Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname

Background Viruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries. Methods Between 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS). Results Of a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS. Conclusions Viruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.

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Respiratory syncytial virus infection among young children with acute respiratory tract infection in Iraq

Eastern Mediterranean Health Journal ◽

10.26719/1999.5.5.941 ◽

1999 ◽

Vol 5 (5) ◽

pp. 941-948

Author(s):

K. A. Albargish ◽

H. J. Hasony

Keyword(s):

Respiratory Syncytial Virus ◽

Virus Infection ◽

Respiratory Infection ◽

Respiratory Syncytial Virus Infection ◽

Acute Respiratory Infection ◽

Acute Respiratory Tract Infection ◽

Control Group ◽

Severe Acute Respiratory Infection ◽

Syncytial Virus ◽

Children Under 5

The incidence of respiratory syncytial virus infection was assessed among 516 children under 5 years with acute respiratory infection and 57 control children free of respiratory infection to determine its relation to epidemiological variables. Respiratory syncytial virus was detected in 188 [37.6%]children with acute respiratory infection and in none of the control group. The infection was highest in those with severe acute respiratory infection, particularly severe bronchiolitis and pneumonia and it precipitated acute bronchial asthma in children over 2 years. The infection was most common in the first 6 months and both sexes were equally affected. Socioeconomic factors and crowding played no significant role in the incidence and spread of the infection. Breastfeeding had no clear protective effect against the infection

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Global Disease Burden Estimates of Respiratory Syncytial Virus–Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta-Analysis

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz059 ◽

2019 ◽

Vol 222 (Supplement_7) ◽

pp. S577-S583 ◽

Cited By ~ 30

Author(s):

Ting Shi ◽

Angeline Denouel ