{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:14:54Z","timestamp":1787022894390,"version":"build-2736575974"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,8,1]]},"abstract":"<jats:p>Objective. The hospitalization rate for bronchiolitis of any cause among US children younger than 1 year is estimated at 31.2 per 1000. No data exist on respiratory syncytial virus (RSV)-specific hospitalization rates among high-risk Native Americans other than Alaska Natives, for whom the incidence of RSV hospitalization was estimated at 150 per 1000 among infants younger than 1 year. We aimed to estimate RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years.<\/jats:p>\n                  <jats:p>Methods. We conducted prospective population-level hospital-based surveillance to determine RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years. From 1997 to 2000, all children who were admitted for acute lower respiratory tract infection between October 1 and March 31 had a nasopharyngeal aspirate obtained and tested for RSV by commercial enzyme immunoassay kits. We reviewed charts of children who tested positive for RSV antigen to determine disease severity.<\/jats:p>\n                  <jats:p>Results. During 3 RSV seasons (1997\u20132000), 51.3% of 1837 admissions for acute lower respiratory tract infection among children younger than 2 years were attributed to RSV infection. The overall seasonal RSV hospitalization rate among children younger than 2 years was 63.6 per 1000 and 91.3 per 1000 among children younger than 1 year. In a univariate analysis, predictors of severity included age &amp;lt;6 months (relative risk: 6.8; 95% confidence interval: 3.1\u201317.0).<\/jats:p>\n                  <jats:p>Conclusions. Navajo and White Mountain Apache children are at high risk for RSV disease requiring hospitalization. A lower threshold for hospitalization or underlying chronic conditions that predispose to severe RSV disease do not seem to explain high RSV hospitalization rates in this population.<\/jats:p>","DOI":"10.1542\/peds.110.2.e20","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T20:17:55Z","timestamp":1092428275000},"page":"e20-e20","source":"Crossref","is-referenced-by-count":47,"title":["Respiratory Syncytial Virus Infection in Navajo and White Mountain Apache Children"],"prefix":"10.1542","volume":"110","author":[{"given":"Jana","family":"Bockova","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine, Division of Pediatric Infectious Diseases, Baltimore, Maryland; and the Johns Hopkins Bloomberg School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Oski","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne\u2019","family":"Croll","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Reid","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Weatherholtz","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathuram","family":"Santosham","sequence":"additional","affiliation":[{"name":"Center for American Indian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth A.","family":"Karron","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Division of Pediatric Infectious Diseases, Baltimore, Maryland; and the Johns Hopkins Bloomberg School of Public Health"},{"name":"Center for Immunization Research, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2002,8,1]]},"reference":[{"key":"2021121006315752600_R1","doi-asserted-by":"crossref","unstructured":"Parrott R, Kim H, Arrobio J, et al. Epidemiology of respiratory syncytial virus infection in Washington, DC. II. Infection and disease with respect to age, immunologic status, race and sex. Am J Epidemiol.1973;98:289\u2013300","DOI":"10.1093\/oxfordjournals.aje.a121558"},{"key":"2021121006315752600_R2","unstructured":"Murphy B, Collins P. Current status of respiratory syncytial virus (RSV) and parainfluenza virus type 3 (PIV3) vaccine development: memorandum from a Joint WHO\/NIAID meeting. Bull WHO.1997;75:307\u2013313"},{"key":"2021121006315752600_R3","doi-asserted-by":"crossref","unstructured":"Shay D, Holman R, Newman R, Liu L, Stout J, Anderson L. Bronchiolitis-associated hospitalizations among US children, 1980\u20131996. JAMA.1999;282:1440\u20131446","DOI":"10.1001\/jama.282.15.1440"},{"key":"2021121006315752600_R4","doi-asserted-by":"crossref","unstructured":"Boyce T, Mellen B, Mitchel E, Wright P, Griffin M. Rates of hospitalization for respiratory syncytial virus infection among children in Medicaid. Pediatr Infect Dis.2000;137:865\u2013870","DOI":"10.1067\/mpd.2000.110531"},{"key":"2021121006315752600_R5","doi-asserted-by":"crossref","unstructured":"Singleton R, Petersen K, Berner J, et al. Hospitalizations for respiratory syncytial virus infection in Alaska Native children. Pediatr Infect Dis.1995;14:26\u201330","DOI":"10.1097\/00006454-199501000-00005"},{"key":"2021121006315752600_R6","doi-asserted-by":"crossref","unstructured":"Lowther S, Shay D, Holman R, et al. Bronchiolitis-associated hospitalizations among American Indian and Alaska Native children. Pediatr Infect Dis.2000;19:11\u201317","DOI":"10.1097\/00006454-200001000-00004"},{"key":"2021121006315752600_R7","doi-asserted-by":"crossref","unstructured":"Bruhn F, Yeager A. Respiratory syncytial virus in early infancy. Am J Dis Child.1977;131:145\u2013148","DOI":"10.1001\/archpedi.1977.02120150027004"},{"key":"2021121006315752600_R8","doi-asserted-by":"crossref","unstructured":"Glezen W, Paredes A, Allison J, Taber L, Frank A. Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level. J Pediatr.1981;98:708\u2013715","DOI":"10.1016\/S0022-3476(81)80829-3"},{"key":"2021121006315752600_R9","doi-asserted-by":"crossref","unstructured":"Glezen WL, Frank A, Kasel J. Risk of primary infection and reinfection with respiratory syncytial virus. Am J Dis Child.1986;140:543\u2013546","DOI":"10.1001\/archpedi.1986.02140200053026"},{"key":"2021121006315752600_R10","doi-asserted-by":"crossref","unstructured":"Holberg C, Wright A, Martinez F, et al. Risk factors for respiratory syncytial virus-associated lower respiratory illnesses in the first year of life. Am J Epidemiol.1991;133:1135\u20131151","DOI":"10.1093\/oxfordjournals.aje.a115826"},{"key":"2021121006315752600_R11","doi-asserted-by":"crossref","unstructured":"Hall C, Powell K, MacDonald N, et al. Respiratory syncytial virus infection in children with immunocompromised immune function. N Engl J Med.1986;315:77\u201381","DOI":"10.1056\/NEJM198607103150201"},{"key":"2021121006315752600_R12","doi-asserted-by":"crossref","unstructured":"MacDonald K, Hall C, Suffin S, et al. Respiratory syncytial virus infection in infants with congenital heart disease. N Engl J Med.1982;307:397\u2013400","DOI":"10.1056\/NEJM198208123070702"},{"key":"2021121006315752600_R13","doi-asserted-by":"crossref","unstructured":"Morris K, Morganlander M, Coulehan JL, et al. Wood burning stoves and lower respiratory infections in American Indian children. Am J Dis Child.1990;144:105\u2013108","DOI":"10.1001\/archpedi.1990.02150250117047"},{"key":"2021121006315752600_R14","doi-asserted-by":"crossref","unstructured":"Robin LF, Lees PS, Winget M, et al. Wood burning stoves and lower respiratory illness in Navajo children. Pediatr Infect Dis J.1996;15:859\u2013865","DOI":"10.1097\/00006454-199610000-00006"},{"key":"2021121006315752600_R15","doi-asserted-by":"crossref","unstructured":"Ward JI, Lum MKW, Hall DB, Silimperi DR, Bender TR. Invasive Haemophilus influenzae type b disease in Alaska: background epidemiology for a vaccine efficacy trial. J Infect Dis.1986;153:17\u201326","DOI":"10.1093\/infdis\/153.1.17"},{"key":"2021121006315752600_R16","unstructured":"Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1992. MMWR Morb Mortal Wkly Rep.1992;41:6"},{"key":"2021121006315752600_R17","doi-asserted-by":"crossref","unstructured":"Zangwill KM, Vadheim CM, Vannier AM, et al. Epidemiology of invasive pneumococcal disease in Southern California: implications for the design and conduct of a pneumococcal conjugate vaccine efficacy trial. J Infect Dis.1996;174:752\u2013759","DOI":"10.1093\/infdis\/174.4.752"},{"key":"2021121006315752600_R18","doi-asserted-by":"crossref","unstructured":"Davidson M, Parkinson AJ, Bulkow LR, et al. The epidemiology of invasive pneumococcal disease in Alaska, 1986\u20131990: ethnic differences and opportunities for prevention. J Infect Dis.1994;170:368\u2013376","DOI":"10.1093\/infdis\/170.2.368"},{"key":"2021121006315752600_R19","unstructured":"Department of Health and Human Services. Indian Health Service. Natality and infant\/maternal mortality statistics. Trends in Indian Health 1998\u20131999. 2000: 63"},{"key":"2021121006315752600_R20","doi-asserted-by":"crossref","unstructured":"Karron R, Singleton R, Bulkow L, et al. Severe respiratory syncytial virus disease in Alaska Native children. J Infect Dis.1999;180:41\u201349","DOI":"10.1086\/314841"},{"key":"2021121006315752600_R21","doi-asserted-by":"crossref","unstructured":"McConnochie K, Hall C, Walsh E, Roghmann K. Variation in severity of respiratory syncytial virus infections with subtype. J Pediatr.1990;117:52\u201362","DOI":"10.1016\/S0022-3476(05)82443-6"},{"key":"2021121006315752600_R22","unstructured":"Hall CB, McCarthy CA. Respiratory syncytial virus. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA: Churchill Livingstone; 2000;2:1782\u20131801"},{"key":"2021121006315752600_R23","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases and Committee of Fetus and Newborn. Prevention of respiratory syncytial virus infections: indications for the use of palivizumab and update on the use of RSV-IGIV. Pediatrics.1998;102:1211\u20131216","DOI":"10.1542\/peds.102.5.1211"},{"key":"2021121006315752600_R24","doi-asserted-by":"crossref","unstructured":"Simoes EAF, King SJ, Lehr MV, et al. Preterm twins and triplets: a high-risk group for severe respiratory syncytial virus infection. Am J Dis Child.1993;147:303\u2013306","DOI":"10.1001\/archpedi.1993.02160270065020"},{"key":"2021121006315752600_R25","doi-asserted-by":"crossref","unstructured":"Wright AL, Bauer M, Naylor A, et al. Increasing breast feeding rates to reduce infant illness at the community level. Pediatrics.1998;101:837\u2013844","DOI":"10.1542\/peds.101.5.837"},{"key":"2021121006315752600_R26","unstructured":"US Department of Health and Human Services. HHS Blueprint for Action on Breastfeeding. Washington, DC: Department of Health and Human Services, Office on Women\u2019s Health; 2000"},{"key":"2021121006315752600_R27","doi-asserted-by":"crossref","unstructured":"Lofgren J, Ramet M, Renko M, et al. Association between surfactant protein A gene locus and severe respiratory syncytial virus infection in infants. J Infect Dis.2002;185:283\u2013289","DOI":"10.1086\/338473"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/110\/2\/e20\/1115879\/pe0802000e20.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/110\/2\/e20\/1115879\/pe0802000e20.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T10:01:42Z","timestamp":1639130502000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/110\/2\/e20\/64348\/Respiratory-Syncytial-Virus-Infection-in-Navajo"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,8,1]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2002,8,1]]},"published-print":{"date-parts":[[2002,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.110.2.e20","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,8,1]]}}}