1
|
Kenmoe S, Nair H. The disease burden of respiratory syncytial virus in older adults. Curr Opin Infect Dis 2024; 37:129-136. [PMID: 38197402 PMCID: PMC10911257 DOI: 10.1097/qco.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE OF REVIEW To highlight the respiratory syncytial virus (RSV) disease burden and the current developments and challenges in RSV prevention for older adults ≥60 years through analysis of RSV epidemiology and the effectiveness of emerging vaccines. RECENT FINDINGS In industrialized countries, RSV incidence rates and hospitalization rates among older adults are estimated to be 600.7 cases per 100 000 person-years and 157 hospitalizations per 100 000 person-years, respectively. Yet, accurately determining RSV morbidity and mortality in older adults is challenging, thus resulting in substantially under-estimating the disease burden. The in-hospital fatality rates vary substantially with age and geographies, and can be as high as 9.1% in developing countries. Two promising RSV vaccines for the elderly have been approved, demonstrating efficacies of up to 94.1%, signifying considerable advancement in RSV prevention. However, concerns over potential side effects remain. SUMMARY RSV is associated with a significant burden in older adults. While the landscape of RSV prevention in older adults is promising with the licensure of vaccines from two companies, current trial data underscore the need for additional studies. Addressing the real-world effectiveness of these vaccines, understanding potential rare side effects, and ensuring broad inclusivity in future trials are crucial steps to maximize their potential benefits.
Collapse
Affiliation(s)
- Sebastien Kenmoe
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- School of Public Health, University of the Witwatersrand, South Africa
| |
Collapse
|
2
|
Luo M, Gong C, Zhang Y, Wang X, Liu Y, Luo Q, Li M, Li A, Wang Y, Dong M, Xu W, Huang F. Comparison of infections with respiratory syncytial virus between children and adults: a multicenter surveillance from 2015 to 2019 in Beijing, China. Eur J Clin Microbiol Infect Dis 2022; 41:1387-1397. [PMID: 36197575 PMCID: PMC9533982 DOI: 10.1007/s10096-022-04492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022]
Abstract
The objective of this study is to investigate the epidemiological and clinical characteristics of the acute respiratory tract infections (ARTI) caused by respiratory syncytial virus (RSV) among the population of all age categories in Beijing, China. Outpatients and inpatients with ARTI were enrolled from 35 sentinel hospitals in Beijing between March 2015 and February 2019. They were interviewed and their medical records were collected using a standardized form. Their respiratory specimens were collected and tested for the nucleic acid of RSV. The RSV-positive specimens were further genotyped into RSV-A and RSV-B groups. A total of 29,923 cases were included in this study. RSV was detected in 623 (2%, 623/29923) patients, with 391 (62.8%) genotypd as RSV-A, 126 (20.2%) as RSV-B, and 106 (17.0%) untyped. The RSV epidemic season usually occurred between October and March covering approximately 90% of annual RSV infections. The RSV-infected children aged < 5 years accounted for 52.2% of the total RSV infections with cough and fever as the most common manifestations. The RSV-infected elderly adults aged ≥ 60 years have the second largest proportion (25.2%) with dyspnea and lymphocytopenia as the most common manifestations and showed an elevated rate of hospitalization, an increased rate of ICU admission, an extended length of hospital stay, and an elevated mortality compared to the RSV-infected children. The RSV infections aged ≥ 60 years old, as the second largest population of the total annual RSV infections, usually developed worse outcomes than children and should be taken seriously.
