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An Improved and High Throughput Respiratory Syncytial Virus (RSV) Micro-neutralization Assay
Published on: January 26, 2019
Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000
Shelah Leader1, Kimmie Kohlhase
1MedImmune, Inc, Gaithersburg, Maryland 20878, USA. Leaders@MedImmune.com
Insights
Severe respiratory syncytial virus (RSV) infections cause significant infant illness and death in the US. Infants of black mothers, Medicaid recipients, and those born prematurely or with low birth weight face the highest risks.
Area of Science:
- Pediatric Infectious Diseases
- Public Health Surveillance
- Health Economics
Background:
- Respiratory syncytial virus (RSV) is a primary cause of severe lower respiratory tract infections in infants.
- Estimating the full burden of RSV, including incidence, risk factors, and economic impact, is crucial for public health planning.
Purpose of the Study:
- To determine the incidence, risk factors, and associated costs of severe RSV infections in US infants.
- Severe RSV was defined by emergency department (ED) visits, hospitalizations, and mortality.
Main Methods:
- Retrospective analysis of national healthcare databases (1997-2000) including ED visits, hospitalizations, and mortality data.
- Hospital charges and Medicare fee schedules were used to estimate economic costs.
- US Census data provided population denominators for incidence calculations.
Main Results:
- During 1997-2000, infants experienced 718,008 ED visits for lower respiratory infections during RSV season, with 29% requiring admission.
- RSV bronchiolitis was the leading cause of infant hospitalization, with total charges exceeding $2.6 billion over 4 years.
- An estimated 390 postneonatal deaths were associated with RSV in 1999, with prematurity and low birth weight increasing mortality risk.
Conclusions:
- RSV represents a substantial burden of infant morbidity and mortality in the United States.
- Infants of black mothers and those with Medicaid insurance had higher rates of severe RSV.
- Prematurity and low birth weight are significant risk factors for RSV-associated mortality.
Objectives:
To provide current estimates of the incidence, associated risk factors, and costs of severe respiratory syncytial virus (RSV) infections among infants in the United States, defined as emergency department (ED) visits, hospitalization, and death.
Study Design:
Retrospective analysis of National Hospital Ambulatory Medical Care Survey data 1997 to 2000; National Hospital Discharge Survey data 1997 to 2000; Perinatal Mortality Linked Files 1998 to 1999. The Hospital Cost Utilization Inpatient Sample data 1997 to 2000 were used to estimate hospitalization costs, and the 2001 Medicare fee schedule was used to estimate ED visit costs. Census data were used for population estimates. Between 1997 and 2000, there were 718,008 ED visits by infants with lower respiratory infection diagnoses during the RSV season (22.8/1000), and 29% were admitted. Costs of ED visits were approximately 202 million US dollars. RSV bronchiolitis was the leading cause of infant hospitalization annually. Total hospital charges for RSV-coded primary diagnoses during the 4 years were more than 2.6 billion US dollars. An estimated 390 RSV-associated postneonatal deaths occurred in 1999. Low birth weight and prematurity significantly increased RSV-associated mortality rates.
Conclusions:
RSV is a major cause of infant morbidity and mortality. Severe RSV is highest among infants of black mothers and Medicaid-insured infants. Prematurity and low birth weight significantly increase RSV mortality rates.
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