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Liu XP, Mao CX, Wang GS, Zhang MZ. Metagenomic next-generation sequencing for pleural effusions induced by viral pleurisy: A case report. World J Clin Cases 2023; 11:844-851. [PMID: 36818630 PMCID: PMC9928708 DOI: 10.12998/wjcc.v11.i4.844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/31/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Viral pleurisy is a viral infected disease with exudative pleural effusions. It is one of the causes for pleural effusions. Because of the difficult etiology diagnosis, clinically pleural effusions tend to be misdiagnosed as tuberculous pleurisy or idiopathic pleural effusion. Here, we report a case of pleural effusion secondary to viral pleurisy which is driven by infection with epstein-barr virus. Viral infection was identified by metagenomic next-generation sequencing (mNGS).
CASE SUMMARY A 40-year-old male with a history of dermatomyositis, rheumatoid arthritis, and secondary interstitial pneumonia was administered with long-term oral prednisone. He presented with fever and chest pain after exposure to cold, accompanied by generalized sore and weakness, night sweat, occasional cough, and few sputums. The computed tomography scan showed bilateral pleural effusions and atelectasis of the partial right lower lobe was revealed. The pleural fluids were found to be yellow and slightly turbid after pleural catheterization. Thoracoscopy showed fibrous adhesion and auto-pleurodesis. Combining the results in pleural fluid analysis and mNGS, the patient was diagnosed as viral pleuritis. After receiving Aciclovir, the symptoms and signs of the patient were relieved.
CONCLUSION Viral infection should be considered in cases of idiopathic pleural effusion unexplained by routine examination. mNGS is helpful for diagnosis.
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Affiliation(s)
- Xue-Ping Liu
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Chen-Xue Mao
- Department of Laboratory Diagnosis, Chongqing KingMed Center for Clinical Laboratory Co., Ltd, Chongqing 400050, China
| | - Guan-Song Wang
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Ming-Zhou Zhang
- Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
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Pereira EQ, Santos MLAD, Uchimura TT, Menezes E. Temporal-spatial analysis of hospitalizations for bronchiolitis in Brazil: prediction of epidemic regions and periods for immunization against the Respiratory Syncytial Virus. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2021304. [PMID: 36921162 PMCID: PMC10014015 DOI: 10.1590/1984-0462/2023/41/2021304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/30/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Due to the high cost and short term of passive immunization against the respiratory syncytial virus, the main virus causing acute viral bronchiolitis, predicting epidemic regions and epidemic months is extremely important. The objective of this study is to identify both the month when the seasonal peak begins and Brazilian regions and states with the highest incidence of monthly hospitalizations due acute viral bronchiolitis. METHODS Based on data obtained from DATASUS, monthly hospitalization rates due acute viral bronchiolitis were calculated for every 10,000 live births to children under 12 months of age in all Brazilian states and the Federal District between 2000 and 2019. Seasonal autoregressive integrated moving average models were estimated to forecast monthly hospitalization rates in 2020. RESULTS A higher incidence of hospitalizations was found for male children, especially under six months of age. As for Brazilian regions, between 2000 and 2019, the South region registered the highest incidence of hospitalizations, followed by the Southeast, Midwest, North and Northeast regions, in this order. Considering the seasonal peak, the period between March and July 2020 comprised the highest expected hospitalization rates. CONCLUSIONS Palivizumab is suggested to be started between February/March and June/July for most Brazilian states, with the exception of Rio Grande do Sul, which, in addition to presenting the highest rates of hospitalizations for acute viral bronchiolitis per 10,000 live births, has the longest seasonal peak between May and September.
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Silva PAN, Ito CRM, Moreira ALE, Santos MO, Barbosa LCG, Wastowski IJ, Carneiro LC, Avelino MAG. Influenza and other respiratory viruses in children: prevalence and clinical features. Eur J Clin Microbiol Infect Dis 2022; 41:1445-1449. [PMID: 36287292 PMCID: PMC9607802 DOI: 10.1007/s10096-022-04515-3] [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: 09/05/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022]
Abstract
With the COVID-19 pandemic still ongoing, the annual season of influenza and other respiratory virus epidemics has arrived. Specimens from patients suspected of respiratory viruses infection were collected. Viral detection was performed following RNA extraction and real-time RT-PCR. During the study period, we received and tested a total of 606 specimens. Rhinovirus virus was the viral type most prevalent, detected in 186 (45.47%) specimens. The age range of patients positive for influenza A, influenza A (H1N1), and influenza B was 18 days to 13 years. With female prevalence for this viral type, cough and asthma were the main clinical manifestations presented by this viral type. Our results indicate that rhinoviruses, adenoviruses, metapneumoviruses, and influenza are among the most important agents of ARI in pediatrics. The epidemic period of respiratory infections observed in Goiânia can be useful for planning and implementing some prevention strategies.
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Affiliation(s)
- Paulo Alex N Silva
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Célia Regina Malveste Ito
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - André Luís Elias Moreira
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Mônica Oliveira Santos
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Lucas Candido Gonçalves Barbosa
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | | | - Lilian Carla Carneiro
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.
| | - Melissa Ameloti Gomes Avelino
- Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.,Departament of Pediatrics, Federal University of Goiás, Goiânia, Brazil
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Juliana AE, Tang MJ, Kemps L, Noort AC, Hermelijn S, Plötz FB, Zonneveld R, Wilschut JC. Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname. PLoS One 2021; 16:e0247000. [PMID: 33606795 PMCID: PMC7894877 DOI: 10.1371/journal.pone.0247000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/29/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Viruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries. METHODS Between 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS). RESULTS Of a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS. CONCLUSIONS Viruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.
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Affiliation(s)
- Amadu E. Juliana
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
- * E-mail:
| | - Ming-Jan Tang
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Lex Kemps
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Albert C. Noort
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Sandra Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Frans B. Plötz
- Department of Pediatrics, Tergooi Hospitals, Blaricum, The Netherlands
- Department of Pediatrics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rens Zonneveld
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Jan C. Wilschut
- Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Orellana JDY, Cunha GMD, Marrero L, Moreira RI, Leite IDC, Horta BL. [Excess deaths during the COVID-19 pandemic: underreporting and regional inequalities in Brazil]. CAD SAUDE PUBLICA 2021; 37:e00259120. [PMID: 33566992 DOI: 10.1590/0102-311x00259120] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 11/06/2020] [Indexed: 01/12/2023] Open
Abstract
Brazil is one of the most heavily impacted countries by the COVID-19 pandemic, and the real number of deaths from the disease makes the scenario even more challenging. This study aimed to estimate the excess deaths and their differences in adults 20 years and older in Manaus (Amazonas State), Fortaleza (Ceará State), Rio de Janeiro, and São Paulo, according to place of death, demographic characteristics, and trajectory over time. The data were obtained from the Mortality Information System and the Central Information Office of the National Civil Registry. The estimates of expected deaths were obtained from quasi-Poisson generalized additive models, adjusting for overdispersion. From February 23 to June 13, 2020, 74,410 natural deaths were recorded in the four cities, with 46% excess deaths (95%CI: 44-47). The largest amount of excess deaths was in Manaus, with 112% (95%CI: 103-121), followed by Fortaleza with 72% (95%CI: 67-78), Rio de Janeiro with 42% (95%CI: 40-45), and São Paulo with 34% (95%CI: 32-36). Excess deaths were greater in males and non-significant in Epidemiologic Weeks (EW) 9-12, except in São Paulo, 10% (95%CI: 6-14). The peak in excess deaths generally occurred in EW 17-20. The number of excess deaths not explained directly by COVID-19 and deaths at home or on public byways is high, especially in Manaus. The high percentages of excess deaths, deaths not explained directly by COVID-19, and deaths outside the hospital suggest high underreporting of deaths from COVID-19 and reinforce the extensive spread of SARS-CoV-2, as well as the need for epidemiological surveillance services to review all causes of deaths associated with respiratory symptoms.
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Affiliation(s)
| | | | | | - Ronaldo Ismerio Moreira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Iuri da Costa Leite
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Silva THD, Pinho JRR, Silva Junior TJD, Carmona F. Epidemiology of viral respiratory infections in children undergoing heart surgery. PROGRESS IN PEDIATRIC CARDIOLOGY 2020; 52:22-25. [PMID: 32288462 PMCID: PMC7110991 DOI: 10.1016/j.ppedcard.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 12/03/2022]
Abstract
Background Acute viral respiratory infections (VRI) are the most common diseases in humans and are associated with high morbidity and mortality in infants and the elderly. Children with congenital heart disease (CHD) are more susceptible to get severe forms of VRI due to their altered lung mechanics, leading to several complications, such as increased hospital stay, longer mechanical ventilation, and higher mortality. This study aimed to identify the frequency of VRI in children with CHD undergoing cardiac surgery, and to compare the major outcomes according to the presence or absence of a VRI. Methods This was a longitudinal, observational cohort study. Nasopharyngeal secretion samples were collected pre- and postoperatively for patients undergoing cardiac surgery, from May 2013 to May 2014. Respiratory viruses were detected using CLART Pneumovir®. Results Forty-eight patients were enrolled. We found a VRI preoperatively in 16 children with CHD before surgery (33.3%), and the frequency of new infections was 8.3% (4 patients). However, in this study, in univariate analyses, the two groups did not differ in any of the studied outcomes. In the multivariate regression models, adjusting for age and STAT category, the presence of a VRI did not show a significant effect on the major outcomes. Conclusions In conclusion, VRI was frequent in children undergoing open-heart surgery, but the presence of a VRI did not impact on major outcomes in this cohort. Children with CHD are more susceptible to get severe forms of VRI, leading to poorer surgical outcomes. We aimed to identify the frequency of VRI in children with CHD undergoing cardiac surgery, and its influence on outcomes. We found a VRI in 16 children with CHD before surgery (33.3%), and the frequency of new infections was 8.3% (4 patients).
