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

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.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.860 ◽

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

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Enterovirus D68–Associated Acute Respiratory Illness — New Vaccine Surveillance Network, United States, July–October, 2017 and 2018

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm6812a1 ◽

2019 ◽

Vol 68 (12) ◽

pp. 277-280 ◽

Cited By ~ 16

Author(s):

Stephanie A. Kujawski ◽

Claire M. Midgley ◽

Brian Rha ◽

Joana Y. Lively ◽

W. Allan Nix ◽

...

Keyword(s):

United States ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Surveillance Network ◽

Enterovirus D68 ◽

Vaccine Surveillance

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Exploring Clinically Meaningful Changes for the Frailty Index in a Longitudinal Cohort of Hospitalized Older Patients

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa084 ◽

2020 ◽

Vol 75 (10) ◽

pp. 1928-1934 ◽

Cited By ~ 3

Author(s):

Olga Theou ◽

Alexandra M van der Valk ◽

Judith Godin ◽

Melissa K Andrew ◽

Janet E McElhaney ◽

...

Keyword(s):

Older Adults ◽

Older Patients ◽

Frailty Index ◽

Respiratory Illness ◽

Research Network ◽

Acute Respiratory Illness ◽

Meaningful Change ◽

Score Change ◽

Surveillance Network ◽

Clinical Frailty Scale

Abstract Background Clinically meaningful change (CMC) for frailty index (FI) scores is little studied. We estimated the CMC by associating changes in FI scores with changes in the Clinical Frailty Scale (CFS) in hospitalized patients. Methods The Serious Outcomes Surveillance Network of the Canadian Immunization Research Network enrolled older adults (65+ years) admitted to hospital with acute respiratory illness (mean age = 79.6 ± 8.4 years; 52.7% female). Patients were assigned CFS and 39-item FI scores in-person at admission and via telephone at 1-month postdischarge. Baseline frailty state was assessed at admission using health status 2 weeks before admission. We classified those whose CFS scores remained unchanged (n = 1,534) or increased (n = 4,390) from baseline to hospital admission, and whose CFS scores remained unchanged (n = 1,565) or decreased (n = 2,546) from admission to postdischarge. For each group, the CMC was represented as the FI score change value that best predicted one level CFS change, having the largest Youden J value in comparison to no change. Results From baseline to admission, 74.1% increased CFS by ≥1 level. From admission to postdischarge, 61.9% decreased CFS by ≥1 levels. A change in FI score of 0.03 best predicted both one-level CFS increase (sensitivity = 70%; specificity = 69%) and decrease (sensitivity = 66%; specificity = 61%) in comparison to no change. Of those who changed CFS by ≥1 levels, 70.9% (baseline to admission) and 72.4% (admission to postdischarge) changed their FI score by at least 0.03. Conclusions A clinically meaningful change of 0.03 in the frailty index score holds promise as a benchmark for assessing the meaningfulness of frailty interventions.

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Enterovirus D68-Associated Acute Respiratory Illness ─ New Vaccine Surveillance Network, United States, July–November 2018–2020

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm7047a1 ◽

2021 ◽

Vol 70 (47) ◽

pp. 1623-1628

Author(s):

Melisa M. Shah ◽

Ariana Perez ◽

Joana Y. Lively ◽

Vasanthi Avadhanula ◽

Julie A. Boom ◽

...

Keyword(s):

United States ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Surveillance Network ◽

Enterovirus D68 ◽

Vaccine Surveillance

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128. Characteristics and Outcomes of Pregnant Women Hospitalized with Influenza in the United States, Flusurv-net, 2010–2019

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.438 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S193-S194

Author(s):

Rachel Holstein ◽

Fatima S Dawood ◽

Pam Daily Kirley ◽

Rachel Herlihy ◽

Kim Yousey-Hindes ◽

...

