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RSV Infections in Adults
7/26/2016
Rosalyn Singleton, MDANTHC, AIP-CDC
729-3418
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RSV Surveillance Study 1993-1996: YK Delta RSV hospitalization rate
15%
3% 3%
0
20
40
60
80
100
120
140
160
180
YK Delta Anchorage, AK
Natives
U.S. estimate
rate
per
1,0
00 i
nfa
nts Hospitalizations per 100 infants
YK Delta RSV hospitalization rate was the highest reported in the US.
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Global estimates of severe RSV:
Rate of Severe or Hospitalized RSV/1000 infants/yr
Nair H et al. Global burden of RSV…Lancet 2010;375:1545-55; Banerji. PIDJ 2009.
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Acute Respiratory Infection and RSV
Hospitalizations – YK Delta < 1 yrs, 1994-2012
228.8
64.9
0
50
100
150
200
250
300
350
400
Ra
te p
er
10
00
In
fan
ts
Study Period
ARI Rates
RSV Rates
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RSV Epidemiology in Adults
U.S. adults Annual attack rate 2-10%, 5-10% in group settings
Hospitalization rate similar to flu in one study
10.6% of pneumonia hosp., 11.4% COPD (Falsey 2005)
Alaska Native adults No data on RSV!
Pneumonia/flu death rate twice that of white U.S.
Pneumonia and COPD most common causes of
potentially preventable hospitalization in YK adults.
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RSV vaccines
RSV vaccines for infants not effective enough
Adult RSV vaccines are effective - in late clinical trials
Potential adult RSV uses:
Adults with high risk conditions: COPD, asthma, CHF, immunocompromise
Pregnant women – to protect their newborn infants
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Proposed Adult RSV Surveillance
Active Surveillance: NP swab on consenting adults hospitalized for respiratory illness, COPD, asthma, CHF
Population: YK Adults 18 years and older
Location: YKDRH, ANMC
Tests: PCR for RSV, Flu, hMPV
Investigators: CDC Atlanta & AIP, UW, ANTHC, YKHC
Research staff: Research nurse recruits
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Objectives: RSV Surveillance
Determine rate of RSV hospitalization in YK adults
Determine rate of RSV hospitalization in YK adults with
COPD, asthma, or bronchiectasis
Determine rate of re-hospitalization with RSV
Evaluate rate of RSV detection in household members
accompanying adult hospitalization with RSV/Flu
Compare sensitivity/specificity of PCR/based Flu tests
with clinical Flu tests
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Questions?