Published online October 1, 2004
PEDIATRICS Vol. 114 No. 4 October 2004, pp. e437-e444 (doi:10.1542/peds.2004-0049)
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ELECTRONIC ARTICLE

Respiratory Syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant Population

Robert C. Holman, MS*, Aaron T. Curns, MPH*, James E. Cheek, MD, MPH{ddagger}, Joseph S. Bresee, MD§, Rosalyn J. Singleton, MD, MPH||, Karen Carver, PhD and Larry J. Anderson, MD§

* Office of the Director, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
{ddagger} Epidemiology Program, Office of Public Health, Indian Health Service Headquarters, Albuquerque, New Mexico
§ Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
|| Alaska Native Tribal Health Consortium and Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
Office of Public Health, Indian Health Service Headquarters, Rockville, Maryland

Objective. To determine the burden of respiratory syncytial virus (RSV) disease among American Indian (AI) and Alaska Native (AN) infants, by examining RSV-associated hospitalizations.

Methods. Infant hospitalizations from 1997 through 2001 with RSV listed as a diagnosis were selected by using Indian Health Service/tribal hospital discharge data for AIs/ANs and National Hospital Discharge Survey data for the general US population.

Results. In 2000–2001, RSV disease was listed as a diagnosis for 14.4% of all AI/AN infant hospitalizations, with bronchiolitis attributable to RSV infection (12.2%) being among the top 5 listed diagnoses. The rate of RSV-specific hospitalizations was 34.4 hospitalizations per 1000 infants for AI/AN infants and 27.4 hospitalizations per 1000 births for the general US infant population. The hospitalization rates for AI/AN infants living in the Alaska and Southwest regions (70.9 and 48.2 hospitalizations per 1000 infants, respectively) were much higher than the overall rate for US infants.

Conclusions. RSV infection is one of the leading causes of hospitalization among all infants in the United States, and AI/AN infants living in the Southwest and Alaska regions are at especially high risk for hospitalizations associated with RSV infection. Development of vaccines, antiviral agents, and other strategies to prevent RSV disease could yield substantial public health benefits.

Key Words: infants • respiratory syncytial virus • RSV • respiratory disease • bronchiolitis • pneumonia • American Indian • Alaska Native • hospitalizations • epidemiology • United States

Abbreviations: RSV, respiratory syncytial virus • AI, American Indian • AN, Alaska Native • ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification • IHS, Indian Health Service • NHDS, National Hospital Discharge Survey

Accepted May 7, 2004.




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