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Risk of primary infection and reinfection with respiratory syncytial virus
Insights
Respiratory syncytial virus (RSV) frequently infects young children, often causing lower respiratory tract disease. While reinfection risk decreases over time, nearly 100,000 US children are hospitalized annually due to severe RSV illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Respiratory syncytial virus (RSV) is a primary cause of severe lower respiratory tract infections in infants and young children.
- High infection rates are observed in the first two years of life, with nearly universal infection by 24 months.
- Lower respiratory tract disease (LRD) is common, but most children experience only one LRD episode.
Purpose of the Study:
- To investigate the incidence and patterns of respiratory syncytial virus infection and reinfection in young children.
- To determine the relationship between antibody levels and the risk of RSV reinfection.
- To estimate the number of children hospitalized annually due to severe RSV infections.
Main Methods:
- Longitudinal follow-up of children from birth in the Houston Family Study.
- Monitoring of infection rates, LRD incidence, and reinfection occurrences.
- Analysis of the correlation between serum neutralizing antibody levels and reinfection risk.
Main Results:
- RSV infection rates were 68.8/100 in the first year and 82.6/100 in the second year of life.
- Approximately 50% of children experienced two RSV infections by 24 months of age.
- The risk of reinfection was inversely related to serum neutralizing antibody levels and decreased significantly by the fourth year.
- An estimated 100,000 children in the U.S. require hospitalization annually for severe RSV illness.
Conclusions:
- RSV infection is nearly universal in early childhood, with a notable incidence of reinfection.
- Lower antibody levels correlate with a higher risk of reinfection, though subsequent illnesses are typically milder.
- Severe RSV infections necessitate hospitalization for a substantial number of children each year in the United States.
Abstract:
Respiratory syncytial virus is the most important cause of serious lower respiratory tract infection in children. For children followed up from birth in the Houston Family Study, the infection rate was 68.8/100 children less than 12 months of age and 82.6/100 during the second year of life. Virtually all children had been infected at least once by 24 months of age, and about one half had experienced two infections. Although lower respiratory tract disease (LRD) was common (22.4/100 during year 1 and 13.0/100 during year 2), most children had only one LRD illness. The risk of reinfection was inversely related to the level of neutralizing antibodies in the serum. Reinfection illnesses were generally mild, and risk of reinfection decreased to only 33.3/100 during year 4. Studies of children with LRD and surveys of hospitalizations provide the basis for an estimate of the number of children hospitalized each year during the respiratory syncytial virus epidemics. Almost 100,000 children in the United States experience an illness of sufficient severity to require hospitalization.