my article on childhood viral respiratory diseases is now out @RoyalSocBiorsb.org.uk/biologist-feat… (delighted to be sandwiched in between a piece on oxylipins and another on latent lepidopterans)🧵
I look at why lockdown wasn't associated with a decrease in childhood deaths, despite a fall in infections
with RSV vaccines on the horizon, and a massive research infrastructure in place for SARS-CoV-2 eurosurveillance.org/content/10.280…
we should leverage this once/if we ever work out how to live with COVID-19
and work out how to make the two current most common diagnoses of infancy and early childhood, bronchiolitis and viral wheeze, diseases of the past polioeradication.org/polio-today/hi… (END)
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the #BronchSTART study dashboard beta.microreact.org/project/cTkH24… already contains a huge amount of data
and you can see that there have been unusual regional variations in the RSV season this year 🧵 1/n
normally the RSV season starts in the urban centres of the NW of England and London at around the same time thorax.bmj.com/content/75/3/2… and spreads to the rest of the country in the following 3 weeks 2/n
this year, like in previous ones, RSV did start (early? late?) in the urban centres of the NW of England and peaked at epidemiological week 30 3/n
a few months ago, a group of us, reading reports of unusual patterns of RSV circulation in Australia (a "winter in summer" ncbi.nlm.nih.gov/pmc/articles/P…)
wondered whether the same might happen this year in the United Kingdom and Ireland 🧵1/n
the premise was simple: could we use a simple online questionnaire, collecting only non-patient identifiable information,
to better understand the geographical dynamics and clinical manifestations of RSV circulation in 2021/22?
It turns out we can 2/n
thanks to BronchSTART, a study powered by hundreds of clinicians in Emergency Departments, working as part of the PERUKI Network, we can now watch this year's RSV epidemic play out in real time 3/n
a lot of interest in my thread describing the impact of RSV this year on infants and children in the UK
and questions about whether children are more at risk from RSV or COVID-19 (new🧵) 1/n
RSV (respiratory syncytial virus) is an RNA virus that causes upper and lower respiratory tract infections in children
our recently published review in Vaccine pubmed.ncbi.nlm.nih.gov/33895016/ gives an in-depth introduction to the epidemiology and virology 2/n
In the average year many thousands of children across the UK develop RSV infection: in 2016 there were 36,028 admissions for children <5 in England thorax.bmj.com/content/thorax…@PHardelid with around ~700 intensive care admissions 3/n
just finished nights on call, and found that a toxic triad of RSV, rhinovirus and SARS-CoV-2 is starting to stretch the Scottish hospital I work in to its limits
it's only August
what went wrong? 🧵1/n
Problem 1. We failed to contain SARS-CoV-2. 2/n
This is a Problem for 3 reasons.
Firstly, there are the (very) small number of children with serious SARS-CoV-2 infection. 3/n
in a typical year in England, there are ~36,000 admissions for bronchiolitis (mainly caused by Respiratory Syncytial Virus, RSV) in infants under the age of 1 thorax.bmj.com/content/75/3/2… 3/n
firstly: why should we vaccinate?
-to protect children, who can (rarely) develop severe disease, require hospitalisation, and (very rarely) die
-to protect vulnerable individuals who have contact with children
-to achieve herd immunity: 21% of UK population aged under 18 2/n
secondly, what do we need to vaccinate children?
-a vaccine that robustly protects against severe disease AND prevents transmission
-robust safety data, including paediatric-focused studies & post-licensure monitoring for potential rare outcomes like vaccine-associated MIS-C 3/n