Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Volume 32, Issue 9, Pages 950-955Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0b013e31829b7e43
Keywords
bronchiolitis; croup; upper respiratory illness; rhinovirus; respiratory syncytial virus
Categories
Funding
- Thrasher New Investigator Award
- Thrasher Research Fund Clinical Research Grant
- NIH [K24 AI 077930, UL1 RR024975, K01 AI070808, AI085062, K23 AI091691-02, U19 AI 095227, R01 HS018454, R01 HS019669, K12 ES 015855]
- March of Dimes Basil O'Conner Award
- MedImmune
- [KL2 RR24977-03]
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Background: Prospective data on viral etiology and clinical characteristics of bronchiolitis and upper respiratory illness (URI) in infants are limited. Methods: This prospective cohort enrolled previously healthy term infants during inpatient or outpatient visits for acute URI or bronchiolitis during September to May 2004 to 2008. Illness severity was determined using an ordinal bronchiolitis severity score. Common respiratory viruses were identified by real-time reverse-transcriptase polymerase chain reaction. Results: Of 648 infants, 67% were enrolled during inpatient visits and 33% during outpatient visits. Seventy percent had bronchiolitis, 3% croup and 27% URI. Among infants with bronchiolitis, 76% had respiratory syncytial virus (RSV), 18% human rhinovirus (HRV), 10% influenza, 2% coronavirus, 3% human metapneumovirus and 1% parainfluenza virus. Among infants with croup, 39% had HRV, 28% parainfluenza virus, 28% RSV, 11% influenza, 6% coronavirus and none human metapneumovirus. Among infants with URI, 46% had HRV, 14% RSV, 12% influenza, 7% coronavirus, 6% parainfluenza virus and 4% human metapneumovirus. Individual viruses exhibited distinct seasonal, demographic and clinical expression. Conclusions: The most common infections among infants seeking care in unscheduled medical visits for URI or bronchiolitis were RSV and HRV. Demographic differences were observed between patients with different viruses, suggesting that host and viral factors play a role in phenotypic expression of viral illness.
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