scholarly journals 1332. Clinical Indicators for When Bronchoalveolar Lavage (BAL) Is Needed Beyond Nasopharyngeal Swab (NP) Testing for Viral Respiratory Infections

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S754-S754
Author(s):  
Patrizia Ulrich ◽  
Derrick Chen
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Nasopharyngeal Swab ◽  
Test Results ◽  
Clinical Indicators ◽  
Gi Symptoms ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Abstract Background This study evaluated the yield of testing NP vs BAL specimens using a multiplex PCR respiratory viral panel (RVP). Methods A retrospective chart review was conducted on all patients from 10/2017-3/2021 who had both an NP swab and BAL tested by RVP within a 4-week period. Results There were 477 cases where patients had both an NP and BAL specimen tested by RVP. Results were NP-/BAL- for 361 (76%) cases, NP+/BAL+ for 58 (12%), NP-/BAL+ for 40 (8%), and NP+/BAL- for 18 (4%). For NP+/BAL+, NP-/BAL+, and NP+/BAL-, respectively, rhinovirus was detected in 23 (40%), 3 (8%), and 16 (89%) cases (p< 0.001); influenza A or B in 9 (16%), 7 (18%), and 0 (0%) (ns); adenovirus in 3 (5%), 10 (25%), and 2 (11%) (p< 0.05); metapneumovirus in 9 (16%), 8 (20%), 2 (11%) (ns); RSV in 8 (14%), 6 (15%), and 1 (6%) (ns); and, parainfluenza in 7 (12%), 6 (15%), and 1 (6%) (ns), respectively. Average ages were 48, 48, and 48 years; numbers of males were 34 (58%), 28 (70%), and 11 (61%); immunocompromised were 56 (97%), 37 (92%), and 17 (94%); and, 16 (28%), 10 (25%), and 6 (33%) had an active malignancy, respectively (all ns). Average symptom durations prior to presentation were 7.0, 13.1, and 9.6 days (ns); pulmonary exams were abnormal in 35 (60%), 24 (60%), and 5 (28%) cases (p< 0.05); shortness of breath (SOB) was present in 40 (69%), 25 (62%), and 8 (44%) (ns); lower respiratory tract infection (LRTI) symptoms were absent in 1 (2%), 12 (30%), and 8 (45%) cases (p< 0.01); when spirometry values were available, they were reduced in 28/31 (90%), 15/19 (79%), and 3/8 (37%) cases (p< 0.05); and, mean SpO2 levels were 91.5%, 93.9%, and 93.7% (ns), respectively. Mean temperatures were 99.0F, 99.0F, and 99.1F (ns); chills, sweats, and malaise were present in 27 (47%), 13 (33%), and 3 (17%) cases (p< 0.05); GI symptoms were present in 20 (34%), 5 (13%), and 10 (56%) cases (p< 0.05); and, acute kidney injury was present in 38 (66%), 13 (33%), and 6 (33%) cases (p< 0.05), respectively. Conclusion Most (88%) RVP test results were concordant between NP and BAL. There were significant differences between cases of NP+/BAL+, NP-/BAL+, and NP+/BAL-. Rhinovirus and GI symptoms were more common for NP+/BAL- vs NP-/BAL+. Conversely, pulmonary exams were more often abnormal and spirometry values reduced for NP-/BAL+ vs NP+/BAL-. Disclosures All Authors: No reported disclosures

Comparison of symptoms of influenza A with abacavir-associated hypersensitivity reaction

2003 ◽  
Vol 14 (7) ◽  
pp. 478-481 ◽  
Author(s):  
Philip Keiser ◽  
Naiel Nassar ◽  
Daniel Skiest ◽  
Charla Andrews ◽  
Beena Yazdani ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Hypersensitivity Reaction ◽  
Odds Ratio ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Gastrointestinal Symptoms ◽  
Gi Symptoms ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Differentiation between abacavir hypersensitivity and viral respiratory infections is problematic. Fifteen cases of abacavir hypersensitivity were matched to 30 controls with culture proven influenza A with no abacavir exposure. Rash was associated with hypersensitivity (odds ratio [OR] = 13.1, P = 0.02) as was the presence of nausea (OR = 30, P < 0.001), vomiting (OR = 17.1, P = 0.001) or diarrhoea (OR = 22, P < 0.001). The number of gastrointestinal symptoms was also predictive of hypersensitivity reaction ( P < 0.001). Respiratory symptoms (cough, sore throat, or dyspnoea) were not associated with abacavir hypersensitivity (OR = 0.08, P = 0.001). Multivariate analysis confirmed the following associations for abacavir hypersensitivity: the number of gastrointestinal symptoms (OR = 8.6, P = 0.0032), cough (OR = 0.039, P = 0.02) and rash (OR = 16.9, P = 0.07). Abacavir hypersensitivity is strongly associated with gastrointestinal (GI) symptoms. Cough without GI symptoms is associated with influenza.

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Viral Respiratory Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S22-S26 ◽  
Author(s):  
Danielle M. Zerr ◽  
Aaron M. Milstone ◽  
W. Charles Huskins ◽  
Kristina A. Bryant
Keyword(s):  
Influenza A ◽  
Infection Prevention ◽  
Virus Isolation ◽  
Respiratory Infections ◽  
Healthcare Associated Infection ◽  
The Past ◽  
Viral Respiratory Infections ◽  
Healthcare Associated ◽  
Pediatric Infection ◽  
Viral Respiratory

Viral respiratory infections pose a significant challenge to pediatric infection prevention programs. We explore issues regarding the prevention of viral respiratory infections by discussing transmission of influenza A virus, isolation of infected patients, and hospital programs for influenza vaccination.

scholarly journals Vitamin D, Zinc and Iron in Adult Patients with Covid-19 and Their Action in The Immune Response as Biomarkers: A Case Report

2021 ◽  
Author(s):  
Eliza Miranda Ramos ◽  
Emerson Luiz Lima Araújo ◽  
Igor Domingos de Souza ◽  
Gilberto Gonçalves Facco ◽  
Antônio Carlos de Abreu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Treatment Period ◽  
Medical Records ◽  
Respiratory Infections ◽  
Blood Levels ◽  
Test Results ◽  
Emerging Virus ◽  
Low Levels ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Abstract: COVID-19 in 2020 brought challenges to the Brazilian public health system with an emerging virus with respiratory contagion called SARS-CoV-2. There are few studies in Brazil and in some countries, on the increased incidence of certain viral respiratory infections, includ-ing H1N1 and coronavirus and their association with low levels of vitamin D, zinc and iron. The aim of this study was to demonstrate that the deficit of vitamin D, zinc and iron has an impact on the infectious process of patients with COVID-19 and to establish new forms of prevention for the worsening of COVID-19 in the human body. Data were collected from medical records and test results from patients being followed up during the treatment period for COVID-19. Patients with low blood levels of vitamin D, zinc and iron during the treatment period of COVID-19 had a higher percentage of worsening and complications requiring hospitalization in intensive care beds. The ingestion of vitamin D, zinc and iron in the treatment period of patients with COVID-19 in addition to being an immunological protector against SARS-CoV-2 and alleviating the process of worsening the disease can also act as a biomarker in cases of this disease.

scholarly journals Effect of the 2009 Influenza A/H1N1 Pandemic on Viral Respiratory Infections in the First Year of Life

2012 ◽  
Vol 31 (11) ◽  
pp. 1107-1112 ◽  
Author(s):  
Linda C. Ede ◽  
Michael J. Loeffelholz ◽  
Pedro Alvarez-Fernandez ◽  
Dan L. Pong ◽  
Janak A. Patel ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
First Year ◽  
H1n1 Pandemic ◽  
Influenza A H1n1 ◽  
Viral Respiratory Infections ◽  
First Year Of Life ◽  
Viral Respiratory

scholarly journals Extensive multiplex PCR diagnostics reveal new insights into the epidemiology of viral respiratory infections

2016 ◽  
Vol 144 (10) ◽  
pp. 2064-2076 ◽  
Author(s):  
S. NICKBAKHSH ◽  
F. THORBURN ◽  
B. VON WISSMANN ◽  
J. McMENAMIN ◽  
R. N. GUNSON ◽  
...  
Keyword(s):  
Viral Infection ◽  
Multiplex Pcr ◽  
Influenza A ◽  
Respiratory Infections ◽  
Respiratory Viruses ◽  
Viral Population ◽  
Future Research ◽  
Infection Prevalence ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

SUMMARYViral respiratory infections continue to pose a major global healthcare burden. At the community level, the co-circulation of respiratory viruses is common and yet studies generally focus on single aetiologies. We conducted the first comprehensive epidemiological analysis to encompass all major respiratory viruses in a single population. Using extensive multiplex PCR diagnostic data generated by the largest NHS board in Scotland, we analysed 44230 patient episodes of respiratory illness that were simultaneously tested for 11 virus groups between 2005 and 2013, spanning the 2009 influenza A pandemic. We measured viral infection prevalence, described co-infections, and identified factors independently associated with viral infection using multivariable logistic regression. Our study provides baseline measures and reveals new insights that will direct future research into the epidemiological consequences of virus co-circulation. In particular, our study shows that (i) human coronavirus infections are more common during influenza seasons and in co-infections than previously recognized, (ii) factors associated with co-infection differ from those associated with viral infection overall, (iii) virus prevalence has increased over time especially in infants aged <1 year, and (iv) viral infection risk is greater in the post-2009 pandemic era, likely reflecting a widespread change in the viral population that warrants further investigation.

