Burden on UK secondary care of rotavirus disease and seasonal infections in children

Abstract

Objective:

Rotavirus is a common infection affecting children under 5 years, which leads to a significant disease burden. This burden is potentially exacerbated by the seasonality of rotavirus, particularly in the context of the seasonality of other common childhood infections. The primary study objective was to describe the pattern and burden of seasonal infections amongst children under 5 years of age with particular attention placed on rotavirus and other gastrointestinal infections.

Methods:

A retrospective analysis of all routine inpatient data relating to selected seasonal infections in the UK was conducted between 2001/02 and 2007/08 using data from Capse Healthcare Knowledge Systems (CHKS, England, Northern Ireland and Wales) and Information Services Division (ISD, Scotland). Admissions with selected diagnoses were extracted based on International Classification of Diseases (ICD)-10 coding. All episodes were processed using a HRG grouper and costs applied according to the NHS National Tariff.

Results:

In the financial year 2007/08, the total number of admissions in the UK for children under 5 years for the selected seasonal infections was 64 879 of which 32 126 admissions were associated with gastrointestinal infections including rotavirus gastroenteritis (RVGE). Seasonal peaks of gastrointestinal infections and RVGE occurred in the spring quarter and respiratory syncytial virus (RSV) and influenza in the winter quarter. Admissions for gastrointestinal infection including RVGE accounted for 35 003 bed days with 9922 due to RVGE. The total cost for admissions involving a diagnosis of seasonal infection was £56 million. Of this, it was estimated that infections with an ICD-10 classification of rotavirus represented a cost of £8.6 million.

Conclusion:

Rotavirus contributes to the significant burden that seasonal infections place on inpatient paediatric resources during the winter and spring months. This study may be limited by issues of clinical coding and the infrequency of confirmatory microbiological testing in real-world practice. Vaccination might be considered as a means of reducing this clinical and economic burden particularly where long-term effectiveness and ease of administration are proven.

Key words:

• Burden
• Children
• Hospitalisation
• Rotavirus
• Seasonal infections
• Secondary care

Transparency

Declaration of funding

This study was funded by, and the writing of this manuscript was supported by, an unrestricted grant from Sanofi-Pasteur MSD.

Declaration of financial and other relationships

N.A., S.C. and L.P. have disclosed that they are full-time employees of Sanofi-Pasteur MSD. C.M. has disclosed that he was an employee of Cardiff Research Consortium which received funding for this study.

Acknowledgements

The authors thank Meridith Johnson for her early input to the project; to Simon Kroll (Imperial College), David Campbell (Sheffield Childrens Hospital) and Roland Salmon (Communicable Disease Surveillance Centre, Wales) for their help in reviewing the manuscript; to Rhys D. Pockett and Sunita Nair for their help in preparing the manuscript for submission; and to Phil James (CHKS) and Stuart Clark (ISD) for providing the data for this study.