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

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.

scholarly journals 2639. Respiratory Virus Detections in Asthma-Related Pediatric Hospitalizations: New Vaccine Surveillance Network, United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S922-S923
Author(s):  
Claire Midgley ◽  
Brian Rha ◽  
Joana Y Lively ◽  
Angela P Campbell ◽  
Julie A Boom ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Virus ◽  
Treatment Strategies ◽  
Respiratory Illness ◽  
Airway Disease ◽  
Supplemental Oxygen ◽  
Surveillance Period ◽  
Surveillance Network ◽  
Day Range ◽  
Syncytial Virus

Abstract Background Respiratory viruses are associated with most asthma exacerbations (AEx) in children; however, the role of different viruses in AEx is unclear. We describe respiratory virus detections among pediatric inpatients with AEx (AEx-inpatients). Methods Through active, prospective surveillance at 7 US medical centers, we enrolled inpatients (<18 years) with acute respiratory illness (ARI) during November 1, 2015–June 30, 2016. We defined an AEx-inpatient as an inpatient with a principal admission or discharge diagnosis of asthma (ICD-10-CM, J45.xx). Mid-turbinate nasal and/or throat swabs were tested by molecular assays for influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus 1–3, rhinovirus or enterovirus (RV/EV), human metapneumovirus and adenovirus. We assessed virus detections among AEx-inpatients throughout the surveillance period or by season (winter: December–February; spring: March–May), and by patient age and history of asthma/reactive airway disease (asthma/RAD). Results We tested 3,897 inpatients with ARI; of whom, 954 were AEx-inpatients. Most AEx-inpatients (741/954 [78%]) reported an asthma/RAD history. Viruses were more frequently detected among AEx-inpatients <5 years (350/458 [76%]) than 5–17 years (305/496 [61%], P < 0.001). Most (615/655 [94%]) detections were of single viruses. The most frequent single virus detections were RV/EV (474/954 [50%]) and RSV (76/954 [8%]) but the frequency of each virus varied by season and age group (figure). Single RV/EVs were the most common virus detections in both seasons and all groups. Single RSV detections were prominent among <5 year olds in winter (40/185 [22%]). Among those with single RV/EV or RSV detections, 285/474 (60%) and 49/76 (64%) required supplemental oxygen, respectively (P = 0.676); median length of stay was 1 day (range: 0–45; IQR: 1–2) and 2 days (range: 0–6; IQR: 1–2.5), respectively (P < 0.001). Conclusion AEx-inpatients <5 years were more likely to have respiratory virus detections than those 5–17 years. Single RV/EVs formed the majority of virus detections throughout the surveillance period, regardless of age. RSV played a notable role in winter among patients <5 years. These findings could inform prevention or treatment strategies for virus-associated AEx. Disclosures All authors: No reported disclosures.

scholarly journals Clinical features of parainfluenza infections among young children hospitalized for acute respiratory illness in Amman, Jordan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leigh M. Howard ◽  
Danielle A. Rankin ◽  
Andrew J. Spieker ◽  
Wenying Gu ◽  
Zaid Haddadin ◽  
...  
Keyword(s):  
Young Children ◽  
Clinical Features ◽  
Pathogen Detection ◽  
Viral Infections ◽  
Respiratory Illness ◽  
Supplemental Oxygen ◽  
Admission Diagnosis ◽  
Acute Respiratory Illness ◽  
Significant Difference ◽  
Children In The Middle

Abstract Background Parainfluenza virus (PIV) is a leading cause of acute respiratory illness (ARI) in children. However, few studies have characterized the clinical features and outcomes associated with PIV infections among young children in the Middle East. Methods We conducted hospital-based surveillance for ARI among children < 2 years of age in a large referral hospital in Amman, Jordan. We systematically collected clinical data and respiratory specimens for pathogen detection using reverse transcription polymerase chain reaction. We compared clinical features of PIV-associated ARI among individual serotypes 1, 2, 3, and 4 and among PIV infections compared with other viral ARI and ARI with no virus detected. We also compared the odds of supplemental oxygen use using logistic regression. Results PIV was detected in 221/3168 (7.0%) children hospitalized with ARI. PIV-3 was the most commonly detected serotype (125/221; 57%). Individual clinical features of PIV infections varied little by individual serotype, although admission diagnosis of ‘croup’ was only associated with PIV-1 and PIV-2. Children with PIV-associated ARI had lower frequency of cough (71% vs 83%; p < 0.001) and wheezing (53% vs 60% p < 0.001) than children with ARI associated with other viruses. We did not find a significant difference in supplemental oxygen use between children with PIV-associated infections (adjusted odds ratio [aOR] 1.12, 95% CI 0.66–1.89, p = 0.68) and infections in which no virus was detected. Conclusions PIV is frequently associated with ARI requiring hospitalization in young Jordanian children. Substantial overlap in clinical features may preclude distinguishing PIV infections from other viral infections at presentation.

