Incidence of Respiratory Syncytial Virus Lower Respiratory Tract Infections During the First 2 Years of Life: A Prospective Study Across Diverse Global Settings

Joanne M Langley; Veronique Bianco; Joseph B Domachowske; Shabir A Madhi; Sonia K Stoszek; Khalequ Zaman; Agustin Bueso; Ana Ceballos; Luis Cousin; Ulises D'Andrea; Ilse Dieussaert; Janet A Englund; Sanjay Gandhi; Olivier Gruselle; Gerco Haars; Lisa Jose; Nicola P Klein; Amanda Leach; Koen Maleux; Thi Lien Anh Nguyen; Thanyawee Puthanakit; Peter Silas; Auchara Tangsathapornpong; Jamaree Teeratakulpisarn; Timo Vesikari; Rachel A Cohen

doi:10.1093/infdis/jiac227

Incidence of Respiratory Syncytial Virus Lower Respiratory Tract Infections During the First 2 Years of Life: A Prospective Study Across Diverse Global Settings

J Infect Dis. 2022 Aug 26;226(3):374-385. doi: 10.1093/infdis/jiac227.

Authors

Joanne M Langley¹, Veronique Bianco², Joseph B Domachowske³, Shabir A Madhi⁴, Sonia K Stoszek², Khalequ Zaman⁵, Agustin Bueso⁶, Ana Ceballos⁷, Luis Cousin⁸, Ulises D'Andrea⁷, Ilse Dieussaert², Janet A Englund⁹, Sanjay Gandhi¹⁰, Olivier Gruselle¹¹, Gerco Haars¹¹, Lisa Jose⁴, Nicola P Klein¹², Amanda Leach², Koen Maleux¹¹, Thi Lien Anh Nguyen¹¹, Thanyawee Puthanakit¹³, Peter Silas¹⁴, Auchara Tangsathapornpong¹⁵, Jamaree Teeratakulpisarn¹⁶, Timo Vesikari¹⁷, Rachel A Cohen²

Affiliations

¹ Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, Nova Scotia, Canada.
² GSK, Rockville, Maryland, USA.
³ Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA.
⁴ South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
⁵ International Centre for Diarrheal Disease, Dhaka, Bangladesh.
⁶ DEMEDICA, San Pedro Sula, Honduras.
⁷ Instituto Medico Rio Cuarto, Rio Cuarto, Cordoba, Argentina.
⁸ Tecnologia en Investigacion, San Pedro Sula, Honduras.
⁹ Seattle Children's Research Institute, University of Washington, Seattle, Washington, USA.
¹⁰ GSK, Mumbai, India.
¹¹ GSK, Wavre, Belgium.
¹² Kaiser Permanente Vaccine Study Center, Oakland, California, USA.
¹³ The Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
¹⁴ Wee Care Pediatrics, Syracuse, Utah, USA.
¹⁵ Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
¹⁶ Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
¹⁷ Vaccine Research Center, University of Tampere, Tampere, Finland.

Abstract

Background: The true burden of lower respiratory tract infections (LRTIs) due to respiratory syncytial virus (RSV) remains unclear. This study aimed to provide more robust, multinational data on RSV-LRTI incidence and burden in the first 2 years of life.

Methods: This prospective, observational cohort study was conducted in Argentina, Bangladesh, Canada, Finland, Honduras, South Africa, Thailand, and United States. Children were followed for 24 months from birth. Suspected LRTIs were detected via active (through regular contacts) and passive surveillance. RSV and other viruses were detected from nasopharyngeal swabs using PCR-based methods.

Results: Of 2401 children, 206 (8.6%) had 227 episodes of RSV-LRTI. Incidence rates (IRs) of first episode of RSV-LRTI were 7.35 (95% confidence interval [CI], 5.88-9.08), 5.50 (95% CI, 4.21-7.07), and 2.87 (95% CI, 2.18-3.70) cases/100 person-years in children aged 0-5, 6-11, and 12-23 months. IRs for RSV-LRTI, severe RSV-LRTI, and RSV hospitalization tended to be higher among 0-5 month olds and in lower-income settings. RSV was detected for 40% of LRTIs in 0-2 month olds and for approximately 20% of LRTIs in older children. Other viruses were codetected in 29.2% of RSV-positive nasopharyngeal swabs.

Conclusions: A substantial burden of RSV-LRTI was observed across diverse settings, impacting the youngest infants the most. Clinical Trials Registration. NCT01995175.

Keywords: burden of disease; epidemiology; incidence; infants; respiratory syncytial virus; respiratory tract infections; young children.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Child
Hospitalization
Humans
Incidence
Infant
Prospective Studies
Respiratory Syncytial Virus Infections*
Respiratory Syncytial Virus, Human*
Respiratory Tract Infections*
Viruses*

Associated data

ClinicalTrials.gov/NCT01995175