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

BMC Infect Dis. 2015 Feb 22:15:87. doi: 10.1186/s12879-015-0806-2.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Family Characteristics
  • Female
  • Humans
  • Infant
  • Influenza A virus / isolation & purification
  • Influenza B virus / isolation & purification
  • Influenza, Human / complications
  • Influenza, Human / epidemiology
  • Influenza, Human / virology*
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data*
  • Pennsylvania / epidemiology
  • Respiratory Syncytial Viruses / isolation & purification
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology*
  • Seasons
  • Young Adult