Last data update: Jun 11, 2024. (Total: 46992 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Iwane M [original query] |
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Investigation of respiratory syncytial virus-associated deaths among US children aged <2 years, 2004-2007
Prill MM , Iwane MK , Little D , Gerber SI . J Pediatric Infect Dis Soc 2016 5 (3) 333-6 We validated the respiratory syncytial virus-coded deaths of children aged <2 years in 2004-2007 using national/state death data and medical records. There were 48 deaths in 4 states, and hospital records for 32 of them were available; 26 of those 32 (81%) had a laboratory finding of respiratory syncytial virus, and 21 of those 26 (81%) had a potential high-risk condition, most commonly preterm birth (35%). |
Molecular characterization of respiratory syncytial viruses infecting children reported to have received palivizumab immunoprophylaxis.
Oliveira DB , Iwane MK , Prill MM , Weinberg GA , Williams JV , Griffin MR , Szilagyi PG , Edwards KM , Staat MA , Hall CB , Durigon EL , Erdman DD . J Clin Virol 2015 65 26-31 BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of respiratory infections in children. Palivizumab (PZ) is the only RSV-specific immunoprophylaxis approved by the U.S. Food and Drug Administration. Mutations leading to amino acid substitutions in the PZ binding site of the RSV F protein have been associated with breakthrough RSV infections in patients receiving PZ. OBJECTIVE: To detect PZ resistance conferring mutations in RSV strains from children who received PZ. STUDY DESIGN: Children aged ≤24 months on October 31 who were hospitalized or had outpatient visits for respiratory illness and/or fever during October-May 2001-2008 in 3 US counties were included. PZ receipt was obtained from parent interviews and medical records among children subsequently infected with RSV. Archived nasal/throat swab specimens were tested for RSV by real-time RT-PCR. The coding region of the PZ binding site of the RSV F protein was sequenced using both Sanger and pyrosequencing methods. RESULTS: Of 8762 enrolled children, 375 (4.3%) were tested for RSV and had a history of PZ receipt, of which 56 (14.9%) were RSV-positive and 45 of these had available archived specimens. Molecular typing identified 42 partial F gene sequences in specimens from 39 children: 19 single RSV subgroup A, 17 subgroup B and 3 mixed infections. Nucleotide substitutions were identified in 12/42 (28.6%) RSV strains. PZ resistance mutations were identified in 4 (10.2%) of the 39 children, of which one had documented PZ receipt. CONCLUSIONS: Although RSV PZ resistance mutations were infrequent, most RSV-associated illnesses in children with a history of PZ receipt were not due to strain resistance. |
Respiratory syncytial virus - United States, July 2012-June 2014
Haynes AK , Prill MM , Iwane MK , Gerber SI . MMWR Morb Mortal Wkly Rep 2014 63 (48) 1133-6 Respiratory syncytial virus (RSV) causes lower respiratory infection among infants and young children worldwide. Annually in the United States, RSV infection has been associated with an estimated 57,527 hospitalizations and 2.1 million outpatient visits among children aged <5 years. In temperate climate zones, RSV generally circulates during the fall, winter, and spring. However, the exact timing and duration of RSV seasons vary by region and from year-to-year. Knowing the start of the RSV season in any given locality is important to health care providers and public health officials who use RSV seasonality data to guide diagnostic testing and the timing of RSV immunoprophylaxis for children at high risk for severe respiratory infection. To describe RSV seasonality (defined as onset, offset, peak, and duration) nationally, by U.S. Department of Health and Human Services (HHS) regions and for the state of Florida, CDC analyzes RSV laboratory detections reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS). Florida is reported separately because it has an earlier season onset and longer season duration than the rest of the country. For 2012-13, the RSV season onset ranged from late October to late December, and season offset ranged from late December to late April, excluding Florida. For 2013-14, the RSV season onset ranged from late October to late January, and season offset from late January to early April, excluding Florida. Weekly updates of RSV national, regional, and state RSV trends are available from NREVSS at http://www.cdc.gov/surveillance/nrevss. |
Respiratory syncytial virus circulation in seven countries with global disease detection regional centers
