title: The clinical and etiological characteristics of influenza-like illness (ILI) in outpatients in Shanghai, China, 2011 to 2013.
abstract: BACKGROUND
  Clinical and etiological characteristics of influenza-like illness (ILI) in outpatients is poorly understood in the southern temperate region of China. We conducted laboratory-based surveillance of viral etiology for ILI outpatients in Shanghai from January 2011 to December 2013.
  
  
  METHODS
  Clinical and epidemiological data from ILI outpatients, both children and adults, were collected. A total of 1970 nasopharyngeal swabs were collected and tested for 12 respiratory viruses using multiplex RT-PCR, and the data were analyzed anonymously.
  
  
  RESULTS
  All 12 respiratory viruses were detected in the specimens. At least one virus was detected in 32.4% of 1970 specimens analyzed, with 1.1% showing co-infections. The most frequently detected agents were influenza A (11.7%), influenza B (9.6%), and rhinoviruses (3.1%).Other viruses were present at a frequency less than 3.0%. We observed a winter peak in the detection rate in ILI patients during 3 years of surveillance and a summer peak in 2012. HCoV, HADV, and HMPV were detected more frequently in children than in adults. Patients infected with influenza virus experienced higher temperatures, more coughs, running noses, headaches and fatigue than patients infected with other viruses and virus-free patients (p<0.001).
  
  
  CONCLUSIONS
  The spectrum, seasonality, age distribution and clinical associations of respiratory virus infections in children and adults with influenza-like illness were analyzed in this study for the first time. To a certain extent, the findings can provide baseline data for evaluating the burden of respiratory virus infection in children and adults in Shanghai. It will also provide clinicians with helpful information about the etiological patterns of outpatients presenting with complaints of acute respiratory syndrome, but further studies should be conducted, and longer-term laboratory-based surveillance would give a better picture of the etiology of ILI.
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Microbiology Laboratory, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Lifeng
authors.initials: L
authors.lastname: Pan
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Microbiology Laboratory, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Linying
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Chuchu
authors.initials: C
authors.lastname: Ye
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Caoyi
authors.initials: C
authors.lastname: Xue
authors.affiliation: Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Yuanping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Microbiology Laboratory, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Microbiology Laboratory, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Ma
authors.affiliation: Department of Microbiology Laboratory, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Huifang
authors.initials: H
authors.lastname: Qiu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009975:Orthomyxoviridae / Q000235:genetics / Q000302:isolation & purification; D010045:Outpatients; D012328:RNA Viruses / Q000235:genetics / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012621:Seasons; D055815:Young Adult
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