Abstract
BackgroundInformation on the etiology and age-specific burden of respiratory viral infections among school-aged children remains limited. Though school aged children are often recognized as driving the transmission of influenza as well as other respiratory viruses, little detailed information is available on the distribution of respiratory infections among children of different ages within this group. Factors other than age including gender and time spent in school may also be important in determining risk of infection but have been little studied in this age group.MethodsWe conducted a cohort study to determine the etiology of influenza like illness (ILI) among 2519 K–12 students during the 2012–13 influenza season. We obtained nasal swabs from students with ILI-related absences. Generalized linear mixed-effect regressions determined associations of outcomes, including ILI and laboratory-confirmed respiratory virus infection, with school grade and other covariates.ResultsOverall, 459 swabs were obtained from 552 ILI–related absences. Respiratory viruses were found in 292 (63.6%) samples. Influenza was found in 189 (41.2%) samples. With influenza B found in 134 (70.9%). Rates of influenza B were significantly higher in grades 1 (10.1, 95% CI 6.8–14.4%), 2 (9.7, 6.6–13.6%), 3 (9.3, 6.3–13.2%), and 4 (9.9, 6.8–13.8%) than in kindergarteners (3.2, 1.5–6.0%). After accounting for grade, sex and self-reported vaccination status, influenza B infection risk was lower among kindergarteners in half-day programs compared to kindergarteners in full-day programs (OR = 0.19; 95% CI 0.08–0.45).ConclusionsILI and influenza infection is concentrated in younger schoolchildren. Reduced infection by respiratory viruses is associated with a truncated school day for kindergarteners but this finding requires further investigation in other grades and populations.
Highlights
Information on the etiology and age-specific burden of respiratory viral infections among schoolaged children remains limited
We found significant variation in Cumulative attack rates (CARs) between grades and schools for children identified with influenza like illness (ILI), children testing positive for any of the viruses tested, and children testing positive for influenza
Influenza was the most common viral pathogen identified among these children, we found the presence of other respiratory viruses in a substantial proportion of detected ILI episodes, suggesting that the burden of ILI in school age children during the normal influenza season may not be entirely due to infection with influenza
Summary
Information on the etiology and age-specific burden of respiratory viral infections among schoolaged children remains limited. Though school aged children are often recognized as driving the transmission of influenza as well as other respiratory viruses, little detailed information is available on the distribution of respiratory infections among children of different ages within this group. In the United States and Australia, the onset of pandemic influenza incidence was linked to school opening dates [11]. Children experience higher rates of infection, shed influenza virus longer than adults, and have social mixing patterns conducive to the propagation of respiratory viruses [5, 12]. Current influenza vaccination programs in the United States target individuals 6 months of age and older. Programs in the United Kingdom target children 17 years of age and younger, with a program that phases universal coverage in beginning with younger children [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
