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Townsend JP, Hassler HB, Lamb AD, Sah P, Alvarez Nishio A, Nguyen C, Tew AD, Galvani AP, Dornburg A. Seasonality of endemic COVID-19. mBio 2023; 14:e0142623. [PMID: 37937979 PMCID: PMC10746271 DOI: 10.1128/mbio.01426-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/04/2023] [Indexed: 11/09/2023] Open
Abstract
IMPORTANCE The seasonality of COVID-19 is important for effective healthcare and public health decision-making. Previous waves of SARS-CoV-2 infections have indicated that the virus will likely persist as an endemic pathogen with distinct surges. However, the timing and patterns of potentially seasonal surges remain uncertain, rendering effective public health policies uninformed and in danger of poorly anticipating opportunities for intervention, such as well-timed booster vaccination drives. Applying an evolutionary approach to long-term data on closely related circulating coronaviruses, our research provides projections of seasonal surges that should be expected at major temperate population centers. These projections enable local public health efforts that are tailored to expected surges at specific locales or regions. This knowledge is crucial for enhancing medical preparedness and facilitating the implementation of targeted public health interventions.
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Affiliation(s)
- Jeffrey P. Townsend
- Department of Biostatistics, Yale School of Public Health, New Haven, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, USA
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, USA
- Program in Microbiology, Yale University, New Haven, USA
| | - Hayley B. Hassler
- Department of Biostatistics, Yale School of Public Health, New Haven, USA
| | - April D. Lamb
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, USA
| | - Pratha Sah
- Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, USA
| | | | - Cameron Nguyen
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, USA
| | - Alexandra D. Tew
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, USA
| | - Alison P. Galvani
- Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, USA
| | - Alex Dornburg
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, USA
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2
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Fang LC, Wang JY, Yu HH, Wang LC, Chiang BL. Respiratory-syncytial virus immunoprophylaxis on asthma symptoms development in prematurity with bronchopulmonary dysplasia. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100161. [PMID: 37781666 PMCID: PMC10510012 DOI: 10.1016/j.jacig.2023.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/15/2023] [Accepted: 06/16/2023] [Indexed: 10/03/2023]
Abstract
Background Infants with respiratory-syncytial virus bronchiolitis hospitalization are more likely to develop wheezing and subsequent asthma. Reportedly, palivizumab prophylaxis effectively prevents respiratory-syncytial virus hospitalization in high-risk children-such as premature infants or infants with bronchopulmonary dysplasia (BPD). Objective We sought to explore the effect of respiratory-syncytial virus immunoprophylaxis on the risk of asthma development in premature infants with BPD in subtropical areas. Methods This case-control study included preterm children with BPD born at Mackay Memorial Hospital, Taipei, Taiwan, from 1999 to 2015. Overall, medical records of 616 eligible participants were retrospectively collected from their birth to the time they attained an age of 5 to 20 years. The primary outcome was onset of active asthma. Results Overall, 576 consecutive cases met the inclusion criteria. Of these, 306 (53.2%) patients had palivizumab exposure and 191 (33.2%) were diagnosed with asthma. Patients with history of respiratory-syncytial virus bronchiolitis hospitalization had a higher risk of developing asthma in the future (adjusted odds ratio, 3.77; 95% CI, 2.30-6.20, P < .001; hazard ratio, 2.56; 95% CI, 1.81-3.62, P < .001). Palivizumab prophylaxis reduced future asthma development through the inhibition of respiratory-syncytial virus bronchiolitis hospitalization (coefficient, -0.021; 95% CI, -0.031 to -0.011, P = .027). Asthmatic children who received palivizumab immunoprophylaxis had a lesser active asthma duration than those who did not (P = .005). Conclusions Children with BPD with hospitalization for respiratory-syncytial virus bronchiolitis had higher risk of developing asthma compared with those without respiratory-syncytial virus infection. Prophylactic palivizumab might reduce later asthma development through inhibition of respiratory-syncytial virus bronchiolitis hospitalization. For those already developing asthma, palivizumab could reduce active asthma duration.
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Affiliation(s)
- Li-Ching Fang
- Section of Pediatric Allergy and Immunology, Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Jen-Yu Wang
- Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsin-Hui Yu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Chieh Wang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Bor-Luen Chiang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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3
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Lee PI, Liu CC, Hu YL, Chen JM. Seasonality and risk factor analysis of respiratory syncytial virus infection in children in Taiwan-A retrospective study from 1995 to 2005. J Med Virol 2023; 95:e29116. [PMID: 37772669 DOI: 10.1002/jmv.29116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023]
Abstract
Respiratory syncytial virus (RSV) is one of the important pathogens leading to acute respiratory tract infection in infants and young children. We aimed to investigate the seasonality of RSV infection in different parts of Taiwan and to delineate the risk factors for severe RSV infections. We collected RSV-infected patients' data by retrospective chart review. A total of 1740 RSV-infected children aged under 18 years were enrolled. The infection was acquired during hospitalization in 103 (7.1%) children, while none of them required ventilator support or needed intensive care before RSV infection. The need for intensive care or ventilator support was significantly associated with congenital heart disease (CHD), chronic lung disease, and neuromuscular diseases. Age <1 year and nosocomially acquired infection are also significant predictors for the need of intensive care. Only the presence of CHD, especially acyanotic CHD, was significantly associated with a fatal outcome. RSV infection occurs all year round. Monthly distribution of RSV infections in Northern Taiwan showed a bimodal pattern, with one peak from March to May, and another from August to October. The distribution in Southern Taiwan showed a single peak from April to July. The occurrence of RSV correlates positively with temperature and rain. The bimodal seasonal distribution pattern in Northern Taiwan may be a transitional pattern shifting from a single high winter peak in temperate areas to a wider summer peak in tropical areas. Continuous surveillance is needed to explore the possible effect of global warming on the seasonality of RSV infection.
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Affiliation(s)
- Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ya-Li Hu
- Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
| | - Jong-Min Chen
- Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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4
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Redlberger-Fritz M, Springer DN, Aberle SW, Camp JV, Aberle JH. Respiratory syncytial virus surge in 2022 caused by lineages already present before the COVID-19 pandemic. J Med Virol 2023; 95:e28830. [PMID: 37282809 DOI: 10.1002/jmv.28830] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
In 2022, Austria experienced a severe respiratory syncytial virus (RSV) epidemic with an earlier-than-usual start (Weeks 35/2021-45/2022) and increased numbers of pediatric patients in emergency departments. This surge came 2 years after a season with no cases detected as a result of coronavirus disease 2019 nonpharmaceutical interventions. We analyzed epidemiologic patterns and the phylodynamics of RSV based on approximately 30 800 respiratory specimens collected year-round over 10 years from ambulatory and hospitalized patients from 248 locations in Austria. Genomic surveillance and phylogenetic analysis of 186 RSV-A and 187 RSV-B partial glycoprotein sequences collected from 2018 to 2022 revealed that the 2022/2023 surge was driven by RSV-B in contrast to the surge in the 2021/2022 season that was driven by RSV-A. Whole-genome sequencing and phylodynamic analysis indicated that the RSV-B strain GB5.0.6a was the predominant genotype in the 2022/2023 season and emerged in late 2019. The results provide insight into RSV evolution and epidemiology that will be applicable to future monitoring efforts with the advent of novel vaccines and therapeutics.
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Affiliation(s)
| | - David N Springer
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Stephan W Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Jeremy V Camp
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Judith H Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
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5
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Kachikis AB, Cho H, Englund JA. Respiratory Syncytial Virus-An Update for Prenatal and Primary Health Providers. Obstet Gynecol Clin North Am 2023; 50:421-437. [PMID: 37149320 DOI: 10.1016/j.ogc.2023.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Respiratory syncytial virus (RSV) infection is a significant cause of morbidity and mortality among infants aged younger than 1 year, adults aged 65 years or older, and immunocompromised persons. Limited data exist on RSV infection in pregnancy and further research is needed. Strides are being made to develop vaccines, including vaccines for maternal immunization, as well as monoclonal antibodies for disease prevention.
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Affiliation(s)
- Alisa B Kachikis
- Department of Obstetrics & Gynecology, University of Washington, 1959 Northeast Pacific Street, Box 356460, Seattle, WA 98195, USA.
| | - Hye Cho
- SUNY Upstate Medical University, Syracuse, NY, USA
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Hospital Pediatric Infectious Diseases, Seattle Children's Hospital Research Institute, University of Washington, Seattle, WA, USA
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Pruccoli G, Castagno E, Raffaldi I, Denina M, Barisone E, Baroero L, Timeus F, Rabbone I, Monzani A, Terragni GM, Lovera C, Brach del Prever A, Manzoni P, Barbaglia M, Roasio L, De Franco S, Calitri C, Lupica M, Felici E, Marciano C, Santovito S, Militerno G, Abrigo E, Curtoni A, Quarello P, Bondone C, Garazzino S. The Importance of RSV Epidemiological Surveillance: A Multicenter Observational Study of RSV Infection during the COVID-19 Pandemic. Viruses 2023; 15:v15020280. [PMID: 36851494 PMCID: PMC9963567 DOI: 10.3390/v15020280] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The restrictive measures adopted worldwide against SARS-CoV-2 produced a drastic reduction in respiratory pathogens, including RSV, but a dramatic rebound was thereafter reported. In this multicenter retrospective observational study in 15 Pediatric Emergency Departments, all children <3 years old with RSV infection admitted between 1 September and 31 December 2021 were included and compared to those admitted in the same period of 2020 and 2019. The primary aim was to evaluate RSV epidemiology during and after the COVID-19 pandemic peak. The secondary aims were to evaluate the clinical features of children with RSV infection. Overall, 1015 children were enrolled: 100 in 2019, 3 in 2020 and 912 in 2021. In 2019, the peak was recorded in December, and in 2021, it was recorded in November. Comparing 2019 to 2021, in 2021 the median age was significantly higher and the age group 2-3 years was more affected. Admissions were significantly higher in 2021 than in 2020 and 2019, and the per-year hospitalization rate was lower in 2021 (84% vs. 93% in 2019), while the duration of admissions was similar. No difference was found in severity between 2019-2020-2021. In conclusion, after the COVID-19 pandemic, an increase in RSV cases in 2021 exceeding the median seasonal peak was detected, with the involvement of older children, while no difference was found in severity.
