scholarly journals Comparison of the Demographics, Clinical Presentations, Seasonality, and Outcome between Adult Patients with Influenza A and B in Two Seasons (2014-2015 and 2015-2016) with Emphasis on H1N1 Infection Outcome

2019 ◽  
Vol 11 (1) ◽  
pp. 43-51
Author(s):  
Abdalla Khalil ◽  
Ahmed Elhadry ◽  
Mohamed Talo ◽  
Mohamed Elwakeel ◽  
Tamer Ahmed ◽  
...  
Keyword(s):  
Influenza A ◽  
Nasal Swab ◽  
Hospital Admissions ◽  
Adult Patients ◽  
Influenza B ◽  
Childbearing Age ◽  
Total Hospital ◽  
Medical Unit ◽  
Clinical Presentations ◽  
Significant Difference

Background: Studies comparing Influenza A and B in our community are extremely limited. Methods: Adult patients (n=1708) with ILI who visited the outpatient clinics or emergency department with FIA-positive nasal swab in two seasons were included in the analysis. Data on demographics, clinical presentation, comorbidities, and prolonged illness (revisit after 48 hours with same presentation and no admission), hospital admissions, death, and LOS were collected. Data on patients tested for H1N1 (309) by Cepheid Xpert Flu Assay (H1N1 positive, 143 [46%]; H1N1 negative, 166 [54%]) were also collected. Results: Prolonged illness was more frequent in patients with influenza B than those with influenza A (15.21% and 10.18%, respectively; P=0.002). There was no significant difference in frequency of total admissions, medical unit or intensive care unit admissions, LOS, and death between patients with influenza A and B. Total admissions were more frequent in H1N1-positive patients than H1N1-negative patients (23.1% and 13.3%, respectively; P=0.024). Prolonged illness was more frequent in H1N1-positive patients (23.1%) than H1N1-negative patients (4.8%) (P < 0.001). There was no statistically significant difference in admission to the medical unit or ICU, death, and LOS between H1N1-positive and H1N1-negative patients. The peak months of influenza A were December in the first season and October in the second season. April was the peak month of influenza B in both seasons. There was no statistically significant difference in the outcome of pregnant patients with influenza (either A or B) compared to non-pregnant women with influenza within the same childbearing age (maternal outcome was not studied). Conclusion: Prolonged illness was more frequent in flu B than in flu A patients. Patients with positive H1N1 had more frequent prolonged illness, and total hospital admissions than those with H1N1-negative patients. There was a different peak month(s) of patients with flu A compared to flu B.

scholarly journals Epidemiological characteristics of four common respiratory viral infections in children

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Guohong Zhu ◽  
Dan Xu ◽  
Yuanyuan Zhang ◽  
Tianlin Wang ◽  
Lingyan Zhang ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Influenza A ◽  
Multiple Infection ◽  
Influenza B ◽  
Preschool Period ◽  
Significant Difference ◽  
Different Seasons ◽  
Tract Infections ◽  
Epidemiological Characteristics

Abstract Background Viruses are the main infectious agents of acute respiratory infections in children. We aim to describe the epidemiological characteristics of viral pathogens of acute respiratory tract infections in outpatient children. Methods From April 2018 to March 2019, the results of viral detection using oral pharyngeal swabs from 103,210 children with acute respiratory tract infection in the outpatient department of the Children’s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV), were detected by the colloidal gold method. Results At least one virus was detected in 38,355 cases; the positivity rate was 37.2%. A total of 1910 cases of mixed infection with two or more viruses were detected, and the positivity rate of multiple infection was 1.9%. The ADV positivity rate was highest in the 3–6-year-old group (18.7%), the FLUA positivity rate was highest in the > 6-year-old group (21.6%), the FLUB positivity rate was highest in the > 6-year-old group (6.6%), and the RSV positivity rate was highest in the < 1-year-old group (10.6%). There was a significant difference in the positivity rate of viral infection among different age groups (χ2 = 1280.7, P < 0.001). The rate of positive viral infection was highest in winter (47.1%). The ADV infection rate was highest in spring (18.2%). The rates of FLUA and FLUB positivity were highest in winter (28.8% and 3.6%, respectively). The rate of RSV positivity was highest in autumn (17.4%). The rate of positive viral infection in different seasons was significantly different (χ2 = 6459.1, P < 0.001). Conclusions Viral infection rates in children differ for different ages and seasons. The positivity rate of ADV is highest in the preschool period and that of RSV is highest in infants; that of FLU increases with age. The total positive rate of viral infection in different seasons is highest in winter, as is the rate of FLU positivity.