Collapse
Affiliation(s)
- Ming Luo
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Cheng Gong
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Yan Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, 102206, China
| | - Xue Wang
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Yang Liu
- Tongzhou Center for Disease Prevention and Control, 1st Luhe Middle School North Road, Tongzhou District, Beijing, 101100, China
| | - Qing Luo
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China.,College of Public Health, Capital Medical University, No.10 West, You'anmen Avenue, Fengtai District, Beijing, 100069, China
| | - Maozhong Li
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Aihua Li
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Yiting Wang
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Mei Dong
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China
| | - Wenbo Xu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, 102206, China.
| | - Fang Huang
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, 16th Hepingli Middle Road, Dongcheng District, Beijing, 100013, China.
| |
Collapse
|
3
|
Teirlinck AC, Broberg EK, Berg AS, Campbell H, Reeves RM, Carnahan A, Lina B, Pakarna G, Bøås H, Nohynek H, Emborg HD, Nair H, Reiche J, Oliva JA, Gorman JO, Paget J, Szymanski K, Danis K, Socan M, Gijon M, Rapp M, Havlíčková M, Trebbien R, Guiomar R, Hirve SS, Buda S, van der Werf S, Meijer A, Fischer TK. Recommendations for respiratory syncytial virus surveillance at national level. Eur Respir J 2021; 58:13993003.03766-2020. [PMID: 33888523 PMCID: PMC8485062 DOI: 10.1183/13993003.03766-2020] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/08/2021] [Indexed: 11/25/2022]
Abstract
Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants aged <6 months. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among older adults. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations for developing a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance and passive laboratory surveillance, using the EU acute respiratory infection and World Health Organization (WHO) extended severe acute respiratory infection case definitions. Furthermore, we recommend the use of quantitative reverse transcriptase PCR-based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at the European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and for estimation of RSV burden and the impact of future immunisation programmes. Recommendations for developing a feasible and sustainable national surveillance strategy for respiratory syncytial virus that will enable harmonisation and data comparison at the European level.https://bit.ly/3rWUOOI
Collapse
Affiliation(s)
- Anne C Teirlinck
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | | | | | | | | | - Håkon Bøås
- Norwegian Institute of Public Health, Oslo, Norway
| | - Hanna Nohynek
- Finnish National Institute for Health and Welfare, Finland
| | | | - Harish Nair
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Jesus Angel Oliva
- Instituto de Salud Carlos III Madrid, CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | | | - Kostas Danis
- Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Maja Socan
- Public Health Institute, Ljubljana, Slovenia
| | | | - Marie Rapp
- Public Health Agency Stockholm, Solna, Sweden
| | | | | | | | | | | | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Thea K Fischer
- Statens Serum Institut, Copenhagen, Denmark.,Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark and Department of Global Health and Infectious Diseases, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
4
|
Pangesti KNA, El Ghany MA, Kesson AM, Hill-Cawthorne GA. Respiratory syncytial virus in the Western Pacific Region: a systematic review and meta-analysis. J Glob Health 2020; 9:020431. [PMID: 31893034 PMCID: PMC6925967 DOI: 10.7189/jogh.09.020431] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of viral pneumonia and bronchiolitis, especially in younger children. The burden of RSV infection in adults, particularly in the older age group, is increasingly recognised. However, RSV disease burden and molecular epidemiology in the World Health Organization (WHO) Western Pacific Region (WPR) has not been reviewed systematically. The aim of this systematic review is to investigate the epidemiological aspects of RSV (incidence, prevalence, seasonality and hospitalisation status) and the associated molecular data in the WPRO countries. Methods A systematic search was conducted in international literature databases (MEDLINE, EMBASE, Scopus and Web of Science) to identify RSV-related publications from January 2000 to October 2017 in the WPR countries. Results A total of 196 studies from 15 WPR countries were included. The positivity rate for RSV among respiratory tract infection patients was 16.73% (95% confidence interval (CI) = 15.12%-18.4%). The RSV-positive cases were mostly found in hospitalised compared with outpatients (18.28% vs 11.54%, P < 0.001), and children compared with adults (20.72% vs 1.87%, P < 0.001). The seasonality of RSV in the WPR countries follows the latitude, with the peak of RSV season occurring in the winter in temperate countries, and during the rainy season in tropical countries. The molecular epidemiology pattern of RSV in WPR countries was similar to the global pattern, with NA1 (RSV A) and BA (RSV B) being the predominant genotypes. Conclusions The available data on RSV are limited in several countries within the WPR, with most data focusing on children and hospitalised patients. Further studies and surveillance, incorporating laboratory testing, are needed to determine the burden of RSV infection in the WPR countries.
