Influence of Previous Respiratory Infection on the Association between Respiratory Syncytial Virus Hospitalization and Childhood Asthma

AbstractObjectivesTo evaluate the rate of hospitalization for acute respiratory tract infection in children less than 24 months with haemodynamically significant congenital cardiac disease, and to describe associated risk factors, preventive measures, aetiology, and clinical course.Materials and methodsWe followed 760 subjects from October 2004 through April 2005 in an epidemiological, multicentric, observational, follow-up, prospective study involving 53 Spanish hospitals.ResultsOf our cohort, 79 patients (10.4%, 95% CI: 8.2%–12.6%) required a total of 105 admissions to hospital related to respiratory infections. The incidence rate was 21.4 new admissions per 1000 patients-months. Significant associated risk factors for hospitalization included, with odds ratios and 95% confidence intervals shown in parentheses: 22q11 deletion (8.2, 2.5–26.3), weight below the 10th centile (5.2, 1.6–17.4), previous respiratory disease (4.5, 2.3–8.6), incomplete immunoprophylaxis against respiratory syncytial virus (2.2, 1.2–3.9), trisomy 21 (2.1, 1.1–4.2), cardiopulmonary bypass (2.0, 1.1–3.4), and siblings aged less than 11 years old (1.7, 1.1–2.9). Bronchiolitis (51.4%), upper respiratory tract infections (25.7%), and pneumonia (20%) were the main diagnoses. An infectious agent was found in 37 cases (35.2%): respiratory syncytial virus in 25,Streptococcus pneumoniaein 5, and Haemophilus influenzae in 4. The odds ratio for hospitalization due to infection by the respiratory syncytial virus increases by 3.05 (95% CI: 2.14 to 4.35) in patients with incomplete prophylaxis. The median length of hospitalization was 7 days. In 18 patients (17.1%), the clinical course of respiratory infection was complicated and 2 died.ConclusionsHospital admissions for respiratory infection in young children with haemodynamically significant congenital cardiac disease are mainly associated with non-cardiac conditions, which may be genetic, malnutrition, or respiratory, and to cardiopulmonary bypass. Respiratory syncytial virus was the most commonly identified infectious agent. Incomplete immunoprophylaxis against the virus increased the risk of hospitalization.

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Efficacy of Oral Ribavirin in Respiratory Syncytial Virus Infection in Hematopoietic Stem Cell Transplant Patients: A Single-Centre Experience

Blood ◽

10.1182/blood-2020-142888 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 6-7

Author(s):

Shona Philip ◽

Adrienne Fulford ◽

Krista Biederman ◽

Brandon Dorland ◽

Anargyros Xenocostas ◽

...

Keyword(s):

Stem Cell ◽

Respiratory Syncytial Virus ◽

Supportive Care ◽

Respiratory Infection ◽

Lower Respiratory Infection ◽

Hematopoietic Stem ◽

Allogeneic Hsct ◽

Rsv Infection ◽

Syncytial Virus ◽

Autologous Hsct

Background: Respiratory syncytial virus (RSV) is one of the most commonly encountered respiratory viruses among patients who have been diagnosed with a hematological malignancy or a hematopoietic stem cell transplantation (HSCT). In immunocompromised patients including HSCT recipients, RSV can progress to a more severe lower respiratory infection (LRI), often complicated by respiratory failure leading to increased morbidity and mortality. Little is known about the best management strategy in this immunocompromised group and strategies to manage RSV is challenging. Data on aerosolized ribavirin to treat RSV infections in HSCT recipients come from small, retrospective studies with heterogeneous treatment combinations but nevertheless, have shown to prevent poor outcomes. There is very little data on oral ribavirin treatment but the retrospective data so far has been promising. Aim: To evaluate the effectiveness of oral ribavirin in HSCT patients with RSV infection at our centre in London, Ontario. Methods: Eighteen HSCT patients with RSV were analyzed retrospectively. In 2012, there were 5 patients treated with supportive care alone. After 2012, there were 13 patients treated with oral ribavirin. RSV diagnosis was established by polymerase chain reaction assay via nasopharyngeal swabs. Oral ribavirin was initiated at 15 mg/kg/day in three divided doses for 7-10 days with possibility of extension in persistently symptomatic patients. An immunodeficiency scoring index (ISI) was used to classify patients as low, moderate, or high risk for progression to lower respiratory infection (LRI) or death. Findings: An outbreak of RSV occurred in our oncology unit in early 2012 where 5 HSCT patients ((3 autologous HSCT and 2 allogeneic HSCT patients) contracted RSV infection as well. No definitive treatment options were available during this period and patients were managed with supportive care alone. 4/5 HSCT patients died of RSV infection leading into an 80% mortality rate. This experience led to the development of a protocol for the HSCT patients focusing on prevention of nosocomial transmission, early PCR testing and treatment with oral ribavirin for those confirmed with RSV infection and signs of pneumonia or LRI. Since 2012, 13 HSCT patients (4 autologous HSCT patients and 9 allogeneic HSCT patients) were diagnosed with RSV infection and promptly treated with oral ribavirin. The median treatment duration was 10 days (range: 7-12). All patients treated with oral ribavirin survived the infection. Oral ribavirin was well tolerated with minor adverse effects. Conclusion: We found that HSCT patients with lower respiratory RSV infections can be successfully managed by use of prevention strategies and oral ribavirin. Although, our experience reflects a small sample size, the protocol was associated with decreased mortality compared to patients who received supportive care alone. Our experience supports the use of oral ribavirin for the early treatment of HSCT patients with RSV associated LRI and may be an alternative to aerosolized RBV. But ongoing review of our experience with this protocol is necessary and large prospective studies are needed to determine the optimal therapy in this patient group. Disclosures No relevant conflicts of interest to declare.