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Affiliation(s)
| | - João Renato Rebello Pinho
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,LIM07, São Paulo Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Fabio Carmona
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Neves KC, Vieira SE. Conditions of vulnerability to the inadequate treatment of bronchiolitis. Rev Assoc Med Bras (1992) 2020; 66:187-193. [DOI: 10.1590/1806-9282.66.2.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/29/2019] [Indexed: 11/22/2022] Open
Abstract
SUMMARY OBJECTIVE To analyze clinical and demographic variables possibly associated with the prescriptions of non-recommended but routinely used therapies for infants with acute viral bronchiolitis. METHODS A cross-sectional study included hospitalized infants with bronchiolitis caused by the respiratory syncytial virus. Those with other associated infections and/or morbidities were excluded. The data were collected from medical records. RESULTS Among 120 cases, 90% used inhaled beta-agonists, 72.5% corticosteroids, 40% antibiotics, and 66.7% inhaled hypertonic saline solution. The use of bronchodilators did not present an independent association with another variable. More frequent use of corticosteroids was associated with low oximetry, longer hospitalization time, and age>3 months. Antibiotic therapy was associated with the presence of fever, longer hospitalization, and age>3 months. Inhaled hypertonic saline solution was associated with longer hospitalization time. CONCLUSIONS Non-recommended prescriptions were frequent. Corticosteroid and antibiotic therapy were associated with signs of severity, as expected, but interestingly, they were more frequently used in infants above 3m, which suggested less safety in the diagnosis of viral bronchiolitis in these patients. The use of bronchodilators was even more worrying since they were indiscriminately used, without association with another variable related to the severity or characteristics of the host. The use of the inhaled hypertonic solution, although not associated with severity, seems to have implied a longer hospitalization time. The identification of these conditions of greater vulnerability to the prescription of inappropriate therapies contributes to the implantation of protocols for the bronchiolitis treatment, for continuing education and for analysis of the effectiveness of the strategies employed.
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Affiliation(s)
- Kattia Cristina Neves
- Universidade de São Paulo, Brasil; Hospital do Servidor Público Estadual de São Paulo, Brasil
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8
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Complete Genome Sequences of Five Human Respiratory Syncytial Virus Isolates Collected in Brazil. GENOME ANNOUNCEMENTS 2018; 6:6/7/e01609-17. [PMID: 29449407 PMCID: PMC5814487 DOI: 10.1128/genomea.01609-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT
Here, we present the complete genome sequences of five human respiratory syncytial virus isolates collected from hospitalized infants suffering from acute respiratory disease. These are the first five complete genome sequences of human respiratory syncytial virus to originate from Brazil.
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Patil SL, Balakrishnan A. Genetic characterization respiratory syncytial virus in Kerala, the southern part of India. J Med Virol 2017; 89:2092-2097. [PMID: 28464224 DOI: 10.1002/jmv.24842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/11/2017] [Indexed: 11/09/2022]
Abstract
Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory tract infection (ALRI) in infants and young children globally. RSV presents two antigenic groups RSV-A and -B. Genetic variability is also very high within each group. RSV circulation varies year to year and even varies among different regions. Data on circulatory pattern of RSV are available from other parts of India except Kerala. The aim of the study was to generate data about groups and genotypes of circulating RSV in Kerala. In this study, RSV positive samples received during January, 2012 to December, 2014 were used for genetic characterization. The samples were tested by using nucleocapsid (N) gene-based conventional multiplex reverse transcriptase polymerase chain reaction (RT-PCR) to identify the RSV group. Genotyping was done by nucleotide sequencing of the C-terminal region of the glycoprotein (G) gene. Out of the 130 patient samples tested, 49 samples were positive for RSV. Among the positive samples, 32 belong to the RSV-A and 17 belong to RSV-B virus. Phylogenetic analysis revealed that all RSV-A sequences (n = 22) belonged to NA1 genotype and five of the sequences showed the novel 72 nucleotide duplication and clustered into the newly designated ON1 genotype. All RSV-B sequences (n = 17) were clustered into the BA (BA9 and 10) genotype. From this study, we concluded both RSV-A and -B were co-circulated in Kerala and RSV-A was observed predominantly in 2012 and RSV-B in 2014. As per our best of knowledge, BA10 genotype is first observed in India.
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Affiliation(s)
- Savita L Patil
- BSL-4 Laboratory, Microbial Containment Complex, National Institute of Virology, Pashan, Pune, Maharashtra, India
| | - Anukumar Balakrishnan
- National Institute of Virology Kerala Unit, Govt. T.D. Medical College Hospital, Vandanam, Alappuzha, Kerala, India
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Durigon EL, Botosso VF, de Oliveira DBL. Human Respiratory Syncytial Virus: Biology, Epidemiology, and Control. HUMAN VIROLOGY IN LATIN AMERICA 2017. [PMCID: PMC7121549 DOI: 10.1007/978-3-319-54567-7_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Monteiro AIMP, Bellei NCJ, Sousa AR, dos Santos AMN, Weckx LY. Respiratory infections in children up to two years of age on prophylaxis with palivizumab. ACTA ACUST UNITED AC 2016; 32:152-8. [PMID: 25119744 PMCID: PMC4183017 DOI: 10.1590/0103-0582201432214813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/27/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify the viruses involved in acute respiratory tract infections and to analyze the rates of hospitalization and death in children on palivizumab prophylaxis. METHODS Prospective cohort of 198 infants up to one year old who were born before 29 weeks of gestational age and infants under two years old with hemodynamically unstable cardiopathy or chronic pulmonary disease who received prophylactic palivizumab against severe respiratory syncytial virus infections in 2008. During the study period, in each episode of acute respiratory tract infection, nasopharyngeal aspirate was collected to identify respiratory syncytial virus, adenovirus, parainfluenza 1, 2 and 3, influenza A and B by direct immunofluorescence, rhinovirus and metapneumovirus by polymerase chain reaction preceded by reverse transcription. Data regarding hospitalization and deaths were monitored. RESULTS Among the 198 studied infants, 117 (59.1%) presented acute respiratory tract infections, with a total of 175 episodes. Of the 76 nasopharyngeal aspirates collected during respiratory tract infections, 37 were positive, as follow: rhinovirus (75.7%), respiratory syncytial virus (18.9%), parainfluenza (8.1%), adenovirus 2 (2.7%), metapneumovirus (2.7%) and three samples presented multiple agents. Of the 198 children, 48 (24.4%) were hospitalized: 30 (15.2%) for non-infectious etiology and 18 (9.1%) for respiratory causes. Among these 18 children, one case of respiratory syncytial virus was identified. Two deaths were reported, but respiratory syncytial virus was not identified. CONCLUSIONS During the prophylaxis period, low frequency of respiratory syncytial virus infections and low rates of hospitalization were observed, suggesting the benefit of palivizumab prophylaxis.
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Affiliation(s)
| | | | | | | | - Lily Yin Weckx
- Escola Paulista de Medicina, Unifesp, São Paulo, SP, Brasil
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Freitas ARR, Donalisio MR. Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations. Mem Inst Oswaldo Cruz 2016; 111:294-301. [PMID: 27120006 PMCID: PMC4878298 DOI: 10.1590/0074-02760150341] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 03/17/2016] [Indexed: 11/21/2022] Open
Abstract
Respiratory syncytial virus (RSV) infection is the leading cause of hospitalisation for respiratory diseases among children under 5 years old. The aim of this study was to analyse RSV seasonality in the five distinct regions of Brazil using time series analysis (wavelet and Fourier series) of the following indicators: monthly positivity of the immunofluorescence reaction for RSV identified by virologic surveillance system, and rate of hospitalisations per bronchiolitis and pneumonia due to RSV in children under 5 years old (codes CID-10 J12.1, J20.5, J21.0 and J21.9). A total of 12,501 samples with 11.6% positivity for RSV (95% confidence interval 11 - 12.2), varying between 7.1 and 21.4% in the five Brazilian regions, was analysed. A strong trend for annual cycles with a stable stationary pattern in the five regions was identified through wavelet analysis of the indicators. The timing of RSV activity by Fourier analysis was similar between the two indicators analysed and showed regional differences. This study reinforces the importance of adjusting the immunisation period for high risk population with the monoclonal antibody palivizumab taking into account regional differences in seasonality of RSV.
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Affiliation(s)
| | - Maria Rita Donalisio
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Campinas, SP, Brasil
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13
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Gurgel RQ, Bezerra PGDM, Duarte MDCMB, Moura AÁ, Souza EL, Silva LSDS, Suzuki CE, Peixoto RB. Relative frequency, Possible Risk Factors, Viral Codetection Rates, and Seasonality of Respiratory Syncytial Virus Among Children With Lower Respiratory Tract Infection in Northeastern Brazil. Medicine (Baltimore) 2016; 95:e3090. [PMID: 27082548 PMCID: PMC4839792 DOI: 10.1097/md.0000000000003090] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 12/11/2022] Open
Abstract
Few studies, each limited to a single major city, have investigated the prevalence and seasonal patterns of different viruses among children with low respiratory tract infections (LRTI) in Northeastern Brazil. The aim of this study was to determine the frequency of respiratory syncytial virus (RSV) and of 7 other viruses in children for LRTI in 4 capitals from this region, and investigate their association with several risk factors, including meteorological data. From April 2012 to March 2013, 507 children, aged up to 24 months and hospitalized with LRTI in one of the participating centers at Aracajú, Salvador, Recife, and Maceió, had a sample of nasopharyngeal aspirate collected and analyzed for the following viruses by reverse-transcription polymerase chain reaction followed by hybridization on low-density microarrays: RSV, influenza, parainfluenza, adenovirus, rhinovirus, metapneumovirus, bocavirus, and coronavirus. The result was positive in 66.5% of cases, RSV was the most common virus (40.2%). Except for rhinovirus (17%), all other virus had frequency rates lower than 6%. Viral coinfections were detected in 13.8% of samples. Possible related risk factors for RSV infection were low age upon entry, attendance of daycare, low gestational age, and low educational level of the father. The relative frequency of viral infections was associated with increasing temperature and decreasing humidity separately, but the results also suggested both associated with increased frequency of RSV. Some of these findings differ from those reported for other regions in Brazil and may be used to guide policies that address LRTI.
