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Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

Relationship of influenza virus infection to associated infections in children who present with influenza-like symptoms

Authors: Yitzchok M. Norowitz, Stephan Kohlhoff, Tamar A. Smith-Norowitz

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Influenza virus is a major health care burden and is associated with significant morbidity and mortality. Data on morbidity and complications (pneumonia, otitis media) related to influenza virus infection in primary care settings are limited with reports mainly obtained from hospital settings. We assessed the prevalence of complications from viral/bacterial infections in influenza- positive compared with influenza- negative children presenting with influenza-like illness (ILI) in a primary care setting.

Methods

This retrospective, practice-based chart review studied complications from viral/bacterial infections in 255 children and adolescents (females/males, 1-21 years) who presented with ILI. We also compared the prevalence of complications by influenza vaccination status between influenza positive (N = 32/121) and influenza negative (N = 50/134) cases (2013-2015). Comparisons for categorical variables were made using chi-squared tests.

Results

The prevalence of complications was similar in influenza positive (18/121) and influenza negative (22/134) patients (P = NS). Patients presenting with ILI, who were vaccinated, were less likely to test positive for influenza compared with patients who were not vaccinated (P = 0.064). However, prevalence of infections was similar in both groups based on vaccination status. We did not find any effect of type of health insurance on influenza status (P > 0.05)

Conclusion

Common respiratory complications of seasonal influenza did not differ in influenza positive compared with influenza negative patients. Vaccination with influenza vaccine may result in decreased duration or severity of symptoms, and remains an important public health intervention. In primary care settings, determination of influenza status may be an important tool for clinicians to predict the likelihood of complications.
Literature
1.
go back to reference Taubenberger JK, Morens DM. The pathology of influenza virus infections. Annu Rev Pathol Mech Dis. 2008;3:499–522.CrossRef Taubenberger JK, Morens DM. The pathology of influenza virus infections. Annu Rev Pathol Mech Dis. 2008;3:499–522.CrossRef
3.
go back to reference Kreijtz JHCM, Fouchier RAM, Rimmelzwaan GF. Immune responses to influenza virus infection. Virus Res. 2011;162:19–30.CrossRefPubMed Kreijtz JHCM, Fouchier RAM, Rimmelzwaan GF. Immune responses to influenza virus infection. Virus Res. 2011;162:19–30.CrossRefPubMed
4.
go back to reference Nitsch-Osuch A, Kuchar E, Gyrczuk E, Topczewska-Cabanek A, Zycinska K, Wardyn K. Clinical manifestations of influenza caused by A/H1N1v virus among children and teenagers consulted in general practice. Eur J Med Res. 2010;15 Suppl 2:105–7.PubMedPubMedCentral Nitsch-Osuch A, Kuchar E, Gyrczuk E, Topczewska-Cabanek A, Zycinska K, Wardyn K. Clinical manifestations of influenza caused by A/H1N1v virus among children and teenagers consulted in general practice. Eur J Med Res. 2010;15 Suppl 2:105–7.PubMedPubMedCentral
5.
go back to reference Heikkinen T, Silvennoinen H, Peltola V, Ziegler T, Vainionpaa R, Vuorinen T, Kainulainen L, Puhakka T, Jartti T, Toikka P, Lehtinen P, Routi T, Juven T. Burden of influenza in children in the community. JID. 2004;190:1369–73.CrossRefPubMed Heikkinen T, Silvennoinen H, Peltola V, Ziegler T, Vainionpaa R, Vuorinen T, Kainulainen L, Puhakka T, Jartti T, Toikka P, Lehtinen P, Routi T, Juven T. Burden of influenza in children in the community. JID. 2004;190:1369–73.CrossRefPubMed
7.
go back to reference Flannery B, Clippard J, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Petrie JG, McLean HG, Belongia EA, Gaglani M, Berman L, Foust A, Sessions W, Thaker SN, Spencer S, Fry AM. Early Estimates of Seasonal Influenza Vaccine Effectiveness-United States, January 2015. MMWR Morb Mortal Wkly Rep. 2015;64(01):10–5.PubMed Flannery B, Clippard J, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Petrie JG, McLean HG, Belongia EA, Gaglani M, Berman L, Foust A, Sessions W, Thaker SN, Spencer S, Fry AM. Early Estimates of Seasonal Influenza Vaccine Effectiveness-United States, January 2015. MMWR Morb Mortal Wkly Rep. 2015;64(01):10–5.PubMed
8.
go back to reference Petric M, Comanor L, Petti CA. Role of the laboratory in diagnosis of influenza during seasonal epidemics and potential pandemics. JID. 2006;194 Suppl 2:S98–110.CrossRefPubMed Petric M, Comanor L, Petti CA. Role of the laboratory in diagnosis of influenza during seasonal epidemics and potential pandemics. JID. 2006;194 Suppl 2:S98–110.CrossRefPubMed
9.
go back to reference Peltola V, Reunanen T, Ziegler T, Silvennoinen H, Heikkinen T. Accuracy of clinical diagnosis of influenza in outpatient children. Clin Infect Dis. 2005;41:1198–200.CrossRefPubMed Peltola V, Reunanen T, Ziegler T, Silvennoinen H, Heikkinen T. Accuracy of clinical diagnosis of influenza in outpatient children. Clin Infect Dis. 2005;41:1198–200.CrossRefPubMed
11.
go back to reference Foo H, Dwyer DE. Rapid tests for the diagnosis of influenza. Aust Prescr. 2009;32:64–7.CrossRef Foo H, Dwyer DE. Rapid tests for the diagnosis of influenza. Aust Prescr. 2009;32:64–7.CrossRef
14.
go back to reference Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumoniae as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis. 2008;198:962–70.CrossRefPubMedPubMedCentral Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumoniae as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis. 2008;198:962–70.CrossRefPubMedPubMedCentral
16.
go back to reference Frank AL, Tauber LH, Wells JM. Comparison of infection rates and severity of illness for influenza A subtypes H1N1 and H3N2. J Infect Dis. 1985;151:73–80.CrossRefPubMed Frank AL, Tauber LH, Wells JM. Comparison of infection rates and severity of illness for influenza A subtypes H1N1 and H3N2. J Infect Dis. 1985;151:73–80.CrossRefPubMed
18.
go back to reference Madhi SA, Schoub B, Klugman KP. Interaction between influenza virus and Streptococcus pneumoniae in severe pneumonia. Expert Rev Respir Med. 2008;2:663–72.CrossRefPubMed Madhi SA, Schoub B, Klugman KP. Interaction between influenza virus and Streptococcus pneumoniae in severe pneumonia. Expert Rev Respir Med. 2008;2:663–72.CrossRefPubMed
19.
go back to reference Grijalva CG, Zhu Y, Williams DJ, Self WH, Ampofo K, Pavia AT, Stockmann CR, McCullers J, Arnold SR, Wunderink RG, Anderson EJ, Lindstrom S, Fry AM, Foppa IM, Finelli L, Bramley AM, Jain S, Griffin MR, Edwards KM. Association between hospitalization with community-acquired laboratory-confirmed influenza pneumonia and prior receipt of influenza vaccination. JAMA. 2015;14:1488–97.CrossRef Grijalva CG, Zhu Y, Williams DJ, Self WH, Ampofo K, Pavia AT, Stockmann CR, McCullers J, Arnold SR, Wunderink RG, Anderson EJ, Lindstrom S, Fry AM, Foppa IM, Finelli L, Bramley AM, Jain S, Griffin MR, Edwards KM. Association between hospitalization with community-acquired laboratory-confirmed influenza pneumonia and prior receipt of influenza vaccination. JAMA. 2015;14:1488–97.CrossRef