scholarly journals Community-acquired bacteraemia in COVID-19 in comparison to influenza A and influenza B: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julinha M. Thelen ◽  
A. G. ( Noud) Buenen ◽  
Marjan van Apeldoorn ◽  
Heiman F. Wertheim ◽  
Mirjam H. A. Hermans ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Culture ◽  
The Netherlands ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Influenza A ◽  
Blood Cultures ◽  
Influenza B ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Background During the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands it was noticed that very few blood cultures from COVID-19 patients turned positive with clinically relevant bacteria. This was particularly evident in comparison to the number of positive blood cultures during previous seasonal epidemics of influenza. This observation raised questions about the occurrence and causative microorganisms of bacteraemia in COVID-19 patients, especially in the perspective of the widely reported overuse of antibiotics and the rising rate of antibiotic resistance. Methods We conducted a retrospective cohort study on blood culture results in influenza A, influenza B and COVID-19 patients presenting to two hospitals in the Netherlands. Our main outcome consisted of the percentage of positive blood cultures. The percentage of clinically relevant blood cultures, isolated bacteria and 30-day all-cause mortality served as our secondary outcomes. Results A total of 1331 viral episodes were analysed in 1324 patients. There was no statistically significant difference (p = 0.47) in overall occurrence of blood culture positivity in COVID-19 patients (9.0, 95% CI 6.8–11.1) in comparison to influenza A (11.4, 95% CI 7.9–14.8) and influenza B patients (10.4, 95% CI 7.1–13.7,). After correcting for the high rate of contamination, the occurrence of clinically relevant bacteraemia in COVID-19 patients amounted to 1.0% (95% CI 0.3–1.8), which was statistically significantly lower (p = 0.04) compared to influenza A patients (4.0, 95% CI 1.9–6.1) and influenza B patients (3.0, 95% CI 1.2–4.9). The most frequently identified bacterial isolates in COVID-19 patients were Escherichia coli (n = 2) and Streptococcus pneumoniae (n = 2). The overall 30-day all-cause mortality for COVID-19 patients was 28.3% (95% CI 24.9–31.7), which was statistically significantly higher (p = <.001) when compared to patients with influenza A (7.1, 95% CI 4.3–9.9) and patients with influenza B (6.4, 95% CI 3.8–9.1). Conclusions We report a very low occurrence of community-acquired bacteraemia amongst COVID-19 patients in comparison to influenza patients. These results reinforce current clinical guidelines on antibiotic management in COVID-19, which only advise utilization of antibiotics when a bacterial co-infection is suspected.

Prevalence and predictors of coronary artery disease in adults with Kawasaki disease

2014 ◽  
Vol 25 (6) ◽  
pp. 1124-1129 ◽  
Author(s):  
Jalaj Garg ◽  
Parasuram Krishnamoorthy ◽  
Chandrasekar Palaniswamy ◽  
Rajiv Paudel ◽  
Saurav Chatterjee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Hospital Admissions ◽  
Artery Aneurysm ◽  
Adult Patients ◽  
Significant Difference ◽  
Traditional Risk Factors ◽  
Artery Disease

