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Farzi R, Pirbonyeh N, Kadivar MR, Moattari A. Prevalence of Influenza Viruses A and B, Adenovirus, Respiratory Syncytial Virus, and Human Metapneumonia Viruses among Children with Acute Respiratory Tract Infection. Adv Virol 2024; 2024:7613948. [PMID: 38292215 PMCID: PMC10824580 DOI: 10.1155/2024/7613948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/04/2023] [Accepted: 12/23/2023] [Indexed: 02/01/2024] Open
Abstract
Background Acute respiratory tract infection (ARTI) is a significant cause of morbidity and mortality among children worldwide. The majority of acute respiratory infections in children are caused by viruses, with respiratory syncytial virus (RSV) being the most frequently encountered. Other important viral pathogens include human metapneumovirus, human coronaviruses, adenovirus, and influenza. These infections can lead to complications such as bronchitis and pneumonia. So, this study aimed to evaluate the prevalence of influenza viruses A and B, adenovirus, respiratory syncytial virus (RSV), and human metapneumovirus (HMPV) in children with ARTI. Methods The molecular diagnostic of polymerase chain reaction approach was used to detect influenza (A and B), metapneumovirus, respiratory syncytial virus (RSV), and adenovirus in respiratory samples of children with acute respiratory infection hospitalization in a teaching hospital of the Shiraz University of Medical Sciences in January 2016-March 2017. Results Of the 340 patients examined, 208 (61.20%) were male and the median age was 3.13 ± 2.38 years. Respiratory viruses were found in 179 (52.64%) patients. The male-to-female ratio was 1.63 : 1 in patients who were viral positive. Detection rates for influenza A, adenovirus, influenza B, RSV, and HMPV were 28.23%, 24.70%, 8.52%, 3.23%, and 2.64%, respectively, and coinfections were detected in 24.02%. The most common combination of two-virus coinfections was IFVA/AdV, followed by IFVB/AdV, AdV, IFVB/IFVA, RSV/IFVA, HMPV/AdV, RSV/AdV, and HMPV/IFVA. Conclusion The high prevalence of respiratory viruses in children hospitalized with ARTI suggests that viral infection may play a role in disease pathogenesis. This should be confirmed through the conduct of case-control studies and may inform the role of vaccination to prevent respiratory viral infections.
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Affiliation(s)
- Rana Farzi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Pirbonyeh
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Burn and Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Rahim Kadivar
- Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Professor Alborzi Clinical Microbiology Research Center, Namazi Hospital, Shiraz Medical University, Shiraz, Iran
| | - Afagh Moattari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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2
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García-Arroyo L, Prim N, Del Cuerpo M, Marín P, Roig MC, Esteban M, Labeaga R, Martí N, Berengua C, Gich I, Navarro F, Rabella N. Prevalence and seasonality of viral respiratory infections in a temperate climate region: A 24-year study (1997-2020). Influenza Other Respir Viruses 2022; 16:756-766. [PMID: 35170253 PMCID: PMC9178050 DOI: 10.1111/irv.12972] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Few long‐term reports have been published on the epidemiology of respiratory viruses despite their frequent involvement in extremely common infections. The aim here was to determine the frequency and distribution of respiratory viruses in a temperate climate area (Barcelona, Spain) throughout a 24‐year period. Methods We collected data on all respiratory viruses detected from 1997 to 2020 in our institution. Clinical specimens were analyzed mainly by conventional techniques, and molecular techniques were also used. Results Of the 59,579 specimens analyzed, 21,382 (35.9%) were positive for at least one virus. The number of positive samples during cold months was significantly higher than in warm months. Respiratory virus infections were detected in patients of all ages, above all in children under 3 years of age, who were most frequently infected with the respiratory syncytial virus, whereas Influenza A virus predominated in the other groups, especially in adults. A clear demographic and seasonal pattern was established for some viruses. Circulation of other respiratory viruses during the FLUAV H1N1pdm09 and SARS‐CoV‐2 pandemics was observed. Conclusions This long‐term study provides new knowledge about the prevalence of respiratory viruses in a Mediterranean region. Throughout the study period, the frequency of some viruses remained constant, whereas others varied with the year. A clear demographic and seasonal pattern was established for some viruses. Patients suffering from severe respiratory infections should be examined for a range of respiratory viruses regardless of gender, age, or season.
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Affiliation(s)
- Laura García-Arroyo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Núria Prim
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Marga Del Cuerpo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Pilar Marín
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Maria Carme Roig
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Mnontserrat Esteban
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Rosa Labeaga
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Neus Martí
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Carla Berengua
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Clinical Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Ferran Navarro
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Núria Rabella
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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3
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Johnson EK, Sylte D, Chaves SS, Li Y, Mahe C, Nair H, Paget J, van Pomeren T, Shi T, Viboud C, James SL. Hospital utilization rates for influenza and RSV: a novel approach and critical assessment. Popul Health Metr 2021; 19:31. [PMID: 34126993 PMCID: PMC8204427 DOI: 10.1186/s12963-021-00252-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/31/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Influenza and respiratory syncytial virus (RSV) contribute significantly to the burden of acute lower respiratory infection (ALRI) inpatient care, but heterogeneous coding practices and availability of inpatient data make it difficult to estimate global hospital utilization for either disease based on coded diagnoses alone. METHODS This study estimates rates of influenza and RSV hospitalization by calculating the proportion of ALRI due to influenza and RSV and applying this proportion to inpatient admissions with ALRI coded as primary diagnosis. Proportions of ALRI attributed to influenza and RSV were extracted from a meta-analysis of 360 total sources describing inpatient hospital admissions which were input to a Bayesian mixed effects model over age with random effects over location. Results of this model were applied to inpatient admission datasets for 44 countries to produce rates of hospital utilization for influenza and RSV respectively, and rates were compared to raw coded admissions for each disease. RESULTS For most age groups, these methods estimated a higher national admission rate than the rate of directly coded influenza or RSV admissions in the same inpatient sources. In many inpatient sources, International Classification of Disease (ICD) coding detail was insufficient to estimate RSV burden directly. The influenza inpatient burden estimates in older adults appear to be substantially underestimated using this method on primary diagnoses alone. Application of the mixed effects model reduced heterogeneity between countries in influenza and RSV which was biased by coding practices and between-country variation. CONCLUSIONS This new method presents the opportunity of estimating hospital utilization rates for influenza and RSV using a wide range of clinical databases. Estimates generally seem promising for influenza and RSV associated hospitalization, but influenza estimates from primary diagnosis seem highly underestimated among older adults. Considerable heterogeneity remains between countries in ALRI coding (i.e., primary vs non-primary cause), and in the age profile of proportion positive for influenza and RSV across studies. While this analysis is interesting because of its wide data utilization and applicability in locations without laboratory-confirmed admission data, understanding the sources of variability and data quality will be essential in future applications of these methods.
