Aaron M. Milstone, M.D.,
Pediatric Infectious Disease Medicine,
Johns Hopkins Children's Center

Early Identification and Management of Viral Infections in Hospitalized Neonates and Infants

Viruses can cause a cold, the flu, and pneumonia in infants and children. When a child develops symptoms such as a fever, runny nose, or cough, doctors become suspicious of a viral infection and can test for certain viruses. Some infants with viral infections do not have these common symptoms, however.

New diagnostic tests are improving our ability to detect known and novel viruses. Using a new rapid test, this program will screen children with symptoms such as fever and cough, as well as children without these common symptoms. The main objectives are: (1) to determine if a new rapid test will improve our ability to diagnose children with contagious viruses; (2) to identify uncommon symptoms of viral infection in neonates and infants; and (3) to determine whether a new rapid diagnostic test will improve outcomes in hospitalized children.

We will test for viral infections in all infants admitted to the hospital, including those admitted for presumed viral infections and those admitted for other reasons. This project provides the exciting and unique opportunity to describe the symptoms of all infants with viral infections, even those without common symptoms. As we learn more about different symptoms viruses cause in children, we can better educate clinicians and parents to recognize these symptoms promptly. We believe that prompt diagnosis may be life-saving for some infants with viral infections.

This project will also evaluate a new rapid diagnostic test in a large and diverse group of children. We will assess whether this new rapid test could reduce the transmission of contagious viruses between children and enable clinicians to start life-saving anti-viral medicines early in a child’s illness.

The results of this study will impact children nationwide, including the most vulnerable hospitalized children as well as those in the community. We look forward to our collaboration with the R Baby Foundation and to sharing our exciting findings with its supporters.

— Aaron M. Milstone, M.D.

John Hopkins University found that 18% of babies/children admitted to the hospital were infected with a respiratory virus. Of these infected children, 17% were admitted for reasons other than flu-like illnesses and 8% had no symptoms. It is well known that infections can be life-threatening in babies. Delayed diagnosis of a viral infection in these babies can put other babies/children at risk of infection. The researchers are now determining if newer tests will better identify infected children who do not have symptoms and what the implications for hospitalized children are so all children receive the best care possible.