The burden of respiratory syncytial virus bronchiolitis on a pediatric inpatient service.

BACKGROUND Respiratory syncytial virus bronchiolitis is the single leading cause of pediatric admissions for infants in the first year of life, presenting regularly in epidemic proportions in the winter months and impacting in major way on pediatric inpatient services. OBJECTIVES To quantitate the burden of RSV disease on a pediatric service with the purpose of providing a database for proper health planning and resource allocation. METHODS We conducted a prospective 5 year study of documented RSV infections in a single pediatric service. RSV disease was confirmed by direct immunofluorescence testing of nasal swabs from all hospitalized cases of bronchiolitis. RESULTS On average, 147 17 cases of RSV bronchiolitis were admitted annually in the November-March RSV season, representing 7%-9% of admissions and 10%-14% of hospital days. There was a consistent male preponderance of admissions (55-64%) and 15-23% of admissions were patients less than 1 month old. In peak months RSS ses accounted for as many of 40% of the hospitalized infants and was the leading cause of over-occupancy (up to 126%) in the pediatric ward during the winter. CONCLUSIONS RSV infection is a major burden for pediatric inpatient services during the winter season. This recurrent and predictable "epidemic," which regularly leads to over-occupancy, requires increased manpower (nursing) and resources (beds, pulse oximeters) to facilitate proper care. Since this annual event is not a surprise nor an unexpected peak, but rather a cyclical predictable epidemiological phenomeon, proper planning and allocation of services are crucial.