Hospitalization for respiratory syncytial virus in the paediatric population in Spain

Abstract

SUMMARYThe aim of this population-based retrospective study was to determine the incidence of hospitalization for community-acquired, laboratory-confirmed respiratory syncytial virus (RSV) infection in an unselected paediatric population from southern Europe. The study was performed in an area with 15 700 children aged less than 5 years attended by a single hospital. The presence of RSV in nasopharyngeal aspirates from children with acute respiratory infection treated in the hospital was investigated in four seasons (July 1996-June 2000. A total of 390 episodes of hospitalization for RSV infection were detected and 83 . 3% of the children were aged less than 1 year old. The annual hospitalization rate was 37/1000 for infants aged less than 6 months and 25/1000 for those aged less than 1 year. During the study period, 2 . 5 % of the infants younger than 1 year and approximately 5 % of those younger than 3 months were hospitalized for RSV infection. The mean length of hospital stay was 5 . 9 days. Seven per cent of the patients required admission to the intensive care unit and more than half of these children were aged less than 1 month. In Spain, community-acquired RSV infection is a highly frequent cause of hospitalization in young children, especially in those aged less than 1 year. Prevention of RSV infection, through the development of vaccines and/or other strategies, should be a public health priority.

Respiratory Syncytial Virus–Associated Hospitalizations Among Children Less Than 24 Months of Age

“…Although recent studies, most of which were retrospective assessments, have consistently shown RSV hospitalizations to be the highest in the first year of life, very few have dissected the exact age of RSV-specific hospitalizations more precisely. [4][5][6][13][14][15][16][17][18][19][20] For example, a retrospective, population-based study from Spain found that among children ,24 months old hospitalized with laboratory-identified RSV, 9% were ,1 month of age, similar to our findings; however, their rate of RSV hospitalizations among infants ,1 month of age was more than twice ours (31 per 1000 vs 13.5 per 1000, respectively). 19 Another study estimated a notably high annual rate of RSV-associated hospitalizations among infants #3 months old, 48.9 per 1000 children, which is more than twice the rate we found.…”

“…[4][5][6][13][14][15][16][17][18][19][20] For example, a retrospective, population-based study from Spain found that among children ,24 months old hospitalized with laboratory-identified RSV, 9% were ,1 month of age, similar to our findings; however, their rate of RSV hospitalizations among infants ,1 month of age was more than twice ours (31 per 1000 vs 13.5 per 1000, respectively). 19 Another study estimated a notably high annual rate of RSV-associated hospitalizations among infants #3 months old, 48.9 per 1000 children, which is more than twice the rate we found. 6 The differences between studies could result from actual differences in disease burden or from the use in database studies of ICD-9-CM-coded discharge diagnoses for RSV-associated syndromes such as bronchiolitis, because they are inaccurate indicators of RSV infection among young infants.…”

Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

“…We previously published the results of a population-based retrospective study performed in the same geographical area to determine the incidence of hospitalization for virologically confirmed, community-acquired RSV infection in children aged <5 years old, which included most of the infants in the present study. The annual hospitalization rate due to RSV infection between July 1996 and June 2000 was 37/1000 among infants aged <6 months, and was 25/1000 and 15/1000 in infants aged <12 and <24 months respectively [6]. Palivizumab prophylaxis was not used in this region until the autumn of 2000.…”

“…The Hospital Donostia is the public hospital for the capital of the province and surrounding regions and annually attends a population of B7000 infants aged <2 years old. This hospital receives more than 97 % of paediatric hospitalizations in its catchment area and nasopharyngeal aspirate for virological analysis is routinely performed for 95 % of children aged <5 years old admitted for bronchiolitis [6]. The inclusion criteria were : hospitalization for more than 24 h, age <2 years, date of birth in the study period, RSV detection in nasopharyngeal aspirate, and a discharge diagnosis of ARI.…”

“…In developed countries, RSV infection is the main cause of hospitalization in infants [3] and 1-4 % of children aged <1 year are hospitalized due to this infection [4][5][6]. RSV-related morbidity and mortality are higher in infants with certain underlying conditions such as prematurity, chronic bronchopulmonary disease and congenital heart disease [2,4], while less information is available on the role of other conditions or risk factors.…”