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Affiliation(s)
- Ricardo Queiroz Gurgel
- From the Departamento de Medicina, Universidade Federal do Sergipe, Aracaju (RQG); Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife (PGDMB, MDCMBD); Departamento de Medicina, Universidade Federal de Alagoas, Maceió (AAM); Fac. de Medicina da Bahia, Universidade Federal da Bahia (ELS); Hosp. Martagão Gesteira, Salvador (LSDSS); and AbbVie Brazil, São Paulo, Brazil (CES, RBP)
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Moraes CTP, Oliveira DBL, Campos ACA, Bosso PA, Lima HN, Stewien KE, Gilio AE, Vieira SE, Botosso VF, Durigon EL. Genetic variability in G2 and F2 region between biological clones of human respiratory syncytial virus with or without host immune selection pressure. Mem Inst Oswaldo Cruz 2015; 110:138-41. [PMID: 25742274 PMCID: PMC4371228 DOI: 10.1590/0074-02760140299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/18/2014] [Indexed: 11/22/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) is an important respiratory pathogens among
children between zero-five years old. Host immunity and viral genetic variability are
important factors that can make vaccine production difficult. In this work,
differences between biological clones of HRSV were detected in clinical samples in
the absence and presence of serum collected from children in the convalescent phase
of the illness and from their biological mothers. Viral clones were selected by
plaque assay in the absence and presence of serum and nucleotide sequences of the G2
and F2 genes of HRSV biological clones were compared. One non-synonymous mutation was
found in the F gene (Ile5Asn) in one clone of an HRSV-B sample and one non-synonymous
mutation was found in the G gene (Ser291Pro) in four clones of the same HRSV-B
sample. Only one of these clones was obtained after treatment with the child's serum.
In addition, some synonymous mutations were determined in two clones of the HRSV-A
samples. In conclusion, it is possible that minor sequences could be selected by host
antibodies contributing to the HRSV evolutionary process, hampering the development
of an effective vaccine, since we verify the same codon alteration in absence and
presence of human sera in individual clones of BR-85 sample.
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Rodríguez-Martínez CE, Rodríguez DA, Nino G. Respiratory syncytial virus, adenoviruses, and mixed acute lower respiratory infections in children in a developing country. J Med Virol 2015; 87:774-81. [PMID: 25648409 DOI: 10.1002/jmv.24139] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/10/2022]
Abstract
There is growing evidence suggesting greater severity and worse outcomes in children with mixed as compared to single respiratory virus infections. However, studies that assess the risk factors that may predispose a child to a mixture of respiratory syncytial virus (RSV) and adenoviral infections, are scarce. In a retrospective cohort study, the study investigated the epidemiology of RSV and adenovirus infections and predictors of mixed RSV-adenoviral infections in young children hospitalized with acute lower respiratory infection in Bogota, Colombia, South America, over a 2-year period 2009-2011. Of a total of 5,539 children admitted with a diagnosis of acute lower respiratory infection, 2,267 (40.9%) who were positive for RSV and/or adenovirus were selected. Out the total number of cases, 1,416 (62.5%) infections occurred during the 3-month period from March to May, the first rainy season of Bogota, Colombia. After controlling for gender, month when the nasopharyngeal sample was taken, and other pre-existing conditions, it was found that an age greater than 6 months (OR:1.74; CI 95%:1.05-2.89; P = 0.030) and malnutrition as a comorbidity (OR:9.92; CI 95%:1.01-100.9; P = 0.049) were independent predictors of mixed RSV-adenoviral infections in the sample of patients. In conclusion, RSV and adenovirus are significant causes of acute lower respiratory infection in infants and young children in Bogota, Colombia, especially during the first rainy season. The identified predictors of mixed RSV-adenoviral infections should be taken into account when planning intervention, in order to reduce the burden of acute lower respiratory infection in young children living in the country.
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Affiliation(s)
- Carlos E Rodríguez-Martínez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Research Unit, Military Hospital of Colombia, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia
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Bardach A, Rey-Ares L, Cafferata ML, Cormick G, Romano M, Ruvinsky S, Savy V. Systematic review and meta-analysis of respiratory syncytial virus infection epidemiology in Latin America. Rev Med Virol 2014; 24:76-89. [PMID: 24757727 DOI: 10.1002/rmv.1775] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Respiratory syncytial virus (RSV) is a frequent cause of acute respiratory infection and the most common cause of bronchiolitis in infants. The aim of this systematic review and meta-analysis was to obtain a comprehensive epidemiological picture of the data available on disease burden, surveillance, and use of resources in Latin America. Pooled estimates are useful for cross-country comparisons. Data from published studies reporting patients with probable or confirmed RSV infection in medical databases and gray literature were included from 74 studies selected from the 291 initially identified. When considering all countries, the largest pooled percentage RSV in low respiratory tract infection patients was found in the group between 0 and 11 months old, 41.5% (95% CI 32.0–51.4). In all countries, percentages were increasingly lower as older children were included in the analyses. The pooled percentage of RSV in LRTIs in the elderly people was 12.6 (95% CI 4.2–24.6). The percentage of RSV infection in hospitalized newborns was 40.9% (95% CI 28.28–54.34). The pooled case fatality ratio for RSV infection was 1.74% (95% CI 1.2–2.4) in the first 2 years of life. The average length of stay excluding intensive care unit admissions among children with risk factors for severe disease was 12.8 (95% CI 8.9–16.7) days, whereas it averaged 7.3 (95% CI 6.1/8.5) days in otherwise healthy children.We could conclude that infants in their first year of age were the most vulnerable population. To our knowledge, this is the first systematic review on RSV disease burden and use of health resources in Latin America.
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Nestor J, Huggins T, Kummerfeldt C, DiVietro M, Walters K, Sahn S. Viral diseases affecting the pleura. J Clin Virol 2013; 58:367-73. [PMID: 23916378 DOI: 10.1016/j.jcv.2013.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/01/2013] [Accepted: 06/07/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Viruses affect the human body in multiple ways producing various disease states. The infections of the pulmonary parenchyma have been well described. However, there has been no current review of the literature pertaining to the pleura. AIM To review the available literature pertaining to diseases of the pleura that are caused by viral infections. METHODS A Medline search was performed and available research and review articles relating to viral infections that resulted in pleural effusions, pleural masses, pleural thickening, and pleural nodularity were reviewed. CONCLUSION There are numerous viruses that cause diseases of the pleura. Pleural effusions and lesions within the pleura are the most common presentation of the disease state. Polymerase chain reaction has the potential to further diagnose viral infections and expand our knowledge base in this field.
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Affiliation(s)
- Jennings Nestor
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, 96 Jonathan Lucas Street, Suite 812 - CSB, MSC 630, Charleston, SC 29425, United States.
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Paiva TM, Ishida MA, Benega MA, Constantino CRA, Silva DBB, Santos KCO, Oliveira MI, Barbosa HA, Carvalhanas TRMP, Schuck-Paim C, Alonso WJ. Shift in the timing of respiratory syncytial virus circulation in a subtropical megalopolis: implications for immunoprophylaxis. J Med Virol 2013; 84:1825-30. [PMID: 22997087 DOI: 10.1002/jmv.23347] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of severe respiratory infections worldwide, and an important cause of childhood bronchiolitis, pneumonia, and mortality. Although prevention of RSV infection by immunoprophylaxis with palivizumab has proved effective, a precise understanding of the timing of RSV outbreaks is necessary to ensure that infants are protected when RSV is circulating. In this study a consistent shift in the seasonal patterns of RSV circulation in southeast Brazil (São Paulo) is reported based on the analysis of 15 years of viral surveillance. Surveillance was conducted from 1996 to 2010 and involved the collection of samples from children with symptoms of acute respiratory infection. Putative changes in school terms, in the proportion of RSV genotypes infecting children and in the seasonal dynamics of several climatic parameters during the period were also investigated. The results revealed a progression in the timing of RSV seasons, with a shift in the onset and peak of RSV epidemics from 2007 onwards. Although lower rainfall and temperatures were associated with the onset of outbreaks, there was no evidence of changes in climate, school terms or in the relative proportion of genotypes in the period analyzed. These findings have direct implications for improving the prophylactic use of palivizumab, and stress the importance of fine tuning prophylaxis with recent surveillance data. In the case of São Paulo, palivizumab prophylaxis should be initiated earlier than suggested currently. Similar adjustments may be necessary in other regions.
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Affiliation(s)
- Terezinha M Paiva
- Center of Respiratory Diseases, Adolfo Lutz Institute, São Paulo, Brazil
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20
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Sentinel surveillance of influenza and other respiratory viruses, Brazil, 2000-2010. Braz J Infect Dis 2013; 17:62-8. [PMID: 23287541 PMCID: PMC9427376 DOI: 10.1016/j.bjid.2012.09.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/19/2012] [Accepted: 09/03/2012] [Indexed: 11/23/2022] Open
Abstract
There are scanty data on the epidemiology of influenza and other respiratory viruses in South America and Brazil. The aim of this study was to summarize the data from the Brazilian surveillance system of influenza and other respiratory viruses and discuss the patterns of viral circulation. The system is based on detecting cases of influenza-like illness in sentinel sites and weekly collection of five nasopharyngeal secretions samples, which are processed in state public health laboratories for respiratory viruses by indirect immunofluorescence assay. Data from 2000 to 2010 were described over time, by region, gender, and age group, and an analysis of Spearman correlation was performed between monthly influenza detection and rainfall and temperature data in two state capitals with the highest number of positive samples, one from the northeast region (Maceió) and other from the southern region (Curitiba). There were 3,291,946 visits for influenza-like illness; of these, 37,120 had samples collected and 6421 tested positive: 1690 (26%) influenza A, 567 (9%) influenza B, 277 (4%) parainfluenza 1, 571 (9%) parainfluenza 2, 589 (9%) parainfluenza 3, 742 (12%) adenovirus, and 1985 (31%) respiratory syncytial virus. Overall, increased activity of respiratory syncytial virus was observed from March to June, preceding the peak of influenza activity, from May to August, but with regional differences. In Maceió, there was a weak correlation between temperature and influenza detection (ρ=0.05), but a moderate positive correlation between rainfall and influenza detection (ρ=0.36). In Curitiba, a high correlation was observed between the decrease in temperature and rainfall and the increase in influenza detection (ρ=-0.83 and -0.78 respectively). These data are important to guide public health control measures as the best time for influenza vaccination and use of antivirals.
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Katzov-Eckert H, Botosso VF, Neto EA, Zanotto PMDA. Phylodynamics and dispersal of HRSV entails its permanence in the general population in between yearly outbreaks in children. PLoS One 2012; 7:e41953. [PMID: 23077477 PMCID: PMC3471929 DOI: 10.1371/journal.pone.0041953] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 06/29/2012] [Indexed: 12/22/2022] Open
Abstract
Background Human respiratory syncytial virus (HRSV) is one of the major etiologic agents of respiratory tract infections among children worldwide. Methodology/Principal Findings Here through a comprehensive analysis of the two major HRSV groups A and B (n = 1983) which comprise of several genotypes, we present a complex pattern of population dynamics of HRSV over a time period of 50 years (1956–2006). Circulation pattern of HRSV revealed a series of expansions and fluctuations of co-circulating lineages with a predominance of HRSVA. Positively selected amino acid substitutions of the G glycoprotein occurred upon population growth of GB3 with a 60-nucleotide insertion (GB3 Insert), while other genotypes acquired substitutions upon both population growth and decrease, thus possibly reflecting a role for immune selected epitopes in linkage to the traced substitution sites that may have important relevance for vaccine design. Analysis evidenced the co-circulation and predominance of distinct HRSV genotypes in Brazil and suggested a year-round presence of the virus. In Brazil, GA2 and GA5 were the main culprits of HRSV outbreaks until recently, when the GB3 Insert became highly prevalent. Using Bayesian methods, we determined the dispersal patterns of genotypes through several inferred migratory routes. Conclusions/Significance Genotypes spread across continents and between neighboring areas. Crucially, genotypes also remained at any given region for extended periods, independent of seasonal outbreaks possibly maintained by re-infecting the general population.
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Affiliation(s)
- Hagit Katzov-Eckert
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute-ICB-II, University of São Paulo, São Paulo, Brazil
| | | | - Eurico Arruda Neto
- Department of Cell Biology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil, and the VGDN Consortium
| | - Paolo Marinho de Andrade Zanotto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute-ICB-II, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Ferronato ÂE, Gilio AE, Ferraro AA, Paulis MD, Vieira SE. Etiological diagnosis reduces the use of antibiotics in infants with bronchiolitis. Clinics (Sao Paulo) 2012; 67:1001-6. [PMID: 23018294 PMCID: PMC3438237 DOI: 10.6061/clinics/2012(09)03] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 04/16/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Acute bronchiolitis is a leading cause of infant hospitalization and is most commonly caused by respiratory syncytial virus. Etiological tests are not required for its diagnosis, but the influence of viral screening on the therapeutic approach for acute bronchiolitis remains unclear. METHODS A historical cohort was performed to assess the impact of viral screening on drug prescriptions. The study included infants up to one year of age who were hospitalized for bronchiolitis. Virus screening was performed using immunofluorescence assays in nasopharyngeal aspirates. The clinical data were obtained from the patients' medical records. Therapeutic changes were considered to be associated with viral screening when made within 24 hours of the release of the results. RESULTS The frequency of prescriptions for beta agonists, corticosteroids and antibiotics was high at the time of admission and was similar among the 230 patients. The diagnosis of pneumonia and otitis was associated with the introduction of antibiotics but did not influence antibiotics maintenance after the results of the virus screening were obtained. Changes in the prescriptions were more frequent for the respiratory syncytial virus patients compared to patients who had negative viral screening results (p =0.004), especially the discontinuation of antibiotics (p<0.001). The identification of respiratory syncytial virus was associated with the suspension of antibiotics (p= 0.003), even after adjusting for confounding variables (p = 0.004); however, it did not influence the suspension of beta-agonists or corticosteroids. CONCLUSION The identification of respiratory syncytial virus in infants with bronchiolitis was independently associated with the discontinuation of antibiotics during hospitalization.
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Gardinassi LG, Marques Simas PV, Salomão JB, Durigon EL, Zanetta Trevisan DM, Cordeiro JA, Lacerda MN, Rahal P, de Souz FP. Seasonality of viral respiratory infections in southeast of Brazil: the influence of temperature and air humidity. Braz J Microbiol 2012; 43:98-108. [PMID: 24031808 PMCID: PMC3768995 DOI: 10.1590/s1517-838220120001000011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 12/12/2010] [Accepted: 08/30/2011] [Indexed: 11/29/2022] Open
Abstract
Viruses are the major cause of lower respiratory tract infections in childhood and the main viruses involved are Human Respiratory Syncytial Virus (HRSV), Human Metapneumovirus (HMPV), Influenzavirus A and B (FLUA and FLUB), Human Parainfluenza Virus 1, 2 and 3 (HPIV1, 2 and 3) and Human Rhinovirus (HRV). The purposes of this study were to detect respiratory viruses in hospitalized children younger than six years and identify the influence of temperature and relative air humidity on the detected viruses. Samples of nasopharyngeal washes were collected from hospitalized children between May/2004 and September/2005. Methods of viral detection were RT-PCR, PCR and HRV amplicons were confirmed by hybridization. Results showed 54% (148/272) of viral positivity. HRSV was detected in 29% (79/272) of the samples; HRV in 23.1% (63/272); HPIV3 in 5.1% (14/272); HMPV in 3.3% (9/272); HPIV1 in 2.9% (8/272); FLUB in 1.4% (4/272), FLUA in 1.1% (3/272), and HPIV2 in 0.3% (1/272). The highest detection rates occurred mainly in the spring 2004 and in the autumn 2005. It was observed that viral respiratory infections tend to increase as the relative air humidity decreases, showing significant association with monthly averages of minimal temperature and minimal relative air humidity. In conclusion, viral respiratory infections vary according to temperature and relative air humidity and viral respiratory infections present major incidences it coldest and driest periods.
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Affiliation(s)
- Luiz Gustavo Gardinassi
- Universidade Estadual Paulista, Instituto de Biociências, Letras e Ciências Exatas, Departamento de Biologia , Ribeirão Preto , Brasil
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Zou L, Zhou J, Li H, Wu J, Mo Y, Chen Q, Fang L, Wu D, Wu J, Ke C. Human adenovirus infection in children with acute respiratory tract disease in Guangzhou, China. APMIS 2012; 120:683-8. [PMID: 22779692 PMCID: PMC7159682 DOI: 10.1111/j.1600-0463.2012.02890.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 01/16/2012] [Indexed: 11/30/2022]
Abstract
Acute respiratory infections (ARI) are the major worldwide health problem due to associated high morbidity and mortality rates. Adenovirus (Adv) is one of the most common causes of viral ARI, and thus calls for specific diagnosis and better understanding of the epidemiology and clinical characteristics. Our aims were to find out the status of Adv infection in children <14 years with ARI, analyze the epidemiology and clinical characteristics among the Adv‐infected children in Guangzhou, China, and to provide some basis for the research of Adv. The throat and pharyngeal swabs were collected among the children with acute respiratory tract infections in outpatient department from September 2006 to August 2008. The samples were analyzed by PCR and the sequences were blasted with the sequences of Adv in GenBank. Clinical data were analyzed along with virological data by using appropriate statistical methods. Adv was detected in 25 out of 512 (4.9%) children. The genome types of 23 samples were determined after analysis of the gene sequence. The most prevalent Adv type was species B type 3. Among the patients, 10 were of Ad3 (43.5%), three were of Ad1 (1.3%), five were of species C Ad2 (21.7%), and five were of species E Ad4 (21.7%). A higher incidence of positive results was found during the summer season, thus showing a pattern of seasonality. There exists Adv infection in children with acute respiratory system diseases in Guangzhou area. No significant differences were found among different age groups and gender groups. Co‐infections with other respiratory virus were detected in 64% of the Adv positive samples.
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Affiliation(s)
- Lirong Zou
- Centre for Disease Control and Prevention of Guangdong province, Guangzhou
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Pica N, Bouvier NM. Environmental factors affecting the transmission of respiratory viruses. Curr Opin Virol 2012; 2:90-5. [PMID: 22440971 PMCID: PMC3311988 DOI: 10.1016/j.coviro.2011.12.003] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/06/2011] [Accepted: 12/09/2011] [Indexed: 11/04/2022]
Abstract
Many viruses are capable of infecting the human respiratory tract to cause disease. These viruses display various transmission patterns among humans; however, they all share the ability to transmit from person to person, and their human transmissibility is influenced by the environment in which pathogen and host meet. This review aims to summarize recent and significant observations regarding the impact of environmental factors such as weather and climate, humidity, temperature, and airflow on the transmission of human respiratory viruses. Where possible, knowledge gaps that require further scientific study will be identified.
