RSV is not only a problem for premature babies
In a multicentre study in Türkiye, 70.6% of children admitted to paediatric intensive care with RSV had no underlying chronic condition. Why that finding matters.
For decades RSV was discussed, in clinical practice and in public, as a problem belonging to a particular group: babies born prematurely, children with congenital heart disease, those with chronic lung disease. That frame led preventive approaches to be designed around the same narrow group.
Data published in recent years break the frame.
A finding from Türkiye
The multicentre RSVP study, drawing on data from many paediatric intensive care units across Türkiye, assessed 646 children admitted with RSV between 2020 and 2024. Two figures stand out:1
- 70% were under 12 months old.
- 70.6% had no underlying chronic condition.
In the same study, pneumonia was found in 59.8% and bronchiolitis in 38.1%; 25.5% required invasive mechanical ventilation.
In other words, seven in ten children admitted to intensive care with RSV in Türkiye would not have been counted as “at risk” before they fell ill.
The finding is not isolated
International literature points the same way. A systematic review and meta-analysis of RSV burden in healthy term-born infants found this group accounts for a considerable share of hospital admissions.2 A recent review of risk factors for severe RSV outcomes in children confirms the picture.3
None of this removes the clinical importance of high-risk groups. Premature birth, bronchopulmonary dysplasia, congenital heart disease and immunodeficiency remain conditions that markedly increase risk.4 What has changed is the assumption that risk lives only there.
Why it matters
Three reasons.
First, for parents. The judgment “my baby was born healthy, this doesn’t concern me” does not match the data. The first six months of life is when both biological vulnerability and hospitalisation risk peak.5
Second, for clinical practice. RSV may not be severe at onset; it can become more severe a few days into the illness.6 Mildness on day one is not a reason to relax monitoring.
Third, for policy. If preventive strategies are built only around high-risk groups, in a way that does not reflect the real distribution of burden, the fact that all infants are at risk gets obscured. Public health literature calls this “mistargeting” and counts it among the main mechanisms that produce missed opportunities.
What to do
The most concrete thing you can do as a parent is to recognise the warning signs: difficulty breathing, pauses in breathing, not drinking enough fluids, and symptoms getting worse. If any of these are present, do not wait.
On preventive options — maternal vaccination in pregnancy and the long-acting monoclonal antibody given directly to the infant — talk to your doctor. Current licensing and reimbursement status in Türkiye may vary.
Sources
- Çoban, Y., Evren, G., Yıldızdaş, D., Zengin, N., Bal, L., Kendirli, T., ve ark., & Dinleyici, E. Ç. (2026). Burden, risk factors, and outcomes of respiratory syncytial virus (RSV) infection in pediatric intensive care units in Türkiye (RSVP Study 2020–2024). BMC Pediatrics, 26(1), Article 298. doi.org/10.1186/s12887-026-06562-7
- Wildenbeest, J. G., Korsten, K., & Bont, L. J. (2022). The burden of respiratory syncytial virus in healthy term-born infants: A systematic review and meta-analysis. Infectious Diseases and Therapy, 11, 1891–1913. doi.org/10.1007/s40121-022-00666-5
- Dallagiacoma, G., Pierantoni, L., Lanari, M., & Pession, A. (2025). Risk factors for severe outcomes of respiratory syncytial virus infection in children. The Lancet Regional Health – Europe, 41, 100923. doi.org/10.1016/j.lanepe.2024.100923
- American Academy of Pediatrics, Committee on Infectious Diseases. (2024). Respiratory syncytial virus. In Red Book: 2024–2027 report of the Committee on Infectious Diseases (33rd ed., pp. 713–721). American Academy of Pediatrics. doi.org/10.1542/9781610027373-S3_017_003
- Li, Y., Wang, X., Blau, D. M., Caballero, M. T., Feikin, D. R., Gill, C. J., Madhi, S. A., Omer, S. B., Simões, E. A. F., Campbell, H., ve ark., & Nair, H. (2022). 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. The Lancet, 399(10340), 2047–2064. doi.org/10.1016/S0140-6736(22)00478-0
- Centers for Disease Control and Prevention (CDC). RSV in infants and young children. www.cdc.gov/rsv/infants-young-children/index.html
The information on this site is for general guidance only and does not replace examination, diagnosis or treatment by a clinician.