{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:04:34Z","timestamp":1789106674454,"version":"build-2803163510"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"the","award":["U01AI088654"],"award-info":[{"award-number":["U01AI088654"]}]},{"name":"the","award":["HHSN272201400006C)"],"award-info":[{"award-number":["HHSN272201400006C)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Respiratory syncytial virus (RSV) is a substantial source of severe illnesses including acute lower respiratory infections (ALRIs) like pneumonia. However, its burden in older children remains less well understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using a community-based prospective cohort, we assessed the burden of symptomatic reverse-transcription polymerase chain reaction\u2013confirmed RSV among Nicaraguan children aged 0\u201314 years from 2011 to 2016. ALRI was defined as physician diagnosis of pneumonia, bronchiolitis, bronchitis, or bronchial hyperreactivity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2011 and 2016, 2575 children participated in the cohort. Of these, 630 (24.5%) had at least 1 episode of symptomatic RSV and 194 (7.5%) had multiple episodes. Subtype was identified in 571 (69.3%) episodes with 408 (71.5%) RSV-A, 157 (27.5%) RSV-B, and 6 (1%) positive for both. Children aged &amp;lt;2 years displayed the highest incidence of symptomatic RSV, with 269.3 cases per 1000 person-years (95% confidence interval [CI], 242.1\u2013299.5). Beyond 2 years, incidence (95% CI) of symptomatic RSV decreased rapidly: 145.6 (129.9\u2013163.1), 37.9 (31.9\u201345.0), and 19.3 (14.9\u201325.0) cases per 1000 person-years among children aged 2\u20134, 5\u20139, and 10\u201314 years, respectively. Incidence of RSV-associated ALRI was highest in children aged &amp;lt;2 years (85.95 per 1000 person-years [95% CI, 71.30\u2013103.61]): 2.1, 9.5, and 17.3 times that of participants aged 2\u20134, 5\u20139, and 10\u201314 years, respectively. Children &amp;lt;2 years old were significantly more likely to have an RSV-associated hospitalization (P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a substantial burden of symptomatic and severe RSV in children. While older children did present with RSV, the rates of symptomatic and severe RSV decreased by as much as 95% beyond age 5.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac598","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T06:05:42Z","timestamp":1667887542000},"source":"Crossref","is-referenced-by-count":10,"title":["Respiratory Syncytial Virus Incidence and Severity in a Community-Based Prospective Cohort of Children Aged 0\u201314 Years"],"prefix":"10.1093","volume":"9","author":[{"given":"Matthew","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5571-9774","authenticated-orcid":false,"given":"John","family":"Kubale","sequence":"additional","affiliation":[{"name":"ICPSR, Institute for Social Research, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermina","family":"Kuan","sequence":"additional","affiliation":[{"name":"Health Center S\u00f3crates Flores Vivas, Ministry of Health , Managua , Nicaragua"},{"name":"Sustainable Sciences Institute , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Ojeda","sequence":"additional","affiliation":[{"name":"Health Center S\u00f3crates Flores Vivas, Ministry of Health , Managua , Nicaragua"},{"name":"Sustainable Sciences Institute , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nivea","family":"Vydiswaran","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nery","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Health Center S\u00f3crates Flores Vivas, Ministry of Health , Managua , Nicaragua"},{"name":"Sustainable Sciences Institute , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Gresh","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Latta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Lopez","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute , Managua , Nicaragua"},{"name":"Centro Nacional de Diagn\u00f3stico y Referencia, Ministry of Health , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Balmaseda","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute , Managua , Nicaragua"},{"name":"Centro Nacional de Diagn\u00f3stico y Referencia, Ministry of Health , Managua , Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9352-7877","authenticated-orcid":false,"given":"Aubree","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , 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