 Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01460-0

  In this study, we demonstrated a significant decrease in both the number of PICU admissions and the length of stay following the introduction of neonatal prophylaxis. […] The observed net effect of Nirsevimab prophylaxis on PICU admissions is even strengthened, as it was similar to the barrier measures implemented to limit the spread of SARS-CoV-2 during the 20212022 epidemic period. […] This study shows that Nirsevimab prophylaxis at birth significantly reduces the PICU burden by decreasing the number and length of stays in the PICU.

• #9 Bronchiolitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565

  Clean and disinfect surfaces and items that people often touch, such as toys and doorknobs. This is especially important if a family member is sick. […] Frequently wash your own hands and those of your child. Wash with soap and water for at least 20 seconds. Keep an alcohol-based hand sanitizer handy to use when you’re away from home. Make sure it contains at least 60% alcohol. […] Cover your mouth and nose with a tissue. Throw away the tissue. Then wash your hands. If soap and water aren’t available, use a hand sanitizer. If you don’t have a tissue, cough or sneeze into your elbow, not your hands. […] Don’t share glasses with others, especially if someone in your family is ill. […] Breastfeed, when possible. Respiratory infections are less common in breastfed babies. […] In the U.S., respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in children who are less than a year old. Two options for immunization can help prevent young infants from getting severe RSV. Both are recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and others.

• #10 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  BRONCHIOLITIS PREVENTION […] Vaccines — Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV — There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy — A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection — Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus]) is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #10 How to prevent RSV and bronchiolitis in babies | Norton Children’s Louisville, Ky.

  https://nortonchildrens.com/news/rsv-bronchiolitis/

  Bronchiolitis is a common lower respiratory tract infection that often appears in children younger than 2 years old. […] Families can take preventive action to avoid infection and limit the spread of the virus: […] Good hand hygiene is the best form of defense against RSV and bronchiolitis. […] Disinfect household objects on a regular basis. […] Use caution when bringing the baby around others. […] Do not expose the baby to secondhand smoke. […] Breastfeeding can offer extra protection.

• #11 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Two monoclonal antibodies used for RSV prophylaxis in infants and young children are available in the United States. Nirsevimab is preferred but may not be available to some infants because of supply limitations; if it is not available, eligible high-risk infants and children should receive palivizumab. […] Nirsevimab a long-acting monoclonal antibody, is recommended for the prevention of RSV in the following infants and young children: All infants […] Children 8 months through 19 months of age who are at increased risk of severe RSV disease and who are entering their second RSV season. […] Only children who meet high-risk criteria should receive more than 1 dose of nirsevimab (1 dose in their first RSV season and 1 dose in their second RSV season). […] High-risk children 8 to 19 months of age include the following: Children with chronic lung disease of prematurity who required medical support any time during the 6-month period before the start of the second RSV season

• #11 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Bronchiolitis prevention […] Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV – There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy – A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection – Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus] is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #11 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #12 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  BRONCHIOLITIS PREVENTION […] Vaccines — Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV — There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy — A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection — Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus]) is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #12 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Avoid smoking around the child, as this increases the risk of respiratory illness. […] Wash hands frequently with soap and water, especially before touching an infant. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for at least 20 seconds. Hands should be rinsed thoroughly and dried with a single-use towel. If you cannot wash your hands in a sink, use a gel with at least 60 percent alcohol. […] Stay away from other adults and children with upper respiratory infection. Keep infants or children home from school or day care when they are sick.

• #13 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Bronchiolitis prevention […] Several vaccines are available that help prevent some of the causes of bronchiolitis: […] RSV – There are two options for preventing severe RSV infections in young infants: […] Vaccination in pregnancy – A vaccine for RSV is available for pregnant people. It is given in the third trimester of pregnancy if the due date is just prior to or during RSV season. Vaccination during pregnancy reduces the risk of severe RSV infections in the newborn during the first few months after birth. […] Antibody injection – Another option for preventing severe RSV infections in infants is a treatment called a „monoclonal antibody” injection. Nirsevimab [brand name: Beyfortus] is given as a single injection to the infant. Nirsevimab is recommended for infants whose birthing parent did not receive the RSV vaccine during pregnancy. If the infant is born during or just before RSV season, nirsevimab may be given to the newborn before discharge from the birth hospital.

• #13 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  Palivizumab prophylaxis should be administered during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity (32 weeks gestation who require 21% O2 for the first 28 days of life). […] To prevent spread of respiratory syncytial virus (RSV), hands should be decontaminated before and after direct contact with patients, after contact with inanimate objects in vicinity of patient, and after removing gloves. Alcohol rubs are the preferred method for hand decontamination. Clinicians should educate personnel and family on hand sanitation. […] Infants should not be exposed to tobacco smoke. […] Exclusive breastfeeding for at least 6 months is recommended to decrease the morbidity of respiratory infections.

