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. 2005 Jan;90(1):F64–F68. doi: 10.1136/adc.2003.029710

Hospital admission of high risk infants for respiratory syncytial virus infection: implications for palivizumab prophylaxis

T Heikkinen, H Valkonen, L Lehtonen, R Vainionpaa, O Ruuskanen
PMCID: PMC1721807  PMID: 15613580

Abstract

Objectives: To determine the rates of hospital admission for respiratory syncytial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis on admissions for RSV infection.

Design: Retrospective cohort study of children born in 1991–2000.

Setting: Tertiary care university hospital.

Methods: Data on all children born during the 10 year period were combined with information on laboratory confirmed RSV infections in these children until the end of 2002. The theoretical impact of palivizumab on RSV associated admissions was estimated by applying the current recommendations for prophylaxis to the study population and using the observed rates of admission in the calculations.

Interventions: None.

Main outcome measures: Rates of RSV infection and hospital admission in different subgroups of children.

Results: Children with chronic lung disease (CLD) were admitted for RSV infection at a rate of 12.0%. The corresponding rates in children born at ⩽28 or 29–32 weeks gestation were 7.1% and 6.8% respectively. Children born at ⩽32 weeks gestation accounted for 6.6% of all admissions due to RSV. Of 586 children who would have met the criteria for palivizumab prophylaxis, 27 (4.6%) were admitted with RSV during the presumed prophylactic period. The number needed to treat to prevent one admission for RSV infection was 15 for children with CLD (with a total cost of €75 000) and 43 for children without CLD born at ⩽32 weeks gestation (with a total cost of €215 000).

Conclusions: The rates of hospital admission for RSV infection in premature infants were substantially lower than those in most previous reports from other countries. Determination of the local rates of RSV admissions in different groups of children would be useful in making decisions about the use of palivizumab.

