Respiratory syncytial virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Although it can affect anyone, RSV is generally considered as the most frequent cause of lower respiratory tract infections in infants and young children. Each year about 125,000 infants are hospitalized with RSV in the United States. For more information on this infection, please visit: http://www.cdc.gov/rsv/.
2016-17 Prophylaxis Guidelines for Texas
The Texas Pediatric Society (TPS), the Texas Chapter of the American Academy of Pediatrics (AAP), Committee on Infectious Diseases and Immunizations and the Department of State Health Services (DSHS) Emerging Acute Infectious Disease Branch (EAIDB) have been gathering data on the timing of the RSV season in Texas since 2001. Using data from the 2001-2015 RSV seasons submitted by providers and healthcare facility laboratories to the CDC NREVSS program, gathered and presented by EAIDB in support of ongoing activities by TPS, we have analyzed the RSV season across the state by Public Health (PH) Regions. The number of RSV antigen tests and the number of positive, and the percent positive were gathered by ISO week number and by PH regions for each and cumulatively for all of these RSV seasons. Standard CDC definitions for the onset and end of RSV season were applied to the cumulative data. The RSV season in Texas varies regionally. Based on 14 years of data, the start of the RSV season for the Coastal, Central, and Southern Regions is usually in October, and the end of the season is sometime from late January to mid-March. For the Northern and Western Regions the onset is usually in November, and the end of the season is usually sometime in March to mid-April. Based on this analysis, we offer these dates for the timing of RSV prophylaxis in hopes of optimizing protection for high risk infants in Texas:
- Upper Coastal TX- Regions 5, 6,- October 1st to February 28th
- Central, and Lower South TX- Regions 7 , 11 -October 15th to March 14th
- Northeast and Upper South TX- Regions 3, 4, 8- November 1st to March 31st
- Far North and West TX- Regions 1, 2, 9, 10 – November 15th to April 14th
These recommendations have changed from last year, now using 4 groups instead of 2 to better match differences regionally in onset and end of season. Region 8 has moved from an early to a later based on current data. To view a map of the regions and counties, please click here. Astute physicians and providers should be allowed to utilize their local experience and local RSV epidemiology data to time the start of prophylaxis in their area, and may be more efficient in utilization of resources with this. They should be allowed access to a similar duration of prophylaxis as their peers who use set start and stop dates. There is good protection from RSV for more than 4 weeks after the last dose of prophylaxis for infants who have received 2 or more doses. The timing of RSV infection varies locally, regionally, and annually. This statement and other advice on the timing of RSV prophylaxis may be incorrect at times. The TPS endorses the use of the new 2014 AAP guidelines on the prevention of RSV in high risk infants and children.
This data was gathered with support from the CDC, DSHS, Johnathan Ledbetter, MPH, and the TPS Committee on Infectious Diseases and Immunizations and RSV Taskforce.
Please direct questions or suggestions to Donald Murphey, MD, Dell Children’s Medical Center, firstname.lastname@example.org, 512-628-1820, or Rachel Jew, Texas Pediatric Society, email@example.com, 512-370-1516.