Longitudinal active sampling for respiratory viral infections across age groups

Abstract

Background Respiratory viral infections are a major cause of morbidity and mortality worldwide. However, their characterization is incomplete because prevalence estimates are based on syndromic surveillance data. Here, we address this shortcoming through the analysis of infection rates among individuals tested regularly for respiratory viral infections, irrespective of their symptoms. Methods We carried out longitudinal sampling and analysis among 214 individuals enrolled at multiple New York City locations from fall 2016 to spring 2018. We combined personal information with weekly nasal swab collection to investigate the prevalence of 18 respiratory viruses among different age groups and to assess risk factors associated with infection susceptibility. Results 17.5% of samples were positive for respiratory viruses. Some viruses circulated predominantly during winter, whereas others were found year round. Rhinovirus and coronavirus were most frequently detected. Children registered the highest positivity rates, and adults with daily contacts with children experienced significantly more infections than their counterparts without children. Conclusion Respiratory viral infections are widespread among the general population with the majority of individuals presenting multiple infections per year. The observations identify children as the principal source of respiratory infections. These findings motivate further active surveillance and analysis of differences in pathogenicity among respiratory viruses.

Viral etiologies of acute respiratory tract infections among hospitalized children – A comparison between single and multiple viral infections

“…24 Similar to results of previous studies, RSV and PIV are the most common cause of lower respiratory tract infections in infants and young children. 25,26 HAdV is accountable for around 10 percent of ARTI in children in the previous study 5 and it was 9% in our study. This was underestimated because patients with a positive quick adenovirus antigen test without proceeding to have xTAG RVP testing were not included in our analysis.…”

“…That could explain why the numbers of cases with adenovirus, RSV and influenza infections were smaller in comparison to previous studies. 5,29 Secondly, the RVP was not a timely test as it might take days to obtain the result. The delay might have contributed to the prolonged course of antibiotics use or lengthened hospital course due to fever.…”

“…4 Multiple viral infections are more commonly seen in pediatric patients than in adults. 5 Multiple viral infections were reported to be associated with increased hospital admissions, intensive care unit admissions, lengthened duration of hospitalization, and prolonged mechanical ventilation use. 6e8 However, some studies indicated that disease severity, management, and outcome were not associated with multiple viral infections.…”

Potential impact of seasonal forcing on a SARS-CoV-2 pandemic

“…As a result, many respiratory viruses show clear seasonal variation in prevalence; the most well-known example being seasonal influenza which peaks every winter in the temperate zone of the Northern Hemisphere [14]. A similar pattern is seen for the four seasonal human coronaviruses: HKU1, NL63, OC43 and 229E (hereafter collectively referred to as "seasonal CoVs") [15][16][17][18][19][20]. These viruses cause respiratory infections which usually are mild and primarily affect young children.…”

Active surveillance documents rates of clinical care seeking due to respiratory illness

“…However, serological studies are retrospective, and thus unsuitable for estimating prevalence in a timely manner, and indirect, and thus not optimal for viruses eliciting short-lived immunity. 9 To estimate the total impact of respiratory illness on the population, multiplicator models based on telephone and web surveys have been used, such as during the 2009 influenza pandemic. 10,11 Studies have estimated that 17%-30% of people experiencing ILI seek medical attention during a typical flu season 2,12-14 ; however, across the world, rates of seeking health care for respiratory symptoms are more heterogeneous and range from 4% to 85%.…”