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Affiliation(s)
- Emily K Johnson
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA.
| | - Dillon Sylte
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - You Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cedric Mahe
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Tayma van Pomeren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Ting Shi
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Spencer L James
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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Núñez-Samudio V, Landires I. Epidemiology of viral respiratory infections in a pediatric reference hospital in Central Panama. BMC Infect Dis 2021; 21:43. [PMID: 33422002 PMCID: PMC7796567 DOI: 10.1186/s12879-020-05720-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Acute respiratory infections (ARIs) are a worldwide public health problem. It is estimated that up to 80% of cases of ARIs are caused by viruses. In Central America, however, we identified few epidemiologic studies on the main ARI-related viruses in hospitalized children. Methods This study retrospectively analyzed the clinical charts of patients ages 29 days to 14 years admitted with diagnoses of ARIs in a pediatric reference hospital in central Panama during 2016. The variables analyzed were age, sex, signs, symptoms, and diagnosis at admission. Samples of patients to whom a viral panel was indicated were analyzed via quantitative polymerase chain reaction, qPCR. Results The most common virus was respiratory syncytial virus (RSV; 25.9%), followed by influenza A virus (10.6%), rhinovirus (10.6%), parainfluenza type 3 (PIV-3; 8.2%) and adenovirus (5.9%). However, virus detection varied with patient age and season. RSV and Influenza virus were respectively identified mainly during July–November and May–July. All cases of viral co-infection occurred in children < 5-years-old. Both influenza A (H1N1) pdm09 and rhinovirus were detected in all pediatric ages analyzed in this study, unlike RSV and PIV-3, which were only present in children < 5-years-old. Conclusions This study analyzed the epidemiological patterns of different respiratory viruses in pediatric patients with ARI from central Panama and found that the prevalence of the specific respiratory viruses identified varied with season and age. The most common viruses were RSV, influenza A, and rhinovirus. There were no reports of human metapneumovirus associated with ARI, which may be explained by the time and geographic location of the study. Knowledge of the local epidemiology of respiratory viruses in tropical countries is helpful in forecasting the peaks of hospitalizations due to ARIs and may help improve prevention efforts aiming at respiratory disease control in these settings.
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Affiliation(s)
- Virginia Núñez-Samudio
- Instituto de Ciencias Médicas, PO Box 0710-00043, Las Tablas, Los Santos, Panama.,Sección de Epidemiología, Departamento de Salud Pública, Región de Salud de Herrera, Ministry of Health, Chitré, Panama
| | - Iván Landires
- Instituto de Ciencias Médicas, PO Box 0710-00043, Las Tablas, Los Santos, Panama. .,Centro Regional Universitario de Azuero (CRUA), Universidad de Panamá, Chitré, Herrera, Panama. .,Hospital Joaquín Pablo Franco Sayas, Región de Salud de Los Santos, Ministry of Health, Las Tablas, Panama.
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5
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Circulation profile of respiratory viruses in symptomatic and asymptomatic children from Midwest Brazil. Braz J Microbiol 2020; 51:1729-1735. [PMID: 32862400 PMCID: PMC7456363 DOI: 10.1007/s42770-020-00368-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 08/21/2020] [Indexed: 02/06/2023] Open
Abstract
Acute respiratory infection (ARI) is a major cause of morbidity and mortality worldwide. Most of these infections are caused by viruses. Infections pose as important triggers of acute episodes of chronic respiratory diseases (CRD). This study sought to evaluate the frequency and circulation profile of respiratory viruses among ARI symptomatic patients and completely asymptomatic children in Midwest Brazil. The study enrolled symptomatic children with and without ARI symptoms. During 1 year, 225 nasal respiratory samples were obtained from patients aged 4–14 years old. The samples were screened by multiplex nested-PCR for 16 common respiratory viruses. From 225 samples, 42 had at least one virus detected. Samples from four different patients had multiple viruses detected. The viral detection rate in symptomatic (20.1%) and asymptomatic patients (14.8%) showed no significant difference. The most frequent viruses detected were rhinovirus (28.6%), FLUA (11.9%), adenovirus (11.9%), human bocavirus (HBoV) (11.9%), and respiratory syncytial virus (RSV) antigenic group A (9.5%). Monthly detection rate was higher during the rainy season. RSVs were detected during the months with higher rainfall indexes and higher air humidity, while FLU and HBoV were detected during the winter months. The obtained results reinforce the importance of viral pathogens in pediatric population, emphasizing similar viral occurrence in symptomatic and asymptomatic children.
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Sengoren Dikis O, Demirci H, Sezgin B, Haberal MA, Akar E, Kaya H. What is the emergency application differences concerning diseases pertinent to the chest between Turkish citizens and Syrian refugees: A cross-sectional study. THE CLINICAL RESPIRATORY JOURNAL 2020; 14:725-731. [PMID: 32202394 DOI: 10.1111/crj.13189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/25/2020] [Accepted: 03/08/2020] [Indexed: 11/29/2022]
Abstract
AIM Millions of Syrians were displaced after the Syrian civil war broke in 2011. Turkey hosts the largest number of refugees. This study aimed to describe the disease patterns of Syrian refugees applying to an emergency department. MATERIAL AND METHODS The study included patients who presented to an emergency department between 2017 and 2018. Study data were retrieved from the hospital's electronic medical records registry. The main study outcome was the ICD-10 codes pertinent to "chest diseases." Additionally, analyzed data were nationality, age, sex, triage status on admission, hospitalization status, and examination date. RESULTS The number of emergency department admissions included in the study period was 378 487 persons, of which 14 262 (3.8%) were Syrian refugees. A total of 62 345 diagnoses (16.5%) were related to the respiratory system. Turkish patients had a significantly higher median age than Syrian refugees. Also, there were significantly more women among Syrian applicants, and acute bronchitis and asthma were more common among Syrian patients. However, the hospitalization rates were similar between the two groups. Moreover, Syrian patients had more applications during the summer seasons and had higher "Yellow" labels in the emergency triage. CONCLUSION There are differences in the disease patterns of Syrian refugees and Turkish citizens applying to the emergency department. This may be explained by the difficulty in communication which, to our opinion, may be reversed as language barriers are overcome and adaptation to the society is completed over time.