Keyword(s):

Pregnant Women ◽

Vaccination Coverage ◽

Birth Outcome ◽

Antiviral Treatment ◽

The United States ◽

Age Group ◽

Research Support ◽

Fetal Outcomes ◽

Surveillance Network ◽

Current Season

Abstract Background Pregnant women are at high-risk for influenza-associated hospitalization. We used data from the U.S. Influenza Hospitalization Surveillance Network (FluSurv-NET) to characterize pregnant women hospitalized with influenza. Methods We included pregnant women (15–44 years) residing within a FluSurv-NET catchment area and hospitalized with laboratory-confirmed influenza between October 1 and April 30, during the 2010–19 influenza seasons. Clinical data were obtained on cases through medical chart abstraction. We examined trends in vaccination coverage and antiviral treatment using the Cochran-Armitage test for trend and characterized maternal interventions and maternal and fetal outcomes during hospitalization. Results Of 9,652 women aged 15–44 years hospitalized with influenza, 2,697 (28%) were pregnant. Median maternal age was 28 years and median gestational age was 32 weeks; 36% were non-Hispanic white, 29% non-Hispanic black, and 20% Hispanic. Underlying conditions were present in 35% (n=931), with asthma (n=613; 22.7%) and chronic metabolic disease (n=204; 7.6%) as the most common; 12% (n=299) were current smokers. Vaccination coverage and antiviral receipt varied by season and age [Figures 1 and 2]. Overall, 31% (n=846) were vaccinated and 89% (n=2,408) received antivirals. Five percent (n=132) had intensive care unit admission, 2% (n=52) required mechanical ventilation, 6% (n=165) developed pneumonia and 0.3% (n=9) died; median length of hospital stay was 2 days (IQR 1–3). The most common symptoms at admission included cough (68%) and fever (66%) [Figure 3]. At discharge, most women (70%; n=1865) were still pregnant while 28% (n=758) were no longer pregnant and 2% (n=44) had unknown pregnancy status. Among women who were no longer pregnant at discharge, 96% (n=726) had pregnancies resulting in live births, 3% (n=25) had pregnancies resulting in loss of the fetus or neonate, and 1.0% (n=7) had unknown birth outcome. Figure 1. Vaccination coverage among pregnant women hospitalized with laboratory-confirmed influenza by season and by age group, FluSurv-NET 2010–2019 Figure 2. Antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza by season and by age group, FluSurv-NET 2010–2019 Figure 3. Symptoms at admission among pregnant women hospitalized with laboratory-confirmed influenza by age group, FluSurv-NET 2010–2019 Conclusion Over 9 influenza seasons, nearly one-third of women aged 15–44 years and hospitalized with influenza were pregnant. Severe maternal and fetal outcomes were rare. While most women received antivirals, fewer than one-third received current season influenza vaccine. Disclosures Sue Kim, MPH, Council of State and Territorial Epidemiologists (CSTE) (Grant/Research Support) Melissa Sutton, MD, MPH, CDC funding (Emerging Infections Program) (Grant/Research Support)

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154. Circulation of Rhinovirus/Enterovirus Respiratory Infections in Children During 2020-21 in the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.154 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S93-S93

Author(s):

Danielle A Rankin ◽

Andrew Speaker ◽

Ariana Perez ◽

Zaid Haddadin ◽

Varvara Probst ◽

...

Keyword(s):

