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Substantial variability in community respiratory syncytial virus season timing
James A Mullins1, Ashley C Lamonte, Joseph S Bresee
1Repiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Insights
Respiratory syncytial virus (RSV) seasons vary significantly by region and year. Local RSV surveillance data are crucial for optimizing the timing of preventive therapies for high-risk children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Respiratory syncytial virus (RSV) is a primary cause of pediatric bronchiolitis and pneumonia.
- Preventive immunoglobulin therapies for RSV are recommended for high-risk children.
- Accurate timing of RSV epidemics is essential for effective prophylaxis.
Purpose of the Study:
- To assess the utility of national surveillance data for defining seasonal RSV outbreak timing.
- To analyze regional and local variations in RSV season onset, peak, and duration.
Main Methods:
- Analysis of weekly RSV testing data from the National Respiratory and Enteric Viruses Surveillance System (1990-2000).
- Calculation of RSV season onset, peak, and duration for the US, census regions, and local labs.
- Estimation of season variability by comparing individual seasons to median measurements.
Main Results:
- RSV seasons in the South began earlier and lasted longer than the national average.
- Midwest RSV seasons commenced later and were shorter than the national average.
- Significant year-to-year and laboratory-based variability in local RSV seasons was observed.
Conclusions:
- RSV season onset and duration exhibit substantial geographic and temporal variability.
- Local RSV surveillance data are necessary for precise season definition.
- Refining the timing of passive immune prophylaxis requires localized RSV data.
Background:
Respiratory syncytial virus (RSV) is the major cause of bronchiolitis and pneumonia in young children. Prevention of RSV disease in children in certain high risk groups through use of immunoglobulin preparations has been recommended by the American Academy of Pediatrics since 1998. A more precise understanding of the timing of annual RSV epidemics should assist providers in maximizing the benefit of these preventive therapies. The objective of this study was to determine whether current national RSV surveillance data could be used to define the timing of seasonal outbreaks
Methods:
Weekly RSV testing data from the National Respiratory and Enteric Viruses Surveillance System for the period July 1990 through June 2000 were analyzed. RSV season onset week, peak week and duration were calculated for the entire United States, Census regions and select local laboratories. Season variability was estimated by comparing calculations for individual RSV seasons to median measurements for the entire surveillance period
Results:
RSV seasons in the South region began significantly earlier (P < 0.05) and lasted longer (P < 0.05) than seasons for the rest of the nation. RSV seasons in the Midwest region began significantly later (P < 0.01) and were shorter (P < 0.05) than those for the rest of the nation. Local RSV seasons varied substantially by year and by laboratory. The variability between laboratories generally increased with distance between laboratories
Conclusions:
Onset weeks and durations of RSV seasons vary substantially by year and location. Local RSV data are needed to accurately define the onset and offset of RSV seasons and to refine timing of passive immune prophylaxis therapy recommendations.