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Respiratory syncytial virus reinfections among infants and young children in the United States, 2011-2019
Although respiratory syncytial virus (RSV) immunoprophylaxis is recommended for high-risk infants, the American Academy of Pediatrics (AAP) recommends against immunoprophylaxis in the same season following a breakthrough hospitalization due to limited risk for a second hospitalization. Evidence in s...
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Published in: | PloS one 2023-02, Vol.18 (2), p.e0281555-e0281555 |
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description | Although respiratory syncytial virus (RSV) immunoprophylaxis is recommended for high-risk infants, the American Academy of Pediatrics (AAP) recommends against immunoprophylaxis in the same season following a breakthrough hospitalization due to limited risk for a second hospitalization. Evidence in support of this recommendation is limited. We estimated population-based re-infection rates from 2011-2019 in children |
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Using claims data from private insurance enrollees, we established cohorts of children <5 years who were followed to ascertain annual (July 1-June 30) and seasonal (November 1- February 28/29) RSV recurrence estimates. Unique RSV episodes included inpatient encounters with RSV diagnosis ≥30 days apart, and outpatient encounters ≥30 days apart from each other as well as from inpatient encounters. The risk of annual and seasonal re-infection was calculated as the proportion of children with a subsequent RSV episode in the same RSV year/season.
Over the 8 assessed seasons/years (N = 6,705,979) and across all age groups annual inpatient and outpatient infection rates were 0.14% and 1.29%, respectively. Among children with a first infection, annual inpatient and outpatient re-infection rates were 0.25% (95% confidence interval (CI) = 0.22-0.28) and 3.44% (95% CI = 3.33-3.56), respectively. Both infection and re-infection rates declined with age.
While medically-attended re-infections contributed numerically only a fraction of the total RSV infections, re-infections among those with previous infection in the same season were of similar magnitude as the general infection risk, suggesting that a previous infection may not attenuate the risk for a re-infection.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281555</identifier><identifier>PMID: 36795639</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Ambulatory care ; Antibodies, Monoclonal, Humanized - therapeutic use ; Antiviral Agents - therapeutic use ; Biology and life sciences ; Bronchitis ; Child ; Child, Preschool ; Children ; Codes ; Confidence intervals ; Health risks ; Hospitalization ; Humans ; Immunoprophylaxis ; Infant ; Infants ; Infections ; Medicine and Health Sciences ; Palivizumab - therapeutic use ; Pediatrics ; People and Places ; Pneumonia ; Population statistics ; Reinfection ; Respiratory syncytial virus ; Respiratory Syncytial Virus Infections - prevention & control ; Respiratory Syncytial Virus, Human ; Risk ; Risk groups ; Seasons ; United States - epidemiology ; Viruses</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0281555-e0281555</ispartof><rights>Copyright: © 2023 Nduaguba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>2023 Nduaguba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Nduaguba et al 2023 Nduaguba et al</rights><rights>2023 Nduaguba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-95166031dd31d692ad09413fa9eb8bda91482319e0da9e183091873d2cf43bab3</citedby><cites>FETCH-LOGICAL-c526t-95166031dd31d692ad09413fa9eb8bda91482319e0da9e183091873d2cf43bab3</cites><orcidid>0000-0002-6518-5961 ; 0000-0001-6383-2603</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2777358707/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2777358707?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36795639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Abidi, Syed Hani</contributor><creatorcontrib>Nduaguba, Sabina O</creatorcontrib><creatorcontrib>Tran, Phuong T</creatorcontrib><creatorcontrib>Choi, Yoonyoung</creatorcontrib><creatorcontrib>Winterstein, Almut G</creatorcontrib><title>Respiratory syncytial virus reinfections among infants and young children in the United States, 2011-2019</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Although respiratory syncytial virus (RSV) immunoprophylaxis is recommended for high-risk infants, the American Academy of Pediatrics (AAP) recommends against immunoprophylaxis in the same season following a breakthrough hospitalization due to limited risk for a second hospitalization. Evidence in support of this recommendation is limited. We estimated population-based re-infection rates from 2011-2019 in children <5 years since RSV risk remains relatively high in this age group.