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Affiliation(s)
- Natalie Pica
- Department of Microbiology, Mount Sinai School of Medicine, New York, NY, USA
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Watanabe ASA, Carraro E, Candeias JMG, Donalísio MR, Leal E, Granato CFH, Bellei N. Viral etiology among the elderly presenting acute respiratory infection during the influenza season. Rev Soc Bras Med Trop 2011; 44:18-21. [PMID: 21340401 DOI: 10.1590/s0037-86822011000100005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 10/18/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Acute respiratory tract infections are the most common illness in all individuals. Rhinoviruses have been reported as the etiology of more than 50% of respiratory tract infections worldwide. The study prospectively evaluated 47 elderly individuals from a group of 384 randomly assigned for acute respiratory viral infections (cold or flu) and assessed the occurrence of human rhinovirus (HRV), influenza A and B, respiratory syncytial virus and metapneumovirus (hMPV) in Botucatu, State of São Paulo, Brazil. METHODS Forty-nine nasal swabs collected from 47 elderly individuals following inclusion visits from 2002 to 2003 were tested by GenScan RT-PCR. HRV-positive samples were sequenced for phylogenetic analysis. RESULTS No sample was positive for influenza A/B or RSV. HRV was detected in 28.6% (14/47) and hMPV in 2% (1/47). Of 14 positive samples, 9 isolates were successfully sequenced, showing the follow group distribution: 6 group A, 1 group B and 2 group C HRVs. CONCLUSIONS The high incidence of HRV during the months of the influenza season requires further study regarding HRV infection impact on respiratory complications among this population. Infection caused by HRV is very frequent and may contribute to increasing the already high demand for healthcare during the influenza season.
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Lima HN, Botosso VF, Oliveira DBL, Campos ACDA, Leal AL, Silva TS, Bosso PAR, Moraes CTP, Filho CGDS, Vieira SE, Gilio AE, Stewien KE, Durigon EL. Molecular epidemiology of the SH (small hydrophobic) gene of human respiratory syncytial virus (HRSV), over 2 consecutive years. Virus Res 2011; 163:82-6. [PMID: 21893117 DOI: 10.1016/j.virusres.2011.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 08/19/2011] [Accepted: 08/22/2011] [Indexed: 11/17/2022]
Abstract
Human respiratory syncytial virus (HRSV) strains were isolated from nasopharyngeal aspirates collected from 965 children between 2004 and 2005, yielding 424 positive samples. We sequenced the small hydrophobic protein (SH) gene of 117 strains and compared them with other viruses identified worldwide. Phylogenetic analysis showed a low genetic variability among the isolates but allowed us to classify the viruses into different genotypes for both groups, HRSVA and HRSVB. It is also shown that the novel BA-like genotype was well segregated from the others, indicating that the mutations are not limited to the G gene.
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Affiliation(s)
- Hildenêr Nogueira Lima
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof. Lineu Prestes 1374, 05508-900 São Paulo, SP, Brazil
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Respiratory Viral Infections. TROPICAL INFECTIOUS DISEASES: PRINCIPLES, PATHOGENS AND PRACTICE 2011. [PMCID: PMC7149827 DOI: 10.1016/b978-0-7020-3935-5.00058-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Luiz LN, Leite JPG, Yokosawa J, Carneiro BM, Pereira Filho E, Oliveira TFDM, Freitas GROE, Costa LF, Paula NTD, Silveira HLD, Nepomuceno JC, Queiróz DAO. Molecular characterization of adenoviruses from children presenting with acute respiratory disease in Uberlândia, Minas Gerais, Brazil, and detection of an isolate genetically related to feline adenovirus. Mem Inst Oswaldo Cruz 2010; 105:712-6. [DOI: 10.1590/s0074-02762010000500019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Accepted: 04/27/2010] [Indexed: 11/22/2022] Open
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Berkley JA, Munywoki P, Ngama M, Kazungu S, Abwao J, Bett A, Lassauniére R, Kresfelder T, Cane PA, Venter M, Scott JAG, Nokes DJ. Viral etiology of severe pneumonia among Kenyan infants and children. JAMA 2010; 303:2051-7. [PMID: 20501927 PMCID: PMC2968755 DOI: 10.1001/jama.2010.675] [Citation(s) in RCA: 238] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Pneumonia is the leading cause of childhood death in sub-Saharan Africa. Comparative estimates of the contribution of causative pathogens to the burden of disease are essential for targeted vaccine development. OBJECTIVE To determine the viral etiology of severe pneumonia among infants and children at a rural Kenyan hospital using comprehensive and sensitive molecular diagnostic techniques. DESIGN, SETTING, AND PARTICIPANTS Prospective observational and case-control study during 2007 in a rural Kenyan district hospital. Participants were children aged 1 day to 12 years, residing in a systematically enumerated catchment area, and who either were admitted to Kilifi District Hospital meeting World Health Organization clinical criteria for severe pneumonia or very severe pneumonia; (2) presented with mild upper respiratory tract infection but were not admitted; or (3) were well infants and children attending for immunization. MAIN OUTCOME MEASURES The presence of respiratory viruses and the odds ratio for admission with severe disease. RESULTS Of 922 eligible admitted patients, 759 were sampled (82% [median age, 9 months]). One or more respiratory viruses were detected in 425 of the 759 sampled (56% [95% confidence interval {CI}, 52%-60%]). Respiratory syncytial virus (RSV) was detected in 260 participants (34% [95% CI, 31%-38%]) and other respiratory viruses were detected in 219 participants (29%; 95% CI, 26%-32%), the most common being Human coronavirus 229E (n = 51 [6.7%]), influenza type A (n = 44 [5.8%]), Parainfluenza type 3 (n = 29 [3.8%]), Human adenovirus (n = 29 [3.8%]), and Human metapneumovirus (n = 23 [3.0%]). Compared with well control participants, detection of RSV was associated with severe disease (5% [corrected] in control participants; adjusted odds ratio, 6.11 [95% CI, 1.65-22.6]) while collectively, other respiratory viruses were not associated with severe disease (23% in control participants; adjusted odds ratio, 1.27 [95% CI, 0.64-2.52]). CONCLUSION In a sample of Kenyan infants and children admitted with severe pneumonia to a rural hospital, RSV was the predominant viral pathogen.
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Affiliation(s)
- James A Berkley
- Kenya Medical Research Institute, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.
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Weckx LY, Fernandes MMA, Monteiro AIMP, Souza AR, Moraes-Pinto MID. Optimization strategy to minimize wastage of palivizumab during the 2008 RSV season in São Paulo, Brazil. J Trop Pediatr 2009; 55:341-2. [PMID: 19203985 DOI: 10.1093/tropej/fmp003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Palivizumab is currently recommended to high-risk children as a prophylaxis for respiratory syncytial virus (RSV) infection. However, it is still very expensive for developing countries like Brazil. Herein, we describe our strategy to minimize wastage of Palivizumab during the 2008 RSV season. Appointments were fixed for 304 children on 2 days of the week, so that a mean of 19.9 children received Palivizumab per day. That allowed remaining volumes of Palivizumab vials to be pooled and used for other children on the same day within the 6 h period after opening a vial. That strategy saved 26.3% of vials, which represents USD $749,143.75.
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Marinheiro JC, Sanalios RB, Santos DCD, Costa CAD, Hársi CM. Duplex-PCR assay for the detection of adenovirus and respiratory syncytial virus in nasopharyngeal samples. Mem Inst Oswaldo Cruz 2009; 104:118-20. [PMID: 19274386 DOI: 10.1590/s0074-02762009000100018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 01/13/2009] [Indexed: 11/21/2022] Open
Abstract
Human adenovirus (HAdV) and human respiratory syncytial virus (HRSV) are important etiologic agents of acute respiratory infections. In this study, a duplex polymerase chain reaction (PCR) assay was developed for the simultaneous detection of HAdV and HRSV in clinical samples. Sixty previously screened nasopharyngeal aspirates were used: 20 HAdV-positive, 20 HRSV-positive and 20 double-negative controls. Eight samples were positive for both viruses. The duplex PCR assay proved to be as sensitive and specific as single-target assays and also detected the mixed infections with certainty. The identification of both viruses in a single reaction offers a reduction in both cost and laboratory diagnostic time.