AbstractBackground: Accelerated coronary atherosclerosis in patients with Kawasaki disease, in conjunction with coronary artery aneurysm and stenosis that characterise this disease, are potential risk factors for developing coronary artery disease in young adults. We aimed to determine the prevalence and predictors of coronary artery disease in adult patients with Kawasaki disease. Methods: All patients aged 18−55 years of age diagnosed with Kawasaki disease were sampled from Nationwide Inpatient Sample database using International Classification of Diseases 9th revision (ICD 9 code 446.1) from 2009 to 2010. Demographics, prevalence of coronary artery disease, and other traditional risk factors in adult patients with Kawasaki disease were analysed using ICD 9 codes. Results: The prevalence of Kawasaki disease among adults was 0.0005% (n=215) of all in-hospital admissions in United States. The mean age was 27.3 years with women (27.6 years) older than men (27.1 years). Traditional risk factors were hypertension (21%), hyperlipidaemia (15.6%), diabetes (11.5%), tobacco use (8.8%), and obesity (8.8%), with no significant difference between men and women. Coronary artery disease (32.4%), however, was more prevalent in men (44.7%) than in women (12.1%; p=0.03). In multivariate regression analysis, after adjusting for demographics and traditional risk factors, hypertension (OR=13.2, p=0.03) was an independent risk factor of coronary artery disease. Conclusion: There was increased preponderance of coronary artery disease in men with Kawasaki disease. On multivariate analysis, hypertension was found to be the only independent predictor of coronary artery disease in this population after adjusting for other risk factors.

scholarly journals Surveillance of Respiratory Viruses in Long Term Care Facilities

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Mary Checivich ◽  
Shari Barlow ◽  
Peter Shult ◽  
Erik Residorf ◽  
Jonathan L. Temte
Keyword(s):  
Influenza A ◽  
Nasal Swab ◽  
Long Term Care ◽  
Respiratory Infections ◽  
Respiratory Viruses ◽  
Influenza B ◽  
Rt Pcr ◽  
Term Care ◽  
Care Facilities

ObjectiveTo assess the feasibility of conducting respiratory virus surveillance for residents of long term care facilities (LTCF) using simple nasal swab specimens and to describe the virology of acute respiratory infections (ARI) in LCTFs.IntroductionAlthough residents of LTCFs have high morbidity and mortality associated with ARIs, there is very limited information on the virology of ARI in LTCFs.[1,2] Moreover, most virological testing of LCTF residents is reactive and is triggered by a resident meeting selected surveillance criteria. We report on incidental findings from a prospective trial of introducing rapid influenza diagnostic testing (RIDT) in ten Wisconsin LTCFs over a two-year period with an approach of testing any resident with ARI.MethodsAny resident with new onset of respiratory symptoms consistent with ARI had a nasal swab specimen collected for RIDT by nursing staff. Following processing for RIDT (Quidel Sofia Influenza A+B FIA), the residual swab was placed into viral transport medium and forwarded to the Wisconsin State Laboratory of Hygiene and tested for influenza using RT-PCR (IVD CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel), and for 17 viruses (Luminex NxTAG Respiratory Pathogen Panel [RPP]). The numbers of viruses in each of 7 categories [influenza A (FluA ), influenza B (FluB), coronaviruses (COR), human metapneumovirus (hMPV), parainfluenza (PARA), respiratory syncytial virus (RSV) and rhinovirus/enterovirus (R/E)], across the two years were compared using chi-square.ResultsTotals of 164 and 190 specimens were submitted during 2016-2017 and 2017-2018, respectively. RPP identified viruses in 56.2% of specimens, with no difference in capture rate between years (55.5% vs. 56.8%). Influenza A (21.5%), influenza B (16.5%), RSV (19.0%) and hMPV (16.5%) accounted for 73.5% of all detections, while coronaviruses (15.5%), rhino/enteroviruses (8.5%) and parainfluenza (2.5%) were less common. Specific distribution of viruses varied significantly across the two years (Table: X2=48.1, df=6; p<0.001).ConclusionsSurveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields virus identification rates similar to those obtained in clinical surveillance of ARI with collection of nasopharyngeal specimens by clinicians and those obtained in a school-based surveillance project of ARI with collection of combined nasal and oropharyngeal specimens collected by trained research assistants. Significant differences in virus composition occurred across the two study years. RSV varied little between years while hMPV demonstrated wide variation. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.References(1) Uršič T, Gorišek Miksić N, Lusa L, Strle F, Petrovec M. Viral respiratory infections in a nursing home: a six-month prospective study. BMC Infect Dis. 2016; 16: 637. Published online 2016 Nov 4. doi: 10.1186/s12879-016-1962-8(2) Masse S, Capai L, Falchi A. Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017. Biomed Res Int. 2017; 2017: 1423718. Published online 2017 Dec 17. doi: 10.1155/2017/1423718

