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Falsaperla R, Sortino V, La Cognata D, Barberi C, Corsello G, Malaventura C, Suppiej A, Collotta AD, Polizzi A, Grassi P, Ruggieri M. Acute Respiratory Tract Infections (ARTIs) in Children after COVID-19-Related Social Distancing: An Epidemiological Study in a Single Center of Southern Italy. Diagnostics (Basel) 2024; 14:1341. [PMID: 39001232 PMCID: PMC11240751 DOI: 10.3390/diagnostics14131341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/06/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
In Sicily (Italy), respiratory syncytial virus (RSV), rhinovirus (HRV), and influenza virus triggered epidemics among children, resulting in an increase in acute respiratory tract infections (ARTIs). Our objective was to capture the epidemiology of respiratory infections in children, determining which pathogens were associated with respiratory infections following the lockdown and whether there were changes in the epidemiological landscape during the post-SARS-CoV-2 pandemic era. MATERIALS AND METHODS We analyzed multiplex respiratory viral PCR data (BioFire® FilmArray® Respiratory Panel 2.1 Plus) from 204 children presenting with respiratory symptoms and/or fever to our Unit of Pediatrics and Pediatric Emergency. RESULTS Viruses were predominantly responsible for ARTIs (99%), with RSV emerging as the most common agent involved in respiratory infections, followed by human rhinovirus/enterovirus and influenza A. RSV and rhinovirus were also the primary agents in coinfections. RSV predominated during winter months, while HRV/EV exhibited greater prevalence than RSV during the fall. Some viruses spread exclusively in coinfections (human coronavirus NL63, adenovirus, metapneumovirus, and parainfluenza viruses 1-3), while others primarily caused mono-infections (influenza A and B). SARS-CoV-2 was detected equally in both mono-infections (41%) and coinfections (59%). CONCLUSIONS Our analysis underlines the predominance of RSV and the importance of implementing preventive strategies for RSV.
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Affiliation(s)
- Raffaele Falsaperla
- Neonatal Intensive Care Unit and Neonatal Accompaniment Unit, San Marco Hospital, Azienda Ospedaliero-Universitaria Policlinico "Rodolico-San Marco", University of Catania, 95121 Catania, Italy
- Unit of Clinical Paediatrics, San Marco Hospital, Azienda Ospedaliero-Universitaria Policlinico, "Rodolico-San Marco", 95121 Catania, Italy
- Medical Sciences Department, University of Ferrara, 44124 Ferrara, Italy
| | - Vincenzo Sortino
- Unit of Clinical Paediatrics, San Marco Hospital, Azienda Ospedaliero-Universitaria Policlinico, "Rodolico-San Marco", 95121 Catania, Italy
| | - Daria La Cognata
- Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Chiara Barberi
- Postgraduate Training Program in Pediatrics, University of Palermo, 90121 Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, 90121 Palermo, Italy
| | | | - Agnese Suppiej
- Medical Sciences Department, University of Ferrara, 44124 Ferrara, Italy
| | - Ausilia Desiree Collotta
- Unit of Clinical Paediatrics, San Marco Hospital, Azienda Ospedaliero-Universitaria Policlinico, "Rodolico-San Marco", 95121 Catania, Italy
| | - Agata Polizzi
- Department of Educational Science, University of Catania, 95123 Catania, Italy
| | - Patrizia Grassi
- Analysis Laboratory, San Marco Hospital, 95121 Catania, Italy
| | - Martino Ruggieri
- Unit of Clinical Pediatrics, AOU "Policlinico", PO "G. Rodolico", University of Catania, 95123 Catania, Italy
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Ciofi degli Atti M, Beccia F, D'Amore C, Ravà L, Bernaschi P, Russo C, Villani A, Perno C, Raponi M. Impact of SARS-CoV-2 Pandemic on Emergency Hospitalizations for Acute Respiratory Infections: The Experience of a Paediatric Tertiary Care Hospital in Italy. Influenza Other Respir Viruses 2024; 18:e13335. [PMID: 38887843 PMCID: PMC11184210 DOI: 10.1111/irv.13335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/16/2024] [Accepted: 05/19/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) are a major healthcare issue in children. The SARS-CoV-2 pandemic changed the epidemiology of ARIs; the aims of this study are to characterize the epidemiological trend of ARI emergency hospitalizations and virology results and to estimate the association of ARI emergency hospitalizations with respiratory viruses from January 2018 to June 2023. METHODS This study was carried out in an Italian tertiary care children's hospital (Bambino Gesù Children's Hospital). The demographic and clinical information of children who accessed the Emergency Department (ED) with ARI and were hospitalized were retrospectively extracted from the electronic health records. Multivariate linear regression model was used to compare the number of ARI hospital admissions with the reported temporal trends in viruses diagnosed from respiratory samples throughout the same time period. RESULTS During the study period, there were 92,140 ED visits and 10,541 hospitalizations due to ARIs, reflecting an admission rate of 11.4%. The highest proportion of hospitalizations occurred in infants ≤ 1 year of age (n = 4840, 45.9% of total admissions), with a hospitalization rate of 22.6%. Emergency hospitalizations aligned closely with the predictions made by the multivariate regression model; peaks in hospitalizations reflected Respiratory Syncytial Virus (RSV) circulation. CONCLUSIONS ARI hospital urgent admissions are a relevant component of ARI disease burden in children. RSV prevention and control are crucial to limit the risk of urgent hospitalizations due to ARIs.
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Affiliation(s)
| | - Flavia Beccia
- Epidemiology, Clinical Pathways and Clinical Risk UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
- University Department of Life Sciences and Public HealthUniversità Cattolica del Sacro CuoreRomeItaly
| | - Carmen D'Amore
- Epidemiology, Clinical Pathways and Clinical Risk UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Lucilla Ravà
- Epidemiology, Clinical Pathways and Clinical Risk UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Paola Bernaschi
- Laboratory Medicine Clinical AreaBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Cristina Russo
- Laboratory Medicine Clinical AreaBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Alberto Villani
- University‐Hospital Paediatric Clinical AreaBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Carlo Federico Perno
- Laboratory Medicine Clinical AreaBambino Gesù Children's Hospital, IRCCSRomeItaly
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Edderdouri K, Kabbaj H, Laamara L, Lahmouddi N, Lamdarsi O, Zouaki A, El Amin G, Zirar J, Seffar M. Contribution of the FilmArray BioFire® Technology in the Diagnosis of Viral Respiratory Infections during the COVID-19 Pandemic at Ibn Sina University Hospital Center in Rabat: Epidemiological Study about 503 Cases. Adv Virol 2023; 2023:2679770. [PMID: 37384256 PMCID: PMC10299880 DOI: 10.1155/2023/2679770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/09/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023] Open
Abstract
Respiratory viruses are the most involved pathogens in acute respiratory infections. During the COVID-19 pandemic, new elements have been brought to this topic, especially at the diagnostic and therapeutic level. The objective of this work is to describe the epidemiology of respiratory viruses in patients admitted to the Ibn Sina University Hospital of Rabat during a period characterized by the emergence and spread of SARS-CoV-2. We conducted a retrospective study from January 1 to December 31. We included all patients treated for acute respiratory infection and for whom a multiplex respiratory panel PCR was requested. Virus detection was performed using a FilmArray RP 2.1 plus BioFire multiplex respiratory panel. The study population was relatively adults with a mean age of 39 years. The sex ratio M/F was 1.20. The survey revealed a high prevalence of 42.3% of patients hospitalized in the adult intensive care unit whose respiratory distress was the most common reason for hospitalization (58%). The positivity rate was 48.1%. This rate was higher in the pediatric population 83.13% compared to adults 29.7%. Monoinfection was found in 36.4% of cases, and codetection in 11.7% of cases. This survey revealed that a total of 322 viruses were detected, HRV being the most incriminated virus (48.7%), followed by RSV in 13.8% of patients. Considering the five most detected viruses in our study (HRV, RSV, PIV3, ADV, and hMPV), we found that the incidence was significantly higher in the pediatric population. SARS-CoV-2 was detected only in adult's population. In our study, we found that influenza A and B viruses, PIV2, MERS, and all bacteria were not detected by this kit during the study period. Regarding the seasonal distribution, RSV and hMPV showed a significantly high incidence during autumn and summer and SARS-CoV-2 and CoV OC43 showed a high peak during winter. In this study, we found a lack of detection of influenza virus and a shift in the usual winter peak of RSV to the summer, while the detection of ADV and HRV was less affected. This difference in detection could be due on the one hand to the difference in stability between enveloped and nonenveloped viruses and on the other hand to the escape of certain viruses to the different sanitary measures introduced after the declaration of the COVID-19 pandemic. These same measures were effective against enveloped viruses such as RSV and influenza viruses. The emergence of SARS-CoV-2 has modified the epidemiology of other respiratory viruses, either directly by viral interference or indirectly by the preventive measures taken.
