Article

Bronchiolitis-associated hospitalizations among US children, 1980-1996

Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 11/1999; 282(15):1440-6.
Source: PubMed

ABSTRACT Respiratory syncytial virus (RSV) causes more lower respiratory tract infections, often manifested as bronchiolitis, among young children than any other pathogen. Few national estimates exist of the hospitalizations attributable to RSV, and recent advances in prophylaxis warrant an update of these estimates.
To describe rates of bronchiolitis-associated hospitalizations and to estimate current hospitalizations associated with RSV infection.
Descriptive analysis of US National Hospital Discharge Survey data from 1980 through 1996.
Children younger than 5 years who were hospitalized in short-stay, non-federal hospitals for bronchiolitis.
Bronchiolitis-associated hospitalization rates by age and year.
During the 17-year study period, an estimated 1.65 million hospitalizations for bronchiolitis occurred among children younger than 5 years, accounting for 7.0 million inpatient days. Fifty-seven percent of these hospitalizations occurred among children younger than 6 months and 81 % among those younger than 1 year. Among children younger than 1 year, annual bronchiolitis hospitalization rates increased 2.4-fold, from 12.9 per 1000 in 1980 to 31.2 per 1000 in 1996. During 1988-1996, infant hospitalization rates for bronchiolitis increased significantly (P for trend <.001), while hospitalization rates for lower respiratory tract diseases excluding bronchiolitis did not vary significantly (P for trend = .20). The proportion of hospitalizations for lower respiratory tract illnesses among children younger than 1 year associated with bronchiolitis increased from 22.2% in 1980 to 47.4% in 1996; among total hospitalizations, this proportion increased from 5.4% to 16.4%. Averaging bronchiolitis hospitalizations during 1994-1996 and assuming that RSV was the etiologic agent in 50% to 80% of November through April hospitalizations, an estimated 51, 240 to 81, 985 annual bronchiolitis hospitalizations among children younger than 1 year were related to RSV infection.
During 1980-1996, rates of hospitalization of infants with bronchiolitis increased substantially, as did the proportion of total and lower respiratory tract hospitalizations associated with bronchiolitis. Annual bronchiolitis hospitalizations associated with RSV infection among infants may be greater than previous estimates for RSV bronchiolitis and pneumonia hospitalizations combined.

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    • "The majority of children hospitalized for RSV infection are under 6 months of age [3]. RSV infections are responsible for 27-96% of hospitalized cases in developing countries [4], and about 100,000 infants are hospitalized annually in the United States alone [5] [6]. RSV infections are also responsible for mortality, with almost nine times the mortality rate of influenza [7]. "
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    • "The majority of children hospitalized for RSV infection are under 6 months of age [3]. RSV infections are responsible for 27-96% of hospitalized cases in developing countries [4], and about 100,000 infants are hospitalized annually in the United States alone [5] [6]. RSV infections are also responsible for mortality, with almost nine times the mortality rate of influenza [7]. "
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    • "The majority of children hospitalized for RSV infection are under 6 months of age [3]. RSV infections are responsible for 27-96% of hospitalized cases in developing countries [4], and about 100,000 infants are hospitalized annually in the United States alone [5] [6]. RSV infections are also responsible for mortality, with almost nine times the mortality rate of influenza [7]. "
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    ABSTRACT: Background: The present study was to investigate the incidence of the respiratory syncytial virus infection in children and to characterize the RSV circulating in Khartoum state during 2011-12 winter seasons. Methodology: Throat swab specimens collected from 224 children less than 5 years old, with respiratory tract infections admitted at Khartoum Hospitals in winter season (2011-2012), were screened for RSV using direct immunofluorescence assay (DFA) and reverse transcription-polymerase chain reaction (RT-PCR). Isolation in cell culture followed by nucleotide sequencing and bioinformatics analysis based on the G gene, were done for the RT-PCR positive RSV samples. Results: Out of 224 patients, RSV infections were detected in 136 (60.7%) patients, by using DFA technique, and 44 (19.6%) patients using RT-PCR. 22 strains of RSV were isolated in Hep-2 cell line. The clinical symptoms including Bronchiolitis, Pneumonia, Asthma and Allergy showed significantly different rates (p<0.05) in having RSV infection, (P-value = 0.017, 0.002, 0.0001, 0.0001) respectively. Bioinformatics analysis of nucleotide sequences of 7 cell culture isolated RSV strains revealed that all analyzed RSV belonged to the RSV-A genotype. Phylogenetic tree of RSV-A sequences showed that, all Sudanese strains were grouped with strains from Belgium and Saudi Arabia. Conclusions: This is the first report on molecular characterization that describes the circulation of RSV genotype in Sudan. DFA and RT-PCR offers rapid methods for detection of RSV in hospitalized children with Respiratory tract infection (RTI).
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