scholarly journals 720. Respiratory and Nonrespiratory Complications Among Patients Hospitalized with Influenza, FluSurv-NET, 2016–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S258-S259
Author(s):  
Shikha Garg ◽  
Charisse Nitura Cummings ◽  
Alissa O’Halloran ◽  
Pam Daily Kirley ◽  
Rachel Herlihy ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Chronic Renal Disease ◽  
Age Groups ◽  
Respiratory Complications ◽  
Research Support ◽  
Surveillance Network ◽  
Wide Range ◽  
History Of ◽  
Syncytial Virus ◽  
Research Grant

Abstract Background Influenza is most commonly associated with respiratory complications; however, nonrespiratory complications occur frequently among patients hospitalized with influenza. We used data from the Influenza Hospitalization Surveillance Network (FluSurv-NET) to describe complications recorded on discharge summaries of patients hospitalized with influenza. Methods We included children (0–17 years) and adults (≥18 years), who resided within a FluSurv-NET catchment area and were hospitalized with laboratory-confirmed influenza during 2016–2017. We abstracted data on underlying conditions and discharge diagnoses from medical charts. We calculated the frequency of respiratory and nonrespiratory complications in all age groups and used univariate and multivariable logistic regression to examine factors associated with select complications among adults. Results Among 17,489 patients, the most common respiratory complications were pneumonia (26%) and acute respiratory failure (23%) and the most common nonrespiratory complications were sepsis (16%) and acute renal failure (ARF) (12%). Complications varied by age group (figure). Pneumonia was the most common respiratory complication in all age groups except 0–4 years; among children aged 0–4 years bronchiolitis was most common (104/712; 15%). Among 97 children aged 0–4 years with bronchiolitis who underwent testing for respiratory syncytial virus (RSV), 37% had RSV. The most common nonrespiratory complication was seizures in children aged 0–17 years (17% had a history of prior seizures) and sepsis in adults. Among adults (n = 16,057), factors most strongly associated with ARF included chronic renal disease (adjusted odds ratio (AOR) 2.5; 95% confidence interval (95% CI) 2.2–2.8), male sex (AOR 1.5 95% CI 1.4–1.7) and age ≥65 years (AOR 1.4 95% CI 1.2–1.7); the factor most strongly associated with sepsis was chronic neuromuscular disease (AOR 1.5 95% CI 1.3–1.8). Conclusion Influenza hospitalizations are associated with a broad spectrum of complications including pneumonia, respiratory failure, sepsis, ARF and seizures. During the influenza season, astute clinicians should keep influenza in the differential diagnosis for patients with a wide range of presentations. :Disclosures. H. K. Talbot, sanofi pasteur: Investigator, Research grant. Gilead: Investigator, Research grant. MedImmune: Investigator, Research grant. Vaxinnate: Safety Board, none. Seqirus: Safety Board, none. E. J. Anderson, NovaVax: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. AbbVie: Consultant, Consulting fee. MedImmune: Investigator, Research support. PaxVax: Investigator, Research support. Micron: Investigator, Research support.

scholarly journals Lessons from 40 years' surveillance of influenza in England and Wales

2007 ◽  
Vol 136 (7) ◽  
pp. 866-875 ◽  
Author(s):  
D. M. FLEMING ◽  
A. J. ELLIOT
Keyword(s):  
Influenza Virus ◽  
General Practitioners ◽  
Hospital Admissions ◽  
Care Delivery ◽  
Influenza Virus Infection ◽  
Respiratory Illness ◽  
The Elderly ◽  
Surveillance Network ◽  
England And Wales ◽  
Syncytial Virus

