Hospitalization In Young Children Research Articles

Hospitalization due to human parainfluenza virus-associated lower respiratory tract illness in rural Thailand

Background Human parainfluenza viruses (HPIVs) are an important cause of acute respiratory illness in young children but little is known about their epidemiology in the tropics. Methods From 2003–2007, we conducted surveillance for hospitalized respiratory illness in rural Thailand. We performed reverse‐transcriptase polymerase chain reaction on nasopharyngeal specimens and enzyme immunoassay on paired sera Results Of 10,097 patients enrolled, 573 (5%) of all ages and 370 (9%) of children <5 years of age had evidence of HPIV infection (HPIV1=189, HPIV2=54, HPIV3=305, untyped=27). Average adjusted annual incidence of HPIV‐associated hospitalized respiratory illness was greatest in children aged <1 year (485 per 100,000 person years). Conclusions In Thailand, HPIV caused substantial illnesses requiring hospitalization in young children.

Vitamin D intake in young children with acute lower respiratory infection.

To determine if vitamin D intake is associated with acute lower respiratory infections (ALRI) in children. The vitamin D intakes of children younger than 5 years of age admitted to hospital with either bronchiolitis or pneumonia were compared to an unmatched control group of the same age without respiratory infection. Caregivers of 197 children completed a questionnaire collecting information on demographic variables, ALRI risk factors and diet. Associations of ALRI with vitamin D intake and other ALRI risk factors were determined. The mean vitamin D intake of children with ALRI was 48 IU/kg/d compared to 60 IU/kg/d in the control group. When controlling for age, ethnicity, socio-economic status, northern residence, breastfeeding, immunizations and smoking contact, children with a vitamin D intake of less than 80 IU/kg/d were greater than 4 times more likely to have ALRI compared to children with a vitamin D intake exceeding 80 IU/kg/day (OR 4.9, 95% CI: 1.5, 16.4). A higher vitamin D intake than currently recommended might be needed to offer protection against diseases such as ALRI. Increased vitamin D supplementation could have important public health consequences, as bronchiolitis and pneumonia are the most common reasons for hospitalization in young children.

Phase 1 Study of the Safety and Immunogenicity of a Live, Attenuated Respiratory Syncytial Virus and Parainfluenza Virus Type 3 Vaccine in Seronegative Children

Respiratory syncytial virus (RSV) and parainfluenza virus type 3 (PIV3) are important causes of lower respiratory tract illness and hospitalization in young children. Currently, there is no licensed vaccine against RSV or PIV3. In this randomized, phase 1, double-blind, placebo-controlled, dose-escalating study, 49 healthy RSV/PIV3-seronegative children 6 to <24 months of age were randomized 2:1 to receive 3 doses (at 10, 10, or 10 median tissue culture infective dose [TCID50]) of MEDI-534 (a live, attenuated RSV/PIV3 chimeric virus vaccine candidate) or placebo at 2-month intervals. Solicited adverse events (SEs) and unsolicited adverse events (AEs) were recorded during days 0 to 28 after each dose. Nasal wash samples were collected 3 times (days 7-10, 12-18, and 28-34) after each dose and at unscheduled illness visits. Blood for antibody response was collected at baseline and 28 days after each dose. Subjects were followed for 180 days after the last dose or to the end of the RSV season. Overall, there was no difference in the incidence of SEs and AEs between the RSV/PIV3 vaccine and placebo arms. Runny/stuffy nose was the most commonly reported SE. Medically attended lower respiratory illness rates were balanced between treatment arms, and there was no evidence of enhanced RSV disease or vaccine-related serious AEs. Vaccine virus was detected in most vaccinees on days 7 to 10 after dose 1 in a dose-dependent manner. Seroresponse to RSV and PIV3 was highest in subjects receiving the 10 dosage. The safety profile and vaccine take as measured by shedding and/or seroresponse in this RSV/PIV3-seronegative pediatric population support the continued development of this RSV/PIV3 pediatric vaccine candidate.

