Respiratory syncytial virus is the main cause of lower respiratory tract infections in infants and young children. Although almost all children are infected before the age of two years, less than 2% develop severe disease necessitating hospitalisation. Risk factors for severe RSV disease include prematurity, chronic lung disease (CLD), young age, low birth weight, congenital heart disease (CHD), and immunodeficiencies. The aims of the studies described in this thesis were to develop a clinical prediction rule to estimate the individual monthly risk of hospitalisation for severe RSV disease in young children (chapter 2.1 ), and to assess the role of the average seasonal RSV pattern in the performance of this prediction rule (chapter 2.2). Furthermore, we aimed to perform a cost-effectiveness analysis of passive immunisation against RSV. Therefore we determined RSV hospitalisation costs in infants and young children and developed a prediction model that estimated anticipated mean RSV hospitalisation costs in children at-risk, based on several child characteristics (chapter 3.1). Then we assessed the incremental costs to prevent one RSV hospitalisation in high-risk children from a societal perspective, using a novel individualised monthly approach for decision making on passive immunisation (chapter 3.2). In addition we aimed to quantify the loss of health related quality of life (HRQoL) in children during the first months after RSV hospitalisation (chapter 4), study the association of severe RSV disease with polymorphisms located in the promoter region of the IL-4 gene and in the IL-4Ra gene (chapter 5), and explore the safety, tolerability, and immunogenicity of BBG2Na, a recombinant RSV vaccine constructed from a G protein sequence, in healthy young adults (chapter 6).

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Erasmus University Rotterdam
R. de Groot (Ronald)
hdl.handle.net/1765/51346
Erasmus MC: University Medical Center Rotterdam

Rietveld, E. (2003, December 10). Respiratory syncytial viral infections in young children : risk assessment and prevention. Retrieved from http://hdl.handle.net/1765/51346