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Affiliation(s)
- Juliana Cristina Marinheiro
- Laboratório de Biologia Molecular de Adenovírus, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brasil, 05508-900
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Positive selection results in frequent reversible amino acid replacements in the G protein gene of human respiratory syncytial virus. PLoS Pathog 2009; 5:e1000254. [PMID: 19119418 PMCID: PMC2603285 DOI: 10.1371/journal.ppat.1000254] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 12/04/2008] [Indexed: 11/23/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) is the major cause of lower respiratory tract infections in children under 5 years of age and the elderly, causing annual disease outbreaks during the fall and winter. Multiple lineages of the HRSVA and HRSVB serotypes co-circulate within a single outbreak and display a strongly temporal pattern of genetic variation, with a replacement of dominant genotypes occurring during consecutive years. In the present study we utilized phylogenetic methods to detect and map sites subject to adaptive evolution in the G protein of HRSVA and HRSVB. A total of 29 and 23 amino acid sites were found to be putatively positively selected in HRSVA and HRSVB, respectively. Several of these sites defined genotypes and lineages within genotypes in both groups, and correlated well with epitopes previously described in group A. Remarkably, 18 of these positively selected tended to revert in time to a previous codon state, producing a “flip-flop” phylogenetic pattern. Such frequent evolutionary reversals in HRSV are indicative of a combination of frequent positive selection, reflecting the changing immune status of the human population, and a limited repertoire of functionally viable amino acids at specific amino acid sites. As part of the Viral Genetic Diversity Network (VGDN), we sequenced the second variable region (G2) of the G protein of human respiratory syncytial virus (HRSV) A and B from 568 patients sampled during 11 consecutive HRSV seasons (1995–2005) in the state of São Paulo, Brazil. A total of 933 HRSVA and 673 HRSB time-stamped sequences, including those sampled here and globally, was used for phylogenetic inference and the analysis of selection pressures. We identified 18 positively selected sites in both HRSVA (9 sites) and HRSVB (9 sites) that tended to revert in time to their previous codon state (i.e. exhibited a “flip-flop” pattern). We argue that these common evolutionary reversals are indicative of frequent positive selection, reflecting the changing immune status of the human population, coupled with a limited repertoire of functional viable amino acids at specific sites. This information is of particular importance since the ectodomain of the G protein is also a target site in vaccines that have so far proven unsuccessful and because it constitutes a significant step towards describing and understanding the immune-escape repertoire of this major human pathogen.
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Oliveira TFM, Freitas GRO, Ribeiro LZG, Yokosawa J, Siqueira MM, Portes SAR, Silveira HL, Calegari T, Costa LF, Mantese OC, Queiróz DAO. Prevalence and clinical aspects of respiratory syncytial virus A and B groups in children seen at Hospital de Clínicas of Uberlândia, MG, Brazil. Mem Inst Oswaldo Cruz 2008; 103:417-22. [PMID: 18797752 DOI: 10.1590/s0074-02762008000500002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 07/07/2008] [Indexed: 11/22/2022] Open
Abstract
Respiratory syncytial virus (RSV) is well recognized as the most important pathogen causing acute respiratory disease in infants and young children, mainly in the form of bronchiolitis and pneumonia. Two major antigenic groups, A and B, have been identified; however, there is disagreement about the severity of the diseases caused by these two types. This study investigated a possible association between RSV groups and severity of disease. Reverse transcription-polymerase chain reaction was used to characterize 128 RSV nasopharyngeal specimens from children less than five years old experiencing acute respiratory disease. A total of 82 of 128 samples (64.1%) could be typed, and, of these, 78% were group A, and 22% were group B. Severity was measured by clinical evaluation associated with demographic factors: for RSV A-infected patients, 53.1% were hospitalized, whereas for RSV B patients, 27.8% were hospitalized (p = 0.07). Around 35.0% of the patients presented risk factors for severity (e.g., prematurity). For those without risk factors, the hospitalization occurred in 47.6% of patients infected with RSV A and in 18.2% infected with RSV B. There was a trend for RSV B infections to be milder than those of RSV A. Even though RSV A-infected patients, including cases without underlying condition and prematurity, were more likely to require hospitalization than those infected by RSV B, the disease severity could not to be attributed to the RSV groups.
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Affiliation(s)
- T F M Oliveira
- Laboratório de Virologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
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do Nascimento CA, Leal AL, Souza TS, de Moraes CTP, Comone P, Tenório ECN, Vedovello D, Quinzani RHA, Gilio AE, Vieira SE, Durigon EL, Botosso VF, Sant'Anna OA. One-step reverse transcriptase polymerase chain reaction for the diagnosis of respiratory syncytial virus in children. J Virol Methods 2008; 148:115-9. [PMID: 18068812 DOI: 10.1016/j.jviromet.2007.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Revised: 10/22/2007] [Accepted: 10/26/2007] [Indexed: 10/22/2022]
Abstract
Human respiratory syncytial virus (HRSV) is the main cause of acute lower respiratory tract infections in infants and children. Rapid diagnosis is required to permit appropriate care and treatment and to avoid unnecessary antibiotic use. Reverse transcriptase (RT-PCR) and indirect immunofluorescence assay (IFA) methods have been considered important tools for virus detection due to their high sensitivity and specificity. In order to maximize use-simplicity and minimize the risk of sample cross-contamination inherent in two-step techniques, a RT-PCR method using only a single tube to detect HRSV in clinical samples was developed. Nasopharyngeal aspirates from 226 patients with acute respiratory illness, ranging from infants to 5 years old, were collected at the University Hospital of the University of Sao Paulo (HU-USP), and tested using IFA, one-step RT-PCR, and semi-nested RT-PCR. One hundred and two (45.1%) samples were positive by at least one of the three methods, and 75 (33.2%) were positive by all methods: 92 (40.7%) were positive by one-step RT-PCR, 84 (37.2%) by IFA, and 96 (42.5%) by the semi-nested RT-PCR technique. One-step RT-PCR was shown to be fast, sensitive, and specific for RSV diagnosis, without the added inconvenience and risk of false positive results associated with semi-nested PCR. The combined use of these two methods enhances HRSV detection.
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Vidal LR, Siqueira MM, Nogueira MB, Raboni SM, Pereira LA, Takahashi GR, Rotta I, Debur MDC, Dalla-Costa LM. The epidemiology and antigenic characterization of influenza viruses isolated in Curitiba, South Brazil. Mem Inst Oswaldo Cruz 2008; 103:180-5. [PMID: 18425270 DOI: 10.1590/s0074-02762008000200009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 03/25/2008] [Indexed: 11/22/2022] Open
Abstract
Several studies conducted all over the world have reported that the influenza virus is associated with great morbidity and mortality rates. In this study, we analyzed the incidence of the influenza virus between 2000 and 2003 in Curitiba. We studied 1621 samples obtained from outpatients and hospitalized patients of both sexes and all ages. The study was conducted at the local primary care health units (outpatients) and at the tertiary care unit (hospitalized) of the General Hospital of the Federal University in the state of Paraná, Brazil. Nasopharyngeal aspirates and, eventually, bronchoalveolar lavage were assayed for the presence of viral antigens, either by indirect immunofluorescence or cell culture. Of the samples studied, 135 (8.3%) were positive for influenza virus, and of those, 103 (76.3%) were positive for type A and 32 (23.7%) for type B. Additionally, positive samples were analyzed by reverse transcription followed by polymerase chain reaction and subtypes H1 and H3 were identified from this group. A high incidence of positive samples was observed mainly in the months with lower temperatures. Furthermore, outpatients showed a higher incidence of influenza viruses than hospitalized patients.
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Affiliation(s)
- Luine Rr Vidal
- Laboratório de Biologia Molecular para Doenças Infecciosa, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, 80060-240, Brasil.
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Camargo PABD, Pinheiro AT, Hercos ACR, Ferrari GF. Oxigenoterapia inalatória em pacientes pediátricos internados em hospital universitário. REVISTA PAULISTA DE PEDIATRIA 2008. [DOI: 10.1590/s0103-05822008000100007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar o uso da oxigenoterapia inalatória em crianças internadas em hospital universitário. MÉTODOS: Estudo prospectivo de crianças atendidas no Pronto-Socorro Pediátrico do Hospital das Clínicas da Faculdade de Medicina de Botucatu e que receberam oxigenoterapia durante a internação, de maio a setembro de 2005. Indicou-se oxigenoterapia se saturação de oxigênio inferior a 90% e frequência respiratória elevada para idade. Crianças em uso crônico de oxigênio ou com necessidade de ventilação mecânica foram excluídas. Foram avaliados: sintomas respiratórios, diagnósticos clínicos, saturação de oxigênio, método e tempo de oxigenoterapia e responsável pela prescrição. RESULTADOS: Foram atendidas 8.709 crianças no pronto-socorro, sendo que 2.769 (32%) apresentaram doenças respiratórias e 97 necessitaram de internação na enfermaria. Destas, 62 (64%) receberam oxigenoterapia. Das 62 crianças, 37 eram do sexo masculino e a idade variou de 2 meses a 14 anos (mediana: 8 meses). A causa de hipóxia foi pneumonia em 52 crianças (84%), asma em cinco, bronquiolite em quatro e traqueomalácia em uma. As prescrições de oxigenoterapia foram feitas por médicos, com monitoração de saturação de oxigênio por oxímetro de pulso. O tempo mediano de administração de O2 foi 6 dias e o cateter nasal foi usado em 94% dos casos, sendo raro o uso de máscaras ou capuz de oxigênio. CONCLUSÕES: A oxigenoterapia inalatória foi mais frequente em crianças com menor idade e em pacientes com pneumonia, sendo sua indicação compatível com critérios internacionais. O uso do cateter nasal mostrou-se seguro, simples, efetivo e de baixo custo.
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Abstract
Respiratory syncytial virus (RSV) presents as yearly epidemics in temperate climates. We analysed the association of atmospheric conditions to RSV epidemics in San Luis Potosí, S.L.P., Mexico. The weekly number of RSV detections from October 2002 and May 2006 were correlated to ambient temperature, barometric pressure, relative humidity, vapour tension, dew point, precipitation, and hours of light using time-series and regression analyses. Of the variation in RSV cases, 49.8% was explained by the study variables. Of the explained variation in RSV cases, 32.5% was explained by the study week and 17.3% was explained by meteorological variables (average daily temperature, maximum daily temperature, temperature at 08:00 hours, and relative humidity at 08:00 hours). We concluded that atmospheric conditions, particularly temperature, partly explain the year to year variability in RSV activity. Identification of additional factors that affect RSV seasonality may help develop a model to predict the onset of RSV epidemics.
