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: 35.29). 11/1999; 282(15):1440-6.
Source: PubMed


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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    • "Respiratory syncytial virus (RSV) infects nearly every child by the age of 2[1]. It causes severe lower respiratory disease in ~2% of these infants, making RSV infection the most frequent cause of hospitalization of infants and children in the developed world234. While supportive care successfully treats nearly all of these infants, in the developing world RSV infection causes the death of an estimated 66,000 to 199,000 children under five years of age annually[5,6]. "
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    • "Respiratory Syncytial Virus (RSV) causes respiratory tract infection in humans and while infections are typically mild, serious illness associated with bronchiolitis and pneumonia can result in hospitalization and death [1]. Vulnerable populations at risk of severe RSV infection include premature infants, young children, the elderly, immunocompromised persons and those with underlying heart or chronic lung disease [2] [3]. "
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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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