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