Etiología de bronquiolitis en niños hospitalizados en el sureste de España

BackgroundBronchiolitis is the most common respiratory disease in children under 2 years-old and a major cause of hospitalization in young children, especially during the winter. ObjectivesTo determine the prevalence and etiology of bronchiolitis in south-east of Spain. Study designA prospective study was conducted during the bronchiolitis season (December-April). Children below 18 months-old admitted to the hospital for a first bronchiolitis episode were included. Nasopharyngeal aspirates were analysed by reverse transcription polymerase chain reaction (RT-PCR) respiratory syncytial virus. ResultsA total of 235 children were included during this period, and 235 RT-PCR were performed. A total of 287 viruses were detected in nasopharyngeal aspirates from 204 infants. Respiratory syncytial virus was the virus detected more frequently, followed by rhinovirus. Co-infections were found in the 36% of children. ConclusionsRespiratory viruses were detected in most of the children below 18 months-old hospitalised with bronchiolitis, and 36% of them showed a mixed infection.

Human Bocavirus and Airway Hyperesponsiveness in Young Children with Lower Respiratory Tract Infection (LRI)

Background and Aims: Human bocavirus is a new virus that can cause acute wheezing in young children. This study is aimed to assess the incidence of human bocavirus- LRI in children younger than 5 years old and the correlation between human bocavirus and airway hyperresponsiveness. Methods: Children younger than 5 years old admitted to the hospital during February 1, 2007 through September 30, 2008 due to LRI were studied. These patients were evaluated for the clinical presentations and their nasopharyngeal aspirates were examined by Polymerase Chain Reaction (RT-PCR) for viruses. Children who had positive PCR for human bocavirus were followed up their clinical and pulmonary function test for 1 year to evaluate the correlation between human bocavirus and airway hyperresponsiveness. Results: 100 hospitalized children with LRI were enrolled during October1, 2007 through September 30, 2008. Human bocavirus was detected in 6 (6%) children with 46.7% co-infection, ranking forth in incidence behind RSV, rhinovirus and parainfluenza virus respectively. During the study period, 15 children with human bocavirus-LRI were studied. The male: female ratio was 4:1 with the mean age of 22 months. Rhonchi and wheezing were found in 73% of cases and 37% of them response well to bronchodilator. Pulmonary function test were normal in all cases. Twenty-five percent of the patients developed recurrent wheezing during 1 year of follow-up. Conclusions: Human bocavirus is one of the significant causes of morbidity leading to hospitalization in young children with LRI. The correlation between human bocavirus-LRI and airway hyperresponsiveness should be further studied.

Epidemiological Study of Hospitalization Associated With Respiratory Syncytial Virus Infection in Taiwanese Children Between 2004 and 2007

Respiratory Syncytial Virus (RSV) is the leading cause of hospitalization in young children. The population-based burden of RSV hospitalization and the effect of potential risk factors on the severity of illness were evaluated in Taiwanese children. We analyzed the annual population-based incidence, underlying diseases and characteristics of hospitalizations due to RSV in Taiwanese children under 5 years of age from 2004 to 2007 by using Taiwan's National Health Insurance database. A total of 11,081 children with RSV-associated hospitalization were studied. Average annual population-based hospitalization incidence was 1,077 and 232 per 100,000 children-year in children under 6 months and under 5 years of age, respectively. The peak incidence occurred between 1 and 2 months of age. The male-to-female incidence risk ratio was 1.4:1 (p < 0.001). There was a significant seasonal distribution with consistent peaks in the spring and autumn every year (p < 0.001). A total of 373 patients (3.3%) had repeated RSV infection. The 943 children (8.5%) with underlying diseases were older (p = 0.001), required longer intensive care unit (ICU) stays (p < 0.001), had a higher rate of endotracheal intubation (p < 0.05), and incurred higher medical costs (p < 0.001). A total of 888 patients (8%) required ICU care. Younger age (p < 0.001), prematurity (p < 0.001), cerebral palsy (p < 0.001) and congenital heart disease (p < 0.001) were independent predictors of requiring ICU care. RSV infection occurs biennially with peaks in spring and fall in Taiwan. Patients with underlying diseases need longer hospital and ICU stays and incur higher medical costs. Younger age, prematurity, congenital heart disease and cerebral palsy are predictors of ICU care.

