scholarly journals 1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Active Surveillance ◽  
Meta Analysis ◽  
The United States ◽  
Administrative Claims ◽  
Prevention Strategies ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants < 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

scholarly journals Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
John M McLaughlin ◽  
Farid Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Study Design ◽  
Meta Analysis ◽  
Full Range ◽  
The United States ◽  
Administrative Claims ◽  
Hospitalization Rates ◽  
Study Characteristics ◽  
Syncytial Virus ◽  
Study Type ◽  
The Impact

Abstract Background Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants and examined the impact of key study characteristics on these estimates. Results We reviewed 3328 articles through August 14, 2020 and identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants <1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI: 17.9–20.9). Study type influenced RSV-associated hospitalization rates (P=.003), with active surveillance studies having pooled rates (11.0; 95%CI: 9.8–12.2) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusions Applying our pooled rates to the 2020 US birth cohort suggests that 79,850 (95%CI: 73,680–86,020) RSV-associated infant hospitalizations occur each year. The full range of RSV-associated hospitalization rates identified in our review can better inform future evaluations of RSV prevention strategies. More research is needed to better understand differences in estimated RSV burden across study design.

scholarly journals Determining the Seasonality of Respiratory Syncytial Virus in the United States: The Impact of Increased Molecular Testing

2017 ◽  
Vol 216 (3) ◽  
pp. 345-355 ◽  
Author(s):  
Claire M Midgley ◽  
Amber K Haynes ◽  
Jason L Baumgardner ◽  
Christina Chommanard ◽  
Sara W Demas ◽  
...  
Keyword(s):  
United States ◽  
Respiratory Syncytial Virus ◽  
The United States ◽  
Molecular Testing ◽  
Syncytial Virus ◽  
The Impact

scholarly journals Estimated Burden of Community-Onset Respiratory Syncytial Virus–Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014–15

2019 ◽  
Vol 9 (5) ◽  
pp. 587-595 ◽  
Author(s):  
Carmen S Arriola ◽  
Lindsay Kim ◽  
Gayle Langley ◽  
Evan J Anderson ◽  
Kyle Openo ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Census Data ◽  
The United States ◽  
Surveillance Network ◽  
Detection Probabilities ◽  
Syncytial Virus ◽  
Us Children ◽  
Us Census ◽  
The Impact ◽  
Community Onset

Abstract Background Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged &lt;2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. Methods From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged &lt;2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. Results We identified 1554 RSV-associated hospitalizations in children aged &lt;2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0–2, 3–5, 6–11, and 12–23 months, respectively. Extrapolating to the US population, an estimated 49 509–59 867 community-onset RSV-associated hospitalizations among children aged &lt;2 years occurred during the 2014–2015 season. Conclusions Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged &lt;2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions.

scholarly journals The 2014–2015 National Impact of the 2014 American Academy of Pediatrics Guidance for Respiratory Syncytial Virus Immunoprophylaxis on Preterm Infants Born in the United States

2017 ◽  
Vol 35 (02) ◽  
pp. 192-200 ◽  
Author(s):  
Amanda Kong ◽  
Leonard Krilov ◽  
Jaime Fergie ◽  
Mitchell Goldstein ◽  
David Diakun ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
The United States ◽  
Full Term ◽  
First Year ◽  
Term Infants ◽  
Medical Claims ◽  
Hospitalization Rates ◽  
Before And After ◽  
Syncytial Virus

Objective This article aims to compare respiratory syncytial virus (RSV) immunoprophylaxis (IP) use and RSV hospitalization rates (RSVH) in preterm and full-term infants without chronic lung disease of prematurity or congenital heart disease before and after the recommendation against RSV IP use in preterm infants born at 29 to 34 weeks' gestational age (wGA). Study Design Infants in commercial and Medicaid claims databases were followed from birth through first year to assess RSV IP and RSVH, as a function of infant's age and wGA. RSV IP was based on pharmacy or outpatient medical claims for palivizumab. RSVH was based on inpatient medical claims with a diagnosis of RSV. Results Commercial and Medicaid infants 29 to 34 wGA represented 2.9 to 3.5% of all births. RSV IP use in infants 29 to 34 wGA decreased 62 to 95% (p < 0.01) in the 2014–2015 season relative to the 2013–2014 season. Compared with the 2013–2014 season, RSVH increased by 2.7-fold (p = 0.02) and 1.4-fold (p = 0.03) for infants aged <3 months and 29 to 34 wGA in the 2014–2015 season with commercial and Medicaid insurance, respectively. In the 2014–2015 season, RSVH for infants 29 to 34 wGA were two to seven times higher than full-term infants without high-risk conditions. Conclusion Following the 2014 RSV IP guidance change, RSV IP use declined and RSVH increased among infants born at 29 to 34 wGA and aged <3 months.