scholarly journals Concurrent outbreaks of influenza A and influenza B

1985 ◽  
Vol 94 (3) ◽  
pp. 331-339 ◽  
Author(s):  
D. W. Spelman ◽  
C. J. McHardy
Keyword(s):  
Young Adults ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Clinical Features ◽  
Older Patients ◽  
Lower Respiratory Tract ◽  
Influenza A ◽  
Clinical Syndrome ◽  
Influenza B ◽  
Significant Difference

SUMMARYDuring the winter of 1982 concurrent outbreaks of influenza A and influenza B occurred. The epidemiology and clinical features of 151 cases referred during this time are described, and patients are discussed according to age and presenting clinical syndrome: croup was the commonest presentation in young children, a typical influenza syndrome predominated in young adults, while older patients were more likely to have lower respiratory tract infection. There was no significant difference between the clinical features of influenza A and influenza B. Unusual clinical features include rash, exudative tonsillitis and the need for myringotomy during the course of influenza.

scholarly journals Arrhythmias in Children with Normal Heart in Albaha, Saudi Arabia

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Abdulmajid Almawazini ◽  
◽  
Saleh Jamaan Al Ghamdi ◽  
Chafik Ibrahim Hassan ◽  
Sami Ahmed Taha ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Hospital Admissions ◽  
Cross Sectional Study ◽  
Supraventricular Arrhythmias ◽  
Normal Heart ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Clinical Presentations ◽  
Significant Difference ◽  
The Common

Introduction: Arrhythmias in children with structurally normal hearts are common and reported as the causes of many hospital admissions. Generally, the risk of death is low. Physical examination is important in children with arrhythmias. Objectives: This study aimed to review the common types and clinical presentations of arrhythmias in children with normal heart structures in Albaha, Saudi Arabia. Methodology: In this hospital-based retrospective cross-sectional study, the medical records of children were reviewed from January 2010 to December 2020. Results: Overall, 214 children were included in this study. The prevalence of arrhythmias was 27.10% in children aged 5-8 years; 18.7%, 8-12 years; 16.82%, 3-5 years; 16.35%, 1-3 years; 13.55%, 12-14 years; and 7.48%, <1 year. Arrhythmias were more frequent in females aged <5 years and in males aged >5 years; however, overall, there was no significant difference between females (47.20%) and males (52.80%). Supraventricular arrhythmias were the commonest and found in 85% of the children and ventricular arrhythmias were found in 15%. Sinus tachycardia was the most common type of arrhythmia, reported in 25% of the children. Conclusion: In general, arrhythmias in the children are asymptomatic. History, clinical examination, and electrocardiography are important for the diagnosis. Supraventricular arrhythmias are the most common. There is no significant difference between females and males with respect to the prevalence of arrhythmias.

scholarly journals Arrhythmias in Children with Normal Heart in Albaha, Saudi Arabia

