Biotechnology Healthcare - July/August 2008 - (Page CB2)

RSV Virology: Understanding RSV Seasonality and the Importance of Local Data RSV prophylaxis should be tailored to local conditions to help ensure infant protection and avoid hospitalization. Epidemiology of RSV and the importance of early planning Bronchiolitis due to respiratory syncytial virus (RSV) is a common and easily transmitted disease affecting infants and young children, and is the leading cause of hospitalization among infants <1 year of age in the United States (Leader 2003a, Leader 2002, McLaurin 2005). Up to 125,000 infants are hospitalized each year due to severe RSV disease, and approximately 20 percent of these are premature infants (Boyce 2000, Horn 2003, Shay 1999). RSV is also responsible for up to 400 deaths annually in children <1 year of age (Shay 2001). Most children are infected before 12 months of age, and by age 2, nearly all children become infected at least once (Glezen 1986). RSV, then, presents an enormous cost burden on the U. S. health care system (Leader2003a, Leader 2003b, McLaurin 2005). RSV hospitalizations have been positively correlated with the level of RSV activity (Figure 1). RSV epidemics in the United States generally occur between late fall and early spring — November to April. However, surveillance FIGURE 1 data indicate that the onset and duration of the RSV season vary greatly from year to year (Tables 1, 2), region to region, and even among local communities (Mullins 2003, Panozzo 2007). Although the American Academy of Pediatrics acknowledges that the inevitability of the RSV season is predictable, other sources support that the severity of the season, time of onset, peak of activity, and end of the RSV season cannot be predicted precisely. The AAP, however, states, “There can be substantial variation in timing of community outbreaks of RSV disease from year to year in the same community and between communities in the same year, even in the same region. These variations, however, occur within the overall pattern of RSV outbreaks, usually beginning in November or December, peaking in January or February, and ending by the end of March or sometime in April”(AAP 2006). Furthermore, approximately 17 percent of bronchiolitis admissions in children <1 year of age and 19 percent in children <5 years of age are estimated to occur outside the peak RSV season of November to April (Shay 1999). RSV hospitalizations correspond with RSV seasons 160 Total RSV hospitalizations 140 120 100 80 60 40 20 July 2002 August 2002 September 2002 October 2002 November 2002 December 2002 January 2003 February 2003 March 2003 April 2003 May 2003 June 2003 July 2003 August 2003 September 2003 October 2003 November 2003 December 2003 January 2004 February 2004 March 2004 April 2004 May 2004 June 2004 July 2004 August 2004 September 2004 October 2004 November 2004 December 2004 January 2005 February 2005 March 2005 April 2005 May 2005 June 2005 0 30% 20% 10% 0 Total RSV hospitalizations Positive RSV tests 70% 60% 50% 40% Positive RSV tests Month Total RSV admissions at Driscoll Children’s Hospital in Corpus Christi, Texas, and percentage of RSV-positive tests over the course of 3 consecutive RSV seasons (2002–2005). RSV positivity was determined by rapid antigen detection or viral culture. RSV, respiratory syncytial virus. SOURCE: FERGIE J. PEDIATR INFECT DIS J. 2007. REPRINTED WITH PERMISSION. 2

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Biotechnology Healthcare - July/August 2008 Openers Contents Editorial/David B. Nash, MD, MBA Drug Track Health Plan Confidential Rheumatoid Arthritis A Decade of Trial, Error, False Starts, and Hope What Path Will Comparative Effectiveness Research Take? RA Therapies in Development: A New Generation of Relief Assessing the Full Impact of RA on Employers and Payers Stem Cells: Health Insurance You Can Bank On Specialty Pharmacy Employer to Employer Personalized Medicine Trends Clinical Briefs

Biotechnology Healthcare - July/August 2008

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