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

Abstract

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

Clinical characteristics and viral etiologies of outpatients with acute respiratory infections in Huzhou of China: a retrospective study

“…In this study, 57.7% were positive for at least one virus, which was similar to the morbidity rates reported in previous studies in Pittsburgh (59.7%) and Vitória of Southeast Brazil (54.3%) [15,25], but was different in China and compared with other reports [1, 3-5, 24, 26]. The single infection (89.8%) was predominant in our study, particularly the FluA virus (47.5%), which was consistent with previous reports in Shandong Province, Beijing, of China and other countries [5,[25][26][27][28][29]. sH3N2 and RhV coinfections were predominant among viral coinfections, which was different from previous reports [5,15,24,29,30].…”

Clinical impact of rapid molecular detection of respiratory pathogens in patients with acute respiratory infection

“…In children with ARI, viral positivity rates range from 40 to 45% by IFA to 67-88% by molecular methods [6][7][8][9]. Viral positivity rates are lower in adults and can vary from 14 to 29% by IFA [10] to 66% by molecular methods [11].…”

Intention to Receive Influenza Vaccine after an Acute Respiratory Illness

“…Previous research using the same methodology has shown that confirmed influenza compared with other respiratory viruses is more often associated with fever, 16 and is associated with a longer time to return to normal activities. 17 In adjusted multivariate regression analyses, the presence of unrevealed but PCR-confirmed influenza was the only significant correlate of influenza vaccination intention among currently unvaccinated children. Presence of confirmed influenza and lack of a high risk condition were significant correlates of influenza vaccination intention among unvaccinated adults.…”