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Hospitalisation for RSV infection in ex-preterm infants-implications for use of RSV immune globulin
M Thomas1, A Bedford-Russell, M Sharland
1Neonatal Unit, St George's Hospital, Blackshaw Road, London SW17 0QT, UK.
Insights
This study found low rates of respiratory syncytial virus (RSV) related hospitalizations and no deaths in ex-preterm infants in the UK. The findings do not support widespread use of RSV immune globulin (RSV-IG) prophylaxis.
Area of Science:
- Neonatal Medicine
- Pediatric Infectious Diseases
- Respiratory Medicine
Background:
- Respiratory syncytial virus (RSV) specific immune globulin (RSV-IG) is available for preventing RSV infection in ex-preterm infants.
- Limited UK data exist on RSV morbidity and mortality in this vulnerable population.
Purpose of the Study:
- To assess RSV-related morbidity and mortality in ex-preterm infants in the UK.
- To compare the hospitalization costs of RSV with the cost-effectiveness of RSV-IG prophylaxis.
Main Methods:
- A cohort of 82 infants born before 32 weeks gestation was studied over up to three RSV seasons.
- Hospital records, referring hospitals, and general practitioners provided data on respiratory illness admissions within the first two years of life.
Main Results:
- The hospitalization rate for confirmed RSV infection was 4% in the first season.
- Infants with chronic lung disease had higher rates of ward and pediatric intensive care unit admissions.
- No deaths attributed to RSV were recorded; RSV-IG prophylaxis was not cost-effective for most infants.
Conclusions:
- Observed RSV morbidity and mortality rates in ex-preterm infants do not support the broad implementation of RSV-IG prophylaxis.
- Further research may be needed to identify specific subgroups that could benefit from prophylaxis.
Background:
Respiratory syncytial virus (RSV) specific immune globulin is now being marketed for prevention of RSV infection in ex-preterm infants. However, there are no published UK data on the morbidity or mortality from RSV in these infants.
Aims:
To determine the morbidity and mortality from RSV infection in a cohort of infants previously treated at a regional neonatal unit, and compare the cost of hospitalisation for RSV with the potential cost of administering RSV immune globulin (RSV-IG) prophylaxis.
Methods:
Infants born at a gestation of less than 32 weeks were studied. Details of admissions for respiratory illness in the first two years of life were collected from hospital records, referring hospitals, and general practitioners.
Results:
Data on 82 infants were collected. Up to three RSV seasons were encountered. The hospitalisation rate for confirmed RSV infection for the first season encountered was 4%. Rates of ward and paediatric intensive care unit admission were higher for infants with chronic lung disease. There were no deaths from RSV. RSV-IG would not have been cost effective for most infants.
Conclusion:
The morbidity and mortality rates from RSV observed in this group do not support the widespread introduction of RSV-IG prophylaxis for ex-preterm infants.