{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:07:49Z","timestamp":1785550069068,"version":"3.56.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bronchiolitis, pneumonia, and croup account for a substantial burden of pediatric hospitalizations. We aim to provide an updated, multi-center, multi-pathogen evaluation of viral detections seen with these acute respiratory illness (ARI) syndromes before and after the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included children &amp;lt;5\u00a0years with a diagnosis of bronchiolitis, pneumonia, or croup during 2017-2023 from the New Vaccine Surveillance Network. Respiratory viruses were detected with a research\u2009\u00b1\u2009clinical respiratory swabs; demographic and clinical data were obtained from caregiver interview and chart review. Virus-specific proportions across all three ARI syndromes were described, including comparisons stratified by age, surveillance year including pre- (2017-2019) and post (2021-2023) COVID-19 onset periods, and underlying medical condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 14\u2009340 cases of bronchiolitis, 4423 cases of pneumonia, and 2367 cases of croup, &amp;gt;80% had one or more respiratory virus detected. Respiratory syncytial virus (RSV) was the most frequent virus detected in bronchiolitis (41%) and pneumonia (26%), with a similar distribution across the COVID-19 onset periods. Parainfluenza virus (PIV) was the most frequent virus detected in croup (28%), but detections fell in the post-COVID-19 onset period by 8.4%; there was a comparable proportion of SARS-CoV-2 detections (7.6%) that emerged among croup cases. Rhinoviruses\/enteroviruses (RV\/EV) were the second most frequently detected virus across all three ARI syndromes and were the predominant virus in children &amp;lt;6\u00a0months and children with an underlying medical condition diagnosed with croup. Codetections were present in 17%-19% of bronchiolitis, pneumonia, and croup cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We found a high proportion of respiratory viral detections in children &amp;lt;5\u00a0years with bronchiolitis, pneumonia, or croup, particularly with RSV, RV\/EV, and PIV. Most viruses were identified in similar proportions before and after the emergence of SARS-CoV-2, except for PIV and influenza virus. In our cohort, there was a high proportion of viral detection across all three ARI syndromes, with RV\/EV frequently detected in certain age groups and among children with underlying conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piaf096","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T12:28:37Z","timestamp":1760531317000},"source":"Crossref","is-referenced-by-count":3,"title":["Viral Detection in Children &amp;lt;5\u00a0Years with Bronchiolitis, Pneumonia, and Croup, New Vaccine Surveillance Network, 2017-2023"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-0764","authenticated-orcid":false,"given":"Zheyi","family":"Teoh","sequence":"first","affiliation":[{"name":"Seattle Children\u2019s Research Institute , Seattle, WA ,","place":["United States"]},{"name":"Department of Pediatrics, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana P","family":"Toepfer","sequence":"additional","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention , Atlanta, GA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Rohlfs","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4281-1824","authenticated-orcid":false,"given":"Christopher J","family":"Harrison","sequence":"additional","affiliation":[{"name":"Children\u2019s Mercy Kansas City , Kansas City, MO ,","place":["United States"]},{"name":"University of Missouri at Kansas City School of Medicine , Kansas City, MO ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen J","family":"Klein","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Research Institute , Seattle, WA ,","place":["United States"]},{"name":"Department of Pediatrics, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5280-4439","authenticated-orcid":false,"given":"Elizabeth P","family":"Schlaudecker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]},{"name":"University of Cincinnati College of Medicine , Cincinnati, OH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3900-379X","authenticated-orcid":false,"given":"Geoffrey A","family":"Weinberg","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine and Dentistry , Rochester, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1134-4178","authenticated-orcid":false,"given":"Janet A","family":"Englund","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Research Institute , Seattle, WA ,","place":["United States"]},{"name":"Department of Pediatrics, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V","family":"Williams","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, UPMC Children\u2019s Hospital of Pittsburgh , Pittsburgh, PA ,","place":["United States"]},{"name":"Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison , Madison, WI ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A","family":"Boom","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital and Baylor College of Medicine , Houston, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila C","family":"Sahni","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital and Baylor College of Medicine , Houston, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian G","family":"Michaels","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, UPMC Children\u2019s Hospital of Pittsburgh , Pittsburgh, PA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Halasa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center , Nashville, TN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center , Nashville, TN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G","family":"Szilagyi","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine and Dentistry , Rochester, NY ,","place":["United States"]},{"name":"Department of Pediatrics, University of California at Los Angeles , Los Angeles, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3275-6657","authenticated-orcid":false,"given":"Rangaraj","family":"Selvarangan","sequence":"additional","affiliation":[{"name":"Children\u2019s Mercy Kansas City , Kansas City, MO ,","place":["United 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