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Affiliation(s)
- Ozlem Sengoren Dikis
- Department of Pulmonary Diseases, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Hakan Demirci
- Department of Family Medicine, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Bişar Sezgin
- Deparment of Emergency Medicine, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Miktat Arif Haberal
- Department of Thoracic Surgery, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Erkan Akar
- Department of Thoracic Surgery, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Halil Kaya
- Deparment of Emergency Medicine, Health Sciences University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Acute Respiratory Illness in Rural Haiti. Int J Infect Dis 2019; 81:176-183. [PMID: 30772468 PMCID: PMC7173118 DOI: 10.1016/j.ijid.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 12/18/2022] Open
Abstract
Top viruses detected in Haitian children are Rhinovirus, Influenza A and Adenovirus. Top bacteria detected in Haitian children are S. pneumoniae and S. aureus. Younger children are more likely to have Influenza A and S. pneumoniae detected. Younger children are more likely to present with fever and diagnosed with pneumonia. These data support early use of Influenza A and S. pneumoniae vaccines in Haiti.
Objectives Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. Methods Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015. Results Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3–5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3–5 years old (71% 3–5yrs; 58% 6–15 years; 25% 16–20 years; p = 0.008). Children 3–10 years old presented with fever more than children 11–20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p < 0.001). Conclusions Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.
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Brini Khalifa I, Hannachi N, Guerrero A, Orth-Höller D, Bhiri S, Bougila J, Boughamoura L, Merchaoui SN, Sboui H, Mahdhaoui N, Schiela B, Laer DHV, Boukadida J, Stoiber H. Demographic and seasonal characteristics of respiratory pathogens in neonates and infants aged 0 to 12 months in the Central-East region of Tunisia. J Med Virol 2018; 91:570-581. [PMID: 30351487 PMCID: PMC6492255 DOI: 10.1002/jmv.25347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/17/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND This study aimed to characterize the epidemiology of pathogenic respiratory agents in patients aged 0 to 12 months and hospitalized for acute respiratory infections in Tunisia between 2013 and 2014. METHODS A total of 20 pathogens, including viruses, Mycoplasma pneumoniae, and Streptococcus pneumoniae, were detected using molecular sensitive assays, and their associations with the patient's demographic data and season were analyzed. RESULTS Viral infectious agents were found in 449 (87.2%) of 515 specimens. Dual and multiple infectious agents were detected in 31.4% and 18.6% of the samples, respectively. Viral infection was predominant in the pediatric environment (90.8%, P < 0.001), male patients (88.0%), and spring (93.8%). Rhinovirus was the most detected virus (51.8%) followed by respiratory syncytial virus A/B (34.4%), coronavirus group (18.5%), adenovirus (17.9%), and parainfluenza viruses 1-4 (10.9%). Respiratory Syncytial virus A/B was significantly associated with gender (38.0% male cases vs 28.3% female cases, P = 0.02). Infections by Adenovirus, Bocavirus, and Metapneumovirus A/B increased with increasing age of patients (predominated cases aged 6-12 months, P < 0.001). S. pneumoniae was detected in 30.9% of th tested samples. In 18.2% of the negative viral infections, only S. pneumoniae was identified. CONCLUSION A predominance of the rhinovirus infection was observed in this study. Coronavirus subtypes were described for the first time in Tunisia. The observed different pathogenic profiles across age groups could be helpful to avoid the misclassification of patients presenting with ARIs at the triage level when no standardized protocol is available. This study will provide clues for physicians informing decisions regarding preventive strategies and medication in Tunisia.
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Affiliation(s)
- Ines Brini Khalifa
- Department of Microbiology, Immunology, and Parasitology, Laboratory of Microbiology, Sousse Medical University, University of Sousse, Sousse, Tunisia.,Department of Microbiology, Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia.,Doctoral School of Biological Sciences, Biotechnology and Health, Higher Institute of Biotechnology of Monastir, Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.,Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Naila Hannachi
- Department of Microbiology, Immunology, and Parasitology, Laboratory of Microbiology, Sousse Medical University, University of Sousse, Sousse, Tunisia.,Department of Microbiology, Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Aida Guerrero
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Dorothea Orth-Höller
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
| | - Sana Bhiri
- Department of Epidemiology and Medical Statistics, Division of Medical Statistics, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Jihene Bougila
- Pediatric Ward, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Lamia Boughamoura
- Pediatric Ward, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | | | - Hassen Sboui
- Neonatology Ward, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Nabiha Mahdhaoui
- Neonatology Ward, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Britta Schiela
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Jalel Boukadida
- Department of Microbiology, Immunology, and Parasitology, Laboratory of Microbiology, Sousse Medical University, University of Sousse, Sousse, Tunisia.,Department of Microbiology, Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Heribert Stoiber
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
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Kurskaya O, Ryabichenko T, Leonova N, Shi W, Bi H, Sharshov K, Kazachkova E, Sobolev I, Prokopyeva E, Kartseva T, Alekseev A, Shestopalov A. Viral etiology of acute respiratory infections in hospitalized children in Novosibirsk City, Russia (2013 - 2017). PLoS One 2018; 13:e0200117. [PMID: 30226876 PMCID: PMC6143185 DOI: 10.1371/journal.pone.0200117] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022] Open
Abstract
Background Acute respiratory infections (ARIs) cause a considerable morbidity and mortality worldwide especially in children. However, there are few studies of the etiological structure of ARIs in Russia. In this work, we analyzed the etiology of ARIs in children (0–15 years old) admitted to Novosibirsk Children’s Municipal Clinical Hospital in 2013–2017. Methods We tested nasal and throat swabs of 1560 children with upper or lower respiratory infection for main respiratory viruses (influenza viruses A and B, parainfluenza virus types 1–4, respiratory syncytial virus, metapneumovirus, four human coronaviruses, rhinovirus, adenovirus and bocavirus) using a RT-PCR Kit. Results We detected 1128 (72.3%) samples were positive for at least one virus. The most frequently detected pathogens were respiratory syncytial virus (358/1560, 23.0%), influenza virus (344/1560, 22.1%), and rhinovirus (235/1560, 15.1%). Viral co-infections were found in 163 out of the 1128 (14.5%) positive samples. We detected significant decrease of the respiratory syncytial virus-infection incidence in children with increasing age, while the reverse relationship was observed for influenza viruses. Conclusions We evaluated the distribution of respiratory viruses in children with ARIs and showed the prevalence of respiratory syncytial virus and influenza virus in the etiological structure of infections. This study is important for the improvement and optimization of diagnostic tactics, control and prevention of the respiratory viral infections.
