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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Respiratory virus infections in febrile children presenting to a general practice out-of-hours service
Marijke Kool1, Miriam Monteny, Gerard J J van Doornum
1Department of General Practice, Erasmus MC, University Medical Center Rotterdam , Rotterdam , the Netherlands.
Insights
In over half of young children with fever, a viral infection was detected. Antibiotic prescriptions were common but not linked to viral test results in this study.
Area of Science:
- Pediatric infectious diseases
- Virology
- General practice research
Background:
- Fever is a common symptom in young children, often presumed to be viral.
- Identifying the cause of fever is crucial for appropriate management.
Purpose of the Study:
- To identify respiratory viruses in febrile children presenting to an out-of-hours service (OHS).
- To characterize symptoms associated with viral infections in these children.
- To investigate the relationship between antibiotic prescriptions and viral detection.
Main Methods:
- Nasopharyngeal swabs were collected from non-hospitalized children (3 months to 6 years) with fever.
- Symptoms were documented via physical examination and questionnaires.
- Logistic regression analyzed associations between symptoms/diagnoses and viral presence.
Main Results:
- A virus was detected in 53% of 257 children tested.
- Adenovirus, RSV type A, and PIV type 1 were the most common viruses.
- Cough and high temperature (≥38.0°C) predicted viral presence, but with low discriminative ability.
- Antibiotics were prescribed to 37.3% of children; 57.4% of these had a detected viral infection.
Conclusions:
- Viral infections are prevalent in over 50% of febrile children attending OHS.
- High antibiotic prescription rates were observed, independent of viral testing outcomes.
Background:
Fever is common in young children and is assumed to be frequently caused by viral infections.
Objectives:
To document respiratory viruses in children with fever presenting at a general practice out-of-hours service (OHS), evaluate presenting symptoms in febrile children with a virus infection, and examine the association between antibiotic prescription and the presence of a viral infection.
Methods:
Nasopharyngeal swabs were obtained to detect respiratory viruses in non-hospitalized children aged ≥ three months to six years presenting with fever at an OHS. Symptoms were assessed using physical examinations and questionnaires. Logistic regression analysis was used to reveal associations between symptoms or diagnoses, and the presence of at least one virus
Results:
In total 257 nasopharyngeal swabs were obtained in 306 eligible children; 53% of these children were infected by at least one virus. The most frequently detected viruses were adenovirus (10.9%), RSV type A (10.5%) and PIV type 1 (8.6%). Cough (OR 2.6; 95% CI: 1.4-4.6) and temperature ≥ 38.0°C (OR 2.1; 95% CI: 1.3-3.5) were independent predictors of the presence of a virus, but the discriminative ability was low (AUC 0.64; 95% CI: 0.58-0.71). Antibiotic prescription rate was 37.3%. In 57.4% of children with an antibiotic prescription, a virus was found.
Conclusion:
In over 50% of all febrile children presenting at an OHS, a virus was found. Antibiotic prescription rate was high and not associated to the outcome of viral testing.
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