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RSV Infection in Young Children

In recent years, the burden of respiratory syncytial virus infection in otherwise healthy youngsters has been unexpectedly large.

Although respiratory syncytial virus (RSV) is a well-recognized cause of respiratory tract illness in infants, the burden of disease in somewhat older children is less well defined. To learn more about the effects of RSV infection among children aged <5 years, researchers with the CDC’s New Vaccine Surveillance Network performed a prospective, population-based survey of acute respiratory infections in three geographically separate counties in the U.S.

Eligible children (n=6225) were hospitalized between 2000 and 2004 or were seen as outpatients in emergency departments (EDs) or primary care clinics between 2002 and 2004; all had received a diagnosis of acute respiratory infection. Nasal and throat swabs for viral detection were obtained from the 5067 children (81%) who were enrolled in the study.

RSV was identified by reverse-transcriptase PCR or tissue culture in specimens from 919 of the enrolled children (18%). Among children in whom RSV was identified, most (97% of outpatients, 55% of inpatients) had not been diagnosed with RSV-associated illness, and 69% had no coexisting health conditions. RSV infection was associated with 20% of the annual hospitalizations, 18% of the ED visits, and 15% of the office visits for acute respiratory infections in the cohort from November through April of the study years. Extrapolating from their findings, the investigators estimated that RSV infections result in 1 of 334 hospitalizations, 1 of 38 ED visits, and 1 of 13 primary care office visits annually in the U.S. among children aged <5 years.

Comment: These findings reveal a staggering burden of RSV infection in young children and highlight the need for additional means to treat and prevent such illness. Any means that are effective in this population would probably also lower the infection rate among high-risk adults who are in contact with children (JW Infect Dis May 20 2005).

— Larry M. Baddour, MD

Published in Journal Watch Infectious Diseases February 4, 2009

Citation(s):

Hall CB et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med 2009 Feb 5; 360:588.

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