• #14 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza — A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 — COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] Other measures — There are several other ways to prevent severe bronchiolitis:

• #14 Bronchiolitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565

  Clean and disinfect surfaces and items that people often touch, such as toys and doorknobs. This is especially important if a family member is sick. […] Frequently wash your own hands and those of your child. Wash with soap and water for at least 20 seconds. Keep an alcohol-based hand sanitizer handy to use when you’re away from home. Make sure it contains at least 60% alcohol. […] Cover your mouth and nose with a tissue. Throw away the tissue. Then wash your hands. If soap and water aren’t available, use a hand sanitizer. If you don’t have a tissue, cough or sneeze into your elbow, not your hands. […] Don’t share glasses with others, especially if someone in your family is ill. […] Breastfeed, when possible. Respiratory infections are less common in breastfed babies. […] In the U.S., respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in children who are less than a year old. Two options for immunization can help prevent young infants from getting severe RSV. Both are recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and others.

• #15 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza – A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 – COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] There are several other ways to prevent severe bronchiolitis:

• #15 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  Palivizumab prophylaxis should be administered during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity (32 weeks gestation who require 21% O2 for the first 28 days of life). […] To prevent spread of respiratory syncytial virus (RSV), hands should be decontaminated before and after direct contact with patients, after contact with inanimate objects in vicinity of patient, and after removing gloves. Alcohol rubs are the preferred method for hand decontamination. Clinicians should educate personnel and family on hand sanitation. […] Infants should not be exposed to tobacco smoke. […] Exclusive breastfeeding for at least 6 months is recommended to decrease the morbidity of respiratory infections.

• #16 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza — A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 — COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] Other measures — There are several other ways to prevent severe bronchiolitis:

• #16 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  Unfortunately, although the use of palivizumab is possibly cost-effective, the cost per individual patient is still high (approximately $5000), which means that the availability of this agent is limited to high-risk patients. […] Nirsevimab was approved by the FDA in July 2023 for prevention of RSV lower respiratory tract disease in newborns and infants entering or during their first RSV season and children up to 24 months old who remain vulnerable to severe RSV disease through their second RSV season. […] Several studies have demonstrated a beneficial effect of breastfeeding, particularly prolonged nursing, for preventing or lessening the severity of RSV bronchiolitis.

• #17 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  If the infant is born outside of the RSV season (summer months in the northern hemisphere), nirsevimab is given before the start of the next RSV season, provided that the infant is <8 months old at that time. Infants who are at high risk for severe RSV infection may receive a second dose of nirsevimab if they are ≤19 months old at the start of their second RSV season. [...] Influenza – A yearly vaccination for influenza virus is recommended for everyone older than six months, especially for household contacts of children younger than five years, and out-of-home caregivers of children younger than five years. Influenza vaccine is also recommended during pregnancy. [...] COVID-19 – COVID-19 vaccination is recommended for everyone six months and older, including pregnant persons. [...] There are several other ways to prevent severe bronchiolitis:

• #17 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  RSV is transmitted via direct contact with secretions of infected patients. Droplets and fomites play a less important role. Meticulous attention to handwashing between patient contacts should reduce the likelihood of hospital staff acquiring RSV infection from patients and of spreading infection by carrying RSV on their hands. […] Attempts to develop a safe and effective RSV vaccine have thus far been unsuccessful. A 1967 study of a formalin-inactivated RSV vaccine resulted in a 15-fold increase in hospitalization and mortality when immunized patients were subsequently reinfected; an adequate explanation for this exaggerated pulmonary response has not been elucidated. […] Active prophylaxis using RSV immunoglobulin intravenously (RSV-IGIV) at high doses was shown to prevent RSV in high-risk patients.

• #18 RSV Prevention – Heritage Pediatrics

  https://www.heritagepediatrics.com/rsv-prevention/

  RSV is a major cause of hospitalization for infants. […] Thankfully, a new product (Beyfortus) was made available that prevents RSV infection in infants. […] Beyfortus (nirsevimab) is a new product developed after decades of research. It contains preformed antibodies that attach to a protein (the F protein) on the outside of the RSV virus. It is given as a single intramuscular shot. Ideally, it’s given shortly before the start of the RSV season to eligible infants. It provides immediate and short-term protection (around 5 months). Beyfortus is more effective and provides longer protection than a currently available product (Synagis) that is only given to the most vulnerable of infants. […] The AAP and CDC recommend the use of Beyfortus for ALL infants under 8 months of age during RSV season. This recommendation is for both term and preterm infants and it includes children who are healthy and children with medical conditions. […] The doctors at Heritage Pediatrics recommend the use of Beyfortus for all infants who are eligible. […] We are confident that the research conducted on Beyfortus demonstrate that it is effective and safe. We expect this medicine will significantly reduce the burden of RSV infections in infants.