Haynes AK , Manangan AP , Iwane MK , Sturm-Ramirez K , Homaira N , Brooks WA , Luby S , Rahman M , Klena JD , Zhang Y , Yu H , Zhan F , Dueger E , Mansour AM , Azazzy N , McCracken JP , Bryan JP , Lopez MR , Burton DC , Bigogo G , Breiman RF , Feikin DR , Njenga K , Montgomery J , Cohen AL , Moyes J , Pretorius M , Cohen C , Venter M , Chittaganpitch M , Thamthitiwat S , Sawatwong P , Baggett HC , Luber G , Gerber SI . J Infect Dis 2013 208 Suppl 3 S246-54 BACKGROUND: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in young children globally, with the highest burden in low- and middle-income countries where the association between RSV activity and climate remains unclear. METHODS: Monthly laboratory-confirmed RSV cases and associations with climate data were assessed for respiratory surveillance sites in tropical and subtropical areas (Bangladesh, China, Egypt, Guatemala, Kenya, South Africa, and Thailand) during 2004-2012. Average monthly minimum and maximum temperatures, relative humidity, and precipitation were calculated using daily local weather data from the US National Climatic Data Center. RESULTS: RSV circulated with 1-2 epidemic periods each year in site areas. RSV seasonal timing and duration were generally consistent within country from year to year. Associations between RSV and weather varied across years and geographic locations. RSV usually peaked in climates with high annual precipitation (Bangladesh, Guatemala, and Thailand) during wet months, whereas RSV peaked during cooler months in moderately hot (China) and arid (Egypt) regions. In South Africa, RSV peaked in autumn, whereas no associations with seasonal weather trends were observed in Kenya. CONCLUSIONS: Further understanding of RSV seasonality in developing countries and various climate regions will be important to better understand the epidemiology of RSV and for timing the use of future RSV vaccines and immunoprophylaxis in low- and middle-income countries. |
Respiratory syncytial virus infection in Guatemala, 2007-2012
McCracken JP , Prill MM , Arvelo W , Lindblade KA , Lopez MR , Estevez A , Muller ML , Munoz F , Bernart C , Cortez M , Moir JC , Ortiz J , Paredes A , Iwane MK . J Infect Dis 2013 208 Suppl 3 S197-206 BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of acute respiratory illness (ARI). Little is known about RSV disease among older children and adults in Central America. METHODS: Prospective surveillance for ARI among hospital patients and clinic patients was conducted in Guatemala during 2007-2012. Nasopharyngeal and oropharyngeal swab specimens were tested for RSV, using real-time reverse-transcription polymerase chain reaction. RESULTS: Of 6287 hospitalizations and 2565 clinic visits for ARI, 24% and 12%, respectively, yielded RSV-positive test results. The incidence of RSV-positive hospitalization for ARI was 5.8 cases/10 000 persons per year and was highest among infants aged <6 months (208 cases/10 000 persons per year); among adults, the greatest incidence was observed among those aged ≥65 years (2.9 cases/10 000 persons per year). The incidence of RSV-positive clinic visitation for ARI was 32 cases/10 000 persons per year and was highest among infants aged 6-23 months (186 cases/10 000 persons per year). Among RSV-positive hospital patients with ARI, underlying cardiovascular disease was associated with death, moribund discharge, intensive care unit admission, or mechanical ventilation (odds ratio, 4.1; 95% confidence interval, 1.9-8.8). The case-fatality proportion among RSV-positive hospital patients with ARI was higher for those aged ≥5 years than for those aged <5 years (13% vs 3%; P < .001). CONCLUSIONS: The incidences of RSV-associated hospitalization and clinic visitation for ARI were highest among young children, but a substantial burden of ARI due to RSV was observed among older children and adults. |
Disparities between black and white children in hospitalizations associated with acute respiratory illness and laboratory-confirmed influenza and respiratory syncytial virus in 3 US counties--2002-2009
