-
Incidence and seasonality of respiratory syncytial virus hospitalisations in young children in Denmark, 2010 to 2015
- Martin T. Jepsen1,2 , Ramona Trebbien1,2 , Hanne Dorthe Emborg1 , Tyra G. Krause1 , Kristian Schønning3,4 , Marianne Voldstedlund1 , Jens Nielsen1 , Thea K. Fischer1,5
-
View Affiliations Hide AffiliationsAffiliations: 1 Statens Serum Institut, Copenhagen S, Denmark 2 These authors contributed equally to this manuscript. 3 Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark 4 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 5 Department of Infectious Diseases and Centre of Global Health, University of Southern Denmark, Odense, DenmarkThea Kølsen Fischerthf ssi.dk
-
View Citation Hide Citation
Citation style for this article: Jepsen Martin T., Trebbien Ramona, Emborg Hanne Dorthe, Krause Tyra G., Schønning Kristian, Voldstedlund Marianne, Nielsen Jens, Fischer Thea K.. Incidence and seasonality of respiratory syncytial virus hospitalisations in young children in Denmark, 2010 to 2015. Euro Surveill. 2018;23(3):pii=17-00163. https://doi.org/10.2807/1560-7917.ES.2018.23.3.17-00163 Received: 04 Mar 2017; Accepted: 25 Jun 2017
Abstract
For future decisions on respiratory syncytial virus (RSV)-vaccination strategies and implementation into national immunisation-programmes, we used national registry data (hospitalisation, microbiology and vital statistics) to determine the age-specific incidence and direct medical costs of annual RSV-associated admissions in children < 5 years-old for the period of 2010–2015. We identified ca 2,500 RSV-associated hospitalisations annually amounting to total direct medical-costs of ca EUR 4.1 million per year. The incidence of RSV-associated hospitalisations peaked in infants 1–2 months of age followed by infants 2–3 months of age, and infants < 1 month of age, respectively. Infant boys were at higher risk of severe RSV infection as compared to infant girls: male-to-female ratio peaked with 1.4 at four months of age and gradually levelled out with increasing age to 1.0 at 4 years of age. Five RSV-associated deaths were identified. Our findings demonstrate that in a western country as Denmark, RSV constitutes a considerable burden on childhood health. Furthermore, the best approach to reduce the high incidence of RSV-associated hospitalisations in young infants < 3 months of age may be maternal vaccination due to general challenges in achieving sufficient and protective immune responses in young infants.
Article metrics loading...
Full text loading...
References
-
Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375(9725):1545-55. https://doi.org/10.1016/S0140-6736(10)60206-1 PMID: 20399493
-
Bardach A, Rey-Ares L, Cafferata ML, Cormick G, Romano M, Ruvinsky S, et al. Systematic review and meta-analysis of respiratory syncytial virus infection epidemiology in Latin America. Rev Med Virol. 2014;24(2):76-89. https://doi.org/10.1002/rmv.1775 PMID: 24757727
-
Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009;360(6):588-98. https://doi.org/10.1056/NEJMoa0804877 PMID: 19196675
-
Chi H, Chang IS, Tsai FY, Huang LM, Shao PL, Chiu NC, et al. Epidemiological study of hospitalization associated with respiratory syncytial virus infection in Taiwanese children between 2004 and 2007. J Formos Med Assoc. 2011;110(6):388-96. https://doi.org/10.1016/S0929-6646(11)60057-0 PMID: 21741007
-
Zhou H, Thompson WW, Viboud CG, Ringholz CM, Cheng PY, Steiner C, et al. Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008. Clin Infect Dis. 2012;54(10):1427-36. https://doi.org/10.1093/cid/cis211 PMID: 22495079
-
Weigl JAI. RSV--a substantial slice of the airway disease burden and the way to a vaccine. Paediatr Int Child Health. 2012;32(sup2) Suppl 2;S9-15. https://doi.org/10.1179/2046904712Z.00000000073 PMID: 23394753
-
Nolan T, Borja-Tabora C, Lopez P, Weckx L, Ulloa-Gutierrez R, Lazcano-Ponce E, et al. Prevalence and Incidence of Respiratory Syncytial Virus and Other Respiratory Viral Infections in Children Aged 6 Months to 10 Years With Influenza-like Illness Enrolled in a Randomized Trial. Clin Infect Dis. 2015;60(11):e80-9. https://doi.org/10.1093/cid/civ065 PMID: 25673560
-
Jain S, Williams DJ, Arnold SR, Ampofo K, Bramley AM, Reed C, et al. CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015;372(9):835-45. https://doi.org/10.1056/NEJMoa1405870 PMID: 25714161
-
Homaira N, Oei JL, Mallitt KA, Abdel-Latif ME, Hilder L, Bajuk B, et al. High burden of RSV hospitalization in very young children: a data linkage study. Epidemiol Infect. 2016;144(8):1612-21. https://doi.org/10.1017/S0950268815003015 PMID: 26626237
-
Graham BS, Anderson LJ. Challenges and Opportunities for Respiratory Syncytial Virus Vaccines. In: Anderson LJ, Graham BS, editors. Challenges and Opportunities for Respiratory Syncytial Virus Vaccines. Berlin, Heidelberg: Springer Berlin Heidelberg; 2013. p. 391-404.
-
Agoti CN, Mwihuri AG, Sande CJ, Onyango CO, Medley GF, Cane PA, et al. Genetic relatedness of infecting and reinfecting respiratory syncytial virus strains identified in a birth cohort from rural Kenya. J Infect Dis. 2012;206(10):1532-41. https://doi.org/10.1093/infdis/jis570 PMID: 22966119
-
Ohuma EO, Okiro EA, Ochola R, Sande CJ, Cane PA, Medley GF, et al. The natural history of respiratory syncytial virus in a birth cohort: the influence of age and previous infection on reinfection and disease. Am J Epidemiol. 2012;176(9):794-802. https://doi.org/10.1093/aje/kws257 PMID: 23059788
-
Hall CB, Walsh EE, Long CE, Schnabel KC. Immunity to and frequency of reinfection with respiratory syncytial virus. J Infect Dis. 1991;163(4):693-8. https://doi.org/10.1093/infdis/163.4.693 PMID: 2010624
-
Hall CB. Respiratory syncytial virus in young children. Lancet. 2010;375(9725):1500-2. https://doi.org/10.1016/S0140-6736(10)60401-1 PMID: 20399494
-
American Academy of Pediatrics Committee on Infectious Diseases American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics. 2014;134(2):415-20. https://doi.org/10.1542/peds.2014-1665 PMID: 25070315
-
Kim HW, Canchola JG, Brandt CD, Pyles G, Chanock RM, Jensen K, et al. Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. Am J Epidemiol. 1969;89(4):422-34. https://doi.org/10.1093/oxfordjournals.aje.a120955 PMID: 4305198
-
Green CA, Scarselli E, Sande CJ, Thompson AJ, de Lara CM, Taylor KS, et al. Chimpanzee adenovirus and MVA-vectored respiratory syncytial virus vaccine is safe and expands humoral and cellular immunity in adults. Sci Transl Med. 2015;7(300):300ra126. https://doi.org/10.1126/scitranslmed.aac5745 PMID: 26268313
-
Phan SI, Chen Z, Xu P, Li Z, Gao X, Foster SL, et al. A respiratory syncytial virus (RSV) vaccine based on parainfluenza virus 5 (PIV5). Vaccine. 2014;32(25):3050-7. https://doi.org/10.1016/j.vaccine.2014.03.049 PMID: 24717150
-
Acosta PL, Caballero MT, Polack FP. Brief history and characterization of enhanced respiratory syncytial virus disease. Clin Vaccine Immunol. 2016;23(3):189-95. https://doi.org/10.1128/CVI.00609-15 PMID: 26677198
-
Modjarrad K, Giersing B, Kaslow DC, Smith PG, Moorthy VSWHO RSV Vaccine Consultation Expert Group. WHO consultation on Respiratory Syncytial Virus Vaccine Development Report from a World Health Organization Meeting held on 23-24 March 2015. Vaccine. 2016;34(2):190-7. https://doi.org/10.1016/j.vaccine.2015.05.093 PMID: 26100926
-
Falsey AR, McElhaney JE, Beran J, van Essen GA, Duval X, Esen M, et al. Respiratory syncytial virus and other respiratory viral infections in older adults with moderate to severe influenza-like illness. J Infect Dis. 2014;209(12):1873-81. https://doi.org/10.1093/infdis/jit839 PMID: 24482398
-
Hall CB, Weinberg GA, Blumkin AK, Edwards KM, Staat MA, Schultz AF, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 2013;132(2):e341-8. https://doi.org/10.1542/peds.2013-0303 PMID: 23878043
-
Nair H, Simões EAF, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JSF, et al. Severe Acute Lower Respiratory Infections Working Group. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380-90. https://doi.org/10.1016/S0140-6736(12)61901-1 PMID: 23369797
-