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Affiliation(s)
- Khalid Edderdouri
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Hakima Kabbaj
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Leila Laamara
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Noureddine Lahmouddi
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Oumayma Lamdarsi
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Amal Zouaki
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Ghizlane El Amin
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Jalila Zirar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Myriam Seffar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
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Koul PA, Saha S, Kaul KA, Mir H, Potdar V, Chadha M, Iuliano D, Lafond KE, Lal RB, Krishnan A. Respiratory syncytial virus among children hospitalized with severe acute respiratory infection in Kashmir, a temperate region in northern India. J Glob Health 2022; 12:04050. [PMID: 35976005 PMCID: PMC9288648 DOI: 10.7189/jogh.12.04050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Severe acute respiratory infections (SARI) are a leading cause of hospitalizations in children, especially due to viral pathogens. We studied the prevalence of respiratory viruses among children aged <5 years hospitalized with severe acute respiratory infections (SARI) in Kashmir, India. Methods We conducted a prospective observational study in two tertiary care hospitals from October 2013 to September 2014, systematically enrolling two children aged <5 years with SARI per day. We defined SARI as history of fever or measured fever (≥38°C) and cough with onset in the last 7 days requiring hospitalization for children aged 3-59 months and as physician-diagnosed acute lower respiratory infection for children aged <3 months. Trained study staff screened children within 24 hours of hospitalization for SARI and collected clinical data and nasopharyngeal swabs from enrolled participants. We tested for respiratory syncytial virus (RSV) A and B, influenza viruses, rhinoviruses (HRV)/enteroviruses, adenovirus (AdV), bocavirus (BoV), human metapneumovirus (hMPV) A and B, coronaviruses (OC43, NL65, C229E), and parainfluenza viruses (PIV) 1, 2, 3 and 4 using standardized duplex real-time polymerase chain reaction. Results Among 4548 respiratory illness admissions screened from October 2013 to September 2014, 1026 met the SARI case definition, and 412 were enrolled (ages = 5 days to 58 months; median = 12 months). Among enrolees, 256 (62%) were positive for any virus; RSV was the most commonly detected (n = 118, 29%) followed by HRV/enteroviruses (n = 88, 21%), PIVs (n = 31, 8%), influenza viruses (n = 18, 4%), BoV (n = 15, 4%), coronaviruses (n = 16, 4%), AdV (n = 14, 3%), and hMPV (n = 9, 2%). Fifty-four children had evidence of virus co-detection. Influenza-associated SARI was more common among children aged 1-5 years (14/18, 78%) while most RSV detections occurred in children <12 months (83/118, 70%). Of the RSV viruses typed (n = 116), the majority were type B (94, 80%). Phylogenetic analysis of G gene of RSV showed circulation of the BA9 genotype with 60bp nucleotide duplication. Conclusions Respiratory viruses, especially RSV, contributed to a substantial proportion of SARI hospitalizations among children <5 years in north India. These data can help guide clinicians on appropriate treatment and prevention strategies.
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Affiliation(s)
- Parvaiz A Koul
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Siddhartha Saha
- Influenza Program, US Centers for Disease Control and Prevention – Delhi office, India
| | | | - Hyder Mir
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | | | - Danielle Iuliano
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn E Lafond
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Renu B Lal
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
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Kamata K, Thein KN, Di Ja L, Win NC, Win SMK, Suzuki Y, Ito A, Osada H, Chon I, Phyu WW, Aizawa Y, Ikuse T, Ota T, Kyaw Y, Tin HH, Shobugawa Y, Watanabe H, Saito R, Saitoh A. Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar. BMC Infect Dis 2022; 22:350. [PMID: 35395744 PMCID: PMC8992414 DOI: 10.1186/s12879-022-07342-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/25/2022] [Indexed: 02/03/2023] Open
Abstract
Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking. Methods This prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients’ samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization. Conclusions Viral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07342-1.
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Affiliation(s)
- Kazuhiro Kamata
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar.,Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | | | - Lasham Di Ja
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Nay Chi Win
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Su Mon Kyaw Win
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Yuko Suzuki
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Ai Ito
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Hidekazu Osada
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar.,Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Irina Chon
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Wint Wint Phyu
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Yuta Aizawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Tatsuki Ikuse
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Tomomi Ota
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Yadanar Kyaw
- Respiratory Medicine Department, Thingangyun Sanpya General Hospital, Yangon, Myanmar
| | - Htay Htay Tin
- Department of Medical Services, National Health Laboratory, Ministry of Health and Sports, Yangon, Myanmar
| | - Yugo Shobugawa
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Hisami Watanabe
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Reiko Saito
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
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Ahmed A, Alsenaidy AM, Mobaireek KF, AlSaadi MM. Viral etiology of acute respiratory infections during 2014–16 in Riyadh, Saudi Arabia. Future Virol 2022. [DOI: 10.2217/fvl-2020-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Viral etiology of respiratory infections is not well understood in Saudi Arabia. This study was conceptualized to understand viral etiology in children with acute respiratory tract infections (ARTI) from Riyadh. Patients and methods: Respiratory viruses were detected by real-time PCR in nasopharyngeal aspirates or swab from 580 children aged ≤5 years. Results: Respiratory viruses were detected in 64% of the samples with 6% mixed viral infections. Respiratory syncytial virus, adenovirus, influenza, parainfluenza and human metapneumovirus infections accounted for 42, 20, 16, 12 and 10%, respectively. Maximum prevalence (37%) was among the lowest age group followed by 30% among the 7- to 12-month age group. Conclusion: The prevalence and determinants of viral etiology are in line with the previous report from the region. No major shift in the viral etiologies was observed in the 2-year study period.
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Affiliation(s)
- Anwar Ahmed
- Centre of Excellence in Biotechnology Research, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Abdulrahman M Alsenaidy
- Department of Biochemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Khalid Fahad Mobaireek
- Pediatric Emergency Department, Children’s Hospital, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Muslim Mohammed AlSaadi
- Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, 11533, Saudi Arabia
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Phommasone K, Xaiyaphet X, Garcia-Rivera JA, Hontz RD, Pathavongsa V, Keomoukda P, Vongsouvath M, Mayxay M, Vongsouvath M, Newton PN, Ashley EA, Dubot-Pérès A. A case-control study of the causes of acute respiratory infection among hospitalized patients in Northeastern Laos. Sci Rep 2022; 12:939. [PMID: 35042900 PMCID: PMC8766494 DOI: 10.1038/s41598-022-04816-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/31/2021] [Indexed: 11/18/2022] Open
Abstract
With the advent of highly sensitive real-time PCR, multiple pathogens have been identified from nasopharyngeal swabs of patients with acute respiratory infections (ARIs). However, the detection of microorganisms in the upper respiratory tract does not necessarily indicate disease causation. We conducted a matched case-control study, nested within a broader fever aetiology project, to facilitate determination of the aetiology of ARIs in hospitalised patients in Northeastern Laos. Consenting febrile patients of any age admitted to Xiengkhuang Provincial Hospital were included if they met the inclusion criteria for ARI presentation (at least one of the following: cough, rhinorrhoea, nasal congestion, sore throat, difficulty breathing, and/or abnormal chest auscultation). One healthy control for each patient, matched by sex, age, and village of residence, was recruited for the study. Nasopharyngeal swabs were collected from participants and tested for 33 pathogens by probe-based multiplex real-time RT-PCR (FastTrack Diagnostics Respiratory pathogen 33 kit). Attributable fraction of illness for a given microorganism was calculated by comparing results between patients and controls (= 100 * [OR - 1]/OR) (OR = odds ratio). Between 24th June 2019 and 24th June 2020, 205 consenting ARI patients and 205 matching controls were recruited. After excluding eight pairs due to age mismatch, 197 pairs were included in the analysis. Males were predominant with sex ratio 1.2:1 and children < 5 years old accounted for 59% of participants. At least one potential pathogen was detected in 173 (88%) patients and 175 (89%) controls. ARI in admitted patients were attributed to influenza B virus, influenza A virus, human metapneumovirus (HMPV), and respiratory syncytial virus (RSV) in 17.8%, 17.2%, 7.5%, and 6.5% of participants, respectively. SARS-CoV-2 was not detected in any cases or controls. Determining ARI aetiology in individual patients remains challenging. Among hospitalised patients with ARI symptoms presenting to a provincial hospital in Northeastern Laos, half were determined to be caused by one of several respiratory viruses, in particular influenza A virus, influenza B virus, HMPV, and RSV.
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Affiliation(s)
- Koukeo Phommasone
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
| | - Xaipasong Xaiyaphet
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Jose A Garcia-Rivera
- U.S. Naval Medical Research Unit TWO (NAMRU-2), Singapore and Phnom Penh, Cambodia
| | - Robert D Hontz
- U.S. Naval Medical Research Unit TWO (NAMRU-2), Singapore and Phnom Penh, Cambodia
| | | | - Patsalin Keomoukda
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Malavanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Institute of Research and Education Development (IRED), Ministry of Health, Vientiane, Lao PDR
- University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Elizabeth A Ashley
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
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8
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Duyu M, Karakaya Z. Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU. Med Intensiva 2021; 45:447-458. [PMID: 34717883 DOI: 10.1016/j.medine.2020.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/24/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children. DESIGN A prospective descriptive study was carried out. SETTING Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. PATIENTS A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded. MAIN VARIABLES OF INTEREST Demographic, clinical, laboratory test and radiographic data were recorded. RESULTS A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be <12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission. CONCLUSIONS Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged <12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.
