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Severe respiratory syncytial virus disease in Alaska native children. RSV Alaska Study Group

R A Karron1, R J Singleton, L Bulkow

  • 1Center for Immunization Research, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA. rkarron@jhsph.edu

The Journal of Infectious Diseases
|June 3, 1999
PubMed

Insights

Infants in Alaska's YK Delta experience extremely high hospitalization rates for respiratory syncytial virus (RSV), a leading cause of infant hospital admissions. Lower antibody levels in infants under six months were linked to severe RSV illness.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Respiratory syncytial virus (RSV) is a common cause of infant respiratory illness.
  • Hospitalization rates for RSV vary globally, with limited data from remote Arctic regions.
  • Previous research suggests certain infant populations may be at higher risk for severe RSV outcomes.

Purpose of the Study:

  • To determine the incidence and severity of RSV hospitalizations in infants in the Yukon-Kuskokwim (YK) Delta, Alaska.
  • To compare RSV disease severity between YK Delta infants and those at Johns Hopkins Hospital (JHH).
  • To identify risk factors for severe RSV disease in YK Delta infants.

Main Methods:

  • A 3-year prospective surveillance study was conducted in the YK Delta.
  • Infant hospitalization data for RSV infection were collected and analyzed.
  • RSV microneutralizing antibody titers were measured in YK Delta infants and correlated with disease severity.

Main Results:

  • The annual RSV hospitalization rate for infants under 1 year in the YK Delta was 53-249/1000, significantly higher than general rates.
  • RSV infection was the most frequent reason for infant hospitalization in the region.
  • One in 125 infants required mechanical ventilation for RSV, and low antibody titers (<1200) in infants ≤6 months were associated with severe disease (OR=6.2, P=.03).
  • Disease severity in non-high-risk YK Delta infants did not differ from JHH infants.

Conclusions:

  • Infants in the YK Delta face a disproportionately high burden of RSV hospitalizations.
  • Newborns in the YK Delta may be at increased risk for severe RSV illness.
  • Lower RSV antibody titers in young infants are a potential indicator of severe disease risk.

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