Outpatient RSV lower respiratory infections among high‐risk infants and other pediatric populations

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Abstract
Objective To identify the frequency of outpatient, non-hospitalized visits for respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) among children and high-risk infants. Study Design Published studies that reported population-based rates of outpatient RSV illness were reviewed. In addition, we conducted a retrospective cohort study from a national claims database including preterm and full term infants born between April 2004 and April 2006 <6 months of age and continuously enrolled through their first RSV season. Results In the selected published studies, rates of outpatient RSV LRI were highest among infants and young children (ranging from 6.9 to 11 per 1,000 children age 1–4 years to 157.5 to 252.0 per 1,000 children age <1 year). In the cohort study, rates of outpatient RSV LRI among preterm infants ≤32 wGA or with chronic lung disease (CLD) ranged from 158.7 to 272.6 visits per 1,000 children. Rates for late preterm (33–36 wGA) infants ranged from 183.3 to 245.7 per 1,000, which was higher than full term infants (128.8 to 171.3 per 1,000). Conclusions Approximately 1 in every 5 of high-risk infants will be affected during their first RSV season, which indicates a fairly high and unrecognized reservoir of disease. Outpatient RSV LRI visits increase with younger age and prematurity. Pediatr Pulmonol. 2010; 45:578–584.