Unusual local epidemic of paediatric respiratory syncytial virus during a time of global pandemic

Nguyen, Edward T T T; Saw, Chia; Morkos, Michael; Abass, Fuad; Foley, David A.; Max, Bulsara

doi:10.1111/jpc.16326

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…The viruses that cause bronchiolitis have remained relatively unchanged during this period 16,17 . The COVID‐19 pandemic introduced distinct changes in both the prevalence and seasonality of respiratory virus worldwide, including uncharacteristic peaks in bronchiolitis cases during summer months of 2021 18–23 . In the ongoing respiratory season, surges in respiratory syncytial virus, influenza, and SARS‐CoV‐2 infections have led to widespread respiratory illnesses 9 , 24–27 .…”

Section: Discussionmentioning

confidence: 99%

“… 16 , 17 The COVID‐19 pandemic introduced distinct changes in both the prevalence and seasonality of respiratory virus worldwide, including uncharacteristic peaks in bronchiolitis cases during summer months of 2021. 18 , 19 , 20 , 21 , 22 , 23 In the ongoing respiratory season, surges in respiratory syncytial virus, influenza, and SARS‐CoV‐2 infections have led to widespread respiratory illnesses. 9 , 24 , 25 , 26 , 27 Whether these epidemiological changes have altered the prognosis of bronchiolitis is unclear.…”

Section: Discussionmentioning

confidence: 99%

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Factors associated with mild bronchiolitis in young infants

McLaren

Espinola

et al. 2023

JACEP Open

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Objective Bronchiolitis within the first 3 months of life is a risk factor for more severe illness. We aimed to identify characteristics associated with mild bronchiolitis in infants ≤90 days old presenting to the emergency department (ED). Methods We conducted a secondary analysis of infants ≤90 days old with clinically diagnosed bronchiolitis using data from the 25th Multicenter Airway Research Collaboration prospective cohort study. We excluded infants with direct intensive care unit admissions. Mild bronchiolitis was defined as (1) sent home after the index ED visit and did not have a return ED visit or had a return ED visit without hospitalization, or (2) were hospitalized from the index ED visit to the inpatient floor for <24 hours. Multivariable logistic regression, adjusting for potential clustering by hospital site, was used to identify factors associated with mild bronchiolitis. Results Of 373 infants aged ≤90 days, 333 were eligible for analysis. Of these, 155 (47%) infants had mild bronchiolitis, and none required mechanical ventilation. Adjusting for infant characteristics, clinical factors associated with mild bronchiolitis included older age (61–90 days vs 0–60 days) (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.52–4.87), adequate oral intake (OR 4.48, 95% CI 2.08–9.66), and lowest ED oxygen saturation ≥94% (OR 3.12, 95% CI 1.55–6.30). Conclusions Among infants aged ≤90 days presenting to the ED with bronchiolitis, about half had mild bronchiolitis. Mild illness was associated with older age (61–90 days), adequate oral intake, and oxygen saturation ≥94%. These predictors may help in the development of strategies to limit unnecessary hospitalization in young infants with bronchiolitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors associated with mild bronchiolitis in young infants

McLaren

Espinola

et al. 2023

JACEP Open

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“…A second retrospective observational study of 294 children between aged 0-16 years hospitalised with RSV in 2018, reported that 22.4% of hospitalisations were infants 0-1 months (31). Furthermore, they noted that in 2019 and 2020 during the SARS-CoV-2 pandemic, the proportion of RSV hospitalisations in infants aged 0-6 months decreased to 16.3% and 5.4% respectively (31).…”

Section: Combined Hospitalisationmentioning

confidence: 99%

“…One study examined proportions of hospitalised RSV requiring respiratory support before and during the SARS-CoV-2 pandemic (31). From a cohort of 294 children aged 0-16 years hospitalised with RSV, they found a statistically signi cant reduction in the proportion requiring respiratory support in 2020, compared to pre-pandemic levels in 2019 (p = 0.004).…”

Section: Respiratory Supportmentioning

confidence: 99%

Respiratory Syncytial Virus disease morbidity in Australian infants aged 0 to 6 months: A systematic review and evaluation