scholarly journals The presence of fever in adults with influenza and other viral respiratory infections

2016 ◽  
Vol 145 (1) ◽  
pp. 148-155 ◽  
Author(s):  
A. A. CHUGHTAI ◽  
Q. WANG ◽  
T. C. DUNG ◽  
C. R. MACINTYRE
Keyword(s):  
Healthcare Workers ◽  
Influenza A ◽  
Respiratory Infections ◽  
Case Definition ◽  
Viral Respiratory Infection ◽  
Respiratory Virus Infection ◽  
Syncytial Virus ◽  
Definition Of ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

SUMMARYWe compared the rates of fever in adult subjects with laboratory-confirmed influenza and other respiratory viruses and examined the factors that predict fever in adults. Symptom data on 158 healthcare workers (HCWs) with a laboratory-confirmed respiratory virus infection were collected using standardized data collection forms from three separate studies. Overall, the rate of fever in confirmed viral respiratory infections in adult HCWs was 23·4% (37/158). Rates varied by virus: human rhinovirus (25·3%, 19/75), influenza A virus (30%, 3/10), coronavirus (28·6%, 2/7), human metapneumovirus (28·6%, 2/7), respiratory syncytial virus (14·3%, 4/28) and parainfluenza virus (8·3%, 1/12). Smoking [relative risk (RR) 4·65, 95% confidence interval (CI) 1·33–16·25] and co-infection with two or more viruses (RR 4·19, 95% CI 1·21–14·52) were significant predictors of fever. Fever is less common in adults with confirmed viral respiratory infections, including influenza, than described in children. More than 75% of adults with a viral respiratory infection do not have fever, which is an important finding for clinical triage of adult patients with respiratory infections. The accepted definition of ‘influenza-like illness’ includes fever and may be insensitive for surveillance when high case-finding is required. A more sensitive case definition could be used to identify adult cases, particularly in event of an emerging viral infection.

scholarly journals Epidemiology of viral respiratory infections in Australian working-age adults (20–64 years): 2010–2013

2018 ◽  
Vol 146 (5) ◽  
pp. 619-626 ◽  
Author(s):  
B. M. Varghese ◽  
E. Dent ◽  
M. Chilver ◽  
S. Cameron ◽  
N. P. Stocks
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Influenza Surveillance ◽  
Influenza B ◽  
Surveillance Network ◽  
Working Age ◽  
Syncytial Virus ◽  
Using Data ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

AbstractAcute respiratory infections cause significant morbidity and mortality accounting for 5.8 million deaths worldwide. In Australia, influenza-like illness (ILI), defined as cough, fever and fatigue is a common presentation in general practice and results in reduced productivity and lost working days. Little is known about the epidemiology of ILI in working-age adults. Using data from the ASPREN influenza surveillance network in Australia (2010–2013) we found that working-age adults made up 45.2% of all ILI notifications with 55% of samples positive for at least one respiratory virus. Viruses most commonly detected in our study included influenza A (20.6%), rhinovirus (18.6%), influenza B (6.2%), human meta-pneumovirus (3.4%), respiratory syncytial virus (3.1%), para-influenza virus (2.6%) and adenovirus (1.3%). We also demonstrated that influenza A is the predominant virus that increases ILI (by 1.2% per month for every positive influenza A case) in working-age adults during autumn–winter months while other viruses are active throughout the year. Understanding the epidemiology of viral respiratory infections through a year will help clinicians make informed decisions about testing, antibiotic and antiviral prescribing and when the beginning of the ‘flu season’ can be more confidently predicted.

scholarly journals Comparison of the Transcriptome Response within the Swine Tracheobronchial Lymphnode Following Infection with PRRSV, PCV-2 or IAV-S.

