Community and nosocomially acquired respiratory syncytial virus infection in a German paediatric hospital from 1988 to 1999

Respiratory syncytial virus (RSV) is the major cause of lower respiratory t ract infections in infants. Since epidemiological data from Germany are sca rce, a large retrospective hospital based analysis was performed. In the fi rst part of the study, laboratory records were checked for RSV positive spe cimens from January 1988 to December 1997. A total of 1664 specimens were p ositive corresponding to 1171 episodes in 1064 patients; 88% were up to 4 y ears old and 47% up to 3 months old. The percentage of premature newborns f rom all patients 0-4 years old was 24%. The rate of nosocomial infection wa s 38%. The core RSV season began in December, lasted until April, and peake d in January and February. In the second part of the study, from April 1, 1 997 to March 31, 1999, which encompassed two RSV winter seasons, patients w ith the ICD-9 coded discharge diagnoses of lower respiratory tract infectio ns, bronchopulmonary dysplasia, (BPD) and prematurity were analysed. Of the premature newborns, 25% were tested RSV positive at least once up to the a ge of 1 year, as were 52% of those with BPD. The rehospitalisation rate due to RSV infection was 22% in patients with BPD, and 8.9% in all premature n ewborns. Of patients with community acquired RSV infection, 12% required in tensive care and 6% had to be ventilated mechanically. The mortality rates in both parts of the study were 0.8% and 0.7%, respectively. Conclusion: Re spiratory syncytial virus infection in young children is also of major impo rtance in Germany. Although the mortality rate is low, the high incidence a nd the severity of the disease in the particular risk group of premature in fants with chronic lung disease contribute to a very high disease burden.