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Recommendations for the diagnosis of respiratory syncytial virus (RSV) infection in children. The Polish Society of Paediatrics and the National Paediatric Consultant’s recommendations
1
Department of Paediatrics, Medical Centre for Postgraduate Education, Warsaw, Poland
2
President of the Polish Paediatric Society
3
Department of Paediatrics, Endocrinology and Paediatric Diabetology, Medical University of Rzeszów, Poland
4
Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
5
Department of Paediatric Allergology, Gastroenterology and Nutrition, Medical University of Łódź, Poland
6
Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
7
Department of Paediatric Endocrinology and Diabetology, Medical University of Lublin, Poland
8
Department and Clinic of Pediatric Nephrology, Wroclaw Medical University, Poland
9
Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdansk, Poland
10
Department of Paediatrics, Haematology and Oncology, A. Jurasz University Hospital No 1, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
11
Clinical Department of Paediatrics with Division of Allergology, Endocrinology, Neurology – Warsaw Children’s Hospital, Dziekanów Leśny, Poland
12
Department of Paediatric Bone Marrow Transplantation, Oncology and Haematology, Wrocław Medical University, Poland
13
Department of Cardiology, Children’s Memorial Health Institute, Warsaw, Poland
14
Department of Paediatrics, Oncology and Children’s Immunology, Pomeranian Medical University, Szczecin, Poland
Publication date: 2025-07-04
Pediatr Pol 2025;61(2):117-128
KEYWORDS
ABSTRACT
Respiratory syncytial virus (RSV) is one of the most important aetiological factors in acute respiratory tractinfections, and the availability of diagnostic methods, including rapid antigen tests (RADTs) and molecularbased assays, is increasing in Poland. The Polish Society of Paediatrics presents these recommendations in order to unify the clinical approach to RSV testing and clarify confusion related to testing. We hereby providecca comprehensive overview of general characteristics of the test methods, recommendations for interpretation of test results and practical implications of the results. We also indicate the goals of RSV testing and recommendations for selected clinical diagnoses. The aim of the guidelines is to maximise the use of available tests in both inpatient and outpatient settings and to assist paediatricians in making clinical decisions.
REFERENCES (62)
1.
Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022; 399: 2047-2064.
2.
Smith M, Kubale J, Kuan G, et al. Respiratory syncytial virus incidence and severity in a community-based prospective cohort of children aged 0-14 years. Open Forum Infect Dis 2022; 9: ofac598. DOI: 10.1093/ofid/ofac598.
3.
Takashima MD, Grimwood K, Sly PD, et al. Epidemiology of respiratory syncytial virus in a community birth cohort of infants in the first 2 years of life. Eur J Pediatr 2021; 180: 2125-2135.
4.
Borszewska-Kornacka MK, Mastalerz-Migas A, Nitsch-Osuch A, et al. Respiratory syncytial virus infections in Polish pediatric patients from an expert perspective. Vaccines (Basel) 2023; 11: 1482. DOI: 10.3390/vaccines11091482.
5.
Rząd M, Kanecki K, Lewtak K, et al. Human respiratory syncytial virus infections among hospitalized children in Poland during 2010-2020: study based on the national hospital registry. J Clin Med 2022; 11: 6451. DOI: 10.3390/jcm11216451.
6.
Martinón-Torres F, Carmo M, Platero L, et al. Clinical and economic hospital burden of acute respiratory infection (BARI) due to respiratory syncytial virus in Spanish children, 2015-2018. BMC Infect Dis 2023; 23: 385. DOI: 10.1186/s12879-023-08358-x.
7.
Del Riccio M, Spreeuwenberg P, Richard Osei-Yeboah, et al. Defining the Burden of Disease of RSV in the European Union: estimates of RSV-associated hospitalisations in children under 5 years of age. A systematic review and modelling study. J Infect Dis 2023; 228: 1528-1538.
8.
