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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Trends in chronologic age and infant respiratory syncytial virus hospitalization: an 8-year cohort study
Jon P Fryzek1, William J Martone, Jessie R Groothuis
1One MedImmune Way, Gaithersburg, MD 20878, USA. GroothuisJ@MedImmune.com
Insights
Infants under 6 months, especially those under 3 months, face the highest risk of respiratory syncytial virus (RSV) hospitalization. The 3- to 6-month age group experienced the greatest proportion of RSV hospitalizations.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a primary cause of severe respiratory infections in young children.
- RSV is the leading cause of infant hospitalizations under one year of age.
Purpose of the Study:
- To analyze trends in RSV hospitalizations (RSVH) among infants in the US from 1998 to 2006.
- To identify age-specific hospitalization rates and proportions for RSV among infants.
Main Methods:
- Utilized the US National Hospital Discharge Survey (NHDS) database from 1998-2006.
- Defined RSVH using ICD-9-CM codes for RSV, RSV-associated bronchiolitis, and pneumonia.
- Analyzed RSVH rates across infant age cohorts: <3 months, 3-6 months, and >6 to <24 months.
Main Results:
- Over 1.1 million RSVHs occurred in children under 24 months.
- Infants <3 months had significantly higher RSVH rates (RR, 7.38) compared to older infants.
- The 3- to 6-month age group showed the highest proportion of RSV hospitalizations annually (14%-23%).
Conclusions:
- The highest relative rates of RSVH were observed in infants younger than 6 months.
- The 3- to 6-month age group accounted for the largest proportion of RSV hospitalizations.
- Further research is needed to understand factors influencing these RSV hospitalization trends.
Introduction:
Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in infants and young children and the leading cause of hospitalization in infants aged <1 year.
Methods:
We examined trends in RSV hospitalization (RSVH) among infants from 1998 to 2006, using the United States (US) National Hospital Discharge Survey (NHDS) database. RSVH was defined by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 079.6 (RSV), 466.11 (acute bronchiolitis due to RSV), and 480.1 (pneumonia due to RSV). Age at the time of hospitalization was determined using NHDS birth records; RSVH rates were analyzed for infants grouped into three age cohorts (<3 months, 3 to 6 months, and >6 to <24 months). Trends in hospitalization rates were evaluated using linear regression. Relative rates (RR) and 95% confidence intervals (CI) were computed to compare average RSVH rates for infants across age-specific groups. The annual proportion of RSVH by age group was also calculated.
Results:
Approximately 1.1 million (90,000-147,000 per year) RSVHs in predominantly term children aged <24 months were analyzed. Compared with children aged >6 to <24 months, rates for RSVH were significantly higher among infants aged <3 months (RR, 7.38; 95% CI, 7.35-7.41) and infants aged 3 to 6 months (RR, 5.28; 95% CI, 5.26-5.29). The proportion of RSVH in the first year of life was lowest among infants aged <1 month (9%). [corrected] The greatest proportion of RSVH was observed in children aged 3 to 6 months (14%-23% RSVH per year; chi-square P<0.0001). When the definition of RSVH was expanded to include unspecified hospitalizations for acute bronchiolitis, similar results were observed.
Conclusion:
RRs were highest among the <3- month and 3- to 6-month age groups. The highest proportion of RSVH was among the 3- to 6-month age group. Analysis of the impact of RSV season, clinical practices, and other factors on these trends is warranted.
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