Abstract
ObjectivesRespiratory Syncytial Virus (RSV) is the leading cause of hospitalization for lower respiratory tract infections (LRTI) in young children worldwide.We evaluate the epidemiological and clinical patterns of RSV infection in infants hospitalized for LRTI in in Palermo, South Italy, Sicily.MethodsWe collected the demographic details of infants hospitalized to G. Di Cristina Children's Hospital in Palermo for LRTI between November 2005 and May 2006. We also included all cases occurred in newborns hospitalized in the Neonatal Intensive Care Unit (NICU) Of Palermo.ResultsDuring the studied period, 335/705 hospitalized infants for LRTI were enrolled in the study. The trend of hospitalization started in late winter and lasting until May 2006 with an epidemic peak in spring. 178/335 infants tested for viral infection showed RSV disease. Three cases occurred in preterm newborns hospitalized from birth in NICU. The likelihood to be RSV+, rather than RSV negative (RSV-) was higher for infants < 6 months and lower for infants with history of breast feeding (P < 0.05). RSV infection was associated with a higher likelihood to be admitted to intensive care unit and to a longer hospitalization and oxygen therapy.ConclusionThe study shows that, in Sicily, RSV is an important cause of LRTI in infants. The seasonal distribution shows that both LRTI and RSV infections peak in late spring, in contrast to Northern Italy. Our data could help to define the regional appropriate start of prophylactic interventions.
Highlights
Almost all children are infected by Respiratory Syncytial Virus (RSV) at least once by 2 years of age, and approximately 1–2% of infants will require hospitalization for RSV negative (RSV-)associated Lower Respiratory Tract Infections (LRTI) [1,2,3]
The trend of LRTI hospitalization started in November 2005, lasting until May 2006 with an epidemic peak in March
The retrospective interview of the pediatricians on because the viral investigation did not perform in the excluded patients has showed that in 60% of the cases the patients have been hospitalized in the weekend when viral analysis was not routinely available, in 10% of the cases the infants were early tested, in 3% of the cases the parents have refused the investigation and in the remaining 27% of cases the clinical, instrumental and epidemiological investigations were considered suitable for the management of LRTI
Summary
Almost all children are infected by Respiratory Syncytial Virus (RSV) at least once by 2 years of age, and approximately 1–2% of infants will require hospitalization for RSV-associated Lower Respiratory Tract Infections (LRTI) [1,2,3]. Infection rates vary from 50–70% during the first year of life, to 100% during the second-third year of age. Immunity is not complete, and reinfection is common [1,2,3,4]. Evidence of RSV infection has been found in every geographic area studied. In countries with a temperate climate, outbreaks generally occur during the autumn and last until spring, with the number of infections peaking in January-March. Epidemics generally coincide with the rainy season [5,6,7]
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