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Published on: April 4, 2019
RSV disease in the pediatric population: epidemiology, seasonal variability, and long-term outcomes
1Division of Infectious Diseases, University of Colorado Denver Health Sciences Center, Denver, USA.
Insights
Severe respiratory syncytial virus (RSV) disease affects many infants, especially premature ones, leading to hospitalizations. Risk factors like prematurity, certain medical conditions, and environmental exposures increase susceptibility to RSV infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Infants under one year, particularly premature infants, face significant risk of severe respiratory syncytial virus (RSV) disease.
- RSV infections lead to approximately 126,000 hospitalizations annually in the United States.
- RSV seasonality exhibits considerable temporal and geographical variability, even within local communities.
Purpose of the Study:
- To identify independent risk factors for severe RSV disease in infants.
- To inform decisions regarding RSV immunoprophylaxis strategies.
- To explore potential long-term outcomes of RSV infection, such as asthma development.
Main Methods:
- Retrospective analysis of infant health data.
- Identification and statistical evaluation of risk factors associated with RSV hospitalization.
- Geographical and temporal analysis of RSV season patterns.
Main Results:
- Gestational age less than 33 weeks, chronic lung disease (CLD), congenital heart disease (CHD), immunosuppression, male sex, household crowding, and daycare attendance are significant risk factors.
- Exposure to indoor tobacco smoke and breastfeeding duration less than two months are potential risk factors.
- High altitude was identified as an additional risk factor for RSV hospitalization in Colorado studies.
Conclusions:
- RSV immunoprophylaxis decisions require consideration of multiple independent risk factors beyond seasonal patterns.
- Prematurity and specific medical conditions significantly elevate the risk of severe RSV disease.
- Long-term consequences of RSV infection, including wheezing and asthma, warrant further investigation.
Abstract:
Infants younger than 1 year, and especially premature infants, are susceptible to severe RSV disease, which accounts for up to 126,000 hospitalizations each year. In the United States, the RSV season generally extends from November though March, but varies considerably both temporally and geographically. Studies, such as the one we have conducted in Colorado, indicate that the RSV season can even vary among local communities. In addition to seasonal variability, other independent risk factors also have to be taken into consideration when considering RSV immunoprophylaxis. Among these are a GA of less than 33 weeks, infants with CLD or CHD or who are immunosuppressed, male sex, household crowding, and daycare attendance. Exposure to indoor tobacco smoke and abbreviated breast feeding (less than 2 months) also may be pertinent risk factors. The Colorado studies show that high altitude also increases the risk of RSV hospitalization. Although hospitalization is a major outcome of severe RSV infections in infants, the development of wheezing and physician-diagnosed asthma later in life may be a long-term outcome that should be considered.
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