The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis.

Rosalie Linssen,Reinout Bem,Bibiche Den Hollander,Job Van Woensel,Louis Bont

doi:10.3390/pathogens10050567

Abstract

Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.

Highlights

Respiratory syncytial virus (RSV) bronchiolitis is a major cause of infant morbidity and mortality worldwide [1,2]
This study aims to (1) identify weather variables that are associated with paediatric intensive care units (PICUs) admissions for RSV bronchiolitis in the Netherlands, and (2) to determine if these variables have changed over time as a possible explanation for the observed increase in PICU burden of RSV bronchiolitis in the Netherlands between 2003 and 2016
This study reported an increase of 166 annual RSV bronchiolitis-related PICU admissions when compared with the years 2003 (83 admissions) to 2016 (249 admissions) [6]

Summary

Introduction

Respiratory syncytial virus (RSV) bronchiolitis is a major cause of infant morbidity and mortality worldwide [1,2]. Up to 5% of RSV-infected children experience acute deterioration of bronchiolitis, necessitating admission to a paediatric intensive care unit (PICU) for mechanical ventilation [3]. Over the last two decades, studies from various countries around the world have reported an increase in the number of PICU admissions for RSV bronchiolitis, associated with rising health care costs and increased pressure on health care systems [3,4,5]. The number of PICU admissions for RSV bronchiolitis has increased approximately fourfold in the Netherlands between 2003 and 2016 (Figure 1A) [6], but the reasons for this increase remain to be elucidated. Further knowledge on the possible causes driving this increased RSV-related burden is warranted to allow for optimal future strategic planning of PICU capacity. PICU admissions peak during the winter, data were shifted into ‘seasons’ from 1 July up to and including 30 June in the year thereafter [6]

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