[The burden and outcomes of acute bronchiolitis among young children hospitalized in Israel].
BACKGROUND
Acute bronchiolitis (AB) is a significant indication for hospitalization during the winter period. Underlying conditions increase risk for severe manifestations.


OBJECTIVE
To estimate the burden and outcomes of AB in northern Israel.


METHODS
A prospective study was performed between 1.12.2005 - 31.3.2006. Previously healthy children younger than 2 years of age, hospitalized with the diagnosis of AB, in three hospitals in northern Israel, were included in this study.


RESULTS
Overall, 465 children (93%) out of 500 children who were hospitalized due to AB and comprised 18% of all hospitalizations during the study period, were included. A pathogen was identified in 91% of cases. A single pathogen was identified in 243 (52%) cases; 2-4 pathogens were found in 176 (39%) children. Common pathogens were respiratory syncytial virus (RSV) and Rhinovirus in 346 (75%) and 129 (28%), of which 192 (41%) and 37 (8%) were sole pathogens respectively. Complete data were available for 390 (82%) children, of whom 78% were younger than 6 months. Patients were hospitalized for 4 +/- 4.4 days; 15 children were treated in intensive care. There was one mortality. An X-ray was performed in 94% of cases. Most children were treated with multiple regimens including intravenous fluids, O2 supplement, physiotherapy, bronchodilators, steroids and antibiotics. Bronchiolitis was attributed to 18% of hospitalizations. On a national scale, assuming that the policy of hospitalization is similar, 4100 children were hospitalized due to AB. This reflects 4% of all hospitalized children a year in Israel and attributing to 16,400 hospitalizations.


CONCLUSIONS
AB is associated with a huge burden, during a short period of the year, on pediatric departments, mainly attributed by infants younger than 6 months of age. The development of effective vaccine against RSV may significantly reduce the burden of morbidity.
Kassis
Imad
I
Pediatric Infectious Disease Unit, Meyer Children Hospital, Haifa, Israel. i_kassis@rambam.health.gov.il
Srugo
Isaac
I
Srur
Suzan
S
Horowitz
Yosef
Y
Almagor
Tal
T
Wolf
Dana
D
Kra-Oz
Zipi
Z
Kennes
Yoram
Y
Rishpon
Shmuel
S
Miron
Dan
D
D001988:Bronchiolitis / Q000191:economics / Q000453:epidemiology* / Q000821:virology; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D017281:Cost of Illness; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D011446:Prospective Studies; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012229:Rhinovirus / Q000302:isolation & purification; D016896:Treatment Outcome