Local variability in respiratory syncytial virus disease severity
a Department of Virology, Erasmus University
Rotterdam, Netherlands, b Department of Paediatrics, Geneva
University Hospital, Switzerland, c Department of Paediatrics, Sophia
Children's Hospital, Rotterdam, Netherlands, d Department of
Epidemiology and Biostatistics, Erasmus University, Rotterdam,
Netherlands, e Laboratory of Virology, Geneva
University Hospital, Switzerland
Correspondence to: Dr Claire-Anne Siegrist, Department of Paediatrics, Geneva University Hospital, 1211 Geneva 14, Switzerland.
Accepted 15 July 1997
Respiratory syncytial virus (RSV) lower respiratory tract
infections are considered to be a serious disease in centres such as
the Sophia Children's Hospital (Rotterdam, the Netherlands), but as
more benign infections in others such as the Geneva Children's Hospital (Switzerland). To assess the clinical severity of RSV infections at the two sites, 151 infants primarily admitted with a
virologically confirmed RSV infection were studied prospectively (1994-5) and retrospectively (1993-4) (55 infants in Geneva and 96 in
Rotterdam). Parameters of RSV morbidity which were more severe in
Rotterdam during the two winter seasons were apnoea (1.8 v
23.9%), the rate of admission to the intensive care unit (3.6 v 28.1%), mechanical ventilation (0 v
7.3%), and length of stay in hospital (6.8 v 9.1 days).
In Geneva higher respiratory rates (59.2 v 51.2), more
wheezing (65.5 v 28.8%), and more retractions (81.8 v 63.3%) were recorded. Fewer infants younger than 4 months (54.9 v 68.7%), but more breast fed infants (94.1 v 38.5%), were admitted in Geneva, although the morbidity
parameters remained different after correction for these two
variables in multivariate analyses. Thus unidentified local factors
influence the pattern and severity of RSV infection and may affect the
results of multicentre prophylactic and therapeutic studies.
© 1997 by Archives of Disease in Childhood
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