Methods: A multi-center clinical research consortium for the natural history of ILI has been conducted across five US military treatment facilities since 2009. Otherwise healthy individuals, birth to ≤65y, with ILI <72h were enrolled in an observational study. Clinical symptoms were collected over 28d. Nasal/throat swabs were collected at baseline and analyzed by target-enriched multiplex PCR (Diatherix Laboratories, Inc).
From 11/2009-5/2014, 898 participants were enrolled and tested by end-point multiplex PCR. Of these, 87 (9.5%) were positive for CVEV. Two (0.2%) were co-infected with CVEV and influenza. Cases of CVEV were identified throughout the year, with the highest numbers of cases occurring between January and May, peaking in March. Patients with CVEV were younger (p=0.006) with a mean age of 17.4y (range 1m-58y). When compared to those with influenza, children attending daycare (p=0.002) and adults who reported being a current smoker (p<0.001) were more likely to have CVEV. Over 80% with CVEV reported cough, sore throat, and runny nose. In adults, over 75% reported myalgia. Adults with CVEV reported more severe upper respiratory symptoms at illness onset (median score: 5 vs. 4, p=0.03) and through 7d, but lower systemic scores (p=0.01), when compared to those with influenza. Among children with CVEV, systemic symptom scores (0.0 vs. 5.0, p=0.014) and total respiratory symptom scores (4 vs.13, p=0.031) were lower than those of children with influenza.
CVEV represents a small but significant viral cause of ILI. CVEV appears to cause more severe upper respiratory symptoms in adults than influenza. By contrast, children with CVEV reported less severe symptoms than those with influenza. Studies of severe ILI among adults should assess the contribution of CVEV, especially in the post-influenza season.
W. J. Chen, None
M. Fairchok, None
C. Schofield, None
T. Lalani, None
P. Danaher, None
M. Rajnik, None
L. Malone, Diatherix Lab: Investigator , Salary
E. Grigorenko, Diatherix lab: Investigator , Salary
D. Stalons, Diatherix Lab: Investigator , Salary
E. Mcdonough, None
D. Mor, None
M. Ridore, None
T. Burgess, None
E. Millar, None