title: Risk factors for severe respiratory syncytial virus infection among Alaska native children.
abstract: OBJECTIVE
  The incidence of hospitalization for respiratory syncytial virus (RSV) infection among Alaska Native children is much higher than among non-Native populations in the United States. We conducted this study to better understand factors associated with hospitalization attributable to RSV infection in this high-risk population.
  
  
  METHODS
  Case-control study, including collection of cord blood for RSV-neutralizing antibody measurement.
  
  
  METHODS
  Remote region of southwest Alaska served by 1 regional hospital and 2 referral hospitals.
  
  
  METHODS
  Case-patients identified through surveillance for RSV infection and matched control subjects without acute respiratory infection hospitalization.
  
  
  RESULTS
  Breastfeeding was associated with a lower risk of RSV hospitalization (odds ratio: 0.34), whereas underlying medical conditions (primarily prematurity) were associated with increased risk (odds ratio: 6.25). Environmental factors associated with a higher risk of hospitalization included household crowding (4 or more children in the household and crowding index > or =2). The level of maternal RSV-neutralizing antibody was not associated with the risk of hospitalization.
  
  
  CONCLUSIONS
  In this region with extremely high risk of RSV hospitalization, several measures, such as encouraging breastfeeding and reducing household crowding, could reduce the risk of hospitalization attributable to RSV.
authors.affiliation: Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska 99508, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Bulkow
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Karron
authors.forename: Lee H
authors.initials: LH
authors.lastname: Harrison
mesh_terms: D000413:Alaska / Q000453:epidemiology; D001942:Breast Feeding / Q000208:ethnology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D004930:Inuit / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D012307:Risk Factors; D012720:Severity of Illness Index