Journal Article

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

Sax, Theresa M, Balasubramani, GK, Eng, Heather F, Nowalk, Mary Patricia, Moehling, Krissy K, Raviotta, Jonathan M, Zimmerman, Richard K, Rinaldo, Charles R, Wisniewski, Stephen, Bullotta, Arlene

2015

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd
• Subject: Adolescent / Adult / Aged / Care and treatment / Child / Child, Preschool / Comparative analysis / Development and progression / Family Characteristics / Female / Fever / Health aspects / Humans / Hyperthermia / Infant / Infectious Diseases / Influenza A virus - isolation & purification / Influenza B virus - isolation & purification / Influenza, Human - complications / Influenza, Human - epidemiology / Influenza, Human - virology / Internal Medicine / Male / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Outpatients - statistics & numerical data / Parasitology / Pennsylvania - epidemiology / Research Article / Respiratory Syncytial Viruses - isolation & purification / Respiratory Tract Infections - complications / Respiratory Tract Infections - epidemiology / Respiratory Tract Infections - virology / Risk factors / Seasons / Tropical Medicine / Viral diseases / Young Adult