Project RSV ComNet

Rationale

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections in children. By the age of one year, 60-70% of the children have been infected by RSV and almost all children have been infected by two years of age.
In Western countries, mortality due to RSV is rare. Hospitalization rates in young children are estimated to be 0.6 to 42.7 cases per 1000 children, with higher rates in younger children. Accurate estimates of the burden of RSV, including in primary care, are necessary to assess the overall impact RSV has on the society. This knowledge is critical for policymakers to make informed decisions regarding the introduction of new RSV interventions.

Aim of RSV ComNet

The aim of RSV ComNet is to measure the clinical and socio-economic disease burden of RSV in young children (aged <5 years) in primary care.

Project design and planning

The project was started in 2019 and continued in the winter of 2020/2021, 2021/2022 and 2022/2023. It consist of the following steps:

• RSV ComNet III: Measuring the clinical and socio-economic disease burden of RSV infections in young children in primary care in six European countries – winter 2021/2022 and 2022/2023
  In the winter of 2021/2022 data collection has been extended to five European countries, namely United Kingdom, Netherlands, Italy, Spain and Belgium. The plan is to write two papers on the data collected in the study. The first focusing on the clinical burden of RSV in young children in primary care, including complications after an RSV episode and the second on the socio-economic burden, including costs, and population-based estimates of RSV infections in young children in primary care. The progress of the data collection for RSV ComNet III is reported in an infographic, which will be regularly updated.
• RSV circulation was disrupted during the winter of 2021/2022 due to the COVID-19 pandemic (Omicron variant). As a result, the target number of participants for RSV ComNet III was not met. RSV Data collection has therefore been extended to the winter of 2022/2023. The study was also expanded to a sixth European country in the winter of 2022/2023, namely France. The progress of the data collection for RSV ComNet III will continue to be reported in an infographic.

Latest update of the progress of the data collection for RSV ComNet III:

Infographics weekly updates

• 2023 | Infographic weekly update week 13
• 2023 | Infographic weekly update week 8
• 2023 | Infographic weekly update week 4
• 2023 | Infographic weekly update week 3  
• 2022 | Infographic weekly update week 51
• 2022 | Infographic weekly update week 49
• 2022 | Infographic weekly update week 18
• 2022 | Infographic weekly update week 13
• 2022 | Infographic weekly update week 9
• 2022 | Infographic weekly update week 5
• 2022 | Infographic weekly update week 3

• RSV ComNet II: Measuring the clinical and socio-economic disease burden of RSV infections in young children in primary care – winter 2020/2021
  The standardized disease burden protocol, developed in and updated after the evaluation in RSV ComNet I is shown below. The burden of RSV in young children will be measured in the Netherlands and the United Kingdom in the winter of 2020-2021. Both countries have chosen to use the infrastructure of the sentinel routine influenza surveillance network to recruit children for the RSV ComNet study. Data collection was extended over the summer because there was no RSV circulation in the winter of 2020/2021 due to the COVID-19 pandemic.

• RSV ComNet I: Development and evaluation of the standardized disease burden protocol to measure the clinical and socio-economic disease burden of RSV infections in young children in primary care – winter 2019/2020
  The focus of RSV ComNet I was to develop and evaluate a standardized disease burden protocol to measure the clinical and socio-economic disease burden of RSV infections in young children (<5 years) in primary care. The second aim was to evaluate whether the infrastructure of existing sentinel surveillance networks of general practitioners (GPs) or paediatricians are appropriate for patient recruitment. The standardized disease burden protocol was evaluated in the Netherlands and Italy during the 2019/2020 winter. The results of the RSV ComNet I study are summarized in the infographic Measuring the burden of RSV among young children in primary care. Results of the RSV ComNet pilot in Italy and the Netherlands and published in BMC infectious Diseases.

Flowchart: Disease Burden Protocol used in RSV ComNet II. Children can be selected via a network of pediatricians or GPs involved in the study or via a routine influenza surveillance network in primary care.

