Abstract
Background There is uncertainty about the burden of hospitalization associated with RSV and influenza in children, including those with underlying medical conditions.
Methods We have applied previously developed methodology to estimate hospitalization rates associated with RSV and influenza for various hospital discharge diagnoses in US children from the 2003-04 through the 2009-10 seasons. Additional data on the prevalence of asthma diagnosis in children and its relation to hospital discharge diagnosis of asthma were used to estimate RSV-associated hospitalization rates in children having a diagnosis of asthma.
Results The estimated average annual rates (per 100,000 children) of RSV-associated hospitalization with a respiratory diagnosis (ICD-9 codes 460-519) in either the principal or secondary position (excluding asthma (ICD-9 code 493) in the principal diagnosis) were 2347.1(95% CI(2223.6,2471.2)) in age <1y; 631.2(543.9,716.9) in age 1y; 322.3(272.8,372.2) in age 2y; 168.8(131.4,207.2) in age 3y; 87.7(59.3,116.2) in age 4y; 62.8(39.3,86.3) in ages 5-6y; 27.6(14.1,41.1) in ages 7-11y; and 33.8(15.2,52.6) in ages 12-17y. The corresponding rates of influenza-associated hospitalization were lower, ranging from 179.3(141.6,217.6) in age <1y to 15.9(10.5,21.3) in ages 12-17y. Children having a diagnosis of asthma had elevated risks for RSV-associated hospitalization, with the rates of RSV-associated hospitalization per 100,000 children having a diagnosis of asthma being 11415(8393,155801) in age <1y, 4343(3216,5639) in age 1y, 2842(2144,3628) in age 2y, and 1393(891.2,1923) in age 3y.
Conclusions The estimated rates of RSV-associated hospitalization in young children were high, and declined rapidly with age. Additionally, we estimated very high rates of RSV-associated hospitalization in young children having a diagnosis of asthma, making those children potential targets for RSV prophylaxis and vaccination.