The contribution of child, family and health service factors to respiratory syncytial virus (RSV) hospital admissions in the first 3 years of life: birth cohort study in Scotland, 2009 to 2015

Introduction Several vaccines for respiratory syncytial virus (RSV) are under development. Designing an effective vaccination programme for RSV requires information about the relative contribution of risk factors for severe RSV symptoms. Aim To inform preventive strategies in Europe by quantifying the contribution of key child, family and health service risk factors to the burden of RSV hospital admissions in young children. Methods We constructed a birth cohort study of all singleton children born in Scotland between October 2009 and September 2012 using linkage between birth registration, maternity, vaccination and hospital admission records, with follow-up until the age of 3 years. RSV-confirmed hospital admissions were defined using linkage to national laboratory surveillance data. We estimated hospital admission rates per 1,000 child years and length of stay according to each risk factor. Cox proportional hazard regression models were used to estimate adjusted hazard ratios. Results There were 5,185 RSV admissions among the 169,726 children in the cohort: 48.6% of admissions occurred before the age of 6 months, and 29.6% after the age of 1 year. Children born prematurely, small for gestational age, between July and December, with chronic conditions, older siblings, mothers < 30 years old or delayed infant vaccination had a significantly increased risk of admission. Minimising the risk posed by older siblings could reduce RSV admissions by up to 34%. Conclusion Future RSV vaccination programmes must protect children throughout early childhood. Vaccination and/or interventions to reduce transmission by older siblings could substantially reduce RSV hospital admissions.

Download Full-text

Risk Factors for Hospital Admission with RSV Bronchiolitis in England: A Population-Based Birth Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0089186 ◽

2014 ◽

Vol 9 (2) ◽

pp. e89186 ◽

Cited By ~ 95

Author(s):

Joanna Murray ◽

Alex Bottle ◽

Mike Sharland ◽

Neena Modi ◽

Paul Aylin ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Hospital Admission ◽

Birth Cohort ◽

Population Based ◽

Birth Cohort Study

Download Full-text

Preschool respiratory hospital admissions following infant bronchiolitis: a birth cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-316317 ◽

2019 ◽

Vol 104 (7) ◽

pp. 658-663 ◽

Cited By ~ 2

Author(s):

Helen Skirrow ◽

Thomas Wincott ◽

Elizabeth Cecil ◽

Alex Bottle ◽

Ceire Costelloe ◽

...

Keyword(s):

Cohort Study ◽

Hospital Admission ◽

Birth Cohort ◽

Hospital Admissions ◽

Public Hospitals ◽

Birth Cohort Study ◽

Comorbid Condition ◽

Upper Respiratory Tract ◽

Tract Infections ◽

Children Under 5

BackgroundBronchiolitis causes significant infant morbidity worldwide from hospital admissions. However, studies quantifying the subsequent respiratory burden in children under 5 years are lacking.ObjectiveTo estimate the risk of subsequent respiratory hospital admissions in children under 5 years in England following bronchiolitis admission in infancy.DesignRetrospective population-based birth cohort study.SettingPublic hospitals in England.PatientsWe constructed a birth cohort of 613 377 infants born between 1 April 2007 and 31 March 2008, followed up until aged 5 years by linking Hospital Episode Statistics admissions data.MethodsWe compared the risk of respiratory hospital admission due to asthma, wheezing and lower and upper respiratory tract infections (LRTI and URTI) in infants who had been admitted for bronchiolitis with those who had not, using Cox proportional hazard regression. We adjusted hazard ratios (HR) for known respiratory illness risk factors including living in deprived households, being born preterm or with a comorbid condition.ResultsWe identified 16 288/613 377 infants (2.7%) with at least one admission for bronchiolitis. Of these, 21.7% had a further respiratory hospital admission by age 5 years compared with 8% without a previous bronchiolitis admission (HR (adjusted) 2.82, 95% CI 2.72 to 2.92). The association was greatest for asthma (HR (adjusted) 4.35, 95% CI 4.00 to 4.73) and wheezing admissions (HR (adjusted) 5.02, 95% CI 4.64 to 5.44), but were also significant for URTI and LRTI admissions.ConclusionsHospital admission for bronchiolitis in infancy is associated with a threefold to fivefold risk of subsequent respiratory hospital admissions from asthma, wheezing and respiratory infections. One in five infants with bronchiolitis hospital admissions will have a subsequent respiratory hospital admission by age 5 years.

Download Full-text

Down Syndrome: A Novel Risk Factor for Respiratory Syncytial Virus Bronchiolitis A Prospective Birth-Cohort Study

PEDIATRICS ◽

10.1542/peds.2007-0788 ◽

2007 ◽

Vol 120 (4) ◽

pp. e1076-e1081 ◽

Cited By ~ 130

Author(s):

B. L.P. Bloemers ◽

A. M. van Furth ◽

M. E. Weijerman ◽

R. J.B.J. Gemke ◽

C. J.M. Broers ◽

...

Keyword(s):

Down Syndrome ◽

Risk Factor ◽

Cohort Study ◽

Respiratory Syncytial Virus ◽

Birth Cohort ◽

Birth Cohort Study ◽

Respiratory Syncytial Virus Bronchiolitis ◽

Syncytial Virus ◽

Prospective Birth Cohort ◽

Prospective Birth Cohort Study

Download Full-text

Association of Sputum Microbial Communities to Smoking in Adulthood and Respiratory Syncytial Virus Lower Respiratory Illness in Early Life: A Longitudinal Birth Cohort Study

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a2937 ◽

2020 ◽

Author(s):

L.K. Honeker ◽

T.F. Carr ◽

D.A. Stern ◽

M.J. Halonen ◽

S. Guerra ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Syncytial Virus ◽

Microbial Communities ◽

Birth Cohort ◽

Early Life ◽

Respiratory Illness ◽

Birth Cohort Study ◽

Syncytial Virus

Download Full-text

Characterizing the risk of respiratory syncytial virus in infants with older siblings: a population-based birth cohort study

Epidemiology and Infection ◽

10.1017/s0950268816002545 ◽

2016 ◽

Vol 145 (2) ◽

pp. 266-271 ◽

Cited By ~ 8

Author(s):

P. JACOBY ◽

K. GLASS ◽

H. C. MOORE

Keyword(s):

Respiratory Syncytial Virus ◽

Birth Cohort ◽

Vaccination Strategy ◽

Population Based ◽

Birth Cohort Study ◽

Older Children ◽

Rsv Infection ◽

Maximum Protection ◽

Syncytial Virus ◽

Older Siblings

SUMMARYFrom a population-based birth cohort of 245 249 children born in Western Australia during 1996–2005, we used linkage of laboratory and birth record datasets to obtain data including all respiratory syncytial virus (RSV) detections during infancy from a subcohort of 87 981 singleton children born in the Perth metropolitan area from 2000 to 2004. Using log binomial regression, we found that the risk of infant RSV detection increases with the number of older siblings, with those having ⩾3 older siblings experiencing almost three times the risk (relative risk 2·83, 95% confidence interval 2·46–3·26) of firstborn children. We estimate that 45% of the RSV detections in our subcohort were attributable to infection from an older sibling. The sibling effect was significantly higher for those infants who were younger during the season of peak risk (winter) than those who were older. Although older siblings were present in our cohort, they had very few RSV detections which could be temporally linked to an infant's infection. We conclude that RSV infection in older children leads to less severe symptoms but is nevertheless an important source of infant infection. Our results lend support to a vaccination strategy which includes family members in order to provide maximum protection for newborn babies.

Download Full-text