The presence of fever in adults with influenza and other viral respiratory infections.
We compared the rates of fever in adult subjects with laboratory-confirmed influenza and other respiratory viruses and examined the factors that predict fever in adults. Symptom data on 158 healthcare workers (HCWs) with a laboratory-confirmed respiratory virus infection were collected using standardized data collection forms from three separate studies. Overall, the rate of fever in confirmed viral respiratory infections in adult HCWs was 23·4% (37/158). Rates varied by virus: human rhinovirus (25·3%, 19/75), influenza A virus (30%, 3/10), coronavirus (28·6%, 2/7), human metapneumovirus (28·6%, 2/7), respiratory syncytial virus (14·3%, 4/28) and parainfluenza virus (8·3%, 1/12). Smoking [relative risk (RR) 4·65, 95% confidence interval (CI) 1·33-16·25] and co-infection with two or more viruses (RR 4·19, 95% CI 1·21-14·52) were significant predictors of fever. Fever is less common in adults with confirmed viral respiratory infections, including influenza, than described in children. More than 75% of adults with a viral respiratory infection do not have fever, which is an important finding for clinical triage of adult patients with respiratory infections. The accepted definition of 'influenza-like illness' includes fever and may be insensitive for surveillance when high case-finding is required. A more sensitive case definition could be used to identify adult cases, particularly in event of an emerging viral infection.
School of Public Health and Community Medicine,UNSW Medicine,University of New South Wales,Sydney,Australia.
A A
AA
Chughtai
The Beijing Centre for Disease Prevention and Control,Beijing,China.
Q
Q
Wang
National Institute of Hygiene and Epidemiology (NIHE),Vietnam.
T C
TC
Dung
School of Public Health and Community Medicine,UNSW Medicine,University of New South Wales,Sydney,Australia.
C R
CR
Macintyre
D000328:Adult; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000473:pathology*; D014777:Virus Diseases / Q000473:pathology*
Fever; influenza-like illness; viral infection
PLoS One. 2010 May 14;5(5):e10658
20498718
Influenza Other Respir Viruses. 2012 Jan;6(1):71-7
21668660
N Engl J Med. 2009 Dec 24;361(26):2507-17
20007555
J Infect Dis. 2003 Nov 15;188(10):1571-7
14624384
Public Health Rep. 2009 Mar-Apr;124(2):193-6
19320359
J Infect Dis. 1995 Aug;172(2):389-94
7622882
Am J Epidemiol. 1985 Jun;121(6):811-22
4014174
Am J Epidemiol. 1982 Aug;116(2):212-27
7114033
Arch Intern Med. 2000 Nov 27;160(21):3243-7
11088084
J Clin Virol. 2007 Mar;38(3):221-6
17241812
Clin Pediatr (Phila). 2007 Jan;46(1):76-9
17164515
Clin Infect Dis. 2000 Jul;31(1):148-51
10913413
Clin Infect Dis. 1999 Feb;28(2):283-90
10064245
Respirology. 2003 Jun;8(2):231-3
12753540
Am J Dis Child. 1986 Nov;140(11):1159-63
3020965
Heart. 2013 Dec;99(24):1843-8
23966030
J Clin Virol. 2008 Jul;42(3):268-72
18455958
Clin Infect Dis. 2015 Jun 1;60(11):1591-5
25733370
Am J Med. 1987 Jun 19;82(6A):15-9
3591813
J Med Virol. 2009 Aug;81(8):1498-507
19551831
Arch Intern Med. 2004 Nov 8;164(20):2206-16
15534156
Infect Control Hosp Epidemiol. 2006 Mar;27(3):266-70
16532414
Eur J Clin Microbiol Infect Dis. 2012 Jul;31(7):1569-74
22080425
Pediatr Infect Dis J. 2005 Jul;24(7):605-10
15999001
Am J Epidemiol. 1980 Dec;112(6):814-9
7457472
Am J Respir Crit Care Med. 2013 May 1;187(9):960-6
23413265
J Am Geriatr Soc. 1992 Feb;40(2):115-9
1740594
J Clin Virol. 2010 Aug;48(4):239-45
20646956
Clin Infect Dis. 2003 Feb 1;36(3):299-305
12539071
J Immunol. 2005 Aug 15;175(4):2684-91
16081845
Vaccine. 2012 Apr 19;30(19):3009-14
22119589
Biomed Environ Sci. 2012 Feb;25(1):61-8
22424628
Clin Immunol Immunopathol. 1991 May;59(2):187-200
2009639
Influenza Other Respir Viruses. 2011 May;5(3):170-9
21477136
BMJ Open. 2015 Apr 22;5(4):e006577
25903751
Arch Fam Med. 1997 Sep-Oct;6(5):459-65
9305689
Emerg Infect Dis. 2003 Jun;9(6):628-33
12781000
Clin Infect Dis. 2009 Apr 15;48(8):1003-32
19281331
Clin Infect Dis. 1997 Dec;25(6):1421-9
9431390
J Intern Med. 2011 Mar;269(3):258-69
21175903
Clin Infect Dis. 2000 Nov;31(5):1166-9
11073747
Epidemiol Infect. 2015 Jan;143(1):37-47
24568719
J Infect Dis. 2010 May 15;201(10):1509-16
20377412