Estimating the burden of respiratory syncytial virus (RSV) on respiratory hospital admissions in children less than five years of age in England, 2007‐2012

Abstract

BackgroundRespiratory syncytial virus (RSV) is a leading cause of hospital admission in young children. With several RSV vaccines candidates undergoing clinical trials, recent estimates of RSV burden are required to provide a baseline for vaccine impact studies.ObjectivesTo estimate the number of RSV‐associated hospital admissions in children aged <5 years in England over a 5‐year period from 2007 using ecological time series modelling of national hospital administrative data.Patients/MethodsMultiple linear regression modelling of weekly time series of laboratory surveillance data and Hospital Episode Statistics (HES) data was used to estimate the number of hospital admissions due to major respiratory pathogens including RSV in children <5 years of age in England from mid‐2007 to mid‐2012, stratified by age group (<6 months, 6‐11 months, 1‐4 years) and primary diagnosis: bronchiolitis, pneumonia, unspecified lower respiratory tract infection (LRTI), bronchitis and upper respiratory tract infection (URTI).ResultsOn average, 33 561 (95% confidence interval 30 429‐38 489) RSV‐associated hospital admissions in children <5 years of age occurred annually from 2007 to 2012. Average annual admission rates were 35.1 (95% CI: 32.9‐38.9) per 1000 children aged <1 year and 5.31 (95% CI: 4.5‐6.6) per 1000 children aged 1‐4 years. About 84% (95% CI: 81‐91%) of RSV‐associated admissions were for LRTI. The diagnosis‐specific burden of RSV‐associated admissions differed significantly by age group.Conclusions RSV remains a significant cause of hospital admissions in young children in England. Individual‐level analysis of RSV‐associated admissions is required to fully describe the burden by age and risk group and identify optimal prevention strategies.

Clinical burden of severe respiratory syncytial virus infection during the first 2 years of life in children born between 2000 and 2011 in Scotland

“…An increased risk of RSVH was seen in children with CHD/PH (10.5%), CLD/BPD (11.2%), Down syndrome (14.8%), cerebral palsy (15.5%), cystic fibrosis (12.6%) and neuromuscular disorders (17.0%), compared with children without a comorbidity (2.0%; all p < 0.0001). [5,[10][11][12], with one study (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)) reporting relatively stable rates [13]. An analysis of 468,138 bronchiolitis episodes (1979-2011) estimated a hospitalisation rate of 46.1/ 1000 infants aged < 1 year in 2011, with the incidence increasing by 1.8% per year between 2004 and 2011 [10].…”

“…An analysis of 468,138 bronchiolitis episodes (1979-2011) estimated a hospitalisation rate of 46.1/ 1000 infants aged < 1 year in 2011, with the incidence increasing by 1.8% per year between 2004 and 2011 [10]. Another recent study (2007-2012) estimated a RSVH rate of 35.1/1000 infants < 1 year, based on 121,968 respiratory admissions, with a general increase in RSVHs over the study period [5]. The authors also noted that by restricting the definition of RSVH to those with a primary diagnosis of upper respiratory tract infection and LRTI, they might have underestimated the true burden of disease [5].…”

“…Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections (LRTI) in early childhood, resulting in a substantial burden on health care services, particularly during the colder months (typically October-March) in Northern Hemisphere countries [1][2][3][4][5]. Robust epidemiological data on RSV LRTI aids planning, guides preventive strategies and helps manage healthcare resources effectively.…”

“…Quantifying the burden of RSV LRTI at a national level can be difficult, due to the limited availability of suitable data sources and a lack of routine testing and confirmatory diagnoses of RSV. Study methodologies have included utilisation of databases of hospital records or medical insurance [3,4] or modelling hospital admissions with national surveillance data [5]. Studies from England have reported RSV hospitalisation (RSVH) rates of 2.4-3.5% in children < 1 year [5,6], rising to 14.3% in those born < 32 weeks' gestational age [wGA] [7].…”

Epidemiology of respiratory viruses in Saudi Arabia: toward a complete picture

“…In comparison with other respiratory viruses, HRSV is the leading cause of lower RTIs in community and hospital studies [90,91]. The virus is responsible for a high percentage of hospital admissions of babies [92]. Evolution of new genotypes of HRSV strains usually leads to recurrent infections in infants [93].…”