Gastroenteritis in childhood: a retrospective study of 650 hospitalized pediatric patients

Acute diarrhea continues to be an important cause of hospitalization in young children, and deaths still occur as a result. We reviewed a large cohort of hospitalized children affected by gastroenteritis. The hypothesis of our study was that clinical characteristics and a limited set of laboratory data can differentiate between the different causative pathogens of diarrhea. A chart review was performed of 650 patients with pathogen-proven diarrhea treated between April 2005 and May 2008 in the children's hospital of the University of Würzburg. Clinical presentation at the time of admission and during hospital stay, laboratory findings, stool pathogen results, and epidemiological data were collected and compared. A severity score was generated. Rotavirus was the most common gastroenteritis pathogen identified, followed by norovirus, adenovirus and Salmonella spp. Nosocomial infections were caused most commonly by norovirus. Rotavirus was the most common agent when there was simultaneous detection of two or more viruses. Rotavirus infections were significantly more severe, with a higher frequency of diarrhea and elevated liver enzymes. Infections due to Salmonella spp showed significantly higher values for C-reactive protein, erythrocyte sedimentation rate, and body temperature. A seasonal distribution was noted, with the peak for rotaviruses/noroviruses in winter/spring, the peak for adenoviruses in November/December, and the peak for Salmonella spp in the summer months. Younger children and toddlers had significantly higher gastroenteritis and airway inflammation scores. Of note, respiratory symptoms and parameters of systemic inflammation differed between the different pathogens. Gastroenteritis is a common reason for hospital admission in previously healthy children during the first years of life. Rotaviruses were found to be the most common pathogens in our cohort. On the basis of clinical and laboratory parameters it appears possible to distinguish between the different causative agents. This may have implications for hospital hygiene management and for the identification of predictive markers of a severe course.

“I Want to Meet Other Kids Like Me”: Support Needs of Children with Asthma and Allergies

Context: Asthma is the most common chronic illness of childhood and the leading cause of hospitalization in young children. Asthma negatively impacts physical health, psychosocial wellbeing, and quality of life for affected children but the psychosocial support needs of children with asthma and severe have not been studied from their point of view.Objective: The objective of this study was to assess the support and education needs and preferred interventions of allergic children with asthma and/or severe allergies.Methods: Qualitative constant comparative content analysis was used to identify major themes from semi-structured individual interviews with 20 children with asthma and allergies and 35 parents.Findings: Children expressed frustration with the limitations imposed by asthma and allergies on their regular activities and normal lives. Parents believed that peer support someone to whom their child could relate as a role model that support could improve both their children’s and their own coping.Conclusions: Parents and children preferred a combination of in-person meetings and internet support to enhance the capacity of children, reduce children’s anxiety, increase their self-care skills, and self-confidence. In addition they believed a support intervention was a stepping stone to developing a community of support for children with asthma, allergies, and anaphylaxis.

Time Series Model to Predict Burden of Viral Respiratory Illness on a Pediatric Intensive Care Unit

In the United States, viral respiratory infections are a leading cause of illness and hospitalization in young children. Caring for children with severe viral respiratory illness can have a substantial impact on resource utilization in the pediatric intensive care unit (PICU). The objective was to build a robust model that captures the periodicity of severe pediatric viral respiratory illness and forecasts the incidence of viral respiratory illness in the PICU. This was a retrospective time series analysis in a PICU at a quaternary care children's hospital. Patients were less than 18 years of age with laboratory-confirmed respiratory syncytial virus, influenza, parainfluenza, or adenovirus infection on or during admission from October 2002 to September 2008. Time series modeling techniques were to used to model viral incidence, using maximum likelihood estimation to identify model parameters. A total of 289 patients were included in the analysis. An autoregressive model of order 10 that included an exogenous variable of community viral incidence from the previous month was able to explain and predict viral incidence in the PICU. A limitation of the study was that it included a single institution. The identified model, derived from historical data from both a PICU and the local community, produced accurate 1-month and 3-month forecasts of severe viral respiratory illness presentation to the PICU. These results suggest that time series models may be useful tools in forecasting the burden of severe viral respiratory illness at the institutional level, helping institutions make decisions to optimize the distribution of resources.

