This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (66)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Iwane, M. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Iwane, M. K.
Related Collections
Right arrowRelated AAP Red Book topics:
Parainfluenza Viral Infections
Influenza
PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1758-1764

Population-Based Surveillance for Hospitalizations Associated With Respiratory Syncytial Virus, Influenza Virus, and Parainfluenza Viruses Among Young Children

Marika K. Iwane, PhD, MPH*, Kathryn M. Edwards, MD{ddagger}, Peter G. Szilagyi, MD, MPH§, Frances J. Walker, MSPH*, Marie R. Griffin, MD||, Geoffrey A. Weinberg, MD§, Charmaine Coulen, MPH*, Katherine A. Poehling, MD, MPH{ddagger}, Laura P. Shone, MSW, DrPH§, Sharon Balter, MD*, Caroline B. Hall, MD§, Dean D. Erdman, DrPH, Karen Wooten, MA*, Benjamin Schwartz, MD* for the New Vaccine Surveillance Network

* National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
{ddagger} Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
§ Department of Pediatrics and Strong Children’s Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York
|| Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Objective. Respiratory syncytial virus (RSV), influenza virus, and parainfluenza viruses (PIV) cause significant morbidity in young children. Although only influenza virus infection and illness is currently vaccine-preventable, vaccines are under development for RSV and PIV. We established a prospective, active population-based surveillance network to provide precise estimates of hospitalization rates for viral acute respiratory illness (ARI) in young children and to measure the potential impact of enhanced vaccine usage on these rates.

Methods. Prospective, active population-based surveillance was conducted in young children who were hospitalized for ARI from October 1, 2000, to September 30, 2001, in Monroe County, New York (Rochester area) and Davidson County, Tennessee (Nashville area). Eligible children younger than 5 years were those who resided in surveillance counties and were hospitalized for febrile or acute respiratory illness. Viral culture and polymerase chain reaction identified viruses from nasal and throat samples obtained from all surveillance children. We measured population-based rates of hospitalization for RSV, influenza virus, and PIV as well as demographic, clinical, and risk factor assessment for each virus.

Results. Of 812 eligible hospital admissions, 592 (73%) children were enrolled. Of the enrolled children, RSV was identified in 20%, influenza in 3%, PIV in 7%, other respiratory viruses in 36%, and no detectable virus in 39%. Population-based rates of ARI hospitalizations in children younger than 5 years were 18 per 1000. Virus-positive hospitalization rates per 1000 children were 3.5 for RSV, 1.2 for PIV, and 0.6 for influenza virus. Younger age (particularly <1 year), black and Hispanic race/ethnicity, male gender, and presence of chronic underlying illness were associated with higher hospitalization rates.

Conclusions. This study confirms that children younger than 5 years and particularly children younger than 1 year have a high burden of hospitalization from RSV, influenza, and PIV. The enhanced use of influenza vaccine and the development of RSV and PIV vaccines have the potential to reduce markedly the pediatric morbidity from ARIs.

Key Words: influenza • RSV • parainfluenza • population-based • hospitalizations

Abbreviations: ARI, acute respiratory illness • RSV, respiratory syncytial virus • PIV, parainfluenza virus • RT-PCR, reverse transcription-polymerase chain reaction • NVSN, New Vaccine Surveillance Network • CDC, Centers for Disease Control and Prevention

Received for publication Sep 22, 2003; Accepted Jan 26, 2004.




This article has been cited by other articles:


Home page
 PediatricsHome page
Committee on Infectious Diseases
Prevention of Influenza: Recommendations for Influenza Immunization of Children, 2007-2008
Pediatrics, April 1, 2008; 121(4): e1016 - e1031.
[Abstract] [Full Text] [PDF]

Home page
 J Clin PharmacolHome page
G. L. Kearns, S. Lu, L. Maganti, X. Li, E. Migoya, T. Ahmed, B. Knorr, and T. F. Reiss
Pharmacokinetics and Safety of Montelukast Oral Granules in Children 1 to 3 Months of Age With Bronchiolitis
J. Clin. Pharmacol., April 1, 2008; 48(4): 502 - 511.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. L. Yorita, R. C. Holman, J. J. Sejvar, C. A. Steiner, and L. B. Schonberger
Infectious Disease Hospitalizations Among Infants in the United States
Pediatrics, February 1, 2008; 121(2): 244 - 252.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
E. K. Miller, M. R. Griffin, K. M. Edwards, G. A. Weinberg, P. G. Szilagyi, M. A. Staat, M. K. Iwane, Y. Zhu, C. B. Hall, G. Fairbrother, et al.
Influenza Burden for Children With Asthma
Pediatrics, January 1, 2008; 121(1): 1 - 8.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J.-A. S. Harris, W. C. Huskins, J. M. Langley, J. D. Siegel, and for the Pediatric Special Interest Group of the So
Health Care Epidemiology Perspective on the October 2006 Recommendations of the Subcommittee on Diagnosis and Management of Bronchiolitis
Pediatrics, October 1, 2007; 120(4): 890 - 892.
[Full Text] [PDF]

Home page
 PediatricsHome page
S. E. Coffin, T. E. Zaoutis, A. B. W. Rosenquist, K. Heydon, G. Herrera, C. B. Bridges, B. Watson, R. Localio, R. L. Hodinka, and R. Keren
Incidence, Complications, and Risk Factors for Prolonged Stay in Children Hospitalized With Community-Acquired Influenza
Pediatrics, April 1, 2007; 119(4): 740 - 748.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Boogaard, A. R. Hulsmann, L. van Veen, A. A. P. H. Vaessen-Verberne, Y. N. Yap, A. J. Sprij, G. Brinkhorst, B. Sibbles, T. Hendriks, S. W. W. Feith, et al.
Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis
Chest, March 1, 2007; 131(3): 788 - 795.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. M. Shuler, M. Iwamoto, C. B. Bridges, M. Marin, R. Neeman, P. Gargiullo, T. A. Yoder, H. L. Keyserling, and P. D. Terebuh
Vaccine Effectiveness Against Medically Attended, Laboratory-Confirmed Influenza Among Children Aged 6 to 59 Months, 2003-2004
Pediatrics, March 1, 2007; 119(3): e587 - e595.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. G. Grijalva, K. A. Poehling, K. M. Edwards, G. A. Weinberg, M. A. Staat, M. K. Iwane, W. Schaffner, and M. R. Griffin
Accuracy and Interpretation of Rapid Influenza Tests in Children
Pediatrics, January 1, 2007; 119(1): e6 - e11.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. Ampofo, P. H. Gesteland, J. Bender, M. Mills, J. Daly, M. Samore, C. Byington, A. T. Pavia, and R. Srivastava
Epidemiology, Complications, and Cost of Hospitalization in Children With Laboratory-Confirmed Influenza Infection
Pediatrics, December 1, 2006; 118(6): 2409 - 2417.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. J. Pelletier, J. M. Mansbach, and C. A. Camargo Jr
Direct Medical Costs of Bronchiolitis Hospitalizations in the United States
Pediatrics, December 1, 2006; 118(6): 2418 - 2423.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
P. G. Szilagyi, M. R. Griffin, L. P. Shone, R. Barth, Y. Zhu, S. Schaffer, S. Ambrose, J. Roy, K. A. Poehling, K. M. Edwards, et al.
The Impact of Conjugate Pneumococcal Vaccination on Routine Childhood Vaccination and Primary Care Use in 2 Counties
Pediatrics, October 1, 2006; 118(4): 1394 - 1402.
[Abstract] [Full Text] [PDF]

