RSV Overview

Disease Burden

RSV is a major human pathogen and the leading cause of infant hospitalization.¹ It is also the leading cause of lower respiratory infection in infants and small children. Approximately two-thirds of all infants are infected with RSV during their first year, and infection is virtually universal by the age of two years.^2,3 Reinfection is also common, because infection does not provide long-lasting immunity. In a study of 15 adults who were challenged by RSV after a natural infection, 47% were reinfected after two months; by 26 months 73% were reinfected.⁴ Some children may become infected during three or four successive RSV seasons.⁴

Premature Infants Are At High Risk for Severe Hospital Outcomes
From RSV⁵

Once Hospitalized With RSV, 33-35 Week GA Infants Have Significantly Worse Outcomes vs Full-Term Infants

^†ICU = intensive care unit.
^*LOS = length of stay.
^‡Statistically significant difference from full-term infants (Duncan multiple range test).
^§P values derived from comparison of 4 GA groups (≤32 weeks' GA, 33-35 weeks' GA, 36 weeks' GA, ≥37 weeks' GA).

A retrospective, multicenter study by Horn and Smout measured the severity of illness in 304 infants ≤1 year of age who were admitted to the hospital with confirmed RSV from April 1995 to September 1996.

In the same study⁵:
Both ≤32 week GA and 33-35 week GA infant groups had greater use of hospital resources and poorer hospital outcomes compared to full-term infants.

Each year, respiratory syncytial virus (RSV) is responsible for up to 125,000 pediatric hospitalizations in the United States.^6-8 Among hospitalized infants with chronic lung and heart disease, the RSV mortality rate may be as high as 3.5%.⁹ Up to half of all pediatric admissions for bronchiolitis and 25% of admissions for pneumonia are due to RSV.¹⁰

Prior to 1998, reported rates of hospital admissions for respiratory infections among low birth weight and premature infants ranged from 41 to 85 admissions per 100 child-years.¹¹ And in several different studies performed between 1989 and 1998, RSV accounted for 42% to 85% of reported infections.^12-14

In 2003, a major children's hospital in Chicago reported an overall weighted mean cost of $41,620 hospital cost per RSV hospitalization—higher than the previously reported accepted average of approximately $27,100 in 1998.¹⁵

References

1. Leader S, Kohlhase K. Ped Infec Dis J. 2002;21:629-632.
2. Glezen WP, Taber LH, Frank AL, et al. Am J Dis Child. 1986;140:543-546.
3. Holberg CJ, Wright AI, Martinez FD, et al. Am J Epidemiol. 1991;133:1135-1151.
4. Hall CB, Walsh EE, Long CE, Schnabel KC. J Infect Dis. 1991;163:693-698.
5. Horn SD, Smout RJ. J Pediatr. 2003;143:S133-S141.
6. Shay DK, Holman RC, Newman RD, et al. JAMA. 1999;282:1440-1446.
7. McLaurin KK, Leader S. Pediatric Academic Societies Meeting, May 14-17, 2005. Abstract #936.
8. Leader S, Kohlhase K. J Pediatrics. 2003;143(5 suppl):S127-S132.
9. Navas L, Wang E, de Carvalho V, et al. J Pediatr. 1992;121:348-354.
10. Heilman CA. J Infect Dis. 1990;161:402-406.
11. Yuksel B, Greenough A. Arch Pediatr Adolesc Med. 1994;148:384-388.
12. Yun B-Y, Kim M-R, Park J-Y. Pediatr Infect Dis J. 1995;14:1054-1059.
13. Wright AL, Taussig LM, Ray CG, et al. Am J Epidemiol. 1989;129:1232-1246.
14. Donati D, Cellesi C, Rossolini A, et al. New Microbiol. 1998;21:365-374.
15. Katz BZ, et al. Pharma and Therap. 2003;28(5):343-345.

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