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Influenza and Other Respiratory Viruses: Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation a

tetano

Editor, Senior Moderator
Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality

Edward Goka1,
Pamela Vallely2,
Kenneth Mutton1,2,
Paul Klapper1,2

Article first published online: 19 OCT 2012

DOI: 10.1111/irv.12020

Please cite this paper as: Goka et al. (2012) Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12020.

Introduction  Recent literature suggests that dual or multiple virus infections may affect disease severity. However, few studies have investigated the effect of co-infection with influenza A viruses.

Objectives  To identify the association between influenza A and respiratory viruses co-infections with disease outcome.

Methodology  Data for samples from North West England tested between January 2007 and June 2011 was analysed for patterns of co-infection between influenza A viruses and eight respiratory viruses. Risk of hospitalisation to ICU or general ward in single versus co-infections was assessed using logistic regression.

Results  Of the 25 596 samples analysed for respiratory viruses 40?7% (10 501) were positive for any virus. Co-infections were detected in 4?7% (137/2879) of all patients with influenza A(H1N1)pdm09, and 7?3% (57/779) of those with other influenza A virus infections. Co-infection between seasonal influenza A viruses and influenza B virus was associated with a significant increase in the risk of admission to ICU/death (OR: 22?0, 95% CI: 2?21?219?8, P = 0?008). Respiratory syncytial virus/influenza A (RSV/Flu A) co-infection also increased this risk but was not statistically significant. For influenza A(H1N1)pdm09, RSV and AdV co-infection increased risk of hospitalisation to general ward whereas Flu B increased risk of admission to ICU, but none of these were statistically significant.

Conclusion  Co-infection is a significant predictor of disease outcome; combined treatment, introduction of an integrated vaccine for all respiratory viruses and development of multi-target rapid diagnostic tests is recommended. Integration of respiratory viruses? co-infections into public health reports could also contribute to the accumulation of evidence.


http://onlinelibrary.wiley.com/doi/10.1111/irv.12020/abstract
 
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