Respiratory syncytial virus (RSV) infection is generally self-limiting and resolves in 10-14 days.
Previously healthy infants who develop RSV bronchiolitis do not typically require hospitalisation, and most who are hospitalised improve with supportive care and are discharged after 2 or 3 days. However, approximately 1% to 3% of all children in the first 12 months of life will be hospitalised because of severe RSV lower respiratory tract disease, with the highest rate of RSV hospitalisations occurring in the first 6 months of life.[8]Committee on Infectious Diseases; American Academy of Pediatrics. Red book. 32nd ed. Elk Grove Village, IL: AAP; 2021.
https://publications.aap.org/aapbooks/book/663/Red-Book-2021-Report-of-the-Committee-on
Worldwide, 1 out of every 200 infants is admitted to the hospital for RSV each year.[22]Shi T, McAllister DA, O'Brien KL, et al; RSV Global Epidemiology Network. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017 Sep 2;390(10098):946-58.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592248
http://www.ncbi.nlm.nih.gov/pubmed/28689664?tool=bestpractice.com
[145]Scheltema NM, Gentile A, Lucion F, et al. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. Lancet Glob Health. 2017 Oct;5(10):e984-91.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599304
http://www.ncbi.nlm.nih.gov/pubmed/28911764?tool=bestpractice.com
In the US, 2% to 5% of infants admitted to hospital with bronchiolitis require mechanical ventilation but mortality is low (estimated to be <0.1%).[146]Fujiogi M, Goto T, Yasunaga H, et al. Trends in bronchiolitis hospitalizations in the United States: 2000-2016. Pediatrics. 2019 Dec;144(6):e20192614.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889950
http://www.ncbi.nlm.nih.gov/pubmed/31699829?tool=bestpractice.com
In developing countries, with limited access to advanced respiratory support, in-hospital case fatality rates are estimated to be approximately 1% with the total number of infant deaths exceeding 20,000 infants per year.