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Affiliation(s)
- Giulia Pruccoli
- Infectious Diseases Unit, Department of Pediatrics, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Emanuele Castagno
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Irene Raffaldi
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Marco Denina
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Elisa Barisone
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Correspondence: ; Tel.: +39-0113135396
| | - Luca Baroero
- Department of Pediatrics, Martini Hospital, 10141 Turin, Italy
| | - Fabio Timeus
- Pediatrics Department, Chivasso Hospital, 10034 Chivasso (TO), Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Alice Monzani
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | | | - Cristina Lovera
- Department of Pediatrics, A.O. S.Croce e Carle, 12100 Cuneo, Italy
| | | | - Paolo Manzoni
- Department of Pediatrics, Ospedale Degli Infermi di Ponderano, University of Turin, 13900 Biella, Italy
| | | | - Luca Roasio
- Department of Pediatrics, Edoardo Agnelli Hospital, 10064 Pinerolo (TO), Italy
| | - Simona De Franco
- Department of Pediatrics, Ospedale di Borgomanero, 28021 Borgomanero (NO), Italy
| | - Carmelina Calitri
- Department of Pediatrics, Ospedale di Rivoli, 10098 Rivoli (TO), Italy
| | - Maddalena Lupica
- Department of Pediatrics, Ospedale di Rivoli, 10098 Rivoli (TO), Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children’s Hospital, AO SS Antonio e Biagio e C. Arrigo, 15121 Alessandria, Italy
| | - Cinzia Marciano
- Pediatric and Pediatric Emergency Unit, Children’s Hospital, AO SS Antonio e Biagio e C. Arrigo, 15121 Alessandria, Italy
| | - Savino Santovito
- Department of Pediatrics, Ospedale Maria Vittoria, ASL Città di Torino, 10143 Turin, Italy
| | - Gaia Militerno
- Department of Pediatrics, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Enrica Abrigo
- Department of Pediatrics, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Antonio Curtoni
- Microbiology and Virology Unit, Molinette Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Paola Quarello
- Department of Pediatric Onco-Hematology, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Claudia Bondone
- Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Silvia Garazzino
- Infectious Diseases Unit, Department of Pediatrics, University of Turin, Regina Margherita Children’s Hospital, A.O.U. Città Della Salute e della Scienza di Torino, 10126 Turin, Italy
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Garba MA, Giwa FJ, Adelaiye H, Olorukooba AA, Abdullahi F, Makarfi H, Löwensteyn Y, Bont L, Abdurraheem F, Uudu E, Mudasir H, Mazur NI. Epidemiology of Respiratory Syncytial Virus-Associated Acute Lower Respiratory Tract Infection among Hospitalized Under-5s in Northwestern Nigeria. J PEDIAT INF DIS-GER 2023. [DOI: 10.1055/s-0042-1760446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Objective Globally, 33 million cases of respiratory syncytial virus (RSV) infections occur annually among under-fives (5s). Ninety-nine percent of deaths from RSV occur in low- and middle-income countries. Under-five pneumonia mortality in Nigeria was estimated at 140,520 in 2017, but RSV epidemiological data are scant due to poor awareness and limited testing. Vaccines for RSV are currently under development and RSV mortality data from this high mortality, low resource setting are essential to maximizing the potential benefit of vaccination as well as promoting vaccine uptake. This study aimed to describe the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) in children younger than 5 years in Zaria, Northwestern Nigeria.
Methods A prospective cohort study was conducted among children aged 1 month to 5 years who were hospitalized with ALRTI in the Emergency Pediatric Unit of a tertiary hospital in Zaria from November 2018 to October 2019. Naso-pharyngeal swabs were obtained for RSV testing using a point-of-care immunoassay technique.
Results Thirty-three percent (35/106) of the children had RSV-related ALRTI. The median age of RSV-positive cases was 8 months (IQR 3–14). Two-thirds of children (68.6%, 24/35) were below 12 months. The RSV mortality rate was 5.7% (2/35). RSV occurred in 10 months of the year with peaks in March and July.
Conclusion A third of admitted children with ALRTI were positive for RSV. Therefore RSV significantly contributes to childhood pneumonia and the dual seasonal peak observed in our study may have implications for vaccine implementation.
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Affiliation(s)
- Maria Ahuoiza Garba
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Fatima Jummai Giwa
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Hamdala Adelaiye
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Abiola Aira Olorukooba
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Fatima Abdullahi
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Hauwa Makarfi
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Yvette Löwensteyn
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Louis Bont
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Fadlullah Abdurraheem
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Ehi Uudu
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Halima Mudasir
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
| | - Natalie I Mazur
- Department of Pediatric Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
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Hsu HT, Huang FL, Ting PJ, Chang CC, Chen PY. The epidemiological features of pediatric viral respiratory infection during the COVID-19 pandemic in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1101-1107. [PMID: 34756671 PMCID: PMC8501510 DOI: 10.1016/j.jmii.2021.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Enhanced nonpharmaceutical interventions (NPIs) to prevent the Coronavirus Disease 2019 (COVID-19) have shown various levels of impact on common respiratory pathogens. We aimed to analyze the epidemiological changes seen in certain common respiratory viruses found in Taiwanese children (e.g., influenza virus, enterovirus, parainfluenza virus, adenovirus and respiratory syncytial virus (RSV)) after the implementation of public health measures, as well as interpret the possible meaning of these changes. METHODS This retrospective observational study examined the viral isolation from children younger than 18 years at a medical center in central Taiwan during the period January 2015-December 2020, a time frame of six years. Viral isolations prior to the COVID-19 pandemic (January 2015-December 2019), along with those during the post-COVID-19 period (January-December 2020) were analyzed and compared. RESULTS A total of 6899 throat swab samples were collected during the pre-pandemic period of 2015-2019, with 2681 of them having a positive result (38.86%). There were a total of 713 samples collected in 2020, with 142 of them showing positive results (19.92%). The overall positive rate of viral isolates significantly decreased in 2020 (p < 0.001). Declines in the isolation of the influenza virus, parainfluenza virus, adenovirus and enterovirus were observed. The RSV surprisingly became the leading isolate, with up to 47 (6.59%) instances in 2020, and showing an unusual peak in the winter of 2020. The rise began in September of 2020 and reached its plateau in November of that year. CONCLUSIONS Most respiratory viruses decreased under NPIs regarding SARS-CoV-2. However, the RSV outbreak in the winter of 2020 had shown the limitation of current NPIs. Possible explanations have been discussed in details and public preventive measures should be reinforced for RSV, particularly amongst people having young children both at home and in care centers.
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Affiliation(s)
- Hao-Ting Hsu
- Section of Pediatric Infectious Disease, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Fang-Liang Huang
- Section of Pediatric Infectious Disease, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Pei-Ju Ting
- Section of Pediatric Infectious Disease, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chun-Chih Chang
- Division of Clinical Microbiology, Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yen Chen
- Section of Pediatric Infectious Disease, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
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9
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Hoang U, Button E, Armstrong M, Okusi C, Ellis J, Zambon M, Anand S, Delanerolle G, Hobbs FDR, van Summeren J, Paget J, de Lusignan S. Assessing the Clinical and Socioeconomic Burden of Respiratory Syncytial Virus in Children Aged Under 5 Years in Primary Care: Protocol for a Prospective Cohort Study in England and Report on the Adaptations of the Study to the COVID-19 Pandemic. JMIR Res Protoc 2022; 11:e38026. [PMID: 35960819 PMCID: PMC9415952 DOI: 10.2196/38026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/21/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) commonly causes lower respiratory tract infections and hospitalization in children. In 2019-2020, the Europe-wide RSV ComNet standardized study protocol was developed to measure the clinical and socioeconomic disease burden of RSV infections among children aged <5 years in primary care. RSV has a recognized seasonality in England. Objective We aimed to describe (1) the adaptations of the RSV ComNet standardized study protocol for England and (2) the challenges of conducting the study during the COVID-19 pandemic. Methods This study was conducted by the Oxford-Royal College of General Practitioners Research and Surveillance Centre—the English national primary care sentinel network. We invited all (N=248) general practices within the network that undertook virology sampling to participate in the study by recruiting eligible patients (registered population: n=3,056,583). Children aged <5 years with the following case definition of RSV infection were included in the study: those consulting a health care practitioner in primary care with symptoms meeting the World Health Organization’s definition of acute respiratory illness or influenza-like illness who have laboratory-confirmed RSV infection. The parents/guardians of these cases were asked to complete 2 previously validated questionnaires (14 and 30 days postsampling). A sample size of at least 100 RSV-positive cases is required to estimate the percentage of children that consult in primary care who need hospitalization. Assuming a swab positivity rate of 20% in children aged <5 years, we estimated that 500 swabs are required. We adapted our method for the pandemic by extending sampling planned for winter 2020-2021 to a rolling data collection, allowing verbal consent and introducing home swabbing because of increased web-based consultations during the COVID-19 pandemic. Results The preliminary results of the data collection between International Organization for Standardization (ISO) weeks 1-41 in 2021 are described. There was no RSV detected in the winter of 2020-2021 through the study. The first positive RSV swab collected through the sentinel network in England was collected in ISO week 17 and then every week since ISO week 25. In total, 16 (N=248, 6.5%) of the virology-sampling practices volunteered to participate; these were high-sampling practices collecting the majority of eligible swabs across the sentinel network—200 (43.8%) out of 457 swabs, of which 54 (N=200, 27%) were positive for RSV. Conclusions Measures to control the COVID-19 pandemic meant there was no circulating RSV last winter; however, RSV has circulated out of season, as detected by the sentinel network. The sentinel network practices have collected 40% (200/500) of the required samples, and 27% (54/200) were RSV positive. We have demonstrated the feasibility of implementing a European-standardized RSV disease burden study protocol in England during a pandemic, and we now need to recruit to this adapted protocol. International Registered Report Identifier (IRRID) DERR1-10.2196/38026
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Affiliation(s)
- Uy Hoang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Elizabeth Button
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Cecilia Okusi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Joanna Ellis
- Reference Microbiology Services, United Kingdom Health Security Agency, London, United Kingdom
| | - Maria Zambon
- Reference Microbiology Services, United Kingdom Health Security Agency, London, United Kingdom
| | - Sneha Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gayathri Delanerolle
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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10
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Impact of COVID-19 on the Changing Patterns of Respiratory Syncytial Virus Infections. Infect Dis Rep 2022; 14:558-568. [PMID: 35893478 PMCID: PMC9394296 DOI: 10.3390/idr14040059] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
Seasonal epidemics of respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children. Preventive measures implemented to reduce the spread of SARS-CoV-2, including facemasks, stay-at-home orders, closure of schools and local-national borders, and hand hygiene, may have also prevented the transmission of RSV and influenza. However, with the easing of COVID-19 imposed restrictions, many regions are noticing a delayed RSV outbreak. Some of these regions have also noted an increase in severity of these delayed RSV outbreaks partly due to a lack of protective immunity in the community following a lack of exposure from the previous season. Lessons learned from the COVID-19 pandemic can be implemented for controlling RSV outbreaks, including: (1) measures to reduce the spread, (2) effective vaccine development, and (3) genomic surveillance tools and computational modeling to predict the timing and severity of RSV outbreaks. These measures can help reduce the severity and prepare the health care system to deal with future RSV outbreaks by appropriate and timely allocation of health care resources.
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11
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Epidemiological and Clinical Characteristics of Respiratory Syncytial Virus Infections in Children Aged <5 Years in China, from 2014−2018. Vaccines (Basel) 2022; 10:vaccines10050810. [PMID: 35632566 PMCID: PMC9147122 DOI: 10.3390/vaccines10050810] [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: 03/23/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Respiratory syncytial virus (RSV) is an important pathogen that causes acute respiratory tract infections in children. To understand the epidemiological and clinical characteristics of RSV in children, we analyzed the RSV diagnostic testing results from the 2014−2018 surveillance of acute respiratory infections in China. Among children aged <5 years, RSV incidence during 2014−2018 was 17.3% (3449/19,898), and 89.1% of RSV-positive individuals were inpatients. Children aged < 6 months had a high proportion in RSV infected individual (n = 1234; 35.8%). The highest RSV detection rate was in winter, RSV-A and RSV-B co-circulated year-round and jointly prevailed in 2015−2016. Cough was the common symptom of RSV infection 93.2% (3216/3449). Compared with older children, those aged <6 months were more likely to show breathing difficulty or lung rale that further developed into bronchopneumonia (p < 0.001). The symptoms such as cough, running nose, and diarrhea had significant differences between the RSV-A and RSV-B groups. The rate of RSV co-detection with other viruses or bacteria was 35.4%. Those coinfected with other viruses had a significantly higher incidence of fever, whereas those coinfected with bacteria had higher incidences of breathing difficulty and severe pneumonia. Our findings highlight the need for accumulating epidemiological information for the prevention and control of RSV.
