Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalization and mortality

  • Edward Goka

    Student thesis: Phd


    Introduction: Epidemiological studies have indicated that 5-38% of influenza like illnesses (ILI) develop into severe disease due to, among others, factors such as; underlying chronic diseases, age, pregnancy, and viral mutations. There are suggestions that dual or multiple virus infections may affect disease severity. This study investigated the association between co-infection between influenza A viruses and other respiratory viruses and disease severity. Methodology: Datum for samples from North West England tested between January 2007 and June 2012 was analysed for patterns of co-infection between influenza A viruses and ten respiratory viruses. Risk of hospitalization to a general ward ICU or death in single versus mixed infections was assessed using multiple logistic regression models. Results: One or more viruses were identified in 37.8% (11,715/30,975) of samples, of which 10.4% (1,214) were mixed infections and 89.6% (10,501) were single infections. Among patients with influenza A(H1N1)pdm09, co-infections occurred in 4.7% (137⁄2,879) vs. 6.5% (59⁄902) in those with seasonal influenza A virus infection. In general, patients with mixed respiratory virus infections had a higher risk of admission to a general ward (OR: 1.43, 95% CI: 1.2 - 1.7, p =
    Date of Award1 Aug 2014
    Original languageEnglish
    Awarding Institution
    • The University of Manchester
    SupervisorPamela Vallely (Supervisor) & Paul Klapper (Supervisor)


    • influenza A virus, Flu A, pandemic influenza A(H1N1)pdm09, respiratory virus infections, influenza B virus, Flu B, respiratory syncytial virus, RSV, rhinovirus, RV, adenovirus, AdV, human metapneumovirus, hMPV, parainfluenza virus types 1 to 3, hPIV1-3, hospitalization, admission to a general ward (GW), admission to an intensive care unit (ICU), death, mortality, severe disease, severity

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