title: Extensive multiplex PCR diagnostics reveal new insights into the epidemiology of viral respiratory infections.
abstract: Viral respiratory infections continue to pose a major global healthcare burden. At the community level, the co-circulation of respiratory viruses is common and yet studies generally focus on single aetiologies. We conducted the first comprehensive epidemiological analysis to encompass all major respiratory viruses in a single population. Using extensive multiplex PCR diagnostic data generated by the largest NHS board in Scotland, we analysed 44230 patient episodes of respiratory illness that were simultaneously tested for 11 virus groups between 2005 and 2013, spanning the 2009 influenza A pandemic. We measured viral infection prevalence, described co-infections, and identified factors independently associated with viral infection using multivariable logistic regression. Our study provides baseline measures and reveals new insights that will direct future research into the epidemiological consequences of virus co-circulation. In particular, our study shows that (i) human coronavirus infections are more common during influenza seasons and in co-infections than previously recognized, (ii) factors associated with co-infection differ from those associated with viral infection overall, (iii) virus prevalence has increased over time especially in infants aged <1 year, and (iv) viral infection risk is greater in the post-2009 pandemic era, likely reflecting a widespread change in the viral population that warrants further investigation.
authors.affiliation: MRC-University of Glasgow Centre for Virus Research,Institute of Infection,Inflammation and Immunity,Glasgow,UK.
authors.forename: S
authors.initials: S
authors.lastname: Nickbakhsh
authors.affiliation: MRC-University of Glasgow Centre for Virus Research,Institute of Infection,Inflammation and Immunity,Glasgow,UK.
authors.forename: F
authors.identifier: 0000-0003-1202-4782
authors.initials: F
authors.lastname: Thorburn
authors.affiliation: Health Protection Scotland,NHS National Services Scotland,Glasgow,UK.
authors.forename: B
authors.initials: B
authors.lastname: VON Wissmann
authors.affiliation: Health Protection Scotland,NHS National Services Scotland,Glasgow,UK.
authors.forename: J
authors.initials: J
authors.lastname: McMENAMIN
authors.affiliation: West of Scotland Specialist Virology Centre,NHS Greater Glasgow and Clyde,GlasgowUK.
authors.forename: R N
authors.initials: RN
authors.lastname: Gunson
authors.affiliation: MRC-University of Glasgow Centre for Virus Research,Institute of Infection,Inflammation and Immunity,Glasgow,UK.
authors.forename: P R
authors.initials: PR
authors.lastname: Murcia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012606:Scotland / Q000453:epidemiology; D012621:Seasons; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult
keywords: Co-infections; pandemic influenza; risk factor analysis; surveillance