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12
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Tiwari L. COVID-19 and outbreak of other respiratory infections: Call for national registries. JOURNAL OF PEDIATRIC CRITICAL CARE 2022. [DOI: 10.4103/jpcc.jpcc_54_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Rios Guzman E, Hultquist JF. Clinical and biological consequences of respiratory syncytial virus genetic diversity. Ther Adv Infect Dis 2022; 9:20499361221128091. [PMID: 36225856 PMCID: PMC9549189 DOI: 10.1177/20499361221128091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common etiological agents of global acute respiratory tract infections with a disproportionate burden among infants, individuals over the age of 65, and immunocompromised populations. The two major subtypes of RSV (A and B) co-circulate with a predominance of either group during different epidemic seasons, with frequently emerging genotypes due to RSV's high genetic variability. Global surveillance systems have improved our understanding of seasonality, disease burden, and genomic evolution of RSV through genotyping by sequencing of attachment (G) glycoprotein. However, the integration of these systems into international infrastructures is in its infancy, resulting in a relatively low number (~2200) of publicly available RSV genomes. These limitations in surveillance hinder our ability to contextualize RSV evolution past current canonical attachment glycoprotein (G)-oriented understanding, thus resulting in gaps in understanding of how genetic diversity can play a role in clinical outcome, therapeutic efficacy, and the host immune response. Furthermore, utilizing emerging RSV genotype information from surveillance and testing the impact of viral evolution using molecular techniques allows us to establish causation between the clinical and biological consequences of arising genotypes, which subsequently aids in informed vaccine design and future vaccination strategy. In this review, we aim to discuss the findings from current molecular surveillance efforts and the gaps in knowledge surrounding the consequence of RSV genetic diversity on disease severity, therapeutic efficacy, and RSV-host interactions.
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Affiliation(s)
- Estefany Rios Guzman
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Judd F. Hultquist
- Robert H. Lurie Medical Research Center,
Northwestern University, 9-141, 303 E. Superior St., Chicago, IL 60611,
USA
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
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14
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Pellegrinelli L, Galli C, Bubba L, Seiti A, Anselmi G, Primache V, Signorini L, Delbue S, Binda S, Pariani E. Respiratory syncytial virus in pediatric influenza-like illness cases in Lombardy, Northern Italy, during seven consecutive winter seasons (from 2014-2015 to 2020-2021). Influenza Other Respir Viruses 2021; 16:481-491. [PMID: 34921508 PMCID: PMC8983902 DOI: 10.1111/irv.12940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza‐like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10 million inhabitants) from 2014–2015 to 2020–2021 winter seasons. Material and Methods Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet). Results RSV accounted for nearly 19% of pediatric ILI with a risk of infection nearly two‐fold greater than that of individuals ≥15 years. RSV positivity rate increased to 28% considering 0–5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly two‐fold higher than the risk of RSV infection, the age group 4–6 months and 7–12 months showed a five‐fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with pre‐existing underlying health conditions had a nearly five‐fold greater risk of getting RSV infection than otherwise healthy 0–5 years old children. RSV was identified in ILI cases <15 years of age in all considered winter seasons except in the 2020–2021 season. Discussion Sentinel surveillance of ILI allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing, and intensity of the RSV and influenza community circulation. This surveillance approach can be implemented to assess the RSV circulation and impact in a real‐time manner.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Arlinda Seiti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lucia Signorini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), University of Genoa, Genoa, Italy
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15
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Clinical Epidemiological Characteristics and Risk Factors for Severe Bronchiolitis Caused by Respiratory Syncytial Virus in Vietnamese Children. Int J Pediatr 2021; 2021:9704666. [PMID: 34819958 PMCID: PMC8608547 DOI: 10.1155/2021/9704666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Bronchiolitis is the most prevalent cause of hospitalization in infants under the age of 12 months. The disease is caused by respiratory syncytial virus (RSV) infection, which can cause breathing difficulties and respiratory failure. Therefore, it is necessary to discover the risk factors of severe bronchiolitis to diagnose and treat promptly. This study is aimed at describing the epidemiological characteristics and clinical features of acute bronchiolitis caused by RSV and assessing the related factors to severe acute bronchiolitis in studied patients. Methods A descriptive cross-sectional study was carried out in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from October 1, 2016, to September 30, 2017. All bronchiolitis admissions < 2 years were included. Results 377 children were evaluated, including 261 boys and 116 girls; children under 6 months accounted for the highest proportion (57%), and 47 (12.5%) of all patients had severe disease. Wheezing was the main reason to be taken to the hospital 261 (69.2%). Clinical symptoms of acute bronchiolitis such as cough, tachypnea, and runny nose were found in all patients. Bronchiolitis cases increased in the winter-spring season, and the highest registered number of patients was 42 in March. Image of bronchiolitis on chest X-ray was found in all patients, and air trapping lung was found in 124 (32.9%) patients. The risk factors included age (≤6 months), low birth weight, preterm birth, nonbreastfeeding for the first six months, early weaning, and exposition to cigarette smoke increased the severe disease (p < 0.05). Conclusion The number of hospitalized infants with bronchiolitis caused by RSV has an upward trend during the winter-spring season (from October to March). This study confirms that age, preterm birth, breastfeeding under 6 months, history of exposure to cigarette smoking, low birth weight, having sibling(s) under five years old going to kindergarten, history of undergoing cesarean section, history of mechanical ventilation, poor living condition, and maternal education are 10 risk factors of severe bronchiolitis caused by RSV.
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16
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Di Mattia G, Nenna R, Mancino E, Rizzo V, Pierangeli A, Villani A, Midulla F. During the COVID-19 pandemic where has respiratory syncytial virus gone? Pediatr Pulmonol 2021; 56:3106-3109. [PMID: 34273135 PMCID: PMC8441855 DOI: 10.1002/ppul.25582] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/07/2021] [Accepted: 07/07/2021] [Indexed: 01/09/2023]
Abstract
The diffusion of the SARS-CoV-2 virus and the implementation of restrictive measures led to a drastic reduction of respiratory syncytial virus (RSV) diffusion. Few RSV cases have been detected worldwide, even after the removal of the restrictions. We review the current literature and present possible explanations on why there has been a significant reduction of RSV detection during the COVID-19 pandemic. We also hypothesize what may happen when RSV begins to circulate again. The increase of an immunologically naïve population, with infants born from mothers who have not reinforced their immunity to RSV, could lead to greater RSV epidemics in the coming seasons. It is crucial to prepare the scientific community and to keep RSV surveillance active to avoid dramatic consequences.
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Affiliation(s)
- Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Rizzo
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, affiliated to Istituto Pasteur Italia, Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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17
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Simões EAF, Dani V, Potdar V, Crow R, Satav S, Chadha MS, Hessong D, Carosone-Link P, Palaskar S, Satav A. Mortality From Respiratory Syncytial Virus in Children Under 2 Years of Age: A Prospective Community Cohort Study in Rural Maharashtra, India. Clin Infect Dis 2021; 73:S193-S202. [PMID: 34472578 PMCID: PMC8411248 DOI: 10.1093/cid/ciab481] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although respiratory syncytial virus (RSV) is the most important viral cause of lower respiratory tract infection deaths in infants, there are few data on infant community deaths caused by RSV. METHODS This was an active surveillance of children younger than 2 years of age in 93 villages, 5 primary health centers, and 3 hospitals serving these villages. Village health workers and counselors at the health facilities monitored all lower respiratory tract infections (LRTIs) in consented subjects. Children with severe, or very severe LRTIs and all who died, had nasopharyngeal swabs collected for detection of RSV by molecular methods. RESULTS In the 12 134 subjects, there were 2064 episodes of severe LRTIs and 1732 of very severe LRTIs, of which 271 and 195, respectively, had RSV. Fifteen of 16 (94%) children with RSV died of LRTIs, 14 in the community and 1 in the hospital. The case fatality ratios for severe RSV LRTIs in the first 6 months of life were 3/52 (7.1%) and 1/36 (2.8%) in the community and hospital, respectively. Of those with very severe LRTIs in the community, 17.6% died. There were no very severe RSV LRTI hospital deaths. The adjusted RSV LRTI mortality rates ranged from 1.0 to 3.0/1000 child-years (CY) overall, and 2.0 to 6.1/1000 CY, accounting for 20% of the LRTI deaths and 10% of the postneonatal infant mortality. CONCLUSIONS Community deaths from RSV account for the majority of RSV LRTI deaths, and efforts at prevention should be preferentially directed at populations where access to care is limited.
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Affiliation(s)
- Eric A F Simões
- Department of Paediatric Infectious Diseases, University of Colorado School of Medicine and Children’s Hospital Colorado Aurora, Colorado, USA
- Centre for Global Health, Department of Epidemiology,Colorado School of Public Health, Aurora, Colorado, USA
| | - Vibhawari Dani
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
| | - Varsha Potdar
- National Institute of Virology, Indian Counsel of Medical Research, Pune, India
| | - Rowena Crow
- Department of Paediatric Infectious Diseases, University of Colorado School of Medicine and Children’s Hospital Colorado Aurora, Colorado, USA
| | - Shilpa Satav
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
| | - Mandeep S Chadha
- National Institute of Virology, Indian Counsel of Medical Research, Pune, India
| | - Danielle Hessong
- Department of Paediatric Infectious Diseases, University of Colorado School of Medicine and Children’s Hospital Colorado Aurora, Colorado, USA
| | - Phyllis Carosone-Link
- Department of Paediatric Infectious Diseases, University of Colorado School of Medicine and Children’s Hospital Colorado Aurora, Colorado, USA
| | - Sameer Palaskar
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
| | - Ashish Satav
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
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18
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang QS, Wood T, Guiomar R, Rodrigues AP, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Demont C, Bangert M, Dückers M, van Summeren J, Paget J. Defining the seasonality of respiratory syncytial virus around the world: National and subnational surveillance data from 12 countries. Influenza Other Respir Viruses 2021; 15:732-741. [PMID: 34255934 PMCID: PMC8542954 DOI: 10.1111/irv.12885] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract infections and have a major burden on society. For prevention and control to be deployed effectively, an improved understanding of the seasonality of RSV is necessary. Objectives The main objective of this study was to contribute to a better understanding of RSV seasonality by examining the GERi multi‐country surveillance dataset. Methods RSV seasons were included in the analysis if they contained ≥100 cases. Seasonality was determined using the “average annual percentage” method. Analyses were performed at a subnational level for the United States and Brazil. Results We included 601 425 RSV cases from 12 countries. Most temperate countries experienced RSV epidemics in the winter, with a median duration of 10–21 weeks. Not all epidemics fit this pattern in a consistent manner, with some occurring later or in an irregular manner. More variation in timing was observed in (sub)tropical countries, and we found substantial differences in seasonality at a subnational level. No association was found between the timing of the epidemic and the dominant RSV subtype. Conclusions Our findings suggest that geographical location or climatic characteristics cannot be used as a definitive predictor for the timing of RSV epidemics and highlight the need for (sub)national data collection and analysis.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Universidad Agraria del Ecuador, Guayaquil, Ecuador.,Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
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19
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Park KY, Seo S, Han J, Park JY. Respiratory virus surveillance in Canada during the COVID-19 pandemic: An epidemiological analysis of the effectiveness of pandemic-related public health measures in reducing seasonal respiratory viruses test positivity. PLoS One 2021; 16:e0253451. [PMID: 34143839 PMCID: PMC8213179 DOI: 10.1371/journal.pone.0253451] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 06/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Various public health measures have been implemented globally to counter the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to evaluate respiratory virus surveillance data to determine the effectiveness of such interventions in reducing transmission of seasonal respiratory viruses. Method We retrospectively analysed data from the Respiratory Virus Detection Surveillance System in Canada, before and during the COVID-19 pandemic, by interrupted time series regression. Results The national level of infection with seasonal respiratory viruses, which generally does not necessitate quarantine or contact screening, was greatly reduced after Canada imposed physical distancing and other quarantine measures. The 2019–2020 influenza season ended earlier than it did in the previous year. The influenza virus was replaced by rhinovirus/enterovirus or parainfluenza virus in the previous year, with the overall test positivity remaining at approximately 35%. However, during the 2019–2020 post-influenza period, the overall test positivity of respiratory viruses during the COVID-19 was still low (7.2%). Moreover, the 2020–2021 influenza season had not occurred by the end of February 2021. Conclusion Respiratory virus surveillance data may provide real-world evidence of the effectiveness of implemented public health interventions during the current and future pandemics.
