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Article

Incidence, Disease Severity, and Follow-Up of Influenza A/A, A/B, and B/B Virus Dual Infections in Children: A Hospital-Based Digital Surveillance Program

1
Vienna Vaccine Safety Initiative, Infectious Diseases & Vaccines, D-10437 Berlin, Germany
2
Laboratoire Chrono-Environnement LCE, UMR CNRS 6249, Université Bourgogne Franche-Comté, F-25000 Besançon, France
3
National Reference Center for Influenza, Robert Koch-Institute, D-13353 Berlin, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Feng Li
Viruses 2022, 14(3), 603; https://doi.org/10.3390/v14030603
Received: 15 February 2022 / Revised: 9 March 2022 / Accepted: 10 March 2022 / Published: 14 March 2022
(This article belongs to the Special Issue Non-A Influenza 2.0)
Influenza virus (IV) coinfection, i.e., simultaneous infection with IV and other viruses, is a common occurrence in humans. However, little is known about the incidence and clinical impact of coinfection with two different IV subtypes or lineages (“dual infections”). We report the incidence, standardized disease severity, and follow-up of IV dual infections from a hospital-based digital surveillance cohort, comprising 6073 pediatric patients fulfilling pre-defined criteria of influenza-like illness in Berlin, Germany. All patients were tested for IV A/B by PCR, including subtypes/lineages. We assessed all patients at the bedside using the mobile ViVI ScoreApp, providing a validated disease severity score in real-time. IV-positive patients underwent follow-up assessments until resolution of symptoms. Overall, IV dual infections were rare (4/6073 cases; 0.07%, incidence 12/100,000 per year) but showed unusual and/or prolonged clinical presentations with slightly above-average disease severity. We observed viral rebound, serial infection, and B/Yamagata-B/Victoria dual infection. Digital tools, used for instant clinical assessments at the bedside, combined with baseline/follow-up virologic investigation, help identify coinfections in cases of prolonged and/or complicated course of illness. Infection with one IV does not necessarily prevent consecutive or simultaneous (co-/dual) infection, highlighting the importance of multivalent influenza vaccination and enhanced digital clinical and virological surveillance. View Full-Text
Keywords: coinfection; influenza A virus; influenza B virus; lineage; subtype; vaccine-preventable disease; disease severity; point-of-care testing; bedside testing; mobile health coinfection; influenza A virus; influenza B virus; lineage; subtype; vaccine-preventable disease; disease severity; point-of-care testing; bedside testing; mobile health
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MDPI and ACS Style

Obermeier, P.E.; Seeber, L.D.; Alchikh, M.; Schweiger, B.; Rath, B.A. Incidence, Disease Severity, and Follow-Up of Influenza A/A, A/B, and B/B Virus Dual Infections in Children: A Hospital-Based Digital Surveillance Program. Viruses 2022, 14, 603. https://doi.org/10.3390/v14030603

AMA Style

Obermeier PE, Seeber LD, Alchikh M, Schweiger B, Rath BA. Incidence, Disease Severity, and Follow-Up of Influenza A/A, A/B, and B/B Virus Dual Infections in Children: A Hospital-Based Digital Surveillance Program. Viruses. 2022; 14(3):603. https://doi.org/10.3390/v14030603

Chicago/Turabian Style

Obermeier, Patrick E., Lea D. Seeber, Maren Alchikh, Brunhilde Schweiger, and Barbara A. Rath. 2022. "Incidence, Disease Severity, and Follow-Up of Influenza A/A, A/B, and B/B Virus Dual Infections in Children: A Hospital-Based Digital Surveillance Program" Viruses 14, no. 3: 603. https://doi.org/10.3390/v14030603

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