1271. Differences in self-reported severity of symptoms between women and men experiencing influenza-like illness
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ARI ID Week 2016 poster.pdf (526.2 kB)
  • Background: Sex-based differences on the severity of influenza-like illness (ILI) among healthy young adults are understudied. Here we compared self-reported symptom severity for non-influenza infections between women and men.

    Methods: We enrolled otherwise healthy adults who presented with influenza-like illness (ILI) at five US military hospitals between 2009-14. Respiratory pathogens were diagnosed by single and multiplex PCR tests. Individuals were asked to classify symptoms as either none, mild, moderate or severe; composite scores were calculated through seven days of illness in the following four categories: (1) lower respiratory: cough, breathing difficulty, hoarseness or chest pain, (2) upper respiratory: earache, runny nose, sore throat or sneezing; (3) systemic: chills, muscle ache, headache and fatigue; (4) total sum.

    Results:

    897 respiratory infections were analyzed, including 492 cases (55%) from men and 405 (45%) from women. The median age of women and men were (28y, IQR [23, 35]) and (29y, IQR [24.2, 35.6]). Women were less likely to be active-duty military (64% vs 92%, p<0.001) or smoke cigarettes (17% vs 25%, p=0.002). Rhinovirus/enterovirus (n=218), influenza (n=173) and coronavirus (n=102) accounted for 55% of all infections. No pathogen was detected in 38.5% of cases (n=345); distributions were similar between women and men. Given significant differences in vaccine rates between men and women, influenza cases were removed from the analysis. Combining all remaining infections and adjusting for age, military status and recent respiratory infection, we found that women were significantly more likely to report severe hoarseness (18.2% vs. 11.7%, p=0.04), fatigue (40.1% vs. 30.4%, p=0.02), earache (14.9% vs. 7.1%, p<0.01), muscle ache (27.1% vs. 15.7%, p<0.01), nausea (8.2% vs. 4.1%, p=0.04) and sore throat (36.3% vs. 27.9%, p=0.04). Composite severity scores did not differ between women and men on the first two days of illness; however, women reported higher severity scores on days 3-7 of illness.

    Conclusion: In this study of healthy young adults, women reported more severe respiratory symptoms than men. Further research regarding sex-based differences on the natural history of respiratory infection is warranted.

    Robert Deiss, MD1, Wei-Ju Chen, PhD2, Christian Coles, PhD2, Mary Fairchok, MD3, Christina Schofield, MD FACP, FIDSA4, Patrick Danaher, MD, FIDSA5, Erin Hansen, BS6, Tahaniyat Lalani, MD1, Jacqueline Owens Milzman, M.S.2, Deepika Mor, MS7, Michelande Ridore, MS8, Timothy Burgess, MD9, Eugene Millar, PhD7 and John Arnold, MD10, (1)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (2)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (3)Pediatrics, Mary Bridge Children's Hospital, Multicare, Tacoma, WA, (4)Madigan Army Medical Center, Tacoma, WA, (5)San Antonio Military Health System, Fort Sam Houston, TX, (6)Naval Health Research Center, San Diego, CA, (7)Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, Rockville, MD, (8)Children's National Medical Center, Washington, DC, (9)Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, (10)Naval Medical Center San Diego, San Diego, CA

    Disclosures:

    R. Deiss, None

    W. J. Chen, None

    C. Coles, None

    M. Fairchok, None

    C. Schofield, None

    P. Danaher, None

    E. Hansen, None

    T. Lalani, None

    J. Owens Milzman, None

    D. Mor, None

    M. Ridore, None

    T. Burgess, None

    E. Millar, None

    J. Arnold, None

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