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Affiliation(s)
- Olga Kurskaya
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
- * E-mail:
| | - Tatyana Ryabichenko
- Department of Propaedeutic of Childhood Diseases, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Natalya Leonova
- Department of Children’s Diseases, Novosibirsk Children’s Municipal Clinical Hospital №6, Novosibirsk, Russia
| | - Weifeng Shi
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Taishan Medical College, Taian, Shandong, China
| | - Hongtao Bi
- Qinghai Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation, Northwest Institute of Plateau Biology, CAS, Xining, China
| | - Kirill Sharshov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Eugenia Kazachkova
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Ivan Sobolev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Elena Prokopyeva
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Tatiana Kartseva
- Department of Propaedeutic of Childhood Diseases, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Alexander Alekseev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Alexander Shestopalov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
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Wollmeister E, Alvarez AE, Bastos JCS, Marson FAL, Ribeiro JD, Baracat ECE, Arns CW, Riccetto AGL. Respiratory syncytial virus in Brazilian infants - Ten years, two cohorts. J Clin Virol 2017; 98:33-36. [PMID: 29227860 PMCID: PMC7106499 DOI: 10.1016/j.jcv.2017.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 01/07/2023]
Abstract
There was 33.1% and 70.3% of RSV patients, respectively, in 2004 and 2014. The month of incidence was different between the cohorts. First cohort: higher age at attendance and number of co-morbidities. Second cohort: lower birth weight and gestational age.
Background Each year, a considerable amount of children will experience at least one episode of acute viral bronchiolitis (AVB) during their first year of life. About 10% of them will be hospitalized, with significant physical and economic burdens. Objectives To compare two cohorts of infants with AVB, from same region, in a ten-year interval, regarding epidemiologic factors and viral etiology. Study design Cohorts: 142 (2004) and 172 (2014) infants at ages zero to 12 months; clinical diagnosis of AVB; medical care in hospital and genetic screening of nasopharyngeal secretion for respiratory viruses. Results The comparative analysis showed a difference in the percentage of respiratory syncytial virus (RSV) positive patients [2004 (33.1%); 2014 (70.3%)] (p < 0.01). No differences were noted regarding gender, breastfeeding, tobacco exposure, crowding and maternal education. There was a difference as to the month of incidence (seasonality) of AVB (higher in April 2014). There was a higher age at attendance in the first cohort, and lower birth weight and gestational age ratios in the second cohort (p < 0.05). There were no differences in hospitalization time, need of mechanical ventilation and number of deaths, however a difference regarding co-morbidities was noted (higher in 2004) (p < 0.001). Conclusion None of the analyzed variables had an impact on severity features. Virology and immunology must be considered in this kind of situation, by studying genetic variants and the maturation of the immune system in AVB by RSV or other viruses.
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Affiliation(s)
- Elinara Wollmeister
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil.
| | - Alfonso Eduardo Alvarez
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil; Center for Research in Pediatrics (CIPED), Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil.
| | | | - Fernando Augusto Lima Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil; Center for Research in Pediatrics (CIPED), Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil; Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil.
| | - José Dirceu Ribeiro
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil; Center for Research in Pediatrics (CIPED), Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil.
| | | | - Clarice Weis Arns
- Department of Genetics, Evolution and Bioagents, Biology Institute, University of Campinas - Unicamp, São Paulo, Brazil.
| | - Adriana Gut Lopes Riccetto
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas - Unicamp, São Paulo, Brazil.
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11
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Respiratory Tract Viral Infections and Coinfections Identified by Anyplex™ II RV16 Detection Kit in Pediatric Patients at a Riyadh Tertiary Care Hospital. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1928795. [PMID: 29359144 PMCID: PMC5735607 DOI: 10.1155/2017/1928795] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/07/2017] [Accepted: 10/08/2017] [Indexed: 02/03/2023]
Abstract
Respiratory infections are caused by an array of viruses, and limited information is available about viral coexistence, comparative symptoms, and the burden of illness. This retrospective cohort study aimed to determine the etiological agents responsible for respiratory tract infections by Anyplex II RV16 detection kit (RV16, Seegene), involving 2266 pediatric patients with respiratory infections admitted to the Department of Pediatrics at King Abdul-Aziz Medical City, Ministry of National Guard, Riyadh, from July 2014 to June 2015. The most frequent respiratory infections were recorded in the 1 to 5 year age group (44.7%). Rhinovirus (32.5%), Adenovirus (16.9%), and Respiratory syncytial virus (RSV) B (10.4%) were most common. In single viral infections, Rhinovirus (41.2%), Metapneumovirus (15.3%), and Bocavirus (13.7%) were most frequent. In multiple viral infections, Rhinovirus (36.7%), Adenovirus (35.2%), Bocavirus (11.2), RSV B (7.8%), and RSV A (6.7%) were most frequent. No significant difference was observed in clinical presentations; however, rhinorrhea and hypodynamia were significantly associated with viral respiratory infections. Most respiratory viral pathogens peaked during December, January, March, and April. Rhinovirus, Adenovirus, and Bocavirus circulations were detected throughout the year. Winter peaks were recorded for Rhinovirus, RSV B, Adenovirus, and RSV A, whereas the Metapneumovirus, and the Bocavirus peaked in March and April. These findings enhance understanding of viral etiology and distribution to improve respiratory infection management and treatment.
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12
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Ábrego LE, Mirazo S, Delfraro A, Franco D, Castillo M, Gaitán M, Castillo J, Moreno B, Pascale JM, Arbiza J. Genotypes of human metapneumovirus circulating during 2010-2012 in children from Panama. J Med Virol 2017; 90:604-608. [DOI: 10.1002/jmv.24969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/21/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Leyda E. Ábrego
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Santiago Mirazo
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
| | - Adriana Delfraro
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
| | - Danilo Franco
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
- School of Medicine; University of Panama; Panama City Panama
| | - Marlene Castillo
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Melissa Gaitán
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan Castillo
- Department of Genomic and Proteomic; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Brechla Moreno
- Deparment of Research in Virology and Biotechnology; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan M. Pascale
- School of Medicine; University of Panama; Panama City Panama
- Department of Genomic and Proteomic; Gorgas Memorial Institute of Health Studies; Panama City Panama
| | - Juan Arbiza
- Virology Section, School of Sciences; University of the Republic; Montevideo Uruguay
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13
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Jonnalagadda S, Rodríguez O, Estrella B, Sabin LL, Sempértegui F, Hamer DH. Etiology of severe pneumonia in Ecuadorian children. PLoS One 2017; 12:e0171687. [PMID: 28182741 PMCID: PMC5300242 DOI: 10.1371/journal.pone.0171687] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/24/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. METHODS This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated. RESULTS Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03). CONCLUSION These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available. TRIAL REGISTRATION ClinicalTrials.gov NCT 00513929.
