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

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.

Download Full-text

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1524 ◽

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

Download Full-text

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

Infection Control and Hospital Epidemiology ◽

10.1086/655990 ◽

2010 ◽

Vol 31 (S1) ◽

pp. S22-S26 ◽

Cited By ~ 6

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.

Download Full-text

Human Coronavirus-HKU1 Infection Among Adults in Cleveland, Ohio

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx052 ◽

2017 ◽

Vol 4 (2) ◽

Cited By ~ 12

Author(s):

Anubhav Kanwar ◽

Suresh Selvaraju ◽

Frank Esper

Keyword(s):

Respiratory Tract ◽

Influenza A ◽

Respiratory Symptoms ◽

Respiratory Infections ◽

Laboratory Data ◽

Gastrointestinal Symptoms ◽

The United States ◽

Supplemental Oxygen ◽

Respiratory Pathogen ◽

Disease Spectrum

Abstract Background Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. Methods Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive. Results Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A. Conclusions Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.

Download Full-text

Contribution of Viral Respiratory Infections to Dengue-Like Illness Presentation at a Community Clinic in Southern Malaysia

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0648 ◽

2021 ◽

Author(s):

Amreeta Dhanoa ◽

Chin Fang Ngim ◽

Nor’azim Mohd Yunos ◽

Syed M. Tupur Husain ◽

Lian Yih Pong ◽

...

Keyword(s):

Odds Ratio ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Multiple Logistic Regression ◽

Chain Reaction ◽

Community Clinic ◽

History Of ◽

Polymerase Chain ◽

Viral Respiratory Infections ◽

Viral Respiratory

This study explored the contribution of viral respiratory infections (VRIs) in dengue-like illness (DLI) patients and their distinguishing clinicolaboratory parameters. Two hundred DLI patients were prospectively recruited (1 July–1 October 2019) from a community clinic in Southern Malaysia. Patients ≥18 years with acute fever and fulfilling the WHO criteria of probable dengue were recruited. They underwent blood testing: blood counts, rapid dengue tests (nonstructural antigen-1/IgM) and polymerase chain reaction (PCR) for dengue, Zika, chikungunya, and Leptospira. Nasopharyngeal swabs (NPSs) were collected for FilmArray®RP2plus testing. From the 200 NPSs, 58 respiratory viruses (RVs) were detected in 54 patients. Of the 96 dengue-confirmed cases, 86 had dengue mono-infection, and 10 were coinfected with RVs. Of the 104 nondengue, 44 were RV positive and 4 Leptospira positive. Zika and chikungunya virus were not detected. Overall, the etiological diagnosis was confirmed for 72% of patients. Clinicolaboratory parameters were compared between dengue mono-infection and VRI mono-infection. Patients with coinfections were excluded. Multiple logistic regression showed that recent household/neighborhood history of dengue (adjusted odds ratio [aOR]: 5.9, 95% CI = 1.7–20.7), leukopenia (aOR: 12.5, 95% CI = 2.6–61.4) and thrombocytopenia (aOR: 5.5, 95% CI = 1.3–23.0) predicted dengue. Inversely, rhinorrhoea (aOR: 0.1, 95% CI = 0.01–0.3) and cough (aOR: 0.3, 95% CI = 0.1–0.9) favored VRI. Thus, VRIs comprise many infections diagnosed initially as DLIs. Early clinicolaboratory parameters can guide physicians screen patients for further testing.

Download Full-text

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

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e31825f29db ◽

2012 ◽

Vol 31 (11) ◽

pp. 1107-1112 ◽

Cited By ~ 8

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

Download Full-text

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

Epidemiology and Infection ◽

10.1017/s0950268816000339 ◽

2016 ◽

Vol 144 (10) ◽

pp. 2064-2076 ◽

Cited By ~ 18

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.

Download Full-text

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

Epidemiology and Infection ◽

10.1017/s0950268816002181 ◽

2016 ◽

Vol 145 (1) ◽

pp. 148-155 ◽

Cited By ~ 10

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.

Download Full-text

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

Epidemiology and Infection ◽

10.1017/s0950268818000286 ◽

2018 ◽

Vol 146 (5) ◽

pp. 619-626 ◽

Cited By ~ 8

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.

Download Full-text

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

Pathogens ◽

10.3390/pathogens9020099 ◽

2020 ◽

Vol 9 (2) ◽

pp. 99 ◽

Cited By ~ 2

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.

Download Full-text