1296. An Observational Study to Determine the Causes and Identify Increases in Influenza-Like Illness (ILI) in Mexico
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • IDWeek2016_LaRed_ILI2014.png (521.0 kB)
    • Background: We sought an alternative design to a typical ILI observational study design in order to determine if circulating respiratory viruses were causing increased disease severity. An observational study was conducted to provide systematic sampling and real time information regarding the pathogens causing ILI and SARI among patients seeking care at the LaRed Network sites in Mexico.

    Methods: A systematic sample was planned with the goal of choosing 3 outpatients and 3 hospitalized subjects per week per site. After ICF was obtained at enrollment, demographics, medical history, NP swabs, sputum, and blood samples were obtained for respiratory pathogen testing including Respifinder® and RT-PCR. In order to determine whether the difference in the proportion of a determined isolated etiologic agent (or hospitalization) in the current 2 weeks has increased in relation to the prior 8 weeks, Fisher’s exact test or the asymptotic test of proportions were utilized.

    Results: Between Jan 2015 to Apr 2016, a total of 776 subjects had been enrolled. An increase in the circulation of RSV-B (p<0.05) was detected on Jun 2015 that was paralleled with increased activity among hospitalized subjects (p<0.05). Parainfluenza-4 had increased circulation (p<0.05) in July 2015, which was also observed among hospitalized subjects (p<0.05). On October 2015, a new increase in the circulation of RSV-B (0.05) once again was paralleled with an increased activity among hospitalized subjects (p<0.05). An increase in the circulation of influenza virus was detected later in the season. On March 2016, influenza A H1N1 (p<0.05), B Victoria (p<0.05), B Yamagata (p<0.05) showed increased circulation. Only influenza A H1N1 was paralleled with increased activity among hospitalized subjects (p<0.05). An increase in circulation of metapneumovirus, parinfluenza-3 and rhinovirus/enterovirus (p<0.05) was observed on April 2016 that was also paralleled by an increased proportion among hospitalized subjects (p<0.05).

    Conclusion: The systematic sampling and real time reports used in this study allowed the identification of seasonal patterns of different etiologic agents and are capable of identifying changes in the severity of disease signaled by an increase in hospitalization attributable to a specific pathogen.

    Juan-Francisco Galán-Herrera, MD, MS, Infectious Diseases, Mexico Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico, Arturo Galindo-Fraga, MD, MS, Hospital Epidemiology and Medical Care Quality Control, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Daniel Noyola, MD, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico, Martin Magaña-Aquino, MD, Infectious Diseases, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico, Sarbelio Moreno-Espinosa, MD, MS, Infectious Diseases, Hospital Infantil de México, Mexico City, Mexico, Beatriz Llamosas-Gallardo, MD, Instituto Nacional de Pediatría, Mexico, Mexico, Alejandra Ramírez-Venegas, MD, Pneumology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico, Laura Freimanis, MD, PhD, Westat Inc., Rockville, MD, Sally Hunsberger, MD, Biostatistics Research Brand, Niaid, National Institute of Allergy and Infectious Diseases, Bethesda, MD, M. Lourdes Guerrero Almeida, MD, MS, Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico, Mary Smolskis, R.N, M.A., Office of Planning and Operations Support, National Institute of Allergy and Infectious Diseases, Rockville, MD, John Beigel, MD, Leidos Biomedical Research, Inc. In support of the National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD and Guillermo Ruiz-Palacios, MD, FIDSA, Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico

    Disclosures:

    J. F. Galán-Herrera, None

    A. Galindo-Fraga, None

    D. Noyola, None

    M. Magaña-Aquino, None

    S. Moreno-Espinosa, None

    B. Llamosas-Gallardo, None

    A. Ramírez-Venegas, None

    L. Freimanis, None

    S. Hunsberger, None

    M. L. Guerrero Almeida, None

    M. Smolskis, None

    J. Beigel, None

    G. Ruiz-Palacios, None

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