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Viral infections in outpatients with medically attended acute respiratory illness during the 2012-2013 influenza season

Zimmerman, RK and Rinaldo, CR and Nowalk, MP and Balasubramani, GK and Moehling, KK and Bullotta, A and Eng, HF and Raviotta, JM and Sax, TM and Wisniewski, S (2015) Viral infections in outpatients with medically attended acute respiratory illness during the 2012-2013 influenza season. BMC Infectious Diseases, 15 (1).

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While it is known that acute respiratory illness (ARI) is caused by an array of viruses, less is known about co-detections and the resultant comparative symptoms and illness burden. This study examined the co-detections, the distribution of viruses, symptoms, and illness burden associated with ARI between December 2012 and March 2013. Methods: Outpatients with ARI were assayed for presence of 18 viruses using multiplex reverse transcriptase polymerase chain reaction (MRT-PCR) to simultaneously detect multiple viruses. Results: Among 935 patients, 60% tested positive for a single virus, 9% tested positive for ≥1 virus and 287 (31%) tested negative. Among children (<18 years), the respective distributions were 63%, 14%, and 23%; whereas for younger adults (18-49 years), the distributions were 58%, 8%, and 34% and for older adults (≥50 years) the distributions were 61%, 5%, and 32% (P < 0.001). Co-detections were more common in children than older adults (P = 0.01), and less frequent in households without children (P = 0.003). Most frequently co-detected viruses were coronavirus, respiratory syncytial virus, and influenza A virus. Compared with single viral infections, those with co-detections less frequently reported sore throat (P = 0.01), missed fewer days of school (1.1 vs. 2 days; P = 0.04), or work (2 vs. 3 days; P = 0.03); other measures of illness severity did not vary. Conclusions: Among outpatients with ARI, 69% of visits were associated with a viral etiology. Co-detections of specific clusters of viruses were observed in 9% of ARI cases particularly in children, were less frequent in households without children, and were less symptomatic (e.g., lower fever) than single infections.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Zimmerman, RKzimmer@pitt.eduZIMMER
Rinaldo, CRRINALDO@pitt.eduRINALDO
Balasubramani, GKBalaGK@edc.pitt.eduBKG100000-0001-7221-1825
Moehling, KKkkm17@pitt.eduKKM17
Bullotta, Aacb10@pitt.eduACB10
Eng, HFHENG@pitt.eduHENG
Raviotta, JMjraviotta@pitt.eduJMR1540000-0001-7551-0628
Sax, TMSaxT@edc.pitt.eduTMS32
Wisniewski, SSTEVEWIS@pitt.eduSTEVEWIS
Date: 22 February 2015
Date Type: Publication
Journal or Publication Title: BMC Infectious Diseases
Volume: 15
Number: 1
DOI or Unique Handle: 10.1186/s12879-015-0806-2
Schools and Programs: Graduate School of Public Health > Epidemiology
School of Medicine > Family Medicine
School of Medicine > Infectious Diseases and Microbiology
School of Medicine > Medicine
Refereed: Yes
Date Deposited: 22 Dec 2016 15:41
Last Modified: 20 Jan 2022 16:55


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