scholarly journals Respiratory Syncytial Virus–associated Acute Otitis Media in Infants and Children

2020 ◽  
Vol 9 (5) ◽  
pp. 544-550
Author(s):  
Matthew Phillips ◽  
Lyn Finelli ◽  
Lisa Saiman ◽  
Chengbin Wang ◽  
Yoonyoung Choi ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
The United States ◽  
Future Research ◽  
Research Strategies ◽  
Syncytial Virus ◽  
The Impact ◽  
In Infants And Children

Abstract Despite recent declines in the incidence of acute otitis media (AOM), more than 5 million cases and 5–6 million primary AOM visits still occur in young children in the United States, resulting in $4.4 billion direct medical costs annually. Our aims in this review are to describe the role of respiratory syncytial virus (RSV) in the etiology of AOM, discuss the prospect of prevention of RSV-associated AOM through immunization, and suggest future research strategies to assess the impact of immunization on RSV-associated AOM.

scholarly journals Hospitalizations for Respiratory Syncytial Virus Among Adults in the United States, 1997–2012

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Susan T. Pastula ◽  
Judith Hackett ◽  
Jenna Coalson ◽  
Xiaohui Jiang ◽  
Tonya Villafana ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
The United States ◽  
Teaching Hospitals ◽  
Inpatient Mortality ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
Lower Respiratory Disease ◽  
Mean Cost

Abstract Background Respiratory syncytial virus (RSV) is an established cause of serious lower respiratory disease in children, but the burden in adults is less well studied. Methods We conducted a retrospective study of hospitalizations among adults ≥20 years from the 1997–2012 National Inpatient Sample. Trends in RSV admissions were described relative to unspecified viral pneumonia admissions. Hospitalization severity indicators were compared among immunocompromised RSV, non-immunocompromised RSV, and influenza admissions. Results An estimated 28237 adult RSV hospitalizations occurred, compared with 652818 influenza hospitalizations; 34% were immunocompromised individuals. Respiratory syncytial virus and influenza patients had similar age, gender, and race distributions, but RSV was more often diagnosed in urban teaching hospitals (73.0% for RSV vs 34.6% for influenza) and large hospitals (71.9% vs 56.4%). Respiratory syncytial virus hospitalization rates increased from 1997 to 2012, particularly for those ≥60, increasing from 0.5 to 4.6 per 100000, whereas unspecified pneumonia admission rates decreased significantly (P &lt; .001). Immunocompromised patients with RSV hospitalization had significantly higher inpatient mortality (P = .013), use of mechanical ventilation (P = .016), mean length of stay (LOS) (P &lt; .001), and mean cost (P &lt; .001) than non-immunocompromised RSV hospitalizations. Overall, RSV hospitalizations were more severe than influenza hospitalizations (6.2% mortality for RSV vs 3.0% for influenza, 16.7% vs 7.2% mechanical ventilation, mean LOS of 6.0 vs 3.6 days, and mean cost of $38828 vs $14519). Conclusions Respiratory syncytial virus hospitalizations in adults are increasing, likely due to increasing recognition and diagnosis. The burden of RSV in adults deserves attention. Although there are fewer hospitalizations than influenza, those that are diagnosed are on average more severe.

scholarly journals The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada

2021 ◽  
Author(s):  
HE Groves ◽  
P Piché-Renaud ◽  
A Peci ◽  
DS Farrar ◽  
S Buckrell ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Respiratory Virus ◽  
Influenza Season ◽  
Virus Detection ◽  
Respiratory Viruses ◽  
Seasonal Epidemic ◽  
Syncytial Virus ◽  
The Impact