2021 ◽  
Author(s):  
Abdulmajid Almawazini ◽  
Saleh Jamaan Al Ghamdi ◽  
Chafik Ibrahim Hassan ◽  
Sami Ahmed Taha ◽  
Ramzi Ahmed Mohammed Alzahrani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Hospital Admissions ◽  
Cross Sectional Study ◽  
Supraventricular Arrhythmias ◽  
Normal Heart ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Clinical Presentations ◽  
Significant Difference ◽  
The Common

Arrhythmias in children with structurally normal hearts are common and reported as the causes of many hospital admissions. Generally, the risk of death is low. Physical examination is important in children with arrhythmias. Objectives: This study aimed to review the common types and clinical presentations of arrhythmias in children with normal heart structures in Albaha, Saudi Arabia. Methodology: In this hospital-based retrospective cross-sectional study, the medical records of children were reviewed from January 2010 to December 2020. Results: Overall, 214 children were included in this study. The prevalence of arrhythmias was 27.10% in children aged 5-8 years; 18.7%, 8-12 years; 16.82%, 3-5 years; 16.35%, 1-3 years; 13.55%, 12-14 years; and 7.48%, &lt;1 year. Arrhythmias were more frequent in females aged &lt;5 years and in males aged &gt;5 years; however, overall, there was no significant difference between females (47.20%) and males (52.80%). Supraventricular arrhythmias were the commonest and found in 85% of the children and ventricular arrhythmias were found in 15%. Sinus tachycardia was the most common type of arrhythmia, reported in 25% of the children. Conclusion: In general, arrhythmias in the children are asymptomatic. History, clinical examination, and electrocardiography are important for the diagnosis. Supraventricular arrhythmias are the most common. There is no significant difference between females and males with respect to the prevalence of arrhythmias.

scholarly journals Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study

2020 ◽  
Vol 13 ◽  
pp. 117863372090408
Author(s):  
Timothée Abaziou ◽  
Clément Delmas ◽  
Fanny Vardon Bounes ◽  
Fabien Bignon ◽  
Laure Crognier ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Influenza A ◽  
Clinical Presentation ◽  
Biological Data ◽  
Classification And Regression Tree ◽  
Influenza B ◽  
Mortality Model ◽  
Clinical Presentations ◽  
Influenza A H1n1

Background: Influenza causes significant morbidity and mortality in adults, and numerous patients require intensive care unit (ICU) admission. Acute respiratory distress syndrome (ARDS) is clearly described in this context, but other clinical presentations exist that need to be assessed for incidence and outcome. The primary goal of this study was to describe the characteristics of patients admitted in ICU for influenza, their clinical presentation, and the 3-month mortality rate. The second objective was to search for 3-month mortality risk factors. Methods: This is a retrospective study including all patients admitted to 3 ICUs due to influenza-related disease between October 2013 and June 2016, which assesses the 3-month mortality rate. We compared clinical presentation, biological data, and outcome at 3 months between survivors and non-survivors. We created a predicting 3-month mortality model with Classification and Regression Tree analysis. Results: Sixty-nine patients were included, 50 patients (72.5%) for ARDS, 5 (7.2%) for myocarditis, and 14 (20.3%) for acute respiratory failure without ARDS criteria. Non-typed influenza A was found in 30 cases (43.5%), influenza A H1N1 in 18 (26.1%), H3N2 in 3 (4.3%), and influenza B in 18 cases (27.5%). The 3-month mortality rate was 29% ( n = 20). Extracorporeal membrane oxygenation (ECMO) was implanted in 23 patients, without any significant increase in mortality (39% vs 24% without ECMO, P = .19). A creatinine serum superior to 96 μmol/L, an aspartate aminotransferase level superior to 68 UI/L, and a Pao2/Fio2 ration below 110 were associated with 3-month mortality in our predictive mortality model. Conclusion: Influenza in ICUs may have several clinical presentations. The mortality rate is high, but ECMO may be an effective rescue therapy.

scholarly journals Respiratory Viruses and Torque Teno Virus in Adults with Acute Respiratory Infections

