Seasonal Pediatric Infectious Diseases: Post Pandemic Epidemiology, RSV and Influenza Burden, and Evidence Based Management and Prevention
Keywords:
pediatric seasonal diseases, RSV, influenza, bronchiolitis, antibiotic stewardship, nirsevimab, immunity debt, AOM, rotavirus, HFMDAbstract
Seasonal infectious diseases remain a leading cause of morbidity, hospitalization, and antimicrobial overuse in the pediatric population worldwide. Respiratory syncytial virus (RSV), influenza, rotavirus gastroenteritis, hand-foot-and-mouth disease (HFMD), acute otitis media (AOM), and viral pneumonia collectively account for the majority of emergency department visits and inpatient admissions in children under five years of age. The COVID-19 pandemic and its associated non-pharmaceutical interventions significantly disrupted the seasonal patterns of these pathogens, creating an "immunity debt" that contributed to off-season surges and increased severity in subsequent years. The 2024–2025 influenza season recorded the highest pediatric mortality since surveillance began in 2004, with 89% of deaths occurring in unvaccinated children. The approval of nirsevimab as a long-acting monoclonal antibody has transformed RSV prophylaxis. Evidence-based management emphasizes supportive care for bronchiolitis, antibiotic stewardship for AOM and pneumonia, and universal immunization strategies. This review synthesizes current epidemiological data, compares clinical outcomes across RSV bronchiolitis, influenza, and AOM, and consolidates updated prevention frameworks aligned with AAP and WHO guidelines.
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