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

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. Most estimates of RSV hospitalization rates are imprecise, having been calculated by using retrospective discharge diagnosis data and stratified age groups no narrower than 6 to 12 months.WHAT THIS STUDY ADDS: Prospective, population-based surveillance data for infants hospitalized with laboratoryconfirmed RSV infection were combined with birth certificate information to yield more precise age-specific hospitalization rates. These data should help determine priorities for the use of existing and future RSV prophylaxis strategies. abstract BACKGROUND: Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. However, estimates of the RSV hospitalization burden have varied, and precision has been limited by the use of age strata grouped in blocks of 6 to $12 months. METHODS:We analyzed data from a 5-year, prospective, population-based surveillance for young children who were hospitalized with laboratoryconfirmed (reverse-transcriptase polymerase chain reaction) RSV acute respiratory illness (ARI) during October through March 2000-2005. The total population at risk was stratified by month of age by birth certificate information to yield hospitalization rates.RESULTS: There were 559 (26%) RSV-infected children among the 2149 enrolled children hospitalized with ARI (85% of all eligible children with ARI). The average RSV hospitalization rate was 5.2 per 1000 children ,24 months old. The highest age-specific rate was in infants 1 month old (25.9 per 1000 children). Infants #2 months of age, who comprised 44% of RSV-hospitalized children, had a hospitalization rate of 17.9 per 1000 children. Most children (79%) were previously healthy. Very preterm infants (,30 weeks' gestation) accounted for only 3% of RSV cases but had RSV hospitalization rates 3 times that of term infants.CONCLUSIONS: Young infants, especially those who were 1 month old, were at greatest risk of RSV hospitalization. Four-fifths of RSVhospitalized infants were previously healthy. To substantially reduce the burden of RSV hospitalizations, effective general preventive strategies will be required for all young infants, not just those with risk factors. Pediatrics 2013;132:e341-e348 AUTHORS:

Observed Effectiveness of Palivizumab for 29–36-Week Gestation Infants

“…1 In most areas of Texas, the RSV season usually starts in October, peaks in late December or early January, and ends by mid-March. 2 Palivizumab is a humanized monoclonal antibody against RSV used to reduce the rates of severe RSV illness in high-risk infants.…”

Cytokine responses in primary and secondary respiratory syncytial virus infections

“…Its impact is most marked in the very young with up to 2% of all infants being hospitalized with an RSV infection during their first winter (1)(2)(3)(4). Worldwide, RSV is responsible for many millions of hospitalizations and many tens of thousands of deaths (5).…”

Comparison of clinical features and diagnosis between the A and B subgroups of respiratory syncytial virus.

“…Estudios previos muestran que la coinfección por distintos virus se asocia a una mayor prolongación del curso clínico 24 , aunque este punto sigue en investigación con resultados controvertidos 25 . Como en otras series, la mayoría de los niños que ingresaron por el VRS eran previamente sanos 26 . No encontramos preferencia de uno de los dos subgrupos por los niños con prematuridad o con patología de base, aunque el número de casos en nuestro estudio fue pequeño para sacar conclusiones definitivas.…”