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Affiliation(s)
- M Duyu
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey.
| | - Z Karakaya
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Pediatrics Istanbul, Turkey
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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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Snoeck CJ, Evdokimov K, Xaydalasouk K, Mongkhoune S, Sausy A, Vilivong K, Pauly M, Hübschen JM, Billamay S, Muller CP, Black AP. Epidemiology of acute respiratory viral infections in children in Vientiane, Lao People's Democratic Republic. J Med Virol 2021; 93:4748-4755. [PMID: 33830514 PMCID: PMC8359973 DOI: 10.1002/jmv.27004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/12/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022]
Abstract
Respiratory infections are one of the most frequent reasons for medical consultations in children. In low resource settings such as in Lao People's Democratic Republic, knowledge gaps and the dearth of laboratory capacity to support differential diagnosis may contribute to antibiotic overuse. We studied the etiology, temporal trends, and genetic diversity of viral respiratory infections in children to provide evidence for prevention and treatment guidelines. From September 2014 to October 2015, throat swabs and nasopharyngeal aspirates from 445 children under 10 years old with symptoms of acute respiratory infection were collected at the Children Hospital in Vientiane. Rapid antigen tests were performed for influenza A and B and respiratory syncytial virus. Real-time reverse-transcription polymerase chain reactions (RT-PCRs) were performed to detect 16 viruses. Influenza infections were detected with a higher sensitivity using PCR than with the rapid antigen test. By RT-PCR screening, at least one pathogen could be identified for 71.7% of cases. Human rhinoviruses were most frequently detected (29.9%), followed by influenza A and B viruses combined (15.9%). We identify and discuss the seasonality of some of the infections. Altogether these data provide a detailed characterization of respiratory pathogens in Lao children and we provide recommendations for vaccination and further studies.
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Affiliation(s)
- Chantal J Snoeck
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Konstantin Evdokimov
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | | | | | - Aurélie Sausy
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Keoudomphone Vilivong
- Institut Pasteur du Laos, Vientiane, Lao PDR.,Wellcome Trust Research Unit, Lao-Oxford-Mahosot Hospital, Vientiane, Lao PDR
| | - Maude Pauly
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Judith M Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | | | - Claude P Muller
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
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11
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Viral Etiology of Acute Lower Respiratory Tract Infections in Hospitalized Children in Nagasaki, a Regional City of Japan in 2013-2015. Pediatr Infect Dis J 2020; 39:687-693. [PMID: 32221164 DOI: 10.1097/inf.0000000000002668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Acute lower respiratory tract infections (ALRIs) are the most common disease for hospitalized children in Japan. The aim of this study was to identify viruses in children hospitalized for ALRIs and to demonstrate epidemiologic and clinical characteristics in Japan. METHODS During a 2-year period from February 2013 to January 2015, we collected nasopharyngeal swab specimens from almost all hospitalized children with ALRIs in Nagasaki, a regional city of Japan, and its environs. Viruses were detected by multiplex polymerase chain reaction from these samples. RESULTS We detected one or more viruses from 259 (69%) of 374 patients, 227 of whom were infected with a single virus, 30 with 2, and 2 with 3 viruses. Detected viruses in this study were rhinovirus (46.4%), respiratory syncytial virus (29.7%), human metapneumovirus (6.8%), parainfluenza virus (5.5%), enterovirus D68 (3.4%), influenza virus (2.7%), adenovirus (2.4%), bocavirus (2.0%) and Coxsackie virus (1.0%). We detected a seasonal shift in respiratory syncytial virus outbreaks from the 2013-2014 to the 2014-2015 seasons. There was no significant difference in clinical course and severity among those viruses. Patients with a history of asthma or underlying diseases were older and more frequently required oxygen therapy than previously healthy patients. CONCLUSIONS Viral etiology in hospitalized children with ALRIs in Nagasaki, Japan, was similar to that in many other countries. Enterovirus D68, which was recently recognized as a causative agent of severe ALRIs, was also identified in this study area. Severity of ALRIs may depend on underlying disease rather than type of etiologic virus.
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12
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Duyu M, Karakaya Z. VIRAL ETIOLOGY AND OUTCOME OF SEVERE LOWER RESPIRATORY TRACT INFECTIONS AMONG CRITICALLY ILL CHILDREN ADMITTED TO THE PICU. Med Intensiva 2020; 45:S0210-5691(20)30164-9. [PMID: 32405129 PMCID: PMC7218367 DOI: 10.1016/j.medin.2020.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/24/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children. DESIGN A prospective descriptive study was carried out. SETTING Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. PATIENTS A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded. MAIN VARIABLES OF INTEREST Demographic, clinical, laboratory test and radiographic data were recorded. RESULTS A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be < 12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission. CONCLUSIONS Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged < 12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.
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Affiliation(s)
- M. Duyu
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey
| | - Z. Karakaya
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Pediatrics Istanbul, Turkey
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13
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Loubet P, Mathieu P, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Duval X, Postil D, Amour S, Rogez S, Lagathu G, L'Honneur AS, Foulongne V, Houhou N, Lina B, Carrat F, Launay O. Characteristics of human metapneumovirus infection in adults hospitalized for community-acquired influenza-like illness in France, 2012-2018: a retrospective observational study. Clin Microbiol Infect 2020; 27:127.e1-127.e6. [PMID: 32283266 PMCID: PMC7195031 DOI: 10.1016/j.cmi.2020.04.005] [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: 01/05/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
Objectives To describe the prevalence, clinical features and complications of human metapneumovirus (hMPV) infections in a population of adults hospitalized with influenza-like illness (ILI). Methods This was a retrospective, observational, multicenter cohort study using prospectively collected data from adult patients hospitalized during influenza virus circulation, for at least 24 h, for community-acquired ILI (with symptom onset <7 days). Data were collected from five French teaching hospitals over six consecutive winters (2012–2018). Respiratory viruses were identified by multiplex reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens. hMPV + patients were compared with hMPV– patients, influenza+ and respiratory syncytial virus (RSV)+ patients using multivariate logistic regressions. Primary outcome was the prevalence of hMPV in patients hospitalized for ILI. Results Among the 3148 patients included (1449 (46%) women, 1988 (63%) aged 65 and over; 2508 (80%) with chronic disease), at least one respiratory virus was detected in 1604 (51%, 95% confidence interval (CI) 49–53), including 100 cases of hMPV (100/3148, 3% 95% CI 3–4), of which 10 (10%) were viral co-infection. In the hMPV + patients, mean length of stay was 7 days, 62% (56/90) developed a complication, 21% (14/68) were admitted to intensive care unit and 4% (4/90) died during hospitalization. In comparison with influenza + patients, hMPV + patients were more frequently >65 years old (adjusted odds ratio (aOR) = 3.3, 95% CI 1.9–6.3) and presented more acute heart failure during hospitalization (aOR = 1.8, 95% CI 1.0–2.9). Compared with RSV + patients, hMPV + patients had less cancer (aOR = 0.4, 95% CI 0.2–0.9) and were less likely to smoke (aOR = 0.5, 95% CI 0.2–0.9) but had similar outcomes, especially high rates of respiratory and cardiovascular complications. Conclusions Adult hMPV infections mainly affect the elderly and patients with chronic conditions and are responsible for frequent cardiac and pulmonary complications similar to those of RSV infections. At-risk populations would benefit from the development of antivirals and vaccines targeting hMPV.
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Affiliation(s)
- P Loubet
- VBMI, INSERM U1047, Department of Infectious and Tropical Disease, CHU Nîmes, Univ Montpellier, Nîmes, France; Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France.
| | - P Mathieu
- Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - N Lenzi
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - F Galtier
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1411, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - F Lainé
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Centre d'Investigations Cliniques, INSERM UMR CIC 1414, Hôpital Pontchaillou, Rennes, France
| | - Z Lesieur
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - P Vanhems
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - X Duval
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1125, Hôpital Bichat Claude Bernard, Paris, France
| | - D Postil
- CHU Dupuytren, CIC 1435, Limoge Cedex, France
| | - S Amour
- Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - S Rogez
- CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France
| | - G Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - A-S L'Honneur
- AHU, Service de Virologie, Hôpital Cochin, Paris, France
| | - V Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - N Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - B Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France
| | - F Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, F75013 Paris, France
| | - O Launay
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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Abstract
Respiratory syncytial virus (RSV) is the most common pathogen associated with acute lower respiratory tract infections in young children. RSV is also a major viral pathogen causing severe lung disease in the adult population, particularly among the elderly. We conducted a review of adult RSV studies published from January 1970 to February 2017 to determine the burden of disease among adults worldwide. There were no restrictions on health care setting or definition of RSV infection. A total of 1530 published studies were identified, 95 of which were included in this review. The incidence rates of hospitalised RSV acute respiratory tract infection (ARI) in adults >65 years old ranged from 7.3 to 13.0/105 population in Africa and Asia and from 190 to 254/105 population in the USA. Higher incidence rates (195–1790/105 population) were observed in adults ≥50 years old for outpatient or emergency visits in the USA. Of all ARI patients, RSV accounted for 1–10% in adults and 2–14% in patients with chronic diseases or transplantation. Given the limitations in the existing data, significant efforts should be made to generate evidence on the burden of RSV infections in adults and to estimate the potential impact of future preventive interventions.
