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Published on: December 10, 2013
RSV-associated hospitalizations in Alaska Native infants
R Singleton1, R A Karron, D G Kruse
1Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.
Insights
Alaska Native children have extremely high rates of respiratory syncytial virus (RSV) hospitalizations, with significant seasonal variation and increased severity in infants and those with pre-existing conditions.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Previous retrospective data indicated high rates of respiratory syncytial virus (RSV)-associated hospitalizations in Alaska Native children.
- The precise epidemiology of RSV infections in this population remained poorly understood.
Purpose of the Study:
- To conduct a prospective hospital-based surveillance study to determine the rates of RSV-associated hospitalizations.
- To characterize RSV epidemiology in Alaska Native children under 36 months of age in the Yukon-Kuskokwim Delta.
Main Methods:
- Prospective hospital-based surveillance.
- Data collection on RSV cases in children under 36 months from October 1993 to September 1995.
- Analysis of hospitalization rates, age distribution, disease severity, and co-circulating viruses.
Main Results:
- RSV hospitalization rates varied dramatically between study years, increasing from 53/1,000 infants in 1993-1994 to 294/1,000 infants in 1994-1995.
- A significant proportion (12%) of RSV cases occurred in infants less than one month old.
- Disease severity was notably higher in premature infants and those with congenital heart or lung conditions (p = .001).
- RSV was the predominant virus identified, with co-circulation of influenza, adenovirus, and parainfluenza.
Conclusions:
- This study highlights extreme seasonal variation and exceptionally high RSV hospitalization rates in Alaska Native children.
- Younger age and pre-existing medical conditions are associated with increased disease severity.
- RSV co-circulates with other respiratory viruses, underscoring the need for comprehensive prevention strategies.
Purpose:
Retrospective reviews for 1986-1992 suggested that Alaska Native children experience high rates of respiratory syncytial virus (RSV)-associated hospitalization; however, the epidemiology of RSV infections has been poorly characterized.
Methods:
A prospective hospital-based surveillance study was undertaken to determine rates of RSV-associated hospitalization in Alaska Native children < 36 months from the Yukon-Kuskokwim Delta.
Results:
During the first study year, October 1993 to September 1994, there were 40 RSV cases (hospitalization rate, 53/1,000 infants < 1 year of age); however, during the second year, October 1994 to September 1995, there were 251 RSV cases (hospitalization rate, 294/1,000 infants). An unusually high proportion, 12%, of RSV cases were < 1 month of age. Disease severity was higher for children with a history of prematurity, heart, or lung disease (p = .001, X2 analysis). Of 255 cell cultures during 1994-1995, 190 were RSV-positive, 11 were positive for influenza, 4 for adenovirus, and 1 for parainfluenza. This study demonstrates wide seasonal variation in a population with an extremely high RSV hospitalization rate; increased disease severity associated with young age and pre-existing medical conditions; and co-circulation of RSV with other viruses.
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