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Master of Public Health

Respiratory Virus Surveillance in Infants Across Different Clinical Setting

AUTHORS

Haddadin Z , Rankin DA , Lipworth L , Suh M , McHenry R , Blozinski A , George SS , Fernandez KN , Varjabedian R , Spieker AJ , Shepard DS , Halasa NB , . The Journal of pediatrics. 2021 3 24; ().

ABSTRACT

OBJECTIVES: We aimed to evaluate the distribution, clinical presentations and severity of common acute respiratory infections (ARI) viruses in infants across three clinical settings.

STUDY DESIGN: In a prospective virus surveillance study, infants under one year with fever and/or respiratory symptoms were enrolled from outpatient (OP), emergency department (ED) and inpatient (IP) settings from 12/16/2019 through 4/30/2020. Demographic and clinical characteristics were collected through parent/guardian interviews, medical chart abstractions and follow-up surveys. Nasal swabs were collected and tested for viruses using qRT-PCR.

RESULTS: We enrolled 366 infants and tested nasal swabs on 360 (98%); median age was 6.3 months, 50% male. In total, 295 (82%) had at least one virus detected; rhinovirus/enterovirus (RV/EV; 42%), respiratory syncytial virus (RSV; 34%), and influenza (15%) were the most common. RSV was the most frequently detected virus in the IP (63%) and ED (37%) settings, and RV/EV was most frequently detected virus in the OP setting (54%). RSV-positive infants had a lower median age (4.9 months), and were more likely to have respiratory distress, and RV/EV-positive infants were less likely to have respiratory distress. Influenza-positive infants had a higher median age (8 months) and were more likely to have systemic symptoms. RSV infection and younger age were associated with higher odds of hospitalization in multivariable logistic regression.

CONCLUSION: Across 3 clinical settings, and combining virological, patient and health-system information, our results highlight the burden of viral ARI among infants. Overall, RSV, RV/EV, and influenza were most commonly detected, with RSV having the highest disease severity.

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