Ting Shi , PhD a , David A McAllister , MD b , Katherine L O'Brien , Prof, MD c , Eric A F Simoes , Prof, MD d , Shabir A Madhi , Prof, PhD e , f , Bradford D Gessner , MD g , Fernando P Polack , Prof, MD h , Evelyn Balsells , MPH a , Sozinho Acacio , MD i , * , Claudia Aguayo , MD j , * , Issifou Alassani , MD k , * , Asad Ali , MD l , * , Martin Antonio , Prof, PhD m , * , Shally Awasthi , Prof, MD n , * , Juliet O Awori , MBBCh o , * , Eduardo Azziz-Baumgartner , MD p , q , * , Henry C Baggett , MD r , s , * , Vicky L Baillie , PhD e , * , Angel Balmaseda , MD t , Alfredo Barahona , MD u , * , Sudha Basnet , PhD v , * , w , Quique Bassat , Prof, MD i , x , y , * , Wilma Basualdo , MD z , * , Godfrey Bigogo , MPH aa , * , Louis Bont , Prof, MD ab , * , Robert F Breiman , Prof, MD ac , * , W Abdullah Brooks , MD c , p , * , Shobha Broor , Prof, MD ad , * , Nigel Bruce , Prof, PhD ae , * , Dana Bruden , MS af , * , Philippe Buchy , PhD ag , ah , * , Stuart Campbell , MBChB a , * , Phyllis Carosone-Link , MS ai , * , Mandeep Chadha , MD aj , * , James Chipeta , PhD ak , * , Monidarin Chou , PhD al , * , Wilfrido Clara , MSc am , * , Cheryl Cohen , PhD an , ao , * , Elizabeth de Cuellar , MD ap , * , Duc-Anh Dang , Prof, PhD aq , * , Budragchaagiin Dash-yandag , MD ar , * , Maria Deloria-Knoll , PhD c , * , Mukesh Dherani , PhD ae , * , Tekchheng Eap , MD as , * , Bernard E Ebruke , MD m , * , Marcela Echavarria , PhD at , * , Carla Cecília de Freitas Lázaro Emediato , RN au , * , Rodrigo A Fasce , BSc av , * , Daniel R Feikin , MD q , * , Luzhao Feng , MD aw , * , Angela Gentile , Prof, MD ax , * , Aubree Gordon , PhD ay , * , Doli Goswami , MBBS c , p , * , Sophie Goyet , PhD ag , * , Michelle Groome , PhD e , f , * , Natasha Halasa , MD az , * , Siddhivinayak Hirve , PhD ba , * , Nusrat Homaira , PhD p , bb , * , Stephen R C Howie , PhD m , bc , bd , * , Jorge Jara , MD be , * , Imane Jroundi , MD x , bf , * , Cissy B Kartasasmita , Prof, PhD bg , * , Najwa Khuri-Bulos , Prof, MD bh , * , Karen L Kotloff , Prof, MD bi , * , Anand Krishnan , Prof, MD ad , * , Romina Libster , MD h , az , bj , * , Olga Lopez , MD bk , * , Marilla G Lucero , MD bl , * , Florencia Lucion , MD ax , * , Socorro P Lupisan , MD bm , * , Debora N Marcone , PhD at , * , John P McCracken , ScD be , * , Mario Mejia , MD bn , * , Jennifer C Moisi , PhD g , * , Joel M Montgomery , PhD bo , * , David P Moore , FCPaeds e , f , * , Cinta Moraleda , MD x , * , Jocelyn Moyes , MBBCh an , ao , * , Patrick Munywoki , PhD o , bp , * , Kuswandewi Mutyara , MD bg , * , Mark P Nicol , Prof, PhD bq , * , D James Nokes , Prof, PhD o , br , * , Pagbajabyn Nymadawa , MD bs , * , Maria Tereza da Costa Oliveira , MD au , * , Histoshi Oshitani , MD bt , * , Nitin Pandey , MD n , * , Gláucia Paranhos-Baccalà , PhD bu , * , Lia N Phillips , MD bv , * , Valentina Sanchez Picot , DVM bu , * , Mustafizur Rahman , PhD p , * , Mala Rakoto-Andrianarivelo , MD bw , * , Zeba A Rasmussen , MD by , * , Barbara A Rath , Prof, PhD by , * , Annick Robinson , Prof, MD bz , * , Candice Romero , MD ca , * , Graciela Russomando , Prof, PhD cb , * , Vahid Salimi , PhD cc , * , Pongpun Sawatwong , MSc r , * , Nienke Scheltema , MD ab , * , Brunhilde Schweiger , PhD cd , * , J Anthony G Scott , Prof, FRCP o , ce , * , Phil Seidenberg , MD cf , * , Kunling Shen , Prof, MD cg , * , Rosalyn Singleton , MD af , ch , * , Viviana Sotomayor , MPH j , * , Tor A Strand , Prof, PhD v , ci , * , Agustinus Sutanto , MD cj , * , Mariam Sylla , Prof, MD ck , * , Milagritos D Tapia , MD bi , * , Somsak Thamthitiwat , MD r , * , Elizabeth D Thomas , MPH by , * , Rafal Tokarz , PhD cl , * , Claudia Turner , PhD cm , * , Marietjie Venter , Prof, PhD cn , * , Sunthareeya Waicharoen , MSc co , * , Jianwei Wang , Prof, PhD cp , * , Wanitda Watthanaworawit , MSc cm , * , Lay-Myint Yoshida , Prof, MD cq , * , Hongjie Yu , MD aw , * , Heather J Zar , Prof, PhD cr , * , Harry Campbell , Prof, MD a , Harish Nair , Prof, PhD a , cs , † , * , RSV Global Epidemiology Network
02 September 2017
We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015.
We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity.
We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6–50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7–3·8) hospital admissions, and 59 600 (48 000–74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2–1·7) hospital admissions, and 27 300 (UR 20 700–36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600–149 400). Incidence and mortality varied substantially from year to year in any given population.
Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admissions in young children, resulting in a substantial burden on health-care services. About 45% of hospital admissions and in-hospital deaths due to RSV-ALRI occur in children younger than 6 months. An effective maternal RSV vaccine or monoclonal antibody could have a substantial effect on disease burden in this age group.