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Updated: Jun 25, 2025
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
Modelling respiratory syncytial virus age-specific risk of hospitalisation in term and preterm infants
Fiona Giannini1, Alexandra B Hogan2, Mohinder Sarna3,4
1Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA, 6009, Australia. fiona.giannini@telethonkids.org.au.
Insights
New RSV prevention strategies are needed. Preterm infants face 2.6 times higher hospitalization risk from RSV than term infants, with risk declining rapidly in the first year of life.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory infections in infants globally.
- Infants born preterm are at the highest risk for severe RSV disease, particularly within the first six months of life.
- New RSV immunisation programs necessitate data-driven strategies for optimal therapeutic use and control.
Purpose of the Study:
- To develop a dynamic compartmental model to characterize RSV transmission and hospitalization risk in Western Australia.
- To create an age-to-risk function that accounts for preterm status and RSV exposure history.
- To provide a foundation for evaluating the impact of RSV prevention measures.
Main Methods:
- A dynamic compartmental model was developed using linked laboratory, perinatal, and hospitalization data (2000-2012) from metropolitan Western Australia.
- The model stratified infants by age and prior exposure, accounting for differential hospitalization risks in preterm (<37 weeks gestation) versus term infants.
- An age-to-risk function was formulated to predict hospitalization risk based on age, RSV exposure, and preterm status.
Main Results:
- The age-to-risk function demonstrated that hospitalization risk, given RSV infection, decreases rapidly within the first 12 months of life for all infants.
- Preterm infants exhibit a 2.6-fold higher hospitalization risk compared to term infants.
- Hospitalization risk, given infection, drops to below 10% of the birth risk by 7 months for term infants and 9 months for preterm infants.
Conclusions:
- The dynamic model and age-to-risk function accurately characterize RSV epidemiology in metropolitan Western Australia.
- The model's stratification by preterm status allows for comparative assessment of targeted versus all-population prevention strategies.
- The developed age-to-risk function has broad applicability for epidemiological characterization of RSV.
Background:
Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infections in children worldwide. The highest incidence of severe disease is in the first 6 months of life, with infants born preterm at greatest risk for severe RSV infections. The licensure of new RSV therapeutics (a long-acting monoclonal antibody and a maternal vaccine) in Europe, USA, UK and most recently in Australia, has driven the need for strategic decision making on the implementation of RSV immunisation programs. Data driven approaches, considering the local RSV epidemiology, are critical to advise on the optimal use of these therapeutics for effective RSV control.
Methods:
We developed a dynamic compartmental model of RSV transmission fitted to individually-linked population-based laboratory, perinatal and hospitalisation data for 2000-2012 from metropolitan Western Australia (WA), stratified by age and prior exposure. We account for the differential risk of RSV-hospitalisation in full-term and preterm infants (defined as < 37 weeks gestation). We formulated a function relating age, RSV exposure history, and preterm status to the risk of RSV-hospitalisation given infection.
Results:
The age-to-risk function shows that risk of hospitalisation, given RSV infection, declines quickly in the first 12 months of life for all infants and is 2.6 times higher in preterm compared with term infants. The hospitalisation risk, given infection, declines to < 10% of the risk at birth by age 7 months for term infants and by 9 months for preterm infants.
Conclusions:
The dynamic model, using the age-to-risk function, characterises RSV epidemiology for metropolitan WA and can now be extended to predict the impact of prevention measures. The stratification of the model by preterm status will enable the comparative assessment of potential strategies in the extended model that target this RSV risk group relative to all-population approaches. Furthermore, the age-to-risk function developed in this work has wider relevance to the epidemiological characterisation of RSV.
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