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Affiliation(s)
- Kyu Young Park
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumin Seo
- Division of Biostatistics, Hallym Institute for Clinical Medicine, Hallym University Medical Center, Anyang, Republic of Korea
| | - Junhee Han
- Department of Statistics, Hallym University, Chuncheon, Republic of Korea
| | - Ji Young Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
- * E-mail:
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20
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The burden of Respiratory Syncytial Virus (RSV) infection in the Middle East and North Africa (MENA) region across age groups: A systematic review. Vaccine 2021; 39:3803-3813. [PMID: 34099329 DOI: 10.1016/j.vaccine.2021.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022]
Abstract
Respiratory Syncytial Virus (RSV) is a common respiratory virus that generally causes a mild illness in children and adults or severe symptoms with complications in infants and the elderly, particularly in the presence of underlying comorbidities. While epidemiological data about this virus are available globally, data from the Middle East and North Africa (MENA) region are still scarce. For this reason, we conducted a systematic review to determine the burden of RSV disease in the MENA region by searching the available literature up until September 2018. A total of 1242 studies were retrieved of which 90 were included in the review. Most of the included studies were conducted in subjects aged 0-18 years with the majority being in children below 3 years of age, while only 2 studies included exclusively adults above 18 years of age. RSV infection rates varied greatly between different studies on hospitalized subjects and ranged between 4% and 82%, while the range was smaller in studies on outpatient subjects (between 6% and 36%). When calculating the RSV infection rates in the hospitalized subjects with different inclusion criteria, we found that it was 19%, 70%, and 33% among subjects admitted with Acute Respiratory Infections (ARIs), Acute Lower Respiratory Infections (ALRIs), and bronchiolitis, respectively. RSV infections were most common during the winter season. With regards to complications, intensive care unit admissions ranged between 1% and 15%, while the need for mechanical ventilation ranged between 1% and 10%. The overall RSV related mortality rate across all age groups in studies included in our review was 1.9%. This review identifies several limitations in the existing data and under-representation of the adult population. Future studies should be providing more evidence on the RSV burden in adults and children with comorbidities in order to better assess the potential impact of future preventive strategies in the MENA region.
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21
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Kim S, Williams TC, Viboud C, Campbell H, Chen J, Spiro DJ. RSV genomic diversity and the development of a globally effective RSV intervention. Vaccine 2021; 39:2811-2820. [PMID: 33895016 DOI: 10.1016/j.vaccine.2021.03.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/23/2022]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of serious lower respiratory tract illness in infants and children and causes significant disease in the elderly and immunocompromised. Recently there has been an acceleration in the development of candidate RSV vaccines, monoclonal antibodies and therapeutics. However, the effects of RSV genomic variability on the implementation of vaccines and therapeutics remain poorly understood. To address this knowledge gap, the National Institute of Allergy and Infectious Diseases and the Fogarty International Center held a workshop to summarize what is known about the global burden and transmission of RSV disease, the phylogeographic dynamics and genomics of the virus, and the networks that exist to improve the understanding of RSV disease. Discussion at the workshop focused on the implications of viral evolution and genomic variability for vaccine and therapeutics development in the context of various immunization strategies. This paper summarizes the meeting, highlights research gaps and future priorities, and outlines what has been achieved since the meeting took place. It concludes with an examination of what the RSV community can learn from our understanding of SARS-CoV-2 genomics and what insights over sixty years of RSV research can offer the rapidly evolving field of COVID-19 vaccines.
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Affiliation(s)
- Sonnie Kim
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thomas C Williams
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Harry Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | | | - David J Spiro
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
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Linssen RS, den Hollander B, Bont L, van Woensel JBM, Bem RA. The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis. Pathogens 2021; 10:pathogens10050567. [PMID: 34067031 PMCID: PMC8150834 DOI: 10.3390/pathogens10050567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.
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Affiliation(s)
- Rosalie S. Linssen
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
- Amsterdam Reproduction & Development (AR&D) and the Amsterdam Infection & Immunity (AR&I) Research Institutes Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-20-56-62453-E
| | - Bibiche den Hollander
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Louis Bont
- UMCU Laboratory of Translational Immunology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3584 EA Utrecht, The Netherlands;
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, 3703 CD Zeist, The Netherlands
| | - Job B. M. van Woensel
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Reinout A. Bem
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
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23
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Roy D, Ghosh R, Dubey S, Dubey MJ, Benito-León J, Kanti Ray B. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci 2021; 48:9-24. [PMID: 32753076 PMCID: PMC7533477 DOI: 10.1017/cjn.2020.173] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Albeit primarily a disease of respiratory tract, the 2019 coronavirus infectious disease (COVID-19) has been found to have causal association with a plethora of neurological, neuropsychiatric and psychological effects. This review aims to analyze them with a discussion of evolving therapeutic recommendations. METHODS PubMed and Google Scholar were searched from 1 January 2020 to 30 May 2020 with the following key terms: "COVID-19", "SARS-CoV-2", "pandemic", "neuro-COVID", "stroke-COVID", "epilepsy-COVID", "COVID-encephalopathy", "SARS-CoV-2-encephalitis", "SARS-CoV-2-rhabdomyolysis", "COVID-demyelinating disease", "neurological manifestations", "psychosocial manifestations", "treatment recommendations", "COVID-19 and therapeutic changes", "psychiatry", "marginalised", "telemedicine", "mental health", "quarantine", "infodemic" and "social media". A few newspaper reports related to COVID-19 and psychosocial impacts have also been added as per context. RESULTS Neurological and neuropsychiatric manifestations of COVID-19 are abundant. Clinical features of both central and peripheral nervous system involvement are evident. These have been categorically analyzed briefly with literature support. Most of the psychological effects are secondary to pandemic-associated regulatory, socioeconomic and psychosocial changes. CONCLUSION Neurological and neuropsychiatric manifestations of this disease are only beginning to unravel. This demands a wide index of suspicion for prompt diagnosis of SARS-CoV-2 to prevent further complications and mortality.
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Affiliation(s)
- Devlina Roy
- Department of General Medicine, Burdwan Medical College, Burdwan, West Bengal, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College, Burdwan, West Bengal, India
| | - Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampore Mental Hospital, Behrampore, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital, “12 de Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
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24
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Viral Etiology of Acute Lower Respiratory Tract Infections in Hospitalized Children in Nagasaki, a Regional City of Japan in 2013-2015. Pediatr Infect Dis J 2020; 39:687-693. [PMID: 32221164 DOI: 10.1097/inf.0000000000002668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Acute lower respiratory tract infections (ALRIs) are the most common disease for hospitalized children in Japan. The aim of this study was to identify viruses in children hospitalized for ALRIs and to demonstrate epidemiologic and clinical characteristics in Japan. METHODS During a 2-year period from February 2013 to January 2015, we collected nasopharyngeal swab specimens from almost all hospitalized children with ALRIs in Nagasaki, a regional city of Japan, and its environs. Viruses were detected by multiplex polymerase chain reaction from these samples. RESULTS We detected one or more viruses from 259 (69%) of 374 patients, 227 of whom were infected with a single virus, 30 with 2, and 2 with 3 viruses. Detected viruses in this study were rhinovirus (46.4%), respiratory syncytial virus (29.7%), human metapneumovirus (6.8%), parainfluenza virus (5.5%), enterovirus D68 (3.4%), influenza virus (2.7%), adenovirus (2.4%), bocavirus (2.0%) and Coxsackie virus (1.0%). We detected a seasonal shift in respiratory syncytial virus outbreaks from the 2013-2014 to the 2014-2015 seasons. There was no significant difference in clinical course and severity among those viruses. Patients with a history of asthma or underlying diseases were older and more frequently required oxygen therapy than previously healthy patients. CONCLUSIONS Viral etiology in hospitalized children with ALRIs in Nagasaki, Japan, was similar to that in many other countries. Enterovirus D68, which was recently recognized as a causative agent of severe ALRIs, was also identified in this study area. Severity of ALRIs may depend on underlying disease rather than type of etiologic virus.
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25
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Brini I, Bhiri S, Ijaz M, Bouguila J, Nouri-Merchaoui S, Boughammoura L, Sboui H, Hannachi N, Boukadida J. Temporal and climate characteristics of respiratory syncytial virus bronchiolitis in neonates and children in Sousse, Tunisia, during a 13-year surveillance. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23379-23389. [PMID: 30569350 DOI: 10.1007/s11356-018-3922-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
This study established the correlation between respiratory syncytial virus (RSV) bronchiolitis and climate factors in the area of Sousse, Tunisia, during 13 years (2003-2015), from neonates and children <= 5 years old and hospitalized in Farhat Hached University-Hospital of Sousse. The meteorological data of Sousse including temperature, rainfall, and humidity were obtained. RSV detection was carried out with the direct immunofluorescence assay. The impact of climate factors on viral circulation was statistically analyzed. From 2003 to 2015, the total rate of RSV bronchiolitis accounted for 34.5% and peaked in 2007 and 2013. RSV infection was higher in male cases and pediatric environment (p<0.001) and was detected in 47.3% of hospitalizations in intensive care units. The epidemic of this pathogen started in October and peaked in January (41.6%). When the infectivity of RSV was at its maximum, the monthly average rainfall was high (31 mm) and the monthly average temperature and the monthly average humidity were at their minimum (11 °C and 66%, respectively). RSV activity was negatively correlated with temperature (r = - 0.78, p = 0.003) and humidity (r = - 0.62, p = 0.03). Regression analysis showed that the monthly average temperature fits into a linear model (R2 = 61%, p < 0.01). No correlation between RSV activity and rainfall was observed (p = 0.48). The meteorological predictions of RSV outbreaks with specific Tunisian climate parameters will help in determining the optimal timing of appropriate preventive strategies. In the area of Sousse, preventive measures should be enhanced since October especially, when the temperature is around 11 °C and humidity is above 60%.
