syncytial Archives - World Asthma Foundation

Caesarean Section and Hospitalization for Respiratory Syncytial Virus Infection: A Population Based Study.

Pediatr Infect Dis J. 2014 Sep 17;

Authors: Kristensen K, Fisker N, Haerskjold A, Ravn H, Simões EA, Stensballe L

Abstract
BACKGROUND AND OBJECTIVE:: Hospitalization for respiratory syncytial virus (RSV) infection and asthma share common determinants, and meta-analyses indicate that children delivered by caesarean section (CS) are at increased risk of asthma. We aimed to investigate whether birth by CS is associated with an increased risk of hospitalization for RSV illness.
METHODS:: This was a population based national register based cohort study, conducted between January 1997 and June 2003, that included all children born in Denmark and all hospitalizations for RSV disease in them from 0 – 23 months of age. We used Cox regression with adjustment for prematurity, asphyxia, birth weight, multiple births, single parenthood, maternal smoking during pregnancy, older siblings, and asthma diagnoses up to 2 weeks before hospitalization for RSV infection, to compare the effects of acute or elective CS versus vaginal delivery, on subsequent hospitalization for RSV disease. A test for homogeneity was used to assess for effect over time.
RESULTS:: 399,175 children with 10,758 hospitalizations for RSV illness were included. 31,715 were born by acute CS and 30,965 by elective CS. Adjusted hazard ratios for hospitalization for RSV infection in children born by acute CS and by elective CS were 1.09 (1.01 – 1.17) and 1.27 (1.19 – 1.36), respectively. The effect of elective CS remained unchanged throughout the first two years of life (p = 0.53), whereas the effect of acute CS was only present in the second year of life (p = 0.001).
CONCLUSION:: Delivery by caesarian section is associated with an increased risk of hospitalization for RSV infeciton. This effect continues at least throughout the first two years of life.

PMID: 25232778 [PubMed – as supplied by publisher]

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Respiratory syncytial virus and seasonal influenza cause similar illnesses in children with sickle cell disease.

Pediatr Blood Cancer. 2014 Jan 31;

Authors: Sadreameli SC, Reller ME, Bundy DG, Casella JF, Strouse JJ

Abstract
BACKGROUND: Respiratory syncytial virus (RSV) is a cause of acute chest syndrome (ACS) in sickle cell disease (SCD), but its clinical course and acute complications have not been well characterized. We compared RSV to seasonal influenza infections in children with SCD.
PROCEDURE: We defined cases as laboratory-confirmed RSV or seasonal influenza infection in inpatients and outpatients <18 years of age with SCD from 1 September 1993 to 30 June 2011. We used Fisher’s exact test to compare proportions, Student’s t-test or Wilcoxon rank-sum test to compare continuous variables, and logistic regression to evaluate associations.
RESULTS: We identified 64 children with RSV and 91 with seasonal influenza. Clinical symptoms, including fever, cough, and rhinorrhea were similar for RSV and influenza, as were complications, including ACS and treatments for SCD. In a multivariable logistic regression model, older age (OR 1.2 per year, 95% CI [1.02-1.5], P?=?0.04), increased white blood cell count at presentation (OR 1.1 per 1,000/?l increase, 95% CI [1.03-1.3], P?=?0.008), and a history of asthma (OR 7, 95% [CI 1.3-37], P?=?0.03) were independently associated with increased risk of ACS in children with RSV. The hospitalization rate for children with SCD and RSV (40 per 1,000 <5 years and 63 per 1,000 <2 years) greatly exceeds the general population (3 in 1,000 <5 years).
CONCLUSIONS: We conclude that RSV infection is often associated with ACS and similar in severity to influenza infection in febrile children with SCD. Pediatr Blood Cancer 2014;9999:1-4. © 2014 Wiley Periodicals, Inc.

PMID: 24481883 [PubMed – as supplied by publisher]

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