Respiratory syncytial virus in young children: community cohort study integrating serological surveys, questionnaire and electronic health records, Born in Bradford cohort, England, 2008 to 2013

Abstract

Background Bronchiolitis caused by respiratory syncytial virus (RSV) is a major cause of mortality and morbidity in infants. Aim To describe RSV epidemiology in children in the community in a high-income setting. Methods We used stored blood samples from the United Kingdom Born in Bradford cohort study that had been collected at birth, age 1 and 2 years old, tested for IgG RSV postfusion F antibody and linked to questionnaires and primary and hospital care records. We used finite mixture models to classify children as RSV infected/not infected according to their antibody concentrations at age 1 and 2 years. We assessed risk factors for primary RSV infection at each age using Poisson regression models. Results The study cohort included 700 children with cord blood samples; 490 had additional blood samples taken at both ages 1 and 2 years old. Of these 490 children, 258 (53%; 95% confidence interval (CI): 48–57%) were first infected with RSV at age 1, 99 of whom (38%; 95% CI: 33–43%) had been in contact with healthcare during peak RSV season (November–January). Having older siblings, birth in October–June and attending formal childcare were associated with risk of RSV infection in infancy. By age 2, a further 164 of 490 children (33%; 95% CI: 29–38%) had been infected. Conclusion Over half of children experienced RSV infection in infancy, a further one third had evidence of primary RSV infection by age 2, and one in seven remained seronegative by their second birthday. These findings will inform future analyses to assess the cost-effectiveness of RSV vaccination programmes in high-income settings.

Infant respiratory syncytial virus infection and childhood asthma: A shift in the paradigm?

“…In contrast, studies focusing on children with an infant RSV LRTI compare this group to those without an infant RSV LRTI, although the latter is a heterogenous group that includes children not infected with RSV in infancy and those who had milder RSV infections in the first year of life. In our study, using molecular and serologic testing to establish RSV infection or no infection during infancy, we found that ∼54% of children are infected with RSV in infancy, which is consistent with other studies 15,16 . Importantly, children without an infant RSV infection had a ∼26% lower risk of childhood asthma than those with an infant RSV infection.…”

Does social distancing impact pediatric upper airway infections? An observational controlled study and a brief literature review

“…Regarding the number of siblings in a family, some recent studies have suggested that this may represent a risk factor because of a small-scale crowding effect [15] , due to the exchange of pathogens. However, it is reasonable to presume a loss of significance of this risk factor during the lockdown period, since every member of the family experienced less social interaction, thus decreasing the potential contact with pathogens [16] , [17] .…”

RSV Replication, Transmission, and Disease Are Influenced by the RSV G Protein

“…Understanding the features that contribute to RSV replication, fitness, and transmissibility is important for understanding the outcomes of infection and disease intervention approaches. RSV infects young children, with many experiencing more than one infection by 2 years of age [1,2]. Globally, RSV causes acute respiratory infection in infants and young children, leading to >60,000 in-hospital deaths and >3 million hospital admissions per year in children <5 years old [3].…”