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Affiliation(s)
- Ines Brini
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
| | - Sana Bhiri
- Department of Epidemiology and Medical Statistics, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Muhammad Ijaz
- Department of Pharmacy, COMSATS University Islamabad, Lahore CAMPUS, Lahore, Pakistan
| | - Jihene Bouguila
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | | | - Lamia Boughammoura
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Hassen Sboui
- Neonatology ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Naila Hannachi
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
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26
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The epidemiologic and clinical features of viral agents among hospitalized children with lower respiratory tract infections. Turk Arch Pediatr 2020; 55:166-173. [PMID: 32684762 PMCID: PMC7344125 DOI: 10.14744/turkpediatriars.2020.39114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/21/2020] [Indexed: 12/25/2022]
Abstract
Aim Acute respiratory tract infections are among the most common infectious diseases worldwide. Respiratory viruses are the leading cause of respiratory infections in children. Herein, we aimed to determine the epidemiologic and clinical feautures of viral agents among hospitalized children with lower respiratory tract infections. Material and Methods Nasopharyngeal swab specimens were obtained from the 422 patients hospitalized with a diagnosis of lower respiratory tract infections between December 2012 and December 2016. Multiplex reverse-transcription polymerase chain reaction was performed for the detection of viruses. Results Viral respiratory pathogens were detected in 311 patients (73.7%). In regard to respiratory virus subtypes, 103 patients (33.1%) had respiratory syncytial virus, 102 (32.7%) had human rhinovirus, 49 (15.7%) had multiple viruses, 15 (4.8%) had parainfluenzavirus, 13 (4.1%) had adenovirus, nine (2.8%) had human metapneumovirus, eight (2.5%) had human coronaviruses, six (1.9%) had bocavirus, five (1.6%) had influenza virus, and one patient (0.3%) had enterovirus. The median age was lower in patients with multiple viruses (p<0.001). The respiratory syncytial virus was more commonly detected in patients with a history of prematurity (p<0.001). Stridor was more common in other viruses including parainfluenza viruses (p<0.001). Conclusion Respiratory viruses are the main causative agents of respiratory tract infections in children. Timely and accurate detection of viruses is necessary in terms of public health. The detection of respiratory viruses also contributes to epidemiologic results and vaccine studies.
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27
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Li Y, Reeves RM, Wang X, Bassat Q, Brooks WA, Cohen C, Moore DP, Nunes M, Rath B, Campbell H, Nair H. Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis. LANCET GLOBAL HEALTH 2020; 7:e1031-e1045. [PMID: 31303294 DOI: 10.1016/s2214-109x(19)30264-5] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/16/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (<5 years) and older people (≥65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control. METHODS In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5° by 5° grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628. FINDINGS We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0·3 months [95% CI -0·3 to 0·9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3·8 months [3·6 to 4·0]) in temperate sites and longer duration (5·2 months [4·9 to 5·5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4·6 months [4·3 to 4·8]), as it was for metapneumovirus (4·8 months [4·4 to 5·1]). By comparison, parainfluenza virus had longer duration of epidemics (6·3 months [6·0 to 6·7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0·2 months [-0·6 to 0·1]; respiratory syncytial virus 0·1 months [-0·2 to 0·4]). INTERPRETATION This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. FUNDING European Union Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).
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Affiliation(s)
- You Li
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK
| | - Rachel M Reeves
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK
| | - Xin Wang
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - W Abdullah Brooks
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Disease, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - David P Moore
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta Nunes
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Barbara Rath
- Vienna Vaccine Safety Initiative, Berlin, Germany; School of Medicine, University of Nottingham, Nottingham, UK
| | - Harry Campbell
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK.
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Melo LDR, Oliveira H, Pires DP, Dabrowska K, Azeredo J. Phage therapy efficacy: a review of the last 10 years of preclinical studies. Crit Rev Microbiol 2020; 46:78-99. [DOI: 10.1080/1040841x.2020.1729695] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Luís D. R. Melo
- CEB – Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Hugo Oliveira
- CEB – Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Diana P. Pires
- CEB – Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Krystyna Dabrowska
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Joana Azeredo
- CEB – Centre of Biological Engineering, University of Minho, Braga, Portugal
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29
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Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? Viruses 2019; 12:v12010014. [PMID: 31861926 PMCID: PMC7020001 DOI: 10.3390/v12010014] [Citation(s) in RCA: 650] [Impact Index Per Article: 130.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 11/16/2022] Open
Abstract
Respiratory viruses infect the human upper respiratory tract, mostly causing mild diseases. However, in vulnerable populations, such as newborns, infants, the elderly and immune-compromised individuals, these opportunistic pathogens can also affect the lower respiratory tract, causing a more severe disease (e.g., pneumonia). Respiratory viruses can also exacerbate asthma and lead to various types of respiratory distress syndromes. Furthermore, as they can adapt fast and cross the species barrier, some of these pathogens, like influenza A and SARS-CoV, have occasionally caused epidemics or pandemics, and were associated with more serious clinical diseases and even mortality. For a few decades now, data reported in the scientific literature has also demonstrated that several respiratory viruses have neuroinvasive capacities, since they can spread from the respiratory tract to the central nervous system (CNS). Viruses infecting human CNS cells could then cause different types of encephalopathy, including encephalitis, and long-term neurological diseases. Like other well-recognized neuroinvasive human viruses, respiratory viruses may damage the CNS as a result of misdirected host immune responses that could be associated with autoimmunity in susceptible individuals (virus-induced neuro-immunopathology) and/or viral replication, which directly causes damage to CNS cells (virus-induced neuropathology). The etiological agent of several neurological disorders remains unidentified. Opportunistic human respiratory pathogens could be associated with the triggering or the exacerbation of these disorders whose etiology remains poorly understood. Herein, we present a global portrait of some of the most prevalent or emerging human respiratory viruses that have been associated with possible pathogenic processes in CNS infection, with a special emphasis on human coronaviruses.
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30
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Investigation of respiratory syncytial virus in children with respiratory tract infection by real-time polymerase chain reaction. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.632224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Obando-Pacheco P, Justicia-Grande AJ, Rivero-Calle I, Rodríguez-Tenreiro C, Sly P, Ramilo O, Mejías A, Baraldi E, Papadopoulos NG, Nair H, Nunes MC, Kragten-Tabatabaie L, Heikkinen T, Greenough A, Stein RT, Manzoni P, Bont L, Martinón-Torres F. Respiratory Syncytial Virus Seasonality: A Global Overview. J Infect Dis 2019; 217:1356-1364. [PMID: 29390105 DOI: 10.1093/infdis/jiy056] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 01/24/2018] [Indexed: 11/12/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections in children. By the age of 1 year, 60%-70% of children have been infected by RSV. In addition, early-life RSV infection is associated with the development of recurrent wheezing and asthma in infancy and childhood. The need for precise epidemiologic data regarding RSV as a worldwide pathogen has been growing steadily as novel RSV therapeutics are reaching the final stages of development. To optimize the prevention, diagnosis, and treatment of RSV infection in a timely manner, knowledge about the differences in the timing of the RSV epidemics worldwide is needed. Previous analyses, based on literature reviews of individual reports obtained from medical databases, have failed to provide global country seasonality patterns. Until recently, only certain countries have been recording RSV incidence through their own surveillance systems. This analysis was based on national RSV surveillance reports and medical databases from 27 countries worldwide. This is the first study to use original-source, high-quality surveillance data to establish a global, robust, and homogeneous report on global country-specific RSV seasonality.
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Affiliation(s)
- Pablo Obando-Pacheco
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago.,GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Antonio José Justicia-Grande
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago.,GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Irene Rivero-Calle
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago.,GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Carmen Rodríguez-Tenreiro
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago.,GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Peter Sly
- Children's Lung Environment and Asthma Research, Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Octavio Ramilo
- Respiratory syncytial virus network (ReSViNET), Zeist.,Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus.,Center for Vaccines and Immunity at Nationwide Children's Hospital, Ohio State University, Columbus
| | - Asunción Mejías
- Respiratory syncytial virus network (ReSViNET), Zeist.,Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus.,Center for Vaccines and Immunity at Nationwide Children's Hospital, Ohio State University, Columbus
| | - Eugenio Baraldi
- Respiratory syncytial virus network (ReSViNET), Zeist.,Women's and Children's Health Department, University of Padova, Torino, Italy
| | - Nikolaos G Papadopoulos
- Respiratory syncytial virus network (ReSViNET), Zeist.,Department of Allergy, 2nd Pediatric Clinic, University of Athens, Greece.,Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Johannesburg, South Africa
| | - Harish Nair
- Respiratory syncytial virus network (ReSViNET), Zeist.,Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Johannesburg, South Africa
| | - Marta C Nunes
- Respiratory syncytial virus network (ReSViNET), Zeist.,Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa
| | - Leyla Kragten-Tabatabaie
- Respiratory syncytial virus network (ReSViNET), Zeist.,Julius Clinical, University Medical Center Utrecht, Zeist
| | - Terho Heikkinen
- Respiratory syncytial virus network (ReSViNET), Zeist.,Department of Pediatrics, University of Turku and Turku University Hospital, Finl
| | - Anne Greenough
- Respiratory syncytial virus network (ReSViNET), Zeist.,MRC & Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, Johannesburg, South Africa.,Department of Women and Children's Health, School of Life Course Sciences.,Faculty of Life Sciences and Medicine, King's College London
| | - Renato T Stein
- Respiratory syncytial virus network (ReSViNET), Zeist.,Pediatric Pulmonology Unit, Pontifícia Universidade Católica RS, Porto Alegre, Brazil
| | - Paolo Manzoni
- Respiratory syncytial virus network (ReSViNET), Zeist.,Neonataology and Neonatal Intensive Care Unit, S Anna Hospital, Torino, Italy
| | - Louis Bont
- Respiratory syncytial virus network (ReSViNET), Zeist.,Department of Pediatrics, University Medical Center Utrecht, The Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, The Netherlands
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago.,GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain.,Respiratory syncytial virus network (ReSViNET), Zeist
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32
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Molecular characterization of circulating respiratory syncytial virus genotypes in Pakistani children, 2010-2013. J Infect Public Health 2019; 13:438-445. [PMID: 31229412 DOI: 10.1016/j.jiph.2019.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Data on the viral etiology of acute lower respiratory infections are scarce in Pakistan. Human respiratory syncytial virus (RSV) is an important cause of morbidity in children but no effective vaccine or antiviral therapy is currently available. As vaccines are expected to become available in the future, it is important to understand the epidemiology of locally prevalent RSV subtypes. This study aimed to define the molecular epidemiology of RSV (A and B) genotypes in Pakistani children under 5 years. METHODS World Health Organization case definitions for influenza-like illness (ILI) and severe acute respiratory illness (SARI) were used for case selection. Children under 5 years who presented with ILI or SARI at tertiary care hospitals from all provinces/regions, including the eight influenza sentinel sites, during October-April each year between 2010 and 2013 were enrolled. Demographic and clinical data of the children were recorded and nasopharyngeal/throat swabs taken for analysis. All samples were tested for RSV A and B using real-time polymerase chain reaction for non-influenza respiratory viruses. Specific oligonucleotide primers for RSV A and B were used for subtyping and sequencing of the G protein, followed by phylogenetic analysis. RESULTS A total of 1941 samples were included. RSV was detected in 472 (24%) children, with RSV A detected in 367 (78%) and RSV B in 105 (22%). The G protein of all RSV A strains clustered in the NA1/GA2 genotype while RSV B strains carried the signature 60 nucleotide duplication and were assigned to three BA genotypes: BA-9, BA-10 and the new BA-13 genotype. CONCLUSIONS This study highlights the importance of RSV as a viral etiologic agent of acute respiratory infections in children in Pakistan, and the diversity of RSV viruses. Continued molecular surveillance for early detection of prevalent and newly emerging genotypes is needed to understand the epidemiology of RSV infections in Pakistan.
