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Abstract

Background

Bronchiolitis caused by respiratory syncytial virus (RSV) is a major cause of mortality and morbidity in infants.

Aim

To describe RSV epidemiology in children in the community in a high-income setting.

Methods

We used stored blood samples from the United Kingdom Born in Bradford cohort study that had been collected at birth, age 1 and 2 years old, tested for IgG RSV postfusion F antibody and linked to questionnaires and primary and hospital care records. We used finite mixture models to classify children as RSV infected/not infected according to their antibody concentrations at age 1 and 2 years. We assessed risk factors for primary RSV infection at each age using Poisson regression models.

Results

The study cohort included 700 children with cord blood samples; 490 had additional blood samples taken at both ages 1 and 2 years old. Of these 490 children, 258 (53%; 95% confidence interval (CI): 48–57%) were first infected with RSV at age 1, 99 of whom (38%; 95% CI: 33–43%) had been in contact with healthcare during peak RSV season (November–January). Having older siblings, birth in October–June and attending formal childcare were associated with risk of RSV infection in infancy. By age 2, a further 164 of 490 children (33%; 95% CI: 29–38%) had been infected.

Conclusion

Over half of children experienced RSV infection in infancy, a further one third had evidence of primary RSV infection by age 2, and one in seven remained seronegative by their second birthday. These findings will inform future analyses to assess the cost-effectiveness of RSV vaccination programmes in high-income settings.

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/content/10.2807/1560-7917.ES.2021.26.6.2000023
2021-02-11
2024-04-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.6.2000023
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References