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Al Amad MA, Al Mahaqri AA, Al Serouri AA, Khader YS. Severe Acute Respiratory Infections With Influenza and Noninfluenza Respiratory Viruses: Yemen, 2011-2016. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019850731. [PMID: 31137990 PMCID: PMC6542124 DOI: 10.1177/0046958019850731] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In 2010, Yemen started the surveillance for severe acute respiratory infections (SARIs) by establishing 2 sentinel sites in Sana’a and Aden city. This study aims to determine the proportions of influenza and noninfluenza viruses among SARI patients and to determine the severity of SARI and its associated factors. The data of SARI patients who were admitted to SARI surveillance sites at Al Johory hospital in Sana’a and Al Wahdah hospital in Aden city during the period 2011-2016 were analyzed. The proportions of positive influenza viruses (type A, B) and noninfluenza viruses (respiratory syncytial, adenovirus, human parainfluenza, and human metapneumovirus), intensive care unit (ICU) admission rate, and fatality rate among SARI patients were calculated. A total of 1811 of SARI patients were admitted during 2011-2016. Of those, 78% were <15 years old. A total of 89 (5%) patients had influenza viruses and 655 (36%) had noninfluenza viruses. The overall ICU admission rate was 40% and the case-fatality rate was 8%. Infection by influenza type (A, B) and mixed (adenovirus, human parainfluenza) was significantly associated with lower ICU admission. Age <15 years old, infection with influenza B, pre-existence of chronic diseases, and admission to Aden site were significantly associated with higher fatality rate among patients. In conclusion; SARI patients in Yemen had a high ICU admission and case-fatality rates. Influenza type B, chronic diseases, and admission to Aden site are associated with higher fatality rate. Expanding surveillance sites and panel of laboratory tests to involve other pathogens will help to provide accurate diagnosis for SARI etiology and give more comprehensive picture. Training staff for SARI case management will help to reduce severe outcomes.
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Affiliation(s)
| | | | | | - Yousef S Khader
- 3 Jordan University of Science and Technology, Irbid, Jordan
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16
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Lagare A, Ousmane S, Dano ID, Issaka B, Issa I, Mainassara HB, Testa J, Tempia S, Mamadou S. Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital-based observational study in Niamey, Niger. Health Sci Rep 2019; 2:e137. [PMID: 31768420 PMCID: PMC6869554 DOI: 10.1002/hsr2.137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AND AIMS In Niger, acute respiratory infections (ARIs) are the second most common cause of death in children aged younger than 5 years. However, the etiology of ARI is poorly understood in the country. This study aims to describe viral and bacterial infections among children aged younger than 5 years hospitalized with febrile ARI at two hospitals in Niamey, Niger's capital city, and the reported clinical procedures. METHODS We conducted a prospective study among children aged younger than 5 years hospitalized with febrile ARI at two national hospitals in Niamey between January and December 2015. Clinical presentation and procedures during admission were documented using a standardized case investigation form. Nasopharyngeal specimens collected from each patient were tested for a panel of respiratory viruses and bacteria using the Fast Track Diagnostic 21 Plus kit. RESULTS We enrolled and tested 638 children aged younger than 5 years, of whom 411 (64.4%) were aged younger than 1 year, and 15 (2.4%) died during the study period. Overall, 496/638 (77.7%) specimens tested positive for at least one respiratory virus or bacterium; of these, 195 (39.3%) tested positive for respiratory viruses, 126 (25.4%) tested positive for respiratory bacteria, and 175 (35.3%) tested positive for both respiratory viruses and bacteria. The predominant viruses detected were respiratory syncytial virus (RSV) (149/638; 23.3%), human parainfluenza virus (HPIV) types 1 to 4 (78/638; 12.2%), human rhinovirus (HRV) (62/638; 9.4%), human adenovirus (HAV) (60/638; 9.4%), and influenza virus (INF) (52/638; 8.1%). Streptococcus pneumoniae (249/638; 39.0%) was the most frequently detected bacterium, followed by Staphylococcus aureus (112/638; 12.2%) and Haemophilus influenzae type B (16/638; 2.5%). Chest X-rays were performed at the discretion of the attending physician on 301 (47.2%) case patients. Of these patients, 231 (76.7%) had abnormal radiological findings. A total of 135/638 (21.2%) and 572/638 (89.7%) children received antibiotic treatment prior to admission and during admission, respectively. CONCLUSION A high proportion of respiratory viruses was detected among children aged younger than 5 years with febrile ARI, raising concerns about excessive use of antibiotics in Niger.
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Affiliation(s)
- Adamou Lagare
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Sani Ousmane
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Ibrahim Dan Dano
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Bassira Issaka
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Idi Issa
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | | | - Jean Testa
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Stefano Tempia
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgia
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
- MassGenics DuluthDuluthGeorgia
| | - Saidou Mamadou
- Faculté des Sciences de la SantéUniversité Abdou MoumouniNiameyNiger
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Rudge JW, Inthalaphone N, Pavlicek R, Paboriboune P, Flaissier B, Monidarin C, Steenkeste N, Davong V, Vongsouvath M, Bonath KA, Messaoudi M, Saadatian-Elahi M, Newton P, Endtz H, Dance D, Paranhos Baccala G, Sanchez Picot V. "Epidemiology and aetiology of influenza-like illness among households in metropolitan Vientiane, Lao PDR": A prospective, community-based cohort study. PLoS One 2019; 14:e0214207. [PMID: 30951544 PMCID: PMC6450629 DOI: 10.1371/journal.pone.0214207] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/08/2019] [Indexed: 11/18/2022] Open
Abstract
Respiratory diseases are a major contributor to morbidity and mortality in many tropical countries, including Lao PDR. However, little has been published regarding viral or bacterial pathogens that can contribute to influenza-like illness (ILI) in a community setting. We report on the results of a community-based surveillance that prospectively monitored the incidence of ILI and its causative pathogens in Vientiane capital in Lao PDR. A cohort of 995 households, including 4885 study participants, were followed-up between May 2015 and May 2016. Nasopharyngeal swabs, throat swabs, and sputum specimens were collected from ILI cases identified through active case-finding. Real-Time PCR was used to test nasopharyngeal swabs for 21 respiratory pathogens, while throat and sputum samples were subjected to bacterial culture. Generalized linear mixed models were used to assess potential risk factors for associations with ILI. In total, 548 episodes of ILI were reported among 476 (9.7%) of the study participants and 330 (33.2%) of the study households. The adjusted estimated incidence of ILI within the study area was 10.7 (95%CI: 9.4-11.9) episodes per 100 person-years. ILI was significantly associated with age group (p<0.001), sex (p<0.001), and number of bedrooms (p = 0.04) in multivariate analysis. In 548 nasopharyngeal swabs, the most commonly detected potential pathogens were Streptococcus pneumoniae (17.0%), Staphylococcus aureus (11.3%), influenza A (11.1%; mostly subtype H3N2), rhinovirus (7.5%), and influenza B (8.0%). Streptococci were isolated from 42 (8.6%) of 536 throat swabs, most (27) of which were Lancefield Group G. Co-infections were observed in 132 (24.1%) of the 548 ILI episodes. Our study generated valuable data on respiratory disease burden and patterns of etiologies associated with community-acquired acute respiratory illness Laos. Establishment of a surveillance strategy in Laos to monitor trends in the epidemiology and burden of acute respiratory infections is required to minimize their impact on human health.
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Affiliation(s)
- James W. Rudge
- Communicable Diseases Policy Research Group, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom; Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nui Inthalaphone
- Center of Infectiology Christophe Mérieux of Laos, Vientiane, Laos
| | | | | | | | | | | | - Viengmon Davong
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
| | | | - K. A. Bonath
- University of Health Sciences, Phnom Penh, Cambodia
| | | | | | - Paul Newton
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
| | | | - David Dance
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
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Etiology of Coinfections in Children with Influenza during 2015/16 Winter Season in Nepal. Int J Microbiol 2018; 2018:8945142. [PMID: 30510579 PMCID: PMC6230385 DOI: 10.1155/2018/8945142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/05/2018] [Accepted: 10/09/2018] [Indexed: 01/17/2023] Open
Abstract
Acute respiratory infections (ARIs) are one of the major public health problems in developing countries like Nepal. Besides the influenza, several other pathogens are responsible for acute respiratory infection in children. Etiology of infections is poorly characterized at the course of clinical management, and hence empirical antimicrobial agents are used. The objective of this study was to characterize the influenza and other respiratory pathogens by real-time PCR assay. A total of 175 throat swab specimens of influenza-positive cases collected at National Influenza Center, Nepal, during the 2015/16 winter season were selected for detecting other respiratory copathogens. Total nucleic acid was extracted using Pure Link viral RNA/DNA mini kit (Invitrogen), and multiplex RT-PCR assays were performed. Influenza A and B viruses were found in 120 (68.6%) and 55 (31.4%) specimens, respectively, among which coinfections were found in 106 (60.6%) specimens. Among the influenza A-positive cases, 25 (20.8%) were A/H1N1 pdm09 and 95 (79.2%) were A/H3 subtypes. Viruses coinfected frequently with influenza virus in children were rhinovirus (26; 14.8%), respiratory syncytial virus A/B (19; 10.8%), adenovirus (14; 8.0%), coronavirus (CoV)-HKU1 (14; 8.0%), CoV-OC43 (5; 2.9%), CoV-229E (2; 1.1%), metapneumovirus A/B (5; 2.9%), bocavirus (6; 3.4%), enterovirus (5; 2.9%), parainfluenza virus-1 (3; 1.7%), and parainfluenza virus-3 (2; 1.1%). Coinfection of Mycoplasma pneumoniae with influenza virus was found in children (5; 2.8%). Most of the viral infection occurred in young children below 5 years of age. In addition to influenza virus, nine different respiratory pathogens were detected, of which coinfections of rhinovirus and respiratory syncytial virus A/B were predominantly found in children. This study gives us better information on the respiratory pathogen profile and coinfection combinations which are important for diagnosis and treatment of ARIs.
