Viral infections in outpatients with medically attended acute respiratory illness during the 2012–2013 influenza season

BMC Infectious Diseases

Stephen Wisniewski³  Theresa M Sax³  Jonathan M Raviotta¹  Heather F Eng³  Arlene Bullotta²  Krissy K Moehling¹  GK Balasubramani³  Mary Patricia Nowalk¹  Charles R Rinaldo²  Richard K Zimmerman¹ 

[1] Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;Departments of Infectious Disease and Microbiology, and Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA;Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

关键词: RSV;    Virus detection;    Viral infections;    Influenza;   

Others  :  1135705
DOI  :  10.1186/s12879-015-0806-2

 received in 2014-11-19, accepted in 2015-02-04,  发布年份 2015

【 摘 要 】

Background

While it is known that acute respiratory illness (ARI) is caused by an array of viruses, less is known about co-detections and the resultant comparative symptoms and illness burden. This study examined the co-detections, the distribution of viruses, symptoms, and illness burden associated with ARI between December 2012 and March 2013.

Methods

Outpatients with ARI were assayed for presence of 18 viruses using multiplex reverse transcriptase polymerase chain reaction (MRT-PCR) to simultaneously detect multiple viruses.

Results

Among 935 patients, 60% tested positive for a single virus, 9% tested positive for ≥1 virus and 287 (31%) tested negative. Among children (<18 years), the respective distributions were 63%, 14%, and 23%; whereas for younger adults (18–49 years), the distributions were 58%, 8%, and 34% and for older adults (≥50 years) the distributions were 61%, 5%, and 32% (P < 0.001). Co-detections were more common in children than older adults (P = 0.01), and less frequent in households without children (P = 0.003). Most frequently co-detected viruses were coronavirus, respiratory syncytial virus, and influenza A virus. Compared with single viral infections, those with co-detections less frequently reported sore throat (P = 0.01), missed fewer days of school (1.1 vs. 2 days; P = 0.04), or work (2 vs. 3 days; P = 0.03); other measures of illness severity did not vary.

Conclusions

Among outpatients with ARI, 69% of visits were associated with a viral etiology. Co-detections of specific clusters of viruses were observed in 9% of ARI cases particularly in children, were less frequent in households without children, and were less symptomatic (e.g., lower fever) than single infections.

【 授权许可】

   
2015 Zimmerman et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Zimmerman RK, Rinaldo CR, Nowalk MP, Balasubramani GK, Thompson MG, Moehling KK, et al.: Influenza and other respiratory virus infections in outpatients with medically attended acute respiratory infection during the 2011–12 influenza season. Influenza Other Respir Viruses 2014, 8(4):397-405.
• [2]Centers for Disease Control and Prevention: Early estimates of seasonal influenza vaccine effectiveness — United States Morb Mortal Wkly Rep (MMWR) 2013, 62(02):32-5.
• [3]Orenstein EW, De Serres G, Haber MJ, Shay DK, Bridges CB, Gargiullo P, et al.: Methodologic issues regarding the use of three observational study designs to assess influenza vaccine effectiveness. Int J Epidemiol 2007, 36(3):623-31.
• [4]Treanor JJ, Talbot HK, Ohmit SE, Coleman LA, Thompson MG, Cheng PY, et al.: Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clin Infect Dis 2012, 55(7):951-9.
• [5]Sanghavi SK, Bullotta A, Husain S, Rinaldo CR: Clinical evaluation of multiplex real-time PCR panels for rapid detection of respiratory viral infections. J Med Virol 2012, 84(1):162-9.
• [6]Pierce VM, Hodinka RL: Comparison of the GenMark diagnostics eSensor respiratory viral panel to real-time PCR for detection of respiratory viruses in children. J Clin Microbiol 2012, 50(11):3458-65.
• [7]Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG: Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009, 42(2):377-81.
• [8]Hustedt JW, Vazquez M: The changing face of pediatric respiratory tract infections: how human metapneumovirus and human bocavirus fit into the overall etiology of respiratory tract infections in young children. Yale J Bio Med 2010, 83(4):193-200.
• [9]Goka EA, Vallely PJ, Mutton KJ, Klapper PE: Single, dual and multiple respiratory virus infections and risk of hospitalization and mortality. Epidemiol Infect 2015, 143(1):37-47.
• [10]Drews AL, Atmar RL, Glezen WP, Baxter BD, Piedra PA, Greenberg SB: Dual respiratory virus infections. Clin Infect Dis 1997, 25(6):1421-9.
• [11]Mengelle C, Mansuy JM, Pierre A, Claudet I, Grouteau E, Micheau P, et al.: The use of a multiplex real-time PCR assay for diagnosing acute respiratory viral infections in children attending an emergency unit. J Clin Virol 2014, 61:411-7.
• [12]Goka E, Vallely P, Mutton K, Klapper P: Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respir Viruses 2013, 7(6):1079-87.
• [13]Martin E: Improving influenza vaccination rates for pediatric asthmatics by use of an asthma educational tool and a patient electronic care system. Clin Pediatr (Phila) 2008, 47(6):588-92.
• [14]Zimmerman RK, Rinaldo CR, Nowalk MP, Balasubramani GK, Thompson MG, Bullotta A, et al.: Detection of influenza virus infection using Two PCR methods. Adv Virol 2014, 2014:3.