Collapse
Affiliation(s)
- Krisna N A Pangesti
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia.,Center for Research and Development of Biomedical and Basic Health Technology, NIHRD, Jakarta, Indonesia
| | - Moataz Abd El Ghany
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.,The Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney ,Australia
| | - Alison M Kesson
- Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.,Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,The Children Hospital at Westmead, Department of Infectious Diseases and Microbiology, Sydney, Australia
| | - Grant A Hill-Cawthorne
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Mollers M, Barnadas C, Broberg EK, Penttinen P, Teirlinck AC, Fischer TK. Current practices for respiratory syncytial virus surveillance across the EU/EEA Member States, 2017. Euro Surveill 2019; 24:1900157. [PMID: 31595876 PMCID: PMC6784450 DOI: 10.2807/1560-7917.es.2019.24.40.1900157] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BackgroundRespiratory syncytial virus (RSV) is a major contributor to lower respiratory tract infections worldwide and several vaccine candidates are currently in development. Following vaccine introduction, reliable RSV surveillance should enable monitoring of vaccination impact. Data on the RSV disease burden in the European Union and European Economic Area (EU/EEA) are sparse.AimThe aim of this study was to gather knowledge on current practices of national RSV surveillance in the EU/EEA.MethodsNational Coordinators and National Focal Points for Influenza (epidemiologists and virologists) from the EU/EEA countries (n = 31) were invited to participate in an online survey in August and September 2017. The questionnaire covered questions on epidemiological and laboratory aspects of RSV surveillance.ResultsAll EU/EEA countries except Liechtenstein replied to the survey. Eighteen countries reported to have a sentinel surveillance system, 26 countries a non-sentinel surveillance system and three countries to have neither. RSV data collection was mostly done within the context of influenza surveillance. A wide range of diagnostic and characterisation assays was used for the detection of RSV.DiscussionThe majority of EU/EEA countries have some surveillance for RSV in place. The prevailing integration of RSV surveillance into the existing influenza sentinel surveillance system may lead to under-reporting of RSV. The documented variations in existing RSV surveillance systems and their outputs indicate that there is scope for developing guidelines on establishing comparable methods and outcomes for RSV surveillance across the EU/EEA, to ensure the availability of a consistent evidence base for assessing future vaccination programmes.
Collapse
Affiliation(s)
- Madelief Mollers
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious disease control, Bilthoven, the Netherlands,European Programme for Intervention Epidemiology Training (EPIET) and European Public Health Microbiology (EUPHEM) training programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden,These authors contributed equally to this manuscript
| | - Céline Barnadas
- European Programme for Intervention Epidemiology Training (EPIET) and European Public Health Microbiology (EUPHEM) training programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden,These authors contributed equally to this manuscript,Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Anne C Teirlinck
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious disease control, Bilthoven, the Netherlands,These authors contributed equally to this manuscript
| | - Thea K Fischer
- Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark,Department of Infectious Diseases and Centre for Global Health, University of Southern Denmark, Odense, Denmark,These authors contributed equally to this manuscript
| |
Collapse
|
7
|
Servia-Dopazo M, Purriños-Hermida MJ, Pérez S, García J, Malvar-Pintos A. [Usefulness of the microbiological surveillance of respiratory syncytial virus in Galicia (Spain): 2008-2017]. GACETA SANITARIA 2019; 34:474-479. [PMID: 30737055 DOI: 10.1016/j.gaceta.2018.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/02/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe whether the microbiological information of the respiratory syncytial virus (RSV), provided by four hospitals on a weekly basis, adequately captures the seasonality of the RSV in the entire community. METHOD Retrospective descriptive study. We compared the detection of RSV in respiratory samples of patients (hospitalized and not) from all age groups, from the 4 hospitals that are part of the microbiological surveillance system (MSS), with data from the Minimum Basic Data Set of hospitalization for bronchiolitis by RSV or another infectious organism, in patients under 5 years of age, admitted to any public hospital in Galicia (seasons 2008/2009 to 2016/2017). An epidemic wave period was considered when the positivity of RSV detections in the total respiratory samples of the SVM exceeded 10%. The sensitivity of the MSS was calculated as a percentage of admissions occurring in the epidemic wave. RESULTS MSS sensitivity was 92% (86%-96%) for RSV bronchiolitis admissions in each season and 79% (75%-84%) for total bronchiolitis admissions. CONCLUSIONS The RSV microbiological surveillance system, based on data from only 4 hospitals, showed very good sensitivity to predict the start and end of the annual RSV wave throughout the Galician region. These results support the use of this information to alert the entire health system of the onset of the wave.
