{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:22:54Z","timestamp":1787656974411,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009139","name":"Deutsches Zentrum f\u00fcr Infektionsforschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010441","name":"Medizinischen Fakult\u00e4t Heidelberg, Universit\u00e4t Heidelberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study aimed to assess the relationship between clinical course and influenza virus characteristics by quantifying viral load and performing phylogenetic analyses in hospitalized children. Children aged 0\u20133 years presenting with an acute respiratory tract infection (RTI) at the Childrens' Hospital Heidelberg\/Germany were included and nasopharyngeal swabs were collected. Viral load was quantified by real\u2010time polymerase chain reaction and influenza virus (sub)type was identified by haemagglutinin gene sequencing. Among 1464 respiratory samples collected, 139 were positive for influenza virus, and 112 samples were selected for viral load analysis and sequencing. Influenza\u2010positive children were significantly older than influenza\u2010negative children (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and presented with symptoms of rhinitis (94.8%), cough (83.7%), and fever (54.3%). They presented most frequently with admission diagnoses of upper RTI (22.3%), febrile convulsion (18.7%), and pneumonia (15.8%). Children with high viral load were younger (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), however clinical presentation was not associated with viral load levels. Comparing influenza A (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009104\/139) and B (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935\/139) infections, no differences in demographic or clinical characteristics were identified. Children with influenza A(H1N1)pdm09 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200954\/104) had pneumonia (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), tachypnoea (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004), rales (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.041), and retractions (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.015) more frequently compared to influenza A(H3N2)\u2010infected children (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950\/104). Phylogenetic analyses showed that the identified influenza virus strains were consistent with nationwide and European data in the corresponding seasons. Viral load and influenza type A compared to B did not correlate with a more severe course of disease; however, viral load was higher in younger children and influenza subtype A(H1N1)pdm09 was significantly associated with lower RTI.\n                  <\/jats:p>","DOI":"10.1002\/jmv.71096","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:26:55Z","timestamp":1786447615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Course, Viral Load, and (Sub)Type of Influenza in Hospitalized Children in Southern Germany"],"prefix":"10.1002","volume":"98","author":[{"given":"Sarah","family":"Klemm","sequence":"first","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"},{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Children's Hospital, Deaconess Foundation Hospital Speyer Speyer Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara Marlene","family":"Ihling","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"},{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Dr. von Hauner Children's Hospital University Hospital of the LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-4163","authenticated-orcid":false,"given":"Julia","family":"Gsenger","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"},{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Department of Paediatrics I Centre for Paediatric and Adolescent Medicine Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6237-9058","authenticated-orcid":false,"given":"Maximillian","family":"Stich","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Department of Paediatrics I Centre for Paediatric and Adolescent Medicine Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0104-8375","authenticated-orcid":false,"given":"Johannes","family":"Pfeil","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Kinder\u2010 und Hausarztpraxis Schwaigern Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silan","family":"\u00dcnal","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"},{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Darmst\u00e4dter Kinderkliniken Darmstadt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Wedde","sequence":"additional","affiliation":[{"name":"Robert Koch Institute, Unit 17: Influenza and Other Respiratory Viruses, National Reference Centre for Influenza Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3432-0438","authenticated-orcid":false,"given":"Ralf","family":"D\u00fcrrwald","sequence":"additional","affiliation":[{"name":"Robert Koch Institute, Unit 17: Influenza and Other Respiratory Viruses, National Reference Centre for Influenza Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3205-9464","authenticated-orcid":false,"given":"Julia","family":"Tabatabai","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases, Virology, Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"},{"name":"Deutsches Zentrum f\u00fcr Infektionsforschung (DZIF), Partner Site Heidelberg Heidelberg Germany"},{"name":"Department of Paediatrics I Centre for Paediatric and Adolescent Medicine Medical Faculty Heidelberg Heidelberg University Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001977"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(19)30545-5"},{"key":"e_1_2_9_4_1","volume-title":"Inanspruchnahme von Influenzaimpfungen bei chronisch kranken Personen im vertrags\u00e4rztlichen Sektor\u2014Auswertung der Abrechnungsdaten f\u00fcr den Zeitraum 2009 bis 2018","author":"Akmatov M. 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