The Burden of Respiratory Syncytial Virus in Children Under 2 Years of Age in a Rural Community in Maharashtra, India

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2021 Sep 2

PMID 34472575

Citations 7

Authors

Ashish Satav

Rowena Crow

Varsha Potdar

Vibhawari Dani

Shilpa Satav

Mandeep Chadha

Danielle Hessong

Phyllis Carosone-Link

Sameer Palaskar

Eric A F Simoes

Affiliations

Soon will be listed here.

Abstract

Background: Globally, respiratory syncytial virus (RSV) is a common cause of acute lower tract infection (LRTI) in children younger than 2 years of age, but there are scant population-based studies on the burden of RSV illness in rural communities and no community studies in preterm infants.

Methods: Active surveillance of LRTI was performed in the community and hospital setting for the population of 93 tribal villages in Melghat, Central India, over 4 respiratory seasons. A nasopharyngeal swab was obtained from cases presenting as a severe LRTI for molecular analysis of respiratory pathogens including RSVA and B.

Results: High rates of RSV-associated LRTI were found in preterm and term infants beyond 6 months of age, extending into the second year of life. Community severe RSV LRTI rates for 0-11 months of age was 22.4 (18.6-27.0)/1000 child-years (CY) and the hospital-associated rate was 14.1 (11.1-17.8)/1000 CY. For preterm infants, these rates were 26.2 (17.8-38.5)/1000 CY and 12.6 (7.2-22.0)/1000 CY. Comparable rates in the first 6 months were 15.9 (11.8-21.4)/1000 CY and 12.9 (9.3-18.0)/1000 CY in term infants and 26.3 (15.4-45.0)/1000 CY and 10.1 (4.2-24.2)/1000 CY for preterms. The single RSV B season had higher incidences of RSV LRTI in every age group than the 2 RSV A seasons in both preterm and term infants. There were 11 deaths, all term infants.

Conclusions: Studies restricted to the healthcare settings significantly underestimate the burden of RSV LRTI and preterm and term infants have comparable burdens of disease in this rural community.

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References

Ochoa T, Bautista R, Davila C, Salazar J, Bazan C, Guerra O . Respiratory syncytial virus-associated hospitalizations in pre-mature infants in Lima, Peru. Am J Trop Med Hyg. 2014; 91(5):1029-34. PMC: 4228870. DOI: 10.4269/ajtmh.13-0648. View

Rowlinson E, Dueger E, Taylor T, Mansour A, Van Beneden C, Abukela M . Incidence and clinical features of respiratory syncytial virus infections in a population-based surveillance site in the Nile Delta Region. J Infect Dis. 2013; 208 Suppl 3:S189-96. DOI: 10.1093/infdis/jit457. View

Munywoki P, Koech D, Agoti C, Lewa C, Cane P, Medley G . The source of respiratory syncytial virus infection in infants: a household cohort study in rural Kenya. J Infect Dis. 2013; 209(11):1685-92. PMC: 4017365. DOI: 10.1093/infdis/jit828. View

Figueras-Aloy J, Manzoni P, Paes B, Simoes E, Bont L, Checchia P . Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease. Infect Dis Ther. 2016; 5(4):417-452. PMC: 5125133. DOI: 10.1007/s40121-016-0130-1. View

Houben M, Bont L, Wilbrink B, Belderbos M, Kimpen J, H A Visser G . Clinical prediction rule for RSV bronchiolitis in healthy newborns: prognostic birth cohort study. Pediatrics. 2010; 127(1):35-41. DOI: 10.1542/peds.2010-0581. View

Geoghegan S, Erviti A, Caballero M, Vallone F, Zanone S, Losada J . Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors. Am J Respir Crit Care Med. 2016; 195(1):96-103. DOI: 10.1164/rccm.201603-0658OC. View

Zachariah P, Ruttenber M, Simoes E . Down syndrome and hospitalizations due to respiratory syncytial virus: a population-based study. J Pediatr. 2011; 160(5):827-31.e1. DOI: 10.1016/j.jpeds.2011.11.004. View

McLaughlin J, Khan F, Schmitt H, Agosti Y, Jodar L, Simoes E . Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis. J Infect Dis. 2020; 225(6):1100-1111. PMC: 8921994. DOI: 10.1093/infdis/jiaa752. View

Checchia P, Paes B, Bont L, Manzoni P, Simoes E, Fauroux B . Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease. Infect Dis Ther. 2017; 6(1):37-56. PMC: 5336417. DOI: 10.1007/s40121-016-0142-x. View

10.