A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children.

BackgroundAcute lower respiratory infections (ALRI) are a major cause of hospitalisation in young children. Many factors can lead to increased risk of ALRI in children and predispose a child to hospitalisation, but population attributable fractions for different risk factors and how these fractions differ between Indigenous and non-Indigenous children is unknown. This study investigates population attributable fractions of known infant and maternal risk factors for ALRI to inform prevention strategies that target high-risk groups or particular risk factors.MethodsA retrospective population-based data linkage study of 245,249 singleton births in Western Australia. Population attributable fractions of known maternal and infant risk factors for hospitalisation with ALRI between 1996 and 2005 were calculated using multiple logistic regression.ResultsThe overall ALRI hospitalisation rate was 16.1/1,000 person-years for non-Aboriginal children and 93.0/1,000 for Aboriginal children. Male gender, being born in autumn, gestational age <33 weeks, and multiple previous pregnancies were significant risk factors for ALRI in both Aboriginal and non-Aboriginal children. In non-Aboriginal children, maternal smoking during pregnancy accounted for 6.3% (95%CI: 5.0, 7.6) of the population attributable fraction for ALRI, being born in autumn accounted for 12.3% (10.8, 13.8), being born to a mother with three or more previous pregnancies accounted for 15.4% (14.1, 17.0) and delivery by elective caesarean accounted for 4.1% (2.8, 5.3). In Aboriginal children, being born to a mother with three or more previous pregnancies accounted for 16.5% (11.8, 20.9), but remote location at birth accounted for 11.7% (8.5, 14.8), maternal age <20 years accounted for 11.2% (7.8, 14.5), and being in the most disadvantaged socio-economic group accounted for 18.4% (-6.5, 37.4) of the population attributable fraction.ConclusionsThe population attributable fractions estimated in this study should help in guiding public health interventions to prevent ALRI. A key risk factor for all children is maternal smoking during pregnancy, and multiple previous pregnancies and autumnal births are important high-risk groups. Specific key target areas are reducing elective caesareans in non-Aboriginal women and reducing teenage pregnancies and improving access to services and living conditions for the Aboriginal population.

Missed well-child care visits, low continuity of care, and risk of ambulatory care-sensitive hospitalizations in young children.

To determine if adherence to the recommended well-child care (WCC) visit schedule, independent of continuity of care (COC), is associated with lower risk of ambulatory care-sensitive hospitalizations (ACSH) and whether this association varies by chronic disease status. Population-based, retrospective cohort study. Hawaii's largest health plan from 1999 to 2006. A total of 36 944 children aged 3.5 years or younger were eligible if they were enrolled prior to 2 months of age, had 4 or more outpatient visits during the study period, and had an enrollment period that overlapped with 1 or more WCC visit interval. Patients' WCC visit adherence and COC index. Risk of ACSH (hazard ratio [HR]). Overall, 8921 (24%) children had 1 or more chronic disease. The proportion of ACSH among healthy children vs those with 1 or more chronic disease were 3% (n = 751) and 7% (n = 645), respectively. For children with chronic disease, those with the lowest WCC visit adherence (0%-25%) had 1.9 times (HR, 1.9; 95% confidence interval [CI], 1.5-2.5) the risk of ACSH compared with those in the highest category (75%-100%). The risk of ACSH for children with chronic disease who fell into the lowest COC category (0-0.25) was 2.4 times (HR, 2.4; 95% CI, 1.7-3.5) higher than for those who fell into the highest category (0.75-1.0). For children with chronic disease, both low WCC visit adherence and COC are independently associated with an increased risk of ACSH. Providing access to a consistent source of primary care appears to be important to this vulnerable population.