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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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Rikhotso MC, Kabue JP, Ledwaba SE, Traoré AN, Potgieter N. Prevalence of Human Bocavirus in Africa and Other Developing Countries between 2005 and 2016: A Potential Emerging Viral Pathogen for Diarrhea. J Trop Med 2018; 2018:7875482. [PMID: 30275840 PMCID: PMC6157109 DOI: 10.1155/2018/7875482] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/20/2018] [Accepted: 07/16/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Human Bocavirus (HBoV) is an emerging virus discovered in 2005 from individuals suffering gastroenteritis and respiratory tract infections. Numerous studies related to the epidemiology and pathogenesis of HBoV have been conducted worldwide. This review reports on HBoV studies in individuals with acute gastroenteritis, with and without respiratory tract infections in Africa between 2005 and 2016. MATERIAL AND METHOD The search engines of PubMed, Google Scholar, and Embase database for published articles of HBoV were used to obtain data between 2005 and 2016. The search words included were as follows: studies performed in Africa or/other developing countries or/worldwide; studies for the detection of HBoV in patients with/without diarrhea and respiratory tract infection; studies using standardized laboratory techniques for detection. RESULTS The search yielded a total of 756 publications with 70 studies meeting the inclusion criteria. Studies included children and individuals of all age groups. HBoV prevalence in Africa was 13% in individuals suffering gastroenteritis with/without respiratory tract infection. CONCLUSION Reports suggest that HBoV infections are increasingly being recognized worldwide. Therefore, surveillance of individuals suffering from infections in Africa is required to monitor the prevalence of HBoV and help understand the role of HBoV in individuals suffering from gastroenteritis with/without respiratory tract infection.
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Affiliation(s)
- Mpumelelo Casper Rikhotso
- Department of Microbiology, School of Mathematical and Natural Science, University of Venda, Thohoyandou, South Africa
| | - Jean Pierre Kabue
- Department of Microbiology, School of Mathematical and Natural Science, University of Venda, Thohoyandou, South Africa
| | - Solanka Ellen Ledwaba
- Department of Microbiology, School of Mathematical and Natural Science, University of Venda, Thohoyandou, South Africa
| | - Afsatou Ndama Traoré
- Department of Microbiology, School of Mathematical and Natural Science, University of Venda, Thohoyandou, South Africa
| | - Natasha Potgieter
- Department of Microbiology, School of Mathematical and Natural Science, University of Venda, Thohoyandou, South Africa
- School of Mathematical Sciences, University of Venda, Thohoyandou, South Africa
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Snoeck CJ, Ponghsavath V, Luetteke N, Kaufmann S, Sausy A, Samountry B, Jutavijittum P, Weber B, Muller CP. Etiology of viral respiratory infections in Northern Lao People's Democratic Republic. J Med Virol 2018; 90:1553-1558. [PMID: 29896913 PMCID: PMC7167017 DOI: 10.1002/jmv.25237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
In Lao People's Democratic Republic (PDR), acute respiratory infections overburden the health care system, but viral etiology, genetic diversity, and seasonality, especially in light of the introduction of influenza vaccination in the country, are poorly understood. From August 2010 to April 2011, 309 outpatients were recruited at the Luang Prabang Provincial Hospital covering highland Lao communities. Nasopharyngeal swabs were screened for the presence of 13 respiratory viruses. At least one virus was detected in 69.6% and dual/triple viral infections in 12.9%/1.9% of the patients. Influenza A and B viruses combined were the most frequently detected pathogens, followed by human adenovirus and respiratory syncytial virus (RSV). The other viruses were detected in less than 10% of the patients. Phylogenetic analyses on a representative set of RSV strains revealed that, while otherwise very rare, the RSV‐B CB1/THB genotype cocirculated with other common genotypes. A single wave of influenza virus and RSV activity was observed during the rainy season, providing further support to influenza vaccination before the onset of the rains. This study provides recommendations for influenza vaccination that still needs optimization and highlights the need for revised guidelines for treatment and prevention of respiratory infections in Lao PDR, as well as for increased surveillance efforts.
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Affiliation(s)
- Chantal J Snoeck
- Infectious Disease Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | | | - Nina Luetteke
- Infectious Disease Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | | | - Aurélie Sausy
- Infectious Disease Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Bounthome Samountry
- Department of Pathology, Faculty of Medicine, University of Health Sciences, Vientiane, Lao PDR
| | - Prapan Jutavijittum
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Claude P Muller
- Infectious Disease Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.,Lao-Lux-Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR.,Laboratoire National de Santé, Dudelange, Luxembourg
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22
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Hassan DA, Rachid SK, Ziebuhr J. A Single-Center Study of Viral Respiratory Tract Infections in Hospitalized Children From the Kurdistan Region of Iraq. Glob Pediatr Health 2018; 5:2333794X18784996. [PMID: 30014009 PMCID: PMC6042015 DOI: 10.1177/2333794x18784996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/08/2017] [Indexed: 11/16/2022] Open
Abstract
Viral respiratory infections are among the most common causes of disease in humans, particularly in young children, and remain a major public health problem worldwide. For many geographic regions, there is limited epidemiological information on the main causative agents of these diseases. In this article, we investigated, in a prospective study, the viral agents leading to acute respiratory disease in children younger than 15 years of age who were admitted to the pediatric emergency unit of a major teaching hospital in Erbil City, capital of the Kurdistan region, Iraq. Nasopharyngeal samples obtained from 269 hospitalized children were analyzed for viral respiratory pathogens using the xTAG Respiratory Virus Panel Fast assay, and the data were correlated with the clinical and demographic information available for these patients. One or more respiratory virus(es) were detected in 203 out of 269 (75.5%) samples. The most frequent viruses were enterovirus/rhinovirus (n = 88; 32.7%), respiratory syncytial virus (n = 55; 20.4%), and human metapneumovirus (n = 36; 13.4%). In 42 samples (15.6%), coinfections with 2 or more respiratory viruses were detected, with enterovirus/rhinovirus, respiratory syncytial virus, human metapneumovirus, and adenovirus being identified as the most common agents in viral coinfections in these patients.
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Affiliation(s)
- Dlshad A Hassan
- Public Health Laboratory Management, Virology Unit, Hawler, Kurdistan Region, Erbil, Iraq
| | | | - John Ziebuhr
- Institute of Medical Virology, Justus Liebig University Giessen, Giessen, Germany
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Chittaganpitch M, Waicharoen S, Yingyong T, Praphasiri P, Sangkitporn S, Olsen SJ, Lindblade KA. Viral etiologies of influenza-like illness and severe acute respiratory infections in Thailand. Influenza Other Respir Viruses 2018. [PMID: 29518269 PMCID: PMC6005612 DOI: 10.1111/irv.12554] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Information on the burden, characteristics and seasonality of non‐influenza respiratory viruses is limited in tropical countries. Objectives Describe the epidemiology of selected non‐influenza respiratory viruses in Thailand between June 2010 and May 2014 using a sentinel surveillance platform established for influenza. Methods Patients with influenza‐like illness (ILI; history of fever or documented temperature ≥38°C, cough, not requiring hospitalization) or severe acute respiratory infection (SARI; history of fever or documented temperature ≥38°C, cough, onset <10 days, requiring hospitalization) were enrolled from 10 sites. Throat swabs were tested for influenza viruses, respiratory syncytial virus (RSV), metapneumovirus (MPV), parainfluenza viruses (PIV) 1‐3, and adenoviruses by polymerase chain reaction (PCR) or real‐time reverse transcriptase‐PCR. Results We screened 15 369 persons with acute respiratory infections and enrolled 8106 cases of ILI (5069 cases <15 years old) and 1754 cases of SARI (1404 cases <15 years old). Among ILI cases <15 years old, influenza viruses (1173, 23%), RSV (447, 9%), and adenoviruses (430, 8%) were the most frequently identified respiratory viruses tested, while for SARI cases <15 years old, RSV (196, 14%) influenza (157, 11%) and adenoviruses (90, 6%) were the most common. The RSV season significantly overlapped the larger influenza season from July to November in Thailand. Conclusions The global expansion of influenza sentinel surveillance provides an opportunity to gather information on the characteristics of cases positive for non‐influenza respiratory viruses, particularly seasonality, although adjustments to case definitions may be required.
