Other Respiratory Viruses Are Important Contributors to Adult Respiratory Hospitalizations and Mortality Even During Peak Weeks of the Influenza Season

Gilca, Rodica; Amini, Rachid; Douville-Fradet, Monique; Charest, Hugues; Dubuque, Josée; Boulianne, Nicole; Skowronski, Danuta M.; Serres, Gaston De

doi:10.1093/ofid/ofu086

Cited by 48 publications

(44 citation statements)

References 37 publications

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“…Numerous respiratory pathogens are associated with hospitalization; notably, influenza, human metapneumovirus, respiratory syncytial virus, rhinovirus, and parainfluenza virus; all of which cause similar symptoms [3]. However, influenza-associated illness accounts for a substantial proportion of these medical events [2,4].…”

Section: Introductionmentioning

confidence: 99%

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

et al. 2018

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Our objective was to identify predictors of severe acute respiratory infection in hospitalised patients and understand the impact of vaccination and neuraminidase inhibitor administration on severe influenza. We analysed data from a study evaluating influenza vaccine effectiveness in two Michigan hospitals during the 2014-2015 and 2015-2016 influenza seasons. Adults admitted to the hospital with an acute respiratory infection were eligible. Through patient interview and medical record review, we evaluated potential risk factors for severe disease, defined as ICU admission, 30-day readmission, and hospital length of stay (LOS). Two hundred sixteen of 1119 participants had PCR-confirmed influenza. Frailty score, Charlson score and tertile of prior-year healthcare visits were associated with LOS. Charlson score >2 (OR 1.5 (1.0-2.3)) was associated with ICU admission. Highest tertile of prior-year visits (OR 0.3 (0.2-0.7)) was associated with decreased ICU admission. Increasing tertile of visits (OR 1.5 (1.2-1.8)) was associated with 30-day readmission. Frailty and prior-year healthcare visits were associated with 30-day readmission among influenza-positive participants. Neuraminidase inhibitors were associated with decreased LOS among vaccinated participants with influenza A (HR 1.6 (1.0-2.4)). Overall, frailty and lack of prior-year healthcare visits were predictors of disease severity. Neuraminidase inhibitors were associated with reduced severity among vaccine recipients.

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Section: Introductionmentioning

confidence: 99%

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

et al. 2018

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“…Human respiratory syncytial virus is considered an important viral agent causing upper respiratory and lower respiratory tract infection, especially in children, the elderly, and immunocompromised adults . Some studies have also shown the importance of RSV as a causative agent of respiratory tract infections in healthy adults, causing significant morbidity …”

Section: Discussionmentioning

confidence: 99%

Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009‐2013

Moreira

Watanabe

Camargo

et al. 2018

Influenza Resp Viruses

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BackgroundThe respiratory syncytial virus (RSV) is recognized as an important cause of respiratory tract infections. Immunocompromised patients, healthcare workers (HCWs) and children contacts are at increased risk of acquiring the infection. However, the impact of asymptomatic infection in transmission has not been well studied. Objectives: this study evaluated the frequency and viral load (VL) of RSV in nasal swab samples of individuals with different risk factors for acquiring infection in a university hospital in Sao Paulo, Brazil.MethodsWe included 196 symptomatic children and their 192 asymptomatic caregivers, 70 symptomatic and 95 asymptomatic HCWs, 43 samples from symptomatic HIV‐positive outpatients, and 100 samples of asymptomatic HIV patients in the period of 2009‐2013.ResultsRSV infection was detected in 10.1% (70/696) of samples, 4.4% (17/387) of asymptomatic patients, and 17.1% (53/309) from symptomatic patients. (P < .0001). The VL of symptomatic patients (4.7 log copies/mL) was significantly higher compared to asymptomatic patients (2.3 log copies/mL). RSV detection among asymptomatic caregivers (6.8%; 13/192) was significantly higher compared to other asymptomatic adults, HIV and HCWs (2.0%; 4/195; P = .0252). A close contact with an infected child at home was an important risk to RSV acquisition [OR 22.6 (95% CI 4.8‐106.7)]. Children who possibly transmitted the virus to their asymptomatic contacts had significantly higher viral load than children who probably did not transmit (P < .0001).ConclusionsAccording to our results, it is important to know if people circulating inside the hospital have close contact with acute respiratory infected children.

