Rates of hospitalisation for influenza, respiratory syncytial virus and human metapneumovirus among infants and young children

To inform the development of a national influenza immunisation programme and the potential role of antiviral drugs in young children, we studied 613 children aged 71 months or younger who attended Leicester Childrens’ Hospital during winter 2001–2002. During periods of respiratory syncytial virus (RSV), influenza, and human metapneumovirus activity, an estimated 12.2% (95% CI: 11.4–13.1), 7.1% (6.3–7.9), and 2.5% (2.1–2.9), respectively, of all medical cases assessed in the hospital were associated with these infections. The respective rates of hospital assessments for RSV, influenza, and human metapneumovirus (HMPV) were 1042 (95% CI: 967–1021), 394 (348–443), and 223 (189–262) per 100,000 children, and for admissions were 517 (465–574), 144 (117–175), and 126 (101–156) per 100,000. Few children with influenza had a prior risk factor. Children with influenza were admitted a median of 4 days after onset of illness and none was coded at discharge as influenza. We conclude that antivirals have little role in the hospital management of children with influenza. Our data provide health economists with information to evaluate the place of universal immunisation of young children against influenza. Hospitalisation rates decreased markedly with referral age, so vaccine would need to be given in early infancy for maximum benefit.