Population-based trends and underlying risk factors for infant respiratory syncytial virus and bronchiolitis hospitalizations

AbstractRespiratory syncytial virus (RSV) infection is a leading cause of hospitalization in infants. Underlying risk factors for RSV infection in the general population are not well understood, as previous work has focused on severe outcomes of infection in a clinical setting. Here we use RSV-specific IgG and IgA antibody measurements from two population-based cross-sectional serosurveys carried out in the Netherlands (n = 682) to classify children up to 5 years as seronegative or seropositive. We employ a generalized additive model to estimate the probability of prior RSV infection as function of age, date of birth within the year, and other risk factors. The analyses show that the majority of children have experienced a RSV infection before the age of 2 years. Age and birthdate are strong predictors of RSV infection in the first years of life, and children born in summer have higher estimated probability of infection than those born in winter [e.g., 0.56 (95% CI 0.45–0.66) vs. 0.32 (0.21–0.45) at age 1 year]. Our analyses reveal that the mean age at infection depends on date of birth, which has implications for the design of vaccination programmes and prioritisation schemes for the prophylactic use of monoclonal antibodies.

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Population-based rates of severe respiratory syncytial virus infection in children with and without risk factors, and outcome in a tertiary care setting

Acta Paediatrica ◽

10.1111/j.1651-2227.2002.tb03282.x ◽

2007 ◽

Vol 91 (5) ◽

pp. 593-598 ◽

Cited By ~ 61

Author(s):

M Eriksson ◽

R Bennet ◽

M Rotzén-Östlund ◽

M Sydow ◽

B Zweygberg Wirgart

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Virus Infection ◽

Respiratory Syncytial Virus Infection ◽

Care Setting ◽

Tertiary Care ◽

Population Based ◽

Severe Respiratory Syncytial Virus ◽

Syncytial Virus ◽

Tertiary Care Setting

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Burden of Respiratory Syncytial Virus Disease and Mortality Risk Factors in Argentina

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0000000000002271 ◽

2019 ◽

Vol 38 (6) ◽

pp. 589-594 ◽

Cited By ~ 3

Author(s):

Angela Gentile ◽

María Florencia Lucion ◽

María del Valle Juarez ◽

María Soledad Areso ◽

Julia Bakir ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Mortality Risk ◽

Virus Disease ◽

Respiratory Syncytial Virus Disease ◽

Syncytial Virus

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Respiratory Syncytial Virus Immunoprophylaxis with Palivizumab: 12-Year Observational Study of Usage and Outcomes in Canada

American Journal of Perinatology ◽

10.1055/s-0041-1725146 ◽

2021 ◽

Author(s):

Ian Mitchell ◽

Abby Li ◽

Candice L. Bjornson ◽

Krista L. Lanctot ◽

Bosco A. Paes ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Burden Of Illness ◽

Respiratory Illness ◽

Smoking Exposure ◽

Key Points ◽

Rsv Infection ◽

History Of ◽

Syncytial Virus ◽

Airway Anomalies

Objective This study aimed to evaluate palivizumab (PVZ) use, trends in indications, and outcomes of respiratory illness hospitalizations (RIH) and respiratory syncytial virus hospitalizations (RSVH). Study Design It involves a large, Canadian prospective (2005–2017) observational multicenter study of children at high risk for RSV infection. Results A total of 25,003 infants (56.3% male) were enrolled at 32 sites; 109,579 PVZ injections were administered. Indications included: prematurity (63.3%); “miscellaneous” (17.8%); hemodynamically significant congenital heart disease (10.5%); bronchopulmonary dysplasia/chronic lung disease (8.4%). The “miscellaneous” group increased over time (4.4% in 2005–2006 to 22.5% in 2016–2017) and included: trisomy 21, airway anomalies, pulmonary disorders, cystic fibrosis, neurological impairments, immunocompromised, cardiac aged >2 years, multiple conditions, and a residual “unclassified” group. Adherence measured by expected versus actual doses plus correct interdose interval was 64.7%. A total of 2,054 RIH occurred (6.9%); 198 (9.6%) required intubation. Three hundred thirty-seven hospitalized children were RSV-positive (overall RSVH 1.6%). Risk factors for RSVH included having siblings, attending daycare, family history of atopy, smoking exposure, and crowded household. Infants with 5 risk factors were 9.0 times (95% CI or confidence interval 4.4–18.2; p < 0.0005) more likely to have RSVH than infants without risk factors. Three adverse events occurred; none were fatal. Conclusion Results are relevant to both clinicians and decision-makers. We confirmed the safety of PVZ. Use of PVZ increased steadily for children with miscellaneous conditions and medical complexity. Medical and social factors pose a risk for severe RIH and RSVH with accompanying burden of illness. A vaccine that protects against RSV is urgently required. Key Points

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Risk factors for severe respiratory syncytial virus-associated lower respiratory tract infection in children

Pediatrics International ◽

10.1046/j.1442-200x.2001.01438.x ◽

2001 ◽

Vol 43 (5) ◽

pp. 489-492 ◽

Cited By ~ 22

Author(s):

Mitsunobu Kaneko ◽

Jun Watanabe ◽

Etsushi Ueno ◽

Mariko Hida ◽

Tomofumi Sone

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Severe Respiratory Syncytial Virus ◽

