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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay

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Published on: January 26, 2019

The Epidemiology of Healthcare-Acquired Respiratory Syncytial Virus Infection Among Hospitalised Paediatric Patients:

B Wahi-Singh^1,2, P Wahi-Singh^1,2, C Lau³

¹Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Influenza and Other Respiratory Viruses

|October 14, 2025

Insights

Hospital-acquired respiratory syncytial virus (HA-RSV) is a significant threat to children in hospitals. This study quantifies HA-RSV

Area of Science:

Pediatric Infectious Diseases
Hospital Epidemiology
Public Health Surveillance

Background:

Hospital-acquired respiratory syncytial virus (HA-RSV) poses a substantial risk to hospitalized children, contributing significantly to RSV-related deaths.
The precise epidemiology, incidence, morbidity, and mortality of HA-RSV remain under-characterized due to limited meta-analytical evidence.

Purpose of the Study:

To systematically review and meta-analyze the incidence, morbidity, and mortality of pediatric HA-RSV infections.
To quantify the epidemiological burden of HA-RSV in hospitalized children globally.

Main Methods:

A systematic review and meta-analysis of English language studies published between January 1975 and March 2024.
Inclusion of studies with primary data on pediatric HA-RSV cases, excluding outbreak reports.
Random-effects meta-analyses were used to synthesize incidence rates (IR), mortality rates (MR), cumulative incidence, and case-fatality rates (CFR).

Main Results:

Twenty-seven studies from 11 countries were included in the analysis.
The pooled HA-RSV incidence rate (IR) among all pediatric patients was 10.86 cases per 1000 person-years.
The pooled mortality rate (MR) was 11.34 deaths per 1000 person-years, with a case-fatality rate (CFR) of 13.30%.

Conclusions:

HA-RSV is an under-recognized cause of significant morbidity and mortality in hospitalized pediatric patients.
Mortality associated with HA-RSV is notably higher than that of community-acquired RSV.
Findings highlight the urgent need for enhanced infection control, standardized diagnostics, and targeted prevention strategies.

Read full analysis

Abstract

Background:

Hospital-acquired respiratory syncytial virus (HA-RSV) infections pose a substantial risk to hospitalised children, previously described as composing a fifth of RSV-related deaths worldwide. Despite this, the epidemiology of HA-RSV remains under-characterised, with limited meta-analytical evidence quantifying its incidence, morbidity and mortality.

Methods:

We conducted a systematic review and meta-analysis of English language papers published between January 1975 and March 2024 searching EMBASE, MEDLINE and CABI Global Health. We included studies with primary data on paediatric HA-RSV cases among either all patients, patients with RSV or patients with healthcare-acquired infections (HAIs). Outbreak reports were excluded for the purposes of this analysis. Using random-effects meta-analyses, we synthesised the HA-RSV incidence rate (IR) and mortality rate (MR) among patient groups, reported as cases and deaths per 1000 person-years respectively. HA-RSV cumulative incidence and case-fatality rate (CFR) are also reported as percentages. The Joanna-Briggs Institute critical appraisal tool was used for quality assessment.

Results:

Twenty-seven studies from 11 countries were included. The pooled HA-RSV IR among all paediatric patients was 10.86 cases (95% confidence interval, 3.83-17.89) per 1000 person-years. The MR was 11.34 (5.57-17.11) deaths per 1000 person-years, and the pooled CFR was 13.30% (3.21%-23.40%). HA-RSV comprised 15.57% of RSV hospitalisations and 22.48% of all HAIs.

Conclusions:

HA-RSV is a serious and under-recognised cause of morbidity and mortality in hospitalised paediatric patients, with significantly higher mortality than community-acquired RSV. These findings underscore the need for strengthened infection control, standardised diagnostic criteria and targeted preventative strategies to mitigate its impact globally.

Keywords:

RSV epidemiology healthcare‐acquired infection incidence meta‐analysis nosocomial paediatric respiratory syncytial virus

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