• #18 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  RSV is transmitted via direct contact with secretions of infected patients. Droplets and fomites play a less important role. Meticulous attention to handwashing between patient contacts should reduce the likelihood of hospital staff acquiring RSV infection from patients and of spreading infection by carrying RSV on their hands. […] Attempts to develop a safe and effective RSV vaccine have thus far been unsuccessful. A 1967 study of a formalin-inactivated RSV vaccine resulted in a 15-fold increase in hospitalization and mortality when immunized patients were subsequently reinfected; an adequate explanation for this exaggerated pulmonary response has not been elucidated. […] Active prophylaxis using RSV immunoglobulin intravenously (RSV-IGIV) at high doses was shown to prevent RSV in high-risk patients.

• #19 RSV Prevention for Babies – Beyfortus – Mesquite Pediatrics | Pediatrician In ,

  https://www.mesquitepediatrics.com/resources/rsv/

  Data from the 2023-2024 RSV season show that Beyfortus was effective against RSV-associated emergency department visits and hospitalization among infants in their first RSV season. Specifically, data from the VISION Multi-Site Network of Electronic Health Records showed Beyfortus was 77% effective at preventing RSV-associated emergency room visits and 98% effective at preventing RSV-associated hospitalization. […] Overall, Beyfortus is very safe, well tolerated, and extremely effective.

• #19 Respiratory Syncytial Virus (RSV) – NFID

  https://www.nfid.org/infectious-disease/rsv/

  The best ways to help prevent the spread of RSV include the following: […] Vaccines and preventive monoclonal antibodies can help protect against RSV: […] Adults: A single dose of RSV vaccine is recommended to protect all adults age 75 years and older and adults age 60-74 years who have certain risk factors. […] CDC recommends protecting all infants against severe RSV either through a maternal RSV vaccine given to the pregnant mother or an RSV antibody given to the baby. […] RSV vaccine for pregnant women: CDC recommends the maternal RSV vaccine (Abrysvo) for pregnant women to help protect babies against severe illness after birth. […] RSV preventive antibody for babies: CDC recommends 1 dose of nirsevimab (a long-acting monoclonal antibody) for all infants younger than age 8 months born to mothers who did not receive a maternal RSV vaccine during pregnancy. […] Researchers are currently working to develop additional tools to help prevent RSV among specific populations including those who are immunocompromised.

• #20 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Children who are severely immunocompromised […] Children with cystic fibrosis who have severe lung disease or whose weight-for-length is less than the 10th percentile […] Children who are American Indian or Alaska Native. […] For eligible children, nirsevimab should be given shortly before the RSV season (typically from October through the end of March in most of the continental United States). […] Palivizumab, also a monoclonal antibody, decreases the frequency of hospitalization for RSV in high-risk infants. It should be used only in situations where nirsevimab is not available. […] The first dose of palivizumab is given just before the usual onset of the RSV season. Subsequent doses are given at 1-month intervals for the duration of the RSV season (usually a total of 5 doses).

• #20 Management of Bronchiolitis in Infants and Children: Summary – AHRQ Evidence Report Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11847/

  Bronchiolitis is the most common lower respiratory tract infection in infants. […] The relative severity of the disease among vulnerable subpopulations suggests that some infants and children may benefit from prophylactic therapy, although the cost-effectiveness of available interventions needs to be explored. […] The largest group of at-risk children are those born prematurely, who often have concurrent chronic lung disease (CLD). Palivizumab or RSVIG IV given on a monthly basis is effective for prophylaxis in high-risk infants and children who have underlying CLD or have been born prematurely and are less than 6 months of age. […] An effective vaccine would be a preferable strategy for prevention of RSV bronchiolitis in at-risk children compared to the passive immunity created by monthly injections of RSVIG.

• #21 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Children who are severely immunocompromised […] Children with cystic fibrosis who have severe lung disease or whose weight-for-length is less than the 10th percentile […] Children who are American Indian or Alaska Native. […] For eligible children, nirsevimab should be given shortly before the RSV season (typically from October through the end of March in most of the continental United States). […] Palivizumab, also a monoclonal antibody, decreases the frequency of hospitalization for RSV in high-risk infants. It should be used only in situations where nirsevimab is not available. […] The first dose of palivizumab is given just before the usual onset of the RSV season. Subsequent doses are given at 1-month intervals for the duration of the RSV season (usually a total of 5 doses).