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“…One patient had a dual-positive rapid influenza diagnostic test for influenza A and influenza B, but PCR testing was positive for influenza A (H 3 N 2 ). [2][3][4][5][6] Of the 37 adults with viral ILIs, 16 (43%) had respiratory syncytial virus (RSV), 10 (27%) had rhinovirus/enterovirus (R/E), 5 (14%) had human parainfluenza virus type 3 (HPIV-3), 4 (11%) had human metapneumovirus (hMPV), and 2 (5%) had coronavirus (Table 1). Elderly patients, more commonly admitted for viral ILIs, had longer LOS for viral ILIs than for influenza.…”

Section: Infection Control Implications Of Protracted Lengths Of Staymentioning

confidence: 99%

“…Two patients had co-colonization with influenza A (H 3 N 2 ) and another respiratory virus, but not a worse prognosis. [4][5][6] None of the 37 adults with viral ILIs had bacterial coinfection at admission or during hospitalization.…”

Section: Infection Control Implications Of Protracted Lengths Of Staymentioning

confidence: 99%

Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H₃N₂) Epidemic

Cunha

Connolly

Musta

et al. 2015

Infect. Control Hosp. Epidemiol.

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We agree that the use of rapid ATP testing has a growing body of published support. However, the lack of common acceptance for rapid ATP testing at this point in time is well expressed in the EPIC 3 Guidelines (2014) from an expert committee in the United Kingdom. 2 Unfortunately, Ms Roady somewhat misses the point of our paper. In our study, we did not attempt to equate rapid ATP testing with detection of bacterial contamination. We showed that the variability that occurs when measuring responses to controlled quantitated microbial cultures is the same variability that occurs when controlled concentrations of pure ATP solutions are measured. The issue is therefore not correlation with detection but data variability.This variability is undetectable to ATP device users and applies to all sources of detected ATP. The ATP variability problem (ie, imprecision in results) that we have outlined in our most recent paper is common to each of the ATP device brands we tested. This finding does have implications for sampling methodology and analysis. 3 We set out to validate several branded ATP devices using a standardized approach and focusing on precision and accuracy. 4 The first issue we encountered was uncontrolled variability and the lack of precision at any testing point. The issue of accuracy is problematic because the scale of relative light units (RLU) is neither universally standardized nor standardized among ATP device suppliers.We welcome the engagement with the industry. We would like to see better quality of results for ATP testing devices, including testing for precision and the development of a common measurement scale. There remains a tremendous upside for ATP use once these issues are resolved. acknowledgmentsPotential conflicts of interest. None of the authors has any conflict of interest to declare.

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Other Respiratory Viruses Are Important Contributors to Adult Respiratory Hospitalizations and Mortality Even During Peak Weeks of the Influenza Season

Abstract: This prospective study conducted during 2 influenza seasons shows that even during the peak weeks of influenza circulation, other respiratory viruses contribute substantially to adult respiratory hospitalizations and mortality and, among the elderly, may exceed influenza.

Cited by 48 publications

References 37 publications

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009‐2013

Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H₃N₂) Epidemic

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Other Respiratory Viruses Are Important Contributors to Adult Respiratory Hospitalizations and Mortality Even During Peak Weeks of the Influenza Season

Abstract: This prospective study conducted during 2 influenza seasons shows that even during the peak weeks of influenza circulation, other respiratory viruses contribute substantially to adult respiratory hospitalizations and mortality and, among the elderly, may exceed influenza.

Cited by 48 publications

References 37 publications

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009‐2013

Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H3N2) Epidemic

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Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H₃N₂) Epidemic