Characterization of viral infections in children with influenza-like-illness during December 2018-January 2019

Shuang Chao; Yuejiao Wang; Baolei Wu; Runqing Li; Jingxiao Dong; Lina Ji; Xuejun Li; Ran Li; Xiaomei Yin; Xiuying Zhao; Wannian Liang

doi:10.3389/fcimb.2023.1351814

Characterization of viral infections in children with influenza-like-illness during December 2018-January 2019

Front Cell Infect Microbiol. 2024 Jan 18:13:1351814. doi: 10.3389/fcimb.2023.1351814. eCollection 2023.

Authors

Shuang Chao^#¹, Yuejiao Wang^#¹, Baolei Wu^#², Runqing Li³, Jingxiao Dong³, Lina Ji¹, Xuejun Li¹, Ran Li¹, Xiaomei Yin¹, Xiuying Zhao³, Wannian Liang²

Affiliations

¹ Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
² Vanke School of Public Health, Tsinghua University, Beijing, China.
³ Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

^# Contributed equally.

Abstract

Introduction: Respiratory viral infection (RVI) is of very concern after the outbreak of COVID-19, especially in pediatric departments. Learning pathogen spectrum of RVI in children previous the epidemic of COVID-19 could provide another perspective for understanding RVI under current situation and help to prepare for the post COVID-19 infection control.

Methods: A nucleic acid sequence-based amplification (NASBA) assay, with 19 pairs of primers targeting various respiratory viruses, was used for multi-pathogen screening of viral infections in children presenting influenza-like illness (ILI) symptoms. Children with ILI at the outpatient department of Beijing Tsinghua Changgung Hospital during the influenza epidemic from 12/2018 to 01/2019 were included. Throat swabs were obtained for both the influenza rapid diagnostic test (IRDT) based on the colloidal gold immunochromatographic assay and the NASBA assay, targeting various respiratory viruses with an integrated chip technology.

Results and discussion: Of 519 patients, 430 (82.9%) were positive in the NASBA assay. The predominant viral pathogens were influenza A H1N1 pdm1/2009 (pH1N1) (48.4%) and influenza A (H3N2) (18.1%), followed by human metapneumovirus (hMPV) (8.8%) and respiratory syncytial virus (RSV) (6.1%). Of the 320 cases identified with influenza A by NASBA, only 128 (40.0%) were positive in the IRDT. The IRDT missed pH1N1 significantly more frequently than A (H3N2) (P<0.01). Influenza A pH1N1 and A (H3N2) were the major pathogens in <6 years and 6-15 years old individuals respectively (P<0.05). In summary, influenza viruses were the major pathogens in children with ILI during the 2018-2019 winter influenza epidemic, while hMPV and RSV were non-negligible. The coexistence of multiple pathogen leading to respiratory infections is the normalcy in winter ILI cases.

Keywords: influenza (flu); influenza rapid diagnostic test (IRDT); influenza-like illness (ILI); nucleic acid sequence-based amplification (NASBA); pediatrics; respiratory viral infection (RVI).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Child
Humans
Infant
Influenza A Virus, H1N1 Subtype*
Influenza A Virus, H3N2 Subtype
Influenza, Human* / diagnosis
Influenza, Human* / epidemiology
Respiratory Syncytial Virus, Human*
Respiratory Tract Infections* / diagnosis
Respiratory Tract Infections* / epidemiology
Virus Diseases*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Beijing Municipal Science & Technology Commission Program of China [grant no. Z181100001718148, 2018 and Beijing High-level Public Health Technical Personnel Project 2023-03-03]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.