• #21 The RSV Prevention Divide | Think Global Health

  https://www.thinkglobalhealth.org/article/rsv-prevention-divide

  One of the biggest barriers to therapeutic access is cost, particularly when it comes to nirsevimab, which has an estimated average price range of $445 in the United States, assuming that half the cost is covered by the federal entitlement program Vaccines for Children. […] „The reality is that the pricing of nirsevimab, which ranges anywhere between $250 and $520, is completely out of reach for almost all low- and middle-income countries,” said Shabir Madhi, head of the Wits Vaccines and Infectious Diseases Analytics Research Unit (Wits VIDA), which led the South African arm of clinical trials for RSVpreF. […] According to Madhi, for nirsevimab to be cost effective in South Africa, it would need to be priced between $30 and $40. […] Rather than expecting LMICs to wait for the cost of nirsevimab to come down, manufacturers could implement a tiered pricing strategy.

• #22 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  Palivizumab prophylaxis should be administered during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity (32 weeks gestation who require 21% O2 for the first 28 days of life). […] To prevent spread of respiratory syncytial virus (RSV), hands should be decontaminated before and after direct contact with patients, after contact with inanimate objects in vicinity of patient, and after removing gloves. Alcohol rubs are the preferred method for hand decontamination. Clinicians should educate personnel and family on hand sanitation. […] Infants should not be exposed to tobacco smoke. […] Exclusive breastfeeding for at least 6 months is recommended to decrease the morbidity of respiratory infections.

• #22 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  Unfortunately, although the use of palivizumab is possibly cost-effective, the cost per individual patient is still high (approximately $5000), which means that the availability of this agent is limited to high-risk patients. […] Nirsevimab was approved by the FDA in July 2023 for prevention of RSV lower respiratory tract disease in newborns and infants entering or during their first RSV season and children up to 24 months old who remain vulnerable to severe RSV disease through their second RSV season. […] Several studies have demonstrated a beneficial effect of breastfeeding, particularly prolonged nursing, for preventing or lessening the severity of RSV bronchiolitis.

• #23 Respiratory Syncytial Virus (RSV) and Human Metapneumovirus Infections – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/respiratory-syncytial-virus-rsv-and-human-metapneumovirus-infections

  Two monoclonal antibodies used for RSV prophylaxis in infants and young children are available in the United States. Nirsevimab is preferred but may not be available to some infants because of supply limitations; if it is not available, eligible high-risk infants and children should receive palivizumab. […] Nirsevimab a long-acting monoclonal antibody, is recommended for the prevention of RSV in the following infants and young children: All infants […] Children 8 months through 19 months of age who are at increased risk of severe RSV disease and who are entering their second RSV season. […] Only children who meet high-risk criteria should receive more than 1 dose of nirsevimab (1 dose in their first RSV season and 1 dose in their second RSV season). […] High-risk children 8 to 19 months of age include the following: Children with chronic lung disease of prematurity who required medical support any time during the 6-month period before the start of the second RSV season

• #23 Management of Bronchiolitis in Infants and Children: Summary – AHRQ Evidence Report Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11847/

  Use of prophylaxis in at-risk groups that were excluded from prior studies would need to be studied or reported before these agents can be recommended more broadly for other groups of infants and children at increased risk of more severe bronchiolitis. […] Studies of palivizumab prophylaxis should examine the effect on long-term outcomes such as the development of symptoms such as wheezing, development of bronchiolitis, hospitalization, and severe disease. […] RSV vaccine research should be encouraged as it would replace the need for prophylaxis. […] Current cost-effectiveness analyses of palivizumab prophylaxis do not provide accurate incremental cost or cost-effectiveness ratios. […] The cost-effectiveness of palivizumab prophylaxis should be reassessed as the new clinical trial data on palivizumab prophylaxis among infants in at-risk groups that were excluded from prior studies become available.

• #24 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  However, a more convenient RSV-specific humanized mouse IgG1 monoclonal antibody preparation, palivizumab, was subsequently developed and FDA-approved in 1998 for prophylaxis for infants at high risk for RSV infection. […] In a multi-institutional, randomized, placebo-controlled study of 1502 high-risk preterm infants in 139 centers in the United States and Canada during the 1996-1997 RSV season, rate of hospitalization was reduced by 5.8% (10.6% in placebo vs. 4.8% in palivizumab group, P 0.001). […] Since palivizumab was licensed for RSV immunoprophylaxis, the recommendations for its use have become more restrictive as additional information became available regarding the epidemiology of RSV hospitalizations and the limited benefit of prophylaxis in selected patient populations. […] AAP guidance regarding palivizumab use is stratified according to risk and can be summarized as follows: Preterm infants born before 29 weeks of gestation, without chronic lung disease of prematurity or congenital heart disease and less than 12 months of age at the start of RSV season; those born on or after 29 weeks of gestation should NOT receive prophylaxis as their rate of hospitalization for bronchiolitis is not different from full-term infants.

