RSV Prophylaxis – Canadian Paediatric Society

RSV – virus causing significant respiratory distress, oxygen requirements in high risk children. Can become complicated by respiratory failure, requiring ICU admission.

Season starts Nov-Dec and goes for another 4-5 months

Risk factors:
Aboriginal populations in northern communities

Palivizumab (monoclonal antibody) for RSV prophylaxis (not treatment):
5 doses 30 days apart
4 doses 38 days apart

reduced rate of hospitalizations

Little evidence to require it after the 1st year unless treatment still required three months before RSV season the second year of life.

Other preventative measures:
hand hygiene
no exposure to cigarette smoke

Recommendations regarding RSV prophylaxis:

Provide to eligible infants prior to discharge from hospital if within RSV season.

CLD/Hemodynamically significant CHD – if treatment required within the last 12 months

Not recommended to continue monthly RSV doses if breakthrough RSV infection occurs.

Not recommended for: children with immunodeficiencies, Down syndrome, cystic fibrosis, upper airway obstruction or a chronic pulmonary disease other than CLD. However, may be considered for children <2 years of age who are on home oxygen, have had a prolonged hospitalization for severe pulmonary disease or are severely immunocompromised.


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