scholarly journals Influenza Clinical Diagnostic Testing and Antiviral Treatment among Children Hospitalized with Acute Respiratory Illness During the 2015–16 Influenza Season

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S356-S356
Author(s):  
Angela P Campbell ◽  
Craig McGowan ◽  
Brian Rha ◽  
Julie A Boom ◽  
Janet Englund ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Influenza Season ◽  
Antiviral Treatment ◽  
Diagnostic Testing ◽  
Respiratory Illness ◽  
Molecular Testing ◽  
Hospitalized Children ◽  
Acute Respiratory Illness ◽  
Research Support ◽  
Clinical Diagnostic

Abstract Background Although antiviral therapy is recommended for hospitalized patients with suspected or confirmed influenza, clinicians often rely on test results to determine management. Rapid influenza diagnostic tests (RIDTs) have suboptimal sensitivity; use of molecular assays may improve care. We evaluated clinical influenza testing and antiviral treatment practices in hospitalized children. Methods Children aged <18 years with acute respiratory illness (ARI) were enrolled through active surveillance at 7 hospitals in the New Vaccine Surveillance Network between November 2015 and June 30, 2016; analysis was restricted to the influenza season. Preliminary data were analyzed for children who had clinical influenza diagnostic testing with a rapid influenza diagnostic test or molecular assay on nasopharyngeal or nasal swabs or nasal washes. Children who had received antivirals prior to hospitalization were excluded. Results Of 2267 children, 1165 (51%) had clinical diagnostic testing on upper respiratory samples: 276 (24%) by RIDT alone, 780 (67%) by molecular testing alone, and 109 (9%) by both. The use of molecular testing alone varied by site, from 10% to 100% of samples tested. Of 116 (10%) children testing positive for influenza, 60 (52%) were treated; by site, treatment of children positive for influenza ranged from 25% to 83%. Antiviral treatment was given to 16/20 (80%) of those admitted ≤2 days from symptom onset vs. 44/96 (46%) children admitted >2 days after onset. Among 94 children tested by one method who were positive, >80% had samples collected in the emergency department or on day of admission, and 47 started treatment (Figure, A): 16/37 (43%) and 31/57 (54%) were treated when tested by RIDT alone and molecular testing alone, respectively. Of those positive children treated, 7/16 (44%) tested by RIDT vs. 22/31 (71%) by molecular testing started treatment on the day of testing (Figure, B). Conclusion Half of hospitalized children with ARI who tested positive for influenza received antiviral treatment. Although there was high variability in testing and treatment by site, in positive patients who were treated the use of molecular testing appeared to be associated with prompt antiviral therapy. Understanding clinician reasons for relatively low treatment overall will require further investigation. Disclosures J. Englund, Gilead: Consultant and Investigator, Research support Chimerix: Investigator, Research support Alios: Investigator, Research support Novavax: Investigator, Research support MedImmune: Investigator, Research support GlaxoSmithKline: Investigator, Research support N. B. Halasa, sanofi pasteur: Research Contractor, Research support Astra Zeneca: Research Contractor, Grant recipient

scholarly journals 721. Clinical Respiratory Syndromes and Association with Influenza Clinical Diagnostic Testing and Antiviral Treatment among Children Hospitalized with Acute Respiratory Illness, 2015–2016

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S259-S259
Author(s):  
Angela P Campbell ◽  
Brian Rha ◽  
Constance Ogokeh ◽  
Janet Englund ◽  
Natasha B Halasa ◽  
...  
Keyword(s):  
Antiviral Treatment ◽  
Diagnostic Testing ◽  
Respiratory Illness ◽  
Clinical Syndrome ◽  
Admission Diagnosis ◽  
Acute Respiratory Illness ◽  
Research Support ◽  
Surveillance Network ◽  
Missed Opportunities ◽  
Percent Positivity

Abstract Background We investigated clinical influenza testing and treatment in children hospitalized with acute respiratory illness (ARI) who had distinct respiratory syndromes. Methods Children <18 years old with ARI were enrolled at seven hospitals in the New Vaccine Surveillance Network (NVSN) between November 1, 2015–June 30, 2016. ICD10 admission diagnosis codes were grouped to define syndromes of bronchiolitis, asthma, pneumonia, and croup. At clinician discretion, influenza testing with a rapid influenza diagnostic test or molecular assay was performed on respiratory samples. As part of the study, each site performed influenza testing using molecular assays on mid-turbinate nasal and throat swabs from all enrolled children. Analysis was restricted to influenza season; children who received antivirals before hospitalization were excluded. Results Among 2,134 children with available ICD10 codes, on preliminary analysis 1,119 (52%) had influenza testing ordered by a clinician: 111 (10%) were positive, and 57 (51%) of 111 received antiviral treatment. Of the 2,134, 858 (40%) had one of the four mutually exclusive syndromes (table). Hospital clinical testing per clinician discretion was influenza positive in 16 of the 858 children (percent positivity per syndrome ranged from <1% to 38%; table). Research study testing of children not undergoing clinical influenza testing identified 11 additional positives. Antiviral treatment was highest for pneumonia patients. Conclusion Understanding testing and treatment practices by clinical syndrome may help to identify missed opportunities for influenza diagnosis and treatment. Table: Disclosures J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. N. B. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.