Voldstedlund M, Haarh M, Mølbak K, the MiBa Board of Representatives CMiBa Board of Representatives. The danish microbiology database (MIBA) 2010 to 2013. Euro Surveill. 2014;19(1):20667. https://doi.org/10.2807/1560-7917.ES2014.19.1.20667 PMID: 24434175
-
World Health Organization (WHO). International Statistical Classification of Diseases and Health-related Problems, 10th Revision. Geneva: WHO; 2015. [Accessed 13 Jan 2017]. Available from: http://apps.who.int/classifications/icd10/browse/2016/en
-
Juel K, Helweg-Larsen K. The Danish registers of causes of death. Dan Med Bull. 1999;46(4):354-7. PMID: 10514943
-
Gubbels S, Nielsen KS, Sandegaard J, Mølbak K, Nielsen J. The development and use of a new methodology to reconstruct courses of admission and ambulatory care based on the Danish National Patient Registry. Int J Med Inform. 2016;95:49-59. https://doi.org/10.1016/j.ijmedinf.2016.08.003 PMID: 27697232
-
Sundhedsdatastyrelsen. DRG-takster 2016. 2016. [Accessed 13 Jan 2017]. Available from: http://sundhedsdatastyrelsen.dk/da/afregning-og-finansiering/takster-drg/takster-2016
-
Hacimustafaoglu M, Celebi S, Aynaci E, Sinirtas M, Koksal N, Kucukerdogan A, et al. The progression of maternal RSV antibodies in the offspring. Arch Dis Child. 2004;89(1):52-3. https://doi.org/10.1136/adc.2002.017780 PMID: 14709507
-
Munoz FM, Piedra PA, Glezen WP. Safety and immunogenicity of respiratory syncytial virus purified fusion protein-2 vaccine in pregnant women. Vaccine. 2003;21(24):3465-7. https://doi.org/10.1016/S0264-410X(03)00352-9 PMID: 12850361
-
Laxminarayan R, Jamison DT, Krupnick AJ, Norheim OF. Valuing vaccines using value of statistical life measures. Vaccine. 2014;32(39):5065-70. https://doi.org/10.1016/j.vaccine.2014.07.003 PMID: 25045822
-
Reyes M, Eriksson M, Bennet R, Hedlund KO, Ehrnst A. Regular pattern of respiratory syncytial virus and rotavirus infections and relation to weather in Stockholm, 1984--1993. Clin Microbiol Infect. 1997;3(6):640-6. https://doi.org/10.1111/j.1469-0691.1997.tb00471.x PMID: 11864206
-
Eriksson M, Bennet R, Rotzén-Ostlund M, von Sydow M, Wirgart BZ. Population-based rates of severe respiratory syncytial virus infection in children with and without risk factors, and outcome in a tertiary care setting. Acta Paediatr. 2002;91(5):593-8. https://doi.org/10.1111/j.1651-2227.2002.tb03282.x PMID: 12113331
-
White LJ, Waris M, Cane PA, Nokes DJ, Medley GF. The transmission dynamics of groups A and B human respiratory syncytial virus (hRSV) in England & Wales and Finland: seasonality and cross-protection. Epidemiol Infect. 2005;133(2):279-89. https://doi.org/10.1017/S0950268804003450 PMID: 15816153
-
Haynes AK, Prill MM, Iwane MK, Gerber SICenters for Disease Control and Prevention (CDC). Respiratory syncytial virus--United States, July 2012-June 2014. MMWR Morb Mortal Wkly Rep. 2014;63(48):1133-6. PMID: 25474034
-
Doucette A, Jiang X, Fryzek J, Coalson J, McLaurin K, Ambrose CS. Trends in Respiratory Syncytial Virus and Bronchiolitis Hospitalization Rates in High-Risk Infants in a United States Nationally Representative Database, 1997-2012. PLoS One. 2016;11(4):e0152208. https://doi.org/10.1371/journal.pone.0152208 PMID: 27050095
-
Waris M. Pattern of respiratory syncytial virus epidemics in Finland: two-year cycles with alternating prevalence of groups A and B. J Infect Dis. 1991;163(3):464-9. https://doi.org/10.1093/infdis/163.3.464 PMID: 1995719
-
