Normalization of Seasonality and Age Distribution of Pediatric RSV Infection Following the Pandemic Disruption in the Netherlands - Report - MDSpire

Normalization of Seasonality and Age Distribution of Pediatric RSV Infection Following the Pandemic Disruption in the Netherlands

  • By

  • Neele Rave

  • Marit E M de Bruijne

  • Rebecca K Stellato

  • Michiel A G E Bannier

  • Daniel M Weinberger

  • Yvette N Löwensteyn

  • Joanne G Wildenbeest

  • Louis J Bont

  • on behalf of

  • the Surveillance of Pediatric REspiratory Admissions in Dutch hospitals (SPREAD) Study Group

  • Marlies Vermaas—van Putten

  • Elly Smit-Kleinlugtenbeld

  • Marieke Peetsold

  • Johannes B van Goudoever

  • Martijn van der Kuip

  • Celine Delhez

  • Robin Kloos

  • Sandy van Gool

  • Nicole de Kort

  • Yvonne Snepvangers

  • Anke Kuijpers

  • Negassi Menelik

  • Romy Wijnker

  • Stephanie de Crom

  • Carien Miedema

  • Jet van Giessen

  • Gavin ten Tusscher

  • Ronald de Moor

  • Mijke Breukels

  • Vincent Jaddoe

  • Rianne Oostenbrink

  • Edmond Rings

  • Jans Velzing

  • Claire Lutterman

  • Judith Vogelzang

  • Gerdien Tramper-Stranders

  • Ilka Vink

  • Annemarie Oudshoorn

  • Marloes Schipperheijn

  • Gerdien Dubbink-Verheij

  • Jeanette von Lindern

  • Mirjam Esser

  • Jantien Wieringa

  • Edwin Rietveld

  • Jolita Bekhof

  • Heleen Dingemanse

  • Laila van der Heijden

  • Emmeline Buddingh

  • Hilde Krom

  • Frank Smit

  • Deveney Wols

  • Michiel Bannier

  • Sophie Kienhorst

  • Rienus Doedens

  • Erwin Hassing

  • Lonneke van Onzenoort—Bokken

  • Marit van de Wiel

  • Ruud Meijneke

  • Tina Faber

  • Machteld van Scherpenzeel

  • Hilde Krom

  • Kaylee Elfring

  • Femke de Groof

  • Hilde Krom

  • Femke Hensen

  • Julia van der Zande

  • Stefanie Henriet

  • Nienke Sonneveld

  • Femke Jongenotter

  • Anne Teirlinck

  • Maaike van Rossem

  • Monique Jacobs

  • Marlies van Houten

  • Sjors Marijnen

  • Erwin Hassing

  • Frans Plötz

  • Andra de Vries

  • Petra Haarsma

  • Gieneke Gonera—de Jong

  • Amara Nassar—Sheikh Rashid

  • Roos van Rhijn

  • Károly Illy

  • Edward Wouters

  • Naomi Reijmerink

  • Stefan van Dorth

  • Nathalie de Bruijn

  • Saskia Schipper

  • Philippe Rosias

  • December 30, 2025

  • 0 min

Share

Restoration of Pediatric RSV Seasonality and Age Patterns Post-COVID in the Netherlands

Overview

The COVID-19 pandemic disrupted typical RSV epidemiology in Dutch children under two, causing an unusual off-season outbreak and increased median age at admission. By winter 2023/2024, RSV seasonality and age distribution largely returned to prepandemic norms, with no significant changes in comorbidities or disease severity.

Background

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections and hospitalizations in young children worldwide, typically peaking in winter months in the Netherlands. The COVID-19 pandemic and associated nonpharmaceutical interventions nearly eliminated RSV circulation during winter 2020/2021, followed by an atypical summer resurgence in 2021. Understanding shifts in RSV seasonality, age distribution, and clinical severity post-pandemic is critical for healthcare planning and intervention strategies.

Data Highlights

PeriodMedian Age at Admission (months)Interquartile Range (months)Significance
Pre-pandemic (2018–2020)2.21.1–5.6Reference
Summer outbreak (2021)4.91.8–11.4P < .05
Winter 2023/20242.71.3–8.0Not significant

Key Findings

  • RSV seasonality in the Netherlands reverted to the typical winter peak pattern by 2023/2024 after an unusual off-season summer outbreak in 2021.
  • The median age of RSV-positive hospitalized children increased significantly during the 2021 summer outbreak but returned to prepandemic levels by winter 2023/2024.
  • No significant differences were observed in the prevalence of preterm birth or comorbidities among RSV-positive children before, during, or after the COVID-19 pandemic.
  • The overall clinical severity, including intensive care admissions and need for mechanical ventilation, did not show consistent changes post-pandemic in this Dutch cohort.
  • A total of 8,457 RSV-positive cases were included from 47 hospitals, with detailed clinical data from 2,708 patients across 13 hospitals.

