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American Academy of Pediatrics
Research Articles

Association of Respiratory Picornaviruses With High Acuity and Severe Illness in a Pediatric Health Care System

Katherine E. Fleming-Dutra, Harold K. Simon, James D. Fortenberry, Robert Jerris, Jaime Radecke and Daniel A. Hirsh
Hospital Pediatrics August 2015, 5 (8) 432-438; DOI: https://doi.org/10.1542/hpeds.2014-0111
Katherine E. Fleming-Dutra
aDepartments of Pediatrics,
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
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Harold K. Simon
aDepartments of Pediatrics,
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
cEmergency Medicine, and
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James D. Fortenberry
aDepartments of Pediatrics,
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
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Robert Jerris
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
dPathology, Emory University School of Medicine, Atlanta, Georgia;
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Jaime Radecke
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
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Daniel A. Hirsh
bChildren's Healthcare of Atlanta, Atlanta, Georgia; and
ePediatric Emergency Medicine Associates, LLC, Atlanta, Georgia
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Abstract

OBJECTIVES: We aimed to determine the illness severity associated with respiratory picornaviruses (rhinovirus/enterovirus).

METHODS: Electronic medical records of pediatric emergency department (PED) visits were reviewed. The percent positive of respiratory pathogens, tested by using viral polymerase chain reaction panel, was determined for the July 2012 to June 2013 period. Logistic regression was used to determine the association of picornaviruses, respiratory syncytial virus (RSV), and influenza with ICU admission during the 2012−2013 academic year. Medical records of visits leading to ICU admission with picornaviruses were reviewed.

RESULTS: During 2012−2013, picornaviruses were more commonly identified (22.6%) among admitted patients than influenza (6.4%) or RSV (15.1%). Picornaviruses and RSV were associated with ICU admission (picornaviruses: adjusted odds ratio [aOR], 1.99 [95% confidence interval (CI): 1.68−2.36]; RSV: aOR, 1.49 [95% CI: 1.20−1.85]) while influenza was not (aOR, 0.93 [95% CI: 0.66−1.29]). Of visits resulting in ICU admission, 79% were from patients with previous high-risk medical conditions, of which asthma or a history of wheezing was the most common (43%).

CONCLUSIONS: Picornaviruses can be associated with severe disease in children, especially those with underlying medical conditions. During times of high picornavirus activity, hospitals should target infection control measures to limit the spread of picornaviruses and protect the vulnerable patients. Future research into targeted therapies for picornaviruses and vaccines is needed.

  • Copyright © 2015 by the American Academy of Pediatrics
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Hospital Pediatrics: 5 (8)
Hospital Pediatrics
Vol. 5, Issue 8
1 Aug 2015
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Association of Respiratory Picornaviruses With High Acuity and Severe Illness in a Pediatric Health Care System
Katherine E. Fleming-Dutra, Harold K. Simon, James D. Fortenberry, Robert Jerris, Jaime Radecke, Daniel A. Hirsh
Hospital Pediatrics Aug 2015, 5 (8) 432-438; DOI: 10.1542/hpeds.2014-0111

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Association of Respiratory Picornaviruses With High Acuity and Severe Illness in a Pediatric Health Care System
Katherine E. Fleming-Dutra, Harold K. Simon, James D. Fortenberry, Robert Jerris, Jaime Radecke, Daniel A. Hirsh
Hospital Pediatrics Aug 2015, 5 (8) 432-438; DOI: 10.1542/hpeds.2014-0111
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