Seasonality, Clinical Characteristics, and Outcomes of Respiratory Syncytial Virus Disease by Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020.

Autor:	Toepfer AP; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Amarin JZ; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Spieker AJ; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Stewart LS; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Staat MA; Department of Pediatrics, University of Cincinnati, and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA., Schlaudecker EP; Department of Pediatrics, University of Cincinnati, and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA., Weinberg GA; Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA., Szilagyi PG; Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA., Englund JA; Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA., Klein EJ; Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA., Michaels MG; Department of Pediatrics, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA., Williams JV; Department of Pediatrics, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA., Selvarangan R; Department of Pathology and Laboratory Medicine, Children's Mercy, Kansas City, Missouri, USA., Harrison CJ; Department of Pathology and Laboratory Medicine, Children's Mercy, Kansas City, Missouri, USA., Lively JY; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Piedra PA; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA., Avadhanula V; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA., Rha B; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Chappell J; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., McMorrow M; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; US Public Health Service, Rockville, Maryland, USA., Moline H; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; US Public Health Service, Rockville, Maryland, USA., Halasa NB; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2024 May 15; Vol. 78 (5), pp. 1352-1359.
DOI:	10.1093/cid/ciae085
Abstrakt:	Background: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established. Methods: During 2016-2020, children aged <5 years were enrolled in prospective surveillance in the emergency department or inpatient settings at 7 US pediatric medical centers. Surveillance data collection included parent/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction. Results: Among 6398 RSV-positive children aged <5 years, 3424 (54%) had subtype RSV-A infections, 2602 (41%) had subtype RSV-B infections, and 272 (5%) were not typed, inconclusive, or mixed infections. In both adjusted and unadjusted analyses, RSV-A-positive children were more likely to be hospitalized, as well as when restricted to <1 year. By season, RSV-A and RSV-B cocirculated in varying levels, with 1 subtype dominating proportionally. Conclusions: Findings indicate that RSV-A and RSV-B may only be marginally clinically distinguishable, but both subtypes are associated with medically attended illness in children aged <5 years. Furthermore, circulation of RSV subtypes varies substantially each year, seasonally and geographically. With introduction of new RSV prevention products, this highlights the importance of continued monitoring of RSV-A and RSV-B subtypes. Competing Interests: Potential conflicts of interest. J. A. E. reports research support from AstraZeneca, GSK, and Pfizer and has consulted for AbbVie, AstraZeneca, Meissa Vaccines, Moderna, Pfizer, and Sanofi. G. A. W. reports honoraria from Merck & Co for writing and revision of chapters in the Merck Manual. E. P. S. reports serving as the principal investigator for the Pfizer Maternal Immunization Study for Safety and Efficacy; honoraria from Sanofi-Pasteur for writing or educational events; grants from Pfizer; support for meetings and/or travel from the Pediatric Infectious Diseases Society; participation on Data Safety Monitoring Board for Division of Microbiology and Infectious Diseases; and serving as board member for the World Society of Pediatric Infectious Diseases and committee chair for the Pediatric Diseases Society. C. J. H.'s institution (where employed at the time of this study) received research funding from GSK, Merck, and Pfizer for vaccine studies for which he is an investigator and honoraria from Pediatric News. R. S. reports research funds from Merck; serving on an advisory board for GSK; and grants from Hologic, BioFire, Becton Dickinson, Luminex, and Cepheid. N. B. H. reports research support from Sanofi and Quidel and honoraria from Genetech. J. V. W. reports grant support from the National Institutes of Health (for work unrelated to this study); consulting fees from Quidel's scientific advisory board; honorarium from the Infectious Disease of Children for a conference presentation; and participation on a GSK independent data monitoring committee and on a data and safety monitoring board for the National Institute of Allergy and Infectious Diseases IMPAACT Study. J. C. reports grant support from Merck. P. A. P. reports grant support from Icosavax, Merck, GSK, Shionogi, IgM Bioscience, Mapp Biologics, Sanofi-Pasteur, and Blue Lake Biotechnology and consulting fees from Takada, Moderna, Merck, and Sanofi-Pasteur. All remaining authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
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