Methods: Retrospective review of all RSV-associated deaths at centres affiliated with the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) over the period 2003-2013, inclusive. Cases were identified using similar ICD codes to capture all deaths where a diagnosis of RSV infection was also present.
Results: Overall, 8 centres reported 66 RSV-associated deaths. RSV was regarded as primarily responsible for deaths in 27 (41%) of cases. The median age of children who died was 11 months (range < 1 month to 16 years). Twenty-five patients (38%) were male. Thirteen deaths (20%) occurred among patients with no known risk factors for severe RSV. Thirty-eight deaths (58%) were among patients who had underlying chronic medical conditions without known immune deficiency, while 14 (21%) occurred among immunocompromised hosts. Community-acquired infections accounted for 43 deaths (65%). Fifty-five subjects (83%) were admitted to an intensive care unit and received mechanical ventilation. Palivizumab use was reported in 4 (6.1%) and 3 (4.6%) for prophylaxis and treatment, respectively. Ribavirin use for treatment was reported in 8 (12%).
Conclusion: RSV-associated deaths were predominantly associated with chronic medical conditions and immunocompromised states among infants. However, 1 out of every 5 deaths occurred among infants with no known risk factors for severe RSV. Deaths associated with nosocomially-acquired infections were observed. Further study of the factors (e.g., immunogenetic) associated with deaths is warranted.
RPS Diagnostics: Board Member , Consulting fee
AbbVie Inc.: Board Member , Consulting fee
S. Fanella, None
S. Asner, None
M. Barton, None
S. Desai, None
C. Foo, None
J. M. Langley, GSK: Investigator , Research support
K. Leifso, None
J. Pernica, None
J. Robinson, None
R. Singh, None
B. Tapiero, None
U. Allen, None
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