A real-time surveillance program that expands respiratory syncytial virus (RSV) tracking to the local level may help improve local decisions regarding disease prevention and management, according to data reported at the annual meeting of the American Academy of Pediatrics (AAP).

Marnie L. Boron, PharmD and Director, Grants, Professional Services with MedImmune Inc. in Gaithersburg, Maryland, and colleagues presented an interim assessment of the 2006-2007 RSV season using the RSV AlertTM program.

The program was developed to assess the variability of the RSV season temporally and geographically in the U.S. by tracking significant (greater than 10% positive levels) activity at the community level with timely reporting. The program incorporates real-time, weekly reports of RSV tests conducted in most U.S. Metropolitan Statistical Areas (MSAs).

“Substantial variation in timing of community RSV epidemic precludes the use of national or regional data to define or predict any one individual community outbreak for any specific season, and the Centers for Disease Control and Prevention (CDC) suggests that practitioners consult local laboratories for up-to-date data on RSV activity,” Dr. Boron pointed out.

Currently, RSV testing is not uniform, she said. What’s more, local data regarding the onset and offset of the RSV season are not always available.

As of 03/09/07, 705 participating laboratories, which are nationwide and cover about 74% of the U.S. population in 50 states, were reporting test data weekly for individual MSAs. Sites represent 246 of the 363 MSAs nationwide.

The analysis of weekly reported tests identified >10% positive in 50% of 246 MSAs, with 1,440 positives of 9,812 tests reported (14.7% positive), Dr. Boron and her team said. The week of 10/27/06 demonstrated 10% positive among 455 labs reporting, suggesting the onset of RSV activity nationwide. Onset of >10% was observed in 43 MSAs before this week.

Offset of RSV activity of >10% was observed the week of 4/13/07 among 552 laboratories reporting data.

Using CDC-defined regions, weeks for onset of >10% positive were 11/3/06 for the Northeast, 11/17/06 for the Midwest, 10/06/06 for the South, and 12/16/06 for the West.

Significant variability was observed for onset of >10% for individual MSAs within each region. Onset ranged from 10/20-12/29 for the Northeast, from 9/29-12/22 for the Midwest, from 9/8-12/15 for the South, and from 10/6-12/29 for the West.

“The 2006/07 RSV AlertTM database represents the largest aggregation of RSV surveillance data in the U.S.,” Dr. Boron and her co-authors said.

They added that more consistent local RSV surveillance will permit more accurate characterization of regional and local differences in yearly RSV epidemics, thereby setting the stage for improved local decisions regarding RSV prevention and management.

RSV infections are the leading cause of hospitalization in the first year of life and may lead to significant morbidity.

Annual Meeting of the American Academy of Pediatrics (AAP)

Written by – Jill Stein
Jill Stein03 at cs.com