Canadian pediatric hospitals face rising RSV hospitalizations in young children: Montreal-led study

Over the past five years, more than 11,000 children in Canada have been hospitalized due to respiratory syncytial virus (RSV), with half of those patients being infants, according to a recent study.

The research completed by the Montreal Children’s Hospital and B.C. Children’s Hospital Research Institute shows that 49.8 per cent of the 11,014 RSV-related hospitalizations recorded during this period were in patients under six months of age.

“They’re vulnerable to severe RSV infection because they haven’t encountered the virus before. They have no prior immunity,” said Dr. Jesse Papenburg, co-senior author of the study.

RSV causes respiratory tract infections such as bronchiolitis and pneumonia.

“In older kids and in adults, usually that’s just a cold, but in younger children, there’s more risk of having severe disease,” said Papenburg.

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The study also shows that, after a near absence during the 2020-2021 season, RSV-related hospitalizations increased in 2021-2022 to 3,170 admissions compared with the pre-pandemic period which had an average of 2,522 admissions per year.

The research, published in JAMA Network Open, identifies RSV-related hospitalizations between 2017 and 2022 in 13 Canadian pediatric tertiary care hospitals participating in the Immunization Monitoring Program ACTive (IMPACT) of the Canadian Paediatric Society. These represent over 90 per cent of pediatric tertiary care beds in the country.

Researchers noted an increase in RSV-related hospitalizations starting in summer 2021, particularly in Quebec, Saskatchewan and Alberta. Lower immunity due to the absence of infections in the previous year (likely because of measures to counter the pandemic), combined with children’s reengagement in social activities and relaxation of physical distancing, may explain this increase, according to the press release.

Case severity and percentage of cases by age, however, remained similar over the five years studied.

According to the press release, RSV is one of the leading causes of hospitalization among children. These hospitalizations represent a major burden for the health-care system.

“Our results highlight all the importance of both regional and national surveillance for RSV,” said Papenburg.

Papenburg says there are a couple of immunization agents that can help reduce RSV rates such as a vaccination for pregnant women which is currently under review by Health Canada.

“We’re expecting Health Canada approval most likely by the end of this calendar year, possibly Q1 of 2024,” said Papenburg.