  1. Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD, et al. , RSV Global Epidemiology Network. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-58.  https://doi.org/10.1016/S0140-6736(17)30938-8  PMID: 28689664 
  2. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375(9725):1545-55.  https://doi.org/10.1016/S0140-6736(10)60206-1  PMID: 20399493 
  3. NHS Digital. Hospital Admitted Patient Care Activity, 2017-18 - NHS Digital. England. 2018 [Accessed 12 Feb 2019]. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2017-18
  4. Wu P, Hartert TV. Evidence for a causal relationship between respiratory syncytial virus infection and asthma. Expert Rev Anti Infect Ther. 2011;9(9):731-45.  https://doi.org/10.1586/eri.11.92  PMID: 21905783 
  5. PATH Vaccine Resource Library. RSV Vaccine and mAb Snapshot. [Accessed 31 May 2019]. Available from: https://vaccineresources.org/details.php?i=1562
  6. Hardelid P, Verfuerden M, McMenamin J, Smyth RL, Gilbert R. The contribution of child, family and health service factors to respiratory syncytial virus (RSV) hospital admissions in the first 3 years of life: birth cohort study in Scotland, 2009 to 2015. Euro Surveill. 2019;24(1):1800046.  https://doi.org/10.2807/1560-7917.ES.2019.24.1.1800046  PMID: 30621817 
  7. Murray J, Bottle A, Sharland M, Modi N, Aylin P, Majeed A, et al. , Medicines for Neonates Investigator Group. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study. PLoS One. 2014;9(2):e89186.  https://doi.org/10.1371/journal.pone.0089186  PMID: 24586581 
  8. Hall CB, Walsh EE, Long CE, Schnabel KC. Immunity to and frequency of reinfection with respiratory syncytial virus. J Infect Dis. 1991;163(4):693-8.  https://doi.org/10.1093/infdis/163.4.693  PMID: 2010624 
  9. Reeves RM, Hardelid P, Gilbert R, Warburton F, Ellis J, Pebody RG. Estimating the burden of respiratory syncytial virus (RSV) on respiratory hospital admissions in children less than five years of age in England, 2007-2012. Influenza Other Respir Viruses. 2017;11(2):122-9.  https://doi.org/10.1111/irv.12443  PMID: 28058797 
  10. Hogan AB, Anderssen RS, Davis S, Moore HC, Lim FJ, Fathima P, et al. Time series analysis of RSV and bronchiolitis seasonality in temperate and tropical Western Australia. Epidemics. 2016;16:49-55.  https://doi.org/10.1016/j.epidem.2016.05.001  PMID: 27294794 
  11. Poletti P, Merler S, Ajelli M, Manfredi P, Munywoki PK, Nokes D, et al. Evaluating vaccination strategies for reducing infant respiratory syncytial virus infection in low-income settings. BMC Med. 2015;13(1):49.  https://doi.org/10.1186/s12916-015-0283-x  PMID: 25857701 
  12. Kinyanjui TM, House TA, Kiti MC, Cane PA, Nokes DJ, Medley GF. Vaccine Induced Herd Immunity for Control of Respiratory Syncytial Virus Disease in a Low-Income Country Setting. PLoS One. 2015;10(9):e0138018.  https://doi.org/10.1371/journal.pone.0138018  PMID: 26390032 
  13. Hall CB, Geiman JM, Biggar R, Kotok DI, Hogan PM, Douglas GR Jr. Respiratory syncytial virus infections within families. N Engl J Med. 1976;294(8):414-9.  https://doi.org/10.1056/NEJM197602192940803  PMID: 173995 
  14. Glezen WP, Taber LH, Frank AL, Kasel JA. Risk of primary infection and reinfection with respiratory syncytial virus. Am J Dis Child. 1986;140(6):543-6. PMID: 3706232 
  15. Kutsaya A, Teros-Jaakkola T, Kakkola L, Toivonen L, Peltola V, Waris M, et al. Prospective clinical and serological follow-up in early childhood reveals a high rate of subclinical RSV infection and a relatively high reinfection rate within the first 3 years of life. Epidemiol Infect. 2016;144(8):1622-33.  https://doi.org/10.1017/S0950268815003143  PMID: 26732801 
  16. Wright J, Small N, Raynor P, Tuffnell D, Bhopal R, Cameron N, et al. , Born in Bradford Scientific Collaborators Group. Cohort Profile: the Born in Bradford multi-ethnic family cohort study. Int J Epidemiol. 2013;42(4):978-91.  https://doi.org/10.1093/ije/dys112  PMID: 23064411 
  17. Pembrey L, Waiblinger D, Griffiths P, Patel M, Azad R, Wright J. Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK. BMC Infect Dis. 2017;17(1):220.  https://doi.org/10.1186/s12879-017-2319-7  PMID: 28320319 
  18. Schepp RM, de Haan CAM, Wilkins D, Layman H, Graham BS, Esser MT, et al. Development and Standardization of a High-Throughput Multiplex Immunoassay for the Simultaneous Quantification of Specific Antibodies to Five Respiratory Syncytial Virus Proteins. MSphere. 2019;4(2):e00236-19.  https://doi.org/10.1128/mSphere.00236-19  PMID: 31019002 
  19. Hardelid P, Williams D, Dezateux C, Tookey PA, Peckham CS, Cubitt WD, et al. Analysis of rubella antibody distribution from newborn dried blood spots using finite mixture models. Epidemiol Infect. 2008;136(12):1698-706.  https://doi.org/10.1017/S0950268808000393  PMID: 18294427 
  20. Vyse AJ, Gay NJ, Hesketh LM, Pebody R, Morgan-Capner P, Miller E. Interpreting serological surveys using mixture models: the seroepidemiology of measles, mumps and rubella in England and Wales at the beginning of the 21st century. Epidemiol Infect. 2006;134(6):1303-12.  https://doi.org/10.1017/S0950268806006340  PMID: 16650326 
  21. Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702-6.  https://doi.org/10.1093/aje/kwh090  PMID: 15033648 
  22. Brandenburg AH, Groen J, van Steensel-Moll HA, Claas EC, Rothbarth PH, Neijens HJ, et al. Respiratory syncytial virus specific serum antibodies in infants under six months of age: limited serological response upon infection. J Med Virol. 1997;52(1):97-104.  https://doi.org/10.1002/(SICI)1096-9071(199705)52:1<97::AID-JMV16>3.0.CO;2-Y  PMID: 9131465 
  23. Ochola R, Sande C, Fegan G, Scott PD, Medley GF, Cane PA, et al. The level and duration of RSV-specific maternal IgG in infants in Kilifi Kenya. PLoS One. 2009;4(12):e8088.  https://doi.org/10.1371/journal.pone.0008088  PMID: 19956576 
  24. Sande CJ, Cane PA, Nokes DJ. The association between age and the development of respiratory syncytial virus neutralising antibody responses following natural infection in infants. Vaccine. 2014;32(37):4726-9.  https://doi.org/10.1016/j.vaccine.2014.05.038  PMID: 25005882 
  25. Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.
  26. Ohuma EO, Okiro EA, Ochola R, Sande CJ, Cane PA, Medley GF, et al. The natural history of respiratory syncytial virus in a birth cohort: the influence of age and previous infection on reinfection and disease. Am J Epidemiol. 2012;176(9):794-802.  https://doi.org/10.1093/aje/kws257  PMID: 23059788 
  27. Nyiro JU, Kombe IK, Sande CJ, Kipkoech J, Kiyuka PK, Onyango CO, et al. Defining the vaccination window for respiratory syncytial virus (RSV) using age-seroprevalence data for children in Kilifi, Kenya. PLoS One. 2017;12(5):e0177803.  https://doi.org/10.1371/journal.pone.0177803  PMID: 28531224 
  28. Munywoki PK, Koech DC, Agoti CN, Lewa C, Cane PA, Medley GF, et al. The source of respiratory syncytial virus infection in infants: a household cohort study in rural Kenya. J Infect Dis. 2014;209(11):1685-92.  https://doi.org/10.1093/infdis/jit828  PMID: 24367040 
  29. Stensballe LG, Ravn H, Kristensen K, Meakins T, Aaby P, Simoes EAF. Seasonal variation of maternally derived respiratory syncytial virus antibodies and association with infant hospitalizations for respiratory syncytial virus. J Pediatr. 2009;154(2):296-8e1.  https://doi.org/10.1016/j.jpeds.2008.07.053  PMID: 19150677 
  30. Okoko JB, Wesumperuma HL, Hart CA. The influence of prematurity and low birthweight on transplacental antibody transfer in a rural West African population. Trop Med Int Health. 2001;6(7):529-34.  https://doi.org/10.1046/j.1365-3156.2001.00741.x  PMID: 11469946 
  31. Chu HY, Steinhoff MC, Magaret A, Zaman K, Roy E, Langdon G, et al. Respiratory syncytial virus transplacental antibody transfer and kinetics in mother-infant pairs in Bangladesh. J Infect Dis. 2014;210(10):1582-9.  https://doi.org/10.1093/infdis/jiu316  PMID: 24903663 
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