542. Influenza-associated Parotitis-Novel occurrence during the 2014-2015 US influenza season
Session: Poster Abstract Session: Respiratory Viruses
Thursday, October 8, 2015
Room: Poster Hall
Background: Influenza is rarely associated with acute parotitis. However, during the 2014–15 influenza season, >200 cases were reported from 25 US states. We characterized risk factors for influenza-associated, non-mumps parotitis from October 2014–March 2015.

Methods: We conducted a case-control study in 14 states. Cases had acute parotitis and laboratory-confirmed influenza. Controls had laboratory-confirmed influenza without parotitis and were 3:1 frequency-matched by age, state, hospitalization, and date of illness. We interviewed participants and sequenced influenza virus RNA.  We compared epidemiologic characteristics of cases and controls using logistic regression.

Results: We enrolled 51 cases and 128 controls. Cases experienced painful (84%), unilateral (67%) swelling; for 50% of cases swelling began a median of 4 days after influenza symptoms began. Cases were significantly more likely to report a history of prior mumps infection and less likely to have influenza-like illness or have taken an influenza antiviral agent. Parotitis was not associated with underlying medical conditions, influenza vaccination, or over-the-counter medications. 

Characteristic+

Cases (n = 51)

Controls (n = 128)

P-value*

Median age, years (IQR)

14 (9, 22)

13 (8, 20)

---

Hospitalized

7 (14%)

11 (9%)

---

Male

37 (73)

67 (52)

0.011

Influenza-like illness

25 (50)

112 (89)

<0.001

Took influenza antiviral

13 (25)

80 (65)

<0.001

Underlying medical condition

23 (45)

56 (44)

0.81

Influenza vaccination

 

 

 

     2013–2014 season

31 (63)

80 (65)

0.60

     2014–2015 season

20 (43)

51 (41)

0.68

Prior mumps infection

6 (12)

2 (2)

0.012

+N (%), unless noted.

*From logistic regression, adjusted for age, state, hospitalization, and date of illness onset.

Conclusion: Acute parotitis was uncharacteristically associated with influenza during the 2014–15 season. Clinicians should consider influenza in patients presenting with acute parotitis during influenza season so antiviral treatment can be provided if indicated. Prior mumps infection was associated with case status, but the clinical significance of this finding is unclear. While no explanatory risk factors for parotitis were identified, pending genetic sequencing may reveal influenza clade-specific associations with parotitis.

Melissa a. Rolfes, PhD, MPH1, Alexander J. Millman, MD2, Pamela Talley, MPH, MD3, Lina I Elbadawi, MD, MS4, Natalie Kramer, CHES, BS5, Lenee Blanton, MPH2, Jeffrey P Davis, MD4, Stefanie Devita, RN, MPH6, John Dreisig, MPH7, Angela Foust, MS8, Mugdha Golwalkar, MPH9, Thomas Haupt, MS4, Anna Kocharian, MS4, Lisa Mchugh, MPH10, Karen Martin, MPH11, Reema Patel, MPH9, Pam Pontones, MA9, Daniela Quilliam, MPH12, Shawn Richards, BS9, Sara Robinson, MPH13, Lori Webber, MLT (ASCP), MT(HEW)14, Meghan Pearce Weinberg, PhD, MPH, EIS, CDC6, Lyn Finelli, DrPH, MS8 and Michael a. Jhung, MD, MPH8, (1)Yale School of Public Health, New Haven, CT, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Infectious Disease Epidemiology, Prevention and Control, Minnesota Department of Health, St Paul, MN, (4)Bureau of Communicable Diseases, Wisconsin Division of Public Health, Madison, WI, (5)Influenza Division, Centers of Disease Control and Prevention, Atlanta, GA, (6)Michigan Department of Health and Human Services, Lansing, MI, (7)New Hampshire Division of Public Health Services, Concord, NH, (8)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (9)Indiana State Department of Health, Indianapolis, IN, (10)New Jersey Department of Health, Trenton, NJ, (11)Minnesota Department of Health, St. Paul, MN, (12)RI Dept of Health, Division of Infectious Disease and Epidemiology, Providence, RI, (13)Maine DHHS, Maine CDC, Infectious Disease Epidemiology, Augusta, ME, (14)Maine DHHS, Maine CDC, Health and Environmental Testing Laborary, Augusta, ME

Disclosures:

M. A. Rolfes, None

A. J. Millman, None

P. Talley, None

L. I. Elbadawi, None

N. Kramer, None

L. Blanton, None

J. P. Davis, None

S. Devita, None

J. Dreisig, None

A. Foust, None

M. Golwalkar, None

T. Haupt, None

A. Kocharian, None

L. Mchugh, None

K. Martin, None

R. Patel, None

P. Pontones, None

D. Quilliam, None

S. Richards, None

S. Robinson, None

L. Webber, None

M. P. Weinberg, None

L. Finelli, None

M. A. Jhung, None

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