Seasonality, Clinical Characteristics, and Outcomes of Respiratory Syncytial Virus Disease by Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020.

Creator(s)

Ariana P. Toepfer
Justin Z. Amarin
Andrew J. Spieker
Laura S. Stewart
Mary Allen Staat
Elizabeth P. Schlaudecker
Geoffrey A. Weinberg
Peter G. Szilagyi
Janet A. Englund
Eileen J. Klein
Marian G. Michaels
John V. Williams
Rangaraj Selvarangan, Children's Mercy HospitalFollow
Christopher J. Harrison, Children's Mercy HospitalFollow
Joana Y. Lively
Pedro A. Piedra
Vasanthi Avadhanula
Brian Rha
James Chappell
Meredith McMorrow
Heidi Moline
Natasha B. Halasa

Document Type

Article

Publication Date

5-15-2024

Identifier

DOI: 10.1093/cid/ciae085; PMCID: PMC11093674

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established.

METHODS: During 2016-2020, children aged/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction.

RESULTS: Among 6398 RSV-positive children aged <5 >years, 3424 (54%) had subtype RSV-A infections, 2602 (41%) had subtype RSV-B infections, and 272 (5%) were not typed, inconclusive, or mixed infections. In both adjusted and unadjusted analyses, RSV-A-positive children were more likely to be hospitalized, as well as when restricted toseason, RSV-A and RSV-B cocirculated in varying levels, with 1 subtype dominating proportionally.

CONCLUSIONS: Findings indicate that RSV-A and RSV-B may only be marginally clinically distinguishable, but both subtypes are associated with medically attended illness in children agedFurthermore, circulation of RSV subtypes varies substantially each year, seasonally and geographically. With introduction of new RSV prevention products, this highlights the importance of continued monitoring of RSV-A and RSV-B subtypes.

Journal Title

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Volume

78

Issue

5

First Page

1352

Last Page

1359

MeSH Keywords

Humans; Respiratory Syncytial Virus Infections; Seasons; Infant; Child, Preschool; United States; Respiratory Syncytial Virus, Human; Male; Female; Prospective Studies; Hospitalization; Infant, Newborn; Respiratory Syncytial Virus Vaccines

Keywords

RSV; RSV-A; RSV-B; hospitalization; seasonality

Comments

Grants and funding

• U01 IP001049/IP/NCIRD CDC HHS/United States
• U01 IP001157/IP/NCIRD CDC HHS/United States
• U01 IP001158/IP/NCIRD CDC HHS/United States

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciae085

Recommended Citation

Toepfer AP, Amarin JZ, Spieker AJ, et al. Seasonality, Clinical Characteristics, and Outcomes of Respiratory Syncytial Virus Disease by Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020. Clin Infect Dis. 2024;78(5):1352-1359. doi:10.1093/cid/ciae085