These are the highest levels of emergency room visits and hospitalizations for ten years in France. The bronchiolitis epidemic is sweeping through bloodless pediatric wards, short of staff and therefore of capacity to accommodate infants. If different viruses can be the cause of this obstruction of the bronchioles, the narrowest ramifications of the respiratory system, the main culprit is known: the respiratory syncytial virus (RSV).
Highly contagious, this virus affects around 64 million people worldwide every year, with a high risk of hospitalization for children under 1 year old and the elderly. About 160,000 die of it each year, three-quarters of children under 5, according to a study published in May in The Lancet. In France, the mortality rate is less than 1%, i.e. several dozen deaths per year.
This RNA virus from the pneumovirus family was identified for the first time in a child in 1957. Despite everything, for sixty years, relatively few treatments have been developed and management remains above all symptomatic: cleaning the nose, fever medication, hydration, ventilation and intubation in the most severe cases. “Given that it is a winter epidemic which has a significant health impact, it is surprising that we have never launched a strategy targeting all newborns in the winter period”underlines Pierre Tissières, head of the pediatric intensive care unit at Bicêtre hospital, at Kremlin-Bicêtre (Val-de-Marne).
But many manufacturers are working on therapeutic strategies that could change the face of future epidemics by reducing the number of children to be admitted to hospital. Thirty-three RSV preventive treatments are in clinical development, nine of which are in advanced stages. On Friday November 4, the Sanofi and AstraZeneca laboratories announced that the European Commission had approved their monoclonal antibody, nirsevimab, sold under the name Beyfortus.
Clinical tests
It is a synthetic antibody treatment to be injected into infants to provide them with direct weapons to fight against the virus. This is called passive immunization, unlike vaccines, which teach the body to make antibodies itself. “It is the most attractive strategy for newborns, because there are few side effects”, notes Marie-Anne Rameix-Welti, virologist at the Ambroise-Paré hospital in Paris. In addition, this makes it possible to establish protection more quickly than with a vaccine.
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