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January 10, 2020
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Over 49K RSV hospitalizations estimated among young children in a single season

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Respiratory syncytial virus causes a significant burden in children aged younger than 2 years. Results from a study published in the Journal of the Pediatric Infectious Diseases Society showed that 49,509 to 59,867 cases of community-onset RSV-associated hospitalizations occurred among children in this age group during the 2014-2015 RSV season — an estimate that might help inform vaccination strategies.

“With RSV vaccines expected to be available in the upcoming years, it is important to establish nationally representative baseline estimates of RSV hospitalizations,” the authors wrote.

Researchers arrived at their numbers by extrapolating rates of laboratory-confirmed RSV hospitalizations in four states to the entire U.S. population using census data. The states — California, Georgia, Minnesota and Oregon — are part of a surveillance network and reported a total of 1,554 RSV-related hospitalizations from October 2014 through April 2015.

Of the hospitalized children with RSV, 27% were admitted to the ICU, 6% required ventilation and five died. RSV hospitalization rates per 100,000 were 1,970 (95% CI, 1,787-2,177), 897 (95% CI, 761-1,073), 531 (95% CI, 459-624) and 358 (95% CI, 317-405) for children aged 0 to 2 months, 3 to 5 months, 6 to 11 months and 12 to 23 months, respectively. No underlying condition was detected in 67% of the population.

According to the CDC, RSV leads to 2.1 million outpatient visits and over 57,000 hospitalizations among children aged younger than 5 years. Previous research has shown that RSV-associated hospitalization of infants also has adverse effects on caregivers, even after discharge.

“This laboratory-based approach that adjusts for testing practices and diagnostic testing sensitivity may produce robust estimates of RSV disease burden to inform prevention strategies and, when used over the years (as it is the case for influenza), could allow for the assessment of the impact of public health interventions,” the authors wrote. “Future studies using this approach could consider a correction factor for differential testing based on severity . . . and should consider expanding surveillance to best capture RSV seasons that do not overlap with circulation of influenza viruses.” – by Eamon Dreisbach

References:

Arriola CS, et al. J Pediatric Infect Dis Soc. 2019;10.1093/jpids/piz087.

CDC. Respiratory syncytial virus infection (RSV). https://www.cdc.gov/rsv/research/us-surveillance.html. Accessed January 8, 2020.

Disclosures: One of the authors reports receiving research funding unrelated to the study from GlaxoSmithKline, Medimmune, Merck, Micron, Novavax, Pfizer, Regeneron and Sanofi-Pasteur, and has also consulted for AbbVie and Pfizer unrelated to the study. The other authors report no relevant financial disclosures.