Abstract
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children worldwide (1-3). In the United States, RSV infection results in >57,000 hospitalizations and 2 million outpatient visits each year among children aged <5 years (3). Recent studies have highlighted the importance of RSV in adults as well as children (4). CDC reported RSV seasonality nationally, by U.S. Department of Health and Human Services (HHS) regions* and for the state of Florida, using a new statistical method that analyzes polymerase chain reaction (PCR) laboratory detections reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS) (https://www.cdc.gov/surveillance/nrevss/index.html). Nationally, across three RSV seasons, lasting from the week ending July 5, 2014 through July 1, 2017, the median RSV onset occurred at week 41 (mid-October), and lasted 31 weeks until week 18 (early May). The median national peak occurred at week 5 (early February). Using these new methods, RSV season circulation patterns differed from those reported from previous seasons (5). Health care providers and public health officials use RSV circulation data to guide diagnostic testing and to time the administration of RSV immunoprophylaxis for populations at high risk for severe respiratory illness (6). With several vaccines and other immunoprophlyaxis products in development, estimates of RSV circulation are also important to the design of clinical trials and future vaccine effectiveness studies.
Highlights
respiratory syncytial virus (RSV) seasonality data can guide diagnostic testing and inform policy decisions regarding administration of currently available immunoprophylaxis products, when indicated, and the timing of clinical trials and future evaluations of vaccines and immunoprophylaxis products currently under development
Palivizumab is a monoclonal antibody recommended by the American Academy of Pediatrics for administration during the RSV season to infants at high risk and young children likely to benefit from immunoprophylaxis, based on their gestational age at birth and the presence of certain underlying medical conditions during the RSV season [6].§ In addition, RSV seasonality data might inform the timing of clinical trials for several RSV vaccines and immunoprophlyaxis products in development, as well as the evaluation of product effectiveness after licensure
Low RSV circulation might not be captured within the National Respiratory and Enteric Virus Surveillance System (NREVSS) onset and offset, at least 97% of detections were accounted for using the RS10 method
Summary
Erica Billig Rose, PhD1; Alexandra Wheatley; Gayle Langley, MD2; Susan Gerber, MD2; Amber Haynes, MPH2. The median national peak occurred at week 5 (early February) Using these new methods, RSV season circulation patterns differed from those reported from previous seasons [5]. The method that consistently captured the highest percentage of PCR detections for retrospectively characterizing RSV seasons was determined to be the retrospective slope 10 (RS10) method [7] This method uses a centered 5-week moving average of RSV detections normalized to a season peak of 1,000 detections. Median onset for the 10 HHS regions (excluding Florida and Hawaii) ranged from week 37 to week 48 (mid-September to early December) and offset ranged from week 15 to week 21 (mid-April to late May) (Figure). The median onset for Florida occurred at week 37 (mid-September), and the season continued through week 16 (mid-April) (Table 2)
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