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Affiliation(s)
| | | | | | - Prabda Praphasiri
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Somchai Sangkitporn
- National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim A Lindblade
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jennings L, Huang QS, Barr I, Lee PI, Kim WJ, Buchy P, Sanicas M, Mungall BA, Chen J. Literature review of the epidemiology of influenza B disease in 15 countries in the Asia-Pacific region. Influenza Other Respir Viruses 2018; 12:383-411. [PMID: 29127742 PMCID: PMC5907823 DOI: 10.1111/irv.12522] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 01/06/2023] Open
Abstract
Influenza control strategies focus on the use of trivalent influenza vaccines containing two influenza A virus subtypes and one of the two circulating influenza type B lineages (Yamagata or Victoria). Mismatches between the vaccine B lineage and the circulating lineage have been regularly documented in many countries, including those in the Asia‐Pacific region. We conducted a literature review with the aim of understanding the relative circulation of influenza B viruses in Asia‐Pacific countries. PubMed and Western Pacific Region Index Medicus were searched for relevant articles on influenza type B published since 1990 in English language for 15 Asia‐Pacific countries. Gray literature was also accessed. From 4834 articles identified, 121 full‐text articles were analyzed. Influenza was reported as an important cause of morbidity in the Asia‐Pacific region, affecting all age groups. In all 15 countries, influenza B was identified and associated with between 0% and 92% of laboratory‐confirmed influenza cases in any one season/year. Influenza type B appeared to cause more illness in children aged between 1 and 10 years than in other age groups. Epidemiological data for the two circulating influenza type B lineages remain limited in several countries in the Asia‐Pacific, although the co‐circulation of both lineages was seen in countries where strain surveillance data were available. Mismatches between circulating B lineages and vaccine strains were observed in all countries with available data. The data suggest that a shift from trivalent to quadrivalent seasonal influenza vaccines could provide additional benefits by providing broader protection.
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Affiliation(s)
- Lance Jennings
- Canterbury District Health Board, Christchurch, New Zealand
| | - Qiu Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, VIC, Australia
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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25
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Chehadeh W, Al-Adwani A, John SE, Al-Dhufairi S, Al-Dousari H, Alkhaledi M, Al-Nakib W. Adenovirus types associated with severe respiratory diseases: A retrospective 4-year study in Kuwait. J Med Virol 2018; 90:1033-1039. [PMID: 29446483 PMCID: PMC7167181 DOI: 10.1002/jmv.25059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/20/2017] [Accepted: 01/23/2018] [Indexed: 12/26/2022]
Abstract
Human adenovirus (HAdV) infection can result in a severe respiratory disease. The aim of this study was to identify HAdV types detected in patients hospitalized for severe respiratory illness. The study population consisted of 743 patients with severe respiratory disease admitted to four major hospitals in Kuwait between January 2013 and December 2016. Respiratory specimens were retrospectively screened for 20 respiratory viruses by real-time PCR. The HAdV hexon gene was amplified and directly sequenced, and HAdV types were identified by performing Bayesian phylogenetic analysis. HAdV DNA was detected in 27 (3.6%) patients, with peaks in November and March. Most patients were infants and young children suffering from pneumonia or acute bronchiolitis. The detected HAdV types were C1, C2, C5, B3, and B7. Clusters of HAdV C1, C2, and C5 were observed with high posterior probability. All patients infected with HAdV C5 and 50% of patients infected with HAdV C2 or B7 were admitted to the intensive care unit (ICU). Co-infection with other viruses was detected in 44.4% of patients. The most common co-infecting virus was rhinovirus (HRV). HAdV/HRV co-infection was detected in two children who presumably developed disseminated HAdV infection and died. This is the first report describing the circulation of HAdV types associated with severe outcomes in Kuwait. These findings highlight the need for a national surveillance system to monitor changes in predominant HAdV types and increased numbers of severe respiratory infections.
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Affiliation(s)
- Wassim Chehadeh
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Anfal Al-Adwani
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Sonia Elezebeth John
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Shaikhah Al-Dhufairi
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Hessa Al-Dousari
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Maha Alkhaledi
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
| | - Widad Al-Nakib
- Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait
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26
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Nguyen VH, Dubot-Pérès A, Russell FM, Dance DAB, Vilivong K, Phommachan S, Syladeth C, Lai J, Lim R, Morpeth M, Mayxay M, Newton PN, Richet H, De Lamballerie X. Acute respiratory infections in hospitalized children in Vientiane, Lao PDR - the importance of Respiratory Syncytial Virus. Sci Rep 2017; 7:9318. [PMID: 28839157 PMCID: PMC5571090 DOI: 10.1038/s41598-017-09006-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/14/2017] [Indexed: 01/12/2023] Open
Abstract
The Human respiratory syncytial virus (RSV) is one of the most important viral pathogens, causing epidemics of acute respiratory infection (ARI), especially bronchiolitis and pneumonia, in children worldwide. To investigate the RSV burden in Laos, we conducted a one-year study in children <5 years old admitted to Mahosot Hospital, Vientiane Capital, to describe clinical and epidemiological characteristics and predictive factors for severity of RSV-associated ARI. Pooled nasal and throat swabs were tested using multiplex real-time PCR for 33 respiratory pathogens (FTD® kit). A total of 383 patients were included, 277 (72.3%) of whom presented with pneumonia. 377 (98.4%) patients were positive for at least one microorganism, of which RSV was the most common virus (41.0%), with a peak observed between June and September, corresponding to the rainy season. Most RSV inpatients had pneumonia (84.1%), of whom 35% had severe pneumonia. Children <3-months old were a high-risk group for severe pneumonia, independently of RSV infection. Our study suggests that RSV infection is frequent in Laos and commonly associated with pneumonia in hospitalized young children. Further investigations are required to provide a better overall view of the Lao nationwide epidemiology and public health burden of RSV infection over time.
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Affiliation(s)
- Van Hoan Nguyen
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
- Department of Infectious Diseases, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Audrey Dubot-Pérès
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France.
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France.
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom.
| | - Fiona M Russell
- Dept. of Paediatrics, The University of Melbourne, Melbourne, Australia
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - David A B Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Keoudomphone Vilivong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Souphatsone Phommachan
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Chanthaphone Syladeth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Jana Lai
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Ruth Lim
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Melinda Morpeth
- Dept. of Paediatrics, The University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR, Vientiane, Laos
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom
| | - Hervé Richet
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
| | - Xavier De Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
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Nguyen HKL, Nguyen SV, Nguyen AP, Hoang PMV, Le TT, Nguyen TC, Hoang HT, Vuong CD, Tran LTT, Le MQ. Surveillance of Severe Acute Respiratory Infection (SARI) for Hospitalized Patients in Northern Vietnam, 2011-2014. Jpn J Infect Dis 2017; 70:522-527. [PMID: 28367882 DOI: 10.7883/yoken.jjid.2016.463] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Severe acute respiratory infections (SARI) are leading causes of hospitalization, morbidity, and mortality in children worldwide. The aim of this study was to identify viral pathogens responsible for SARI in northern Vietnam in the period from 2011 to 2014. Throat swabs and tracheal aspirates were collected from SARI patients according to WHO guidelines. The presence of 13 different viral pathogens (influenza A[H1N1]pdm09; A/H3N2; A/H5; A/H7 and B; para influenza 1,2,3; RSV; HMPV; adeno; severe acute respiratory syndrome-CoV and rhino) was tested by conventional/real-time reverse transcription-polymerase chain reaction. During the study period, 975 samples were collected and tested. More than 30% (32.1%, 313 samples) of the samples showed evidence of infection with influenza viruses, including A/H3N2 (48 samples), A (H1N1) pdm09 (221 samples), influenza B (42 samples), and co-infection of A (H1N1) pdm09 or A/H3N2 and influenza B (2 samples). Other respiratory pathogens were detected in 101 samples, including rhinovirus (73 samples), adenovirus (10 samples), hMPV (9 samples), parainfluenza 3 (5 samples), parainfluenza 2 (3 samples), and RSV (1 sample). Influenza A/H5, A/H7, or SARS-CoV were not detected. Respiratory viral infection, particularly infection of influenza and rhinoviruses, were associated with high rates of SARI hospitalization, and future studies correlating the clinical aspects are needed to design interventions, including targeted vaccination.
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Affiliation(s)
| | - Son Vu Nguyen
- Virology Department, National Institute of Hygiene and Epidemiology
| | | | | | - Thanh Thi Le
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Thach Co Nguyen
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Huong Thu Hoang
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Cuong Duc Vuong
- Virology Department, National Institute of Hygiene and Epidemiology
| | | | - Mai Quynh Le
- Virology Department, National Institute of Hygiene and Epidemiology
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Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city. PLoS One 2017; 12:e0174488. [PMID: 28346512 PMCID: PMC5367831 DOI: 10.1371/journal.pone.0174488] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 03/09/2017] [Indexed: 02/01/2023] Open
Abstract
The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had significant involvement in coinfections with P values of 0.0001, 0.009 and 0.0001, 0.0001 and 0.001 respectively. Further investigations are required to better understand the clinical roles of the isolated pathogens and their seasonality.
