Use of respiratory syncytial virus surveillance data to optimize the timing of immunoprophylaxis
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Published on: January 26, 2019
Catherine A Panozzo1, Lauren J Stockman, Aaron T Curns
1Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
A new method using surveillance data optimizes respiratory syncytial virus (RSV) immunoprophylaxis timing for high-risk children. This approach improves protection at season onset compared to fixed dates, ensuring better local coverage.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health Surveillance
Background:
- The American Academy of Pediatrics (AAP) recommends immunoprophylaxis for high-risk children against severe respiratory syncytial virus (RSV) infection.
- Optimal timing of immunoprophylaxis is crucial for effective protection during the RSV season.
Purpose of the Study:
- To develop and evaluate an approach using surveillance data to guide the local application of AAP RSV immunoprophylaxis recommendations.
- To compare a 5-year median-based method with a fixed date method for optimizing prophylaxis timing.
Main Methods:
- Analysis of National Respiratory and Enteric Virus Surveillance System laboratory data (1992-2007).
- Definition of local RSV seasons using median onset dates (2002-2007).
- Comparison of a 5-year median-based schedule against a fixed November 1 start date.
Main Results:
- A 5-year median-based schedule demonstrated similar season timing and duration compared to 10- or 15-year data.
- This method increased season protection at onset by 15% versus a fixed start date.
- Identified communities with extended RSV season durations.
Conclusions:
- The 5-year median method effectively characterizes local RSV season timing.
- This approach allows for optimal application of AAP recommendations for palivizumab prophylaxis timing in local communities.
Objective:
For children in the United States who are at high risk for severe respiratory syncytial virus (RSV) infection, the American Academy of Pediatrics (AAP) recommends administering immunoprophylaxis during the RSV season. We present an approach to using surveillance data to help guide application of AAP recommendations for immunoprophylaxis to local patterns of RSV outbreaks.
Methods:
We analyzed data from laboratories that report consistently to the National Respiratory and Enteric Virus Surveillance System from 1992 to 2007. Local RSV seasons were defined and an immunoprophylaxis schedule was determined by using the median onset dates from each laboratory during 2002-2007. We applied these dates to 10 preceding years of RSV detection data. We compared how well the 5-year median-based method and a fixed date method were able to match the timing of immunoprophylaxis to the RSV season.
Results:
Nineteen laboratories met our inclusion criteria and generally experienced only 1 RSV outbreak per season. Five years of data gave similar median onset/offset dates and season duration, as did 10 years and 15 years of data. The 5-year median schedule increased the number of seasons that children were protected at the season onset by 15% compared with a fixed start date of November 1 and identified communities that experienced RSV seasons with extended durations.
Conclusions:
The 5-year median method can be used to characterize timing of RSV seasons and optimally apply the current AAP recommendations for timing of palivizumab prophylaxis to the local community.
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