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“RSV is a very common infection in young children — almost everyone will be infected by age 2. In the United States, 2-3 percent of all infants infected with RSV will be hospitalized,” says Octavio Ramilo, MD, division chief of Infectious Diseases at Nationwide Children’s Hospital.

In fact, RSV — respiratory syncytial virus — is the most common cause of bronchiolitis and pneumonia in children younger than 1 year in the US, making it the most frequent reason for hospitalization in that age group. “When these babies get sick, they need oxygen and IV fluids. Around the world, hospitalization is often not an option,” says Dr. Ramilo. “Worldwide, RSV is the second leading cause of death in the first year of life after malaria.”

Dr. Ramilo is one of a team of investigators who are leading a major research effort directed toward two goals. First, to understand how the immune system responds to RSV, so that, second, they can develop a safe and effective vaccine against RSV.

The researchers — Dr. Ramilo, Mark Peeples, PhD, and Asuncion Mejias, MD, PhD, all principal investigators in the Center for Vaccines and Immunity at Nationwide Children’s — along with their teams and collaborators recently published two papers in The Journal of Infectious Diseases that break new ground in achieving those goals.

The first study investigated antibody levels in infants during acute RSV infection. The question was: Do maternal antibodies help to protect infants from more severe disease? The answer is important because if serum antibody levels are protective, attempts to boost or supplement these antibodies in infants would likely protect them from more severe RSV disease.

In the second study, the researchers correlated RSV genotypes to immune profiles and disease severity. The team found that infants infected with a specific RSV strain had higher viral loads in the upper respiratory tract, and that infection caused by that specific genotype was associated with greater clinical severity and a distinct host immune response.

Moving forward, the team is working towards a live attenuated RSV vaccine lacking these immunosuppressive effects. Such a vaccine would likely be given to a child at six months to one year of age. Read more about these studies here.