Iwane MK , Chaves SS , Szilagyi PG , Edwards KM , Hall CB , Staat MA , Brown CJ , Griffin MR , Weinberg GA , Poehling KA , Prill MM , Williams JV , Bridges CB . Am J Epidemiol 2013 177 (7) 656-65 Few US studies have assessed racial disparities in viral respiratory hospitalizations among children. This study enrolled black and white children under 5 years of age who were hospitalized for acute respiratory illness (ARI) in 3 US counties during October-May 2002-2009. Population-based rates of hospitalization were calculated by race for ARI and laboratory-confirmed influenza and respiratory syncytial virus (RSV), using US Census denominators. Relative rates of hospitalization between racial groups were estimated. Of 1,415 hospitalized black children and 1,824 hospitalized white children with ARI enrolled in the study, 108 (8%) black children and 111 (6%) white children had influenza and 230 (19%) black children and 441 (29%) white children had RSV. Hospitalization rates were higher among black children than among white children for ARI (relative rate (RR) = 1.7, 95% confidence interval (CI): 1.6, 1.8) and influenza (RR = 2.1, 95% CI: 1.6, 2.9). For RSV, rates were similar among black and white children under age 12 months but higher for black children aged 12 months or more (for ages 12-23 months, RR = 1.7, 95% CI: 1.1, 2.5; for ages 24-59 months, RR = 2.2, 95% CI: 1.3, 3.6). Black children versus white children were significantly more likely to have public insurance or no insurance (85% vs. 43%) and a history of asthma/wheezing (28% vs. 18%) but not more severe illness. The observed racial disparities require further study. |
Burden of human metapneumovirus infection in young children
Edwards KM , Zhu Y , Griffin MR , Weinberg GA , Hall CB , Szilagyi PG , Staat MA , Iwane M , Prill MM , Williams JV . N Engl J Med 2013 368 (7) 633-43 BACKGROUND: The inpatient and outpatient burden of human metapneumovirus (HMPV) infection among young children has not been well established. METHODS: We conducted prospective, population-based surveillance for acute respiratory illness or fever among inpatient and outpatient children less than 5 years of age in three U.S. counties from 2003 through 2009. Clinical and demographic data were obtained from parents and medical records, HMPV was detected by means of a reverse-transcriptase polymerase-chain-reaction assay, and population-based rates of hospitalization and estimated rates of outpatient visits associated with HMPV infection were determined. RESULTS: HMPV was detected in 200 of 3490 hospitalized children (6%), 222 of 3257 children in outpatient clinics (7%), 224 of 3001 children in the emergency department (7%), and 10 of 770 asymptomatic controls (1%). Overall annual rates of hospitalization associated with HMPV infection were 1 per 1000 children less than 5 years of age, 3 per 1000 infants less than 6 months of age, and 2 per 1000 children 6 to 11 months of age. Children hospitalized with HMPV infection, as compared with those hospitalized without HMPV infection, were older and more likely to receive a diagnosis of pneumonia or asthma, to require supplemental oxygen, and to have a longer stay in the intensive care unit. The estimated annual burden of outpatient visits associated with HMPV infection was 55 clinic visits and 13 emergency department visits per 1000 children. The majority of HMPV-positive inpatient and outpatient children had no underlying medical conditions, although premature birth and asthma were more frequent among hospitalized children with HMPV infection than among those without HMPV infection. CONCLUSIONS: HMPV infection is associated with a substantial burden of hospitalizations and outpatient visits among children throughout the first 5 years of life, especially during the first year. Most children with HMPV infection were previously healthy. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health.). |
The burden of influenza in young children, 2004-2009
Poehling KA , Edwards KM , Griffin MR , Szilagyi PG , Staat MA , Iwane MK , Snively BM , Suerken CK , Hall CB , Weinberg GA , Chaves SS , Zhu Y , McNeal MM , Bridges CB . Pediatrics 2013 131 (2) 207-16 OBJECTIVE: To characterize the health care burden of influenza from 2004 through 2009, years when influenza vaccine recommendations were expanded to all children aged ≥6 months. METHODS: Population-based surveillance for laboratory-confirmed influenza was performed among children aged <5 years presenting with fever and/or acute respiratory illness to inpatient and outpatient settings during 5 influenza seasons in 3 US counties. Enrolled children had nasal/throat swabs tested for influenza by reverse transcriptase-polymerase chain reaction and their medical records reviewed. Rates of influenza hospitalizations per 1000 population and proportions of outpatients (emergency department and clinic) with influenza were computed. RESULTS: The study population comprised 2970, 2698, and 2920 children from inpatient, emergency department, and clinic settings, respectively. The single-season influenza