Onwuchekwa C, Moreo LM, Menon S, et al. Underascertainment of respiratory syncytial virus infection in adults due to diagnostic testing limitations: a systematic literature review and meta-analysis. J Infect Dis 2023; 228: 173-184.
9.
Rozenbaum MH, Begier E, Kurosky SK, et al. Incidence of respiratory syncytial virus infection in older adults: limitations of current data. Infect Dis Ther 2023; 12: 1487-1504.
10.
Centers for Disease Control and Prevention. Prevention, RSV infection. Available from: https://www.cdc.gov/rsv/clinic... (Accessed: 31.10.2023).
11.
Bernstein DI, Mejias A, Rath B, et al. Summarizing study characteristics and diagnostic performance of commercially available tests for respiratory syncytial virus: a scoping literature review in the COVID-19 era. J Appl Lab Med 2023; 8: 353-371.
12.
Onwuchekwa C, Atwell J, Moreo LM, et al. Pediatric RSV diagnostic testing performance: a systematic review and meta-analysis. J Infect Dis 2023; 228: 1516-1527.
13.
Lee N, Walsh EE, Sander I, et al. Delayed diagnosis of respiratory syncytial virus infections in hospitalized adults: individual patient data, record review analysis and physician survey in the United States. J Infect Dis 2019; 220: 969-979.
14.
Yin N, Van Nuffelen M, Bartiaux M, et al. Clinical impact of the rapid molecular detection of RSV and influenza A and B viruses in the emergency department. PLoS One 2022; 17: e0274222. DOI: 10.1371/journal.pone.0274222. .
15.
Fabbris C, Cestaro W, Menegaldo A, et al. Is oro/nasopharyngeal swab for SARS-CoV-2 detection a safe procedure? Complications observed among a case series of 4876 consecutive swabs. Am J Otolaryngol 2021; 42: 102758. DOI: 10.1016/j.amjoto.2020.102758.
16.
Koskinen A, Tolvi M, Jauhiainen M, et al. Complications of COVID-19 nasopharyngeal swab test. JAMA Otolaryngol Head Neck Surg 2021; 147: 672-674.
17.
Zuurbier RP, Bont LJ, Langedijk AC, et al. Low sensitivity of BinaxNOW RSV in infants. J Infect Dis 2020; 222 (Suppl 7): S640-S647.
18.
Larsson E, Johansson S, Frøbert O, et al. Evaluation of the ImmuView RSV test for rapid detection of respiratory syncytial virus in adult patients with influenza-like symptoms. Microbiol Spectr 2021; 9: e0093721. DOI: 10.1128/Spectrum.00937-21.
19.
Jung BK, Choi SH, Lee JH, et al. Performance evaluation of four rapid antigen tests for the detection of respiratory syncytial virus. J Med Virol 2016; 88: 1720-1724.
20.
Papagiannis D, Perlepe G, Tendolouri T, et al. Proportion of respiratory syncytial virus, SARS-CoV-2, influenza A/B, and adenovirus cases via rapid tests in the community during winter 2023 – a cross sectional study. Diseases 2023; 11: 122. DOI: 10.3390/diseases-11030122.
21.
Mesquita FDS, Oliveira DBL, Crema D, et al. Rapid antigen detection test for respiratory syncytial virus diagnosis as a diagnostic tool. J Pediatr (Rio J) 2017; 93: 246-252.
22.
Jonckheere S, Verfaillie C, Boel A, et al. Multicenter evaluation of BD Veritor System and RSV K-SeT for rapid detection of respiratory syncytial virus in a diagnostic laboratory setting. Diagn Microbiol Infect Dis 2015; 83: 37-40.
23.
Sanbonmatsu-Gámez S, Pérez-Ruiz M, Lara-Oya A, et al. Analytical performance of the automated multianalyte point-of-care mariPOC® for the detection of respiratory viruses. Diagn Microbiol Infect Dis 2015; 83: 252-256.
24.
Jang JW, Cho CH, Nam MH, et al. Clinical performance evaluation of the Sofia RSV FIA rapid antigen test for diagnosis of respiratory syncytial virus infection. J Clin Microbiol 2015; 53: 684-686.
25.
Miernyk K, Bulkow L, DeByle C, et al. Performance of a rapid antigen test (Binax NOW® RSV) for diagnosis of respiratory syncytial virus compared with real-time polymerase chain reaction in a pediatric population. J Clin Virol 2011; 50: 240-243.
26.
Papenburg J, Buckeridge DL, De Serres G, Boivin G. Host and viral factors affecting clinical performance of a rapid diagnostic test for respiratory syncytial virus in hospitalized children. J Pediatr 2013; 163: 911-913.
27.
Teoh Z, Conrey S, McNeal M, et al. Burden of respiratory viruses in children less than 2 years old in a community-based longitudinal US birth cohort. Clin Infect Dis 2023; 77: 901-909.
28.
Chonmaitree T, Alvarez-Fernandez P, Jennings K, et al. Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development. Clin Infect Dis 2015; 60: 1-9.
29.
Wrotek A, Czajkowska M, Jackowska T. Seasonality of respiratory syncytial virus hospitalization. Adv Exp Med Biol 2020; 1279: 93-100.
30.
van Summeren J, Meijer A, Aspelund G, et al. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Euro Surveill 2021; 26: 2100639. DOI: 10.2807/1560-7917.ES.2021.26.29.2100639.
31.
Cohen R, Ashman M, Taha MK, et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Infect Dis Now 2021; 51: 418-423.
32.
Tabatabai J, Thielen A, Lehners N, et al. Respiratory syncytial virus A in haematological patients with prolonged shedding: premature stop codons and deletion of the genotype ON1 72-nucleotide-duplication in the attachment G gene. J Clin Virol 2018; 98: 10-17.
33.
Hall CB, Douglas RG, Geiman JM. Respiratory syncytial virus infections in infants: quantitation and duration of shedding. J Pediatr 1976; 89: 11-15.
34.
Hogan A, Caya C, Papenburg J. Rapid and simple molecular tests for the detection of respiratory syncytial virus: a review. Expert Rev Mol Diagn 2018; 18: 617-629.
36.
Ralston SL, Lieberthal AS, Meissner HC. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 2014; 134: e1474-e1502. DOI: 10.1542/peds.2014-2742.
37.
Aguilera-Alonso D, Illán-Ramos M, Daoud Z, et al. Analysis of the impact of diagnostic virology tests on the use of antibiotics in paediatric inpatients with community-acquired pneumonia. Enferm Infecc Microbiol Clin (Engl Ed) 2020; 38: 230-233.
38.
Schnell J, Schroeder L, Sinclair K, et al. The effect of early knowledge of respiratory syncytial virus positivity on medical decision making and throughput time within the pediatric emergency department. Pediatr Emerg Care 2020; 36: 134-137.
39.
Rogan DT, Kochar MS, Yang S, Quinn JV. Impact of rapid molecular respiratory virus testing on real-time decision making in a pediatric emergency department. J Mol Diagn 2017; 19: 460-467.
40.
Rossi GA, Ballarini S, Silvestri M, et al. Respiratory syncytial virus and airway microbiota – a complex interplay and its reflection on morbidity. Pediatr Allergy Immunol 2021; 32: 1141-1151.
41.
Do Q, Dao TM, Nguyen TNT, et al. Procalcitonin identifies bacterial coinfections in vietnamese children with severe respiratory syncytial virus pneumonia. Biomed Res Int 2020; 2020: 7915158. DOI: 10.1155/2020/7915158. .
42.
Andrade A, Bang H, Reddick K, et al. Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing. Am J Emerg Med 2023; 66: 146-151.
43.
Wrotek A, Kobiałka M, Grochowski B, et al. Respiratory complications in children hospitalized with respiratory syncytial virus infection. Adv Exp Med Biol 2020; 1279: 113-120.
44.
Thomas E, Mattila JM, Lehtinen P, et al. Burden of respiratory syncytial virus infection during the first year of life. J Infect Dis 2021; 223: 811-817.
