Pune: A recent cluster of severe respiratory syncytial virus (RSV) cases progressing rapidly into viral pneumonia in the city highlighted the rise in instances of this infection in very young children in the last few years. Despite RSV being the most common viral infection and the leading cause of infant mortality, awareness about it remains low. With World Pneumonia Day to be marked on Nov 12 this year, medical experts highlighted the need to prevent, treat, and raise knowledge about pneumonia and RSV, especially among vulnerable populations. “RSV is highly prevalent during the monsoon, and there is a significant rise in cases among children below five years of age in recent years,” says Dr Shailaja Mane, head of the paediatrics department at Dr DY Patil Medical College, Hospital and Research Centre. She added, “Around two months ago, we witnessed a cluster of severe RSV cases progressing rapidly into viral pneumonia, with several infants requiring paediatric ICU admission and even ventilator support. Fortunately, there were no fatalities. When the lungs are still developing, up to around nine years of age, children are especially vulnerable, and RSV-related pneumonia can worsen fast within a few days.” Studies globally identify RSV as a leading cause of severe childhood pneumonia, reinforcing the need for greater awareness, prevention, and early diagnosis. There is a shift from bacterial to viral predominance in pneumonia etiology, underscoring the importance of early and accurate diagnosis. One such research led by Johns Hopkins Bloomberg School of Public Health, published in The Lancet, analysed data from approximately 10,000 children, revealing that 61% of severe pneumonia cases were viral, with RSV responsible for 31% of the cases. Dr Prashant Laxmanrao Ramtekkar, consultant paediatrician and neonatologist at Motherhood Hospitals, said, “RSV impacts small airways of lungs, inducing concerning symptoms such as breathing problems, cough, fever, and even poor appetite. Babies below one year of age, born pre-term, suffering from lung and heart problems or having weak immunity are most susceptible. It is imperative for parents to watch out for warning signs such as rapid breathing, chest retractions, wheezing, blue lips or skin (cyanosis), and the child’s inability to accept feeds. These signs can mean medical emergencies.” RSV spreads fast, so it is important for parents to look for symptoms, says Dr Vishal Kole, consultant, paediatrics and neonatology at Surya Mother and Child Super Speciality Hospital. He said, “I recently treated a three-month-old baby, who caught what seemed like a simple cold. However, within 48 hours, her breathing became laboured, she refused feeds, and her oxygen saturation fell below 90%. That’s how unpredictable viral pneumonia can be. Infants below six months, premature babies, and children with congenital heart or lung disease are the most susceptible to RSV. Nearly all children are infected with RSV by age two. It is also the most common cause of bronchiolitis and pneumonia in infants.” While there is no cure for RSV, timely treatment is lifesaving, said Dr Abhay Mahindre, director of neonatology at Noble Hospital. “Treatment focuses on supportive and symptomatic care. Antibiotics are not effective as RSV is a virus. Smoke exposure increases the risk and severity of RSV. The Long-Acting Monoclonal Antibody (Nirsevimab), approved for use in India since mid-2024, is a major medical advancement for preventing severe RSV infection in infants. Nirsevimab provides passive immunity, meaning it gives the baby ready-made antibodies immediately, offering protection throughout the entire RSV season with a single shot, though cost is a big concern.”