Home page
 J Trop PediatrHome page
R. Al-Toum, S. Bdour, and H. Ayyash
Epidemiology and Clinical Characteristics of Respiratory Syncytial Virus Infections in Jordan
J Trop Pediatr, August 1, 2006; 52(4): 282 - 287.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
K. A. Poehling, K. M. Edwards, G. A. Weinberg, P. Szilagyi, M. A. Staat, M. K. Iwane, C. B. Bridges, C. G. Grijalva, Y. Zhu, D. I. Bernstein, et al.
The underrecognized burden of influenza in young children.
N. Engl. J. Med., July 6, 2006; 355(1): 31 - 40.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
K. A. Poehling, Y. Zhu, Y.-W. Tang, and K. Edwards
Accuracy and Impact of a Point-of-Care Rapid Influenza Test in Young Children With Respiratory Illnesses
Arch Pediatr Adolesc Med, July 1, 2006; 160(7): 713 - 718.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
F. T. Bourgeois, C. Valim, J. C. Wei, A. J. McAdam, and K. D. Mandl
Influenza and Other Respiratory Virus-Related Emergency Department Visits Among Young Children
Pediatrics, July 1, 2006; 118(1): e1 - e8.
[Abstract] [Full Text] [PDF]

Home page
 J. Immunol.Home page
A. A. Divekar, D. M. W. Zaiss, F. E.-H. Lee, D. Liu, D. J. Topham, A. J. A. M. Sijts, and T. R. Mosmann
Protein Vaccines Induce Uncommitted IL-2-Secreting Human and Mouse CD4 T Cells, Whereas Infections Induce More IFN-{gamma}-Secreting Cells
J. Immunol., February 1, 2006; 176(3): 1465 - 1473.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
Brief Report: Respiratory Syncytial Virus Activity--United States, 2004-2005
JAMA, January 18, 2006; 295(3): 267 - 268.
[Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
J S Nguyen-Van-Tam
Influenza related hospital admissions in children: evidence about the burden keeps growing but the route to policy change remains uncertain
Arch. Dis. Child., January 1, 2006; 91(1): 5 - 7.
[Full Text] [PDF]

Home page
 NEJMHome page
N. Bhat, J. G. Wright, K. R. Broder, E. L. Murray, M. E. Greenberg, M. J. Glover, A. M. Likos, D. L. Posey, A. Klimov, S. E. Lindstrom, et al.
Influenza-Associated Deaths among Children in the United States, 2003-2004
N. Engl. J. Med., December 15, 2005; 353(24): 2559 - 2567.
[Abstract] [Full Text] [PDF]

Home page
 Proc. Natl. Acad. Sci. USAHome page
T. Allander, M. T. Tammi, M. Eriksson, A. Bjerkner, A. Tiveljung-Lindell, and B. Andersson
From The Cover: Cloning of a human parvovirus by molecular screening of respiratory tract samples
PNAS, September 6, 2005; 102(36): 12891 - 12896.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. P. Ritzwoller, C. B. Bridges, S. Shetterly, K. Yamasaki, M. Kolczak, and E. K. France
Effectiveness of the 2003-2004 Influenza Vaccine Among Children 6 Months to 8 Years of Age, With 1 vs 2 Doses
Pediatrics, July 1, 2005; 116(1): 153 - 159.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
S. G. Humiston, E. B. Lerner, E. Hepworth, T. Blythe, and J. G. Goepp
Parent Opinions About Universal Influenza Vaccination for Infants and Toddlers
Arch Pediatr Adolesc Med, February 1, 2005; 159(2): 108 - 112.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
W. W. Thompson, D. K. Shay, E. Weintraub, L. Brammer, C. B. Bridges, N. J. Cox, and K. Fukuda
Influenza-Associated Hospitalizations in the United States
JAMA, September 15, 2004; 292(11): 1333 - 1340.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
H. C. Meissner and M. B. Rennels
Unpredictable Patterns of Viral Respiratory Disease in Children
Pediatrics, June 1, 2004; 113(6): 1814 - 1816.
[Full Text] [PDF]