Category: Virology: Studies of the Epidemiology of Viral Infections

Poster Session: Virology: Studies of the Epidemiology of Viral Infections

1714 - Influenza C Virus in U.S. Children with Acute Respiratory Infection 2016-2019

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Presenting Author(s)

Bethany K. Sederdahl

Medical Student
University of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

Geoffrey A. Weinberg

Professor
University of Rochester School of Medicine & Dentistry
Rochester, NY
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Angela P. Campbell

Medical Officer
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RS

Rangaraj Selvarangan

Director
Children’s Mercy Kansas City
Kansas City, Missouri
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JS

Jennifer E. Schuster

Associate Professor
Children’s Mercy Kansas City
Kansas City, Missouri
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CH

Christopher J. Harrison

Professor
The Children's Mercy Hospital- Kansas City
Kansas City, Missouri
Disclosure: GSK (Grant/Research Support, Infant menigiciccal B conjugate vaccine trial)Merck (Research Grant or Support, Infant pneumococcal conjugate vaccine trial)
BR

Brian Rha

Medical Epidemiologist
Division of Viral Diseases, U.S. Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JL

Joana Y. Lively

Epidemiologist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MP

Manish M. Patel

Medical Officer
U.S. Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BS

Bo Shu

Biologist
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JB

Julie A. Boom

Associate professor
Baylor College of Medicine and Texas Children's Hospital
Houston, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
VA

Vasanthi Avadhanula

Assistant professor
Baylor College of Medicine
Houston, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Natasha B. Halasa

Craig Weaver Professor of Pediatrics
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it's a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)
LS

Laura S. Stewart

Program Manager
Vanderbilt University Medical Center
Nashville, Tennessee
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
PS

Peter G. Szilagyi

Professor
UCLA School of Medicine
Agoura Hills, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RH

Robert Hickey

Professor
Childrens Hospital of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MM

Marian G. Michaels

Professor
UPMC Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JW

John V. Williams

Professor
University of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: GlaxoSmithKline (Advisor or Review Panel member)IDConnect (Advisor or Review Panel member)Quidel (Advisor or Review Panel member)

Background: Influenza C virus (ICV) is associated with acute respiratory infection (ARI); however, the burden of ICV is not well-described. We sought to determine the burden and characteristics of ICV in a prospective, population-based cohort.

Methods: The study was conducted within the New Vaccine Surveillance Network (NVSN), a CDC-led, seven-site network that performs population-based surveillance for ARI in children < 5 years. Nasal/throat swabs were collected from emergency department (ED) or inpatient children with ARI, or healthy controls in clinic, between 12/05/2016-10/31/2019 and tested by real-time RT-PCR for ICV and other respiratory viruses. Preliminary data were extracted and demographic/clinical features of ICV+ cases analyzed. We sequenced the hemagglutinin-esterase (HE) gene from ICV+ Pittsburgh samples.

Results: Among 19,321 children with ARI or healthy controls enrolled and tested for ICV from 2016-2019, 115/17,668 (0.7%) ARI cases and 8/1653 (0.5%) healthy controls tested positive for ICV. The median age of ICV+ ARI subjects was 19 months (IQR 10,46) and 81(70%) were ≤36 months. 42.6% (49) were white, 33.9% (39) black, and 16.5% (19) Hispanic, with the remainder Asian or unknown; 56.5% (62) attended daycare. Among ICV+ ARI cases, 67.8% (78) had fever, 94.8% (109) cough, and 60.8% (70) wheezing. 45.2% (52) ICV+ cases occurred in 2016-17, 6.5% (8) in 2017-2018, and 47.8% (55) in 2018-19 (Table). 40% (46) of ICV+ cases were seen in the ED, while the remainder were inpatients. Median length of stay was 2d (IQR,1-3) with 15 admitted to ICU. 67.8% (78/115) ARI cases had 1 or 2 co-detected pathogens, with rhinovirus (26), respiratory syncytial virus (26), and adenovirus (14) most frequently co-detected. ARI symptoms including fever, myalgias, chills, and wheezing did not differ significantly between coinfected subjects and those who were only ICV+. HE sequences were in the two currently circulating Kanagawa and Sao Paulo lineages.ICV+ Cases by Site and Year

Conclusion: ICV was an uncommon cause of ARI symptoms leading to healthcare encounters in young children. The prevalence varied year-to-year and between different geographic regions. Most children infected with ICV were ≤3 years old and had co-detected pathogens. ICV was similarly rarely detected in healthy controls.