SUMMARYThe influenza virus continues to pose a significant threat to public health throughout the world. Current avian influenza outbreaks in humans have heightened the need for improved surveillance and planning. Despite recent advances in the development of vaccines and antiviral drugs, seasonal epidemics of influenza continue to contribute significantly to general practitioner workloads, emergency hospital admissions, and deaths. In this paper we review data produced by the Royal College of General Practitioners Weekly Returns Service, a sentinel general practice surveillance network that has been in operation for over 40 years in England and Wales. We show a gradually decreasing trend in the incidence of respiratory illness associated with influenza virus infection (influenza-like illness; ILI) over the 40 years and speculate that there are limits to how far an existing virus can drift and yet produce substantial new epidemics. The burden of disease caused by influenza presented to general practitioners varies considerably by age in each winter. In the pandemic winter of 1969/70 persons of working age were most severely affected; in the serious influenza epidemic of 1989/90 children were particularly affected; in the millennium winter (in which the NHS was severely stretched) ILI was almost confined to adults, especially the elderly. Serious confounders from infections due to respiratory syncytial virus are discussed, especially in relation to assessing influenza vaccine effectiveness. Increasing pressure on hospitals during epidemic periods are shown and are attributed to changing patterns of health-care delivery.

scholarly journals 2328. Human Respiratory Syncytial Virus Subgroups among Hospitalized Infants in the United States, 2015–2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S799-S800
Author(s):  
Brian Rha ◽  
Teresa C T Peret ◽  
Lijuan Wang ◽  
Joana Y Lively ◽  
Aaron Curns ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Kansas City ◽  
Geographic Location ◽  
The United States ◽  
Prevention Measures ◽  
Chi Square ◽  
Surveillance Network ◽  
Respiratory Illnesses ◽  
Monthly Distribution ◽  
Syncytial Virus

Abstract Background Respiratory syncytial virus (RSV) is a major cause of severe acute respiratory illnesses (ARI) in young children. Circulation of RSV subgroups A and B can vary by season and geographic location, and may have implications for disease susceptibility, outcomes, and prevention measures. We investigated RSV subgroup distribution among samples collected in the New Vaccine Surveillance Network. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children < 12 months of age at seven pediatric hospital sites. Mid-turbinate nasal and throat flocked swabs (combined when both available) and/or tracheal aspirates were collected and tested for RSV at each site using real-time reverse transcription polymerase chain reaction (rRT–PCR) assays; RSV A/B subgroup results were available from four sites that did their own subgroup testing (Cincinnati, Kansas City, Houston, and Oakland). At three sites (Rochester, Nashville, Seattle), approximately 50 RSV-positive specimens were sampled based on the monthly distribution for each site and 1:1 distribution by gender, and then assayed for subgroup at CDC. Patient information was obtained from medical records; chi-square tests were used to compare the distribution of A and B subgroups by site. Results Of 704 RSV-positive hospitalized infants, subgroup data from 586 were analyzed; 340 (58%) were RSV A and 246 (42%) were RSV B. The median age for both RSV A and RSV B patients was 2 months. Subgroup distribution varied by geographic location, with the overall proportion of RSV A ranging from 18–83% across sites (P < 0.01). Peak RSV A and B detections by month varied by site, occurring from November–February (figure). Conclusion During the 2015–2016 season, RSV A and B subgroups co-circulated among hospitalized infants enrolled at seven US sites. The predominance of RSV subgroup varied by geographic location. Continued surveillance and additional subgroup testing over multiple seasons should improve understanding of the epidemiologic significance of RSV infections by subgroup. Disclosures All authors: No reported disclosures.

scholarly journals 92. Incidence of Respiratory Syncytial Virus Infection among Hospitalized Adults, 2017–2019

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S7-S8
Author(s):  
Angela Branche ◽  
Lisa Saiman ◽  
Edward E Walsh ◽  
Ann R Falsey ◽  
William Sieling ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Census Data ◽  
Vaccine Development ◽  
Respiratory Illness ◽  
Incidence Rates ◽  
Case Definition ◽  
Cardiopulmonary Disease ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Surveillance Area

