Parainfluenza

A retrospective ecologic cohort analysis drawing on data from July 1, 2011, to June 30, 2022, in independent, unlinked datasets to visualize and define associations between hepatitis diagnoses in children and virus activity.
The Victorian Agency for Health Information collates, analyses and shares health data from public hospitals across the Australian state of Victoria (population 6.5 million).⁷ Data are collated under one of 2 main datasets: the Victorian Emergency Minimum Dataset captures emergency department presentations in Victorian public hospitals, and the Victorian Admitted Episodes Dataset (VAED) contains data from Victorian public hospital admissions. Data are stored by ICD-10-AM codes and hepatitis cases were identified using a broad set of relevant codes. We extracted fields related to date of presentation; age (5-year bands); patient area of residence, aggregated to statistical area level 3 (SA3). (“SA3s are designed to provide a regional breakdown of Australia. They generally have a population of between 30,000 and 130,000 people. In regional areas, SA3s represent the area serviced by regional cities that have a population >20,000 people. In the major cities, SA3s represent the area serviced by a major transport and commercial hub. They often closely align to large urban local government areas (eg, Gladstone, Geelong). In outer regional and remote areas, SA3s represent areas that are widely recognized as having a distinct identity and similar social and economic characteristics.”⁸ )
Monash Health (MH), based in southeast Melbourne, is the largest health network in Victoria, with >210,000 annual pediatric and adult presentations across 3 emergency departments.⁹ The Royal Children’s Hospital Melbourne (RCH) is the largest children’s hospital in Victoria, with care extending to children from Tasmania, New South Wales and other Australian states. RCH has almost 55,000 admissions annually, with various other non-admission services.¹ We obtained respiratory multiplex polymerase chain reaction (PCR) test results during our study period from the 2 pediatric tertiary care hospitals in Victoria. PCR assays reported results for the following viruses: adenovirus, influenza A and B, parainfluenza 1, 2, 3 and 4, SARS-CoV-2, human metapneumovirus (hMPV), respiratory syncytial virus (RSV), parechovirus and picornavirus using commercial multiplex respiratory PCR panels (AusDiagnostics, Syndey, Australia). Data fields included date of test, patient area of residence aggregated to SA3 and PCR test result.
Our inclusion criteria were all respiratory multiplex PCR assays performed at MH and the Royal Children’s Hospital for patients of all ages with a Victorian residential SA3. All hepatitis presentations were included from the VAED, and Victorian Emergency Minimum Dataset between July 1, 2011, and June 30, 2022, if the patient was <19 years old on the day of presentation. Hepatitis A-E cases were excluded, as these cases had an identified viral etiology. Patient records were not available for analysis to ensure patient de-identification.