Contribution of RSV to bronchiolitis and pneumonia-associated hospitalizations in English children, April 1995-March 1998.

Estimates of the number of hospitalizations attributable to specific pathogens are required to predict the potential impact of vaccination. All hospital admissions for lower respiratory tract infection (LRI) in children < 5 years in England in 1995-8 were reviewed. Most admissions (76.8%) were not associated with specific organisms. Seasonality in pathogens that cause bronchiolitis and pneumonia was used to predict the proportion of cases with unspecified aetiology attributable to different organisms using multiple linear regression. Of 12,298 admissions for LRI, 17.5% were due to RSV infection. An estimated 74.8% (95% CI, 72.0-77.7%) of 'unspecified bronchiolitis' admissions and 16.3% (95% CI, 13.7-18.8%) of unspecified pneumonia' admissions were RSV related. The total mean annual incidence of hospital admissions attributable to RSV is 28.3/1000 children < 1 year of age, and 1.3/1000 children 1-4 years old. The greater burden of RSV infection than indicated through discharge data is revealed through applying simple statistical methods.