Respiratory syncytial virus (RSV), a pathogen known for causing respiratory tract infections, is the second cause of death after malaria after the neonatal period. The course of these infections is mostly mild. However, in vulnerable patients groups RSV infections may cause severe symptoms and even death. Acute lower respiratory tract infections in young children are notorious. In children aged younger than 5 years, these infections are an important cause of death. Among these young children, the global RSV mortality is 55.000 to 199.000 deaths a year.


As RSV infections are a major health burden, research is being conducted into prevention strategies. Development of a vaccine against respiratory syncytial virus is a global health priority. Two approaches to RSV immunisation are being considered in young children: (1) maternal immunisation and (2) paediatric immunisation. Effectiveness of the preventive measures is particularly relevant to the patient population at risk of unfavourable course of RSV infections. Therefore, a better understanding of children at high risk of life-threatening RSV infection is vital. The RSV GOLD project aims to characterize this population of young children who die with RSV infection.

Characteristics of interest

Knowledge of characteristics of children dying with RSV infection will contribute to the development of an evidence base to inform vaccine policy. Such characteristics include age distribution, World Bank Income status and more. Age is relevant, as the target population for maternal immunisation is young infants (typically younger than 6 months) and the target population for paediatric vaccines is children with sufficiently mature immune systems (generally older than 6 months). Distribution of World Bank Income status may give insight into risk factors for RSV-related childhood mortality, for instance limited access to medical care.

Relevance of a Global Registry

Although RSV-related mortality in children poses an important global health problem, clinical data are scarce. Previous reports of RSV-related mortality in young children described studies done in one centre, region, or country. None of them were large enough to draw robust conclusions on the clinical and socioeconomic profile of children who die with RSV infection globally. Moreover, most studies have been performed in high-income countries, whilst 99% of RSV-related deaths in young children occur in low- and middle-income countries. In order to fill this knowledge gap, the RSV GOLD project was initiated to create a global online database of respiratory syncytial virus-associated mortality in young children.