The fourth wave of the coronavirus pandemic is fast approaching us. We all live with the fear of an increase in the number of cases and the vision of a possible lockdown. Meanwhile, the coronavirus is not the only threat that could affect our health this fall.
Press material
Pediatricians and neonatologists confirm that this year the RS virus infection season started in mid-August, faster than in previous years. The RS virus is especially dangerous for premature babies and for them it can be more dangerous than the coronavirus [1]. It is worth protecting premature babies against RSV. The key is to avoid people with symptoms of infection, take care of hygiene and wash their hands before each contact with a child [2,3]. One of the most effective methods of reducing RSV respiratory tract infections is immunoprophylaxis [2]. Children born before the 33rd week of pregnancy can benefit from it as early as October 1 as part of the drug program financed from the budget of the Ministry of Health [9].
The RS virus, i.e. respiratory syncytial virus, is responsible for 70% of respiratory tract infections in children under 2 years of age [4]. Especially for premature babies, infection with this virus can be very dangerous – it can lead to severe infections, the treatment of which must take place in a hospital in the neonatal intensive care unit. It is associated with an underdeveloped respiratory system and an immature immune system. A newborn baby, especially in the first months of life, benefits from the mother’s antibodies, which she transmits to him mainly in the third trimester of pregnancy. In premature babies, especially those born before the third trimester, antibody levels may be too low and therefore insufficient to protect against infections. Additionally, the lung volume of premature infants born at 3 weeks of gestation is three times smaller, and the lung surface area four times smaller compared to the volume and size of the lungs of a full-term child [3]. At birth, premature babies are 30 times more likely to develop lower respiratory tract infections than full-term babies [5].
– This year, slightly earlier than usual, we observed an increased number of infections caused by the RS virus and many children are hospitalized in neonatal and pediatric wards. This was due to the coronavirus pandemic. While the restrictions were in place, the spread of the coronavirus and other viruses was limited, but the summer months during which the restrictions were lifted meant that the RS virus attacking the respiratory tract emerged faster than usual. Fortunately, today we are starting immunization, and therefore the administration of ready-made antibodies, to those children who qualify for the RSV prevention program. I appeal to all parents of premature babies not to delay giving their children the first dose of immunoprophylaxis. Let’s not wait until the end of October, because the RS virus is very dangerous for premature babies and it is worth protecting the baby from it as soon as possible – said prof. dr hab. n. med. Ewa Helwich, national consultant in the field of neonatology.
In Poland, the season of increased morbidity caused by the RS virus lasts from October to April. This year, in many countries around the world, including Poland, the RS virus started to be active faster, already at the beginning of August. Infections caused by the RS virus in premature babies can lead to severe breathing disorders, the need for artificial ventilation with a respirator, and consequently to hypoxia and the risk of further health complications. Additional complications are very common in children infected with RS. It may be pneumothorax, otitis media. Wheezing and reactive airways may persist even 5-8 years after acute infection [7]. Therefore, in the season of the virus occurrence, it is worth protecting your child against it.
– The return of a premature baby to the intensive care unit is always a step back in its development. Although the problem of separating parents of premature babies from their children is not as big as at the beginning of the coronavirus pandemic in March 2020, it is still worth doing everything to prevent re-hospitalization. A stay in a hospital is unnecessary stress not only for a baby, but also for its parents. I appeal to all parents of premature babies who are eligible for antibodies to come to the immunization points. – emphasizes prof. dr hab. n. med. Maria Katarzyna Borszewska-Kornacka, neonatologist, president of the Coalition for Premature Infant Foundation.
What is immunoprophylaxis?
There is no vaccine against the RS virus, therefore the most effective method of protection against infection is the administration of immunoprophylaxis, ie ready-made antibodies [8].
– Ready antibodies, which are administered as immunoprophylaxis, immediately protect the child against the RS virus, inhibiting its action. They are administered intramuscularly, but it is not a vaccine. The administered antibodies are immediately ready to block and neutralize the RS virus, and not, as in the case of protective vaccinations, the body thanks to the so-called immune memory, it begins to produce them only after contact with a specific germ. The protective effect of antibodies to the RS virus is therefore temporary and lasts about 30 days after drug administration. Therefore, in the season of increased morbidity, the administration of antibodies must be repeated every four weeks, and only 5 doses provide sufficient protection, explains Prof. Maria K. Borszewska-Kornacka.
Who can use the security?
In Poland, there is a drug program under which premature babies who meet the eligibility criteria can benefit from free immunoprophylaxis9 These are:
- children under the age of 1 and born up to the 28th week of pregnancy (28 weeks and 6 days) or with bronchopulmonary dysplasia;
- children who are under 6 months of age and were born between the 29th and 32nd weeks of pregnancy (32 weeks and 6 days).
Immunoprophylaxis is carried out by accredited neonatal centers throughout Poland. There are 67 of them. They are prepared to make the immunization visit safe for the child and his parents – the sanitary regime is in force, visits are scheduled at appropriate intervals to minimize the number of people staying in the center at the same time and thus reduce the risk of coronavirus infection. Parents should therefore not give up on immunoprophylaxis for fear of being infected with SARS-CoV-2. With the next wave of the pandemic, they should take care of their child’s health and protect them from RSV to avoid infection, infection and unnecessary hospital stay.
The list of centers that carry out RSV immunoprophylaxis in the infection season 2021/22 can be found on the website of the Coalition for Premature Infant Foundation: https://www.koalicjadlawczesniaka.pl/kryteria-kfinansacji-do-programu-profilaktyki-zakazen-rsv-i-lista -resrodkow-implementing-program /