45.
Heikkinen T, Ojala E, Waris M. Clinical and socioeconomic burden of respiratory syncytial virus infection in children. J Infect Dis 2017; 215: 17-23.
46.
Hryniewicz W, Albrecht P, Radzikowski A (eds.). Rekomendacje postępowania w pozaszpitalnych zakażeniach układu oddechowego. Narodowy Instytut Leków, Warszawa 2016.
47.
Ramgopal S, Cotter JM, Navanandan N, et al. Viral detection is associated with severe disease in children with suspected community-acquired pneumonia. Pediatr Emerg Care 2023; 39: 465-469.
48.
García CG, Bhore R, Soriano-Fallas A, et al. Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. Pediatrics 2010; 126: e1453-e1460. DOI: 10.1542/peds.2010-0507.
49.
Hervás D, Reina J, Yañez A, et al. Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis 2012; 31: 1975-1981.
50.
Ramagopal G, Brow E, Mannu A, et al. Demographic, clinical and hematological profile of children with bronchiolitis: a comparative study between respiratory synctial virus [RSV] and [Non RSV] groups. J Clin Diagn Res 2016; 10: SC05-SC08. DOI: 10.7860/JCDR/2016/20331.8262.
51.
Christou E, Bourousis E, Pouliakis A, et al. The differences between RSV and no RSV acute bronchiolitis in hospitalized infants: a cross-sectional study. Glob Pediatr Health 2022; 9: 2333794x221138437. DOI: 10.1177/2333794X221138437.
52.
National Institute for Health and Care Excellence (NICE). Bronchiolitis in children: diagnosis and management. 2015 (update 9.08.2021).
53.
Takeyama A, Hashimoto K, Sato M, et al. Respiratory syncytial virus shedding by children hospitalized with lower respiratory tract infection. J Med Virol 2016; 88: 938-946.
54.
Chen S, Wang Y, Li A, et al. Etiologies of hospitalized acute bronchiolitis in children 2 years of age and younger: a 3 years’ study during a Pertussis epidemic. Front Pediatr 2021; 9: 621381. DOI: 10.3389/fped.2021.621381. .
56.
Kutter JS, de Meulder D, Bestebroer TM, et al. Small quantities of respiratory syncytial virus RNA only in large droplets around infants hospitalized with acute respiratory infections. Antimicrob Resist Infect Control 2021; 10: 100. DOI: 10.1186/s13756-021-00968-x.
57.
Berry L, Lansbury L, Gale L, et al. Point of care testing of influenza A/B and RSV in an adult respiratory assessment unit is associated with improvement in isolation practices and reduction in hospital length of stay. J Med Microbiol 2020; 69: 697-704.
58.
Wrotek A, Czajkowska M, Jackowska T. Nosocomial infections in patients hospitalized with respiratory syncytial virus: a practice review. Adv Exp Med Biol 2020; 1271: 1-10.
59.
Englund JA, Cohen RA, Bianco V, et al. Evaluation of clinical case definitions for respiratory syncytial virus lower respiratory tract infection in young children. J Pediatric Infect Dis Soc 2023; 12: 273-281.
60.
Modjarrad K, Giersing B, Kaslow DC, et al.; WHO RSV Vaccine Consultation Expert Group. WHO consultation on Respiratory Syncytial Virus Vaccine Development Report from a World Health Organization Meeting held on 23-24 March 2015. Vaccine 2016; 34: 190-197.
61.
Hryniewicz W, Ozorowski T (eds.). Rekomendacje diagnostyki, terapii i profilaktyki antybiotykowej zakażeń w szpitalu [11.03.2022]. Available at: rekomendacje-kompendium_20150504.pdf.
62.
Fitzpatrick T, Malcolm W, McMenamin J, et al. Community-based antibiotic prescribing attributable to respiratory syncytial virus and other common respiratory viruses in young children: a population-based time-series study of Scottish children. Clin Infect Dis 2021; 72: 2144-2153.
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