Background

Acute otitis media (AOM) occurs as a complication of viral upper respiratory tract infections in young children. AOM and respiratory viruses both display seasonal variation. Our objective was to examine the temporal association between circulating respiratory viruses and the occurrence of pediatric ambulatory care visits for AOM.

Methods

This retrospective study included 9 seasons of respiratory viral activity (2002-2010) in Utah. We used Intermountain Healthcare's electronic medical records to assess community respiratory viral activity via laboratory-based active surveillance and to identify children <18 years with outpatient visits and ICD-9 codes for AOM. We assessed the strength of the association between AOM and individual respiratory viruses using interrupted time series analyses.

Results

During the study period, 96,418 respiratory viral tests were performed; 46,460 (48%) were positive. The most commonly identified viruses were: RSV (22%), rhinovirus (8%), influenza (8%), parainfluenza (4%), human metapneumovirus (3%), and adenovirus (3%). AOM was diagnosed during 271,268 ambulatory visits. There were significant associations between peak activity of RSV, human metapneumovirus, influenza A, and office visits for AOM. Adenovirus, parainfluenza, and rhinovirus were not associated with visits for AOM.

Conclusions

Seasonal RSV, human metapneumovirus, and influenza activity were temporally associated with increased diagnoses of AOM among children. These findings support the role of individual respiratory viruses in the development AOM. These data also underscore the potential for respiratory viral vaccines to reduce the burden of AOM.

CDC Public Access

KM1 CA156723/CA/NCI NIH HHS/United States
U01 AI074419/AI/NIAID NIH HHS/United States
U01 AI082184/AI/NIAID NIH HHS/United States
U01A1082482/PHS HHS/United States
U01AI074419-01/AI/NIAID NIH HHS/United States
U01AI082184-01/AI/NIAID NIH HHS/United States
U18-IP000303-01/IP/NCIRD CDC HHS/United States
UL1 RR025764/RR/NCRR NIH HHS/United States
UL1RR025764/RR/NCRR NIH HHS/United States