Respiratory syncytial virus bronchiolitis among refugees and asylum seekers from war-torn countries

Background: Bronchiolitis is a prominent illness in children with a high burden in the developing world. Our objective was to assess bronchiolitis severity among infants and toddlers of refugees and asylum seekers who fled from developing countries with high disease burden to a developed country. Study Design: A retrospective cohort comparative-group study of children 0–24 months of age who were admitted with a diagnosis of respiratory syncytial virus (RSV) bronchiolitis to a tertiary university-affiliated medical center during 2009–2017. The refugees and asylum seekers (study group) were mostly from war-torn African countries, and the control group was comprised of children from Israel (controls), a developed country. The primary outcome was length of stay (LOS), and the secondary outcomes were nutritional support and disease characteristics. Results: A total of 185 patients were included (92 refugees and 93 controls). The mean LOS was higher for the former compared to the latter (4.7 ± 3.2 vs. 3.5 ± 2 days, respectively, p =.004). More hospitalized refugees required nutritional support compared to controls (48% vs. 24%, respectively, p =.002). No differences were found in vital signs, physical findings and symptoms, laboratory results, or complications. Conclusions: Refugees and asylum seekers from developing countries presented with a longer RSV bronchiolitis disease course and required more nutritional support compared to their Israeli counterparts. This may suggest a more severe disease.