Severe Respiratory Syncytial Virus Disease in Alaska Native Children

Abstract

Hospitalization rates for respiratory syncytial virus (RSV) infection range from 1 to 20/1000 infants. To determine the rate and severity of RSV infections requiring hospitalization for infants in the Yukon-Kuskokwim (YK) Delta of Alaska, a 3-year prospective surveillance study was conducted. The annual rate of RSV hospitalization for YK Delta infants <1 year of age was 53-249/1000. RSV infection was the most frequent cause of infant hospitalization. RSV disease severity did not differ among non-high-risk infants in the YK Delta and at Johns Hopkins Hospital (JHH). On average, 1/125 infants born in the YK Delta required mechanical ventilation for RSV infection. During the peak season, approximately $1034/child <3 years of age was spent on RSV hospitalization in the YK Delta. In YK Delta infants </=6 months old, RSV microneutralizing antibody titers <1200 were associated with severe disease (odds ratio=6.2, P=.03). In the YK Delta and at JHH, newborns may be at greater risk for severe RSV illness than previously thought.

Infectious Disease Hospitalizations Among American Indian and Alaska Native Infants

“…8,9,14,[35][36][37] LRTIs accounted for almost 75% of AI/AN infant infectious disease hospitalizations and for Ͼ50% of infant hospitalizations in the general US population. Although the LRTI hospitalization rate for AI/AN infants declined and the rate for US infants increased, the rate for LRTI hospitalizations for the AI/AN infant population was more than double that for the general US infant population at the end of the study period.…”

Trends in infectious disease hospitalizations among American Indians and Alaska Natives

“…[1][2][3][4][5]20,24 Although the hospitalization rate for lower respiratory tract infections declined during the study period, it nevertheless accounted for approximately a third of infectious disease hospitalizations and approximately 60% of infectious disease hospitalization deaths in 1994. A prospective study of Alaska Native infants in theYukon-Kuskokwim Delta ofAlaska showed that respiratory syncytial virus infection was the most frequent cause of infant hospitalizations (53 per 1000 during October 1993-September 1994 and 249 per 1000 during October 1994-September 1995).…”

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

“…In addition, previous studies suggested that American Indian (AI) and Alaska Native (AN) children and infants have higher rates of hospitalization associated with respiratory infections, compared with the general US population, with RSV being considered an important cause of these infections. [7][8][9][10][11][12][13][14] One study reported that almost 75% of all infectious disease hospitalizations among AI/AN infants were associated with lower respiratory tract infections. 13 It is estimated that 50% to 80% of infant hospitalizations for treatment of bronchiolitis and one-third of hospitalizations for treatment of pneumonia are RSV-related.…”

“…2,9,13,25 A high rate of RSV hospitalizations for AI/AN infants living in Alaska was also noted in a prospective patient-based study. 11 Several factors could contribute to the high rates of RSV hospitalization among AI/AN children living in the Alaska and Southwest regions. Most of the AIs/ ANs living in these regions reside in remote villages or on rural reservations.…”