Respiratory Viruses Blamed for High Hospitalization Rates

Acute respiratory virus infections are associated with high hospitalization rates among low-income individuals with chronic underlying conditions, according to a new study.

"Low-income individuals with conditions such as bronchitis, pneumonia, obstructive pulmonary disease, asthma or congestive heart failure are 10 times more likely to be hospitalized than middle-income persons with the same conditions," says the study's principal investigator Dr. W. Paul Glezen with Baylor College of Medicine. "Almost half of the patients had an acute respiratory virus infection that caused their hospitalization."

Results of the four-year study appear in the Jan. 26 edition of the Journal of the American Medical Association (JAMA).

Researchers took throat and nasal cultures from patients at four Houston-area health clinics who were admitted to the hospital with a respiratory illness. These illnesses were influenza, respiratory syncytial virus (RSV) and parainfluenza, a group of viruses that includes measles, mumps and croup.

"We were surprised by the large number of parainfluenza cases in adults because we normally only see this virus in children," says Dr. Glezen, a Baylor professor of molecular virology and microbiology. "Many adults had become re-infected with one of these viruses which led to the high hospitalization rates."

The majority of low-income individuals in the study had pulmonary problems - asthma in children and obstructive pulmonary disease in adults. Many of these individuals were also diagnosed with more than one chronic underlying condition.

Dr. Glezen believes the high hospitalization rates can be blamed on low-income patients having more than one chronic underlying condition. Most do not receive ongoing treatment, so they develop serious complications that lead to hospitalization.

Although hospitalization rates have declined overall since 1980, hospitalization rates for acute respiratory illnesses have steadily increased during the same time period. However, Baylor researchers believe that the virus infections can be prevented.

"This study shows the need for an expanded vaccine, like the influenza vaccine, that contains antigens for parainfluenza and RSV," Dr. Glezen says. "If we give this vaccine annually to people with chronic underlying conditions and those in high-risk categories, such as the elderly, we can help them fight off illness and greatly decrease hospitalization rates."

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©2006 Texas Medical Center

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