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Molecular epidemiology of human respiratory syncytial virus (HRSV) in Iranian military trainees with acute respiratory symptoms in 2017

Iranian Journal of Microbiology ◽

10.18502/ijm.v12i5.4612 ◽

2020 ◽

Author(s):

Mohammad Hadi Karbalaie Niya ◽

Ali Salimi Jeda ◽

Ahmad Tavakoli ◽

Hesam Sohani ◽

Safarnezhad Tameshkel ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Molecular Epidemiology ◽

Respiratory Infection ◽

Respiratory Symptoms ◽

Phylogenetic Analyses ◽

Respiratory Illness ◽

Cold Season ◽

The Philippines ◽

Common Symptom ◽

Syncytial Virus

Background and Objectives: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in many populations, including military recruits receiving basic training. Therefore, this study was set out to determine the molecular epidemiology, genotype and phylogenetic features of RSVs in patients with respiratory infection as a case study. Materials and Methods: In this study, military barracks of Tehran, Iran, between January to March 2017 exposed to respiratory diseases were used for sampling. Throat swabs were taken, a reverse transcriptase-polymerase chain reaction (RTPCR) assay was performed to identify RSV and then the genotyping and phylogenetic analyses of RSVs in patients with a respiratory infection. Results: Among 400 Iranian military trainees with respiratory symptoms, RSV infection was identified in 2.75% (11/400) using RT-PCR. Sequencing showed the incidence of type A (2.5%, n=10) to be much higher than type B (0.25%, n=1); Sore throat was the most common symptom among RSV patients. Phylogenetic analysis revealed that the majority of strains from the studied samples were more consistent with those from the Philippines and the US strains. Conclusion: This study is the first to document RSV as a major cause of acute respiratory illness among military trainees in Iran. The prevalence of RSV is substantial in the cold season and the prevalence of genotype A is dominant in the country, leading to take essential steps in preparing a preventive vaccine against this viral infection.

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SEROPREVALENCE OF BOVINE RESPIRATORY SYNCYTIAL VIRUS (BRSV) IN VOJVODINA

Archives of Veterinary Medicine ◽

10.46784/e-avm.v4i2.183 ◽

2012 ◽

Vol 4 (2) ◽

pp. 23-29 ◽

Cited By ~ 1

Author(s):

Dejan Bugarski ◽

Tamaš Petrović ◽

Dubravka Milanov ◽

Sava Lazić

Keyword(s):

Respiratory Syncytial Virus ◽

Dairy Cattle ◽

Respiratory Infection ◽

Dairy Farms ◽

Bovine Respiratory Syncytial Virus ◽

Animal Production ◽

Serological Examination ◽

Production Group ◽

Fattening Period ◽

Syncytial Virus

This paper presents the results of serological examination of respiratory infection with bovine respiratory syncytial virus (BRSV) on dairy farms and cattle feedlots in Vojvodina. Seropositive animals were detected on all examined farms. The seroprevalence differed depending on the age of examined animals, i.e. of animal production group. For dairy cattle seroprevalence was the lowest in calves aged about 3.5 months, and in animals older than 1 year it was 100%. In the calves between 30 and 70 days of age, when pneumonia was frequent, seroconversion was not detected. Upon the arrival of new calves in feedlots seroprevalence was 22.89%. The number of seropositive animals during the fattening period increased, so after reconvalescence of clinical pneumonia, 90% of animals were seropositive, and 96.43% at the end of fattening period. This investigation detected prevalence of BRSV and its importance in the etiology of pneumonia, especially in feedlots.

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