20.
go back to reference Echenique IA, Chan PA, Chapin KC, Andera SB, Fava JL, Mermel LA. Clinical characteristics and outcomes in hospitalized patients with respiratory viral co-infection during the 2009 H1N1 influenza pandemic. PLOS One. 2013;8(4):e60845.CrossRefPubMedPubMedCentral Echenique IA, Chan PA, Chapin KC, Andera SB, Fava JL, Mermel LA. Clinical characteristics and outcomes in hospitalized patients with respiratory viral co-infection during the 2009 H1N1 influenza pandemic. PLOS One. 2013;8(4):e60845.CrossRefPubMedPubMedCentral
21.
go back to reference Semple MG, Cowell A, Dove W, Greensill J, McNamara PS, et al. Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis. J Infect Dis. 2005;191:382–6.CrossRefPubMed Semple MG, Cowell A, Dove W, Greensill J, McNamara PS, et al. Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis. J Infect Dis. 2005;191:382–6.CrossRefPubMed
22.
go back to reference Foulongne V, Guyon G, Rodiere M, Segondy M. Human metapneumovirus infection in young children hospitalized with respiratory tract disease. Pediatr Infect Dis J. 2006;25:354–9.CrossRefPubMed Foulongne V, Guyon G, Rodiere M, Segondy M. Human metapneumovirus infection in young children hospitalized with respiratory tract disease. Pediatr Infect Dis J. 2006;25:354–9.CrossRefPubMed
23.
go back to reference Konig B, Konig W, Arnold R, Werchau H, Ihorst G, et al. Prospective study of human metapneumovirus infection in children less than 3 years of age. J Clin Microbiol. 2004;42:4632–5.CrossRefPubMedPubMedCentral Konig B, Konig W, Arnold R, Werchau H, Ihorst G, et al. Prospective study of human metapneumovirus infection in children less than 3 years of age. J Clin Microbiol. 2004;42:4632–5.CrossRefPubMedPubMedCentral
24.
go back to reference Garcia-Garcia MI, Calvo C, Perez-Brena P, De-Cea JM, Acosta B, et al. Prevalence and clinical characteristic of human metapneumovirus infections in hospitalized infants in Spain. Pediatr Pulmonol. 2006;41:863–71.CrossRefPubMed Garcia-Garcia MI, Calvo C, Perez-Brena P, De-Cea JM, Acosta B, et al. Prevalence and clinical characteristic of human metapneumovirus infections in hospitalized infants in Spain. Pediatr Pulmonol. 2006;41:863–71.CrossRefPubMed
25.
go back to reference Wildesmann A, Schildgen O, Eis-Hubinger AM, Geikowski T, Glatzel T, et al. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. Eur J Pediatr. 2006;165:467–75.CrossRef Wildesmann A, Schildgen O, Eis-Hubinger AM, Geikowski T, Glatzel T, et al. Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections. Eur J Pediatr. 2006;165:467–75.CrossRef
26.
go back to reference Wolf DG, Greenberg D, Kalkstein D, Shemer-Avni Y, Givon-Lavi N, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J. 2006;25:320–4.CrossRefPubMed Wolf DG, Greenberg D, Kalkstein D, Shemer-Avni Y, Givon-Lavi N, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J. 2006;25:320–4.CrossRefPubMed
27.
go back to reference Cheng AC, Holmes M, Irving LB, Brown SGA, Waterer GW, Korman TM, Friedman ND, Senanayake S, Dwyer DE, Brady S, Simpson G, Wood-Baker R, Upham J, Paterson D, Jenkins C, Wark P, Kelly PM, Kotsimbos T. Influenza vaccine effectiveness against hospitalization with confirmed influenza in the 2010-11 seasons: a test-negative observational study. PLOS One. 2013;8(7):e68760.CrossRefPubMedPubMedCentral Cheng AC, Holmes M, Irving LB, Brown SGA, Waterer GW, Korman TM, Friedman ND, Senanayake S, Dwyer DE, Brady S, Simpson G, Wood-Baker R, Upham J, Paterson D, Jenkins C, Wark P, Kelly PM, Kotsimbos T. Influenza vaccine effectiveness against hospitalization with confirmed influenza in the 2010-11 seasons: a test-negative observational study. PLOS One. 2013;8(7):e68760.CrossRefPubMedPubMedCentral
28.
go back to reference Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systemic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44.CrossRefPubMed Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systemic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44.CrossRefPubMed
29.
go back to reference Fiore AE, Uyeki TM, Broder K, and the Centers for Disease Control and Prevention (CDC), et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep. 2010;59:1–62.PubMed Fiore AE, Uyeki TM, Broder K, and the Centers for Disease Control and Prevention (CDC), et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep. 2010;59:1–62.PubMed
31.
go back to reference Kotagal M, Carle AC, Kessler LG, Flum DR. Limited impact on health and access to care for 19- to 25- year-olds following the patient protection and affordable care act. JAMA Pediatr. 2014;168:1023–9.CrossRefPubMedPubMedCentral Kotagal M, Carle AC, Kessler LG, Flum DR. Limited impact on health and access to care for 19- to 25- year-olds following the patient protection and affordable care act. JAMA Pediatr. 2014;168:1023–9.CrossRefPubMedPubMedCentral
Metadata
Title
Relationship of influenza virus infection to associated infections in children who present with influenza-like symptoms
Authors
Yitzchok M. Norowitz
Stephan Kohlhoff
Tamar A. Smith-Norowitz
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1642-8

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