Background: Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children under 2 years, especially in low- and middle-income countries like India. The role of RSV in causing serious illness is frequently under-recognised. As a result, impact of RSV-related complications are often underestimated by both clinicians and the public. Aims: This study aims to assess the current awareness, diagnostic and management practices related to RSV and associated barriers, among Indian healthcare professionals (HCPs). This was followed by the development of expert-driven recommendations suited to the Indian context. Materials and Methods: A nationwide, expert-designed digital survey was conducted amongst Indian paediatricians and neonatologists from January to March 2025. The survey explored epidemiology, clinical burden, seasonal trends, diagnostic access, prophylaxis and cost implications of RSV infection. A comprehensive literature review supported the synthesis of evidence, and an expert consensus meeting to develop practice-oriented statements, providing clear, evidence-based guidance to improve clinical decision-making and patient care. Results: The survey captured insights from 80 clinicians, of whom 81% were affiliated with private institutions. Amongst these, the majority reported RSV prevalence in children under 2 years of age as 16%–30%. In addition, 60% of respondents indicated that RSV contributed to up to 20% of neonatal intensive care unit and paediatric intensive care unit admissions. Bronchiolitis was identified as the most common complication requiring hospitalisation, reported by 42% of respondents. About 61% of high-risk infants required extended hospitalisation for 5–10 days, and 86% required respiratory support. The cost per hospitalisation ranged from ₹30,000 to ₹60,000. Seasonal peaks in RSV cases were observed from October to March. While 52% of clinicians considered Indian patients comparable to Western cohorts in terms of phenotype, 63% of healthcare professionals viewed RSV as an unmet need in India and supported palivizumab use in high-risk infants. Conclusion: RSV poses a significant burden on high-risk children in India. This expert opinion recommends focused management strategies, including immunoprophylaxis and enhanced surveillance, to improve outcomes in this vulnerable population.
Saluja et al. (Sun,) studied this question.
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