Abstract
BACKGROUND: There are incomplete data on the global burden of viral lower respiratory tract infection, in particular the role of Respiratory Syncytial Virus, in children requiring health services. FINDINGS: In this study set in a large urban area of southern China from 1 January 2007 to 31 December 2010, children 1 month to 14 years of age with RSV-associated "severe" or "very severe pneumonia" according to World Health Organization definitions, and meeting local criteria for admission to the pediatric intensive care unit, were followed for the course of their admission. The median age was 3 months and 79% (135/171) of children with RSV were under six months of age. All children needed supplemental oxygen, and 22% required mechanical ventilatory support. The mortality rate was 3.5%. In multivariate analysis, congenital heart disease and Trisomy 21 were associated with death. CONCLUSIONS: Children admitted to an intensive care unit with RSV-associated severe/very pneumonia in a large urban setting in southern China were most commonly ≤ six months old and almost one quarter of these had respiratory failure. The overall mortality rate was 3.5%. RSV vaccine strategies that would protect children from early infancy are urgently needed.