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Kenmoe S, Tchendjou P, Vernet M, Moyo‐Tetang S, Mossus T, Njankouo‐Ripa M, Kenne A, Penlap Beng V, Vabret A, Njouom R. Viral etiology of severe acute respiratory infections in hospitalized children in Cameroon, 2011-2013. Influenza Other Respir Viruses 2016; 10:386-93. [PMID: 27012372 PMCID: PMC4947949 DOI: 10.1111/irv.12391] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Severe acute respiratory illness (SARI) is recognized as an important cause of morbidity, mortality, and hospitalization among children in developing countries. Little is known, however, in tropical countries like Cameroon about the cause and seasonality of respiratory infections, especially in hospitalized settings. OBJECTIVES Our study investigates the viral etiology and seasonality of SARI in hospitalized children in Yaounde, Cameroon. METHODS Prospective clinic surveillance was conducted to identify hospitalized children aged ≤15 years presenting with respiratory symptoms ≤5-day duration. Demographic and clinical data, and respiratory specimens were collected. Nasopharyngeal samples were tested for 17 respiratory viruses using a multiplex polymerase chain reaction. The viral distribution and demographic data were statistically analyzed. RESULTS From September 2011 through September 2013, 347 children aged ≤15 years were enrolled. At least one virus was identified in each of 65·4% children, of which 29·5% were coinfections; 27·3% were positive for human adenovirus (hAdV), 13·2% for human respiratory syncytial virus (hRSV), 11·5% for rhinovirus/enterovirus (RV/EV), 10·6% for human bocavirus (hBoV), 9·8% for influenza virus (Inf), 6·6% for human parainfluenza virus (hPIV), 5·7% for human coronavirus (hCoV), and 2·3% for human metapneumovirus (hMPV). While hRSV showed seasonal patterns, hAdV and RV/EV were detected throughout the year and no evident temporal patterns were observed for the remaining viruses. CONCLUSION Respiratory viruses were associated with a high burden of hospitalizations among children in Cameroon. Nevertheless, additional studies evaluating asymptomatic Cameroonian children will be important in understanding the relationship between viral carriage and disease.
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Affiliation(s)
- Sebastien Kenmoe
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
- Département de BiochimieUniversité de Yaoundé 1YaoundeCameroun
- Virology ServicePôle de BiologieCHU de CaenCaenFrance
| | - Patrice Tchendjou
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
| | - Marie‐Astrid Vernet
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
| | | | - Tatiana Mossus
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
| | | | - Angeladine Kenne
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
| | | | - Astrid Vabret
- Virology ServicePôle de BiologieCHU de CaenCaenFrance
| | - Richard Njouom
- Centre Pasteur of CameroonInternational Network of Pasteur InstitutesYaoundeCameroon
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Lefebvre A, Manoha C, Bour JB, Abbas R, Fournel I, Tiv M, Pothier P, Astruc K, Aho-Glélé LS. Human metapneumovirus in patients hospitalized with acute respiratory infections: A meta-analysis. J Clin Virol 2016; 81:68-77. [PMID: 27337518 PMCID: PMC7106388 DOI: 10.1016/j.jcv.2016.05.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 12/31/2022]
Abstract
This meta-analysis aimed to estimate the prevalence of human metapneumovirus (hMPV) infections in patients hospitalized for acute respiratory infection (ARI) and to study factors associated with this prevalence. Medline and ScienceDirect databases were searched for prospective observational studies that screened hospitalized patients with ARI for hMPV by RT-PCR, with data available at December 27, 2014. The risk of bias was assessed regarding participation rate, definition of ARI, description of diagnostic technique, method of inclusion identical for all subjects, standardized and identical sampling method for all subjects, analysis performed according to the relevant subgroups, and presentation of data sources. Random-effect meta-analysis with arcsine transformation and meta-regressions was used. In the 75 articles included, the prevalence of hMPV among hospitalized ARI was 6.24% (95% CI 5.25-7.30). An effect of the duration of the inclusion period was observed (p=0.0114), with a higher prevalence of hMPV in studies conducted during periods of 7-11 months (10.56%, 95% CI 5.97-16.27) or complete years (7.55%, 95% CI 5.90-9.38) than in periods of 6 months or less (5.36%, 95% CI 4.29-6.54). A significant increase in the incidence with increasing distance from the equator was observed (p=0.0384). hMPV should be taken into account as a possible etiology in hospitalized ARI.
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Affiliation(s)
- Annick Lefebvre
- Epidemiology and infection control unit, Dijon University Hospital, France.
| | | | | | - Rachid Abbas
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Isabelle Fournel
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Michel Tiv
- Epidemiology and infection control unit, Dijon University Hospital, France
| | | | - Karine Astruc
- Epidemiology and infection control unit, Dijon University Hospital, France
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Sun H, Sun Q, Jiang W, Chen Z, Huang L, Wang M, Ji W, Shao X, Yan Y. Prevalence of rhinovirus in wheezing children: a comparison with respiratory syncytial virus wheezing. Braz J Infect Dis 2016; 20:179-83. [PMID: 26859065 PMCID: PMC9427575 DOI: 10.1016/j.bjid.2015.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 12/18/2015] [Indexed: 11/14/2022] Open
Abstract
Objective To explore the distribution and clinical manifestations of rhinovirus infection in wheezing children, and compare the clinical differences between rhinovirus- and respiratory syncytial virus-induced wheezing. Materials and methods This prospective cohort study was carried out in Children's Hospital of Soochow University from Dec 2012 to Nov 2014. We enrolled consecutive hospitalized children <60 months of age presented with wheezing. Clinical data including cough, fever, dyspnea, crackles were recorded by pediatricians on the first day of admission. Meanwhile, nasopharyngeal aspirates were obtained to test for respiratory viruses, by using polymerase chain reaction method for rhinovirus, human bocavirus, and human metapneumovirus, and direct immunofluorescence assay to test for respiratory syncytial virus, adenovirus, parainfluenza virus types 1–3, and influenza virus types A and B. Results Rhinovirus was a main causative agent isolated in 14.7% of the hospitalized wheezing children in Suzhou, China, being second to respiratory syncytial virus (21.0%). Different from respiratory syncytial virus infection, which peaked in winter months, rhinovirus could be detected all year round, peaked between July and September, and in November. Children with rhinovirus infection were older and presented with more often allergic sensitizations, blood eosinophilia, and leukocytosis than those of respiratory syncytial virus infection. Logistic regression analysis revealed that rhinovirus-infected children experienced earlier wheezing more often than respiratory syncytial virus children (odds ratio, 3.441; 95% confidence interval, 1.187–9.979; p = 0.023). Conclusion Rhinovirus was a main viral pathogen in wheezing children, especially in summer time. Rhinovirus-induced wheezing was different from respiratory syncytial virus, apart from seasonal epidemics; these two groups differed with regard to age, allergic sensitizations, laboratory test, and history of wheezing episodes.
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Affiliation(s)
- Huiquan Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Qiufeng Sun
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wunjun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xuejun Shao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
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Lagare A, Maïnassara HB, Issaka B, Sidiki A, Tempia S. Viral and bacterial etiology of severe acute respiratory illness among children < 5 years of age without influenza in Niger. BMC Infect Dis 2015; 15:515. [PMID: 26567015 PMCID: PMC4644278 DOI: 10.1186/s12879-015-1251-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/28/2015] [Indexed: 01/18/2023] Open
Abstract
Background Globally, pneumonia is the leading cause of morbidity and mortality in children, with the highest burden experienced in sub-Saharan Africa and Asia. However, there is a dearth of information on the etiology of severe acute respiratory illness (SARI) in Africa, including Niger. Methods We implemented a retrospective study as part of national influenza sentinel surveillance in Niger. We randomly selected a sample of nasopharyngeal specimens collected from children <5 years of age hospitalized with SARI from January 2010 through December 2012 in Niger. The samples were selected from individuals that tested negative by real-time reverse transcription polymerase chain reaction (rRT-PCR) for influenza A and B virus. The samples were analyzed using the Fast Track Diagnostic Respiratory Pathogens 21plus Kit (BioMérieux, Luxemburg), which detects 23 respiratory pathogens including 18 viral and 5 bacterial agents. Results Among the 160 samples tested, 138 (86 %) tested positive for at least one viral or bacterial pathogen; in 22 (16 %) sample, only one pathogen was detected. We detected at least one respiratory virus in 126 (78 %) samples and at least one bacterium in 102 (64 %) samples. Respiratory syncytial virus (56/160; 35 %), rhinovirus (47/160; 29 %) and parainfluenza virus (39/160; 24 %) were the most common viral pathogens detected. Among bacterial pathogens, Streptococcus pneumoniae (90/160; 56 %) and Haemophilus influenzae type b (20/160; 12 %) predominated. Conclusions The high prevalence of certain viral and bacterial pathogens among children <5 years of age with SARI highlights the need for continued and expanded surveillance in Niger.
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Affiliation(s)
- Adamou Lagare
- Centre de Recherche Médicale et Sanitaire (CERMES), 634 Bld de la Nation, BP:10887, YN034-, Niamey, Niger.
| | - Halima Boubacar Maïnassara
- Centre de Recherche Médicale et Sanitaire (CERMES), 634 Bld de la Nation, BP:10887, YN034-, Niamey, Niger.
| | - Bassira Issaka
- Centre de Recherche Médicale et Sanitaire (CERMES), 634 Bld de la Nation, BP:10887, YN034-, Niamey, Niger.
| | - Ali Sidiki
- Centre de Recherche Médicale et Sanitaire (CERMES), 634 Bld de la Nation, BP:10887, YN034-, Niamey, Niger.
| | - Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Georgia, Atlanta, USA. .,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.