Collapse
Affiliation(s)
- Miguel Servia-Dopazo
- Departamento de Medicina Preventiva y Salud Pública, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela (A Coruña), España
| | - María Jesús Purriños-Hermida
- Servicio de Epidemiología, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España.
| | - Sonia Pérez
- Servicio de Microbiología, Complejo Hospitalario Universitario de Vigo, Vigo (Pontevedra), España; Grupo de Enfermedades Inflamatorias e Infecciosas y Trastornos Inmunitarios, Instituto de Investigación Sanitaria Galicia Sur, Servizo Galego de Saúde - Universidade de Vigo, Vigo (Pontevedra), España
| | - Juan García
- Servicio de Microbiología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - Alberto Malvar-Pintos
- Servicio de Epidemiología, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España
| | | | | |
Collapse
|
8
|
Jiménez-Jorge S, Delgado-Sanz C, de Mateo S, Pozo F, Casas I, Larrauri A. Vigilancia del virus respiratorio sincitial en el marco del Sistema de Vigilancia de la Gripe en España, 2006-2014. Enferm Infecc Microbiol Clin 2016; 34:117-20. [DOI: 10.1016/j.eimc.2014.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022]
|
9
|
RSV Outbreak Investigation Team *. Contributing and Terminating Factors of a Large RSV Outbreak in an Adult Hematology and Transplant Unit. PLOS CURRENTS 2014; 6:ecurrents.outbreaks.3bc85b2a508d205ecc4a5534ecb1f9be. [PMID: 25687181 PMCID: PMC4169394 DOI: 10.1371/currents.outbreaks.3bc85b2a508d205ecc4a5534ecb1f9be] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In January 2012, an increase of respiratory syncytial virus (RSV) infections on an adult hematology and transplant unit in a German university hospital was detected. We investigated the outbreak to assess its timing and extent and to identify risk factors for transmission. METHODS We tested and typed patient samples pro- and retrospectively for RSV. We conducted a cohort and a case-control study. A confirmed outbreak case had laboratory-diagnosed, nosocomially-acquired RSV infection. Possible outbreak cases had pneumonia but were not laboratory-confirmed. RESULTS Of 53 outbreak cases, 36 (68%) were confirmed and 17 (32%) possible. Retrospective testing and chart review dated the beginning of the outbreak to November 2011. Patients with community-acquired RSV infection were identified when the community epidemic began in January 2012. In multivariable analysis (controlling for contact with medical personnel, hygiene behaviour and age) patients with active social behaviour were more at risk for RSV infection (odds ratio 23.8, 95% confidence interval, 1.3 to 434.9; p-value, 0.03). Confirmed outbreak cases were more likely than controls to have been accomodated together with a confirmed or possible case before their onset of illness (OR 9.3, 95%CI: 2.1-85.1; p<0.001). Control measures, including isolation of every patient in the unit, initiated until the end of January terminated the outbreak. CONCLUSIONS Epidemiological investigations revealed co-accomodation with a case-patient and active social behaviour as likely risk factors for RSV infection. Awareness of and vigorous testing for respiratory viruses in immunosuppressed hospitalised patients is necessary to timely detect cases with outbreak potential. Isolation of patients with respiratory infectious illnesses is crucial to prevent the continuation or occurrence of outbreaks.
