title: Severity of influenza and noninfluenza acute respiratory illness among pregnant women, 2010-2012.
abstract: OBJECTIVE
  The objective of the study was to identify characteristics of influenza illness contrasted with noninfluenza acute respiratory illness (ARI) in pregnant women.
  
  
  METHODS
  ARI among pregnant women was identified through daily surveillance during 2 influenza seasons (2010-2012). Within 8 days of illness onset, nasopharyngeal swabs were collected, and an interview was conducted for symptoms and other characteristics. A follow-up telephone interview was conducted 1-2 weeks later, and medical records were extracted. Severity of illness was evaluated by self-assessment of 12 illness symptoms, subjective ratings of overall impairment, highest reported temperature, illness duration, and medical utilization.
  
  
  RESULTS
  Of 292 pregnant women with ARI, 100 tested positive for influenza viruses. Women with influenza illnesses reported higher symptom severity than those with noninfluenza ARI (median score, 18 vs 16 of 36; P < .05) and were more likely to report severe subjective feverishness (18% vs 5%; P < .001), myalgia (28% vs 14%; P < .005), cough (46% vs 30%; P < .01), and chills (25% vs 13%; P < .01). More influenza illnesses were associated with fever greater than 38.9°C (20% vs 5%; P < .001) and higher subjective impairment (mean score, 5.9 vs 4.8; P < .001). Differences in overall symptom severity, fever, cough, chills, early health care-seeking behavior, and impairment remained significant in multivariate models after adjusting for study site, season, age, vaccination status, and number of days since illness onset.
  
  
  CONCLUSIONS
  Influenza had a greater negative impact on pregnant women than noninfluenza ARIs, as indicated by symptom severity and greater likelihood of elevated temperature. These results highlight the importance of preventing and treating influenza illnesses in pregnant women.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Battelle, Atlanta, GA. Electronic address: lsokolow@cdc.gov.
authors.forename: Leslie Z
authors.initials: LZ
authors.lastname: Sokolow
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Naleway
authors.affiliation: Division of Research, Kaiser Foundation Research Institute, Oakland, CA; Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA.
authors.forename: De-Kun
authors.initials: DK
authors.lastname: Li
authors.affiliation: Abt Associates, Inc, Cambridge, MA.
authors.forename: Pat
authors.initials: P
authors.lastname: Shifflett
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Sue
authors.initials: S
authors.lastname: Reynolds
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Henninger
authors.affiliation: Division of Research, Kaiser Foundation Research Institute, Oakland, CA.
authors.forename: Jeannette R
authors.initials: JR
authors.lastname: Ferber
authors.affiliation: Division of Research, Kaiser Foundation Research Institute, Oakland, CA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Odouli
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Irving
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Thompson
mesh_terms: D000328:Adult; D023341:Chills / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D003371:Cough / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005334:Fever / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D063806:Myalgia / Q000209:etiology / Q000503:physiopathology; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index; D055815:Young Adult
keywords: acute respiratory illness; illness severity; influenza; influenza vaccine; pregnancy