Light Michael, Bauman Jay, Mavunda Kunjana, Malinoski Frank, Eggleston Mark
Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, USA.
Pediatr Infect Dis J. 2008 Jun;27(6):512-8. doi: 10.1097/INF.0b013e318168daf1.
Florida experiences year-round outbreaks of respiratory syncytial virus (RSV), but it is unknown if there is a correlation between RSV virology data and disease-related hospitalizations. We analyzed RSV surveillance and hospitalization data for the state of Florida to determine if there is an association between seasonal virology data and the incidence of International Classification of Diseases, 9th revision, clinical modification (ICD-9-CM) coded hospitalizations for RSV lower respiratory tract illness.
We conducted a retrospective analysis for each of 5 regions of Florida for 4 years (2001-2004) of monthly RSV surveillance data presented on the Florida Department of Health website and hospitalization data provided by the Agency for Health Care Administration. RSV was considered present when > or =10% of laboratory tests were positive in a given month and the duration of seasons was determined by the number of consecutive months threshold values were exceeded. Hospitalizations in children 24 months of age and younger were defined as RSV related if any of the following RSV-specific ICD-9-CM codes appeared on the discharge summary: 079.6 RSV; 466.11 acute bronchiolitis caused by RSV; and 480.1 pneumonia caused by RSV.
RSV circulated year-round statewide and seasons ranged from 7-8 months in the southwest, northwest, and north regions of Florida to 11-12 months in the central and southeast regions, respectively. More than 23,000 children younger than 24 months of age were hospitalized throughout the state for an RSV-related illness during the 4-year period, with almost 20,000 (86%) of the admissions in infants less than 12 months of age. There were 23 hospitalizations yearly per 1000 births and more than 90% of discharges occurred during the defined RSV seasons.
To our knowledge, this is the first study to demonstrate a positive correlation between RSV test data and hospitalizations both statewide and for individual regions within Florida. It would be prudent for clinicians to obtain results of local RSV virology data to guide decisions on timing of prophylaxis to prevent RSV hospitalizations.
佛罗里达州全年都有呼吸道合胞病毒(RSV)疫情爆发,但RSV病毒学数据与疾病相关住院情况之间是否存在关联尚不清楚。我们分析了佛罗里达州的RSV监测和住院数据,以确定季节性病毒学数据与国际疾病分类第九版临床修订本(ICD-9-CM)编码的RSV下呼吸道疾病住院发生率之间是否存在关联。
我们对佛罗里达州5个地区中的每个地区进行了回顾性分析,分析了4年(2001 - 2004年)佛罗里达州卫生部网站上每月公布的RSV监测数据以及医疗保健管理局提供的住院数据。当给定月份中≥10%的实验室检测呈阳性时,即认为存在RSV,季节持续时间由连续超过阈值的月数确定。如果出院小结上出现以下任何一个RSV特异性ICD-9-CM编码,则将24个月及以下儿童的住院定义为与RSV相关:079.6 RSV;466.11 RSV引起的急性细支气管炎;以及480.1 RSV引起的肺炎。
RSV在全州全年传播,季节时长在佛罗里达州的西南部、西北部和北部地区为7 - 8个月,在中部和东南部地区分别为11 - 12个月。在这4年期间,全州有超过23000名24个月以下儿童因RSV相关疾病住院,其中近20000名(86%)为12个月以下婴儿。每1000例出生中有23例住院,超过90%的出院发生在定义的RSV季节期间。
据我们所知,这是第一项证明RSV检测数据与佛罗里达州全州及各个地区住院情况之间存在正相关的研究。临床医生获取当地RSV病毒学数据结果以指导预防RSV住院的预防时机决策是谨慎的做法。