Respiratory viral infections during the 2009–2010 winter season in Central England, UK: incidence and patterns of multiple virus co-infections

Abstract

Acute viral respiratory infections are the most common infections in humans. Co-infection with different respiratory viruses is well documented but not necessarily well understood. The aim of this study was to utilise laboratory data from the winter season following the 2009 influenza A(H1N1) outbreak to investigate rates of respiratory virus co-infections, virus prevalence in different age groups and temporal variations in virus detection. The Health Protection Agency Public Health Laboratory (HPA PHL) Birmingham, UK, routinely uses polymerase chain reaction (PCR) to detect common respiratory viruses. The results from specimens received for respiratory virus investigations from late September 2009 to April 2010 were analysed. A total of 4,821 specimen results were analysed. Of these, 323 (13.2 %) had co-detections of two viruses, 22 (0.9 %) had three viruses and four (0.2 %) had four viruses. Reciprocal patterns of positive or negative associations between different virus pairs were found. Statistical analysis confirmed the significance of negative associations between influenza A and human metapneumovirus (HMPV), and influenza A and rhinovirus. Positive associations between parainfluenza with rhinovirus, rhinovirus with respiratory syncytial virus (RSV) and adenovirus with rhinovirus, parainfluenza and RSV were also significant. Age and temporal distributions of the different viruses were typical. This study found that the co-detection of different respiratory viruses is not random and most associations are reciprocal, either positively or negatively. The pandemic strain of influenza A(H1N1) was notable in that it was the least likely to be co-detected with another respiratory virus.

Risk factors of prolonged hospital stay in children with viral severe acute respiratory infections

“…Co-infection of influenza with other viruses was detected in 13 cases, mainly with RSV. This is in contrast to the results of Tanner et al, who reported that the pandemic strain of influenza A(H1N1) was notable in that it was the least likely to be co-detected with another respiratory virus [36].…”

Respiratory viruses and influenza-like illness: Epidemiology and outcomes in children aged 6 months to 10 years in a multi-country population sample

“…18 A UK-based analysis found negative associations between influenza A and hMPV, and between influenza A and rhinovirus. 22 Positive associations were found between parainfluenza and rhinovirus, RSV and rhinovirus, adenovirus and rhinovirus, and parainfluenza and RSV. 22 No correlation was found between co-infection and clinical severity in a study in Brazil evaluating children under 5 years who sought medical care for respiratory tract infections.…”

“…22 Positive associations were found between parainfluenza and rhinovirus, RSV and rhinovirus, adenovirus and rhinovirus, and parainfluenza and RSV. 22 No correlation was found between co-infection and clinical severity in a study in Brazil evaluating children under 5 years who sought medical care for respiratory tract infections. 23 More research is needed to understand the interaction of respiratory viruses, and the host response to infection.…”

Integrated DNA and RNA extraction using magnetic beads from viral pathogens causing acute respiratory infections

“…An estimated 1.4 million deaths caused by pneumonia occurred in 2010, and pneumonia was responsible for 18.3% of total child deaths among children younger than 5 years of age worldwide; therefore, ensuring a correct diagnosis and providing timely treatment are crucial to accelerate the reduction of morbidity and mortality caused by pneumonia12. An abundance of experimental and epidemiological studies have identified viruses as the pathogens underlying most ARIs34. The World Health Organization estimates that approximately 34 million children under 5 years of age are infected with respiratory syncytial virus (RSV) each year, which represents 22% of all causes of acute lower respiratory infections (ALRIs), and 69,000–199,000 children die of RSV-associated ALRIs56.…”