Respiratory syncytial virus is the leading pathogen for infant hospitalizations, but a second contender is close behind in prevalence: human rhinovirus.
For three virus seasons before the first RSV drug, nirsevimab, was approved, HRV accounted for two-thirds of as many RSV cases in children, according to a study published Feb. 7 in JAMA Pediatrics.
The researchers analyzed records from a tertiary hospital in France to find HRV-related burden, which was documented as a percentage of the RSV-related burden for the number of days of hospitalization or ventilation use. They found that the magnitude of HRV burden was 68% of RSV-related hospital admissions, 51% of RSV-related days of hospitalization, and 27% of RSV-related days of ventilation.
In November 2023, before RSV peaked, many U.S. children's hospitals were reporting capacity surges. One in Texas saw 500 new respiratory cases a day.
In conclusion, the study authors said the findings "draw attention to challenges" to managing non-RSV infections, including HRV.
"The promised 86.5% individual efficacy of nirsevimab may not translate to an 86.5% reduction in bronchiolitis [HRV] burden," they wrote. "Efforts must be made to include HRV in the development of multipathogen vaccines and to continue [...] developing tailored protocols for home enteral nutrition and home oxygen therapy for infants with moderately severe bronchiolitis. Until then, adherence to universal preventive hygiene measures remains particularly critical."