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Comparing respiratory virus burden among infants across emergency care and in-patient settings

Adrian Trenholme, Shirley Lawrence, Cameron Grant, Namrata Prasad, Claire Newbern, Angela Todd, Tim Wood, Sue Huang
European Respiratory Journal 2016 48: PA1606; DOI: 10.1183/13993003.congress-2016.PA1606
Adrian Trenholme
1Paediatrics, Kidz First Hospital, Auckland, New Zealand
3Paediatrics, University of Auckland, Auckland, New Zealand
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Shirley Lawrence
1Paediatrics, Kidz First Hospital, Auckland, New Zealand
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Cameron Grant
3Paediatrics, University of Auckland, Auckland, New Zealand
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Namrata Prasad
2Health Science, Institute of Environmental Science and Research Limited, Wellington, New Zealand
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Claire Newbern
2Health Science, Institute of Environmental Science and Research Limited, Wellington, New Zealand
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Angela Todd
2Health Science, Institute of Environmental Science and Research Limited, Wellington, New Zealand
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Tim Wood
2Health Science, Institute of Environmental Science and Research Limited, Wellington, New Zealand
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Sue Huang
2Health Science, Institute of Environmental Science and Research Limited, Wellington, New Zealand
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Abstract

Respiratory virus infections are leading causes of admission for infants <1y age; however, the burden among children discharged from emergency care (EC) is not well described. The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance project, a prospective, population-based respiratory virus surveillance in Auckland New Zealand, provided the opportunity to study these infants.

During the 2014-2015 winter seasons, patients under 1 year old presenting with respiratory symptoms at the Kidz First Children's Hospital had respiratory samples tested for influenza, RSV and Rhinoviruses using real time PCR assays. Rates of visits and patient characteristics were compared between settings.

Virus positivity was high in both settings (Table). Admission rates were higher for those identified as RSV positive, Maori/Pacific Islander, from lower SES areas, <6months and female. In both the EC and admitted patients influenza positivity was higher for older infants. Among those with influenza, admission was higher for children <6 months of age (OR=2.7, 9%%CI: 1.3-5.5) and females (OR=2.8, 95%CI: 1.4-5.6). For RSV, Maori/Pacific Islanders (OR=2.4, 95%CI: 1.2-5.0) and females (OR=2.3, 95%CI: 1.4-4.1) were associated with admission.The socioeconomic gradient was striking with 166 RV admissions per 100,000 children for highest income areas compared to 4415 per 100,000 children in the lowest.

Infants seen in Emergency care have a significant respiratory virus burden with females Maori, Pacific, disadvantaged, RSV positive and <6 months most affected.

Infants<1yInfluenzaRSVRhinovirus
Emergency care discharges70/149 17%114/408 28%74/411 18%
Admission69/526 13%106/250 42%48/250 19%

  • Viruses
  • Children
  • Infections
  • Copyright ©the authors 2016
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Comparing respiratory virus burden among infants across emergency care and in-patient settings
Adrian Trenholme, Shirley Lawrence, Cameron Grant, Namrata Prasad, Claire Newbern, Angela Todd, Tim Wood, Sue Huang
European Respiratory Journal Sep 2016, 48 (suppl 60) PA1606; DOI: 10.1183/13993003.congress-2016.PA1606

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Comparing respiratory virus burden among infants across emergency care and in-patient settings
Adrian Trenholme, Shirley Lawrence, Cameron Grant, Namrata Prasad, Claire Newbern, Angela Todd, Tim Wood, Sue Huang
European Respiratory Journal Sep 2016, 48 (suppl 60) PA1606; DOI: 10.1183/13993003.congress-2016.PA1606
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