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. 2019 Jan 1;68(1):113-119.
doi: 10.1093/cid/ciy413.

Pediatric Investigators Collaborative Network on Infections in Canada Study of Respiratory Syncytial Virus-associated Deaths in Pediatric Patients in Canada, 2003-2013

Jennifer Tam  1 , Jesse Papenburg  2 , Sergio Fanella  3 , Sandra Asner  1   4 , Michelle Barton  5 , Cybele Bergeron  6 , Shalini Desai  7 , Charles Hui  8 , Cheryl Foo  9 , Joanne M Langley  10 , Kirk Leifso  11 , My-Linh Ma  12 , Jeffrey Pernica  7 , Joan Robinson  13 , Roopi Singh  1 , Bruce Tapiero  14 , Upton Allen  1
Affiliations

Pediatric Investigators Collaborative Network on Infections in Canada Study of Respiratory Syncytial Virus-associated Deaths in Pediatric Patients in Canada, 2003-2013

Jennifer Tam et al. Clin Infect Dis. .

Abstract

Background: Respiratory syncytial virus (RSV) is a major cause of pneumonia and bronchiolitis in children. Mortality rates in previously healthy children hospitalized with RSV are <0.5%, but up to 37% in patients with underlying medical conditions. The objective of this study was to characterize factors associated with deaths among children hospitalized with RSV infection in Canadian pediatric centers.

Methods: A retrospective case series of children aged ≤18 years with RSV-associated deaths at centers affiliated with the Pediatric Investigators Collaborative Network on Infections in Canada from 2003–2013, inclusive, was performed [corrected]. Cases were identified using RSV-specific International Classification of Diseases codes to capture deaths where a diagnosis of RSV infection was present.

Results: Eleven centers reported 79 RSV-associated deaths. RSV was regarded as primarily responsible for death in 32 cases (40.5%). Median age at death was 11 months (range, <1 month to 16 years). Thirty-nine patients (49.4%) were male. Fourteen patients (17.7%) had no known risk factors for severe RSV infection. Healthcare-associated RSV infections (HAIs) accounted for 29 deaths (36.7%), with RSV judged to be the primary cause of death in 9 of these cases.

Conclusions: RSV-associated deaths were predominantly associated with chronic medical conditions and immunocompromised states among infants; however, 1 in 5 deaths occurred among patients with no known risk factors for severe RSV. Mortality associated with HAI accounted for over a third of cases. These findings highlight patient groups that should be targeted for RSV prevention strategies such as infection control practices, immunoprophylaxis, and future vaccination programs.

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Figures

Figure 1.
Figure 1.
Age distribution of children in whom respiratory syncytial virus was associated with death in Canadian tertiary care pediatric hospitals, 2003–2013.
Figure 2.
Figure 2.
Month of death of children in whom respiratory syncytial virus was associated with death in Canadian tertiary care pediatric hospitals, 2003–2013.
See this image and copyright information in PMC

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