Intervirology ◽  
2015 ◽  
Vol 58 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Afiono Agung Prasetyo ◽  
Martinus Nuherwan Desyardi ◽  
Jimmy Tanamas ◽  
Suradi ◽  
Reviono ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Influenza A ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Respiratory Viruses ◽  
Torque Teno Virus ◽  
Adult Patients ◽  
H3n2 Virus ◽  
Influenza B Virus ◽  
Influenza B

Objective: To define the molecular epidemiology of respiratory viral infections in adult patients. Methods: Nasal and throat swabs were collected from all adult patients with influenza-like illness (ILI), acute respiratory infection (ARI), or severe ARI (SARI) admitted to a tertiary hospital in Surakarta, Indonesia, between March 2010 and April 2011 and analyzed for 19 respiratory viruses and for torque teno virus (TTV) and human gyrovirus (HGyV). Results: Respiratory viruses were detected in 61.3% of the subjects, most of whom had ARI (90.8%, OR = 11.39), were hospitalized (96.9%, OR = 22.31), had asthma exacerbation (90.9%, OR = 8.67), and/or had pneumonia (80%, OR = 4.0). Human rhinovirus (HRV) A43 predominated. Influenza A H3N2, human metapneumovirus (HMPV) subtypes A1 and A2, the influenza B virus, human adenovirus B, and human coronavirus OC43 were also detected. All respiratory viruses were detected in the transition month between the rainy and dry seasons. No mixed respiratory virus infection was found. Coinfections of the influenza A H3N2 virus with TTV, HMPV with TTV, HRV with TTV, and human parainfluenza virus-3 with TTV were found in 4.7, 2.8, 19.8, and 0.9% of the samples, respectively. Conclusions: This study highlights the need to perform routine detection of respiratory viruses in adults hospitalized with ARI, asthma exacerbation, and/or pneumonia.

scholarly journals Epidemiological characteristics of four common respiratory viral infections in children

2020 ◽  
Author(s):  
Guohong Zhu ◽  
Dan Xu ◽  
Yuanyuan Zhang ◽  
Tianlin Wang ◽  
Lingyan Zhang ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Influenza A ◽  
Multiple Infection ◽  
Influenza B ◽  
Preschool Period ◽  
Significant Difference ◽  
Different Seasons ◽  
Tract Infections ◽  
Epidemiological Characteristics

Abstract Background: Viruses are the main infectious agents of acute respiratory infections (ARIs) in children. We aim to describe the epidemiological characteristics of viral pathogens of acute respiratory tract infections in outpatient children. Methods: From April 2018 to March 2019, the results of viral detection using oral pharyngeal swabs from 103,210 children with acute respiratory tract infection in the outpatient department of the Children’s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV), were detected by the colloidal gold method.Results: At least one virus was detected in 38,355 cases; the positivity rate was 37.2%. A total of 1910 cases of mixed infection with two or more viruses were detected, and the positivity rate of multiple infection was 1.9%. The ADV positivity rate was highest in the 3-6-year-old group (18.7%), the FLUA positivity rate was highest in the >6-year-old group (21.6%), the FLUB positivity rate was highest in the >6-year-old group (6.6%), and the RSV positivity rate was highest in the <1-year-old group (10.6%). There was a significant difference in the positivity rate of viral infection among different age groups (χ2 = 1280.7, P < 0.001). The rate of positive viral infection was highest in winter (47.1%). The ADV infection rate was highest in spring (18.2%). The rates of FLUA and FLUB positivity were highest in winter (28.8% and 3.6%, respectively). The rate of RSV positivity was highest in autumn (17.4%). The rate of positive viral infection in different seasons was significantly different (χ2 = 6459.1, P < 0.001).Conclusions: Viral infection rates in children differ for different ages and seasons. The positivity rate of ADV is highest in the preschool period and that of RSV is highest in infants; that of FLU increases with age. The total positive rate of viral infection in different seasons is highest in winter, as is the rate of FLU positivity.

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