Estimated Burden of Community-Onset Respiratory Syncytial Virus-Associated Hospitalizations Among Children Aged < 2 Years in the United States, 2014-15

• Authors: Carmen S. Arriola, Centers for Disease Control and Prevention; Lindsay Kim, Centers for Disease Control and Prevention; Gayle Langley, Centers for Disease Control and Prevention; Evan Anderson, Emory University; Kyle Openo, Atlanta Vet Affairs Medical Center; Andrew M. Martin, Atlanta Vet Affairs Medical Center; Ruth Lynfield, Minnesota Department of Health; Erica Bye, Minnesota Department of Health; Kathy Como-Sabetti, Minnesota Department of Health; Arthur Reingold, California Emerging Infections Program; Shua Chai, California Emerging Infections Program; Pam Daily, California Emerging Infections Program; Ann Thomas, Oregon Public Health Division; Courtney Crawford, Oregon Public Health Division; Carrie Reed, Emory University; S. Garg, Centers for Disease Control and Prevention; Sandra S. Chaves, Centers for Disease Control and Prevention
• Journal Title: Journal of the Pediatric Infectious Diseases Society
• Volume: Volume 9, Number 5
• Publisher: Oxford University Press | 2020-11-01, Pages 587-595
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1093/jpids/piz087
• Subjects: Health Sciences, Health Care Management; Health Sciences, Public Health; Biology, Virology; Health Sciences, Epidemiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Infectious Diseases; Pediatrics; children; disease burden; RSV; Young children; Influenza; Infections; Surveillance; diagnosis; Infants; Disease; Hospitals; Networks; Rates

Abstract

Background: Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged <2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. Methods: From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged <2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. Results: We identified 1554 RSV-associated hospitalizations in children aged <2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0-2, 3-5, 6-11, and 12-23 months, respectively. Extrapolating to the US population, an estimated 49 509-59 867 community-onset RSV-associated hospitalizations among children aged <2 years occurred during the 2014-2015 season. Conclusions: Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged <2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions.