Influenza

WHO Global Respiratory Syncytial Virus Surveillance

WHO Meeting to Launch Phase-2 of the RSV Surveillance Pilot

The pilot phase demonstrated the feasibility of leveraging GISRS for RSV surveillance with marginal incremental costs and without any significant adverse impact on influenza surveillance. With support from the Bill & Melinda Gates Foundation, the WHO RSV surveillance has been extended for 3 years till 2021 with additional Gavi-eligible low- and middle-income countries showing an interest in joining the next phase of the RSV surveillance.

The launch of the extension phase is scheduled at a meeting (10 -12 April 2019) in Kathmandu, Nepal.

Smiling baby in Brazil
WHO/Anna Kari

Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization due to acute lower respiratory infection especially in infants and young children. Currently available options (Palivizumab) for preventing and treating RSV are limited to select populations in high-resource settings. Fortunately, several vaccine candidates are now in the human testing phase targeting young children, older adults and pregnant women, and an effective safe vaccine is likely to be available in the near future.

Several countries test for RSV as part of influenza and other respiratory virus surveillance. Important challenges to be addressed include the need for global standardization of virologic and epidemiological surveillance and the review of criteria for a RSV case definition. Addressing these challenges will enable improved identification of RSV infection especially in infants and young children.

The WHO Global Influenza Programme with support from the Bill & Melinda Gates Foundation, piloted a RSV surveillance strategy Phase I based on the Global Influenza Surveillance and Response System (GISRS) in 14 countries in order to standardized RSV surveillance and provide evidence to support Public Health and to inform RSV vaccination policy. The Pilot Phase I was supported by 4 RSV Reference Laboratories and the International Reagent Resource (IRR) of the Centers for Disease Control and Prevention, USA.

WHO RSV Surveillance Strategy Outcomes of Phase I

WHO RSV strategic guidance

The outcomes of the two-year WHO RSV Surveillance pilot project based on the GISRS were reviewed in a meeting in Bangkok in October 2018. These outcomes included the following key points.

- The feasibility of leveraging GISRS for RSV surveillance with marginal incremental costs and without any significant adverse impact on influenza surveillance was confirmed.

- Molecular real-time RT PCR detection of RSV was standardized in pilot countries.

- The pilot phase generated evidence on seasonality, high burden in children less than two years, the performance of the extended SARI and ARI case definitions for RSV and extension of surveillance to pediatric sentinel sites provided additional benefits for influenza surveillance.

- With support from the Bill & Melinda Gates Foundation, the WHO RSV surveillance has been extended for 3 years until 2021 as Phase II. Based on the outcomes of Phase I, the Phase II strategy aims to strengthen RSV surveillance at younger ages, estimation of burden of severe RSV disease and extend laboratory surveillance to include molecular typing and genetic characterization of RSV isolates.

- WHO GIP and GISRS congratulates Phase 1 countries and welcomes the addition of eight Gavi-eligible low- and middle-income countries to Phase II of the WHO Global RSV surveillance.

- Phase II of the WHO Global RSV Surveillance is scheduled to be launched at a meeting in Kathmandu, Nepal on the 10 -12 April 2019.

Note: Publication of Phase II strategy in progress