Title | Evidence for Cross-Protection Against Subsequent Febrile Respiratory Illness Episodes From Prior Infections by Different Viruses Among Singapore Military Recruits 2009-2014. | ||
Author | Chen, I-Cheng Mark; Loh, Jin Phang; Chuah, Cheryl X P; Gao, Qiu Han Christine; Sun, Yinxiaohe; Ng, Sock Hoon; Koh, Wee-Hong Victor; Goh, Ee Hui; Zhao, Xiahong; Tambyah, Paul Anantharajah; Cook, Alex R; Chng, Jeremiah; Pang, Junxiong; Tan, Boon-Huan; Lee, Vernon J | ||
Journal | J Infect Dis | Publication Year/Month | 2019-May |
PMID | 30722024 | PMCID | PMC6534195 |
Affiliation + expend | 1.Saw Swee Hock School of Public Health, National University of Singapore and National University Hospital System, Singapore. |
BACKGROUND: Few studies have evaluated the relative cross-protection conferred by infection with different groups of viruses through studies of sequential infections in humans. We investigated the presence of short-lived relative cross-protection conferred by specific prior viral infections against subsequent febrile respiratory illness (FRI). METHODS: Men enlisted in basic military training between December 2009 and December 2014 were recruited, with the first FRI as the study entry point. ResPlex II assays and real-time polymerase chain reaction assays were used to detect viral pathogens in nasal wash samples, and survival analyses were performed to determine whether infection with particular viruses conferred short-lived relative cross-protection against FRI. RESULTS: Prior infection with adenovirus (hazard ratio [HR], 0.24; 95% confidence interval [CI], .14-.44) or influenza virus (HR, 0.52; 95% CI, .38-.73) conferred relative protection against subsequent FRI episode. Results were statistically significant even after adjustment for the interval between enlistment and FRI (P < .001). Adenovirus-positive participants with FRI episodes tended to be protected against subsequent infection with adenovirus, coronavirus, enterovirus/rhinovirus, and influenza virus (P = .062-.093), while men with influenza virus-positive FRI episodes tended be protected against subsequent infection with adenovirus (P = .044) and influenza virus (P = .081). CONCLUSION: Prior adenovirus or influenza virus infection conferred cross-protection against subsequent FRI episodes relative to prior infection due to other circulating viruses.