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Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka.

Publication ,  Journal Article
Shapiro, D; Bodinayake, CK; Nagahawatte, A; Devasiri, V; Kurukulasooriya, R; Hsiang, J; Nicholson, B; De Silva, AD; Østbye, T; Reller, ME ...
Published in: Am J Trop Med Hyg
July 2017

In tropical and subtropical settings, the epidemiology of viral acute respiratory tract infections varies widely between countries. We determined the etiology, seasonality, and clinical presentation of viral acute respiratory tract infections among outpatients in southern Sri Lanka. From March 2013 to January 2015, we enrolled outpatients presenting with influenza-like illness (ILI). Nasal/nasopharyngeal samples were tested in duplicate using antigen-based rapid influenza testing and multiplex polymerase chain reaction (PCR) for respiratory viruses. Monthly proportion positive was calculated for each virus. Bivariable and multivariable logistic regression were used to identify associations between sociodemographic/clinical information and viral detection. Of 571 subjects, most (470, 82.3%) were ≥ 5 years of age and 53.1% were male. A respiratory virus was detected by PCR in 63.6% (N = 363). Common viral etiologies included influenza (223, 39%), human enterovirus/rhinovirus (HEV/HRV, 14.5%), respiratory syncytial virus (RSV, 4.2%), and human metapneumovirus (hMPV, 3.9%). Both ILI and influenza showed clear seasonal variation, with peaks from March to June each year. RSV and hMPV activity peaked from May to July, whereas HEV/HRV was seen year-round. Patients with respiratory viruses detected were more likely to report pain with breathing (odds ratio [OR] = 2.60, P = 0.003), anorexia (OR = 2.29, P < 0.001), and fatigue (OR = 2.00, P = 0.002) compared with patients with no respiratory viruses detected. ILI showed clear seasonal variation in southern Sri Lanka, with most activity during March to June; peak activity was largely due to influenza. Targeted infection prevention activities such as influenza vaccination in January-February may have a large public health impact in this region.

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Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

July 2017

Volume

97

Issue

1

Start / End Page

88 / 96

Location

United States

Related Subject Headings

  • Young Adult
  • Viruses
  • Virus Diseases
  • Tropical Medicine
  • Sri Lanka
  • Seasons
  • Respiratory Tract Infections
  • Prevalence
  • Outpatients
  • Middle Aged
 

Citation

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Shapiro, D., Bodinayake, C. K., Nagahawatte, A., Devasiri, V., Kurukulasooriya, R., Hsiang, J., … Tillekeratne, L. G. (2017). Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka. Am J Trop Med Hyg, 97(1), 88–96. https://doi.org/10.4269/ajtmh.17-0032
Shapiro, David, Champica K. Bodinayake, Ajith Nagahawatte, Vasantha Devasiri, Ruvini Kurukulasooriya, Jeremy Hsiang, Bradley Nicholson, et al. “Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka.Am J Trop Med Hyg 97, no. 1 (July 2017): 88–96. https://doi.org/10.4269/ajtmh.17-0032.
Shapiro D, Bodinayake CK, Nagahawatte A, Devasiri V, Kurukulasooriya R, Hsiang J, et al. Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka. Am J Trop Med Hyg. 2017 Jul;97(1):88–96.
Shapiro, David, et al. “Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka.Am J Trop Med Hyg, vol. 97, no. 1, July 2017, pp. 88–96. Pubmed, doi:10.4269/ajtmh.17-0032.
Shapiro D, Bodinayake CK, Nagahawatte A, Devasiri V, Kurukulasooriya R, Hsiang J, Nicholson B, De Silva AD, Østbye T, Reller ME, Woods CW, Tillekeratne LG. Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka. Am J Trop Med Hyg. 2017 Jul;97(1):88–96.

Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

July 2017

Volume

97

Issue

1

Start / End Page

88 / 96

Location

United States

Related Subject Headings

  • Young Adult
  • Viruses
  • Virus Diseases
  • Tropical Medicine
  • Sri Lanka
  • Seasons
  • Respiratory Tract Infections
  • Prevalence
  • Outpatients
  • Middle Aged