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Vieira SE, Gilio AE, Durigon EL, Ejzenberg B. Lower respiratory tract infection caused by respiratory syncytial virus in infants: the role played by specific antibodies. Clinics (Sao Paulo) 2007; 62:709-16. [PMID: 18209912 DOI: 10.1590/s1807-59322007000600009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Accepted: 08/30/2007] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is a major etiological agent of lower respiratory tract infection in infants. Genotypes of this virus and the role of the infants' serum antibodies have yet to be fully clarified. This knowledge is important for the development of effective therapeutic and prophylactic measures. OBJECTIVES To evaluate the types and genotypes of RSV causing respiratory tract infection in infants, to analyze the association of subtype-specific serum antibodies with the occurrence of infection and to evaluate the presence of subtype-specific antibodies in the infants' mothers and their association with the profile of the childrens' serum antibodies. METHODS This was a prospective study on infants hospitalized with respiratory infection. Nasopharyngeal secretions were collected for viral investigation using indirect immunofluorescence and viral culture and blood was collected to test for antibodies using the Luminex Multiplex system. RESULTS 192 infants were evaluated, with 60.9% having RSV (73.5%- A and 20.5% B). Six genotypes of the virus were identified: A5, A2, B3, B5, A7 and B4. The seroprevalence of the subtype-specific serum antibodies was high. The presence and levels of subtype-specific antibodies were similar, irrespective of the presence of infection or the viral type or genotype. The mothers' antibody profiles were similar to their infants'. CONCLUSIONS Although the prevalence of subtype-specific antibodies was elevated, these antibodies did not provide protection independently of virus type/genotype. The similarity in the profiles of subtype-specific antibodies presented by the mothers and their children was consistent with transplacental passage.
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Affiliation(s)
- Sandra E Vieira
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
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Almeida-Junior AA, da Silva MTN, Almeida CCB, Ribeiro JD. Relationship between physiologic deadspace/tidal volume ratio and gas exchange in infants with acute bronchiolitis on invasive mechanical ventilation. Pediatr Crit Care Med 2007; 8:372-7. [PMID: 17545938 DOI: 10.1097/01.pcc.0000269389.51189.a8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the association between deadspace/tidal volume ratio (Vd/Vt) and gas exchange variables: Pao2, Paco2, Pao2/Fio2, arterial/alveolar oxygen tension ratio (Pao2/PAo2), alveolar-arterial oxygen tension difference/arterial oxygen tension ratio (P(A-a)o2/Pao2), carbon dioxide production (Vco2), ventilation index ([Paco2 x peak inspiratory pressure x mechanical respiratory rate]/1000), and oxygenation index ([mean airway pressure x Fio2 x 100]/Pao2), all measured at an early stage in children with obstructive acute respiratory failure. DESIGN Prospective, cross-sectional, observational study. SETTING Pediatric intensive care unit, university hospital. PATIENTS Twenty-nine infants with acute bronchiolitis, defined according to clinical and radiologic criteria. Children with chronic pulmonary disease, neuromuscular disease, congenital cardiopathies, or hemodynamic instability were excluded. INTERVENTIONS Measurements were made between 24 and 72 hrs of mechanical ventilation using volumetric capnography and arterial blood gas analysis. MEASUREMENTS AND MAIN RESULTS The following variables significantly correlated with Vd/Vt, calculated using Spearman's correlation coefficient (rs): Pao2 (rs = -0.63, p < .001), Pao2/Fio2 (rs = -0.56, p = .002), Pao2/PAo2 (rs = -0.46, p = .012), P(A-a)o2/Pao2 (rs = -0.46, p = .012), Paco2 (rs = 0.51, p = .005), Vco2 (rs = -0,62, p < .01), oxygenation index (rs = 0.48, p = .009), and ventilation index (rs = -0.53, p = .003). A statistically significant association was found between an increase in Vd/Vt and severity of lung injury, defined as Pao2/Fio2 <200 (p = .03, Mann-Whitney). CONCLUSIONS In the study population, Vd/Vt not only reflected ventilatory disorders, as is well recognized, but also was associated with disturbances of oxygenation. These results warrant further evaluation of the usefulness of serial measurement of Vd/Vt as a marker of disease severity in severe acute bronchiolitis and other causes of respiratory failure.
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Affiliation(s)
- Armando A Almeida-Junior
- Pediatric Intensive Care Unit, Center for Investigation in Pediatrics, State University of Campinas Medical School, Campinas, SP, Brazil.
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D'Souza RM, Bambrick HJ, Kjellstrom TE, Kelsall LM, Guest CS, Hanigan I. Seasonal variation in acute hospital admissions and emergency room presentations among children in the Australian Capital Territory. J Paediatr Child Health 2007; 43:359-65. [PMID: 17489825 DOI: 10.1111/j.1440-1754.2007.01080.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To examine seasonal variation in hospital use for five paediatric conditions of the Australian Capital Territory residents. METHODS Hospital admissions (1993-2004) and emergency room (ER) presentations (1999-2004) for asthma, croup, bronchiolitis, other respiratory conditions and diarrhoea of children aged <5 years were compared by month and season. RESULTS The five conditions comprised 14% of admissions and 24% of ER presentations of children aged <5 years. Bronchiolitis (both admissions and ER presentations) were the highest in the 0-1 year age group (>80%) and the other four conditions peaked at 1-2 years. Children aged 0-2 years contributed 66% of diarrhoea, 62% of croup and 44% of other respiratory admissions whereas ER presentations were higher for other respiratory conditions (57%) and lower for croup (47%). Boys showed higher rates of admissions and ER presentations for all conditions except diarrhoea. Strong seasonal associations were apparent. Incident rate ratios of admissions were significantly higher in autumn compared with summer for asthma and croup whereas bronchiolitis and other respiratory conditions admissions were the highest in winter. Diarrhoea admissions were the highest in spring. ER presentations of the five conditions also showed similar associations with season. CONCLUSION Hospital admissions and ER presentations of these five conditions showed strong seasonal patterns, knowledge of which could contribute to improved resource planning (staffing) to meet expected increases in demand for services and scheduling of elective admissions. These findings could be extended to develop a model for forecasting hospital use and to explore the causes of these diseases to ameliorate seasonal effects.
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Affiliation(s)
- Rennie M D'Souza
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
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Moura PO, Roberto AF, Hein N, Baldacci E, Vieira SE, Ejzenberg B, Perrini P, Stewien KE, Durigon EL, Mehnert DU, Hársi CM. Molecular epidemiology of human adenovirus isolated from children hospitalized with acute respiratory infection in São Paulo, Brazil. J Med Virol 2007; 79:174-81. [PMID: 17177301 DOI: 10.1002/jmv.20778] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In a study of acute respiratory disease, two collections of nasopharyngeal aspirates (NPA) were obtained from children hospitalized at the Pediatric Clinic of the University Hospital, São Paulo, in 1995 and 2000. Adenovirus was detected in 33 (8.2%) of 401 children followed. These viruses were isolated in HEp-2, HEK-293, or NCI-H292 cells and serotyped by neutralization. The genome types were determined after restriction analyses of the genomic DNA extracted from infected cells. Nineteen isolates were characterized as Human adenovirus B, genome types HAdV-3a, HAdV-7h, and HAdV-7h1; 11 as Human adenovirus C, genome types HAdV-1D10, HAdV-2D25, HAdV-5D2, and HAdV-6D3. Our findings show that species C adenoviruses present an endemic infection pattern, with co-circulation of different serotypes and genome types; no new genomic variant was observed. Species B adenoviruses showed epidemic infection patterns, with shifts in the predominant genome type. The isolates from 1995 belong to genome type 7h, or the variant 7h1, with a clear substitution of the type 7b, prevalent in São Paulo for more then 10 years. In 2000, the variant 7h1 predominated and the emergence of the type 3a was observed. Almost 10 years passed between the identification of HAdV-7h in Argentina and its detection in São Paulo. The geographic isolation of these two countries was reduced by the increase in population mobility due to growing commercial relationships.
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Affiliation(s)
- Patrícia O Moura
- Department of Microbiology, Virology Laboratories, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Costa LF, Yokosawa J, Mantese OC, Oliveira TFM, Silveira HL, Nepomuceno LL, Moreira LS, Dyonisio G, Rossi LMG, Oliveira RC, Ribeiro LZG, Queiróz DAO. Respiratory viruses in children younger than five years old with acute respiratory disease from 2001 to 2004 in Uberlândia, MG, Brazil. Mem Inst Oswaldo Cruz 2006; 101:301-6. [PMID: 16862327 DOI: 10.1590/s0074-02762006000300014] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 04/27/2006] [Indexed: 11/22/2022] Open
Abstract
The main viruses involved in acute respiratory diseases among children are: respiratory syncytial virus (RSV), influenzavirus (FLU), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV). The purpose of the present study was to identify respiratory viruses that affected children younger than five years old in Uberlândia, Midwestern Brazil. Nasopharyngeal aspirates from 379 children attended at Hospital de Clínicas (HC/UFU), from 2001 to 2004, with acute respiratory disease, were collected and tested by immunofluorescence assay (IFA) to detect RSV, FLU A and B, PIV 1, 2, and 3 and AdV, and RT-PCR to detect HRV. RSV was detected in 26.4% (100/379) of samples, FLU A and B in 9.5% (36/379), PIV 1, 2 and 3 in 6.3% (24/379) and AdV in 3.7% (14/379). HRV were detected in 29.6% (112/379) of the negative and indeterminate samples tested by IFI. RSV, particularly among children less than six months of life, and HRV cases showed highest incidence. Negative samples by both IFA and RT-PCR might reflect the presence of other pathogens, such as hMPV, coronavirus, and bacteria. Laboratorial diagnosis constituted an essential instrument to determine the incidence of the most common viruses in respiratory infections among children in this region.
