Respiratory viruses and influenza-like illness: Epidemiology and outcomes in children aged 6 months to 10 years in a multi-country population sample

Background: Better population data on respiratory viruses in children in tropical and southern hemisphere countries is needed. Methods: The epidemiology of respiratory viruses among healthy children (6 months to < 10 years) with influenza-like illness (ILI) was determined in a population sample derived from an influenza vaccine trial (NCT01051661) in 17 centers in eight countries (Australia, South East Asia and Latin America). Active surveillance for ILI was conducted for approximately 1 year (between February 2010 and August 2011), with PCR analysis of nasal and throat swabs. Results: 6266 children were included, of whom 2421 experienced 3717 ILI episodes. Rhinovirus/enterovirus had the highest prevalence (41.5%), followed by influenza (15.8%), adenovirus (9.8%), parainfluenza and respiratory syncytial virus (RSV) (both 9.7%), coronavirus (5.6%), human metapneumovirus (5.5%) and human bocavirus (HBov) (2.0%). Corresponding incidence per 100 person-years was 29.78, 11.34, 7.03, 6.96, 6.94, 4.00, 3.98 and 1.41. Except for influenza, respiratory virus prevalence declined with age. The incidence of medicallyattended ILI associated with viral infection ranged from 1.03 (HBov) to 23.69 (rhinovirus/ enterovirus). The percentage of children missing school or daycare ranged from 21.4% (HBov) to 52.1% (influenza). Conclusions: Active surveillance of healthy children provided evidence of respiratory illness burden associated with several viruses, with a substantial burden in older children. (C) 2016 Published by Elsevier Ltd on behalf of The British Infection Association.GlaxoSmithKline Biologicals S.AGSK Vaccines, 20 Ave Fleming, B-1330 Wavre, BelgiumCtr Estudios Infectol Pediat, Cali, ColombiaUniv Fed Sao Paulo, Dept Pediat, Pediat Infect Dis, Sao Paulo, BrazilRes Inst Trop Med, Dept Hlth, Muntinlupa, PhilippinesInst Costarricense Invest Clin, San Jose, Costa RicaNatl Inst Publ Hlth Mexico, Cuernavaca, Morelos, MexicoPhramongkutklao Hosp, Dept Pediat, Infect Dis Unit, Bangkok, ThailandInst Nacl Pediat Mexico, Mexico City, DF, MexicoUniv Autonoma Nuevo Leon, Med Serv, Monterrey, MexicoHosp Gen Durango, Durango, MexicoFac Ciencias Med Santa Casa Sao Paulo, Sao Paulo, BrazilAssoc Fundo Incent Pesquisa, Dept Pediat, Sao Paulo, BrazilNatl Univ Singapore, Natl Healthcare Grp Polyclin, Singapore, SingaporeGSK Vaccines, King Of Prussia, PA USAUniv Melbourne, Murdoch Childrens Res Inst, Carlton, Vic, AustraliaUniv Melbourne, Melbourne Sch Populat & Global Hlth, Carlton, Vic, AustraliaPediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc