1780. Community-Based Prospective Study of Respiratory Syncytial Virus Disease in Mothers and Infants in Rural Nepal
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • IDSAPoster_09202013SEND.pdf (1.3 MB)
  • Background: Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality globally. Respiratory syncytial virus (RSV) is the most important viral cause of ALRI. The majority of RSV disease burden is in the developing world, though the clinical presentation of disease in these populations is not well-studied.
    Methods: A prospective randomized controlled trial of maternal influenza immunization is being conducted in rural southern Nepal.  Women were enrolled into this study during the 2nd trimester of pregnancy, and with their infants, followed prospectively through weekly home visits until six months postpartum. Baseline sociodemographic, birth outcome, and clinical information associated with respiratory illness episodes were collected by field staff at home visits. Nasopharyngeal samples were collected with symptoms of a respiratory tract infection and tested for RSV at the University of Washington by reverse transcriptase polymerase chain reaction. Clinical and virologic data were analyzed using Stata 11.0.
    Results: From May 2011 to April 2012, RSV was detected in 133 (7.7%) of 1743 nasopharyngeal samples collected during respiratory illness episodes. A clear seasonality to RSV incidence was seen in southern Nepal, with a peak in October. RSV was detected in 21 (5.2%) of 408 maternal samples; 8 of these were collected during pregnancy (median days before delivery: 93; range, 9-199). RSV was detected in 77 (8.4%) of 913 infant samples. Mean viral load of maternal illness episodes (log10 viral load 5.2 copies/mL) did not differ significantly from infant illness episodes (log10 viral load 5.5 copies/mL; P = 0.23). No relationship was observed between age and viral load among infants (n=76; R2 = 0.00). Maternal and infant illness episodes did not differ by duration of cough (2.3 vs. 2.8 days, P = 0.58) or fever (2.4 vs 1.3 days, P = 0.06) among a subset of 13 mothers and 64 infants.
    Conclusion: In a community-based prospective study in south Asia, we found a substantial burden of RSV disease. Maternal and infant RSV-positive illness episodes did not differ in symptom duration or viral load, suggesting a similar clinical impact of RSV disease in mothers and infants.
    Helen Y. Chu, MD MPH, Allergy & Infectious Diseases, University of Washington, Seattle, WA, Mark C. Steinhoff, M.D., Division of Infectious Diseases, Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, Joanne Katz, ScD, Johns Hopkins University, Baltimore, MD, James Tielsch, PhD, Global Health, George Washington University, Washington, DC, Jane Kuypers, PhD, University of Washington, Seattle, WA and Janet A. Englund, MD, FIDSA, Seattle Children's Hospital, Seattle, WA


    H. Y. Chu, None

    M. C. Steinhoff, None

    J. Katz, None

    J. Tielsch, None

    J. Kuypers, None

    J. A. Englund, PIDS: Board Member,
    Chimerix: Investigator, Research support
    Gilead: Investigator, Research support
    Novartis: Investigator, Research support
    GlaxoSmithKline: Consultant, Consulting fee

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