Pandemic influenza A(H1N1) 2009 and respiratory syncytial virus associated hospitalizations

To determine the contribution of influenza and respiratory syncytial virus (RSV) as the cause of lower respiratory tract infection (LRTI) associated hospitalizations during the first year of the influenza A(H1N1) 2009 pandemic and to assess the severity of illness during the second pandemic wave. Patients admitted with LRTI from April 2009 through March 2010 were assessed for the presence of influenza and RSV. Pandemic influenza virus was detected by means of a nested RT-PCR assay and/or the CDC's real time-PCR protocol. RSV was detected using a one-step RT-PCR assay. The characteristics of patients admitted during the first and second pandemic outbreaks were compared. 657 patients with LRTI were admitted during the study period. Pandemic influenza virus was detected in 180 and RSV in 133. Influenza was the most common cause of infection in adults, while RSV was more common in children. There were no differences in disease severity between the first and second pandemic outbreaks. Pandemic influenza virus was associated to increased numbers of hospitalizations and deaths; particularly in adults. The severity of the first and second pandemic outbreaks was similar. RSV continues to be the main pathogen responsible for hospitalizations in young children.

Bronchiolitis: Recent Evidence on Diagnosis and Management

Viral bronchiolitis is a leading cause of acute illness and hospitalization of young children. Research into the variation in treatment and outcomes for bronchiolitis across different settings has led to evidence-based clinical practice guidelines. Ongoing investigation continues to expand this body of evidence. Authors of recent surveillance studies have defined the presence of coinfections with multiple viruses in some cases of bronchiolitis. Underlying comorbidities and young age remain the most important predictors for severe bronchiolitis. Pulse oximetry plays an important role in driving use of health care resources. Evidence-based reviews have suggested a limited role for diagnostic laboratory or radiographic tests in typical cases of bronchiolitis. Several large, recent trials have revealed a lack of efficacy for routine use of either bronchodilators or corticosteroids for treatment of bronchiolitis. Preliminary evidence suggests a potential future role for a combination of these therapies and other novel treatments such as nebulized hypertonic saline.

The Role of Toll Pathways in Viral Respiratory Disease During Early Childhood

Virus-induced respiratory disease accounts for the majority of hospitalizations of young children during the winter months. The major viral causes of lower respiratory tract disease in infants and children are respiratory syncytial virus (RSV), rhinovirus, metapneumovirus (hMPV), parainfluenza virus 3 (PIV-3), and influenza. The primary antiviral mechanism involves the activation of cytotoxic T cells and the clearance of virus-infected epithelial cells, and Toll-like receptors that recognize microbial molecular patterns are thought to initiate and orchestrate the immune response. Here, we review the role of Toll-like receptors in modulating the immune response to respiratory viral disease, including the role of maturation of the TLR system in early life.

Hospital-Based Surveillance to Estimate the Burden of Rotavirus Gastroenteritis Among European Children Younger Than 5 Years of Age

Rotavirus is the leading cause of acute gastroenteritis requiring hospitalization in young children. Data on the burden of rotavirus gastroenteritis are needed to guide recommendations for rotavirus vaccine use. This study was undertaken to estimate the burden of rotavirus gastroenteritis in European children <5 years of age. This prospective, study was conducted in 12 hospitals in France, Germany, Italy, Spain, and the United Kingdom. A sample of all children aged <5 years presenting to emergency departments or hospitalized because of community-acquired acute gastroenteritis was enrolled for parental interview and stool collection. Acute gastroenteritis was defined as diarrhea (>/=3 loose stools per 24 hours) for <14 days. Rotavirus was detected by enzyme-linked immunosorbent assay and typed by reverse-transcriptase polymerase chain reaction. Between February 2005 and August 2006, 3734 children with community-acquired acute gastroenteritis were recruited and retained for analysis (55.9% via the emergency department, 41.8% hospitalized). Of the 2928 community-acquired acute gastroenteritis cases for which stool samples were available, 43.4% were rotavirus-positive by enzyme-linked immunosorbent assay (32.8% emergency department, 56.2% hospitalized). Of these rotavirus gastroenteritis cases 80.9% occurred in children aged <2 years and 15.9% among infants aged <6 months. Acute gastroenteritis was more severe in rotavirus-positive subjects (Vesikari score >/= 11 in 53.3% compared with 31.0% of rotavirus-negative subjects). All 1271 rotavirus-positive strains were genotyped (G1P[8]: 40.3%; G9P[8]: 31.2%; G4P[8]: 13.5%; G3P[8]: 7.1%). Rotavirus gastroenteritis places high demands on European health care systems, accounting for 56.2% of hospitalizations and 32.8% of emergency department visits because of community-acquired acute gastroenteritis in children aged <5 years. Most community-acquired rotavirus gastroenteritis occurs in children aged <2 years, and a high proportion occurs in infants aged <6 months. Cases were also observed among very young infants <2 months of age. Rotavirus vaccination is expected to have a major impact in reducing morbidity and the pressure on hospital services in Europe.

