RATIONALE: Respiratory syncytial virus (RSV) is an important cause of hospitalization and death in infants worldwide. Most RSV deaths occur in developing countries, where burden and risk factors for life-threatening illness are unclear. OBJECTIVES: We defined the burden of life-threatening (O(2) saturation [O(2) sat] ≤ 87%) and fatal RSV infection, and characterized risk factors for life-threatening disease in hospitalized children. Special emphasis was placed on studying the impact of dietary habits during pregnancy. We hypothesized that dietary preferences, differing from those of our remote ancestors, would negatively impact children's pulmonary health. For instance, a diet rich in carbohydrates is a signature of recent millennia and typical of low-income populations, heavily burdened by life-threatening RSV disease. METHODS: Prospective study in a catchment population of 56,560 children under 2 years of age during the RSV season in Argentina. All children with respiratory signs and O(2) sat less than 93% on admission were included. MEASUREMENTS AND MAIN RESULTS: Among 1,293 children with respiratory infections, 797(61.6%) were infected with RSV: 106 of these had life-threatening disease; 1.9 per 1,000 children (95% confidence interval [CI], 1.5-2.2/1,000) under 24 months. A total of 22 hospitalized children died (9 RSV(+)), 26 died at home due to acute respiratory infection (14 attributed to RSV); all were under 12 months old. The annual attributable mortality rate for RSV was 0.7 per 1,000 infants (95% CI, 0.4-1.1/1,000). Life-threatening disease was dose-dependently associated with carbohydrate ingestion during pregnancy (adjusted odds ratio from 3.29 [95% CI, 1.15-9.44] to 7.36 [95% CI, 2.41-22.5] versus the lowest quartile). CONCLUSIONS: Life-threatening and fatal RSV infections are a heavy burden on infants in the developing world. Diets rich in carbohydrates during pregnancy are associated with these severe outcomes.
RATIONALE: Respiratory syncytial virus (RSV) is an important cause of hospitalization and death in infants worldwide. Most RSV deaths occur in developing countries, where burden and risk factors for life-threatening illness are unclear. OBJECTIVES: We defined the burden of life-threatening (O(2) saturation [O(2) sat] ≤ 87%) and fatal RSV infection, and characterized risk factors for life-threatening disease in hospitalized children. Special emphasis was placed on studying the impact of dietary habits during pregnancy. We hypothesized that dietary preferences, differing from those of our remote ancestors, would negatively impact children's pulmonary health. For instance, a diet rich in carbohydrates is a signature of recent millennia and typical of low-income populations, heavily burdened by life-threatening RSV disease. METHODS: Prospective study in a catchment population of 56,560 children under 2 years of age during the RSV season in Argentina. All children with respiratory signs and O(2) sat less than 93% on admission were included. MEASUREMENTS AND MAIN RESULTS: Among 1,293 children with respiratory infections, 797(61.6%) were infected with RSV: 106 of these had life-threatening disease; 1.9 per 1,000 children (95% confidence interval [CI], 1.5-2.2/1,000) under 24 months. A total of 22 hospitalized children died (9 RSV(+)), 26 died at home due to acute respiratory infection (14 attributed to RSV); all were under 12 months old. The annual attributable mortality rate for RSV was 0.7 per 1,000 infants (95% CI, 0.4-1.1/1,000). Life-threatening disease was dose-dependently associated with carbohydrate ingestion during pregnancy (adjusted odds ratio from 3.29 [95% CI, 1.15-9.44] to 7.36 [95% CI, 2.41-22.5] versus the lowest quartile). CONCLUSIONS: Life-threatening and fatal RSV infections are a heavy burden on infants in the developing world. Diets rich in carbohydrates during pregnancy are associated with these severe outcomes.
Authors: Mauricio T Caballero; M Elina Serra; Patricio L Acosta; Jacqui Marzec; Luz Gibbons; Maximiliano Salim; Andrea Rodriguez; Andrea Reynaldi; Alejandro Garcia; Daniela Bado; Ursula J Buchholz; Diego R Hijano; Silvina Coviello; Dawn Newcomb; Miguel Bellabarba; Fausto M Ferolla; Romina Libster; Ada Berenstein; Susana Siniawaski; Valeria Blumetti; Marcela Echavarria; Leonardo Pinto; Andrea Lawrence; M Fabiana Ossorio; Arnoldo Grosman; Cecilia G Mateu; Carola Bayle; Alejandra Dericco; Mariana Pellegrini; Ignacio Igarza; Horacio A Repetto; Luciano Alva Grimaldi; Prathyusha Gudapati; Norberto R Polack; Fernando Althabe; Min Shi; Fernando Ferrero; Eduardo Bergel; Renato T Stein; R Stokes Peebles; Mark Boothby; Steven R Kleeberger; Fernando P Polack Journal: J Clin Invest Date: 2015-01-02 Impact factor: 14.808
Authors: Ashley Rajappan; Anna Pearce; Hazel M Inskip; Janis Baird; Sarah R Crozier; Cyrus Cooper; Keith M Godfrey; Graham Roberts; Jane S A Lucas; Katharine C Pike Journal: Pediatr Pulmonol Date: 2017-08-16
Authors: Jason P Lynch; Md Al Amin Sikder; Bodie F Curren; Rhiannon B Werder; Jennifer Simpson; Páraic Ó Cuív; Paul G Dennis; Mark L Everard; Simon Phipps Journal: Front Immunol Date: 2017-02-16 Impact factor: 7.561