Incidence of respiratory virus illness and hospitalizations in a Panama and El Salvador birth cohort, 2014-2018.
Eduardo Azziz-Baumgartner, Lindsey M Duca, Rosalba González, Arlene Calvo, S Cornelia Kaydos-Daniels, Natalie Olson, Adam MacNeil, Vic Veguilla, Rhina Domínguez, Andrea Vicari, Rafael Rauda, Nga Vuong, Alba María Ropero, Julio Armero, Rachael Porter, Danilo Franco, Juan Miguel Pascale
Author Information
Eduardo Azziz-Baumgartner: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lindsey M Duca: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rosalba González: Gorgas Institute, Panama City, Panama.
Arlene Calvo: Gorgas Institute, Panama City, Panama.
S Cornelia Kaydos-Daniels: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Natalie Olson: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Adam MacNeil: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Vic Veguilla: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rhina Domínguez: National Institute of Health of El Salvador, El Salvador.
Andrea Vicari: Pan American Health Organization.
Rafael Rauda: National Institute of Health of El Salvador, El Salvador.
Nga Vuong: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Alba María Ropero: Pan American Health Organization.
Julio Armero: National Institute of Health of El Salvador, El Salvador.
Rachael Porter: Centers for Disease Control and Prevention, Atlanta, GA, USA.
Danilo Franco: Gorgas Institute, Panama City, Panama.
Juan Miguel Pascale: Gorgas Institute, Panama City, Panama.
Background: Respiratory viruses remain a key cause of early childhood illness, hospitalization, and death globally.The recent pandemic has rekindled interest in the control of respiratory viruses among paediatric populations. We estimate the burden of such viruses among children <2 years. Methods: Enrolled neonates were followed until two years of age. Weekly active symptom monitoring for the development of acute respiratory illnesses (ARI) defined as cough, rhinorrhoea, difficulty breathing, asthenia, anorexia, irritability, or vomiting was conducted. When the child had ARI and fever, nasopharyngeal swabbing was performed, and samples were tested through singleplex RT-PCR. Incidence of respiratory viruses was calculated by dividing the number of laboratory-confirmed detections by the person-time accrued during weeks when that virus was detectable through national surveillance then corrected for under-ascertainment among untested children. Findings: During December 2014-November 2017, 1567 enrolled neonates contributed 2,186.9 person-years (py). Six in ten (64·4%) children developed ARI (total 2493 episodes). Among children <2 years, incidence of respiratory syncytial virus (RSV)-associated ARI episodes (21·0, 95%CI 19·3-22·8, per 100py) and rhinovirus-associated (20·5, 95%CI 20·4-20·7) were similar and higher than parainfluenza 1-3-associated (14·2, 95%CI 12·2-16·1), human metapneumovirus-associated (9·2, 95%CI 7·7-10·8), influenza-associated (5·9, 95%CI 4·4-7·5), and adenovirus-associated ARI episodes (5·1, 95%CI 5·0-5·2). Children aged <3 months had the highest rates of RSV ARI (49·1, 95%CI 44·0-54·1 per 100py) followed by children aged 3-5 (25·1, 95%CI 20·1-30·0), 6-11 (17·6, 95%CI 13·2-21·9), and 12-23 months (11·9, 95%CI 10·8-12·9). One in ten children with RSV was referred to the hospital (2·5, 95%CI 2·1-2·8, per 100py). Interpretation: Children frequently developed viral ARI and a substantive proportion required hospital care. Such findings suggest the importance of exploring the value of new interventions and increasing uptake of existing prevention measures to mitigate burden of epidemic-prone respiratory viruses. Funding: The study was supported by the Centers for Disease Control and Prevention.
