Seroepidemiology of respiratory syncytial virus in western India with special reference to appropriate age for infant vaccination

Abstract

Respiratory syncytial virus (RSV) causes significant infant mortality worldwide and a vaccine may be available soon. This study determined age-stratified anti-RSV antibody positivity (enzyme-linked immunosorbent assay [ELISA]) at Pune, India (cord blood-85 years). Antibody positivity declined from 100% at birth to 71.3%(3 months), and 0.7% (6 months). A significant rise was noted at 15 months (16%), 16to 24 months (64.5%) and 4 years (95.2%) with concomitant IgM-anti-RSV positivity indicative of recent infection. Antibody decline was higher in infants born preterm than full-term. Across subsequent age groups including the elderly, antibody positivity was similar and comparable, suggestive of repeated exposure to the virus.Early protection/vaccination is essential for the infant population. K E Y W O R D Santibody prevalence, maternal antibodies, preterm/full-term infants, respiratory syncytial virus

Disease Burden Due to Respiratory Syncytial Virus in Indian Pediatric Population: A Literature Review

“…Anti-RSV antibodies were more in adult population because of prior exposure to RSV. 45 , 46 Percentage of population reported positive for anti-RSV antibodies is presented in Table 6 .…”

“… 49 Considering significant prevalence of RSV in Indian children there is a need to provide effective interventions for the prevention of RSV which require understanding of current dynamics of maternal anti-RSV antibodies, so that necessary preventive measures can be planned and executed. Serological data in the study conducted by Arankalle et al 46 revealed that, approximately 30% of infants by the age of 3 months and almost the entire infant population by the age of 6 months is devoid of anti-RSV antibodies which indicates that children (0-6 months) need early protection with the vaccine-induced immune response. Furthermore, it is suggested that below mentioned 3 target populations would be the appropriate age groups for vaccination.…”

“…• • Pregnant women to protect newborns both by transplacental transfer of antibodies and by blocking transmission • • Infants (<6 months of age) who have the highest risk of severe disease • • Children >6 months of age to prevent disease in them and reduce potential transmission to younger children Neutralizing antibody titers of greater than or equal to 1:64 and greater than or equal to 1:256 for hRSV-A and hRSV-B respectively, were shown to be protective in relation to RSV-associated hospitalizations. 46 Currently, monoclonal antibodies and antiviral medications are available for the prevention and treatment of RSV infections which were reported to be expensive and thus, reserved for high risk infants, mainly in high income countries. It has been estimated that the cost of prophylaxis with monoclonal antibodies and treatment with antivirals would be more than 10 times the actual cost of longer hospitalization in untreated patients and this magnitude is likely to be much more in India.…”

“…Neutralizing antibody titers of greater than or equal to 1:64 and greater than or equal to 1:256 for hRSV-A and hRSV-B respectively, were shown to be protective in relation to RSV-associated hospitalizations. 46 Currently, monoclonal antibodies and antiviral medications are available for the prevention and treatment of RSV infections which were reported to be expensive and thus, reserved for high risk infants, mainly in high income countries.…”

Evaluation of respiratory syncytial virus IgG antibody dynamics in mother-infant pairs cohort

“…All blood samples we collected at sixth month had negative anti-RSV Ig G antibody levels. Arankalle et al [19] found that only 0.7% of babies who were all positive for RSV antibodies at birth were positive for anti-RSV antibodies at the sixth month. In another study, the infants' anti-RSV IgG antibody positivity rate at sixth month was reported as 16% [20].…”