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Selected References

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  1. Boyce T. G., Mellen B. G., Mitchel E. F., Jr, Wright P. F., Griffin M. R. Rates of hospitalization for respiratory syncytial virus infection among children in medicaid. J Pediatr. 2000 Dec;137(6):865–870. doi: 10.1067/mpd.2000.110531. [DOI] [PubMed] [Google Scholar]
  2. Carbonell-Estrany X., Quero J., IRIS Study Group Hospitalization rates for respiratory syncytial virus infection in premature infants born during two consecutive seasons. Pediatr Infect Dis J. 2001 Sep;20(9):874–879. doi: 10.1097/00006454-200109000-00010. [DOI] [PubMed] [Google Scholar]
  3. Clark S. J., Beresford M. W., Subhedar N. V., Shaw N. J. Respiratory syncytial virus infection in high risk infants and the potential impact of prophylaxis in a United Kingdom cohort. Arch Dis Child. 2000 Oct;83(4):313–316. doi: 10.1136/adc.83.4.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cunningham C. K., McMillan J. A., Gross S. J. Rehospitalization for respiratory illness in infants of less than 32 weeks' gestation. Pediatrics. 1991 Sep;88(3):527–532. [PubMed] [Google Scholar]
  5. Englund J. A. Prevention strategies for respiratory syncytial virus: passive and active immunization. J Pediatr. 1999 Aug;135(2 Pt 2):38–44. [PubMed] [Google Scholar]
  6. Fariña Diana, Rodríguez Susana P., Bauer Gabriela, Novali Luis, Bouzas Liliana, González Helena, Gilli Clara, Laffaire Enrique. Respiratory syncytial virus prophylaxis: cost-effective analysis in Argentina. Pediatr Infect Dis J. 2002 Apr;21(4):287–291. doi: 10.1097/00006454-200204000-00006. [DOI] [PubMed] [Google Scholar]
  7. Greenough A., Cox S., Alexander J., Lenney W., Turnbull F., Burgess S., Chetcuti P. A., Shaw N. J., Woods A., Boorman J. Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child. 2001 Dec;85(6):463–468. doi: 10.1136/adc.85.6.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Groothuis J. R., Gutierrez K. M., Lauer B. A. Respiratory syncytial virus infection in children with bronchopulmonary dysplasia. Pediatrics. 1988 Aug;82(2):199–203. [PubMed] [Google Scholar]
  9. Joffe S., Escobar G. J., Black S. B., Armstrong M. A., Lieu T. A. Rehospitalization for respiratory syncytial virus among premature infants. Pediatrics. 1999 Oct;104(4 Pt 1):894–899. doi: 10.1542/peds.104.4.894. [DOI] [PubMed] [Google Scholar]
  10. Johnson S., Oliver C., Prince G. A., Hemming V. G., Pfarr D. S., Wang S. C., Dormitzer M., O'Grady J., Koenig S., Tamura J. K. Development of a humanized monoclonal antibody (MEDI-493) with potent in vitro and in vivo activity against respiratory syncytial virus. J Infect Dis. 1997 Nov;176(5):1215–1224. doi: 10.1086/514115. [DOI] [PubMed] [Google Scholar]
  11. Kamal-Bahl Sachin, Doshi Jalpa, Campbell James. Economic analyses of respiratory syncytial virus immunoprophylaxis in high-risk infants: a systematic review. Arch Pediatr Adolesc Med. 2002 Oct;156(10):1034–1041. doi: 10.1001/archpedi.156.10.1034. [DOI] [PubMed] [Google Scholar]
  12. McCormick Jonathan, Tubman Richard. Readmission with respiratory syncytial virus (RSV) infection among graduates from a neonatal intensive care unit. Pediatr Pulmonol. 2002 Oct;34(4):262–266. doi: 10.1002/ppul.10169. [DOI] [PubMed] [Google Scholar]
  13. Moler F. W., Brown R. W., Faix R. G., Gilsdorf J. R. Comments on palivizumab (Synagis) Pediatrics. 1999 Feb;103(2):495–497. doi: 10.1542/peds.103.2.495. [DOI] [PubMed] [Google Scholar]
  14. Oh Paul I., Lanctôt Krista L., Yoon Alice, Lee David S. C., Paes Bosco A., Simmons Brian S., Parison Diana, Manzi Patricia, Composs Investigators Palivizumab prophylaxis for respiratory syncytial virus in Canada: utilization and outcomes. Pediatr Infect Dis J. 2002 Jun;21(6):512–518. doi: 10.1097/00006454-200206000-00007. [DOI] [PubMed] [Google Scholar]
  15. Ruuskanen O., Ogra P. L. Respiratory syncytial virus. Curr Probl Pediatr. 1993 Feb;23(2):50–79. doi: 10.1016/0045-9380(93)90003-U. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sharland M., Bedford-Russell A. Preventing respiratory syncitial virus bronchiolitis. BMJ. 2001 Jan 13;322(7278):62–63. doi: 10.1136/bmj.322.7278.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Shireman Theresa I., Braman Karen S. Impact and cost-effectiveness of respiratory syncytial virus prophylaxis for Kansas medicaid's high-risk children. Arch Pediatr Adolesc Med. 2002 Dec;156(12):1251–1255. doi: 10.1001/archpedi.156.12.1251. [DOI] [PubMed] [Google Scholar]
  18. Simoes E. A. Respiratory syncytial virus infection. Lancet. 1999 Sep 4;354(9181):847–852. doi: 10.1016/S0140-6736(99)80040-3. [DOI] [PubMed] [Google Scholar]
  19. Stevens T. P., Sinkin R. A., Hall C. B., Maniscalco W. M., McConnochie K. M. Respiratory syncytial virus and premature infants born at 32 weeks' gestation or earlier: hospitalization and economic implications of prophylaxis. Arch Pediatr Adolesc Med. 2000 Jan;154(1):55–61. [PubMed] [Google Scholar]
  20. Thomas M., Bedford-Russell A., Sharland M. Hospitalisation for RSV infection in ex-preterm infants-implications for use of RSV immune globulin. Arch Dis Child. 2000 Aug;83(2):122–127. doi: 10.1136/adc.83.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Waris M., Meurman O., Mufson M. A., Ruuskanen O., Halonen P. Shedding of infectious virus and virus antigen during acute infection with respiratory syncytial virus. J Med Virol. 1992 Oct;38(2):111–116. doi: 10.1002/jmv.1890380208. [DOI] [PubMed] [Google Scholar]
  22. 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 Mar;163(3):464–469. doi: 10.1093/infdis/163.3.464. [DOI] [PubMed] [Google Scholar]

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