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The Epidemiology and Clinical Characteristics of Young Children Hospitalized With Respiratory Syncytial Virus Infections in Guatemala (2007–2010)

Fischer Langley, Gayle MD*; McCracken, John PhD; Arvelo, Wences MD; Estevez, Alejandra PhD; Villarruel, Gissela MPH*; Prill, Mila MPH*; Iwane, Marika PhD*; Gray, Jennifer MD; Moscoso, Fabiola MD; Reyes, Lissette MD§; Moir, Juan Carlos MD§; Ortiz, Jose MS; Lindblade, Kim PhD

The Pediatric Infectious Disease Journal: June 2013 - Volume 32 - Issue 6 - p 629–635
doi: 10.1097/INF.0b013e318289e3bc
Original Studies

Background: There have been few population-based studies from Central America on respiratory syncytial virus (RSV) infections in young children. We report population-based incidence rates and describe epidemiological and clinical characteristics of children <5 years old hospitalized with RSV infections in Guatemala.

Methods: Prospective, active hospital-based surveillance for acute respiratory infections in children <5 years old was conducted at 3 hospitals in Guatemala from November 2007 through July 2010. RSV hospitalization rates were calculated for areas where the catchment population could be defined. Comparisons were made between children who were RSV-positive and RSV-negative.

Results: RSV was detected in 549 (25%) of enrolled children. Overall, annual rates of RSV hospitalizations ranged from 5.9 to 45.9 and 2.0 to 13.7 per 1000 children <1 year old and <5 years old, respectively, but varied by location and calendar year. Rates generally decreased with age—children <6 months had rates up to 30 times higher than older children, but children >12 months old still had rates up to 5.5 per 1000 per year and accounted for 42% of deaths. Children with RSV infections were more likely to have signs of respiratory distress (85% versus 63%, P < 0.001) compared with those without RSV infections, but case fatality ratios were similar (3–4%).

Conclusions: The large burden and severity of RSV infections in young Guatemalan children is similar in magnitude and age distribution to RSV disease burdens found in other developing countries and suggests that this population would benefit from prevention strategies, including vaccines against RSV that are currently under development.

From the *Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Center for Health Studies, University of the Valley; International Emerging Infections Program, Regional Office for Central America and Panama, Centers for Disease Control and Prevention; §Ministry of Public Health and Welfare; and Guatemalan Institute for Social Security, Guatemala City, Guatemala.

Accepted for publication January 25, 2013.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Funding for these activities was provided by the Centers for Disease Control and Prevention’s Global Disease Detection, Emerging Infections appropriations through a grant to the Universidad del Valle de Guatemala, number 1U01GH000028-03. The Centers for Disease Control and Prevention participated in all aspects of study design, data collection, data analysis and article preparation. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Gayle Fischer Langley, MD, Centers for Disease Control and Prevention, 1600 Clifton Road, MS C-25, Atlanta, GA 30333. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.