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Epidemiology. 2019 Nov;30(6):918-926. doi: 10.1097/EDE.0000000000001092.

Hospitalizations Associated with Respiratory Syncytial Virus and Influenza in Children, Including Children Diagnosed with Asthma.

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From the Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard TH Chan School of Public Health, Boston, MA.
Vaccines Division, Merck & Co., Inc., Kenilworth, NJ.
Influenza Division, National Center for Immunization and Respiratory Diseases, US CDC, Atlanta, GA.
Yale School of Medicine, New Haven, CT.
Division of International Epidemiology and Population Studies, Agency for Healthcare Research and Quality, United States Department of Health and Human Services, Rockville, MD.
Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD.
Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA.



There is uncertainty about the burden of hospitalization associated with respiratory syncytial virus (RSV) and influenza in children, including those with underlying medical conditions.


We applied previously developed methodology to Health Care Cost and Utilization Project hospitalization data and additional data related to asthma diagnosis/previous history in hospitalized children to estimate RSV and influenza-associated hospitalization rates in different subpopulations of US children between 2003 and 2010.


The estimated average annual rates (per 100,000 children) of RSV-associated hospitalization with a respiratory cause (ICD-9 codes 460-519) present anywhere in the discharge diagnosis were 2,381 (95% CI(2252,2515)) in children <1 year of age; 710.6 (609.1, 809.2) (1 y old); 395 (327.7, 462.4) (2 y old); 211.3 (154.6, 266.8) (3 y old); 111.1 (62.4, 160.1) (4 y old); 72.3 (29.3, 116.4) (5-6 y of age); 35.6 (9.9,62.2) (7-11 y of age); and 39 (17.5, 60.6) (12-17 y of age). The corresponding rates of influenza-associated hospitalization were lower, ranging from 181 (142.5, 220.3) in <1 year old to 17.9 (11.7, 24.2) in 12-17 years of age. The relative risks for RSV-related hospitalization associated with a prior diagnosis of asthma in age groups <5 y ranged between 3.1 (2.1, 4.7) (<1 y old) and 6.7 (4.2, 11.8) (2 y old; the corresponding risks for influenza-related hospitalization ranged from 2.8 (2.1, 4) (<1y old) to 4.9 (3.8, 6.4) (3 y old).


RSV-associated hospitalization rates in young children are high and decline rapidly with age. There are additional risks for both RSV and influenza hospitalization associated with a prior diagnosis of asthma, with the rates of RSV-related hospitalization in the youngest children diagnosed with asthma being particularly high.

[Available on 2020-11-01]

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