Larry J. Anderson

Respiratory Syncytial Virus Pneumonia among the Elderly: An Assessment of Disease Burden

Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory tract disease among the elderly, but national estimates of the burden of this disease have not been made. To estimate the morbidity, mortality, and medical costs of RSV-associated pneumonia among US elderly, national hospital discharge data, vital statistics, etiologic studies of adult pneumonia hospitalizations, and Medicare cost data were reviewed. In the United States, 687,000 hospitalizations and 74,000 deaths caused by pneumonia occur annually among the elderly; approximately 2%-9% of these are caused by RSV. At a cost of

Possible transmission of parvovirus B19 from intravenous immune globulin

11,000 per RSV pneumonia hospitalization, the estimated annual cost of RSV pneumonia hospitalizations is

Severe Bronchiolitis and Respiratory Syncytial Virus Among Young Children in Hawaii

150-

Prevalence of Antibodies to Human Parvovirus B19 Nonstructural Protein in Persons with Various Clinical Outcomes following B19 Infection

680 million. Exacerbations of congestive heart failure and other chronic conditions may also contribute substantially to RSV disease burden among the elderly. The total RSV disease burden is probably great enough to justify development of an RSV vaccine for use in this group.

Community outbreak of thyrotoxicosis: Epidemiology, immunogenetic characteristics, and long-term outcome

To look for genetic changes in human parvovirus B19 that might be associated with chronic infection, we sequenced B19 DNA obtained from serum specimens collected over an approximately 1‐year period from a patient with systemic vasculitis. A comparison of the nucleotide sequences of the VP1/VP2 gene from four specimens revealed an abrupt change in the B19 genotype that coincided with initiation of intravenous immune globulin (IVIG) therapy. We suspect that one or more of the lots of IVIG administered to the patient were contaminated with B19. If true, this finding suggests that investigators must be careful in linking B19 infection to disease based on detection of B19 DNA in persons who have received multiple unit blood products. J. Med. Virol. 53:233–236, 1997. Published 1997 Wiley‐Liss, Inc. This article was prepared by a group consisting of both United States government employees and non‐United States government employees, and as such is subject to 17 U.S.C. Sec. 105.

Use of mixture models in determining laboratory criterion for identification of seropositive individuals: application to parvovirus B19 serology.

Background: Lower respiratory tract infections are a leading cause of hospitalization and mortality among children worldwide. Our objective was to describe the incidence and epidemiology of severe bronchiolitis, respiratory syncytial virus (RSV), and pneumonia among children in Hawaii. Methods: Retrospective analysis of the patient-linked hospital discharge data associated with bronchiolitis, RSV, and pneumonia among Hawaii residents younger than 5 years of age during 1997 through 2004 using the Hawaii State Inpatient Database. Results: During 1997 through 2004, the average annual incidence rates for bronchiolitis, RSV, and pneumonia were 3.8, 2.7, and 6.8 per 1000 children younger than 5 years, respectively. The incidence of each condition was higher for infants younger than 1 year (15.1, 9.8, and 15.9 per 1000 infants, respectively) than the incidence for children 1–4 years of age, and higher for boys compared with girls. The incidence of each condition was highest among Native Hawaiian and other Pacific Islander children compared with children of other race groups living in Hawaii. Most hospitalizations occurred during the months of October through February. Estimated median hospital charges were

Human Parvovirus B19

4806 (bronchiolitis),

Monoclonal capture antibody ELISA for respiratory syncytial virus: detection of individual viral antigens and determination of monoclonal antibody specificities.

5465 (RSV) and

Human Parvovirus B19 Infection during Pregnancy

5240 (pneumonia), with overall average annual charges of

Detection of antibodies and antigens of human parvovirus B19 by enzyme-linked immunosorbent assay.

11.5 million. Conclusion: The incidence and hospitalization rates for bronchiolitis, RSV, and pneumonia among children younger than 5 years of age in Hawaii were low; the corresponding hospitalization rates were lower than those for the general U.S. population. However, the hospitalization rates for each condition among Hawaiian and other Pacific Islander children were much higher than those for other race groups or for the U.S. population.