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Affiliation(s)
- L F Costa
- Laboratório de Virologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, 38400-902, Brasil
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D'Elia C, Siqueira MM, Portes SA, Sant'Anna CC. Infecções do trato respiratório inferior pelo vírus sincicial respiratório em crianças hospitalizadas menores de um ano de idade. Rev Soc Bras Med Trop 2005; 38:7-10. [PMID: 15717087 DOI: 10.1590/s0037-86822005000100002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Analisou-se características clínicas e evolutivas em crianças menores de um ano internadas com infecção do trato respiratório inferior por vírus sincicial respiratório (VSR). Feito estudo transversal com 89 lactentes hospitalizados durante as épocas de maior incidência do VSR, em 1997 e 1998, na cidade do Rio de Janeiro. Foram pesquisados antígenos virais, nas secreções de nasofaringe, com anticorpos monoclonais anti-VSR, antiinfluenza A e B e antiparainfluenza tipo 3, por ensaio de imunofluorescência indireta. Formaram-se três grupos: bronquiolite ou bronquite sibilante (n=44), pneumonia (n=26) e bronquiolite e pneumonia (n=19). Houve positividade para o VSR em 42 (47,1%) pacientes. Em 1997 a média de dias de oxigenoterapia foi de 5,2 e em 1998, de 2,5 dias (p> 0,05). Não houve diferença de apresentação clínica entre os lactentes que apresentaram positividade para o VSR e aqueles cujo resultado foi negativo. A sensibilidade e especificidade da sibilância em relação ao isolamento de VSR foram 85% e 65%, respectivamente. O VSR foi o principal causador de infeções do trato respiratório inferior em lactentes que necessitaram de hospitalização.
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Affiliation(s)
- Cláudio D'Elia
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ
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Tsuchiya LRRV, Costa LMD, Raboni SM, Nogueira MB, Pereira LA, Rotta I, Takahashi GRA, Coelho M, Siqueira MM. Viral respiratory infection in Curitiba, Southern Brazil. J Infect 2005; 51:401-7. [PMID: 16321652 DOI: 10.1016/j.jinf.2004.12.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Accepted: 12/04/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Viral infection is the major cause of respiratory tract pathology affecting individuals of all ages, especially children and immunocompromised patients. There is a paucity of data on etiological and epidemiological infection caused by virus, in Southern Brazil. The aim of this study was to evaluate the seasonality, and the incidence of the viruses involved in respiratory infections in Curitiba, South Brazil. METHODS Two hundred seventy-three nasopharyngeal aspirates (NPA) from primary care health units and 1348 NPA or bronchoalveolar lavages from a tertiary-care teaching hospital were studied. Viruses were identified by indirect immunofluorescence and cellular culture. RESULTS Thirty percent of tested samples scored positive for the presence of virions. The percentages of infection for each virus from outpatients and hospitalized, respectively, were 3.3, 19.3 for respiratory syncytial virus; 13.9, 3.5 for influenza A, 3.0, 1.7 for influenza B; 3.3, 5.6 for parainfluenza virus and 2.2, 0.8 for adenovirus. A higher incidence of positive results was found during the winter season, thus showing a pattern of seasonality. CONCLUSION Viral agents are one of the main etiologies of respiratory tract pathology in the population studied.
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Affiliation(s)
- Luine R R V Tsuchiya
- Laboratory of Virology, Hospital de Clínicas da Universidade Federal do Paraná, Brazil.
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Bhatt JM, Everard ML. Do environmental pollutants influence the onset of respiratory syncytial virus epidemics or disease severity? Paediatr Respir Rev 2004; 5:333-8. [PMID: 15531259 DOI: 10.1016/j.prrv.2004.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The trigger for annual epidemics of respiratory syncytial virus (RSV) infections and the factors contributing to the disappearance of RSV infections in late winter remain obscure. Similarly, there is no adequate explanation for the higher morbidity and admission rates in industrialised as compared with rural areas. It has been suggested that a variety of environmental factors such as temperature, daylight and humidity may influence the onset and waning of the epidemics. However, the few studies assessing these variables fail to support such a link. In many tropical countries the annual epidemic occurs in the summer or autumn, arguing against temperature having a direct influence. A number of studies have suggested that indoor pollutants, including cigarette smoke, are associated with an increased likelihood of being admitted to hospital with severe lower respiratory tract disease. One study exploring the potential role of outdoor pollutants on the pattern of RSV related illness in infancy was unable to identify a clear link between a variety of pollutants and the timing of the epidemic. Nitric oxide levels were higher in winter than during the summer and much higher winter peaks of NO were observe in industrialised areas as compared with urban and rural areas. Whether this or other environmental pollutants contribute to the higher incidence of severe disease in industrialised areas is unclear. Further work is required to explore the possible influence of NO and other environmental pollutants on both the timing and severity of epidemics.
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Affiliation(s)
- Jayesh M Bhatt
- Pediatric Respiratory Unit, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK
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Moura FEA, Blanc A, Frabasile S, Delfraro A, de Sierra MJ, Tome L, Ramos EAG, Siqueira MM, Arbiza J. Genetic diversity of respiratory syncytial virus isolated during an epidemic period from children of northeastern Brazil. J Med Virol 2004; 74:156-60. [PMID: 15258982 DOI: 10.1002/jmv.20159] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Outbreaks of human respiratory syncytial virus (HRSV) are the leading cause of serious acute lower respiratory viral disease in many countries in different continents. Data on clinical and epidemiological aspects of HRSV infections in this country have been reported, but there is lack of data regarding the molecular epidemiology of this virus in Salvador. The genetic variability of HRSV isolated during an outbreak in Salvador, Brazil (1999) has been analysed. Partial sequences of the G protein gene of 13 isolates from antigenic group A and 4 isolates from antigenic group B of HRSV were determined. Nucleotide sequences of C-terminal G gene were compared to sequences of HRSV isolates from countries of South America and from the rest of the world available at the GenBank. Brazilian group A and B isolates were clustered into previously characterised genotypes: GA5, GA2, GA7, and GB3, SAB3, respectively. This is the first study of GA7 and SAB3 genotypes circulation in South American countries. It is interesting to point out that viruses isolated in Salvador appear to be closer related with those from Montevideo-Uruguay and Buenos Aires, Argentina strains, suggesting circulation of similar strains among different South American countries in different seasons. Moreover, viruses closely related genetically circulated in the same year in Salvador and distant places such as Mozambique, supporting the previous suggestion on the complexity of HRSV strain circulation patterns, and the high capability of HRSV spreading world-wide.
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Affiliation(s)
- Fernanda Edna Araújo Moura
- Laboratório de Patología e Doenças Virais, Centro de Pesquisa Gonçalo Moniz, FIOCRUZ, Rua Waldemar Falcão, Brotas, Salvador, Bahia, Brazil
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Moura FEA, Borges LC, Portes SAR, Ramos EAG, Siqueira MM. Respiratory syncytial virus infections during an epidemic period in Salvador, Brazil. Viral antigenic group analysis and description of clinical and epidemiological aspects. Mem Inst Oswaldo Cruz 2003; 98:739-43. [PMID: 14595448 DOI: 10.1590/s0074-02762003000600005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acute respiratory infections (ARI) caused by respiratory syncytial virus (RSV) were studied in 482 children from Salvador, BA, Brazil, over a period of 12 months. The epidemic period of RSV infections in Salvador occurred from February (summer) to August (winter), with peaks in May, June, and July. The grouping characteristics of 84 RSV present in nasopharyngeal secretions of children seen at a reference university hospital were analyzed. RSV represented 17.4% of all cases and 54.5% of the positive samples. Sixty-four RSV strains were assigned to group A and 14 to group B. Both groups circulated in the five months of the epidemic period studied. Infections by both groups of RSV were more frequent in children up to one year of age. The incidence of RSV ARI was slightly more frequent in males, although group B had more infected females.
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Affiliation(s)
- Fernanda Edna Araújo Moura
- Laboratório de Patologia e Doenças Virais, Centro de Pesquisas Gonçalo Moniz-Fiocruz, 40295-001 Salvador, BA, Brasil.
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Vieira SE, Gilio AE, Miyao CR, Pahl MMC, Lotufo JPB, Hein N, Betta SL, Durigon EL, Botosso V, Ejzenberg B, Okay Y. Nosocomial respiratory syncytial virus infection in a pediatric ward. Infect Control Hosp Epidemiol 2003; 24:468-9. [PMID: 12887231 DOI: 10.1086/503481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vieira RA, Diniz EMA, Vaz FAC. Clinical and laboratory study of newborns with lower respiratory tract infection due to respiratory viruses. J Matern Fetal Neonatal Med 2003; 13:341-50. [PMID: 12916686 DOI: 10.1080/jmf.13.5.341.350] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine the prevalence of lower respiratory tract infection due to respiratory viruses in the neonatal period at admission to the neonatal intensive care unit and to compare the clinical, laboratory and radiological aspects of the clinical course, according to the etiological agent, in the neonatal period. METHODS Ninety newborns were studied, from January 1999 to January 2001, with bronchiolitis and/or pneumonia. The newborns were classified into three groups, according to the etiological agent identified initially: viral infection (group A), mixed viral-bacterial infection (group B), and bacterial infection (group C). RESULTS The virus was identified in 72 newborns (80.0%); the most prevalent was respiratory syncytial virus (RSV) (44.4%), followed by influenza A virus (22.2%). Coughing, wheezing and an interstitial infiltrate were significantly more frequent in newborns with viral infection. Mixed infection was more associated with sepsis. There was a correlation between viral infection and low values of initial and subsequent white blood cell count and C-reactive protein. RSV was the most important virus in these patients. CONCLUSIONS It was observed that, although the majority of viral respiratory infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial infection.
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Affiliation(s)
- R A Vieira
- Department of Pediatrics, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
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