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Published online November 23, 2009
PEDIATRICS Vol. 124 No. 6 December 2009, pp. e1072-e1080 (doi:10.1542/peds.2008-3074)
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ARTICLE

Relative Impact of Influenza and Respiratory Syncytial Virus in Young Children

Florence T. Bourgeois, MD, MPHa,b, Clarissa Valim, MD, ScDc,d, Alexander J. McAdam, MD, PhDe, Kenneth D. Mandl, MD, MPHa,b,f

a Division of Emergency Medicine
c Clinical Research Program
e Department of Laboratory Medicine
f Children's Hospital Informatics Program, Children's Hospital Boston, Boston, Massachusetts
b Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
d Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts

OBJECTIVE: We measured the relative impact of influenza and respiratory syncytial virus (RSV) infections in young children in terms of emergency department (ED) visits, clinical care requirements, and overall resource use.

METHODS: Patients who were aged ≤7 years and treated in the ED of a tertiary care pediatric hospital for an acute respiratory infection were enrolled during 2 winter seasons between 2003 and 2005. We quantified health care resource use for children with influenza or RSV infections, and extrapolated results to estimate the national resource use associated with influenza and RSV infections.

RESULTS: Nationally, an estimated 10.2 ED visits per 1000 children were attributable to influenza and 21.5 visits per 1000 to RSV. Children who were aged 0 to 23 months and infected with RSV had the highest rate of ED visits with 64.4 visits per 1000 children. Significantly more children required hospitalization as a result of an RSV infection compared with influenza, with national hospitalization rates of 8.5 and 1.4 per 1000 children, respectively. The total number of workdays missed yearly by caregivers of children who required ED care was 246965 days for influenza infections and 716404 days for RSV infections.

CONCLUSION: For young children, RSV is associated with higher rates of ED visits, hospitalization, and caregiver resource use than is influenza. Our results provide data on the large number of children who receive outpatient care for influenza and RSV illnesses and serve to inform analyses of prevention programs and treatments for both influenza and RSV disease.

Key Words: burden of illness • influenza • respiratory syncytial virus • emergency health services

Abbreviations: RSV—respiratory syncytial virus • ED—emergency department • ARI—acute respiratory infection • RT-PCR—reverse transcriptase–polymerase chain reaction • DFA—direct immunofluorescent antibody stain • CI—confidence interval

Accepted Jun 22, 2009.


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