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Ramos-Fernández JM, Hernández-Yuste A, Gutiérrez-Bedmar M, Cordón Martínez AM, Moreno-Pérez D. Does exposure of pregnant women to epidemic respiratory syncytial virus affect the severity of bronchiolitis? Enferm Infecc Microbiol Clin 2019; 37:251-255. [PMID: 30100097 DOI: 10.1016/j.eimc.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Passive transplacental immunity against respiratory syncytial virus (RSV) appears to mediate in the protection of the infant for the first 6 months of life. Lower environmental exposure in pregnant women to RSV epidemic may influence the susceptibility of these infants to infection by lowering the levels of antibodies that are transferred to the fetus. OBJECTIVES To contrast the risk of severe disease progression in infants with acute bronchiolitis by RSV, according to the mother's level of exposure to epidemic. METHOD Retrospective cohort study of previously healthy infants with RSV-acute bronchiolitis during 5 epidemics was made. We compared the severity of the infection in those born during the period of risk (when is less likely the mother's exposure to epidemic and the transfer of antibodies to the fetus: October 15th-December 15th in our latitude) with the rest of acute bronchiolitis. Bivariate analysis was performed regarding birth in period of risk and the rest of variables, using the Chi-square test. Multivariate logistic regression analysis was performed to study possible classical confounding factors. RESULTS 695 infants were included in the study. 356 infants were born during the period of risk. Of the 56 patients requiring admission to PICU, 40 of them (71.4%) were born in this period (p=0.002). In the multivariate analysis, the birth in the period of risk showed a 6.5 OR (95% CI: 2.13-19.7) independently of the rest of variables. CONCLUSIONS The worst clinical disease progression of the acute bronchiolitis by the RSV in less than 6 months age is related to lower exposure of the pregnant woman to the RSV epidemic.
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Affiliation(s)
| | | | - Mario Gutiérrez-Bedmar
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Málaga, Spain
| | | | - David Moreno-Pérez
- Servicio de Pediatría, Unidad de enfermedades infecciosas, Hospital Materno-Infantil, IBIMA, Málaga, Spain; Departamento de Pediatría y Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
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Divarathne MVM, Ahamed RR, Noordeen F. The Impact of RSV-Associated Respiratory Disease on Children in Asia. J PEDIAT INF DIS-GER 2019; 14:79-88. [PMID: 32300274 PMCID: PMC7117084 DOI: 10.1055/s-0038-1637752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 02/13/2018] [Indexed: 12/12/2022]
Abstract
Acute respiratory tract infections (ARTIs) are leading contributors to the global infectious disease burden, which is estimated to be 112,900,000 disability adjusted life years. Viruses contribute to the etiology of ARTIs in a big way compared with other microorganisms. Since the discovery of respiratory syncytial virus (RSV) 61 years ago, the virus has been recognized as a major cause of ARTI and hospitalization in children. The morbidity and mortality attributable to RSV infection appear to be higher in infants < 3 months and in those with known risk factors such as prematurity, chronic lung, and congenital heart diseases. Crowded living conditions, exposure to tobacco smoke, and industrial or other types of air pollution also increase the risk of RSV-associated ARTI. Many epidemiological studies have been conducted in developed countries to understand the seasonal patterns and risk factors associated with RSV infections. Dearth of information on RSV-associated morbidity and mortality in Asian and developing countries indicates the need for regional reviews to evaluate RSV-associated disease burden in these countries. Epidemiological studies including surveillance is the key to track the disease burden including risk factors, seasonality, morbidity, and mortality associated with RSV infection in these countries. These data will contribute to improve the clinical diagnosis and plan preventive strategies in resource-limited developing countries.
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Affiliation(s)
| | - Rukshan Rafeek Ahamed
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Broberg EK, Waris M, Johansen K, Snacken R, Penttinen P. Seasonality and geographical spread of respiratory syncytial virus epidemics in 15 European countries, 2010 to 2016. ACTA ACUST UNITED AC 2019; 23. [PMID: 29409569 PMCID: PMC5801642 DOI: 10.2807/1560-7917.es.2018.23.5.17-00284] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Respiratory syncytial virus (RSV) is considered the most common pathogen causing severe lower respiratory tract infections among infants and young children. We describe the seasonality and geographical spread of RSV infection in 15 countries of the European Union and European Economic Area. We performed a retrospective descriptive study of weekly laboratory-confirmed RSV detections between weeks 40/2010 and 20/2016, in patients investigated for influenza-like illness, acute respiratory infection or following the clinician's judgment. Six countries reported 4,230 sentinel RSV laboratory diagnoses from primary care and 14 countries reported 156,188 non-sentinel laboratory diagnoses from primary care or hospitals. The median length of the RSV season based on sentinel and non-sentinel surveillance was 16 (range: 9-24) and 18 (range: 8-24) weeks, respectively. The median peak weeks for sentinel and non-sentinel detections were week 4 (range: 48 to 11) and week 4.5 (range: 49 to 17), respectively. RSV detections peaked later (r = 0.56; p = 0.0360) and seasons lasted longer with increasing latitude (r = 0.57; p = 0.0329). Our data demonstrated regular seasonality with moderate correlation between timing of the epidemic and increasing latitude of the country. This study supports the use of RSV diagnostics within influenza or other surveillance systems to monitor RSV seasonality and geographical spread.
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Affiliation(s)
- Eeva K Broberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Matti Waris
- Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - René Snacken
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Knowledge of acute respiratory infection in under-fives and homebased practices by their caregivers in an urban community in southern Nigeria. Afr J Thorac Crit Care Med 2018; 24. [PMID: 34541517 PMCID: PMC8424659 DOI: 10.7196/ajtccm.2018.v24i4.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background
Acute respiratory infection (ARI) is a common respiratory problem in Nigeria and spans a spectrum of infections, from the
common cold to pneumonia. ARI is the leading cause of mortality in children under 5 years of age, with the majority of deaths occurring
in developing countries.
Objectives
To assess the knowledge of and the home-based practices used by caregivers of under-fives during episodes of ARI.
Methods
A descriptive cross-sectional study was conducted among an urban community in Edo State, Nigeria. Participants were selected
using a multistage sampling technique. A pretested researcher-administered questionnaire was used for data collection.
Results
Of the 346 participating caregivers, the majority had poor knowledge of ARI-related aspects and only some respondents showed
good or fair knowledge. Specifically, only 12 respondents (3.5%) showed good knowledge of ARI symptoms and only nine (2.6%) showed
good knowledge of the danger signs associated with ARIs. The majority of respondents (n=163; 81.1%) used shea butter oil (orioyo) as a
home remedy.
Conclusion
Despite a high level of awareness of ARI among caregivers in the sampled community, a poor level of knowledge of the
symptoms, causes and danger signs of ARI was observed. Various homemade preparations and remedies were used to treat ARIs.
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Aykac K, Karadag-Oncel E, Tanır Basaranoglu S, Alp A, Cengiz AB, Ceyhan M, Kara A. Respiratory viral infections in infants with possible sepsis. J Med Virol 2018; 91:171-178. [PMID: 30192397 PMCID: PMC7166951 DOI: 10.1002/jmv.25309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 08/01/2018] [Indexed: 12/14/2022]
Abstract
Background Knowledge of infections leading to sepsis is needed to develop comprehensive infection prevention and sepsis, as well as early recognition and treatment strategies.The aim of this study was to investigate the etiology of sepsis and evaluate the proportion of respiratory viral pathogens in infants under two years of age with possible sepsis. Methods The prospective study was performed in two years. Multiplex reverse transcriptase polymerase chain reaction (RT‐PCR) was performed to detect viral pathogens. All patients who were included in this study had sepsis symptoms as defined by the Surviving Sepsis Campaign. Results We compared 90 patients with sepsis into three groups as patients (n = 33) who had only viral positivity in nasopharyngeal swab, patients (17) had proven bacterial infection with or without viral infection, and patients (40) without the pathogen detection. Human rhinovirus (16.7%) and influenza (7.8%) were the most commonly seen viruses. A cough was more common in the viral infection group than other groups (
P = 0.02) and median thrombocyte count was lower in the bacterial infection group than the others (
P = 0.01). Patients having bacterial sepsis had the longest duration of hospitalization than the other groups (
P = 0.04). During winter and spring seaons, patients with sepsis had more viral infection; however, in summer and autumn period, patients were mostly in a state that we could not prove infection agents (
P = 0.02). Conclusions Our results suggest that respiratory tract viruses may play an important role in patients with sepsis and they should be kept in mind, especially during winter and spring seasons. In overall infection, viral respiratory viruses as a single pathogen with a detection rate of 36.6% in sepsis etiology.
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Affiliation(s)
- Kubra Aykac
- Pediatric Infection Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
| | - Eda Karadag-Oncel
- Pediatric Infection Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
| | | | - Alpaslan Alp
- Microbiology and Clinical Microbiology Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
| | - Ali Bulent Cengiz
- Pediatric Infection Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
| | - Mehmet Ceyhan
- Pediatric Infection Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
| | - Ates Kara
- Pediatric Infection Department, Hacettepe University Medicine Faculty Hospital, Ankara, Turkey
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Chi H, Chung CH, Lin YJ, Lin CH. Seasonal peaks and risk factors of respiratory syncytial virus infections related hospitalization of preterm infants in Taiwan. PLoS One 2018; 13:e0197410. [PMID: 29746578 PMCID: PMC5944988 DOI: 10.1371/journal.pone.0197410] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/01/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess the nationwide seasonal peaks, risk factors, and utilization of medical resources of respiratory syncytial virus-associated hospitalization (RSVH) in preterm infants in Taiwan. Study design A Taiwan nationwide birth cohort was extracted from the Birth Certificate Application Database during 2007–2009 and prospectively linked to the National Health Insurance database. We evaluated the seasonal peaks and risk factors (gestational age [GA], chronologic age [CA], and bronchopulmonary dysplasia [BPD]) associated with the RSVH of preterm infants. The length of hospital stays (LOS), care in intensive care unit (ICU), and use of mechanical ventilation (MV) were also analyzed. Results There is a total duration of 9 months of RSVH season in Taiwan, three seasonal peaks and two seasonal peaks of RSVH in preterm infants with BPD and without BPD, respectively. Preterm infants had significantly higher RSVH rate than term infants (2.6% vs 0.9%, p<0.0001). Preterm infants born at 29–35 weeks of gestational age (wGA) with BPD had significantly higher RSVH rate than those without BPD (p<0.0001). Preterm infants without BPD born at < 32 wGA had higher RSVH rate than those born at 33–35 wGA (p<0.0001). Overall, 56.4% of RSVH occurred within 9 months of CA. Preterm infants with BPD had significantly higher ICU admission rate within 18 months of CA (p<0.0001), MV usage within 12 months of CA (p<0.0001) and LOS within 18 months of CA (p<0.001) than those without BPD. RSVH occurred within 6 months of CA was significantly associated with higher ICU admission rate (p<0.0001), MV usage (p = 0.0002) and longer LOS (p<0.001) in preterm infants without BPD. Conclusions There is a total duration of 9 months of RSVH season in Taiwan. Preterm < 32 wGA, BPD, and CA within 6 months were risk factors of RSVH which also contribute to higher utilization of medical resources.
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Affiliation(s)
- Hsin Chi
- Department of Pediatrics, Mackay Memorial Hospital and Mackay Children’s Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Ching-Hu Chung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yuh-Jyh Lin
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chyi-Her Lin
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail:
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Linster M, Do LAH, Minh NNQ, Chen Y, Zhe Z, Tuan TA, Tuan HM, Su YCF, van Doorn HR, Moorthy M, Smith GJD. Clinical and Molecular Epidemiology of Human Parainfluenza Viruses 1-4 in Children from Viet Nam. Sci Rep 2018; 8:6833. [PMID: 29717150 PMCID: PMC5931535 DOI: 10.1038/s41598-018-24767-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/20/2018] [Indexed: 11/08/2022] Open
Abstract
HPIVs are serologically and genetically grouped into four species that account for up to 10% of all hospitalizations due to acute respiratory infection in children under the age of five. Genetic and epidemiological data for the four HPIVs derived from two pediatric cohorts in Viet Nam are presented. Respiratory samples were screened for HPIV1-4 by real-time PCR. Demographic and clinical data of patients infected with different HPIV were compared. We used a hemi-nested PCR approach to generate viral genome sequences from HPIV-positive samples and conducted a comprehensive phylogenetic analysis. In total, 170 samples tested positive for HPIV. HPIV3 was most commonly detected in our cohort and 80 co-detections of HPIV with other respiratory viruses were found. Phylogenetic analyses suggest local endemic circulation as well as punctuated introductions of new HPIV lineages. Viral gene flow analysis revealed that Viet Nam is a net importer of viral genetic diversity. Epidemiological analyses imply similar disease severity for all HPIV species. HPIV sequences from Viet Nam formed local clusters and were interspersed with sequences from diverse geographic regions. Combined, this new knowledge will help to investigate global HPIV circulation patterns in more detail and ultimately define more suitable vaccine strains.