United States ◽

Panel Member ◽

Respiratory Viruses ◽

Research Support ◽

Review Panel ◽

Surveillance Network ◽

Material Support ◽

Percent Positivity ◽

Vaccine Surveillance ◽

Research Grant

Abstract Background Sharp declines in influenza and respiratory syncytial virus (RSV) circulation across the U.S. have been described during the pandemic in temporal association with community mitigation for control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine relative frequencies of rhinovirus/enterovirus (RV/EV) and other respiratory viruses in children presenting to emergency departments or hospitalized with acute respiratory illness (ARI) prior to and during the COVID-19 pandemic. Methods We conducted a multi-center active prospective ARI surveillance study in children as part of the New Vaccine Surveillance Network (NVSN) from December 2016 through January 2021. Molecular testing for RV/EV, RSV, influenza, and other respiratory viruses [i.e., human metapneumovirus, parainfluenza virus (Types 1-4), and adenovirus] were performed on specimens collected from children enrolled children. Cumulative percent positivity of each virus type during March 2020–January 2021 was compared from March-January in the prior seasons (2017-2018, 2018-2019, 2019-2020) using Pearson’s chi-squared. Data are provisional. Results Among 69,403 eligible children, 37,676 (54%) were enrolled and tested for respiratory viruses. The number of both eligible and enrolled children declined in early 2020 (Figure 1), but 4,691 children (52% of eligible) were enrolled and tested during March 2020-January 2021. From March 2020-January 2021, the overall percentage of enrolled children with respiratory testing who had detectable RV/EV was similar compared to the same time period in 2017-2018 and 2019-2020 (Figure 1, Table 1). In contrast, the percent positivity of RSV, influenza, and other respiratory viruses combined declined compared to prior years, (p< 0.001, Figure 1, Table 1). Figure 1. Percentage of Viral Detection Among Enrolled Children Who Received Respiratory Testing, New Vaccine Surveillance Network (NVSN), United States, December 2016 – January 2021 Table 1. Percent of Respiratory Viruses Circulating in March 2020– January 2021, compared to March-January in Prior Years, New Vaccine Surveillance Network (NVSN), United States, March 2017 – January 2021 Conclusion During 2020, RV/EV continued to circulate among children receiving care for ARI despite abrupt declines in other respiratory viruses within this population. These findings warrant further studies to understand virologic, behavioral, biological, and/or environmental factors associated with this continued RV/EV circulation. Disclosures Jennifer E. Schuster, MD, Merck, Sharpe, and Dohme (Individual(s) Involved: Self): Grant/Research Support Marian G. Michaels, MD, MPH, Viracor (Grant/Research Support, performs assay for research study no financial support) John V. Williams, MD, GlaxoSmithKline (Advisor or Review Panel member, Independent Data Monitoring Committee)Quidel (Advisor or Review Panel member, Scientific Advisory Board) Elizabeth P. Schlaudecker, MD, MPH, Pfizer (Grant/Research Support)Sanofi Pasteur (Advisor or Review Panel member) Christopher J. Harrison, MD, GSK (Grant/Research Support)Merck (Grant/Research Support)Pfizer (Grant/Research Support, Scientific Research Study Investigator, Research Grant or Support) Janet A. Englund, MD, AstraZeneca (Consultant, Grant/Research Support)GlaxoSmithKline (Research Grant or Support)Meissa Vaccines (Consultant)Pfizer (Research Grant or Support)Sanofi Pasteur (Consultant)Teva Pharmaceuticals (Consultant) Claire Midgley, PhD, Nothing to disclose Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Quidel (Grant/Research Support, Other Financial or Material Support, Donation of supplies/kits)Sanofi (Grant/Research Support, Other Financial or Material Support, HAI/NAI testing) Natasha B. Halasa, MD, MPH, Genentech (Individual(s) Involved: Self): I receive an honorarium for lectures - it’s a education grant, supported by genetech, Other Financial or Material Support, Other Financial or Material Support; Sanofi (Individual(s) Involved: Self): Grant/Research Support, Research Grant or Support

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2738. Influenza Vaccination During Pregnancy Among Mothers of Infants with Acute Respiratory Illness, United States, 2016–2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2416 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S963-S964

Author(s):

Constance E Ogokeh ◽

Manish Patel ◽

Joana Y Lively ◽

Mary A Staat ◽

Geoffrey A Weinberg ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Pregnant Women ◽

Influenza Season ◽

Respiratory Illness ◽

Vaccine Safety ◽

Acute Respiratory Illness ◽

Surveillance Network ◽

Vaccination History ◽

Maternal Influenza

Abstract Background Influenza vaccination has been shown to reduce influenza risk in pregnant women and their infants who are not yet age-eligible for vaccine. Ascertainment of vaccination history is important for vaccine safety and effectiveness evaluations. Our goals were to (a) determine coverage, location, and timing of maternal influenza vaccination and (b) compare a subset of self-reported influenza vaccinations with documented vaccine records. Methods We enrolled children < 18 years. with acute respiratory illness in 7 pediatric hospitals and emergency departments in the New Vaccine Surveillance Network from December 1, 2016 to October 31, 2018. We interviewed all mothers of enrolled infants < 1 year, and obtained mother’s influenza vaccine information while pregnant. As an option, sites obtained maternal influenza vaccine records from reported sources (e.g., registries, provider records, pharmacies). Results Among 5,458 mothers, 2,944 (54%) self-reported receiving influenza vaccine during pregnancy (57% in 2016–2017; 51% in 2017–2018), varying from 49% to 74% by site. Among self-reported vaccinees, 17%, 36%, and 47% received vaccine during their first, second, and third trimester, respectively. Most women (76%) were vaccinated at their OB/GYN or midwife office, 7% at their primary care provider, 7% at their workplace, and 5% at a retail pharmacy. Among 1,338 infants < 6 months. during early influenza season (i.e., born from June to August) and thus ineligible for vaccination, only 46% of mothers reported receiving vaccine during pregnancy (42% reported not receiving it, 12% were unsure). Of 2,242 women for whom vaccine verification was attempted, 1,491 (67%) self-reported receiving influenza vaccine during pregnancy; of those, documentation of vaccine receipt was found for 901 (60%). Conclusion Influenza vaccination coverage among pregnant women was suboptimal, potentially increasing the risk of influenza in unvaccinated pregnant women. Infants born to unvaccinated women, particularly those born from June to August, may also be at higher risk since they are not age-eligible to receive vaccine before influenza season. The optimal approach to ascertainment of maternal vaccination history with accuracy and completeness merits further investigation. Disclosures All authors: No reported disclosures.