hospitalization rates were 0.4 to 1.0 per 1000 children aged <5 years and highest for infants <6 months. The proportion of outpatient children with influenza ranged from 10% to 25% annually. Among children hospitalized with influenza, 58% had physician-ordered influenza testing, 35% had discharge diagnoses of influenza, and 2% received antiviral medication. Among outpatients with influenza, 7% were tested for influenza, 7% were diagnosed with influenza, and <1% had antiviral treatment. Throughout the 5 study seasons, <45% of influenza-negative children ≥6 months were fully vaccinated against influenza. CONCLUSIONS: Despite expanded vaccination recommendations, many children are insufficiently vaccinated, and substantial influenza burden remains. Antiviral use was low. Future studies need to evaluate trends in use of vaccine and antiviral agents and their impact on disease burden and identify strategies to prevent influenza in young infants. |
The epidemiology and clinical characteristics of young children hospitalized with respiratory syncytial virus infections in Guatemala (2007-2010)
Langley GF , McCracken J , Arvelo W , Estevez A , Villarruel G , Prill M , Iwane M , Gray J , Moscoso F , Reyes L , Moir JC , Ortiz J , Lindblade K . Pediatr Infect Dis J 2013 32 (6) 629-35 BACKGROUND: There have been few population-based studies from Central America on respiratory syncytial virus (RSV) infections in young children. We report population-based incidence rates and describe epidemiological and clinical characteristics of children < 5 years old hospitalized with RSV infections in Guatemala. METHODS: Prospective, active hospital-based surveillance for acute respiratory infections in children <5 years old was conducted at three hospitals in Guatemala from November 2007 through July 2010. RSV hospitalization rates were calculated for areas where the catchment population could be defined. Comparisons were made between children who were RSV-positive and RSV-negative. RESULTS: RSV was detected in 549 (25%) of enrolled children. Overall, annual rates of RSV hospitalizations ranged from 5.9 to 45.9 and 2.0 to 13.7 per 1000 children <1 year old and <5 years old, respectively, but varied by location and calendar year. Rates generally decreased with age-children <6 months had rates up to 30 times higher than older children, but children >12 months old still had rates up to 5.5 per 1000 per year and accounted for 42% of deaths. Children with RSV infections were more likely to have signs of respiratory distress (85% vs. 63%, p<0.001) compared to those without RSV infections, but case fatality ratios were similar (3-4%). CONCLUSIONS: The large burden and severity of RSV infections in young Guatemalan children is similar in magnitude and age distribution to RSV disease burdens found in other developing countries and suggests that this population would benefit from prevention strategies, including vaccines against RSV that are currently under development. |
Validity of parental report of influenza vaccination in young children seeking medical care
Brown C , Clayton-Boswell H , Chaves SS , Prill MM , Iwane MK , Szilagyi PG , Edwards KM , Staat MA , Weinberg GA , Fairbrother G , Hall CB , Zhu Y , Bridges CB . Vaccine 2011 29 (51) 9488-9492 BACKGROUND: Despite frequent use of self-reported information to determine pediatric influenza vaccination coverage, little data are available on the validity of parental reporting of their child's influenza vaccination status and on factors affecting its accuracy. METHODS: We compared parent reported influenza vaccination of children to documented reports of vaccination collected from medical records (the criterion standard) among children aged 6-59 months who presented to selected hospitals, emergency departments, and clinics in three U.S. counties with acute respiratory illness during three influenza seasons (November through May of 2004-2007). Demographic and epidemiologic data were collected from chart reviews and parental surveys. RESULTS: Among 3072 children aged 6-59 months, 47.5% were reported by the parent to have received influenza vaccine and 39.5% of children had medical record verification of influenza vaccination. Sensitivity and specificity of parental reporting was 92.1% and 82.3%, respectively, when compared to the immunization record. However, 17.7% of children whose parents reported vaccination had no influenza vaccination documented in their medical records, and this proportion was even higher at 28.6%, among children with an underlying high-risk medical condition. Greater reporting accuracy was associated with younger age of child (6-23 months vs. 24-59 months), white non-Hispanic race/ethnicity, having health insurance, and having a mother with a college education. CONCLUSIONS: Our findings indicate that although parental report of influenza vaccination is fairly reliable ( approximately 76-96%), over reporting by parents often occurs and immunization record review remains the preferable method for determining vaccination status in children. |
