Grant: Operating Grant: SickKids-CIHR-IHDCYH New Investigator Grants

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for acute respiratory tract infection in infants and children. Development of an RSV vaccine has been listed as a public health priority and it is thus encouraging that several vaccines are in development. In addition to the acute burden of disease resulting in significant numbers of hospitalizations, studies have shown that severe RSV may play a causal role in the subsequent development of pediatric asthma. We propose a series of studies using laboratory data from public health and hospital laboratories across Ontario linked to health administrative data housed at the Institute for Clinical Evaluative Sciences in order to estimate the acute and long-term burden of severe RSV infection in the pediatric population. We will quantify the burden of RSV-related disease in hospitals in Ontario by finely stratified age groups and in high-risk populations (e.g., immunocompromised, premature), examine the association between RSV hospitalization and subsequent development of pediatric asthma using a validated outcome measure, and calculate the attributable costs of severe RSV in young children, including in extended follow-up time after confirmed RSV infection to account for these longer-term outcomes. We will use laboratory-confirmation of RSV infection, a superior measure to commonly used measures of bronchiolitis that are non-specific, to estimate RSV burden as well and to measure the association with pediatric asthma, as well as the long-term attributable cost of these hospitalizations. Efforts are currently needed to better understand the epidemiology of RSV infections in this critical, prevaccine era, in order to make policy recommendations and to evaluate future vaccine strategies, as well as in considering modeling interventions and performing cost-effectiveness analyses. Having current, high-quality evidence in the Canadian context will help clinicians and policy-makers make optimal decisions to mitigate the impact and cost of this infectious disease.