Abstract
Respiratory syncytial virus (RSV) is the most common pathogen associated with acute lower respiratory tract infections in young children. RSV is also a major viral pathogen causing severe lung disease in the adult population, particularly among the elderly. We conducted a review of adult RSV studies published from January 1970 to February 2017 to determine the burden of disease among adults worldwide. There were no restrictions on health care setting or definition of RSV infection. A total of 1530 published studies were identified, 95 of which were included in this review. The incidence rates of hospitalised RSV acute respiratory tract infection (ARI) in adults >65 years old ranged from 7.3 to 13.0/105 population in Africa and Asia and from 190 to 254/105 population in the USA. Higher incidence rates (195-1790/105 population) were observed in adults ≥50 years old for outpatient or emergency visits in the USA. Of all ARI patients, RSV accounted for 1-10% in adults and 2-14% in patients with chronic diseases or transplantation. Given the limitations in the existing data, significant efforts should be made to generate evidence on the burden of RSV infections in adults and to estimate the potential impact of future preventive interventions.
Highlights
Respiratory syncytial virus (RSV) was first recognised as a cause of bronchiolitis among infants in 1957, and is the most commonly identified cause of lower respiratory tract infections (LRTI) in young children [1]
The search strings included terms related to RSV (‘respiratory syncytial virus’, ‘respiratory syncytial viruses’, ‘RSV’, ‘respiratory syncytial virus infection’), outcomes of interest (‘incidence’, ‘mortality’, ‘prevalence’, ‘risk factor’, ‘risk’, ‘distribution’, ‘etiology’, ‘aetiology’, ‘epidemiology’) and study design (‘surveillance’, ‘observational’, ‘case-control’)
This review describes the incidence and the proportion of RSV among patients with respiratory infections in adult populations worldwide
Summary
Respiratory syncytial virus (RSV) was first recognised as a cause of bronchiolitis among infants in 1957, and is the most commonly identified cause of lower respiratory tract infections (LRTI) in young children [1]. It is an enveloped RNA virus of the Paramyxoviridae family and Pneumovirinae subfamily [2], displaying minimal antigenic heterogeneity [3]. RSV infections occur from late fall through early spring in temperate climates over a season of 4–6 months, exhibiting a clear pattern of winter incidence [5]. In higher-latitude locations, RSV infection tends to have broader variation, even within individual temperate zones, with peak activity outside of typical winter months [7]
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