• #24 The RSV Prevention Divide | Think Global Health

  https://www.thinkglobalhealth.org/article/rsv-prevention-divide

  One of the biggest barriers to therapeutic access is cost, particularly when it comes to nirsevimab, which has an estimated average price range of $445 in the United States, assuming that half the cost is covered by the federal entitlement program Vaccines for Children. […] „The reality is that the pricing of nirsevimab, which ranges anywhere between $250 and $520, is completely out of reach for almost all low- and middle-income countries,” said Shabir Madhi, head of the Wits Vaccines and Infectious Diseases Analytics Research Unit (Wits VIDA), which led the South African arm of clinical trials for RSVpreF. […] According to Madhi, for nirsevimab to be cost effective in South Africa, it would need to be priced between $30 and $40. […] Rather than expecting LMICs to wait for the cost of nirsevimab to come down, manufacturers could implement a tiered pricing strategy.

• #25 The RSV Prevention Divide | Think Global Health

  https://www.thinkglobalhealth.org/article/rsv-prevention-divide

  Another approach would be to encourage the entry of competitors into the market. […] Philanthropic organizations can also help offset the cost of public health interventions. […] For a vaccine or antibody to be successfully integrated into LMICs, it should align with existing public health infrastructure and be accepted by the target population. […] Achieving this requires vaccine manufacturers to invest in partnerships with stakeholders in LMICs, who often have invaluable insight into the practicality of an intervention. […] Developers also need to demonstrate the efficacy of RSV-preventive interventions to LMIC governments to encourage their adoption. […] Supporting the development of respiratory surveillance systems is also critical. […] To raise awareness and foster dialogue, Louis Bont, a pediatric infectious disease physician and researcher at Wilhelmina Children’s Hospital in the Netherlands, collaborated with the WHO to create the RSV Roadshow Web Series.

• #26 The RSV Prevention Divide | Think Global Health

  https://www.thinkglobalhealth.org/article/rsv-prevention-divide

  Another approach would be to encourage the entry of competitors into the market. […] Philanthropic organizations can also help offset the cost of public health interventions. […] For a vaccine or antibody to be successfully integrated into LMICs, it should align with existing public health infrastructure and be accepted by the target population. […] Achieving this requires vaccine manufacturers to invest in partnerships with stakeholders in LMICs, who often have invaluable insight into the practicality of an intervention. […] Developers also need to demonstrate the efficacy of RSV-preventive interventions to LMIC governments to encourage their adoption. […] Supporting the development of respiratory surveillance systems is also critical. […] To raise awareness and foster dialogue, Louis Bont, a pediatric infectious disease physician and researcher at Wilhelmina Children’s Hospital in the Netherlands, collaborated with the WHO to create the RSV Roadshow Web Series.

• #27 Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01460-0

  Severe acute viral bronchiolitis is a common cause of admissions to pediatric intensive care units (PICUs), resulting in a significant organizational burden each winter. […] The recent introduction of generalized neonatal prophylactic therapies using Nirsevimab, a monoclonal antibody targeting the respiratory syncytial virus (RSV), has significantly reduced consultations and hospitalizations. […] The introduction of generalized neonatal prophylaxis with Nirsevimab significantly impacts the burden of severe acute bronchiolitis in the PICU. […] Prophylactic administration of Nirsevimab, An anti-VRS monoclonal antibody, after delivery significantly affects the burden of severe acute viral bronchiolitis in pediatric intensive care. […] Our findings indicate a notable reduction in hospitalizations and PICU length of stay during the winter of 20232024 compared to 20222023, suggesting an effect of Nirsevimab generalized prophylaxis on the severe acute bronchiolitis PICU burden.

• #28 Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01460-0

  In this study, we demonstrated a significant decrease in both the number of PICU admissions and the length of stay following the introduction of neonatal prophylaxis. […] The observed net effect of Nirsevimab prophylaxis on PICU admissions is even strengthened, as it was similar to the barrier measures implemented to limit the spread of SARS-CoV-2 during the 20212022 epidemic period. […] This study shows that Nirsevimab prophylaxis at birth significantly reduces the PICU burden by decreasing the number and length of stays in the PICU.

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