Impact of Respiratory Virus Infections on Persons With Chronic Underlying Conditions
CONTEXT While hospitalization rates have declined overall, hospitalizations for acute lower respiratory tract infections have increased steadily since 1980. Development of new approaches for prevention of acute respiratory tract conditions requires studies of the etiologies of infections and quantif...
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Published in | JAMA : the journal of the American Medical Association Vol. 283; no. 4; pp. 499 - 505 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
American Medical Association
26.01.2000
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Subjects | |
Online Access | Get full text |
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Summary: | CONTEXT While hospitalization rates have declined overall, hospitalizations
for acute lower respiratory tract infections have increased steadily since
1980. Development of new approaches for prevention of acute respiratory tract
conditions requires studies of the etiologies of infections and quantification
of the risk of hospitalization for vulnerable patients. OBJECTIVE To determine the frequency of specific virus infections associated with
acute respiratory tract conditions leading to hospitalization of chronically
ill patients. DESIGN Analysis of viral etiology of patients hospitalized with acute respiratory
tract conditions between July 1991 and June 1995. SETTING Four large clinics and related hospitals serving diverse populations
representative of Harris County, Texas. PATIENTS A total of 1029 patients who were hospitalized for pneumonia, tracheobronchitis,
bronchiolitis, croup, exacerbations of asthma or chronic obstructive pulmonary
disease, and/or congestive heart failure. MAIN OUTCOME MEASURE Virus infection, defined by culture, antigen detection, and significant
rise in serum antibodies, by underlying condition; hospitalization rates by
low- vs middle-income status. RESULTS Ninety-three percent of patients older than 5 years had a chronic underlying
condition; a chronic pulmonary condition was most common. Patients with chronic
pulmonary disease from low-income populations were hospitalized at a rate
of 398.6 per 10,000, almost 8 times higher than the rate for patients from
middle-income groups (52.2 per 10,000; P<.001).
Of the 403 patients (44.4% of adults and 32.3% of children) who submitted
convalescent serum specimens for antibody testing, respiratory tract virus
infections were detected in 181 (44.9%). Influenza, parainfluenza, and respiratory
syncytial virus (RSV) infections accounted for 75% of all virus infections. CONCLUSIONS Our study suggests that respiratory virus infections commonly trigger
serious acute respiratory conditions that result in hospitalization of patients
with chronic underlying conditions, highlighting the need for development
of effective vaccines for these viruses, especially for parainfluenza and
RSV. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0098-7484 1538-3598 |
DOI: | 10.1001/jama.283.4.499 |