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Affiliation(s)
- Martin Linster
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Lien Anh Ha Do
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Murdoch's Children Research Institute, Melbourne, Australia
| | - Ngo Ngoc Quang Minh
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Children's Hospital 1, Ho Chi Minh City, Vietnam
| | - Yihui Chen
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Zhu Zhe
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | | | - Ha Manh Tuan
- Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Yvonne C F Su
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit-Viet Nam, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Mahesh Moorthy
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
- Department of Clinical Virology, Christian Medical College, Vellore, India.
| | - Gavin J D Smith
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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40
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Chiu SN, Wang JN, Fu YC, Chung HT, Chang LY, Wu MH, Hua YC, Lin MT, Lu CW, Chen CA, Wu JM, Wang JK. Efficacy of a Novel Palivizumab Prophylaxis Protocol for Respiratory Syncytial Virus Infection in Congenital Heart Disease: A Multicenter Study. J Pediatr 2018; 195:108-114.e1. [PMID: 29395174 DOI: 10.1016/j.jpeds.2017.11.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the efficacy of a novel palivizumab protocol for hemodynamically significant congenital heart disease (hsCHD) in subtropical areas without clear respiratory syncytial virus seasonality. STUDY DESIGN Since July 2013, the National Health Insurance program has provided reimbursement for palivizumab prophylaxis with a novel monthly protocol in selected patients with hsCHD under 1 year of age. We performed a multicenter study to assess the trend of respiratory syncytial virus hospitalizations in patients with hsCHD from 2010 to 2016 during the prepalivizumab, transition, and postpalivizumab periods, and compared treatment and propensity-matched control groups. RESULTS A total of 747 patients were enrolled in the study group and 809 in the control group. The male:female was 836:720. Cyanotic CHD was observed in 42.9% of patients. The mean age at diagnosis of CHD was 32.9 days. After 516 685 patient-days of follow-up and a mean of 3.9 doses of palivizumab in the treatment group, respiratory syncytial virus hospitalization rates decreased by 53% and 49% before and after match compared with the control group (P = .009 and .029, respectively). Hospitalization days and intensive care unit admission rate also decreased similarly in the treatment group. The efficacy of this protocol was more prominent in patients with cyanotic hsCHD. The annual respiratory syncytial virus-associated hospitalization rates also decreased significantly from the prepalivizumab to the palivizumab period (from 4.8% to 2.0%; P = .038). CONCLUSION Palivizumab prophylaxis through the novel monthly protocol for patients with hsCHD is effective in reducing respiratory syncytial virus-related hospitalizations.
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Affiliation(s)
- Shuenn-Nan Chiu
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
| | - Jieh-Neng Wang
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yun-Ching Fu
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hung-Tao Chung
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan
| | - Mei-Hwan Wu
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
| | - Yu-Chuan Hua
- Cardiac Children's Foundation Taiwan, Taipei, Taiwan
| | - Ming-Tai Lin
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
| | - Chun-Wei Lu
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
| | - Chun-An Chen
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
| | - Jing-Ming Wu
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
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Janet S, Broad J, Snape MD. Respiratory syncytial virus seasonality and its implications on prevention strategies. Hum Vaccin Immunother 2018; 14:234-244. [PMID: 29194014 PMCID: PMC5791579 DOI: 10.1080/21645515.2017.1403707] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/06/2017] [Indexed: 01/04/2023] Open
Abstract
With maternal and infant vaccines against respiratory syncytial virus (RSV) in development, it is timely to consider how the deployment of these vaccines might vary according to local RSV disease seasonality. In temperate regions RSV infection is predictably limited to a period of 3 to 5 months, while in tropical regions disease seasonality is often both more variable and more prolonged. Accordingly, in tropical regions a year-round immunisation schedule for both maternal and infant immunisation might be appropriate. In contrast, in temperate regions the benefit of year-round maternal immunisation would be heavily dependent on the duration of protection this provided, potentially necessitating a strategy directed at children due to be born in the months immediately prior to the RSV season. This review will consider the impact of seasonality on maternal and infant immunisation strategies against RSV, and the potential of an alternative approach of passive immunisation for all infants immediately prior to the RSV season.
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Affiliation(s)
- Sophie Janet
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Jonathan Broad
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Matthew D. Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
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Hoeppner T, Borland M, Babl FE, Neutze J, Phillips N, Krieser D, Dalziel SR, Davidson A, Donath S, Jachno K, South M, Williams A, Zhang G, Oakley E. Influence of weather on incidence of bronchiolitis in Australia and New Zealand. J Paediatr Child Health 2017; 53:1000-1006. [PMID: 28727197 DOI: 10.1111/jpc.13614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 02/23/2017] [Accepted: 03/02/2017] [Indexed: 01/19/2023]
Abstract
AIM We aimed to examine the impact of weather on hospital admissions with bronchiolitis in Australia and New Zealand. METHODS We collected data for inpatient admissions of infants aged 2-12 months to seven hospitals in four cities in Australia and New Zealand from 2009 until 2011. Correlation of hospital admissions with minimum daily temperature, wind speed, relative humidity and rainfall was examined using linear, Poisson and negative binomial regression analyses as well as general estimated equation models. To account for possible lag between exposure to weather and admission to hospital, analyses were conducted for time lags of 0-4 weeks. RESULTS During the study period, 3876 patients were admitted to the study hospitals. Hospital admissions showed strong seasonality with peaks in wintertime, onset in autumn and offset in spring. The onset of peak incidence was preceded by a drop in temperature. Minimum temperature was inversely correlated with hospital admissions, whereas wind speed was directly correlated. These correlations were sustained for time lags of up to 4 weeks. Standardised correlation coefficients ranged from -0.14 to -0.54 for minimum temperature and from 0.18 to 0.39 for wind speed. Relative humidity and rainfall showed no correlation with hospital admissions in our study. CONCLUSION A decrease in temperature and increasing wind speed are associated with increasing incidence of bronchiolitis hospital admissions in Australia and New Zealand.
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Affiliation(s)
- Tobias Hoeppner
- Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia
| | - Meredith Borland
- Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health and School of Primary, Rural and Aboriginal Health, University of Western Australia, Perth, Western Australia, Australia
| | - Franz E Babl
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jocelyn Neutze
- Department of Emergency Medicine, Kidz First Children's Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Natalie Phillips
- Emergency Department, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.,Children's Health Research Centre, University of Queensland Medical Research Institute, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - David Krieser
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia
| | - Stuart R Dalziel
- Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Andrew Davidson
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Susan Donath
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Jachno
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Mike South
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Amanda Williams
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Centre for Genetic Origins of Health and Disease, Curtin University and University of Western Australia, Perth, Western Australia, Australia
| | - Ed Oakley
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Nyoka R, Omony J, Mwalili SM, Achia TNO, Gichangi A, Mwambi H. Effect of climate on incidence of respiratory syncytial virus infections in a refugee camp in Kenya: A non-Gaussian time-series analysis. PLoS One 2017; 12:e0178323. [PMID: 28570627 PMCID: PMC5453485 DOI: 10.1371/journal.pone.0178323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/18/2017] [Indexed: 01/16/2023] Open
Abstract
Respiratory syncytial virus (RSV) is one of the major causes of acute lower respiratory tract infections (ALRTI) in children. Children younger than 1 year are the most susceptible to RSV infection. RSV infections occur seasonally in temperate climate regions. Based on RSV surveillance and climatic data, we developed statistical models that were assessed and compared to predict the relationship between weather and RSV incidence among refugee children younger than 5 years in Dadaab refugee camp in Kenya. Most time-series analyses rely on the assumption of Gaussian-distributed data. However, surveillance data often do not have a Gaussian distribution. We used a generalized linear model (GLM) with a sinusoidal component over time to account for seasonal variation and extended it to a generalized additive model (GAM) with smoothing cubic splines. Climatic factors were included as covariates in the models before and after timescale decompositions, and the results were compared. Models with decomposed covariates fit RSV incidence data better than those without. The Poisson GAM with decomposed covariates of climatic factors fit the data well and had a higher explanatory and predictive power than GLM. The best model predicted the relationship between atmospheric conditions and RSV infection incidence among children younger than 5 years. This knowledge helps public health officials to prepare for, and respond more effectively to increasing RSV incidence in low-resource regions or communities.
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Affiliation(s)
- Raymond Nyoka
- School of Mathematics, Statistics and Computer Science, University of KwaZulu- Natal, Scottsville, South Africa
| | - Jimmy Omony
- Molecular Genetics Department, University of Groningen, Groningen, Netherlands
| | - Samuel M. Mwalili
- Statistics Department, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Thomas N. O. Achia
- School of Mathematics, Statistics and Computer Science, University of KwaZulu- Natal, Scottsville, South Africa
| | - Anthony Gichangi
- Jhpiego - an affiliate of John Hopkins University, Westlands, Nairobi, Kenya
| | - Henry Mwambi
- School of Mathematics, Statistics and Computer Science, University of KwaZulu- Natal, Scottsville, South Africa
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Respiratory Syncytial Virus Infection-associated Hospitalization Rates in Infants and Children With Cystic Fibrosis. Pediatr Infect Dis J 2017; 36:545-548. [PMID: 28005688 DOI: 10.1097/inf.0000000000001501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infections with respiratory syncytial virus (RSV) are the leading cause for hospital admissions in infants and young children. The incidence of RSV-related hospitalizations in patients with cystic fibrosis (CF) is unclear. To date, no effective treatment for RSV infections is available. Thus, prophylaxis with the monoclonal antibody palivizumab is an important option. METHODS In a retrospective, single-center study at the Department of Pediatrics and Adolescent Medicine of the Medical University Graz, Austria, we analyzed all CF patients born between 1995 and 2012, who were admitted for respiratory problems between 1995 and 2014. We also defined a group of hypothetical RSV infections with the following criteria: admission caused by a respiratory infection during the first RSV season of life when no test for RSV was performed. Furthermore, we assessed the effectiveness of palivizumab as a prevention of RSV-related hospitalizations. RESULTS A total of 51 patients with CF were identified. The RSV-related hospitalization rate for the first RSV season was 0. Two patients (3.9%) were hospitalized 3 and 4 times, respectively, caused by RSV infections. The mean age at the time of admission was 12.4 ± 2.5 years. One case (1.9%) met our criteria for hypothetical RSV infections. There was no difference in RSV-related hospitalization rates between patients who received palivizumab and those who did not. CONCLUSIONS We found a low rate of RSV-related hospitalizations and could not demonstrate a benefit of palivizumab prophylaxis regarding a decrease of RSV-related hospital admissions. The role of RSV reinfections in CF patients beyond infancy appears to be underestimated.
