- AAP Interim Guidance for Use of Palivizumab Prophylaxis (9/23/2021)
- Updated AAP Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus
- AAP Guidance on the Prevention of RSV in High Risk Infants (from Red Book)
- RSV Information for Healthcare Professionals (CDC)
RSV in Texas
RSV: The Texas Pediatric Society Infectious Diseases Committee is pleased to provide updated information on respiratory viral surveillance in children in our state.
Per Texas DSHS RSV website “Individual cases of RSV are not reportable by law in Texas.RSV data are reported voluntarily by sentinel Texas laboratories on a weekly basis through the National Respiratory and Enteric Virus Surveillance System (NREVSS) sponsored by the Centers for Disease Control and Prevention (CDC). Sentinel providers report both the number of RSV tests performed and the number of positive tests detected on a weekly basis.”
RSV activity is shown by Texas DSHS as number of tests performed, number of tests positive, and the percent of tests positive at https://www.dshs.texas.gov/IDCU/disease/rsv/Data/. A line indicates a cutoff of 3% for the percent positive RSV PCR tests. The definition of the start of the RSV season is the first of 2 consecutive weeks with ≥3% positive RSV PCR tests.
Historically, this information was submitted by an increasing number of clinical microbiology labs that serve large numbers of children in different regions around the state. This began as a voluntary unfunded program with the Centers for Disease Control, Texas Department of State Health Services, and the Texas Pediatric Society with 8 labs representing larger pediatric centers around the state. It expanded with the addition of many more hospital laboratories with some support from MedImmune, via SDI. All of this data was combined at the CDC, in the NREVSS database. It was returned to Texas to clean up and present. The sites were grouped into regions and the data from those areas are combined. A list of the current sites and their grouping was provided. This was done for several years by Diana Newton and Dr. Don Murphey at Cook Children’s Medical Center in Fort Worth.
Elise Huebner, MS, CPH, CIC, currently serves as the acting RSV/Flu Surveillance Coordinator at Texas DSHS in Austin. The Texas RSV task force chaired by Dr. Manjusha Gaglani and includes some of the TPS Infectious Disease Committee members. If you have questions, please contact Dr. Gaglani at Manjusha.Gaglani@bswhealth.org or call 254-935-5047. (Updated 7/15/2021).
Season Updates for Texas
HHSC Updates Respiratory Syncytial Virus (RSV) Season Schedule (Sept. 30, 2021) RSV Season schedule has been updated to reflect the end of the summer season and the beginning of the traditional 2021-2022 season. HHSC requires prescribing providers reassess the need for RSV prophylaxis beginning Oct. 1, 2021. A new prior authorization is required for clients who continue to meet the criteria for treatment with Synagis during the traditional season.
2021- 22 RSV Assessment and Synagis Authorization (Sept. 7, 2021) Beginning October 1, 2021, providers will be required to re-assess the need for prophylaxis therapy. Providers must request a new prior authorization and, if approved, members will be eligible for up to 5 monthly doses of Synagis. The fall and winter season schedule can be found here. Instructions for obtaining prior authorization for people enrolled in Medicaid and CHIP managed care, traditional Medicaid, and the CSHCN Services program can be found here.
Respiratory Syncytial Virus and Synagis Authorization During Summer and Winter 2021-22 (Aug. 25, 2021) Due to the summertime resurgence of RSV, HHSC began opening DSHS regions gradually between June 21- July 23. All children who meet prior authorization criteria will eligible for up to 5 monthly doses of Synagis. Children who received Synagis will require reassessment when the traditional 2021-2022 RSV season begins on October 1, 2021. This is considered a separate season from the summer season.
Atypical Respiratory Syncytial Virus (RSV) Season Advisory (July 21, 2021) HHSC news release on the unprecedented summertime resurgence of RSV activity. On July 23, 2021, HHSC opened all DSHS regions, and providers may start monthly Palivizumab (Synagis) injections for RSV prophylaxis for clients who meet clinical criteria. This reopening is considered the start of a new RSV season, separate from the regular 2020-21 RSV season. When this announcement was released, clients who meet the prior authorization criteria qualify for up to 5 monthly shots of Palivizumab (Synagis).
HHSC to Reopen RSV Season in Select Regions - HHSC reopened the RSV season for certain regions on June 21, 2021. Providers may start monthly palivizumab (Synagis) prophylaxis treatment for all eligible clients beginning on the dates shown below:
Please direct questions or suggestions to Dr. Gaglani, MBBS, FAAP, FIDSA, FPIDS, McLane Children’s Baylor Scott & White Health who co-chairs the TPS Infectious Disease and Immunizations Committee and leads the TPS RSV Task Force at Manjusha.Gaglani@bswhealth.org or call 254-935-5047, or Alix Bronner, Texas Pediatric Society, firstname.lastname@example.org, 512-370-1509.