2797. Rates of Respiratory Syncytial Virus (RSV) Infection among Hospitalized Adults by Congestive Heart Failure Status—United States, 2015–2017

Background Respiratory syncytial virus (RSV) can cause severe disease in older adults and adults with cardiopulmonary conditions, such as congestive heart failure (CHF). RSV vaccines in development may target adults based on age or medical conditions. We assessed rates of RSV infection in hospitalized adults by CHF status using RSV surveillance conducted through the Centers for Disease Control and Prevention’s Emerging Infections Program, a population-based platform in the United States Methods RSV surveillance was performed during two seasons (2015–2017) from October 1–April 30 at seven US sites covering an annual catchment population up to 13.7 million adults. Adults (≥ 18 years) admitted to a hospital from the catchment area and with laboratory-confirmed RSV infections identified by clinician-directed testing were included. Demographic data and any history of CHF were abstracted from medical charts. For adults ≥ 65 years, county-level CHF prevalence was obtained from 2015 Centers for Medicare and Medicaid Services (CMS) data. To estimate county-level CHF prevalence for adults < 65 years, we used 2015–2016 National Health and Nutrition Examination Survey and CMS data. We calculated crude incidence rates (and 95% exact Poisson confidence intervals) of RSV by CHF status and age group (< 65 years vs. ≥ 65 years) using RSV cases (numerator) and catchment area county-level population estimates from the US Census (denominator). Results During 2015–2017, a total of 2,211 hospitalized RSV cases were identified; 2,055 (92.9%) had CHF status documented. The majority were ≥ 65 years (n = 1236, 60.1%) and 26.8% (n = 550) had CHF. The crude rate of RSV was 62.7 (95% CI: 57.5–68.2) per 100,000 population in adults with CHF compared with 6.1 (95% CI: 5.7–6.4) per 100,000 population in adults without CHF (rate ratio: 10.3, 95% CI: 9.3–11.3). In both age groups, those with CHF had higher rates of RSV than those without CHF. Rates were highest in adults ≥ 65 years with CHF (73.4 per 100,000 population, 95% CI: 66.4–80.9). Conclusion Using population-based surveillance, we found that adults with CHF had RSV hospitalization rates 10 times higher than those without CHF. Identifying high-risk populations for RSV infection are critical to inform clinical practice and future RSV vaccine policy. Disclosures All authors: No reported disclosures.