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

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard K Zimmerman ◽  
Charles R Rinaldo ◽  
Mary Patricia Nowalk ◽  
GK Balasubramani ◽  
Krissy K Moehling ◽  
...  
Keyword(s):  
Viral Infections ◽  
Influenza Season ◽  
Respiratory Illness ◽  
Acute Respiratory Illness

scholarly journals Costs associated with acute respiratory illness and select virus infections in hospitalized children, El Salvador and Panama, 2012–2013

2019 ◽  
Vol 79 (2) ◽  
pp. 108-114
Author(s):  
Jorge H. Jara ◽  
Eduardo Azziz-Baumgartner ◽  
Tirza De Leon ◽  
Kathia Luciani ◽  
Yarisa Sujey Brizuela ◽  
...  
Keyword(s):  
El Salvador ◽  
Respiratory Illness ◽  
Hospitalized Children ◽  
Acute Respiratory Illness ◽  
Virus Infections

scholarly journals Association of influenza outbreaks with advanced pediatric medical support

2018 ◽  
Vol 146 (11) ◽  
pp. 1366-1371 ◽  
Author(s):  
Jennifer Guyther ◽  
Richard Lichenstein ◽  
Yonghong Gao ◽  
James A. Zhou ◽  
Adebola Ajao ◽  
...  
Keyword(s):  
Influenza Season ◽  
Respiratory Illness ◽  
Retrospective Data ◽  
Acute Respiratory Illness ◽  
Medical Support ◽  
Influenza Outbreak ◽  
Severe Influenza ◽  
Advanced Support ◽  
Rate Ratios ◽  
Influenza Outbreaks

AbstractRetrospective data evaluated increases in advanced medical support for children with medically attended acute respiratory illness (MAARI) during influenza outbreak periods (IOP). Advanced support included hospitalisation, intensive care unit admission, or mechanical ventilation, for children aged 0–17 years hospitalised in Maryland's 50 acute-care hospitals over 12 influenza seasons. Weekly numbers of positive influenza tests in the Maryland area defined IOP for each season as the fewest consecutive weeks, including the peak week containing at least 85% of positive tests with a 2-week buffer on either side of the IOP. Peak IOP (PIOP) was defined as four consecutive weeks containing the peak week with the most number of positive influenza tests. Off-PIOP was defined as the ‘shoulder’ weeks during each IOP. Non-influenza season (NIS) was the remaining weeks of that study season. Rate ratios of mean daily MAARI-related admissions resulting in advanced medical support outcomes during PIOP or Off-PIOP were compared with the NIS and were significantly elevated for all 12 study seasons combined. The results suggest that influenza outbreaks are associated with increased advanced medical support utilisation by children with MAARI. We feel that this data may help preparedness for severe influenza epidemics or pandemic.

Comparison of Laboratory-Confirmed Influenza and Noninfluenza Acute Respiratory Illness in Healthcare Personnel during the 2010–2011 Influenza Season

2014 ◽  
Vol 35 (5) ◽  
pp. 538-546 ◽  
Author(s):  
Emily Henkle ◽  
Stephanie A. Irving ◽  
Allison L. Naleway ◽  
Manjusha J. Gaglani ◽  
Sarah Ball ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Symptom Severity ◽  
Daily Living ◽  
Influenza Season ◽  
Negative Impact ◽  
Respiratory Illness ◽  
Subjective Health ◽  
Healthcare Personnel ◽  
Acute Respiratory Illness ◽  
Severity Scores

Objective.Compare the severity of illnesses associated with influenza and noninfluenza acute respiratory illness (ARI) in healthcare personnel (HCP).Design.Prospective observational cohort.Participants.HCP at 2 healthcare organizations with direct patient contact were enrolled prior to the 2010–2011 influenza season.Methods.HCP who were fewer than 8 days from the start of fever/feverishness/chills and cough were eligible for real-time reverse-transcription polymerase chain reaction influenza virus testing of respiratory specimen. Illness severity was assessed by the sum of self-rated severity (0, absent; 3, severe) of 12 illness symptoms, subjective health (0, best health; 9, worst health), activities of daily living impairment (0, able to perform; 9, unable to perform), missed work, and duration of illness.Results.Of 1,701 HCP enrolled, 267 were tested for influenza, and 58 (22%) of these tested positive. Influenza compared with noninfluenza illnesses was associated with higher summed 12-symptom severity score (mean [standard deviation], 17.9 [5.4] vs 14.6 [4.8]; P < .001), worse subjective health (4.5 [1.8] vs 4.0 [1.8]; P < .05), greater impairment of activities of daily living (4.9 [2.5] vs 3.8 [2.5]; P < .01), and more missed work (12.1 [10.5] vs 7.8 [10.5] hours; P < .01). Differences in symptom severity, activities of daily living, and missed work remained significant after adjusting for illness and participant characteristics.Conclusions.Influenza had a greater negative impact on HCP than noninfluenza ARIs, indicated by higher symptom severity scores, less ability to perform activities of daily living, and more missed work. These results highlight the importance of efforts to prevent influenza infection in HCP.

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