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Frailty Hinders Recovery From Influenza and Acute Respiratory Illness in Older Adults

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa092 ◽

2020 ◽

Vol 222 (3) ◽

pp. 428-437 ◽

Cited By ~ 3

Author(s):

Caitlin Lees ◽

Judith Godin ◽

Janet E McElhaney ◽

Shelly A McNeil ◽

Mark Loeb ◽

...

Keyword(s):

Older Adults ◽

Adverse Outcome ◽

Frailty Index ◽

Respiratory Illness ◽

Acute Illness ◽

Vaccination Status ◽

Acute Respiratory Illness ◽

Surveillance Network ◽

Lower Odds ◽

Poor Recovery

Abstract Background We examined frailty as a predictor of recovery in older adults hospitalized with influenza and acute respiratory illness. Methods A total of 5011 patients aged ≥65 years were admitted to Canadian Serious Outcomes Surveillance Network hospitals during the 2011/2012, 2012/2013, and 2013/2014 influenza seasons. Frailty was measured using a previously validated frailty index (FI). Poor recovery was defined as death by 30 days postdischarge or an increase of more than 0.06 (≥2 persistent new health deficits) on the FI. Multivariable logistic regression controlled for age, sex, season, influenza diagnosis, and influenza vaccination status. Results Mean age was 79.4 (standard deviation = 8.4) years; 53.1% were women. At baseline, 15.0% (n = 750) were nonfrail, 39.3% (n = 1971) were prefrail, 39.8% (n = 1995) were frail, and 5.9% (n = 295) were most frail. Poor recovery was experienced by 21.4%, 52.0% of whom had died. Frailty was associated with lower odds of recovery in all 3 seasons: 2011/2012 (odds ratio [OR] = 0.70; 95% confidence interval [CI], 0.59–0.84), 2012/2013 (OR = 0.72; 95% CI, 0.66–0.79), and 2013/2014 (OR = 0.75; 95% CI, 0.69–0.82); results varied by season, influenza status, vaccination status, and age. Conclusions Increasing frailty is associated with lower odds of recovery, and persistent worsening frailty is an important adverse outcome of acute illness.

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1511. Influenza antiviral use in patients hospitalized with laboratory-confirmed influenza in the United States, FluSurv-NET, 2015 – 2019

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1692 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S759-S759

Author(s):

Mark W Tenforde ◽

Charisse N Cummings ◽

Melissa Sutton ◽

Sue Kim ◽

Amber Maslar ◽

...

Keyword(s):

