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. 2020 Nov 10;9(5):587-595.
doi: 10.1093/jpids/piz087.

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

Carmen S Arriola  1 , Lindsay Kim  2 , Gayle Langley  2 , Evan J Anderson  3   4 , Kyle Openo  4 , Andrew M Martin  4 , Ruth Lynfield  5 , Erica Bye  5 , Kathy Como-Sabetti  5 , Arthur Reingold  6 , Shua Chai  6 , Pam Daily  6 , Ann Thomas  7 , Courtney Crawford  7 , C Reed  1 , S Garg  1 , Sandra S Chaves  1
Affiliations

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

Carmen S Arriola et al. J Pediatric Infect Dis Soc. .

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.

Keywords: RSV; children; disease burden.

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Figures

Figure 1.
Figure 1.
Proportion of patients tested for RSV by age group and study site, Influenza Hospitalization Surveillance Network, December 2014–April 2015. Abbreviation: RSV, respiratory syncytial virus.
Figure 2.
Figure 2.
Distribution of respiratory syncytial virus (RSV) test type use by site and age group in children aged <2 years hospitalized with RSV, Influenza Hospitalization Surveillance Network, December 2014–April 2015. *Other: Viral culture, other unknown. Abbreviations: CA, California; GA, Georgia; MN, Minnesota; OR, Oregon; PCR, polymerase chain reaction.
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