The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study

Joanne G Wildenbeest, Marie-Noelle Billard, Roy P Zuurbier, Koos Korsten, Annefleur C Langedijk, Peter M van de Ven, Matthew D Snape, Simon B Drysdale, Andrew J Pollard, Hannah Robinson, Terho Heikkinen, Steve Cunningham, Thomas O'Neill, Bishoy Rizkalla, Ana Isabel Dacosta-Urbieta, Federico Martinón-Torres, Marlies van Houten, Louis J Bont*, RESCEU Investigators

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. The burden of RSV infection in healthy term infants has not yet been established. Accurate healthcare burden data in healthy infants are necessary to determine RSV immunization policy when RSV immunization becomes available.
We performed a multicenter prospective, observational birth cohort study in healthy term-born infants (≥37 weeks of gestation) in five sites located in different European countries to determine the healthcare burden of RSV. The incidence of RSV-associated hospitalizations in the first year of life was determined by parental questionnaires and hospital chart reviews. We performed active RSV surveillance in a nested cohort to determine the incidence of medically-attended RSV infection.
In total, 9154 infants born between July 2017 and April 2020 were followed during the first year of life and 993 participated in the nested active surveillance cohort. The incidence of RSV hospitalization in the total cohort was 1·8% (95% CI 1·6-2·1). There were eight pediatric intensive care unit admissions, corresponding to 5·5% of RSV hospitalizations and 0·09% of the total cohort. Incidences of RSV infection confirmed by any diagnostic assay and medically-attended RSV infection in the active surveillance cohort were 26·2% (95% CI 24·0-28·6) and 14·1% (95% CI 12·3-16·0), respectively.
RSV-associated acute respiratory infection causes substantial morbidity, leading to the hospitalization of one in every 56 healthy term-born infants in high-income settings. Immunization of pregnant women or healthy term-born infants during their first winter season could have a significant impact on the healthcare burden caused by RSV infections.

Original languageEnglish
JournalThe Lancet Respiratory Medicine
Early online date10 Nov 2022
Publication statusE-pub ahead of print - 10 Nov 2022


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