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PEDIATRICS Vol. 112 No. 2 August 2003, pp. 494

WINTER VIRUSES: INFLUENZA- AND RESPIRATORY SYNCYTIAL VIRUS-RELATED MORBIDITY IN CHRONIC LUNG DISEASE

Allen Adinoff, MD

Aurora, CO

Griffin MR, Coffey CS, Neuzil KM, Mitchel EF Jr, Wright PF, Edwards KM. Arch Intern Med. 2002;162:1229–1236

	Purpose of the Study.

TOP Purpose of the Study. Patient Population and Methods. Results. Conclusions. Reviewer's Comments.

 
Chronic lung disease predisposes to serious consequences of respiratory viruses. Although increasing influenza immunization rates in older adults signal an awareness of the impact of influenza, children with asthma are infrequently immunized. Although respiratory syncytial virus (RSV) is recognized as an important target of vaccine development for infants, its impact on adults is underappreciated.

	Patient Population and Methods.

TOP Purpose of the Study. Patient Population and Methods. Results. Conclusions. Reviewer's Comments.

 
We performed a retrospective cohort study to estimate rates of hospitalizations, deaths, outpatient visits, and antibiotic courses attributable to influenza and RSV in persons with chronic lung disease in the Tennessee Medicaid program from 1995–1999. Differences between study event rates when influenza was co-circulating with RSV and event rates when RSV was circulating alone were used to calculate influenza-attributable morbidity. Differences in rates when RSV was circulating alone and during summer months were calculated to assess the effect of RSV.

	Results.

TOP Purpose of the Study. Patient Population and Methods. Results. Conclusions. Reviewer's Comments.

 
Influenza- and RSV-associated hospitalizations were highest at the extremes of age. There were an estimated 8 and 23 hospitalizations per 1000 children younger than 5 years annually attributable to influenza and RSV, respectively. There were 23 and 18 hospitalizations, as well as 2 and 5 deaths per 1000 persons 65 years or older annually attributable to influenza and RSV, respectively. Both viruses were associated with an excess of outpatient visits in children, and antibiotic prescriptions in all age groups.

	Conclusions.

TOP Purpose of the Study. Patient Population and Methods. Results. Conclusions. Reviewer's Comments.

 
Among persons with chronic lung disease, influenza virus and RSV accounted for 15% to 33% of acute respiratory hospitalizations in children, 7% to 9% of such hospitalizations in adults, and 9% of deaths in those 65 years or older.

	Reviewer’s Comments.

TOP Purpose of the Study. Patient Population and Methods. Results. Conclusions. Reviewer's Comments.

 
This study reminds us that influenza and RSV remain potentially serious infectious illnesses in patients with chronic lung disease. It seems to me that we might be more vigorous in our effects to vaccinate seniors (who often initiate the process themselves) than younger children with asthma whose parents may resist giving an injection.

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PEDIATRICS (ISSN 1098-4275). ©2003 by the American Academy of Pediatrics

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This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Adinoff, A. Search for Related Content PubMed Articles by Adinoff, A. Related Collections Infectious Disease & Immunity Related AAP Red Book topics: Influenza Social Bookmarking                         What's this?