Human coronavirus in young children hospitalized for acute respiratory illness and asymptomatic controls
Prill MM , Iwane MK , Edwards KM , Williams JV , Weinberg GA , Staat MA , Willby MJ , Talbot HK , Hall CB , Szilagyi PG , Griffin MR , Curns AT , Erdman DD . Pediatr Infect Dis J 2011 31 (3) 235-40 BACKGROUND: Human coronaviruses (HCoVs) have been detected in children with upper and lower respiratory symptoms but little is known about their relationship with severe respiratory illness. OBJECTIVE: To compare the prevalence of HCoV species among children hospitalized for acute respiratory illness and/or fever with asymptomatic controls and to assess the severity of outcomes among hospitalized children with HCoV compared with other respiratory viruses. METHODS: From December 2003-April 2004 and October 2004-April 2005, we conducted prospective, population-based surveillance of children <5 years of age hospitalized for ARI/fever in three US counties. Asymptomatic outpatient controls were enrolled concurrently. Nasal/throat swabs were tested for HCoV species HKU1, NL63, 229E, and OC43 by RT-PCR. Specimens from hospitalized children were also tested for other common respiratory viruses. Demographic and medical data were collected by parent/guardian interview and medical chart review. RESULTS: Overall, HCoV was detected in 113 (7.6%) of 1481 hospitalized children (83 [5.7%] after excluding 30 cases coinfected with other viruses) and 53 (7.1%) of 742 controls. The prevalence of HCoV or individual species was not significantly higher among hospitalized children than controls. Hospitalized children testing positive for HCoV alone tended to be less ill than those infected with other viruses, whereas those coinfected with HCoV and other viruses were clinically similar to those infected with other viruses alone. CONCLUSION: In this study of children hospitalized for acute respiratory illness and/or fever, HCoV infection was not associated with hospitalization or with increased severity of illness. |
Human rhinovirus species associated with hospitalizations for acute respiratory illness in young US children
Iwane MK , Prill MM , Lu X , Miller EK , Edwards KM , Hall CB , Griffin MR , Staat MA , Anderson LJ , Williams JV , Weinberg GA , Ali A , Szilagyi PG , Zhu Y , Erdman DD . J Infect Dis 2011 204 (11) 1702-10 BACKGROUND: The contribution of human rhinovirus (HRV) to severe acute respiratory illness (ARI) is unclear.OBJECTIVE: To assess the association between HRV species detection and ARI hospitalizations. METHODS: Children <5 years old hospitalized for ARI were prospectively enrolled between December 2003 and April 2005 in 3 US counties. Asymptomatic controls were enrolled between December 2003 and March 2004 and between October 2004 and April 2005 in clinics. Nasal and throat swab samples were tested for HRV and other viruses (ie, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, and influenza virus) by reverse-transcription-polymerase chain reaction, and genetic sequencing identified HRV species and types. HRV species detection was compared between controls and patients hospitalized during months in which controls were enrolled. RESULTS: A total of 1867 children with 1947 ARI hospitalizations and 784 controls with 790 clinic visits were enrolled and tested for HRV. The HRV-A detection rate among participants ≥24 months old was 8.1% in the hospitalized group and 2.2% in the control group (P = .009), and the HRV-C detection rates among those ≥6 months old were 8.2% and 3.9%, respectively (P = .002); among younger children, the detection rates for both species were similar between groups. The HRV-B detection rate was ≤1%. A broad diversity of HRV types was observed in both groups. Clinical presentations were similar among HRV species. Compared with children infected with other viruses, children with HRV detected were similar for severe hospital outcomes and more commonly had histories or diagnoses of asthma or wheezing. CONCLUSIONS: HRV-A and HRV-C were associated with ARI hospitalization and serious illness outcomes. |
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