Abstract Background Respiratory syncytial virus (RSV) infection has been increasingly recognized as an important cause of acute respiratory illness (ARI) and a trigger for exacerbation of underlying cardiopulmonary disease in adults. Incidence of hospitalized RSV infection remains uncertain as adults have not been systematically screened. Previous incidence estimates, derived primarily from modeling studies, have ranged from 84 to 190/100K population in adults >65 years of age. Accurate burden data are critical to inform RSV vaccine development for adults. We used active surveillance among hospitalized adults to determine population-based incidence rates of RSV infection. Methods Hospitalized adults ≥ 18 years old residing in the surveillance area with >2 ARI symptoms or exacerbation of underlying cardiopulmonary disease were screened for eligibility during October 2017–April 2018 and October 2018 to April 2019 in 3 hospitals in Rochester, NY and New York City. Respiratory specimens were tested for RSV using PCR assays. RSV incidence per 100,000 persons (per 2010 US Census data) was adjusted by percent market share for study hospitals in their catchment area. Results In total, 8,217 hospitalized adults residing in the surveillance area that met the surveillance case definition were tested for RSV; 768 (9.4%) were positive. Adults were aged 18–49 (12%), 50–64 (30%), and ≥65 years old (58%); 55% were female. RSV infection incidence varied from year 1 to year 2 and was highest in patients aged ≥65 years old (table). Conclusion This is the largest prospective RSV incidence study to date. Preliminary results indicate that the incidence of RSV infection may be higher than previously reported, especially in urban-dwelling adults >65 years of age. Results confirm the need for vaccines to prevent RSV infections in older adults. Disclosures All Authors: No reported Disclosures.

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 &lt;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 &lt;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 301. Detection of Pneumococcal Pneumonia During SARS-CoV-2 Infection

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S257-S257
Author(s):  
Anne Watkins ◽  
Devyn Yolda-Carr ◽  
Isabel M Ott ◽  
Maura Nakahata ◽  
Adam Moore ◽  
...  
Keyword(s):  
Pneumococcal Pneumonia ◽  
Viral Infections ◽  
Panel Member ◽  
Upper Respiratory Tract ◽  
Diagnostic Systems ◽  
Research Support ◽  
Review Panel ◽  
Syncytial Virus ◽  
The Relationship ◽  
Research Grant

Abstract Background Streptococcus pneumoniae (pneumococcus) is a common colonizer of the upper respiratory tract and can progress to cause invasive and mucosal disease. Additionally, infection with pneumococcus can complicate respiratory viral infections (influenza, respiratory syncytial virus, etc.) by exacerbating the initial disease. Limited data exist describing the potential relationship of SARS-CoV-2 infection with pneumococcus and the role of co-infection in influencing COVID-19 severity. Methods Inpatients and healthcare workers testing positive for SARS-CoV-2 during March-August 2020 were tested for pneumococcus through culture-enrichment of saliva followed by RT-qPCR (to identify carriage) and for inpatients only, serotype-specific urine antigen detection (UAD) assays (to identify pneumococcal pneumonia). A multinomial multivariate regression model was used to examine the relationship between pneumococcal detection and COVID-19 severity. Results Among the 126 subjects who tested positive for SARS-CoV-2, the median age was 62 years; 54.9% of subjects were male; 88.89% were inpatients; 23.5% had an ICU stay; and 13.5% died. Pneumococcus was detected in 17 subjects (13.5%) by any method, including 5 subjects (4.0%) by RT-qPCR and 12 subjects (13.6%) by UAD. Little to no bacterial growth was observed on 21/235 culture plates. Detection by UAD was associated with both moderate and severe COVID-19 disease while RT-qPCR detection in saliva was not associated with severity. None of the 12 individuals who were UAD-positive died. Conclusion Pneumococcal pneumonia (as determined by UAD) continues to occur during the ongoing pandemic and may be associated with more serious COVID-19 outcomes. Detection of pneumococcal carriage may be masked by high levels of antibiotic use. Future studies should better characterize the relationship between pneumococcus and SARS-CoV-2 across all disease severity levels. Disclosures Akiko Iwasaki, PhD, 4Bio (Consultant, Advisor or Review Panel member)Adaptive Biotechnologies (Consultant, Advisor or Review Panel member)Blavatnik (Grant/Research Support)HHMI (Grant/Research Support)Mathers (Grant/Research Support)NIH (Grant/Research Support)Spring Discovery (Grant/Research Support)Spring Discovery (Consultant, Advisor or Review Panel member)Vedanta InProTher (Consultant, Advisor or Review Panel member)Yale School of Medicine (Grant/Research Support) Nathan D. Grubaugh, PhD, Tempus Labs (Consultant) Ronika Alexander-Parrish, RN, MAEd, Pfizer (Employee, Shareholder) Adriano Arguedas, MD, Pfizer (Employee) Bradford D. Gessner, MD, MPH, Pfizer Inc. (Employee) Daniel Weinberger, PhD, Affinivax (Consultant)Merck (Consultant, Grant/Research Support)Pfizer (Consultant, Grant/Research Support) Anne Wyllie, PhD, Global Diagnostic Systems (Consultant)Pfizer (Advisor or Review Panel member, Research Grant or Support)PPS Health (Consultant)Tempus Labs, Inc (Research Grant or Support)