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Affiliation(s)
- Sivani Jonnalagadda
- Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | | | - Bertha Estrella
- Corporación Ecuatoriana de Biotecnología, Quito, Ecuador
- Universidad Central del Ecuador, Escuela de Medicina, Quito, Ecuador
| | - Lora L. Sabin
- Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Fernando Sempértegui
- Corporación Ecuatoriana de Biotecnología, Quito, Ecuador
- Universidad Central del Ecuador, Escuela de Medicina, Quito, Ecuador
| | - Davidson H. Hamer
- Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
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14
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Ahmadi A, Farhadi E, Salimian J, Amani J. Designing a vaccine therapy candidate against Propionibacterium acnes: a bioinformatics approach. MOLECULAR GENETICS MICROBIOLOGY AND VIROLOGY 2017. [DOI: 10.3103/s0891416816030022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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García-Corzo JR, Niederbacher-Velásquez J, González-Rugeles C, Rodríguez-Villamizar L, Machuca-Pérez M, Torres-Prieto A, Ortiz-Rodríguez G, Romero-Salazar M. Etiología y estacionalidad de las infecciones respiratorias virales en menores de cinco años en Bucaramanga, Colombia. IATREIA 2017. [DOI: 10.17533/udea.iatreia.v30n2a01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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16
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N'gattia AK, Coulibaly D, Nzussouo NT, Kadjo HA, Chérif D, Traoré Y, Kouakou BK, Kouassi PD, Ekra KD, Dagnan NS, Williams T, Tiembré I. Effects of climatological parameters in modeling and forecasting seasonal influenza transmission in Abidjan, Cote d'Ivoire. BMC Public Health 2016; 16:972. [PMID: 27624302 PMCID: PMC5022141 DOI: 10.1186/s12889-016-3503-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 08/12/2016] [Indexed: 12/03/2022] Open
Abstract
Background In temperate regions, influenza epidemics occur in the winter and correlate with certain climatological parameters. In African tropical regions, the effects of climatological parameters on influenza epidemics are not well defined. This study aims to identify and model the effects of climatological parameters on seasonal influenza activity in Abidjan, Cote d’Ivoire. Methods We studied the effects of weekly rainfall, humidity, and temperature on laboratory-confirmed influenza cases in Abidjan from 2007 to 2010. We used the Box-Jenkins method with the autoregressive integrated moving average (ARIMA) process to create models using data from 2007–2010 and to assess the predictive value of best model on data from 2011 to 2012. Results The weekly number of influenza cases showed significant cross-correlation with certain prior weeks for both rainfall, and relative humidity. The best fitting multivariate model (ARIMAX (2,0,0) _RF) included the number of influenza cases during 1-week and 2-weeks prior, and the rainfall during the current week and 5-weeks prior. The performance of this model showed an increase of >3 % for Akaike Information Criterion (AIC) and 2.5 % for Bayesian Information Criterion (BIC) compared to the reference univariate ARIMA (2,0,0). The prediction of the weekly number of influenza cases during 2011–2012 with the best fitting multivariate model (ARIMAX (2,0,0) _RF), showed that the observed values were within the 95 % confidence interval of the predicted values during 97 of 104 weeks. Conclusion Including rainfall increases the performances of fitted and predicted models. The timing of influenza in Abidjan can be partially explained by rainfall influence, in a setting with little change in temperature throughout the year. These findings can help clinicians to anticipate influenza cases during the rainy season by implementing preventive measures. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3503-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A K N'gattia
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire. .,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire.
| | - D Coulibaly
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire
| | - N Talla Nzussouo
- Influenza Division, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - H A Kadjo
- Department of Virology, Respiratory Diseases, Pasteur Institute, 01 BP 490, Abidjan 01, Côte d'Ivoire
| | - D Chérif
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire
| | - Y Traoré
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - B K Kouakou
- Department of Virology, Respiratory Diseases, Pasteur Institute, 01 BP 490, Abidjan 01, Côte d'Ivoire
| | - P D Kouassi
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Department of Public Health and Community Medicine, Alassane Ouattara University, BP V 18, Bouaké, Côte d'Ivoire
| | - K D Ekra
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - N S Dagnan
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - T Williams
- Influenza Division, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - I Tiembré
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
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Richter J, Panayiotou C, Tryfonos C, Koptides D, Koliou M, Kalogirou N, Georgiou E, Christodoulou C. Aetiology of Acute Respiratory Tract Infections in Hospitalised Children in Cyprus. PLoS One 2016; 11:e0147041. [PMID: 26761647 PMCID: PMC4720120 DOI: 10.1371/journal.pone.0147041] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 12/28/2015] [Indexed: 01/06/2023] Open
Abstract
In order to improve clinical management and prevention of viral infections in hospitalised children improved etiological insight is needed. The aim of the present study was to assess the spectrum of respiratory viral pathogens in children admitted to hospital with acute respiratory tract infections in Cyprus. For this purpose nasopharyngeal swab samples from 424 children less than 12 years of age with acute respiratory tract infections were collected over three epidemic seasons and were analysed for the presence of the most common 15 respiratory viruses. A viral pathogen was identified in 86% of the samples, with multiple infections being observed in almost 20% of the samples. The most frequently detected viruses were RSV (30.4%) and Rhinovirus (27.4%). RSV exhibited a clear seasonality with marked peaks in January/February, while rhinovirus infections did not exhibit a pronounced seasonality being detected almost throughout the year. While RSV and PIV3 incidence decreased significantly with age, the opposite was observed for influenza A and B as well as adenovirus infections. The data presented expand our understanding of the epidemiology of viral respiratory tract infections in Cypriot children and will be helpful to the clinicians and researchers interested in the treatment and control of viral respiratory tract infections.