Using claims data from private insurance enrollees, we established cohorts of children <5 years who were followed to ascertain annual (July 1-June 30) and seasonal (November 1- February 28/29) RSV recurrence estimates. Unique RSV episodes included inpatient encounters with RSV diagnosis ≥30 days apart, and outpatient encounters ≥30 days apart from each other as well as from inpatient encounters. The risk of annual and seasonal re-infection was calculated as the proportion of children with a subsequent RSV episode in the same RSV year/season.
Over the 8 assessed seasons/years (N = 6,705,979) and across all age groups annual inpatient and outpatient infection rates were 0.14% and 1.29%, respectively. Among children with a first infection, annual inpatient and outpatient re-infection rates were 0.25% (95% confidence interval (CI) = 0.22-0.28) and 3.44% (95% CI = 3.33-3.56), respectively. Both infection and re-infection rates declined with age.
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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nduaguba, Sabina O</au><au>Tran, Phuong T</au><au>Choi, Yoonyoung</au><au>Winterstein, Almut G</au><au>Abidi, Syed Hani</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Respiratory syncytial virus reinfections among infants and young children in the United States, 2011-2019</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-16</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0281555</spage><epage>e0281555</epage><pages>e0281555-e0281555</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Although respiratory syncytial virus (RSV) immunoprophylaxis is recommended for high-risk infants, the American Academy of Pediatrics (AAP) recommends against immunoprophylaxis in the same season following a breakthrough hospitalization due to limited risk for a second hospitalization. Evidence in support of this recommendation is limited. We estimated population-based re-infection rates from 2011-2019 in children <5 years since RSV risk remains relatively high in this age group.
Using claims data from private insurance enrollees, we established cohorts of children <5 years who were followed to ascertain annual (July 1-June 30) and seasonal (November 1- February 28/29) RSV recurrence estimates. Unique RSV episodes included inpatient encounters with RSV diagnosis ≥30 days apart, and outpatient encounters ≥30 days apart from each other as well as from inpatient encounters. The risk of annual and seasonal re-infection was calculated as the proportion of children with a subsequent RSV episode in the same RSV year/season.
Over the 8 assessed seasons/years (N = 6,705,979) and across all age groups annual inpatient and outpatient infection rates were 0.14% and 1.29%, respectively. Among children with a first infection, annual inpatient and outpatient re-infection rates were 0.25% (95% confidence interval (CI) = 0.22-0.28) and 3.44% (95% CI = 3.33-3.56), respectively. Both infection and re-infection rates declined with age.
While medically-attended re-infections contributed numerically only a fraction of the total RSV infections, re-infections among those with previous infection in the same season were of similar magnitude as the general infection risk, suggesting that a previous infection may not attenuate the risk for a re-infection.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36795639</pmid><doi>10.1371/journal.pone.0281555</doi><orcidid>https://orcid.org/0000-0002-6518-5961</orcidid><orcidid>https://orcid.org/0000-0001-6383-2603</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Age Ambulatory care Antibodies, Monoclonal, Humanized - therapeutic use Antiviral Agents - therapeutic use Biology and life sciences Bronchitis Child Child, Preschool Children Codes Confidence intervals Health risks Hospitalization Humans Immunoprophylaxis Infant Infants Infections Medicine and Health Sciences Palivizumab - therapeutic use Pediatrics People and Places Pneumonia Population statistics Reinfection Respiratory syncytial virus Respiratory Syncytial Virus Infections - prevention & control Respiratory Syncytial Virus, Human Risk Risk groups Seasons United States - epidemiology Viruses |
title | Respiratory syncytial virus reinfections among infants and young children in the United States, 2011-2019 |
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