Managing Respiratory Syncytial Virus
We are seeing an increase in the number of children with RSV and expect these numbers to continue to grow as large numbers of children are exposed to viruses that they have not yet experienced.
NHS England has been planning for a potential rise in paediatric respiratory infections since April 2021, with paediatric units bringing forward their usual winter planning, escalation and emergency processes which will support an increased capacity in terms of beds, workforce and ward supplies.
As part of NHS preparedness and in response to summer case detections by PHE surveillance, the offer of the preventative medicine palivizumab has been brought forward from the usual October start date and the number of doses has been extended from 5 to 7.
Palivizumab will also be offered to a young children who are at the highest risk of complications from RSV, reducing the risk of hospitalisation in those most vulnerable.
PHE has also extended its surveillance system to ensure early signals of respiratory illnesses are being reported from a sample of NHS trusts. This usually ends in May and resumes in October, but will now continue into the summer months.
Public Health England (PHE) modelling on the impact of an increase in cases of RSV this season is work in progress however, it has listed three possible scenarios with the first listed being most likely and the third least likely.
- An earlier outbreak with 20-50% increase in total number of RSV cases / admissions.
- A normal or quieter than normal RSV season (particularly if Non-Pharmaceutical Interventions are maintained).
- Larger outbreak with 100% increase in total number of RSV cases / admissions.
Actions for health professionals
We all have a part to play in caring for children who present with RSV effectively and helping to educate parents on how to be confident about caring for their unwell child. Please make sure that you:
- understand the symptoms and point parents to our resource page on how to care for an unwell child
- are aware of the pathways for escalation
- have the paediatric hotline numbers to hand and seek advice where needed
- sign up to the e-Learning programme to enhance your skills and ability to provide care through and beyond the respiratory surge
- Bronchiolitis pathway for GPs using Whipps Cross
- Bronchiolitis pathway for GPs using Newham Hospital
- Bronchiolitis pathway for GPs in Tower Hamlets
- Bronchiolitis pathway for GPs using Barking, Havering and Redbridge University Hospitals
- Gov.uk guidance on RSV symptoms, transmission, prevention and treatment
- Gov.uk respiratory syncytial virus (RSV): guidance, data and analysis
- Bronchiolitis pathway for primary care and community settings
- RCPCH National guidance for the management of children with bronchiolitis
- RCPCH Bronchiolitis flow chart
- The Medical Device Training team organise and provide training on a wide range of medical devices and equipment used in Barts Health serving North East London. You can access training resources for a number of devices used in the Trust, including user manuals, competency forms and training videos - simply click on the name of the device. For medical devices and equipment used at BHRUT and Homerton please contact your local Medical Device Training team.
- FAQs for GPs on managing fever in children
- Video on safety netting for bronchiolitis - this safety net guide is for mild bronchiolitis. This primer relies on a reasonable level of diagnostic certainty – not absolute certainty – but enough clarity to be confident in assigning the diagnosis
- Bronchiolitis for primary care (7mins)
- More than just a snuffly nose – Bronchiolitis (the first part is for GPs)
- How to spot a sick child (9mins)
- Package of new resources from e-learning for health for the predicted respiratory surge
- NICE guidance
- Royal College of paediatrics and child health management for Bronchiolitis