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. 2009 Oct;14(8):521–526. doi: 10.1093/pch/14.8.521

TABLE 1.

Canadian respiratory syncytial virus risk scoring tool for infants born between 33 and 35 weeks gestation

Risk factor Score
Yes No
Birth month is November, December or January 25 0
Infant to attend daycare OR siblings attend daycare 17 0
More than five individuals in the home including the infant (ie, six or more) 13 0
Small for gestational age (birth weight less than the 10th percentile for gestational age) 12 0
Immediate family (mother, father, sibling) history without eczema (without eczema = Yes) 12 0
Sex is male 11 0
Two or more smokers in the household 10 0

A total score from 0 to 48 means low risk, from 49 to 64 means moderate risk, and from 65 to 100 means high risk. Adapted from reference 22