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Swine flu H1N1: RS virus causes more hospitalizations

November 25, 2:22 PMTampa Health Care ExaminerCarolyn Chambers Clark
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Although the big buzz has been about H1N1 seasonal flu, an analysis from Children's Hospital Boston, based on patients seen in its emergency department (ED) during several recent flu seasons, shows that another virus -- respiratory syncytial virus (RSV) -- takes a substantially greater disease toll among young children than does seasonal flu.

photo:CDC

 Prior studies have shown that by 3 years of age, nearly 100 percent of children are infected with RSV. According to the CDC, RSV is the most common cause of bronchiolitis and pneumonia in children under 1 year of age in the U.S.

"RSV has been underappreciated," says Bourgeois, who is also affiliated with Harvard Medical School. "There's been disproportionate attention given to influenza, even though our data show morbidity to be very high from RSV. Based on our data, much more should be done in terms of prevention."

The RSV season begins in October, but generally doesn't peak until January and lasts through April/May, so it will become more visible in the coming months, she adds.

Using census data and data on pediatric acute respiratory illness from the National Hospital and Ambulatory Medical Care Survey, Bourgeois and colleagues were able to extrapolate their data nationally and determine population-based rates of RSV and flu illnesses.

  • They estimate that 21.5 ED visits per 1,000 children were attributable to RSV, as compared with 10.2 per 1,000 for seasonal flu.
  • Children under age 2 with RSV had the most visits -- 64.4 per 1,000
  • Estimated hospitalization rates were 8.5 per 1000 for RSV, versus 1.4 per 1000 for flu.
  • Nationally, caregivers missed an estimated 716,404 workdays each year for RSV and 246,965 for flu.

Although the study only looked at children age 7 and younger, the researchers believe their findings are relevant to older age groups, since young children drive transmission of viral infections, the researchers say. Recent hospitalization and mortality data indicate that, like flu, RSV disproportionately affects elderly persons.*

Bourgeois says: "Many of the prevention measures people are following for H1N1 -- such as frequent handwashing, using alcohol-based hand-sanitizers, and staying home when they're sick -- should apply every winter, to every viral season," she says.

 For more on the study

If RSV causes more hospitalizations than H1N1, why are we so focused on swine flu?

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