Acute respiratory tract infections

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Scope

What is the incidence of acute respiratory tract infections in the general population?

Definition

Rate (age, sex ratio)	Context (population size studied, location, date data taken, end-point measured)	Definition of end-point	Reference
Incidence rates of first episodes of GP-diagnosed respiratory tract infections per 1000 person-years All M F 0–4 years 5–14 yrs 15–49 yrs 50–64 yrs 65–74 years >74 years Acute otitis media 15.6 16.3 15.0 135.9 33.5 5.4 3.2 2.7 1.6 Rhinitis 51.0 45.1 57.5 211.5 47.6 40.3 39.3 41.7 41.9 Acute sinusitis 22.7 15.7 29.9 2.9 7.4 29.7 25.8 17.2 9.6 Acute tonsillitis 10.2 8.7 11.7 25.8 13.6 12.0 3.2 2.3 0.8 Acute laryngitis 4.5 4.0 5.1 16.2 2.6 3.5 5.2 4.5 3.7 Acute bronchitis 19.9 18.6 21.5 55.4 14.0 12.8 21.8 31.8 42.0 Influenza 2.2 2.2 2.2 1.8 1.9 2.4 2.3 1.6 2.4 Pneumonia 6.4 6.7 6.2 16.6 4.8 3.2 6.1 12.5 21.6 Asthma /COPD exacerb. 1.4 1.4 1.5 3.7 1.0 0.7 1.5 3.5 3.7 Red text = upper RTI Blue text = lower RTI	Netherlands, 90 computerized general practices with 358 008 patients recorded consecutive patient contacts in a 12-month period between May 2000 and April 2002, doctor diagnosed ARIs	Defined URTI GP-diagnoses as occurrence of acute otitis media (ICPC code H71), acute rhinitis (R74), acute sinusitis (R75), acute tonsillitis (R76) and acute laryngitis (R77). LRTI GP diagnoses defined as acute bronchitis (R78), influenza (R80), pneumonia (R81) or exacerbations of asthma or COPD (R78)	E Hak, MM Rovers, MM Kuyvenhoven, FG Schellevis and TJM Verheij. Incidence of GP-diagnosed respiratory tract infections according to age, gender and high-risk co-morbidity: the Second Dutch National Survey of General Practice. Family Practice Advance Access published on 7 February 2006.
Variables Number Total ARI 984 (100)* Fever 238 (24.2) Runny/blocked nose 945 (96.0) Cough 756 (76.8) Rattly or wheezy chest 329 (33.4) Wheeze present 95 (9.7) Upper respiratory infections† 655 (66.6) Lower respiratory infections 329 (33.4) Nonwheezy LRI† 234 (23.8) Wheezy LRI† 95 (9.7) Physician visit 478 (48.6) Hospitalization 17 (1.7) RSV 5 (29.4)‡ Rhinoviruses 3 (17.6)‡ Parainfluenza 3 1 (5.9)‡ Influenza 1 (5.9)‡ Parainfluenza and RSV 1 (5.9)‡ Adenovirus 1 (5.9)‡ No virus detected 5 (29.4)‡ *Numbers in parentheses, percent. †Mutually exclusive. ‡As % of hospitalized. The majority reported 2–5 episodes of ARI in the first year (range = 0–11 episodes; mean = 4.1).	Study conducted btw July 1996 and July 1999, 263 infants at high risk of atopy (i.e. at least 1 parent with a doctor-diagnosed history of asthma, hay fever or eczema) followed until they reached 1yo. Australia, all ARIs.	Parent diagnosed	Merci M. H. Kusel, Nicholas H. de Klerk, Patrick G. Holt, Tatiana Kebadze, Sebastian L. Johnston, and Peter D. Sly. Role of Respiratory Viruses in Acute Upper and Lower Respiratory Tract Illness in the First Year of Life: A Birth Cohort Study. Pediatr Infect Dis J 2006;25: 680–686
See attached document for rates of wheeze in children expressed in % in different countries.	Europe, different studies all summarised, majority of studies use data from 1990’s.	Wheeze (from ISAAC)	Document sourced from: Swatee P Patel, Marjo-Riitta Järvelin and Mark P Little. Systematic review of worldwide variations of the prevalence of wheezing symptoms in children. Environmental Health 2008, 7:57.

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