TY - JOUR
T1 - Assessing the Burden of Laboratory-Confirmed Respiratory Syncytial Virus Infection in a Population Cohort of Australian Children Through Record Linkage
AU - Moore, Hannah C.
AU - Lim, Faye J.
AU - Fathima, Parveen
AU - Barnes, Rosanne
AU - Smith, David W.
AU - de Klerk, Nicholas
AU - Blyth, Christopher C.
PY - 2020/6/16
Y1 - 2020/6/16
N2 - BACKGROUND: Significant progress has been made towards an effective respiratory syncytial virus (RSV) vaccine. Age-stratified estimates of RSV burden are urgently needed for vaccine implementation. Current estimates are limited to small cohorts or clinical coding data only. We present estimates of laboratory-confirmed RSV across multiple severity levels. METHODS: We linked laboratory, perinatal, and hospital data of 469 589 children born in Western Australia in 1996-2012. Respiratory syncytial virus tests and detections were classified into community, emergency department (ED), and hospital levels to estimate infection rates. Clinical diagnoses given to children with RSV infection presenting to ED or hospitalized were identified. RESULTS: In 2000-2012, 10% (n = 45 699) of children were tested for RSV and 16% (n = 11 461) of these tested positive. Respiratory syncytial virus was detected in community, ED (both 0.3 per 1000 child-years), and hospital (2.4 per 1000 child-years) settings. Respiratory syncytial virus-confirmed rates were highest among children aged <3 months (31 per 1000 child-years). At least one third of children with RSV infection presenting to ED were diagnosed as other infection, other respiratory, or other (eg, agranulocytosis). CONCLUSIONS: Respiratory syncytial virus is pervasive across multiple severity levels and diagnoses. Vaccines targeting children <3 months must be prioritized. Given that most children are never tested, estimating the under-ascertainment of RSV infection is imperative.
AB - BACKGROUND: Significant progress has been made towards an effective respiratory syncytial virus (RSV) vaccine. Age-stratified estimates of RSV burden are urgently needed for vaccine implementation. Current estimates are limited to small cohorts or clinical coding data only. We present estimates of laboratory-confirmed RSV across multiple severity levels. METHODS: We linked laboratory, perinatal, and hospital data of 469 589 children born in Western Australia in 1996-2012. Respiratory syncytial virus tests and detections were classified into community, emergency department (ED), and hospital levels to estimate infection rates. Clinical diagnoses given to children with RSV infection presenting to ED or hospitalized were identified. RESULTS: In 2000-2012, 10% (n = 45 699) of children were tested for RSV and 16% (n = 11 461) of these tested positive. Respiratory syncytial virus was detected in community, ED (both 0.3 per 1000 child-years), and hospital (2.4 per 1000 child-years) settings. Respiratory syncytial virus-confirmed rates were highest among children aged <3 months (31 per 1000 child-years). At least one third of children with RSV infection presenting to ED were diagnosed as other infection, other respiratory, or other (eg, agranulocytosis). CONCLUSIONS: Respiratory syncytial virus is pervasive across multiple severity levels and diagnoses. Vaccines targeting children <3 months must be prioritized. Given that most children are never tested, estimating the under-ascertainment of RSV infection is imperative.
KW - data linkage
KW - hospitalization
KW - infants
KW - population
KW - respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=85086681498&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiaa058
DO - 10.1093/infdis/jiaa058
M3 - Article
C2 - 32031631
AN - SCOPUS:85086681498
VL - 222
SP - 92
EP - 101
JO - Journal Infectious Diseases
JF - Journal Infectious Diseases
SN - 0022-1899
IS - 1
ER -