Weigl JAI, Puppe W, Schmitt HJ. Seasonality of respiratory syncytial virus-positive hospitalizations in children in Kiel, Germany, over a 7-year period. Infection. 2002;30(4):186-92. https://doi.org/10.1007/s15010-002-2159-1 PMID: 12236558
-
Duppenthaler A, Gorgievski-Hrisoho M, Frey U, Aebi C. Two-year periodicity of respiratory syncytial virus epidemics in Switzerland. Infection. 2003;31(2):75-80. https://doi.org/10.1007/s15010-002-3124-8 PMID: 12682811
-
Avendaño LF, Palomino MA, Larrañaga C. Surveillance for respiratory syncytial virus in infants hospitalized for acute lower respiratory infection in Chile (1989 to 2000). J Clin Microbiol. 2003;41(10):4879-82. https://doi.org/10.1128/JCM.41.10.4879-4882.2003 PMID: 14532249
-
Deshpande SA, Northern V. The clinical and health economic burden of respiratory syncytial virus disease among children under 2 years of age in a defined geographical area. Arch Dis Child. 2003;88(12):1065-9. https://doi.org/10.1136/adc.88.12.1065 PMID: 14670770
-
Svensson C, Berg K, Sigurs N, Trollfors B. Incidence, risk factors and hospital burden in children under five years of age hospitalised with respiratory syncytial virus infections. Acta Paediatr. 2015;104(9):922-6. https://doi.org/10.1111/apa.13061 PMID: 26036725
-
La Via WV, Grant SW, Stutman HR, Marks MI. Clinical profile of pediatric patients hospitalized with respiratory syncytial virus infection. Clin Pediatr (Phila). 1993;32(8):450-4. https://doi.org/10.1177/000992289303200801 PMID: 8104752
-
Numa A. Outcome of respiratory syncytial virus infection and a cost-benefit analysis of prophylaxis. J Paediatr Child Health. 2000;36(5):422-7. https://doi.org/10.1046/j.1440-1754.2000.00303.x PMID: 11036794
-
Hussey GD, Apolles P, Arendse Z, Yeates J, Robertson A, Swingler G, et al. Respiratory syncytial virus infection in children hospitalised with acute lower respiratory tract infection. S Afr Med J. 2000;90(5):509-12. PMID: 10901825
-
Fjaerli HO, Farstad T, Bratlid D. Hospitalisations for respiratory syncytial virus bronchiolitis in Akershus, Norway, 1993-2000: a population-based retrospective study. BMC Pediatr. 2004;4(1):25. https://doi.org/10.1186/1471-2431-4-25 PMID: 15606912
-
Tsolia MN, Kafetzis D, Danelatou K, Astral H, Kallergi K, Spyridis P, et al. Epidemiology of respiratory syncytial virus bronchiolitis in hospitalized infants in Greece. Eur J Epidemiol. 2003;18(1):55-61. https://doi.org/10.1023/A:1022556215190 PMID: 12705624
-
Hon KL, Leung TF, Cheng WY, Ko NM, Tang WK, Wong WW, et al. Respiratory syncytial virus morbidity, premorbid factors, seasonality, and implications for prophylaxis. J Crit Care. 2012;27(5):464-8. https://doi.org/10.1016/j.jcrc.2011.12.001 PMID: 22227087
-
Gil-Prieto R, Gonzalez-Escalada A, Marín-García P, Gallardo-Pino C, Gil-de-Miguel A. Respiratory Syncytial Virus Bronchiolitis in Children up to 5 Years of Age in Spain: Epidemiology and Comorbidities: An Observational Study. Medicine (Baltimore). 2015;94(21):e831. https://doi.org/10.1097/MD.0000000000000831 PMID: 26020386
-
Bont L, Checchia PA, Fauroux B, Figueras-Aloy J, Manzoni P, Paes B, et al. Defining the Epidemiology and Burden of Severe Respiratory Syncytial Virus Infection Among Infants and Children in Western Countries. Infect Dis Ther. 2016;5(3):271-98. https://doi.org/10.1007/s40121-016-0123-0 PMID: 27480325
Data & Media loading...