Nationwide survey of severe respiratory syncytial virus infection in children who do not meet indications for palivizumab in Japan.

In Japan, palivizumab, a humanized monoclonal antibody specific for respiratory syncytial virus (RSV), has been available since 2002. However, its use is limited to children at risk of severe RSV infection, with specific criteria that have been validated in large-scale clinical studies. The Pharmaceutical Committee of the Japan Pediatric Society established a committee to conduct a nationwide questionnaire survey to determine which diseases place children at risk of severe RSV infection and require preventive measures. A questionnaire sent to 613 medical institutions, including major pediatric hospitals and general hospitals with pediatric services, received 272 responses (44.4%). In total, 1,115 children not meeting current indications for palivizumab therapy were hospitalized for severe RSV infection, 16 (1.4%) of whom died; this suggests that palivizumab therapy should be considered for children with severe immunodeficiency or those at risk of nosocomial RSV infection in whom prevention of RSV infection by standard control measures appears difficult.