Impact of the COVID-19 pandemic

Due to the COVID-19 pandemic and the related non-pharmacological interventions (NPIs) there was hardly any RSV circulation in the winter of 2020/2021. This was also seen in in the winter of 2020 in countries in the Southern hemisphere, such as Australia and South Africa. Therefore, we have written a publication about the levels of RSV circulation in the winter of 2020/2021 in Europe, and the expectations for the coming summer and autumn/winter 2021/2022. This paper is published in Eurosurveillance. The main conclusions from this paper were that it is likely that the non-pharmaceutical interventions inhibited the RSV activity, especially the closure of schools and day-care facilities, and future RSV epidemic(s) could start outside the usual winter season and might be larger than usual.

COVID-19 vaccines are now available and every European country has launched a COVID-19 vaccination program. This led to the relaxation of the COVID-19 measures. Therefore, we expect the impact of the COVID-19 pandemic to be smaller in the 2021/2022 winter.

Sharing our research and results

We share our research and its results in providing access to the posters, oral presentations and scientific papers on the subject.

Publications

• 2022 | Disease burden of an RSV infection in young children in primary care in the Netherlands: period October 2020 – September 2021: results RSV ComNet II-study: the Netherlands. Summeren, J. van, Meijer, A., Moleman, Y., Hendriksen, J., Korevaar, J., Wijsman, L., Goderski, G., Hooiveld, M., Paget, J. Nivel: 2022
• 2021 | Evaluation of a standardised protocol to measure the disease burden of respiratory syncytial virus infection in young children in primary care. Summeren, J.J.G.T. van, Rizzo, C., Hooiveld, M., Korevaar, J.C., Hendriksen, J.M.T., Dückers, M.L.A., Loconsole, D., Chironna, M., Bangert, M., Demont, C., Meijer, A., Caini, S., Pandolfi, E., Paget, J. BMC Infectious Diseases: 2021(705)
• 2021 | 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? Summeren, J. van, Meijer, A., Aspelund, G., Casalegno, J.B., Erna, G., Hoang, U., Lina, B., Lusignan, S. de, Teirlinck, A.C., Paget, J. Eurosurveillance: 2021, 26(29)
• 2021 | ENGLISH SUMMARY IN ARTICLE: Very little RSV last winter, how can this be explained and what can we expect in the coming seasons?  (Dutch title: Weinig RS-virus afgelopen winter; hoe komt dit en wat zijn de verwachtingen voor de komende seizoenen?). Summeren, J.J.G.T. van, Hendriksen, J.M.T., Paget, J., Meijer, A. Tijdschrift voor Infectieziekten: 2021, 16(3), p. 80-85
• 2021 | Sars-Cov2 not detected in a pediatric population with acute respiratory infection in primary care in Central and Southern Italy from November 2019 to early March 2020. Rizzo, C., Loconsole, D., Pandolfi, E., Ciofi Degli Atti, M., Summeren, J. van, Paget, J., Russo, L., Campagna, I., Croci, I., Gesualdo, F., Concato, C., Linardos, G., Bartolucci, V., Ciampini, S., Onetti Muda, A., Raponi, M., Chironna, M. Frontiers in Pediatrics: 2021, 9, 620598