Comparison of Automated Microarray Detection with Real-Time PCR Assays for Detection of Respiratory Viruses in Specimens Obtained from Children

Respiratory virus infections are a major health concern and represent the primary cause of testing consultation and hospitalization for young children. We developed and compared two assays that allow the detection of up to 23 different respiratory viruses that frequently infect children. The first method consisted of single TaqMan quantitative real-time PCR assays in a 96-well-plate format. The second consisted of a multiplex PCR followed by primer extension and microarray hybridization in an integrated molecular diagnostic device, the Infiniti analyzer. Both of our assays can detect adenoviruses of groups A, B, C, and E; coronaviruses HKU1, 229E, NL63, and OC43; enteroviruses A, B, C, and D; rhinoviruses of genotypes A and B; influenza viruses A and B; human metapneumoviruses (HMPV) A and B, human respiratory syncytial viruses (HRSV) A and B; and parainfluenza viruses of types 1, 2, and 3. These tests were used to identify viruses in 221 nasopharyngeal aspirates obtained from children hospitalized for respiratory tract infections. Respiratory viruses were detected with at least one of the two methods in 81.4% of the 221 specimens: 10.0% were positive for HRSV A, 38.0% for HRSV B, 13.1% for influenzavirus A, 8.6% for any coronaviruses, 13.1% for rhinoviruses or enteroviruses, 7.2% for adenoviruses, 4.1% for HMPV, and 1.5% for parainfluenzaviruses. Multiple viral infections were found in 13.1% of the specimens. The two methods yielded concordant results for 94.1% of specimens. These tests allowed a thorough etiological assessment of respiratory viruses infecting children in hospital settings and would assist public health interventions.

Respiratory infection in congenital cardiac disease. Hospitalizations in young children in Spain during 2004 and 2005: the CIVIC Epidemiologic Study

To evaluate the rate of hospitalization for acute respiratory tract infection in children less than 24 months with haemodynamically significant congenital cardiac disease, and to describe associated risk factors, preventive measures, aetiology, and clinical course. We followed 760 subjects from October 2004 through April 2005 in an epidemiological, multicentric, observational, follow-up, prospective study involving 53 Spanish hospitals. Of our cohort, 79 patients (10.4%, 95% CI: 8.2%-12.6%) required a total of 105 admissions to hospital related to respiratory infections. The incidence rate was 21.4 new admissions per 1000 patients-months. Significant associated risk factors for hospitalization included, with odds ratios and 95% confidence intervals shown in parentheses: 22q11 deletion (8.2, 2.5-26.3), weight below the 10th centile (5.2, 1.6-17.4), previous respiratory disease (4.5, 2.3-8.6), incomplete immunoprophylaxis against respiratory syncytial virus (2.2, 1.2-3.9), trisomy 21 (2.1, 1.1-4.2), cardiopulmonary bypass (2.0, 1.1-3.4), and siblings aged less than 11 years old (1.7, 1.1-2.9). Bronchiolitis (51.4%), upper respiratory tract infections (25.7%), and pneumonia (20%) were the main diagnoses. An infectious agent was found in 37 cases (35.2%): respiratory syncytial virus in 25, Streptococcus pneumoniae in 5, and Haemophilus influenzae in 4. The odds ratio for hospitalization due to infection by the respiratory syncytial virus increases by 3.05 (95% CI: 2.14 to 4.35) in patients with incomplete prophylaxis. The median length of hospitalization was 7 days. In 18 patients (17.1%), the clinical course of respiratory infection was complicated and 2 died. Hospital admissions for respiratory infection in young children with haemodynamically significant congenital cardiac disease are mainly associated with non-cardiac conditions, which may be genetic, malnutrition, or respiratory, and to cardiopulmonary bypass. Respiratory syncytial virus was the most commonly identified infectious agent. Incomplete immunoprophylaxis against the virus increased the risk of hospitalization.