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Affiliation(s)
- Jan Richter
- Cyprus Institute of Neurology and Genetics, Department of Molecular Virology, Nicosia, Cyprus
- * E-mail:
| | - Christakis Panayiotou
- Cyprus Institute of Neurology and Genetics, Department of Molecular Virology, Nicosia, Cyprus
| | - Christina Tryfonos
- Cyprus Institute of Neurology and Genetics, Department of Molecular Virology, Nicosia, Cyprus
| | - Dana Koptides
- Cyprus Institute of Neurology and Genetics, Department of Molecular Virology, Nicosia, Cyprus
| | - Maria Koliou
- Archbishop Makarios III Hospital, Department of Pediatrics, Nicosia, Cyprus
| | - Nikolas Kalogirou
- Archbishop Makarios III Hospital, Department of Pediatrics, Nicosia, Cyprus
| | - Eleni Georgiou
- Archbishop Makarios III Hospital, Department of Pediatrics, Nicosia, Cyprus
| | - Christina Christodoulou
- Cyprus Institute of Neurology and Genetics, Department of Molecular Virology, Nicosia, Cyprus
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18
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Cui B, Zhang D, Pan H, Zhang F, Farrar J, Law F, van Doorn HR, Wu B, Ba-Thein W. Viral aetiology of acute respiratory infections among children and associated meteorological factors in southern China. BMC Infect Dis 2015; 15:124. [PMID: 25884513 PMCID: PMC4365542 DOI: 10.1186/s12879-015-0863-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 03/02/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) are common in children and mostly caused by viruses, but the significance of the detection of multiple viruses in ARIs is unclear. This study investigated 14 respiratory viruses in ARIs among children and associated meteorological factors in Shantou, southern China. METHODS Paired nasal/throat-flocked swabs collected from 1,074 children with ARIs, who visited outpatient walk-in clinics in a tertiary hospital between December 2010 and November 2011, were examined for fourteen respiratory viruses--influenza viruses (FluA, FluB), respiratory syncytial viruses (RSV A and B), human coronaviruses (hCoV: 229E, OC43, HKU1, NL63), human metapneumoviruses (hMPV A and B), parainfluenza viruses (PIV1-4), human rhinoviruses (HRV A, B, C), enteroviruses (EV), adenoviruses (ADV), human bocavirus (hBoV), and human parechoviruses (hPeV)--by multiplex real-time PCR. RESULTS We identified at least one virus in 82.3% (884/1,074) and multiple viruses in 38.6% (415/1,074) of patients. EV and HRV were the most frequently detected single viruses (42.3%, 374/884 and 39.9%, 353/884 respectively) and co-detected pair (23.1%, 96/415). Overlapping seasonal trends of viruses were recorded over the year, with dual peaks for EV and single peaks for the others. By logistic regression analysis, EV was positively associated with the average temperature and humidity, hCoV, and PIV4, but negatively with HRV, PIV3, and hBoV. HRV was inversely associated with EV and PIV3. CONCLUSIONS This study reports high viral detection and co-detection rates in pediatric ARI cases mainly due to EV and HRV. Many viruses circulated throughout the year with similar seasonal trends in association with temperature, humidity, and wind velocity. Statistically significant associations were present among the viruses. Understanding the polyviral etiology and viral interactions in the cases with multiple viruses warrants further studies.
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Affiliation(s)
- Binglin Cui
- Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Dangui Zhang
- The Research Center of Translational Medicine, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Hui Pan
- Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Fan Zhang
- Oncology Research Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Jeremy Farrar
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam.
| | - Frieda Law
- Consultant Office, Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam.
| | - Beiyan Wu
- Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - William Ba-Thein
- Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China.
- Department of Microbiology and Immunology, Shantou University Medical College, Shantou, Guangdong, 515041, P.R. China.
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Proença-Módena JL, Buzatto GP, Paula FE, Saturno TH, Delcaro LS, Prates MC, Tamashiro E, Valera FC, Arruda E, Anselmo-Lima WT. Respiratory viruses are continuously detected in children with chronic tonsillitis throughout the year. Int J Pediatr Otorhinolaryngol 2014; 78:1655-61. [PMID: 25128448 PMCID: PMC7112801 DOI: 10.1016/j.ijporl.2014.07.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 07/10/2014] [Accepted: 07/12/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the oscillations on the viral detection in adenotonsillar tissues from patients with chronic adenotonsillar diseases as an indicia of the presence of persistent viral infections or acute subclinical infections. STUDY DESIGN Cross-sectional prospective study. SETTING Tertiary hospital. METHODS The fluctuations of respiratory virus detection were compared to the major climatic variables during a two-year period using adenoids and palatine tonsils from 172 children with adenotonsillar hypertrophy and clinical evidence of obstructive sleep apnoea syndrome or recurrent adenotonsillitis, without symptoms of acute respiratory infection (ARI), by TaqMan real-time PCR. RESULTS The rate of detection of at least one respiratory virus in adenotonsillar tissue was 87%. The most frequently detected viruses were human adenovirus in 52.8%, human enterovirus in 47.2%, human rhinovirus in 33.8%, human bocavirus in 31.1%, human metapneumovirus in 18.3% and human respiratory syncytial virus in 17.2%. Although increased detection of human enterovirus occurred in summer/autumn months, and there were summer nadirs of human respiratory syncytial virus in both years of the study, there was no obvious viral seasonality in contrast to reports with ARI patients in many regions of the world. CONCLUSION Respiratory viruses are continuously highly detected during whole year, and without any clinical symptomatology, indicating that viral genome of some virus can persist in lymphoepithelial tissues of the upper respiratory tract.
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Affiliation(s)
- José Luiz Proença-Módena
- Department of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Virology Research Center, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Guilherme P. Buzatto
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Flávia E. Paula
- Department of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Virology Research Center, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Tamara H. Saturno
- Virology Research Center, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Luana S. Delcaro
- Department of Internal Medicine, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Mirela C. Prates
- Virology Research Center, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Fabiana C.P. Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Eurico Arruda
- Department of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil,Virology Research Center, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Wilma T. Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil,Corresponding author at: Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, FMRP-USP, Avenida dos Bandeirantes 3900, Ribeirão Preto, SP 14049-900, Brazil. Tel.: +55 16 36022862; fax: +55 16 36022860
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Lekana-Douki SE, Nkoghe D, Drosten C, Ngoungou EB, Drexler JF, Leroy EM. Viral etiology and seasonality of influenza-like illness in Gabon, March 2010 to June 2011. BMC Infect Dis 2014; 14:373. [PMID: 25000832 PMCID: PMC4107952 DOI: 10.1186/1471-2334-14-373] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/30/2014] [Indexed: 12/13/2022] Open
Abstract
Background Surveillance of influenza-like illness (ILI) in Central Africa began only recently, and few data are therefore available on the circulation of influenza virus and other respiratory viruses. In Gabon, a Central African country, we established a surveillance network in four major towns in order to analyze cases of ILI among patients who visited health centers between March 2010 and June 2011, and to determine the viral etiology. Methods Nasal swabs were sent for analysis to the Centre International de Recherches Médicales de Franceville, where they were screened for 17 respiratory viruses in a multiplex real-time reverse transcription polymerase chain reaction for all pathogens according the following pairs: adenovirus/parainfluenza virus 4, respiratory syncytial virus/human metapneumovirus, parainfluenza virus 1/parainfluenza virus 2, pandemic influenza virus A/seasonal influenza virus A (H1N1, H3N2)/seasonal influenza virus B, human coronaviruses 229E/OC43, human coronaviruses NL63/HKU1, rhinovirus/human parechovirus, and enterovirus/parainfluenza virus 3. Results We analyzed a total of 1041 specimens, of which 639 (61%) were positive for at least one virus. Three-quarters of the patients were children under five years old. We therefore focused on this age group, in which 68.1% of patients were positive for at least one virus. The most common viruses were adenoviruses (17.5%), followed by parainfluenza viruses (PIVs) 1–4 (16.8%), enteroviruses (EV) (14.7%), respiratory syncytial virus (RSV) (13.5%), and influenza virus (11.9%). The prevalence of some viruses was subject to geographic and seasonal variations. One-third of positive samples contained more than one virus. Conclusions Like most studies in the world, the virus PIVs, EV, RSV, Influenza virus, HRV were predominant among children under five years old in Gabon. An exception is made for adenoviruses which have a high prevalence in our study. However adenoviruses can be detected in asymptomatic persons. These finding gave a better knowledge of the circulation and the seasonality of the viruses involved in ILI in Gabon.
