Respiratory Syncytial Virus Surveillance
Respiratory Syncytial Virus (RSV) has long been recognized as an important respiratory pathogen that causes severe disease and mortality, particularly in very young children but also in other age and at-risk groups. RSV is a leading cause of hospitalization due to acute lower respiratory infection especially in infants and young children.
New preventative tools – including RSV vaccines and monoclonal antibodies – are now licenced and have been introduced in several high and upper-middle income countries. The WHO Strategic Advisory Group of Experts on Immunization (SAGE) recommends two approaches to protect young enfants: a single dose of the RSV maternal vaccine in the 3rd trimester of pregnancy, and direct administration of a long-acting monoclonal antibody to the infant.
The WHO Global Influenza Programme, with support from the Gates Foundation, leverages the Global Influenza Surveillance and Response System (GISRS) to integrate RSV testing to better understand RSV epidemiology and disease burden, to inform vaccine introduction policies and guidelines. Updated WHO standards and implementation guidance for integrated surveillance of influenza, SARS-CoV-2, and RSV were published in December 2024.
Over a period of 3 years (2016-18), WHO successfully piloted Phase I of an RSV surveillance strategy based on GISRS in 14 countries. This phase aimed to develop standards for integration of RSV within GISRS. Phase II, conducted from 2019 to 2024, expanded to include 11 additional countries and a subset of six low- and middle-income countries (LMICs) for RSV-associated burden estimation. The current Phase III (2025–2027) focuses on RSV-associated burden estimation among younger children in 24 LMICs, to generate the evidence required to inform national policies for introduction of the vaccine in countries.
The RSV disease burden can be characterized in several different ways (Pebody et al, 2019 https://doi.org/10.1111/irv.12667 ). In the absence of resources for special disease burden studies, a tiered approach towards disease burden estimation using surveillance data is proposed for the second phase of RSV surveillance. Even simple estimates of proportion of RSV-associated hospitalizations are important to raise awareness of disease burden among policy-makers and providers.
The WHO RSV surveillance program aims to provide countries with a platform based on established approaches to collect these data.
Meeting reports
Respiratory syncytial virus sequencing considerations for an expanded Global Influenza Surveillance and...
In recent years, rapid progress has been made in the development of new pharmaceutical interventions against respiratory syncytial virus (RSV), including...
Progress of respiratory syncytial virus surveillance and disease burden estimation based on the Global...
The WHO has implemented the RSV surveillance strategy based on GISRS since 2015. Based on the experiences gained in integrated surveillance of influenza...
Summary report on the WHO workshop on estimation of respiratory syncytial virus (RSV) disease burden...
This report summarizes the proceedings from the “WHO workshop on estimation of respiratory syncytial virus (RSV) disease burden based on RSV surveillance...
WHO Meeting of Final Review of the RSV Surveillance Pilot Based on the Global Influenza Surveillance...
The meeting summarized the outcomes and the lessons learnt from the pilot phase. Key takeaway messages included the feasibility of leveraging the influenza...
WHO meeting of mid-term review of the RSV surveillance pilot based on the global influenza surveillance...
A standardized and robust global Respiratory Syncytial Virus (RSV) surveillance system is important to better understand the seasonality of RSV infections...
Respiratory syncytial virus (RSV) is an important viral respiratory pathogen, causing acute, sometimes fatal lower respiratory tract infections in infants...
WHO Informal Consultation on Surveillance of RSV on the Global Influenza Surveillance and Response System...
Respiratory syncytial virus (RSV) is the leading viral cause of acute lower respiratory tract infections in infants and young children in whom this virus...
References
- Cai W, Buda S, Schuler E, Hirve S, Zhang W, Haas W, Buda S. Risk factors for hospitalized respiratory syncytial virus disease and its severe outcomes. Influenza Other Respi Viruses. 2020
- Jackson S, Peret T, Ziegler T, Hirve S, ……, Zhang W. Results from the WHO external quality assessment for the respiratory syncytial virus pilot, 2016-17. Influenza Other Respi Viruses. 2020
- Chadha M, Hirve S, Bancej C, Barr I, Baumeister E, Caetano B, Chittaganpitch M, Darmaa B, Ellis J, Fasce R, Herve K, Jackson S, Leung V, Pisareva M, Moyes J, Naguib A, Tivane A, Zhang W. Human respiratory syncytial virus and influenza seasonality patterns – Early findings from the WHO global respiratory virus surveillance. Influenza Other Respi Viruses. 2019
- Pebody R, Moyes J, Hirve S, Campbell H, Jackson S, Moen A, Nair H, Simões E, Smith PG, Wairagkar N, Zhang W. Approaches to use the WHO Respiratory Syncytial Virus Surveillance platform to estimate disease burden. Influenza Other Respi Viruses. 2019
- Hirve S, Crawford N, Palekar R, Zhang W, WHO RSV Surveillance Group. Clinical characteristics, predictors and performance of case definition – interim results from the WHO global respiratory syncytial virus surveillance pilot. Influenza Other Respi Viruses. 2019
- Pebody R, Moyes J, Hirve S, Campbell H, Jackson S, Moen A, Nair H, Simões E, Smith PG, Wairagkar N, Zhang W. Approaches to use the WHO Respiratory Syncytial Virus Surveillance platform to estimate disease burden. Influenza Other Respi Viruses. 2019
- Broor S, Campbell H, Hirve S, Hague S, Jackson S, Moen A, Nair H, Palekar R, Rajatonirina S, Smith P, Venter M, Wairagkar N, Zambon M, Ziegler T, Zhang W. Leveraging the Global Influenza Surveillance and Response System for global respiratory syncytial virus surveillance – opportunities and challenges. Influenza Other Respi Viruses. 2019
- Cai W, Tolksdorf K, Hirve S, Schuler E, Zhang W, Haas W, Buda S. Evaluation of using ICD-10 code data for respiratory syncytial virus surveillance. Influenza Other Respi Viruses. 2019
Related links