Program Schedule

Do Viral Diagnoses in Primary Care Precede and Predict Those Obtained in Secondary Care: A Temporal Trend Comparison Study

Session: Poster Abstract Session: Viral Infections: Epidemiology
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Children with respiratory tract infections (RTIs) form a large proportion of primary care (PC) consultations. In secondary care (SC), high levels of viral activity can lead to increased pressure on already limited resources. Current national RTI surveillance systems are not at present used to provide local ‘early-warning’ systems to provide real-time indicators to predict when SC may experience increased pressure. This study investigates if viruses isolated from children presenting to Bristol PC with RTI precede and predict the same viruses isolated from children in local SC.

Methods: The PC dataset was sourced from the NIHR funded ‘TARGET’ study, including throat swabs from Bristol children presenting to PC with acute RTI during August 2011-May 2013. Viral detection results from SC respiratory samples from the same age group were retrospectively sourced for children with a Bristol postcode, presenting simultaneously to a local hospital. Influenza A&B, respiratory syncytial virus (RSV), human metapneumovirus, parainfluenzaviruses, adenovirus, rhinovirus and enterovirus were studied. Time series graphs were generated using weekly numbers of positive samples and proportion of respiratory samples positive.

Results: 596 and 949 samples were analysed in PC and SC respectively. ‘Flu A: (PC n=26 (4.3%), SC n=23 (2.4%)) demonstrated a seasonal pattern, with two periods of increased activity simultaneously observed in December 2011-April 2012, and January 2013-May 2013. ‘Flu B: (PC n=30(5.0%), SC n=9(1.0%)) demonstrated one peak of increased activity, again simultaneously, from December 2012. RSV: (PC n=58 (9.7%), SC n=216 (23.0%)) demonstrated two peaks in PC and SC around December in both 2012 and 2013. Graphical analysis of further viruses will be presented.

Conclusion: To our knowledge this is the first study to investigate if there is potential for PC virus surveillance as an ‘early-warning’ utility for a city. Preliminary analyses suggest that PC is unlikely to offer a predefined indicator to local SC services. Although this study was limited by small numbers of positive samples, some viruses isolated in Bristol PC follow the same temporal patterns as those in SC, suggesting that either PC or SC data could be used for real-time surveillance of circulating viruses causing children to require PC and SC.

Michelle S. Toleman1, Peter Muir2, Peter S. Blair1, Hannah V. Thornton1, Sophie Turnball1, Niamh M. Redmond1, John P. Leeming3, Barry Vipond2, Andrew M. Lovering3, Alastair D. Hay1 and TARGET study team, (1)University of Bristol, School of Social and Community Medicine, Bristol, United Kingdom, (2)Specialist Virology Centre, Public Health England, Bristol, United Kingdom, (3)Bristol Centre for Antimicrobial Research and Evaluation, Bristol, United Kingdom


M. S. Toleman, None

P. Muir, None

P. S. Blair, None

H. V. Thornton, None

S. Turnball, None

N. M. Redmond, None

J. P. Leeming, None

B. Vipond, None

A. M. Lovering, None

A. D. Hay, None

Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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