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. 2024 Jun 21:12:100394.
doi: 10.1016/j.ijregi.2024.100394. eCollection 2024 Sep.

Prospective cohort study of patient demographics, viral agents, seasonality, and outcomes of influenza-like illness in Mexico in the late H1N1-pandemic and post-pandemic years (2010-2014)

Arturo Galindo-Fraga  1 , Paola Del Carmen Guerra-de-Blas  2 , Ana A Ortiz-Hernández  3 , Kevin Rubenstein  4 , Ana M Ortega-Villa  5 , Alejandra Ramírez-Venegas  6 , Rafael Valdez-Vázquez  7 , Sarbelio Moreno-Espinosa  8 , Beatriz Llamosas-Gallardo  3 , Santiago Pérez-Patrigeon  9   10 , Daniel E Noyola  11 , Martín Magaña-Aquino  12 , Ana Vilardell-Dávila  2 , M Lourdes Guerrero  10 , John H Powers  13 , John Beigel  5 , Guillermo M Ruiz-Palacios  10 ; Mexican Emerging Infectious Disease Clinical Research Network
Affiliations

Prospective cohort study of patient demographics, viral agents, seasonality, and outcomes of influenza-like illness in Mexico in the late H1N1-pandemic and post-pandemic years (2010-2014)

Arturo Galindo-Fraga et al. IJID Reg. .

Abstract

Objectives: Influenza-like illness (ILI) caused by respiratory viruses results in various respiratory clinical manifestations. The ILI002 prospective observational cohort study aimed to describe viral agents, seasonality, and outcomes of patients with ILI during four seasons in the influenza H1N1-pandemic and post-pandemic years (2010-2014).

Methods: Patients from six Mexican hospitals were enrolled from April 2010 to March 2014. Clinical data and nasopharyngeal swabs were obtained and tested for viral respiratory pathogens by real-time reverse-transcription polymerase chain reaction.

Results: Of the 5662 enrolled participants, 64.9% were adults and 35.1% were children. Among the 5629 participants with single-pathogen detection, rhinovirus (20.2%), influenza virus (11.2%), respiratory syncytial virus (RSV) (7.2%), and coronavirus (6.8%) were the most frequent pathogens. Co-infection occurred in 14.5% of cases; 49.3% of participants required hospitalization, particularly in RSV cases (42.9% adults, 89.6% children). The mortality rate was 2.8% higher among older adult participants and those with comorbidities. Influenza H1N1 had the highest mortality rate, yet almost half of the deceased had no pathogen. Rhinovirus persisted year-round, while influenza, coronavirus, and RSV peaked during cooler months.

Conclusions: Analyses showed that some viruses causing ILI may lead to severe disease and hospitalization irrespective of comorbidities. These findings may help in decision-making about public health policies on prevention measures, vaccination, treatment, and administration of health care.

Keywords: Clinical characteristics; Influenza-like illness; Respiratory viruses; Seasonality.

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Conflict of interest statement

Doctor Daniel E. Noyola reports a relationship with AbbVie Inc, Sanofi Pasteur, MSD, GSK, Pfizer, and AstraZeneca that includes speaking and lecture fees. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Figures

Figure 1
Figure 1
Flowchart of study participants seeking care for influenza-like illness at 6 hospitals in Mexico.
Figure 2
Figure 2
Monthly distribution of viral isolates for the most prevalent viruses (April 2010 to April 2014). RSV, respiratory syncytial virus.
Figure 3
Figure 3
Distribution of viral isolates (April 2010 to April 2014). Monthly frequencies of observed virus subtypes are shown for coronavirus (a), influenza virus (b), respiratory syncytial virus (c), and rhinovirus (d). Co-infected individuals are counted multiple times, once for each virus subtype detected. RSV, respiratory syncytial virus.
See this image and copyright information in PMC

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