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Mixed viral infections circulating in hospitalized patients with respiratory tract infections in kuwait. Adv Virol 2015; 2015:714062. [PMID: 25983755 PMCID: PMC4423027 DOI: 10.1155/2015/714062] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/26/2015] [Accepted: 03/30/2015] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to determine the frequency of viral mixed detection in hospitalized patients with respiratory tract infections and to evaluate the correlation between viral mixed detection and clinical severity. Hospitalized patients with respiratory tract infections (RTI) were investigated for 15 respiratory viruses by using sensitive molecular techniques. In total, 850 hospitalized patients aged between 3 days and 80 years were screened from September 2010 to April 2014. Among the 351 (47.8%) patients diagnosed with viral infections, viral mixed detection was identified in 49 patients (14%), with human rhinovirus (HRV) being the most common virus associated with viral mixed detection (7.1%), followed by adenovirus (AdV) (4%) and human coronavirus-OC43 (HCoV-OC43) (3.7%). The highest combination of viral mixed detection was identified with HRV and AdV (2%), followed by HRV and HCoV-OC43 (1.4%). Pneumonia and bronchiolitis were the most frequent reason for hospitalization with viral mixed detection (9.1%). There were statistical significance differences between mixed and single detection in patients diagnosed with bronchiolitis (P = 0.002) and pneumonia (P = 0.019). Our findings might indicate a significant association between respiratory virus mixed detection and the possibility of developing more severe LRTI such as bronchiolitis and pneumonia when compared with single detection.
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Abstract
Human rhinoviruses (HRVs) are widespread respiratory pathogens and a major cause of acute respiratory tract infections. The aim of this study was to investigate the molecular epidemiology of rhinovirus infections in children in Cyprus over three consecutive winter seasons. From a total of 116 rhinovirus-positive samples, 68 were sequenced in the 5'-UTR and VP4/VP2 regions. Thirty-six (52.9%) samples were identified as HRV-A and 27 (39.7%) as HRV-C, with only five (7.4%) samples belonging to the HRV-B species. Of these, a total of 46 different genotypes were identified. In the VP2/VP4 phylogenetic tree all strains clustered in three different well-defined clades, whereas the 5'-UTR tree exhibited clades with a mixed clustering of HRV-A and HRV-C strains reflecting the evolutionary history of recombination between HRV-A and HRV-C that has been observed previously. In summary, a high intra- and inter-season diversity of HRV types was observed. Despite its geographical isolation the frequency of HRV species in Cyprus is comparable to that reported in other regions of the world supporting the concept of an unrestricted global circulation. This study assesses, for the first time, the epidemiology of rhinovirus infections in Cypriot children and will be helpful to clinicians and researchers interested in the treatment and control of viral respiratory tract infections.
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Lanaspa M, Annamalay AA, LeSouëf P, Bassat Q. Epidemiology, etiology, x-ray features, importance of co-infections and clinical features of viral pneumonia in developing countries. Expert Rev Anti Infect Ther 2014; 12:31-47. [PMID: 24410617 PMCID: PMC7103723 DOI: 10.1586/14787210.2014.866517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pneumonia is still the number one killer of young children globally, accounting for 18% of mortality in children under 5 years of age. An estimated 120 million new cases of pneumonia occur globally each year. In developing countries, management and prevention efforts against pneumonia have traditionally focused on bacterial pathogens. More recently however, viral pathogens have gained attention as a result of improved diagnostic methods, such as polymerase chain reaction, outbreaks of severe disease caused by emerging pathogens, discovery of new respiratory viruses as well as the decrease in bacterial pneumonia as a consequence of the introduction of highly effective conjugate vaccines. Although the epidemiology, etiology and clinical characterization of viral infections are being studied extensively in the developed world, little data are available from low- and middle-income countries. In this paper, we review the epidemiology, etiology, clinical and radiological features of viral pneumonia in developing countries.
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Affiliation(s)
- Miguel Lanaspa
- Barcelona Center for International Health Research, Hospital Clinic, University of Barcelona, Rosello 132, 08036 Barcelona, Spain
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Katz MA, Muthoka P, Emukule GO, Kalani R, Njuguna H, Waiboci LW, Ahmed JA, Bigogo G, Feikin DR, Njenga MK, Breiman RF, Mott JA. Results from the first six years of national sentinel surveillance for influenza in Kenya, July 2007-June 2013. PLoS One 2014; 9:e98615. [PMID: 24955962 PMCID: PMC4067481 DOI: 10.1371/journal.pone.0098615] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/05/2014] [Indexed: 12/01/2022] Open
Abstract
Background Recent studies have shown that influenza is associated with significant disease burden in many countries in the tropics, but until recently national surveillance for influenza was not conducted in most countries in Africa. Methods In 2007, the Kenyan Ministry of Health with technical support from the CDC-Kenya established a national sentinel surveillance system for influenza. At 11 hospitals, for every hospitalized patient with severe acute respiratory illness (SARI), and for the first three outpatients with influenza-like illness (ILI) per day, we collected both nasopharyngeal and oropharyngeal swabs. Beginning in 2008, we conducted in-hospital follow-up for SARI patients to determine outcome. Specimens were tested by real time RT-PCR for influenza A and B. Influenza A-positive specimens were subtyped for H1, H3, H5, and (beginning in May 2009) A(H1N1)pdm09. Results From July 1, 2007 through June 30, 2013, we collected specimens from 24,762 SARI and 14,013 ILI patients. For SARI and ILI case-patients, the median ages were 12 months and 16 months, respectively, and 44% and 47% were female. In all, 2,378 (9.6%) SARI cases and 2,041 (14.6%) ILI cases were positive for influenza viruses. Most influenza-associated SARI cases (58.6%) were in children <2 years old. Of all influenza-positive specimens, 78% were influenza A, 21% were influenza B, and 1% were influenza A/B coinfections. Influenza circulated in every month. In four of the six years influenza activity peaked during July–November. Of 9,419 SARI patients, 2.7% died; the median length of hospitalization was 4 days. Conclusions During six years of surveillance in Kenya, influenza was associated with nearly 10 percent of hospitalized SARI cases and one-sixth of outpatient ILI cases. Most influenza-associated SARI and ILI cases were in children <2 years old; interventions to reduce the burden of influenza, such as vaccine, could consider young children as a priority group.
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Affiliation(s)
- Mark A. Katz
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
- * E-mail:
| | | | - Gideon O. Emukule
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Henry Njuguna
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Lilian W. Waiboci
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Jamal A. Ahmed
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Godfrey Bigogo
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Daniel R. Feikin
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Moses K. Njenga
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Robert F. Breiman
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Joshua A. Mott
- Centers for Disease Control and Prevention-Kenya/Kenya Medical Research Institute, Nairobi, Kenya
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Sentilhes AC, Choumlivong K, Celhay O, Sisouk T, Phonekeo D, Vongphrachanh P, Brey P, Buchy P. Respiratory virus infections in hospitalized children and adults in Lao PDR. Influenza Other Respir Viruses 2013; 7:1070-8. [PMID: 23796419 PMCID: PMC4634274 DOI: 10.1111/irv.12135] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2013] [Indexed: 11/26/2022] Open
Abstract
Background Acute respiratory infections are an important cause of morbidity and mortality worldwide, with a major burden of disease in developing countries. The relative contribution of viruses in acute lower respiratory infections (ALRI) is, however, poorly documented in Lao PDR. Objective The objective of this study is to investigate the etiology of ALRI in patients of all ages in two hospitals of Laos. Methods Multiplex PCR/RT‐PCR methods were used to target 18 major common respiratory viruses. Between August 2009 and October 2010, samples from 292 patients presenting with ALRI were collected. Results and conclusion Viruses were detected in 162 (55%) samples. In 48% (140/292) of the total ALRI cases, a single virus was detected while coinfections were observed in 8% (22/292) of the samples. The most frequent viruses were rhinovirus/enterovirus (35%), human respiratory syncytial virus (26%), and influenza viruses (13%). Parainfluenza viruses were detected in 9%, adenovirus in 6%, human metapneumovirus in 4%, coronaviruses (229E, NL63, OC43, HKU1) in 4%, and bocavirus in 3% of ALRI specimens. Most viral infections occurred in patients below 5 years of age. The distribution of viruses varied according to age‐groups. No significant correlation was observed between the severity of the disease and the age of patients or the virus species. This study provides the description of viral etiology among patients presenting with ALRI in Lao PDR. Additional investigations are required to better understand the clinical role of the different viruses and their seasonality in Laos.
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Affiliation(s)
- Anne-Charlotte Sentilhes
- National Center for Laboratory and Epidemiology, Vientiane, Lao PDR; Virology Unit, Institut Pasteur in Cambodia, Réseau International des Instituts Pasteur, Phnom Penh, Cambodia; Institut Pasteur in Laos, Réseau International des Instituts Pasteur, Vientiane, Lao PDR
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