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Smith RJ, Hogan AB, Mercer GN. Unexpected Infection Spikes in a Model of Respiratory Syncytial Virus Vaccination. Vaccines (Basel) 2017; 5:E12. [PMID: 28524109 PMCID: PMC5492009 DOI: 10.3390/vaccines5020012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/06/2017] [Accepted: 05/15/2017] [Indexed: 12/04/2022] Open
Abstract
Respiratory Syncytial Virus (RSV) is an acute respiratory infection that infects millions of children and infants worldwide. Recent research has shown promise for the development of a vaccine, with a range of vaccine types now in clinical trials or preclinical development. We extend an existing mathematical model with seasonal transmission to include vaccination. We model vaccination both as a continuous process, applying the vaccine during pregnancy, and as a discrete one, using impulsive differential equations, applying pulse vaccination. We develop conditions for the stability of the disease-free equilibrium and show that this equilibrium can be destabilised under certain extreme conditions, even with 100% coverage using an (unrealistic) vaccine. Using impulsive differential equations and introducing a new quantity, the impulsive reproduction number, we showed that eradication could be acheived with 75% coverage, while 50% coverage resulted in low-level oscillations. A vaccine that targets RSV infection has the potential to significantly reduce the overall prevalence of the disease, but appropriate coverage is critical.
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Affiliation(s)
- Robert J Smith
- Department of Mathematics and Faculty of Medicine, The University of Ottawa, 585 King Edward Ave, Ottawa, ON K1N 6N5, Canada.
| | - Alexandra B Hogan
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London W2 1PG, UK and Research School of Population Health, The Australian National University, Canberra 2601, Australia.
| | - Geoffry N Mercer
- Research School of Population Health, The Australian National University, Canberra 2601, Australia.
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Sloan C, Heaton M, Kang S, Berrett C, Wu P, Gebretsadik T, Sicignano N, Evans A, Lee R, Hartert T. The impact of temperature and relative humidity on spatiotemporal patterns of infant bronchiolitis epidemics in the contiguous United States. Health Place 2017; 45:46-54. [PMID: 28285184 PMCID: PMC5502811 DOI: 10.1016/j.healthplace.2017.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/09/2016] [Accepted: 02/24/2017] [Indexed: 11/28/2022]
Abstract
Infant bronchiolitis is primarily due to infection by respiratory syncytial virus (RSV), which is highly seasonal. The goal of the study is to understand how circulation of RSV is impacted by fluctuations in temperature and humidity in order to inform prevention efforts. Using data from the Military Health System (MHS) Data Repository (MDR), we calculated rates of infant bronchiolitis for the contiguous US from July 2004 to June 2013. Monthly temperature and relative humidity were extracted from the National Climate Data Center. Using a spatiotemporal generalized linear model for binomial data, we estimated bronchiolitis rates and the effects of temperature and relative humidity while allowing them to vary over location and time. Our results indicate a seasonal pattern that begins in the Southeast during November or December, then spreading in a Northwest direction. The relationships of temperature and humidity were spatially heterogeneous, and we find that climate can partially account for early onset or longer epidemic duration. Small changes in climate may be associated with larger fluctuations in epidemic duration.
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Affiliation(s)
| | | | - Sorah Kang
- Brigham Young University, Provo, UT, USA
| | | | - Pingsheng Wu
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicholas Sicignano
- Health ResearchTx, Trevose, PA, USA; Navy and Marine Corps Public Health Center, Portsmouth, VA, USA
| | - Amber Evans
- Navy and Marine Corps Public Health Center, Portsmouth, VA, USA
| | - Rees Lee
- Naval Medical Research Unit Dayton, Wright Patterson AFB, OH, USA
| | - Tina Hartert
- Vanderbilt University Medical Center, Nashville, TN, USA
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47
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Agoti CN, Munywoki PK, Phan MVT, Otieno JR, Kamau E, Bett A, Kombe I, Githinji G, Medley GF, Cane PA, Kellam P, Cotten M, Nokes DJ. Transmission patterns and evolution of respiratory syncytial virus in a community outbreak identified by genomic analysis. Virus Evol 2017; 3:vex006. [PMID: 28458916 PMCID: PMC5399923 DOI: 10.1093/ve/vex006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Detailed information on the source, spread and evolution of respiratory syncytial virus (RSV) during seasonal community outbreaks remains sparse. Molecular analyses of attachment (G) gene sequences from hospitalized cases suggest that multiple genotypes and variants co-circulate during epidemics and that RSV persistence over successive seasons is characterized by replacement and multiple new introductions of variants. No studies have defined the patterns of introduction, spread and evolution of RSV at the local community and household level. We present a whole genome sequence analysis of 131 RSV group A viruses collected during 6-month household-based RSV infection surveillance in Coastal Kenya, 2010 within an area of 12 km2. RSV infections were identified by regular symptom-independent screening of all household members twice weekly. Phylogenetic analysis revealed that the RSV A viruses in nine households were closely related to genotype GA2 and fell within a single branch of the global phylogeny. Genomic analysis allowed the detection of household-specific variation in seven households. For comparison, using only G gene analysis, household-specific variation was found only in one of the nine households. Nucleotide changes were observed both intra-host (viruses identified from same individual in follow-up sampling) and inter-host (viruses identified from different household members) and these coupled with sampling dates enabled a partial reconstruction of the within household transmission chains. The genomic evolutionary rate for the household dataset was estimated as 2.307 × 10 − 3 (95% highest posterior density: 0.935–4.165× 10 − 3) substitutions/site/year. We conclude that (i) at the household level, most RSV infections arise from the introduction of a single virus variant followed by accumulation of household specific variation and (ii) analysis of complete virus genomes is crucial to better understand viral transmission in the community. A key question arising is whether prevention of RSV introduction or spread within the household by vaccinating key transmitting household members would lead to a reduced onward community-wide transmission.
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Affiliation(s)
- Charles N Agoti
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya.,School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Patrick K Munywoki
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya.,School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - My V T Phan
- The Wellcome Trust Sanger Institute, Cambridge, UK.,Virosciences Department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James R Otieno
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya
| | - Everlyn Kamau
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya
| | - Anne Bett
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya
| | - Ivy Kombe
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya
| | - George Githinji
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya
| | - Graham F Medley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Patricia A Cane
- Virus Reference Department, Public Health England, London, UK
| | - Paul Kellam
- The Wellcome Trust Sanger Institute, Cambridge, UK.,Department of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Matthew Cotten
- The Wellcome Trust Sanger Institute, Cambridge, UK.,Virosciences Department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D James Nokes
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Collaborative Programme, Kilifi, Kenya.,School of Life Sciences and WIDER, University of Warwick, Coventry, UK
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Koyuncu E, Arı ME, Yoldaş T, Ertuğrul İ, Örün UA, Karademir S, Zorlu P. ALT SOLUNUM YOLU ENFEKSİYONU NEDENİ İLE HASTANEYE YATIRILAN İKİ YAŞ ALTI ÇOCUKLARDA RSV ENFEKSİYONU SIKLIĞI VE RİSK FAKTÖRLERİ. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2017. [DOI: 10.17944/mkutfd.303612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Gamiño‐Arroyo AE, Moreno‐Espinosa S, Llamosas‐Gallardo B, Ortiz‐Hernández AA, Guerrero ML, Galindo‐Fraga A, Galán‐Herrera JF, Prado‐Galbarro FJ, Beigel JH, Ruiz‐Palacios GM, Noyola DE. Epidemiology and clinical characteristics of respiratory syncytial virus infections among children and adults in Mexico. Influenza Other Respir Viruses 2017; 11:48-56. [PMID: 27439650 PMCID: PMC5155644 DOI: 10.1111/irv.12414] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading etiological agent of acute respiratory tract infections and hospitalizations in children. However, little information is available regarding RSV infections in Latin American countries, particularly among adult patients. OBJECTIVE To describe the epidemiology of RSV infection and to analyze the factors associated with severe infections in children and adults in Mexico. METHODS Patients ≥1 month old, who presented with an influenza-like illness (ILI) to six hospitals in Mexico, were eligible for participation in the study. Multiplex reverse-transcriptase polymerase chain reaction identified viral pathogens in nasal swabs from 5629 episodes of ILI. Patients in whom RSV was detected were included in this report. RESULTS Respiratory syncytial virus was detected in 399 children and 171 adults. RSV A was detected in 413 cases and RSV B in 163, including six patients who had coinfection with both subtypes; 414 (72.6%) patients required hospital admission, including 96 (16.8%) patients that required admission to the intensive care unit. Coinfection with one or more respiratory pathogens other than RSV was detected in 159 cases. Young age (in children) and older age (in adults) as well as the presence of some underlying conditions were associated with more severe disease. CONCLUSIONS This study confirms that RSV is an important respiratory pathogen in children in Mexico. In addition, a substantial number of cases in adults were also detected highlighting the relevance of this virus in all ages. It is important to identify subjects at high risk of complications who may benefit from current or future preventive interventions.
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Affiliation(s)
| | | | | | | | - M. Lourdes Guerrero
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
| | - Arturo Galindo‐Fraga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
| | - Juan F. Galán‐Herrera
- Mexico Emerging Infectious Diseases Clinical Research Network Coordinating CenterMexico CityMexico
| | | | - John H. Beigel
- Leidos Biomedical, Frederick, MD, in support of the National Institutes of Allergy and Infectious Diseases, National Institutes of HealthBethesdaMDUSA
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50
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Rossati A. Global Warming and Its Health Impact. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:7-20. [PMID: 28051192 PMCID: PMC6679631 DOI: 10.15171/ijoem.2017.963] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 12/30/2022]
Abstract
Since the mid-19th century, human activities have increased greenhouse gases such as carbon dioxide, methane, and nitrous oxide in the Earth's atmosphere that resulted in increased average temperature. The effects of rising temperature include soil degradation, loss of productivity of agricultural land, desertification, loss of biodiversity, degradation of ecosystems, reduced fresh-water resources, acidification of the oceans, and the disruption and depletion of stratospheric ozone. All these have an impact on human health, causing non-communicable diseases such as injuries during natural disasters, malnutrition during famine, and increased mortality during heat waves due to complications in chronically ill patients. Direct exposure to natural disasters has also an impact on mental health and, although too complex to be quantified, a link has even been established between climate and civil violence. Over time, climate change can reduce agricultural resources through reduced availability of water, alterations and shrinking arable land, increased pollution, accumulation of toxic substances in the food chain, and creation of habitats suitable to the transmission of human and animal pathogens. People living in low-income countries are particularly vulnerable. Climate change scenarios include a change in distribution of infectious diseases with warming and changes in outbreaks associated with weather extreme events. After floods, increased cases of leptospirosis, campylobacter infections and cryptosporidiosis are reported. Global warming affects water heating, rising the transmission of water-borne pathogens. Pathogens transmitted by vectors are particularly sensitive to climate change because they spend a good part of their life cycle in a cold-blooded host invertebrate whose temperature is similar to the environment. A warmer climate presents more favorable conditions for the survival and the completion of the life cycle of the vector, going as far as to speed it up as in the case of mosquitoes. Diseases transmitted by mosquitoes include some of the most widespread worldwide illnesses such as malaria and viral diseases. Tick-borne diseases have increased in the past years in cold regions, because rising temperatures accelerate the cycle of development, the production of eggs, and the density and distribution of the tick population. The areas of presence of ticks and diseases that they can transmit have increased, both in terms of geographical extension than in altitude. In the next years the engagement of the health sector would be working to develop prevention and adaptation programs in order to reduce the costs and burden of climate change.
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Affiliation(s)
- Antonella Rossati
- Department of Infectious Diseases, University Hospital "Maggiore della Carità", Novara, Italy.
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