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Affiliation(s)
| | | | | | | | | | - Eric M Leroy
- Centre International de Recherches Médicales de Franceville, BP 769 Franceville, Gabon.
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Comparison of a new transport medium with universal transport medium at a tropical field site. Diagn Microbiol Infect Dis 2014; 80:107-10. [PMID: 25070008 PMCID: PMC4164576 DOI: 10.1016/j.diagmicrobio.2014.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 01/13/2023]
Abstract
Limited data are available in rural Honduran settings describing the etiology of respiratory infections, partially due to limited specimen transport. A new molecular transport media (MTM) preserves released nucleic acid at ambient temperature for later detection. Prospective surveillance was conducted in a Honduran clinic to identify 233 children less than 5 years of age presenting with respiratory symptoms. We obtained 2 nasopharyngeal samples and stored 1 in PrimeStore® MTM at room temperature and 1 in universal transport media (UTM) at -80 °C. The specimens were then transported to Cincinnati Children's Hospital and tested for 16 respiratory viruses using a multiplex PCR panel. The 2 specimen collection systems were similar for detecting the 4 most common viruses: influenza (Kappa = 0.7676, P < 0.0001), human metapneumovirus (Kappa = 0.8770, P < 0.0001), respiratory syncytial virus (Kappa = 0.6849, P < 0.0001), and parainfluenza (Kappa = 0.8796, P < 0.0001). These results suggest that clinical specimens transported via PrimeStore® MTM and UTM yield similar viral multiplex PCR results.
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Budge PJ, Griffin MR, Edwards KM, Williams JV, Verastegui H, Hartinger SM, Johnson M, Klemenc JM, Zhu Y, Gil AI, Lanata CF, Grijalva CG. A household-based study of acute viral respiratory illnesses in Andean children. Pediatr Infect Dis J 2014; 33:443-7. [PMID: 24378948 PMCID: PMC4223552 DOI: 10.1097/inf.0000000000000135] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Few community studies have measured the incidence, severity and etiology of acute respiratory illness (ARI) among children living at high-altitude in remote rural settings. METHODS We conducted active, household-based ARI surveillance among children aged <3 years in rural highland communities of San Marcos, Cajamarca, Peru from May 2009 through September 2011 (RESPIRA-PERU study). ARI (defined by fever or cough) were considered lower respiratory tract infections if tachypnea, wheezing, grunting, stridor or retractions were present. Nasal swabs collected during ARI episodes were tested for respiratory viruses by real-time, reverse-transcriptase polymerase chain reaction. ARI incidence was calculated using Poisson regression. RESULTS During 755.1 child-years of observation among 892 children in 58 communities, 4475 ARI were observed, yielding an adjusted incidence of 6.2 ARI/child-year (95% confidence interval: 5.9-6.5). Families sought medical care for 24% of ARI, 4% were classified as lower respiratory tract infections and 1% led to hospitalization. Of 5 deaths among cohort children, 2 were attributed to ARI. One or more respiratory viruses were detected in 67% of 3957 samples collected. Virus-specific incidence rates per 100 child-years were: rhinovirus, 236; adenovirus, 73; parainfluenza virus, 46; influenza, 37; respiratory syncytial virus, 30 and human metapneumovirus, 17. Respiratory syncytial virus, metapneumovirus and parainfluenza virus 1-3 comprised a disproportionate share of lower respiratory tract infections compared with other etiologies. CONCLUSIONS In this high-altitude rural setting with low-population density, ARI in young children were common, frequently severe and associated with a number of different respiratory viruses. Effective strategies for prevention and control of these infections are needed.
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Affiliation(s)
- Philip J. Budge
- Division of Infectious Diseases, Department of Internal Medicine, Vanderbilt University, Nashville, TN, USA
| | - Marie R. Griffin
- Department of Preventive Medicine, Vanderbilt University, Nashville, TN, USA
| | - Kathryn M. Edwards
- Vanderbilt Vaccine Research Program, Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University, Nashville, TN, USA
- Department of Pediatrics, Vanderbilt University, Nashville, TN, USA
| | - John V. Williams
- Department of Pediatrics, Vanderbilt University, Nashville, TN, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
| | | | - Stella M. Hartinger
- Instituto de Investigacion Nutricional, Lima, Peru
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Monika Johnson
- Department of Pediatrics, Vanderbilt University, Nashville, TN, USA
| | | | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Ana I. Gil
- Instituto de Investigacion Nutricional, Lima, Peru
| | | | - Carlos G. Grijalva
- Department of Preventive Medicine, Vanderbilt University, Nashville, TN, USA
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McCracken JP, Arvelo W, Ortíz J, Reyes L, Gray J, Estevez A, Castañeda O, Langley G, Lindblade KA. Comparative epidemiology of human metapneumovirus- and respiratory syncytial virus-associated hospitalizations in Guatemala. Influenza Other Respir Viruses 2014; 8:414-21. [PMID: 24761765 PMCID: PMC4181800 DOI: 10.1111/irv.12251] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 11/23/2022] Open
Abstract
Background Human metapneumovirus (HMPV) is an important cause of acute respiratory infections (ARI), but little is known about how it compares with respiratory syncytial virus (RSV) in Central America. Objectives In this study, we describe hospitalized cases of HMPV- and RSV-ARI in Guatemala. Methods We conducted surveillance at three hospitals (November 2007–December 2012) and tested nasopharyngeal and oropharyngeal swab specimens for HMPV and RSV using real-time reverse transcription-polymerase chain reaction. We calculated incidence rates, and compared the epidemiology and outcomes of HMPV-positive versus RSV-positive and RSV-HMPV-negative cases. Results We enrolled and tested specimens from 6288 ARI cases; 596 (9%) were HMPV-positive and 1485 (24%) were RSV-positive. We observed a seasonal pattern of RSV but not HMPV. The proportion HMPV-positive was low (3%) and RSV-positive high (41%) for age <1 month, whereas these proportions were similar (∼20%) by age 2 years. The annual incidence of hospitalized HMPV-ARI was 102/100 000 children aged <5 years [95% confidence interval (CI): 75–178], 2·6/100 000 persons aged 5–17 years (95%CI: 1·2–5·0), and 2·6/100 000 persons aged ≥18 years (95%CI: 1·5–4·9). Among children aged <5 years, HMPV-positive cases were less severe than HMPV-RSV-negative cases after adjustment for confounders [odds ratio (OR) for intensive care = 0·63, 95% CI 0·47–0·84]; OR for death = 0·46, 95% CI 0·23–0·92). Conclusions Human metapneumovirus is a substantial contributor to ARI hospitalization in Guatemala, but HMPV hospitalizations are less frequent than RSV and, in young children, less severe than other etiologies. Preventive interventions should take into account the wide variation in incidence by age and unpredictable timing of incidence peaks.
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Affiliation(s)
- John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
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McCracken JP, Prill MM, Arvelo W, Lindblade KA, López MR, Estevez A, Müller ML, Muñoz F, Bernart C, Cortez M, Moir JC, Ortíz J, Paredes A, Iwane MK. Respiratory syncytial virus infection in Guatemala, 2007-2012. J Infect Dis 2014; 208 Suppl 3:S197-206. [PMID: 24265479 DOI: 10.1093/infdis/jit517] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of acute respiratory illness (ARI). Little is known about RSV disease among older children and adults in Central America. METHODS Prospective surveillance for ARI among hospital patients and clinic patients was conducted in Guatemala during 2007-2012. Nasopharyngeal and oropharyngeal swab specimens were tested for RSV, using real-time reverse-transcription polymerase chain reaction. RESULTS Of 6287 hospitalizations and 2565 clinic visits for ARI, 24% and 12%, respectively, yielded RSV-positive test results. The incidence of RSV-positive hospitalization for ARI was 5.8 cases/10 000 persons per year and was highest among infants aged <6 months (208 cases/10 000 persons per year); among adults, the greatest incidence was observed among those aged ≥ 65 years (2.9 cases/10 000 persons per year). The incidence of RSV-positive clinic visitation for ARI was 32 cases/10 000 persons per year and was highest among infants aged 6-23 months (186 cases/10 000 persons per year). Among RSV-positive hospital patients with ARI, underlying cardiovascular disease was associated with death, moribund discharge, intensive care unit admission, or mechanical ventilation (odds ratio, 4.1; 95% confidence interval, 1.9-8.8). The case-fatality proportion among RSV-positive hospital patients with ARI was higher for those aged ≥ 5 years than for those aged <5 years (13% vs 3%; P < .001). CONCLUSIONS The incidences of RSV-associated hospitalization and clinic visitation for ARI were highest among young children, but a substantial burden of ARI due to RSV was observed among older children and adults.
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IgA and neutralizing antibodies to influenza a virus in human milk: a randomized trial of antenatal influenza immunization. PLoS One 2013; 8:e70867. [PMID: 23967126 PMCID: PMC3743877 DOI: 10.1371/journal.pone.0070867] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 06/21/2013] [Indexed: 11/22/2022] Open
Abstract
Background Antenatal immunization of mothers with influenza vaccine increases serum antibodies and reduces the rates of influenza illness in mothers and their infants. We report the effect of antenatal immunization on the levels of specific anti-influenza IgA levels in human breast milk. (ClinicalTrials.gov identifier NCT00142389; http://clinicaltrials.gov/ct2/show/NCT00142389). Methods and Findings The Mother's Gift study was a prospective, blinded, randomized controlled trial that assigned 340 pregnant Bangladeshi mothers to receive either trivalent inactivated influenza vaccine, or 23-valent pneumococcal polysaccharide vaccine during the third trimester. We evaluated breast milk at birth, 6 weeks, 6 months, and 12 months, and serum at 10 weeks and 12 months. Milk and serum specimens from 57 subjects were assayed for specific IgA antibody to influenza A/New Caledonia (H1N1) using an enzyme-linked immunosorbent assay (ELISA) and a virus neutralization assay, and for total IgA using ELISA. Influenza-specific IgA levels in breast milk were significantly higher in influenza vaccinees than in pneumococcal controls for at least 6 months postpartum (p = 0.04). Geometric mean concentrations ranged from 8.0 to 91.1 ELISA units/ml in vaccinees, versus 2.3 to 13.7 ELISA units/mL in controls. Virus neutralization titers in milk were 1.2 to 3 fold greater in vaccinees, and correlated with influenza-specific IgA levels (r = 0.86). Greater exclusivity of breastfeeding in the first 6 months of life significantly decreased the expected number of respiratory illness with fever episodes in infants of influenza-vaccinated mothers (p = 0.0042) but not in infants of pneumococcal-vaccinated mothers (p = 0.4154). Conclusions The sustained high levels of actively produced anti-influenza IgA in breast milk and the decreased infant episodes of respiratory illness with fever suggest that breastfeeding may provide local mucosal protection for the infant for at least 6 months. Studies are needed to determine the cellular and immunologic mechanisms of breast milk-mediated protection after antepartum immunization. Trial Registration ClinicalTrials.gov NCT00142389
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Harada Y, Kinoshita F, Yoshida LM, Minh LN, Suzuki M, Morimoto K, Toku Y, Tomimasu K, Moriuchi H, Ariyoshi K. Does respiratory virus coinfection increases the clinical severity of acute respiratory infection among children infected with respiratory syncytial virus? Pediatr Infect Dis J 2013; 32:441-5. [PMID: 23838658 DOI: 10.1097/inf.0b013e31828ba08c] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection in children less than 5 years of age. The impact of non-RSV respiratory virus coinfection on the severity of RSV disease is unknown. METHODS This hospital-based prospective study was conducted in Nagasaki, Japan, on all children less than 5 years of age with acute respiratory infection (ARI) who had undergone a rapid RSV diagnostic test between April 2009 and March 2010. Thirteen respiratory viruses were identified from nasopharyngeal swab samples using a multiplex polymerase chain reaction; polymerase chain reaction-positive samples were considered as confirmed respiratory virus infections. The cases were classified into 3 categories (pneumonia, moderate-to-severe nonpneumonic ARI and mild ARI) according to the findings of the chest radiograph and the hospitalization records. RESULTS Among 384 cases enrolled, 371 were eligible for analysis, of whom 85 (23%) were classified as pneumonia cases; 137 (37%) as moderate-to-severe nonpneumonic ARI cases and 162 (40%) as mild ARI cases. RSV was detected in 172 cases (61.6%), and 31 cases (18.0%) had double or triple infections with other respiratory viruses. RSV infection was more frequently observed in pneumonia cases (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.31-3.9) and moderate-to-severe nonpneumonic ARI cases (OR: 2.95; 95% CI: 1.82-4.78) than in mild ARI cases. The association with moderate-to-severe nonpneumonic ARI cases was stronger with RSV/non-RSV respiratory virus coinfection (adjusted OR: 4.91; 95% CI: 1.9-12.7) than with RSV single infection (adjusted OR: 2.77; 95% CI: 1.64-4.7). CONCLUSIONS Non-RSV respiratory virus coinfection is not uncommon in RSV-infected children and may increase the severity of RSV disease.
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Affiliation(s)
- Yoshitaka Harada
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Japan
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