Simoes E, Dani V, Potdar V, Crow R, Satav S, Chadha M . Mortality From Respiratory Syncytial Virus in Children Under 2 Years of Age: A Prospective Community Cohort Study in Rural Maharashtra, India. Clin Infect Dis. 2021; 73(Suppl_3):S193-S202. PMC: 8411248. DOI: 10.1093/cid/ciab481. View

11.

Simoes E, Mutyara K, Soh S, Agustian D, Hibberd M, Kartasasmita C . The epidemiology of respiratory syncytial virus lower respiratory tract infections in children less than 5 years of age in Indonesia. Pediatr Infect Dis J. 2011; 30(9):778-84. DOI: 10.1097/INF.0b013e318218ab9e. View

12.

Kubale J, Kuan G, Gresh L, Ojeda S, Azziz-Baumgartner E, Sanchez N . Assessing the Incidence of Symptomatic Respiratory Syncytial Virus Illness Within a Prospective Birth Cohort in Managua, Nicaragua. Clin Infect Dis. 2019; 70(10):2029-2035. PMC: 7201406. DOI: 10.1093/cid/ciz585. View

13.

Paes B, Fauroux B, Figueras-Aloy J, Bont L, Checchia P, Simoes E . Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Chronic Lung Disease. Infect Dis Ther. 2016; 5(4):453-471. PMC: 5125140. DOI: 10.1007/s40121-016-0137-7. View

14.

Koul P, Mir H, Saha S, Chadha M, Potdar V, Widdowson M . Respiratory viruses in returning Hajj & Umrah pilgrims with acute respiratory illness in 2014-2015. Indian J Med Res. 2018; 148(3):329-333. PMC: 6251276. DOI: 10.4103/ijmr.IJMR_890_17. View

15.

Hall C, Simoes E, Anderson L . Clinical and epidemiologic features of respiratory syncytial virus. Curr Top Microbiol Immunol. 2013; 372:39-57. DOI: 10.1007/978-3-642-38919-1_2. View

16.

Chawanpaiboon S, Vogel J, Moller A, Lumbiganon P, Petzold M, Hogan D . Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2018; 7(1):e37-e46. PMC: 6293055. DOI: 10.1016/S2214-109X(18)30451-0. View

17.

Wu A, Budge P, Williams J, Griffin M, Edwards K, Johnson M . Incidence and Risk Factors for Respiratory Syncytial Virus and Human Metapneumovirus Infections among Children in the Remote Highlands of Peru. PLoS One. 2015; 10(6):e0130233. PMC: 4479592. DOI: 10.1371/journal.pone.0130233. View

18.

Aranda S, Polack F . Prevention of Pediatric Respiratory Syncytial Virus Lower Respiratory Tract Illness: Perspectives for the Next Decade. Front Immunol. 2019; 10:1006. PMC: 6524688. DOI: 10.3389/fimmu.2019.01006. View

19.

Ohuma E, Okiro E, Ochola R, Sande C, Cane P, Medley G . The natural history of respiratory syncytial virus in a birth cohort: the influence of age and previous infection on reinfection and disease. Am J Epidemiol. 2012; 176(9):794-802. PMC: 3481264. DOI: 10.1093/aje/kws257. View

20.

Robertson S, Roca A, Alonso P, Simoes E, Kartasasmita C, Olaleye D . Respiratory syncytial virus infection: denominator-based studies in Indonesia, Mozambique, Nigeria and South Africa. Bull World Health Organ. 2005; 82(12):914-22. PMC: 2623097. DOI: /S0042-96862004001200007. View