Describing the Respiratory Syncytial Virus season in Wales using Moving Epidemic Method thresholds for cases aged under five in Wales
PHE ePoster Library. Harris C. Apr 9, 2019; 257460
Caroline Harris
Caroline Harris
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Abstract
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Abstract Background:
Respiratory Syncytial Virus (RSV) annually causes substantial burden of disease in children under five years, and is the leading cause of hospitalisations in UK children under 1 year. RSV seasons in Wales are clearly defined, occurring during autumn-winter, with a single peak in activity. We applied the MEM technique, previously used to characterise influenza seasons, to calculate pre-epidemic and intensity thresholds for RSV activity.MethodRespiratory screen test data from 2010 to 2018, were extracted from the national laboratory test database in Wales. The majority (96%) of samples were from hospital patients. Weekly RSV incidence and percentage sample positivity were calculated for children <5 years. We used the MEM package in R to determine pre-epidemic and intensity thresholds, start week and duration of RSV seasons.
Results:
The pre-epidemic threshold for weekly RSV incidence in children <5 years was 6.4 /100,000. Medium, high and very high intensity thresholds were 18.8, 33.8 and 43.8 /100,000 respectively. Based on weekly incidence, the average RSV season started during week 44 (range 43-47) and lasted 11 weeks (95% CI 11-12).The pre-epidemic threshold for weekly percentage of RSV sample positivity was 22%. Similar to results from analysis of weekly incidence, weekly sample positivity crossed the pre-epidemic threshold on average during week 44 (range 42-46). Percentage positivity data indicated a slightly longer season of 12.5 weeks (95% CI 12-13.64).DiscussionThese results will inform alerts sent to paediatricians and health boards within Wales at the start of seasonal RSV activity and during times of high intensity activity. Changes in testing patterns can affect weekly incidence, however monitoring weekly incidence and positivity for RSV alongside pre-epidemic thresholds may provide a robust indicator of seasonal activity. This will assist in planning within paediatric departments and inform advice on prescribing of the monoclonal antibody Palivizumab for vulnerable children.
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