Pathogens ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 99 ◽  
Author(s):  
Miller ◽  
Fleming ◽  
Lager
Keyword(s):  
Gene Expression ◽  
Influenza A ◽  
Respiratory Infections ◽  
Statistical Tests ◽  
Respiratory Pathogen ◽  
Porcine Circovirus ◽  
Respiratory Syndrome Virus ◽  
Swine Industry ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Porcine reproductive and respiratory syndrome virus (PRRSV) is a major respiratory pathogen of swine that has become extremely costly to the swine industry worldwide, often causing losses in production and animal life due to their ease of spread. However, the intracellular changes that occur in pigs following viral respiratory infections are still scantily understood for PRRSV, as well as other viral respiratory infections. The aim of this study was to acquire a better understanding of the PRRS disease by comparing gene expression changes that occur in tracheobronchial lymph nodes (TBLN) of pigs infected with either porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus type 2 (PCV-2), or swine influenza A virus (IAV-S) infections. The study identified and compared gene expression changes in the TBLN of 80 pigs following infection by PRRSV, PCV-2, IAV-S, or sham inoculation. Total RNA was pooled for each group and time-point (1, 3, 6, and 14 dpi) to make 16 libraries—analyses are by Digital Gene Expression Tag Profiling (DGETP). The data underwent standard filtering to generate a list of sequence tag raw counts that were then analyzed using multidimensional and differential expression statistical tests. The results showed that PRRSV, IAV-S and PCV-2 viral infections followed a clinical course in the pigs typical of experimental infection of young pigs with these viruses. Gene expression results echoed this course, as well as uncovered genes related to intersecting and unique host immune responses to the three viruses. By testing and observing the host response to other respiratory viruses, our study has elucidated similarities and differences that can assist in the development of vaccines and therapeutics that shorten or prevent a chronic PRRSV infection.

scholarly journals 862. Impact of Caregiver Health on Pediatric Healthcare-Associated Viral Respiratory Infections (HAVRIs): A Retrospective Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Maude Paquette ◽  
Allyson Shephard ◽  
Pat Bedard ◽  
Nisha Thampi ◽  
Nisha Thampi
Keyword(s):  
Respiratory Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Prevention Measures ◽  
Poor Outcomes ◽  
Viral Respiratory Infections ◽  
Healthcare Associated ◽  
The Impact ◽  
Viral Respiratory

Abstract Background The burden of healthcare-associated viral respiratory infections (HAVRIs) in children is significant, with increased healthcare costs and risk of poor outcomes. However, while healthcare workers are the main target of infection prevention measures, little is known about the impact of sick contacts during hospitalization on the incidence of HAVRIs. The objective of our study was to determine the proportion of pediatric HAVRIs following contact with an ill caregiver or visitor. Secondary objectives were to describe the characteristics of affected patients as well as the complications associated with the HAVRI episodes. Methods This is a retrospective chart review that took place in a pediatric tertiary care center with both multiple and single-bed rooms. All cases of HAVRIs that occurred between December 2017 and July 2019 in patients aged less than 18 years old were included in the study. HAVRIs were defined as a laboratory confirmed respiratory viral illness occurring after 72 hours of admission. Results Forty-four HAVRIs were included in the analysis. The majority (n=32, 72.7%) were among patients aged less than 24 months. Only 2 patients had no comorbidities and almost half (n=21, 47.7%) had multiple complex medical conditions. Rhinovirus was the most frequently isolated virus (n=20, 45.5%). Nine patients (20.5%) had a documented contact with a sick caregiver (n=8, 88.9%) or sick visitor (n=2, 22.2%) in the 7 days prior to the onset of new respiratory symptoms and subsequent HAVRI diagnosis. In the 72 hours prior to HAVRI onset, 18 patients (40.9%) were in a single-bed room and 6 patients (13.6%) were already under droplet/contact precautions. Twelve patients (27.3%) had new or increased O2 requirements and 4 (9.1%) were transferred to the intensive care unit. There were no associated deaths. Conclusion Our study suggests that having a contact with a sick caregiver or visitor is a potential risk factor for acquiring a HAVRI. This reinforces the relevance of a strict visitor-screening policy and of educating caregivers on the importance of appropriate hand hygiene when caring for their child. Of note, more than one third of HAVRI cases occurred in patients already in a single-bed room, with or without additional precautions, suggesting that those measures are not entirely protective. Disclosures All Authors: No reported disclosures

Effect of the 2009 Influenza A/H1N1 Pandemic on Viral Respiratory Infections in the First Year of Life

2013 ◽  
Vol 32 (1) ◽  
pp. 95-96
Author(s):  
Catiane Tiecher Cusinato ◽  
Caroline Beck ◽  
Nêmora Tregnago Barcellos ◽  
Fernando Herz Wolff
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
First Year ◽  
H1n1 Pandemic ◽  
Influenza A H1n1 ◽  
Viral Respiratory Infections ◽  
First Year Of Life ◽  
Viral Respiratory
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