Self,

Buskirk,

Clark

et al. 2023

Preprint

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Background To appraise and synthesise the evidence of respiratory syncytial virus infection morbidity among Australian aged 0 to 6 months, and to assess the implications for future vaccination strategies. Methods Electronic databases (MEDLINE, EMBASE, Pubmed and Global Health) were searched in April 2023. Full-text articles published between 2000 and 2023 in English language that examined markers of disease morbidity in infants aged up to 6 months in Australia who had laboratory confirmed respiratory syncytial virus infection were eligible for inclusion. From 259 studies screened, 191 qualified for full text review, 175 were excluded based of pre-specified criteria. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis without meta-analysis guidelines. Quality of evidence was assessed with Critical Appraisal Skills Programme criteria. Results Sixteen studies from all states and territories in Australia were included. Our findings indicated that infants aged 0 to 6 months had higher respiratory syncytial virus testing, positivity and incidence rates, higher rates of hospitalisation in both general wards and intensive care units, and were more likely to require respiratory support compared to children and adults of all ages. Indigenous infants aged up to 6 months demonstrated higher respiratory syncytial virus incidence and hospitalisation, compared to non-Indigenous infants. Age-related trends persisted in geographic areas with varying respiratory syncytial virus season transmission, and also persisted despite the impact of the SARS-CoV-2 pandemic. Conclusions A significant proportion of Australia’s respiratory syncytial virus-associated morbidity is accounted for by infants aged 0 to 6 months, who are particularly vulnerable to severe disease. Vaccination of women during the latter stages of pregnancy may be a cost efficient way to protect young infants who account for a disproportionate burden of severe respiratory syncytial virus disease.

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Respiratory syncytial virus disease morbidity in Australian infants aged 0 to 6 months: a systematic review with narrative synthesis

Self,

Van Buskirk,

Clark

et al. 2023

BMC Public Health

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Background A significant proportion of the global respiratory syncytial virus (RSV) associated morbidity is accounted for by infants aged 0 to 6 months, who are particularly vulnerable to severe disease. In 2015, 44% of global hospitalisations in infants in this age group were secondary to RSV. The objective of this systematic review is to appraise and synthesise the local evidence of RSV infection morbidity among Australian infants aged 0 to 6 months and to assess the implications for future immunisation strategies. Methods Electronic databases (Medline, Embase, Pubmed and Global Health) were searched for full-text articles published between 2000 and 2023 in English language. Studies that examined markers of RSV disease morbidity in infants aged 0 to 6 months in Australia who had laboratory confirmed RSV infection were eligible for inclusion. The outcomes of interest were incidence, prevalence, testing rate, positivity rate, mortality, emergency department visits, community health visits, hospitalisation, intensive care unit admission, supplementary oxygen use, mechanical ventilation, risk factors for disease severity and monoclonal antibody use. Results The database search identified 469 studies. After removal of duplicates and full-text review, 17 articles were eligible for inclusion. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis without meta-analysis guidelines. Conclusions Qualitative analysis of the included studies showed that Australian infants aged 0 to 6 months have higher rates of RSV testing, positivity and incidence; and more likely to develop severe disease that requires hospitalisation, intensive care unit admission or respiratory support, compared to children and adults of all ages. Aboriginal and Torres Strait Islander infants aged 0 to 6 months demonstrated higher rates of RSV infection and hospitalisation, compared to non-Indigenous infants. Age-related trends persisted in geographic areas with varying seasonal transmission of RSV, and during the SARS-CoV-2 pandemic. Passive immunisation strategies targeting infants in their first 6 months of life, either via vaccination of pregnant women or administration of long-acting monoclonal antibody during infancy, could effectively reduce RSV disease burden in Australia.

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Unusual local epidemic of paediatric respiratory syncytial virus during a time of global pandemic

Cited by 3 publications

References 21 publications

Factors associated with mild bronchiolitis in young infants

Factors associated with mild bronchiolitis in young infants

Respiratory Syncytial Virus disease morbidity in Australian infants aged 0 to 6 months: A systematic review and evaluation

Respiratory syncytial virus disease morbidity in Australian infants aged 0 to 6 months: a systematic review with narrative synthesis

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