{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:34:35Z","timestamp":1788561275203,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute for Allergy","award":["U01 AI088654"],"award-info":[{"award-number":["U01 AI088654"]}]},{"name":"National Institute for Allergy","award":["R01 AI120997"],"award-info":[{"award-number":["R01 AI120997"]}]},{"name":"National Institute for Allergy","award":["U01 AI144616"],"award-info":[{"award-number":["U01 AI144616"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["T32GM007863"],"award-info":[{"award-number":["T32GM007863"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Children constitute an important component of the influenza burden and community transmission, but the frequency of asymptomatic infection and post-influenza sequelae at the community level is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two community-based prospective cohort studies (2011\u20132020, 2017\u20132020) and 1 case-ascertained study (2012\u20132017) were conducted in Managua, Nicaragua. Non-immunocompromised children aged 0\u201314 years with \u22651 influenza infections, determined by polymerase chain reaction and hemagglutination inhibition assay, were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1272 influenza infections occurred in the household-based portion of the study. Influenza infection was asymptomatic in 84 (6.6%) infections, and the asymptomatic fraction increased with age (1.7%, 3.5%, and 9.1% for ages 0\u20131, 2\u20134, and 5\u201314, respectively; P &amp;lt; .001). Of asymptomatic children, 43 (51.2%) shed virus, compared to 1099 (92.5%) symptomatic children (P &amp;lt; .001). Also, 2140 cases of influenza occurred in the primary care portion of the study. Sequelae of influenza were rare, with the most common being pneumonia (52, 2.4%) and acute otitis media (71, 3.3%). A\/H1N1 had higher age-adjusted odds of acute otitis media (odds ratio [OR] 1.99, 95% confidence interval [CI]: 1.14\u20133.48; P = .015) and hospitalization (OR 3.73, 95% CI: 1.68\u20138.67; P = .002) than A\/H3N2. B\/Victoria had higher age-adjusted odds of pneumonia (OR 10.99, 95% CI: 1.34\u201390.28; P = .026) than B\/Yamagata.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Asymptomatic influenza infection is much less common in children than adults, although viral shedding still occurs in asymptomatic children. Post-influenza sequelae are rare in children in the community setting, and virus strain may be important in understanding the risk of sequelae.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac734","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T09:00:20Z","timestamp":1662541220000},"page":"e1012-e1020","source":"Crossref","is-referenced-by-count":48,"title":["The Spectrum of Influenza in Children"],"prefix":"10.1093","volume":"76","author":[{"given":"Gregory","family":"Hoy","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermina","family":"Kuan","sequence":"additional","affiliation":[{"name":"Sustainable Sciences Institute , Managua , Nicaragua"},{"name":"Centro de Salud So\u0301crates Flores Vivas, Ministry of Health , Managua , 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