Collapse
|
10
|
Abstract
Respiratory syncytial virus is a highly infectious virus that commonly causes bronchiolitis and leads to high morbidity and a low, but important, incidence of mortality. Supportive therapy is the foundation of management. Hydration/nutrition and respiratory support are important evidence-based interventions. For children with severe disease, continuous positive airway pressure or mechanical ventilation may be necessary. Ribavirin may be used for treatment of patients with severe disease. Palivizumab provides important ongoing immunoprophylaxis during epidemic months for high-risk infants. Caregiver education and incorporating an explanation of all therapies and anticipatory guidance, including strategies for reducing the risk of infection, are vital.
Collapse
|
11
|
Decreasing incidence of adenotonsillar problems in Dutch general practice: real or artefact? Br J Gen Pract 2010; 59:e368-75. [PMID: 20875250 DOI: 10.3399/bjgp09x473141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The incidence of hypertrophy and recurrent infections of the tonsils/adenoids appears to be decreasing in the Netherlands. It is uncertain whether this is a 'real' decrease in the incidence of disease or an 'artefact'. AIM To investigate possible causes of the decreasing incidence of adenotonsillar problems among Dutch children. DESIGN OF STUDY Observational. SETTING A nationally representative general practice database. METHOD Incidence rates were calculated over 2002-2005 among children aged 0-14 years. Multilevel Poisson regression analyses were used to examine the following possible causes of changing incidence rates: change in recording (more substitution codes), change in the demand for care (fewer visits to the GP), and change in the supply of care (fewer antibiotic prescriptions and referrals). Indications for a 'real' change in the incidence of disease were examined by calculating incidence rates of other clinical manifestations of microbial pathogens that may cause adenotonsillar problems. RESULTS The incidence rate decreased significantly (P = 0.017) from 3.0 to 1.3 per 1000 children per year. Correcting for demand for and supply of care led to a smaller decline in yearly incidence, from 2.9 to 1.7 per 1000 children per year (P = 0.105). No clearly similar trend was found in other clinical manifestations of viruses and bacteria that may cause adenotonsillar problems. CONCLUSION Part of the declining trend can be explained by a change in the demand for and supply of care, but no apparent causal clue emerged for the residual declining trend in the incidence of disease.
Collapse
|
12
|
Niang MN, Diop OM, Sarr FD, Goudiaby D, Malou-Sompy H, Ndiaye K, Vabret A, Baril L. Viral etiology of respiratory infections in children under 5 years old living in tropical rural areas of Senegal: The EVIRA project. J Med Virol 2010; 82:866-72. [PMID: 20336732 PMCID: PMC7166331 DOI: 10.1002/jmv.21665] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Acute respiratory infection is one of the leading causes of child morbidity, especially in developing countries. Viruses are recognized as the predominant causative agents of acute respiratory infections. In Senegal, few data concerning the causes of respiratory infections are available, and those known relate mainly to classical influenza infections. Clinical and virological surveillance of acute respiratory infections was carried out in a rural community in children less than 5 years old. A standardized questionnaire was used and a nasopharyngeal swab sample was collected from each patient. These samples were tested for the detection of 20 respiratory viruses by multiplex RT-PCR or by viral culture. A total of 82 acute respiratory episodes were included, and 48 (58.5%) were found to be positive, with a total of 55 viral detections; several samples were positive for two (n = 5) or 3 (n = 1) viruses. Ten different viruses were identified: influenza viruses A, B, and C (n = 25), human respiratory syncytial virus type A (n = 13), rhinoviruses (n = 8), human coronaviruses type 229E and NL63 (n = 6), parainfluenza viruses 3 and 4 (n = 2), and bocavirus (n = 1). These results provide evidence on the importance and the diversity of viruses as causative agents of acute respiratory infections in children living in a rural community in Senegal. The establishment of sentinel surveillance sites could help estimate the burden of acute respiratory infection in the pediatric population and should help prepare the health care systems to identify and respond to new viral respiratory emergencies.
Collapse
|