Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Heinonen, Santtu; Peltola, Ville; Silvennoinen, Heli; Vahlberg, Tero; Heikkinen, Terho

doi:10.1007/s10096-011-1479-4

Cited by 25 publications

(29 citation statements)

References 30 publications

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“…The variety of other potential co-infecting pathogens may have caused the lower performance of all case definitions in the 0–4 years age group [10]. One way to improve the specificity of the ILI definition in this particular age group would be a higher temperature cut-off because the multivariate model showed that in the youngest age group, only high body temperatures above 38.5 °C were strongly associated with influenza.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal case definition should be applicable every year, internationally and in all medical settings (i.e community, outpatient and inpatient departments), regardless of the patients’ age or co-infections with co-circulating respiratory viruses such as respiratory syncytial virus (RSV) or rhinovirus [1]. Several previous studies have attempted to evaluate and compare the performance of the current ILI definitions, but are restricted either to a single hospital setting [3-8] or to cohort studies [9,10]. Only few studies have evaluated the performance of the current ILI/ARI definitions in the context of a national influenza sentinel network over several years [11,12] and none included a paediatric population.…”

Section: Introductionmentioning

confidence: 99%

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Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014

et al. 2017

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International case definitions recommended by the Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the World Health Organization (WHO) are commonly used for influenza surveillance. We evaluated clinical factors associated with the laboratory-confirmed diagnosis of influenza and the performance of these influenza case definitions by using a complete dataset of 14,994 patients with acute respiratory infection (ARI) from whom a specimen was collected between August 2009 and April 2014 by the Groupes Régionaux d’Observation de la Grippe (GROG), a French national influenza surveillance network. Cough and fever ≥ 39 °C most accurately predicted an influenza infection in all age groups. Several other symptoms were associated with an increased risk of influenza (headache, weakness, myalgia, coryza) or decreased risk (adenopathy, pharyngitis, shortness of breath, otitis/otalgia, bronchitis/ bronchiolitis), but not throughout all age groups. The WHO case definition for influenza-like illness (ILI) had the highest specificity with 21.4%, while the ECDC ILI case definition had the highest sensitivity with 96.1%. The diagnosis among children younger than 5 years remains challenging. The study compared the performance of clinical influenza definitions based on outpatient surveillance and will contribute to improving the comparability of data shared at international level.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014

et al. 2017

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“…A variety of clinical syndromes are associated with the common respiratory viruses, including the common cold, pharyngitis, laryngitis, influenza-like illness, laryngeotracheobronchitis (croup), bronchiolitis, and pneumonia. Certain viruses are often associated with specific syndromes and age groups ( Table 2), although clinical disease is commonly overlapping and each syndrome can be caused by many different respiratory viruses (68,69). RSV is the single most important agent of respiratory disease in infancy and is the most common cause of bronchiolitis and pneumonia in infants and young children worldwide (26,27,70,71).…”

Section: Clinical Significancementioning

confidence: 99%

“…The clinical diagnosis of respiratory viruses can be difficult, since signs and symptoms are often overlapping and not always specific for any one viral agent (68,69) when multiple pathogens are circulating in a given community, as is the case in the fall-winter-spring seasonal activity observed in most cities throughout the U.S. and other parts of the world. Clinical findings may vary with age, underlying conditions of the host, previous infection, and the circulating type, and may fail to identify the persons at highest risk for complications.…”

Section: Diagnostic Approachesmentioning

confidence: 99%

Respiratory RNA Viruses

Hodinka

2016

Microbiol Spectr

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Acute upper and lower respiratory infections are a major public health problem and a leading cause of morbidity and mortality worldwide. At greatest risk are young children, the elderly, the chronically ill, and those with suppressed or compromised immune systems. Viruses are the predominant cause of respiratory tract illnesses and include RNA viruses such as respiratory syncytial virus, influenza virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Laboratory testing is required for a reliable diagnosis of viral respiratory infections, as a clinical diagnosis can be difficult since signs and symptoms are often overlapping and not specific for any one virus. Recent advances in technology have resulted in the development of newer diagnostic assays that offer great promise for rapid and accurate detection of respiratory viral infections. This chapter emphasizes the fundamental characteristics and clinical importance of the various RNA viruses that cause upper and lower respiratory tract diseases in the immunocompromised host. It highlights the laboratory methods that can be used to make a rapid and definitive diagnosis for the greatest impact on the care and management of ill patients, and the prevention and control of hospital-acquired infections and community outbreaks.

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“…A Finnish group who used a matched case-control study in children aged ≤13 years to compare confirmed influenza patients with those who had respiratory symptoms but were influenza-negative found fever to be the only reliable predictor of influenza [54]. …”

Section: Clinical Manifestations Of Diseasementioning

confidence: 99%

The burden of seasonal and pandemic influenza in infants and children

2013

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The burden of influenza is unevenly distributed, with more severe outcomes in children aged <5 years than older children and adults. In spite of this, immunisation policies for young children are far from universal. This article provides an overview of the published evidence on the burden of influenza in children worldwide, with a particular interest in the impact of pandemic influenza in 2009–2010 (caused by the H1N1pdm09 virus). In an average season, up to 9.8 % of 0- to 14-year olds present with influenza, but incidence rates can be markedly higher in younger children. Children aged <5 years have greater rates of hospitalisation and complications than their older counterparts, particularly if the children have co-existing illnesses; historically, this age group have had higher mortality rates from the disease than other children, although during the 2009–2010 pandemic the median age of those who died of influenza was higher than in previous seasons. Admissions to hospital and emergency departments appear to have been more frequent in children with H1N1pdm09 infections than during previous seasonal epidemics, with pneumonia continuing to be a common complication in this setting. Outcomes in children hospitalised with severe disease also seem to have been worse for those infected with H1N1pdm09 viruses compared with seasonal viruses. Studies in children confirm that vaccination reduces the incidence of seasonal influenza and the associated burden, underlining the importance of targeting this group in national immunisation policies. Conclusions: Children aged <5 years are especially vulnerable to influenza, particularly that caused by seasonal viruses, and vaccination in this group can be an effective strategy for reducing disease burden.

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Signs and symptoms predicting influenza in children: a matched case–control analysis of prospectively collected clinical data

Cited by 25 publications

References 30 publications

Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014

Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014

Respiratory RNA Viruses

The burden of seasonal and pandemic influenza in infants and children

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