751. Acute Respiratory Illness Hospitalizations Among Young Children — Multi-Center Viral Surveillance Network, United States, 2015–2016
Session: Poster Abstract Session: Respiratory Infections: Viral
Thursday, October 4, 2018
Room: S Poster Hall

Background: Viral infections are a significant cause of severe acute respiratory illnesses (ARI) in young children.  Understanding the current epidemiology of these viruses is important for informing treatment and prevention measures.  We describe the New Vaccine Surveillance Network (NVSN) and report preliminary results from 2015–16.

Methods: Prospective active surveillance for hospitalized ARI was conducted from 11/1/2015 to 6/30/2016 among children <5 years of age at seven pediatric hospital sites (Figure) using a broad case definition based on admission diagnoses.  Parent interviews and medical chart reviews were performed, and mid-turbinate nasal and throat flocked swabs and/or tracheal aspirates were tested for adenovirus, human metapneumovirus (HMPV), influenza, parainfluenza viruses (PIV) 1–3, respiratory syncytial virus (RSV), and rhinovirus/enterovirus using molecular diagnostic assays at each site.  Asymptomatic controls <5 years of age were also enrolled.

Results: Among 2974 hospitalized children with ARI whose specimens were tested for viruses, 2228 (75%) were <2 years old, with 745 (25%) 0–2 months, and 309 (10%) 3–5 months old.  The majority were male (58%; n = 1732) and 63% (n = 1093) had no documented comorbid conditions.  The median length of stay was 2 days; 1683 (57%) received supplemental oxygen, 435 (15%) were admitted to intensive care, 95 (3%) required mechanical ventilation, and 1 (<1%) died.  Viruses were detected in 2242 (75%) children with ARI, with >1 virus detected in 234 (8%).  RSV was detected in 1039 (35%) children with ARI, HMPV in 245 (8%), influenza in 104 (4%), and PIV-1, PIV-2, and PIV-3 in 49 (2%), 2 (<1%), and 78 (3%), respectively.    Rhinovirus/enterovirus was detected in 849 (29%) and adenovirus in 118 (4%) children with ARI, but were also detected in 18% (n = 227) and 5% (n = 60), respectively, of the 1243 controls tested; the other viruses were more rarely detected in controls. 

Conclusion: During the 2015–16 season, viral detections were common in young children hospitalized for ARI at seven US sites.  NVSN combines clinical data with current molecular laboratory techniques to describe respiratory virus epidemiology in cases of hospitalized pediatric ARI in order to inform current and future prevention, treatment, and healthcare utilization measures.


Brian Rha, MD, MSPH1, Angela P. Campbell, MD, MPH, FPIDS, FIDSA2, Darius McDaniel, MSPH1, Rangaraj Selvarangan, PhD3, Natasha Halasa, MD, MPH4, Janet Englund, MD, FIDSA5, Julie A. Boom, MD6,7, Parvin H. Azimi, MD8, Geoffrey A. Weinberg, MD, FIDSA, FPIDS9, Mary A. Staat, M.D., M.P.H.10, Monica N. Singer, MD, MPH11, Leila C. Sahni, MPH6, Monica McNeal, MS10, Eileen J. Klein, MD, MPH12, Christopher J. Harrison, M.D., FAAP, FPIDS3, John V. Williams, MD13, Joana Yu, MPH1,14, Daniella Figueroa-Downing, MPH1, Mila M. Prill, MSPH1, Brett L. Whitaker, MS1, Aaron T. Curns, MPH1, Gayle E. Langley, MD, MPH15, Daniel C. Payne, PhD, MSPH16 and Susan I. Gerber, MD1, (1)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (2)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (3)The Children's Mercy Hospital and Clinics, Kansas City, MO, (4)Vanderbilt University Medical Center, Nashville, TN, (5)Department of Pediatrics, University of Washington, Seattle, WA, (6)Texas Children's Hospital, Houston, TX, (7)Baylor College of Medicine, Texas Children's Hospital, Houston, TX, (8)UCSF Benioff Children's Hospital Oakland, Oakland, CA, (9)University of Rochester School of Medicine and Dentistry, Rochester, NY, (10)Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (11)UCSF Benioff Children’s Hospital Oakland, Oakland, CA, (12)Seattle Children's Hospital, Seattle, WA, (13)Children's Hospital of Pittsburgh, Pittsburgh, PA, (14)IHRC, Atlanta, GA, (15)Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (16)Centers for Disease Control and Prevention, Atlanta, GA


B. Rha, None

A. P. Campbell, None

D. McDaniel, None

R. Selvarangan, None

N. Halasa, Sanofi Pasteur: Investigator , Research support . GSK: Consultant , Consulting fee . Moderna: Consultant , Consulting fee .

J. Englund, Gilead: Consultant and Investigator , Consulting fee and Research support . Novavax: Investigator , Research support . GlaxoSmithKline: Investigator , Research support . Alios: Investigator , Research support . MedImmune: Investigator , Research support .

J. A. Boom, None

P. H. Azimi, None

G. A. Weinberg, None

M. A. Staat, None

M. N. Singer, None

L. C. Sahni, None

M. McNeal, None

E. J. Klein, None

C. J. Harrison, None

J. V. Williams, Quidel: Board Member , Consulting fee . GlaxoSmithKline: Consultant , Consulting fee .

J. Yu, None

D. Figueroa-Downing, None

M. M. Prill, None

B. L. Whitaker, None

A. T. Curns, None

G. E. Langley, None

D. C. Payne, None

S. I. Gerber, None

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