Objective: Assess the temporal correlation between circulating respiratory viruses and occurrence of ambulatory care visits for AOM in children.
Methods: This retrospective study included 9 seasons of respiratory viral activity (2002-2010) in Utah using the Intermountain Healthcare (Intermountain) system. We identified children <18 years with an ICD-9 code consistent with AOM diagnosed during an outpatient visit and assessed respiratory viral activity via laboratory-based active surveillance. We used interrupted time series models to assess the correlation between AOM and circulating respiratory viruses.
Results: AOM was diagnosed during a total of 208,934 ambulatory visits at an Intermountain facility during the study period. Concurrently, 96,486 children had a viral respiratory test performed. Of these, 49,640 (51%) were positive. The most frequently identified viruses included: RSV (43%), influenza virus (16%), rhinovirus (15%), parainfluenza virus (8%), adenoviruses (6%), and human metapneumovirus (5%). There were significant correlations between AOM and influenza virus A, RSV, and human metapneumovirus. Peak correlations were observed 8 weeks after RSV activity (P<0.001) and 7 weeks after human metapneumovirus activity (P<0.001).
Conclusions: Influenza A, RSV, and human metapneumovirus have a seasonal role associated with increased diagnoses of AOM among children. These findings have important implications for the use and development of viral vaccines to treat AOM.