United States ◽

Symptom Onset ◽

Early Treatment ◽

Antiviral Treatment ◽

The United States ◽

Sampled Data ◽

Emerging Infections ◽

Research Support ◽

Surveillance Network ◽

Late Treatment

Abstract Background Antiviral therapy is recommended for all patients hospitalized with influenza to reduce morbidity and mortality. We used data from the population-based Influenza Hospitalization Surveillance Network (FluSurv-NET) to evaluate trends in influenza antiviral use in patients hospitalized with influenza over 4 seasons in the United States. Methods We included cases residing within the FluSurv-NET catchment area and hospitalized with laboratory-confirmed influenza from October 1 – April 30 during 2015-16 through 2018-19 seasons. For 2015-16 and 2016-17, chart abstraction of demographic and clinical characteristics and antiviral use was performed on all cases; for 2017-18 and 2018-19, all patients < 50-years and an age-stratified random sample of older adults were sampled. Data were weighted to reflect the probability of selection. We assessed the frequency of treatment, by season and age group, and evaluated trends by season using the Cochran-Armitage test. Among those receiving antivirals, we used multivariable logistic regression to assess the association between the days from symptom onset to admission and receipt of early (0-2 days from symptom onset) versus late (> 2 days) treatment, adjusting for age, sex, race/ethnicity, and underlying medical conditions. Results Over 4 seasons, we sampled 62,182 patients; 54% female and 63% non-Hispanic white. Overall, 92% of patients received antivirals, increasing from 86% in 2015-16 to 94% in 2018-19; use increased by season in all age strata (p < 0.001) [Figure]. Most received oseltamivir (99%); in 2018-19, 2% received baloxavir. Of those who received antivirals, 38% received early treatment. The median days from symptom onset to admission was 1 day (interquartile range [IQR] 1-3) for those who received early treatment and 4 days (IQR 3-6) for those who received late treatment. Ninety-three percent who received antivirals started within 1 day of admission. For each additional day from symptom onset to admission, the adjusted odds of late treatment was 8.56 (95% confidence interval: 7.83-9.35). Figure. Weighted percentage of hospitalized patients receiving influenza antivirals by influenza season and age strata, FluSurv-NET, 2015-16 through 2018-19. Conclusion In patients hospitalized with influenza, most received antiviral treatment within 1 day of admission. However, a majority had delays from symptoms onset to initiation, due to late presentation of illness. Disclosures Melissa Sutton, MD, MPH, CDC funding (Emerging Infections Program) (Grant/Research Support) Sue Kim, MPH, Council of State and Territorial Epidemiologists (CSTE) (Grant/Research Support) Nisha B. Alden, MPH, CDC (Grant/Research Support)

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751. Acute Respiratory Illness Hospitalizations Among Young Children: Multi-Center Viral Surveillance Network, United States, 2015–2016

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.758 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S270-S270

Author(s):

Brian Rha ◽

Angela P Campbell ◽

Darius McDaniel ◽

Rangaraj Selvarangan ◽

Natasha Halasa ◽

...

Keyword(s):

Young Children ◽

Viral Infections ◽

Respiratory Illness ◽

Supplemental Oxygen ◽

Case Definition ◽

Molecular Diagnostic ◽

Prevention Measures ◽

Research Support ◽

Surveillance Network ◽

Syncytial Virus

Abstract Background Viral infections are a significant cause of severe acute respiratory illnesses (ARI) in young children. Understanding the current epidemiology of these viruses is important for informing treatment and prevention measures. We describe the New Vaccine Surveillance Network (NVSN) and report preliminary results from 2015 to 2016. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children <5 years of age at seven pediatric hospital sites (figure) using a broad case definition based on admission diagnoses. Parent interviews and medical chart reviews were performed, and mid-turbinate nasal and throat flocked swabs and/or tracheal aspirates were tested for adenovirus, human metapneumovirus (HMPV), influenza, parainfluenza viruses (PIV) 1–3, respiratory syncytial virus (RSV), and rhinovirus/enterovirus using molecular diagnostic assays at each site. Asymptomatic controls <5 years of age were also enrolled. Results Among 2,974 hospitalized children with ARI whose specimens were tested for viruses, 2,228 (75%) were <2 years old, with 745 (25%) 0–2 months, and 309 (10%) 3–5 months old. The majority were male (58%; n = 1,732) and 63% (n = 1,093) had no documented comorbid conditions. The median length of stay was 2 days; 1,683 (57%) received supplemental oxygen, 435 (15%) were admitted to intensive care, 95 (3%) required mechanical ventilation, and 1 (<1%) died. Viruses were detected in 2,242 (75%) children with ARI, with >1 virus detected in 234 (8%). RSV was detected in 1,039 (35%) children with ARI, HMPV in 245 (8%), influenza in 104 (4%), and PIV-1, PIV-2, and PIV-3 in 49 (2%), 2 (<1%), and 78 (3%), respectively. Rhinovirus/enterovirus was detected in 849 (29%) and adenovirus in 118 (4%) children with ARI, but were also detected in 18% (n = 227) and 5% (n = 60), respectively, of the 1,243 controls tested; the other viruses were more rarely detected in controls. Conclusion During the 2015–2016 season, viral detections were common in young children hospitalized for ARI at seven US sites. NVSN combines clinical data with current molecular laboratory techniques to describe respiratory virus epidemiology in cases of hospitalized pediatric ARI in order to inform current and future prevention, treatment, and healthcare utilization measures. Disclosures N. Halasa, Sanofi Pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee. 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. J. V. Williams, Quidel: Board Member, Consulting fee. GlaxoSmithKline: Consultant, Consulting fee.

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