Incidence of respiratory syncytial virus-positive hospitalizations in Germany

Epidemiological data, especially population-based data, oil respiratory syn cytial virus (RSV)-related hospitalizations in Germany have been lacking to date. Since Palivizumab (Synagis, Abbott, USA) is already available and ne w vaccines for active immunization are under development, these data are ur gently needed, From July 1996 to June 1999, nasopharyngeal aspirates of chi ldren hospitalized ill Kiel with an acute respiratory tract infection were tested by multiplex reverse transcriptase polymerase chain reaction. Of 1,2 41 patients, 150 (12.1%) were RSV positive. RSV was the predominant pathoge n detected through the end of the second year. In 37 (25%) children an unde rlying condition was present. For the city of Kiel and close surroundings, the cumulative incidence of RSV-positive hospitalizations in infants was 1, 214/10(5) (725/10(5) in children less than 2 years). For those children les s than 2 years old born with a gestational age of less than 32 weeks or 32- 37 weeks, the cumulative incidence was 2,025/10(5) and 1,202/10(5), respect ively (dose-effect response). For the group less than 32 weeks of age, bron chopulmonary dysplasia (BPD) as an underlying condition carried a relative risk of 17.8. The RSV season began between the end of September and January and ended between March and July. The population-based incidence of RSV-po sitive hospitalizations in Kiel is close to that reported from the UK and S candinavia. Throughout Germany, approximately 10,000 RSV-related hospitaliz ations in infants call be expected annually. Prematurity is an effect modif ier and BPD a strong risk factor for RSV-positive hospitalization in popula tion-based studies. There is considerable variation ill the start and end o f the yearly epidemic.