Estimating the Undetected Burden of Respiratory Syncytial Virus Hospitalizations in Adults Through Capture–Recapture Methods

Abstract

ABSTRACTIntroductionTraditional surveillance systems may underestimate the burden caused by respiratory syncytial virus (RSV). Capture–recapture methods provide alternatives for estimating the number of RSV‐related hospitalizations in a population.MethodsCapture–recapture methods were used to estimate the number of RSV‐related hospitalizations in adults in Middle Tennessee from two independent hospitalization surveillance systems during consecutive respiratory seasons from 2016–2017 to 2019–2020. Data from the Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) and the Emerging Infections Program (EIP) were used. Annual RSV hospitalization rates were calculated using the capture–recapture estimates weighted by hospitals' market share divided by the corresponding census population.ResultsUsing capture–recapture methods, the estimated overall adult hospitalization rates varied from 8.3 (95% CI: 5.9–15.4) RSV‐related hospitalizations per 10,000 persons during the 2016–2017 season to 28.4 (95% CI: 18.2–59.0) hospitalizations per 10,000 persons in the 2019–2020 season. The proportion of hospitalizations that HAIVEN determined ranged from 8.7% to 36.7% of the total capture–recapture estimated hospitalization, whereas EIP detected 23.5% to 52.7% of the total capture–recapture estimated hospitalizations.ConclusionCapture–recapture estimates showed that individual traditional surveillance systems underestimated the hospitalization burden in adults. Using capture–recapture allows for a more comprehensive estimate of RSV hospitalizations.