Rhinovirus‐Associated Hospitalizations in Young Children

Background. Rhinoviruses frequently cause the common cold but have not been considered important causes of acute respiratory hospitalizations in children. Methods. A population-based surveillance study was performed among children <5 years of age who were hospitalized with respiratory symptoms or fever and who resided within counties encompassing Nashville, Tennessee, or Rochester, New York, from October 2000 through September 2001. Data collected included questionnaires, nasal and throat swabs for viral culture and polymerase chain reaction testing, and chart review. Rates of rhinovirus-associated hospitalizations were calculated. Results. Of 592 children enrolled, 156 (26%) were rhinovirus positive, representing 4.8 (95% confidence interval [CI], 4.3–5.2) rhinovirus-associated hospitalizations/1000 children. Age-specific rates per 1000 children were 17.6 (95% CI, 14.9–20.6) for 0–5-month-olds, 6.0 (95% CI, 5.0–7.0) for 6–23-month-olds, and 2.0 (95% CI, 1.6, 2.4) for 24–59-month-olds (P<.01) Children with a history of wheezing/asthma had significantly more rhinovirusassociated hospitalizations than those without a history (25.3/1000 children [95% CI, 21.6–29.5/1000 children] vs. 3.1/1000 children [95% CI, 2.7–3.5/1000 children]). Conclusions. Rhinoviruses were associated with nearly 5 hospitalizations/1000 children <5 years of age and were highest in children with a history of wheezing/asthma.

Rotavirus gastroenteritis: epidemiological data from a regional hospital in Belgium

The Belgian Institute of Public Health registered from 2000 to 2005 a yearly average of 6,790 hospital admissions for rotavirus gastroenteritis in children less than 5 years of age. Very efficacious rotavirus vaccines are available nowadays. The surveillance of hospitalisation due to rotavirus gastroenteritis is a good target for the follow-up of vaccine-related prevention. In a large regional Belgian hospital, rotavirus is associated with 12% to 21% of all hospitalisation days among children less than 2 years of age. The general implementation of rotavirus vaccination could dramatically reduce the hospitalisation of young children due to rotavirus gastroenteritis in developed countries.

Asthma hospitalization patterns in young children relating to admission age, infection presence, sex, and race

Although childhood hospitalizations for asthma are common, there are few detailed temporal and demographic descriptions of these hospitalizations. To relate temporal patterns of asthma hospitalization in young children to admission age, sex, comorbid infection, and race. Retrospective analysis of 151,391 New York State hospitalizations with a principal diagnosis of asthma between January 1, 1990, and December 31, 2004, in children younger than 5 years. Admission patterns across time were related to admission age, sex, race, and comorbid diagnoses of common infections. Although the overall hospitalization rate decreased, it was still 63.8 per 10,000 in 2004. Higher hospitalization rates were consistently observed in children younger than 3 years, African Americans, and boys. Fall increases and summer declines in overall monthly hospitalization rates and monthly median ages exemplified the seasonality observed in the study population. However, admissions with concomitant common infections peaked in the winter, not fall months. Sex did not affect the observed seasonality. Compared with white patients, African Americans not only manifested more than 3-fold higher hospitalization rates but also more repeated hospitalizations. The concurrent cyclical increases in median age and monthly admissions suggest that seasonal factors affecting older children may relate to fall increases in asthma admissions. These fall peaks are not accounted for by recognizable concomitant common respiratory tract infections. Understanding the basis for these seasonal variations may lead to prevention strategies that could decrease asthma admissions. Asthma hospitalizations in young children continued to be highly prevalent in New York State, especially in African American patients.