Poster presentations

• 2023 | Poster: Evaluating the disease burden of RSV infections in young children in primary care and emergency departments: A systematic literature review. Lotte van Heuvel, Susanne Heemskerk, Jojanneke van Summeren, Mathieu Bangert, Rolf Kramer, John Paget. 7th RESVINET Conference, 22-24 February, 2023.
• 2022 | Poster: Disease burden of RSV infections in young children in primary care: preliminary results from the RSV ComNet study in five European countries. Jojanneke van Summeren, Caterina Rizzo, Elisabetta Pandolfi, César García Vera, María Garcés Sánchez, Santiago Alfayate, Uy Hoang, Elizabeth Button, Simon de Lusignan, Danielle Strens, Marc Raes, Sarah Hak, Joanne Wildenbeest, Louis Bont, Rolf Kramer, Mathieu Bangert, Saverio Caini, Adam Meijer, John Paget. 12th RSV Symposium, 29 September – 2 October 2022
• 2021 | Poster: Measuring the clinical and socio-economic disease burden of RSV infections in young children in primary care in 5 European countries: The RSV ComNet study. Jojanneke van Summeren, Caterina Rizzo, Elisabetta Pandolfi, Uy Hoang, Simon de Lusignan, Louis Bont, Joanne Wildenbeest, Adam Meijer, Marc Raes, Danielle Strens, César García Vera, María Garces-Sanchez, Mathieu Bangert, Clarisse Demont, Saverio Caini, Michel Dückers, John Paget. 6^th RESVINET Conference, 10-12 November 2021.
• 2021 | Poster: RSV clinical burden and healthcare use in primary care in children aged less than five years in two Italian regions, 2019/20 winter season. Rizzo C, Loconsole D, Pandolfi E, van Summeren J, Paget J, Concato C, Onetti Muda A, Perno CF, Demont C, Ciofi degli Atti M, Raponi M, Chironna M. 6^th RESVINET Conference, 10-12 November 2021.
• 2020 | Poster: Measuring the burden of RSV among young children in primary care: Results of the RSV ComNet pilot in Italy and the Netherlands. Summeren JJGT van, Rizzo C, Hooiveld M, Korevaar J, Dückers M, Hendriksen J, Caini S, Bangert M, Demont C, Meijer A, Pandolfi E, Paget J. European Society for Paediatric Infectious Diseases (ESPID) virtual meeting, 26-29 October 2020

Oral presentations

• 2020 | Presentation: Disease burden of RSV in young children in primary care: RSV ComNet pilot study in Italy & the Netherlands. Summeren JJGT van, Rizzo C, Kwakkelstein S, Hooiveld M, Korevaar J, Dückers M, Hendriksen J, Caini S, Bangert M, Demont C, Meijer A, Pandolfi E, Paget J. European Scientific Working group on Influenza (ESWI) virtual meeting, 6-9 December 2020

Project partners

Their research is done in a collaboration between several partners:

• Overall coordination of the RSV ComNet project: Nivel, Utrecht, the Netherlands and National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands.
• Coordination and data collection in the Netherlands: Wilhelmina Children’s Hospital, University Medical Center Utrecht (UMCU), Utrecht the Netherlands
• Coordination and data collection in Italy: Bambino Gesù Children’s Hospital (OPBG), Rome, Italy and University of Pisa, Italy
• Coordination and data collection in the United Kingdom: University of Oxford, Nuffield Department of Primary Care Health Sciences, United Kingdom; Royal College of General Practitioners RCGP, United Kingdom
• Coordination and data collection in Spain: Asociación Española de Pediatría de Atención Primaria (AEP) and the Surveillance Network in Primary Care Pediatrics (PAP.en.Red), Spain
• Coordination and data collection in Belgium: Realidad, Grimbergen, Belgium
• Coordination and data collection in France: Centre d'Investigation Clinique, Hospices Civils de Lyon, France; Inserm, France

Funding

The RSV ComNet study was funded by Sanofi Pasteur and AstraZeneca. 

• Project activities were organized and planned in collaboration with Sanofi Pasteur, but all implementation work was done by Nivel and the country partners.
• Datasets are held by Nivel and the country partners and not shared with Sanofi Pasteur and AstraZeneca.
• Epidemiological analyses are completed in collaboration with Sanofi Pasteur, but all public health implications and conclusions are determined by Nivel and the country partners.

Want to know more?

For more information on this project, please feel free to get in touch with the Nivel expert(s) involved. You will find them on the right, together with the (future) Nivel deliverables (publications) and other relevant content. We look forward to getting in touch with you!