Open AccessViral etiology and seasonal trends of pediatric acute febrile illness in southern Puerto Rico; a seven-year review
Author(s) -
Liliana Sánchez-González,
Talía M. Quandelacy,
Michael A. Johansson,
Brenda Torres-Velásquez,
Olga Lorenzi,
Mariana Tavarez,
Sanet Torres,
Luisa I. Alvarado,
Gabriela Paz–Bailey
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0247481
Subject(s) - dengue fever , etiology , dengue virus , arbovirus , respiratory tract infections , medicine , incidence (geometry) , zika virus , pediatrics , serotype , rhinovirus , virus , virology , respiratory system , physics , optics
Background Acute febrile illness (AFI) is an important cause for seeking health care among children. Knowledge of the most common etiologic agents of AFI and its seasonality is limited in most tropical regions. Methodology/Principal findings To describe the viral etiology of AFI in pediatric patients (≤18 years) recruited through a sentinel enhanced dengue surveillance system (SEDSS) in Southern Puerto Rico, we analyzed data for patients enrolled from 2012 to May 2018. To identify seasonal patterns, we applied time-series analyses to monthly arboviral and respiratory infection case data. We calculated coherence and phase differences for paired time-series to quantify the association between each time series. A viral pathogen was found in 47% of the 14,738 patients. Influenza A virus was the most common pathogen detected (26%). The incidence of Zika and dengue virus etiologies increased with age. Arboviral infections peaked between June and September throughout the times-series. Respiratory infections have seasonal peaks occurring in the fall and winter months of each year, though patterns vary by individual respiratory pathogen. Conclusions/Significance Distinct seasonal patterns and differences in relative frequency by age groups seen in this study can guide clinical and laboratory assessment in pediatric patients with AFI in Puerto Rico.