AbstractBackgroundThe ongoing coronavirus disease 2019 (COVID-19) pandemic has resulted in implementation of public health measures worldwide to mitigate disease spread, including; travel restrictions, lockdowns, messaging on handwashing, use of face coverings and physical distancing. As the pandemic progresses, exceptional decreases in seasonal respiratory viruses are increasingly reported. We aimed to evaluate the impact of the pandemic on circulation of influenza, respiratory syncytial virus and other seasonal respiratory viruses in Canada.MethodsEpidemiologic data were obtained from the Canadian Respiratory Virus Detection Surveillance System. Weekly data from the week ending 30th August 2014 until the week ending the 13th February 2021 were analysed. We compared trends in laboratory detection and test volumes during the 2020/2021 influenza season with baseline pre-pandemic seasons from 2014 to 2019.FindingsWe observed a dramatically lower percentage of tests positive for all seasonal respiratory viruses during 2020-2021 compared to baseline. For influenza A and B the percent positive decreased to 0·0017 and 0·0061 times that of baseline respectively and for RSV, the percent positive dropped to 0·0145 times that of baseline. Ongoing detection of enterovirus/rhinovirus occurred, with regional variation in the epidemic patterns and intensity.InterpretationWe report an effective absence of the annual seasonal epidemic of most seasonal respiratory viruses in 2020/2021. This dramatic decrease is likely related to implementation of multi-layered public health measures during the pandemic. The impact of such measures may have relevance for public health practice in mitigating seasonal respiratory virus epidemics and for informing responses to future respiratory virus pandemics.FundingNo additional funding source was required for this study.Research in contextEvidence before this studyWe searched PubMed, preprint servers and country-specific public health rapid communications to identify surveillance and epidemiological studies on influenza, respiratory syncytial virus and other seasonal respiratory virus detection during the COVID-19 pandemic. A number of regional and national studies were identified worldwide. The majority of these studies focus on influenza epidemiology and all studies show consistent decreases in circulation of seasonal non-SARS-CoV-2 respiratory viruses. One previous study on the impact of non-pharmaceutical interventions on laboratory detections of influenza A and B in Canada included data for the 2019/2020 influenza season. Another recent study examined the effect of seasonal respiratory virus transmission on COVID-19 syndromic surveillance in the province of Ontario, Canada. No previous Canada-wide study has described the epidemiology of influenza, respiratory syncytial virus and other seasonal respiratory virus detection during the 2020/2021 influenza season.Added value of this studyThe Canadian Respiratory Virus Detection Surveillance System provides weekly respiratory virus detection reports from sentinel laboratories across Canada for influenza, respiratory syncytial virus, parainfluenza viruses, adenovirus, human metapneumovirus, enterovirus/rhinovirus and seasonal coronaviruses. Data have been collected continuously since 2004. Analysis of this dataset provides a comprehensive assessment of the impact of the COVID-19 pandemic on circulation of seasonal respiratory viruses in Canada and analysis of data from the Canadian Public Health Infobase on COVID-19 allowed comparison of SARS-CoV-2 epidemiology. This is the first country-wide study in the Northern hemisphere to describe the concurrent epidemiology of all major seasonal respiratory viruses and SARS-CoV-2 during the 2020/2021 influenza season.Implications of all the available evidenceThe effective absence of the annual seasonal epidemic for most non-SARS-CoV-2 respiratory viruses in 2020/2021 has important public health implications for informing ongoing and future responses to respiratory virus epidemics and pandemics.

scholarly journals Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States

2021 ◽  
Author(s):  
Mark Blaxill ◽  
Toby Rogers ◽  
Cynthia Nevison
Keyword(s):  
Forecast Model ◽  
The United States ◽  
Population Projections ◽  
Base Case ◽  
Prevention Strategies ◽  
Total Base ◽  
Cost Categories ◽  
The Cost ◽  
The Impact ◽  
First Time

AbstractThe cost of ASD in the U.S. is estimated using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Future ASD costs increase dramatically: total base-case costs of $223 (175–271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29–6.78) trillion/year by 2060, with substantial potential savings through ASD prevention. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs raise pressing policy questions and demand an urgent focus on prevention strategies.

scholarly journals Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau
Keyword(s):  
Public Health ◽  
United States ◽  
Population Health ◽  
Health Care Policy ◽  
The United States ◽  
Extensive Literature ◽  
Master Of Public Health ◽  
Telephone Interviews ◽  
Public Health Training ◽  
The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

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