Epidemiology of laboratory-confirmed respiratory syncytial virus infection in young children in England, 2010-2014: the importance of birth month

Abstract

The epidemiology of laboratory-confirmed respiratory syncytial virus (RSV) infections in young children has not recently been described in England, and is an essential step in identifying optimal target groups for future licensed RSV vaccines. We used two laboratory surveillance systems to examine the total number and number of positive RSV tests in children aged <5 years in England from 2010 to 2014. We derived odds ratios (ORs) with 95% confidence intervals (CIs) comparing children by birth month, using multivariable logistic regression models adjusted for age, season and sex. Forty-seven percent of RSV tests (29 851/63 827) and 57% (7405/13 034) of positive results in children aged <5 years were in infants aged <6 months. Moreover, 38% (4982/13 034) of positive results were in infants aged <3 months. Infants born in September, October and November had the highest odds of a positive RSV test during their first year of life compared to infants born in January (OR 2·1, 95% CI 1·7-2·7; OR 2·4, 95% CI 2·1-2·8; and OR 2·4, 95% CI 2·1-2·7, respectively). Our results highlight the importance of young age and birth month near the beginning of the RSV season to the risk of laboratory-confirmed RSV infection. Future control measures should consider protection for these groups.

Keywords: Children; England; epidemiology; laboratory-confirmed; respiratory syncytial virus.

Fig. 1.

Total number (blue) and number of positive (red) respiratory syncytial virus tests in children aged <5 years recorded in the Respiratory DataMart System from week 27 (2010) to week 26 (2014), over time.

Fig. 2.

Total number (red) and number of positive (green) respiratory syncytial virus tests in children aged <5 years recorded in the Respiratory DataMart System from week 27 (2010) to week 26 (2014), by age in months.

Fig. 3.

Odds ratios and 95% confidence intervals (CI) from final multiple logistic regression model using Respiratory DataMart System data to compare odds of a positive result if tested for respiratory syncytial virus by birth month, showing results for infants aged <1 year only. Infants born in January are the baseline group.

Fig. 4.

Odds ratios from final multiple logistic regression model using Respiratory DataMart System data to compare odds of a positive result if tested for respiratory syncytial virus by birth month, stratified by age in years. Infants born in January are the baseline group.