Modelling estimates of the burden of Respiratory Syncytial virus infection in adults and the elderly in the United Kingdom

Fleming, Douglas; Taylor, Robert J.; Lustig, Roger; Schuck‐Paim, Cynthia; Haguinet, François; Webb, David J.; Logie, John; Matias, Gonçalo; Taylor, Stephen

doi:10.1186/s12879-015-1218-z

Cited by 147 publications

(154 citation statements)

References 26 publications

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“…An exception was a recent US study examining RSV in medically attended illnesses of all severities [32] which extended down to age 50, as well as previous studies from the United Kingdom that examined visits to general practitioners among individuals of all ages [33]. Modeling studies suggest a modest burden of RSV-associated medical visits, but little burden of hospitalizations, in those 18-49 years, especially for those with underlying risk conditions [6]. …”

Section: Discussionmentioning

confidence: 99%

Respiratory syncytial virus hospitalization in middle-aged and older adults

Malosh

Martin

Callear

et al. 2017

Journal of Clinical Virology

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Background The importance of Respiratory Syncytial Virus (RSV) is increasingly recognized in hospitalized adults, but mainly in those ≥ 65 years. Objectives We sought to describe the epidemiology and clinical severity of RSV compared to influenza in hospitalized adults ≥18 years. Study Design Adults hospitalized with acute respiratory illnesses (ARI) of ≤10 days duration were prospectively enrolled from two Michigan hospitals during two influenza seasons. Collected specimens were tested for RSV and influenza by real-time, reverse transcription polymerase chain reaction (RT-PCR). Viral load and subtype were determined for RSV-positive specimens. We evaluated factors associated with RSV and outcomes of infection using multivariable logistic regression. RSV-positive patients were separately compared to two reference groups: RSV-negative and influenza-negative, and influenza-positive patients. Results RSV was detected in 84 (7%) of 1259 hospitalized individuals (55 RSV-B, 29 RSV-A). The highest prevalence was found in 50-64 year olds (40/460; 8.7%); 98% of RSV cases in this age group had at least one chronic comorbidity. RSV detection was associated with obesity (OR: 1.71 95% CI: 0.99-3.06, p=0.03). Individuals with RSV were admitted to the hospital later in their illness and had a higher median Charlson comborbidity index (3 vs 2 p < 0.001) compared to those with influenza. Clinical severity of RSV-associated hospitalizations was similar to influenza-associated hospitalizations. Discussion In this study we observed the highest frequency of RSV-associated hospitalizations among adult 50-64 years old; many of whom had chronic comorbidities. Our results suggest the potential benefit of including these individuals in future RSV vaccination strategies.

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Section: Discussionmentioning

confidence: 99%

Respiratory syncytial virus hospitalization in middle-aged and older adults

Malosh

Martin

Callear

et al. 2017

Journal of Clinical Virology

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“…These models have been used in similar studies 4, 10, 12, 13. All models used the weekly number of laboratory‐confirmed episodes in children <5 years of age in England for the following pathogens as the independent variables: RSV, influenza A, influenza B, rhinovirus, parainfluenza, human metapneumovirus (hMPV) and adenovirus.…”

Section: Methodsmentioning

confidence: 99%

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

Reeves

Hardelid

Gilbert

et al. 2017

Influenza Resp Viruses

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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.

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“…Globally, RSV is responsible for over 33 million new episodes of acute lower respiratory tract infection in children, with at least 3.4 million severe cases that require hospital admissions each year (1,2). A growing body of evidence shows that RSV infection has become a significant burden in the elderly in industrialized countries (3)(4)(5)(6). In addition, RSV infection may contribute to the onset of development of type 2 diabetes (7).…”

mentioning

confidence: 99%

Suppression of IRG-1 Reduces Inflammatory Cell Infiltration and Lung Injury in Respiratory Syncytial Virus Infection by Reducing Production of Reactive Oxygen Species

Ren

Zhuo

et al. 2016

J Virol

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Respiratory syncytial virus (RSV) infection is a common cause of lower respiratory tract illness in infants and children. RSV is a negative-sense, single-strand RNA (ssRNA) virus that mainly infects airway epithelial cells. Accumulating evidence indicates that reactive oxygen species (ROS) production is a major factor for pulmonary inflammation and tissue damage of RSV disease. We investigated immune-responsive gene-1 (IRG1) expression during RSV infection, since IRG1 has been shown to mediate innate immune response to intracellular bacterial pathogens by modulating ROS and itaconic acid production. We found that RSV infection induced IRG1 expression in human A549 cells and in the lung tissues of RSV-infected mice. RSV infection or IRG1 overexpression promoted ROS production. Accordingly, knockdown of IRG1 induction blocked RSV-induced ROS production and proinflammatory cytokine gene expression. Finally, we showed that suppression of IRG1 induction reduced immune cell infiltration and prevented lung injury in RSV-infected mice. These results therefore link IRG1 induction to ROS production and immune lung injury after RSV infection. IMPORTANCERSV infection is among the most common causes of childhood diseases. Recent studies identify ROS production as a factor contributing to RSV disease. We investigated the cause of ROS production and identified IRG1 as a critical factor linking ROS production to immune lung injury after RSV infection. We found that IRG1 was induced in A549 alveolar epithelial cells and in mouse lungs after RSV infection. Importantly, suppression of IRG1 induction reduced inflammatory cell infiltration and lung injury in mice. This study links IRG1 induction to oxidative damage and RSV disease. It also uncovers a potential therapeutic target in reducing RSV-caused lung injury. Human infection with respiratory syncytial virus (RSV) is a major cause of childhood disease of lower respiratory tract infection with common cold-like symptoms. The infection is frequently associated with the development of bronchospasm and bronchiolitis, particularly in children less than 1 year old. Globally, RSV is responsible for over 33 million new episodes of acute lower respiratory tract infection in children, with at least 3.4 million severe cases that require hospital admissions each year (1, 2). A growing body of evidence shows that RSV infection has become a significant burden in the elderly in industrialized countries (3-6). In addition, RSV infection may contribute to the onset of development of type 2 diabetes (7). Proinflammatory response in the lung is thought to play a fundamental role in RSV disease, but the mechanisms regulating RSV disease and long-term consequences are incompletely defined (8-13).RSV is a negative-sense, single-strand RNA virus of the family Paramyxoviridae, which also includes common respiratory viruses such as those causing measles and mumps. Human RSV infects polarized epithelial cells in the airway and, to lesser degrees, macrophages and dendritic cells (14,15). RSV stimul...

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Modelling estimates of the burden of Respiratory Syncytial virus infection in adults and the elderly in the United Kingdom

Cited by 147 publications

References 26 publications

Respiratory syncytial virus hospitalization in middle-aged and older adults

Respiratory syncytial virus hospitalization in middle-aged and older adults

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

Suppression of IRG-1 Reduces Inflammatory Cell Infiltration and Lung Injury in Respiratory Syncytial Virus Infection by Reducing Production of Reactive Oxygen Species

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