Influenza and other respiratory virus infections in outpatients with medically attended acute respiratory infection during the 2011‐12 influenza season. Issue 4 (23rd May 2014)

• Record Type: Journal Article
• Authors: Zimmerman, Richard K.; Rinaldo, Charles R.; Nowalk, Mary Patricia; GK, Balasubramani; Thompson, Mark G.; Moehling, Krissy K.; Bullotta, Arlene; Wisniewski, Stephen
• Is Part Of: Influenza and other respiratory viruses. Volume 8:Issue 4(2014:Jul.)
• Page Start: 397
• Page End: 405
• Publication Date: 2014-05-23
• Subjects: Influenza -- Periodicals; Respiratory infections -- Periodicals; Virus diseases -- Periodicals; Influenza, Human -- Periodicals; Respiratory Tract Diseases -- Periodicals; Virus Diseases -- Periodicals; Grippe -- Périodiques; Appareil respiratoire -- Infections -- Périodiques; Maladies à virus -- Périodiques; 616.203
• DOI: 10.1111/irv.12247
• Languages: English
• ISSNs: 1750-2640

Abstract

<abstract abstract-type="main" id="irv12247-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="irv12247-sec-0001" sec-type="section"> <title>Background</title> <p>Respiratory tract infections are a major cause of outpatient visits, yet only a portion is tested to determine the etiologic organism. Multiplex reverse transcriptase polymerase chain reaction (MRT‐PCR) assays for detection of multiple viruses are being used increasingly in clinical settings.</p> </sec> <sec id="irv12247-sec-0002" sec-type="section"> <title>Methods</title> <p>During January–April 2012, outpatients with acute respiratory illness (≤7 days) were tested for influenza using singleplex RT‐PCR (SRT‐PCR). A subset was assayed for 18 viruses using MRT‐PCR to compare detection of influenza and examine the distribution of viruses and characteristics of patients using multinomial logistic regression.</p> </sec> <sec id="irv12247-sec-0003" sec-type="section"> <title>Results</title> <p>Among 662 participants (6 months–82 years), detection of influenza was similar between the MRT‐PCR and SRT‐PCR (κ = 0·83). No virus was identified in 267 (40.3%) samples. Commonly detected viruses were human rhinovirus (HRV, 15·4%), coronavirus (CoV, 10·4%), respiratory syncytial virus (RSV, 8·4%), human metapneumovirus (hMPV, 8·3%), and influenza (6%). Co‐detections were infrequent (6·9%) and most commonly occurred among those <18 years old. In regression analyses, compared with non‐viral illnesses, RSV and hMPV were significantly more frequent in children and less frequent in 18‐ to 49‐year‐olds than in those ≥50 years (<italic>P </italic>=<italic> </italic>0·01), fever was more common in hMPV and influenza infections (<italic>P </italic>=<italic> </italic>0·008), nasal congestion was more frequent in CoV, HRV, hMPV, influenza and RSV infections (<italic>P </italic>=<italic> </italic>0·001), and body mass index was higher among those with influenza (<italic>P </italic>=<italic> </italic>0·036).</p> </sec> <sec id="irv12247-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Using MRT‐PCR, a viral etiology was found in three‐fifths of patients with medically attended outpatient visits for acute respiratory illness during the influenza season; co‐detected viruses were infrequent. Symptoms varied by viral etiology.</p> </sec> </abstract>