Respiratory Syncytial Virus (RSV) might sound like a complicated medical term, but for millions of families across the globe, especially in India, it’s become a harsh and deadly reality. Though often mistaken for a seasonal cold, RSV is the leading cause of lower respiratory tract infections in children under five—and it’s killing thousands.Each year, RSV is linked to approximately 3.6 million hospitalisations and nearly 100,000 deaths in children under five. India, with its annual birth cohort of over 25 million, contributes significantly to this global burden. In 2024 alone, 2,360 infant deaths in just three cities—Bengaluru, Kolkata, and Mumbai—were reported as RSV-related and experts believe this is only the tip of the iceberg.Respiratory Syncytial Virus (RSV) is a highly contagious virus that infects the respiratory tract, particularly affecting the nose, throat, lungs, and breathing passages. It spreads through droplets from an infected person via coughing, sneezing, or even kissing. Contaminated surfaces like cribs, toys, or door handles can also carry the virus for hours.RSV is so widespread that almost every child is infected by it at least once by the age of two. While it might look like a regular cold in some cases, in many infants, RSV progresses rapidly into bronchiolitis or pneumonia—both of which can be life-threatening.Shockingly, around 80% of children under two who are hospitalised with RSV have no prior risk factors. Which means even full-term, healthy infants are at risk.Why Is RSV So Underdiagnosed in India?Despite being a notifiable disease in India for nearly five decades, RSV is severely under-tested. Dr. Vasant M. Khalatkar, National President of the IAP, pointed out that RSV testing in India often happens only when a full-blown outbreak occurs—like the one seen in Kolkata earlier this year.“People still treat it as a bad cold,” Dr. Khalatkar said at a Bengaluru roundtable on RSV. “But for infants, RSV can escalate within three days from mild symptoms to severe respiratory complications that demand hospitalisation, oxygen support, or ventilation.”A lack of awareness among caregivers and healthcare providers, combined with limited diagnostic access, has created a dangerous information gap—one that continues to cost young lives.RSV Is the Leading Cause of Pediatric Respiratory Illness in IndiaDr. Bhavesh Kotak, Head of Medical Affairs at Dr Reddy’s, underscored that RSV accounts for 63% of all acute respiratory infections in young children, citing WHO-backed data. In India, this means a significant share of childhood respiratory hospitalisations are linked to RSV, especially during monsoon and early winter months.RSV doesn’t discriminate—children from all socio-economic backgrounds, including those born full-term, are frequently hospitalised. Unlike in high-income countries that have early preventive care and widespread immunisation, India still struggles with timely diagnosis and access to life-saving tools.The most promising development in the fight against RSV is the introduction of long-acting monoclonal antibodies (mAbs) and maternal vaccines—both backed by WHO and CDC guidelines.Palivizumab, available for several years, has been used in high-risk infants but requires monthly doses throughout the RSV season.Nirsevimab, a new and highly effective long-acting antibody, offers season-long protection with a single dose and is now being rolled out globally, including in India.Additionally, the WHO recommends maternal vaccination with Abrysvo® during weeks 32–36 of pregnancy to protect babies after birth. This approach helps infants develop passive immunity and dramatically lowers their risk of severe RSV disease.Dr. Khalatkar emphasised that immunisation—when paired with awareness and access—can significantly reduce RSV-related hospitalisations and deaths.Is This Crisis Preventable?Let’s break this down: India has 25 million newborns annually. Without preventive strategies, even a small percentage developing severe RSV means hundreds of thousands of hospitalisations and thousands of avoidable deaths. Unlike high-income countries, India faces several hurdles:Low RSV awareness among parents and healthcare providersInfrequent diagnostic testingLimited access to immunisation optionsLack of inclusion of RSV immunisation in national programsThis gap is precisely where action is most needed.Global Agencies Push for ImmunisationAccording to the Centers for Disease Control and Prevention (CDC), RSV is the leading cause of hospitalisation in U.S. children under one year. RSV also causes 100,000–160,000 hospitalisations annually in U.S. adults aged 60 and older. The CDC recommends:One-time RSV vaccination for adults 75+ and those aged 60–74 with chronic conditionsMaternal RSV vaccine for pregnant women during the third trimesterNirsevimab injection for babies born during or just before RSV season (October to March)If adopted effectively in India, similar immunisation protocols could transform RSV management—especially for the first 6 months of an infant’s life, when vulnerability is highest.Simple precautions like handwashing, covering coughs, and disinfecting surfaces are useful but insufficient in high-burden, high-transmission environments—particularly for babies under 12 months. Experts unanimously agree that preventive immunisation is the game-changer.WHO’s Dr. Kate O’Brien summed it up clearly: “The RSV immunisation products can transform the fight against severe RSV disease, dramatically reduce hospitalisations and deaths, and save many infant lives globally.”RSV is no longer a vague acronym in pediatric medicine—it’s a clear and present danger to child health in India and worldwide. And while developed nations have made strides in RSV prevention, India remains at a critical crossroad.