Modelling estimates of the burden of respiratory syncytial virus infection in children in the UK

Objective The burden of respiratory syncytial virus (RSV) illness is not well characterised in primary care. We estimated the burden of disease attributable to RSV in children in the UK between 1995 and 2009. Design Time-series regression modelling. Setting A multiple linear regression model based on weekly viral surveillance (RSV and influenza, Public Health England), and controlled for non-specific seasonal drivers of disease, estimated the proportion of general practitioner (GP) episodes of care (counted as first visit in a series within 28days; Clinical Practice Research Datalink, CPRD), hospitalisations (Hospital Episode Statistics, HES) and deaths (Office of National Statistics, ONS) attributable to RSV each season. Participants Children 0-17years registered with a GP in CPRD, or with a respiratory disease outcome in the HES or ONS databases. Primary outcome measures RSV-attributable burden of GP episodes, hospitalisations and deaths due to respiratory disease by age. RSV-attributable burden associated with selected antibiotic prescriptions. Results RSV-attributable respiratory disease in the UK resulted in an estimated 450158 GP episodes, 29160 hospitalisations and 83 deaths per average season in children and adolescents, with the highest proportions in children <6months of age (14441/100000 population, 4184/100000 and 6/100000, respectively). In an average season, there were an estimated 125478 GP episodes for otitis media and 416133 prescriptions for antibiotics attributable to RSV. More GP episodes, hospitalisations and deaths from respiratory disease were attributable to RSV than to influenza in children under 5years. Conclusions The burden of RSV in children in the UK exceeds that of influenza. RSV in children and adolescents contributes substantially to GP office visits for a diverse range of illnesses, and was associated with an average 416133 prescribed antibiotic courses per season. Effective antiviral treatments and preventive vaccines are urgently needed for the management of RSV infection in children.