scholarly journals Clinical and Virological Characteristics of Acute Sinusitis in Children

2019 ◽  
Vol 69 (10) ◽  
pp. 1764-1770 ◽  
Author(s):  
Gregory P DeMuri ◽  
Jens C Eickhoff ◽  
James C Gern ◽  
Ellen R Wald
Keyword(s):  
Pathogenic Bacteria ◽  
Viral Infections ◽  
Diagnostic Testing ◽  
Median Number ◽  
Acute Sinusitis ◽  
Molecular Diagnostic ◽  
Upper Respiratory Infection ◽  
Acute Bacterial Sinusitis ◽  
Upper Respiratory ◽  
Syncytial Virus

Abstract Background Acute bacterial sinusitis is a frequent complication of viral upper respiratory infection (URI). We describe the clinical and virologic features of URIs that remain uncomplicated and those that precede an episode of sinusitis. We hypothesize that certain viruses are more likely to lead to acute sinusitis, and we compare viruses identified at the time of diagnosis of sinusitis with those identified early in the URI. Methods Children aged 48–96 months were followed longitudinally for 1 year. Nasal samples were obtained at surveillance visits, on Day 3–4 of the URI, and on Day 10, when sinusitis was diagnosed. Molecular diagnostic testing was performed on nasal washes for common respiratory viruses and pathogenic bacteria. A standardized score was used to quantify symptom severity. Results We evaluated 519 URIs, and 37 illnesses in 31 patients met the criteria for sinusitis. Respiratory syncytial virus was detected more frequently in URI visits that led to sinusitis, compared to in uncomplicated URIs (10.8% vs 3.4%; P = .05). New viruses were detected in 29% of sinusitis episodes, and their pattern was different than those patterns observed at surveillance. The median number of URIs per subject per year was 1 (range 0–9) in uncomplicated URI subjects and 3 (range 1–9) in sinusitis subjects (P < .001). Conclusions Children who developed sinusitis experienced more frequent URIs, compared to children whose URIs remained uncomplicated. When nasal samples were obtained on the day of diagnosis of acute sinusitis, nearly 30% of children had a new virus identified, suggesting that some children deemed to have sinusitis were experiencing sequential viral infections.

scholarly journals RSV: perspectives to strengthen the need for protection in all infants

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jose Antonio Navarro Alonso ◽  
Louis J. Bont ◽  
Elena Bozzola ◽  
Egbert Herting ◽  
Federico Lega ◽  
...  
Keyword(s):  
Young Children ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Implementation Strategies ◽  
Respiratory Illness ◽  
Health Decision ◽  
Care Systems ◽  
Syncytial Virus ◽  
Multi Stakeholder ◽  
First Year Of Life

AbstractRespiratory syncytial virus (RSV)—the most common viral cause of bronchiolitis—is a significant cause of serious illness among young children between the ages of 0–5 years and is especially concerning in the first year of life. Globally, RSV is a common cause of childhood acute lower respiratory illness (ALRI) and a major cause of hospital admissions in young children and infants and represents a substantial burden for health-care systems. This burden is strongly felt as there are currently no effective preventative options that are available for all infants. However, a renaissance in RSV prevention strategies is unfolding, with several new prophylactic options such as monoclonal antibodies and maternal vaccinations that are soon to be available. A key concern is that health decision makers and systems may not be ready to take full advantage of forthcoming technological innovations. A multi-stakeholder approach is necessary to bridge data gaps to fully utilise upcoming options. Knowledge must be made available at multiple levels to ensure that parents and doctors are aware of preventative options, but also to ensure that stakeholders and policymakers are given the necessary information to best advise implementation strategies.

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