Bronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children, 1979-1997

A 1985 estimate that 4500 respiratory syncytial virus (RSV)-associated deat hs occur annually among US children has not been updated using nationally r epresentative data. Thus, 1979-1997 multiple cause-of-death records for chi ldren <5 years old listing bronchiolitis, pneumonia, or any respiratory tra ct disease were examined. Deaths among children associated with any respira tory disease declined from 4631 in 1979 to 2502 in 1997. During the 19-year study period, 1806 bronchiolitis-associated deaths occurred (annual mean, 95 deaths; range, 66-127 deaths). Of these deaths, 1435 (79%) occurred amon g infants <1 year old. Congenital heart disease, lung disease, or prematuri ty was listed in death records of 179 (9.9%), 99 (5.5%), and 76 (4.2%) chil dren dying with bronchiolitis, respectively. By applying published proporti ons of children hospitalized for bronchiolitis or pneumonia who were RSV-in fected to bronchiolitis and pneumonia deaths, it was estimated that less th an or equal to 510 RSV-associated deaths occurred annually during the study period, fewer than previously estimated.