The study shows the economic burden of RSV in European children who need basic care

Infections of the respiratory tract -Syncytial virus (RSV) in children who need basic care Eurosurveillance.

In the study, attempts were made to give insights into public health policy and to support costs and performance analyzes for RSV immunization strategies. RSV infections are a main cause of acute respiratory infections in children, whereby almost all children have at least one RSV infection up to the age of 2. While some children develop a severe form of RSV diseases that may require hospital stays, most of the infections are treated in basic care.

Significant differences in social costs in age groups and countries

The study included 3,414 children under 5 years with acute respiratory infection in Belgium, Italy, the Netherlands, Spain and the United Kingdom (Great Britain), 33% of which were tested positively for RSV. Children were recruited by basic care doctors for the RSV season 2020/21 (only in Great Britain), 2021/22 and 2022/23. In children in whom RSV was diagnosed, the costs for the treatment of basic care and the absence of parental work were assessed over 30 days by questionnaires that were filled out by the parents. The calculation of the general economic burden included outpatient health costs and missed working days by parents, whereby the results were layered by country and age and the group of children who were diagnosed RSV.

The researchers found that the RSV infections led to a significant economic burden, whereby the costs between the five countries participating in this study significantly vary: The average outpatient health costs per RSV episode was EUR 97 in the Netherlands up to EUR 300 in Spain and were mostly powered by basic care visits. The cost of the parental absence of work was between EUR 454 in Great Britain and EUR 994 in Belgium.

The main sources of cost were repeated visits to doctors and parents who were missing the work to take care of their sick children. The costs in connection with health care were higher in infants aged 1, while the work distance for parents was a higher proportion of costs between children between 1 and 5 years. The drug costs for the treatment of RSV infections contributed the least to the general economic burden in all countries and age groups.

The average number of visits in basic care per child varied in the Netherlands up to 3.0 in Spain of 1.4. There were big differences in the hospital stay rates, which was 4% of the infections, which led to hospital stays in the Netherlands and Italy up to 44% in Belgium. However, this may be due to the fact that Belgium included data on children in care outside of the hours. The proportion of children who had prescribed medication was between 26% in Great Britain and 77% in Italy. The absence of the parents was significant between the countries and was enough between 13% of the parents who reported absences, and an average of 1.3 absenteeism in Spain up to 71% of parents who were missing an average of 4.1 days free working days in Belgium.

The study has some restrictions. There may be some selection distortions from doctors when choosing children, and the study only included the costs within 30 days of the first visit to the doctor. The Covid 19 pandemic could also have influenced the data. Although it indicates that self -reported devices are used as a valid alternative to documented work ability, but some assumptions were taken on the basis of incomplete information in the data analysis. Based on existing research, it was assumed that all costs are related to other viruses with RSV regardless of possible infections.

The results for the definition of immunization strategies

The differences shown in the data underline how important it is to take into account country-specific cost estimates when defining RSV immunization strategies. These can vary strongly on differences in health systems, maintenance behavior and guidelines for parental leave.

This study also deals with a critical gap when understanding the general economic effects of RSV infections in childhood, since most studies on the economic burden of RSV have so far focused on the costs that are associated with RSV-related hospital stay and do not contain any costs from basic care. While infections treated in basic care have lower health costs, they still contribute significantly to the general economic burden of RSV.

“Our results are particularly in good time in particular in view of the recent introduction of RSV immunization strategies for infants and the continuous development of several RSV vaccines for toddlers and older children.“The authors said.