Clinical Implications

Clinicians and healthcare planners can anticipate a return to typical RSV seasonal patterns and age distributions in pediatric populations post-pandemic, facilitating more predictable resource allocation during winter RSV peaks. Continued surveillance remains essential to detect any future epidemiological shifts and to optimize timing for preventive interventions such as immunization.

Conclusion

The COVID-19 pandemic caused a temporary disruption in RSV epidemiology among young children in the Netherlands, but by 2023/2024, both seasonality and age distribution of RSV infections had largely normalized to prepandemic patterns. This underscores the resilience of RSV epidemiology and the importance of ongoing surveillance.

References

  1. Dutch National Institute for Public Health and the Environment (RIVM) Annual Report 2023/2024 -- Surveillance of Acute Respiratory Infections including RSV
  2. Original Study Authors, 2024 -- Restoration of Seasonal Patterns and Age Distribution of Pediatric RSV Infections in the Netherlands Post-Pandemic

Original Source(s)

Normalization of Seasonality and Age Distribution of Pediatric RSV Infection Following the Pandemic Disruption in the Netherlands

  • by Neele Rave, Marit E M de Bruijne, Rebecca K Stellato, Michiel A G E Bannier, Daniel M Weinberger, Yvette N Löwensteyn, Joanne G Wildenbeest, Louis J Bont, on behalf of, the Surveillance of Pediatric REspiratory Admissions in Dutch hospitals (SPREAD) Study Group, Marlies Vermaas—van Putten, Elly Smit-Kleinlugtenbeld, Marieke Peetsold, Johannes B van Goudoever, Martijn van der Kuip, Celine Delhez, Robin Kloos, Sandy van Gool, Nicole de Kort, Yvonne Snepvangers, Anke Kuijpers, Negassi Menelik, Romy Wijnker, Stephanie de Crom, Carien Miedema, Jet van Giessen, Gavin ten Tusscher, Ronald de Moor, Mijke Breukels, Vincent Jaddoe, Rianne Oostenbrink, Edmond Rings, Jans Velzing, Claire Lutterman, Judith Vogelzang, Gerdien Tramper-Stranders, Ilka Vink, Annemarie Oudshoorn, Marloes Schipperheijn, Gerdien Dubbink-Verheij, Jeanette von Lindern, Mirjam Esser, Jantien Wieringa, Edwin Rietveld, Jolita Bekhof, Heleen Dingemanse, Laila van der Heijden, Emmeline Buddingh, Hilde Krom, Frank Smit, Deveney Wols, Michiel Bannier, Sophie Kienhorst, Rienus Doedens, Erwin Hassing, Lonneke van Onzenoort—Bokken, Marit van de Wiel, Ruud Meijneke, Tina Faber, Machteld van Scherpenzeel, Hilde Krom, Kaylee Elfring, Femke de Groof, Hilde Krom, Femke Hensen, Julia van der Zande, Stefanie Henriet, Nienke Sonneveld, Femke Jongenotter, Anne Teirlinck, Maaike van Rossem, Monique Jacobs, Marlies van Houten, Sjors Marijnen, Erwin Hassing, Frans Plötz, Andra de Vries, Petra Haarsma, Gieneke Gonera—de Jong, Amara Nassar—Sheikh Rashid, Roos van Rhijn, Károly Illy, Edward Wouters, Naomi Reijmerink, Stefan van Dorth, Nathalie de Bruijn, Saskia Schipper, Philippe Rosias

  • December 30, 2025

Related Content

Long-term epidemiological patterns of pediatric infectious diseases in an urban district of Shanghai, 2015–2023

Recent COVID-19 Shot Linked to Less Spread

Protection against spread appeared strongest within 6 months of vaccination, while exposed vaccinated contacts showed no measurable reduction in infection risk.

Acute liver failure and secondary TMA-like phenomenon following SARS-CoV-2 and Mycoplasma pneumoniae co-detection in a child: a case report