Syncytial Virus

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746. Characteristics of Respiratory Syncytial Virus (RSV) Infection Among Hospitalized Adults, United States, 2014–2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.753 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S268-S268 ◽

Cited By ~ 1

Author(s):

Lindsay Kim ◽

Bryanna Cikesh ◽

Pam Daily Kirley ◽

Evan J Anderson ◽

Seth Eckel ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Case Series ◽

Chronic Obstructive ◽

Medical Conditions ◽

Research Support ◽

Catchment Population ◽

Icd Codes ◽

Syncytial Virus ◽

Research Grant

Abstract Background Respiratory syncytial virus (RSV) vaccines are in clinical development for older adults. We described RSV infections among adults requiring hospitalization and risk factors for severe outcomes using a population-based platform, the Influenza Hospitalization Surveillance Network (FluSurv-NET). Methods Surveillance occurred October 1–April 30 (2014–2017) at sites located in seven states (California, Georgia, Michigan, Minnesota, New York, Oregon, and Tennessee) covering an annual catchment population of up to 13 million adults ≥18 years. Laboratory-confirmed RSV cases were identified using hospital and state public health laboratories, hospital infection preventionists, and/or reportable condition databases. Medical charts were reviewed for demographic and clinical data. International Classification of Diseases (ICD) discharge codes were abstracted. Odds ratios (Oregon) and 95% confidence intervals (CIs) were determined to assess risk factors for ICU hospitalization and deaths. Results A total of 2,326 hospitalized RSV cases were identified. Over half were ≥65 years (62%, n = 1,438/2,326), female (59%, n = 1,362/2,326), white (70%, n = 1,301/1,855), and had ≥3 underlying medical conditions (52%, n = 1,204/2,326). 20% (n = 398/2,000) were hospitalized in the ICU (median length of stay, 3 days; interquartile range, 1–6 days), and 5% (n = 96/2,001) died in the hospital. Congestive heart failure (CHF; OR: 1.4, 95% CI: 1.1–1.8) and chronic obstructive pulmonary disease (COPD; OR: 1.3, 95% CI: 1.1–1.7) were associated with ICU admission, while age ≥80 years (OR: 4.1, 95% CI: 1.8–12.1) and CHF (OR: 2.4, 95% CI: 1.6–3.6) were associated with in-hospital deaths. RSV-specific ICD codes were listed in the first 9 positions in only 44% (879/1,987) of cases. Conclusion To our knowledge, this is the largest US case series of RSV-infected hospitalized adults. Most cases were ≥65 years and had multiple underlying medical conditions. Older age, CHF, and COPD were associated with the most severe outcomes. Few cases had RSV-specific ICD codes, suggesting that administrative data underestimate adult RSV-related hospitalizations. Continued surveillance is needed to understand the epidemiology of RSV among adults as vaccine products move toward licensure. Disclosures E. J. Anderson, NovaVax: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. AbbVie: Consultant, Consulting fee. MedImmune: Investigator, Research support. PaxVax: Investigator, Research support. Micron: Investigator, Research support. H. K. Talbot, sanofi pasteur: Investigator, Research grant. Gilead: Investigator, Research grant. MedImmune: Investigator, Research grant. Vaxinnate: Safety Board, none. Seqirus: Safety Board, none.

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What risk factors for sudden infant death syndrome are preterm and term medically complex infants exposed to at home?

Paediatrics & Child Health ◽

10.1093/pch/pxaa070 ◽

2020 ◽

Author(s):

Ian Mitchell ◽

Daniel Y Wang ◽

Christine Troskie ◽

Lisa Loczy ◽

Abby Li ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Maternal Smoking ◽

Sudden Infant Death ◽

Sudden Infant ◽

Term Infants ◽

Medical Complexity ◽

Syncytial Virus

Abstract Objectives Risk factors for sudden infant death syndrome include premature birth, maternal smoking, prone or side sleeping position, sleeping with blankets, sharing a sleeping surface with an adult, and sleeping without an adult in the room. In this study, we compare parents’ responses on sleep patterns in premature and term infants with medical complexity. Methods Parents of children enrolled in the Canadian Respiratory Syncytial Virus Evaluation Study of Palivizumab were phoned monthly regarding their child’s health status until the end of each respiratory syncytial virus season. Baseline data were obtained on patient demographics, medical history, and neonatal course. Responses on adherence to safe sleep recommendations were recorded as part of the assessment. Results A total of 2,526 preterms and 670 term infants with medical complexity were enrolled. Statistically significant differences were found in maternal smoking rates between the two groups: 13.3% (preterm); 9.3% (term) infants (χ 2=8.1, df=1, P=0.004) and with respect to toys in the crib: 12.3% (term) versus 5.8% preterms (χ 2=24.5, df=1, P<0.0005). Preterm infants were also significantly more likely to be placed prone to sleep (8.8%), compared with term infants (3.3%), (χ 2=18.1, df=1, P<0.0005). Conclusion All the infants in this study had frequent medical contacts. There is a greater prevalence of some risk factors for sudden infant death syndrome in preterm infants compared to term infants with medical complexity. Specific educational interventions for vulnerable infants may be necessary.

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