Respiratory Syncytial Virus Infection in Guatemala, 2007-2012

Background. Respiratory syncytial virus (RSV) is a major cause of acute respiratory illness (ARI). Little is known about RSV disease among older children and adults in Central America. Methods. Prospective surveillance for ARI among hospital patients and clinic patients was conducted in Guatemala during 2007-2012. Nasopharyngeal and oropharyngeal swab specimens were tested for RSV, using real-time reverse-transcription polymerase chain reaction. Results. Of 6287 hospitalizations and 2565 clinic visits for ARI, 24% and 12%, respectively, yielded RSV-positive test results. The incidence of RSV-positive hospitalization for ARI was 5.8 cases/10 000 persons per year and was highest among infants aged <6 months (208 cases/10 000 persons per year); among adults, the greatest incidence was observed among those aged >= 65 years (2.9 cases/10 000 persons per year). The incidence of RSV-positive clinic visitation for ARI was 32 cases/10 000 persons per year and was highest among infants aged 6-23 months (186 cases/10 000 persons per year). Among RSV-positive hospital patients with ARI, underlying cardiovascular disease was associated with death, moribund discharge, intensive care unit admission, or mechanical ventilation (odds ratio, 4.1; 95% confidence interval, 1.9-8.8). The case-fatality proportion among RSV-positive hospital patients with ARI was higher for those aged >= 5 years than for those aged <5 years (13% vs 3%; P < .001). Conclusions. The incidences of RSV-associated hospitalization and clinic visitation for ARI were highest among young children, but a substantial burden of ARI due to RSV was observed among older children and adults.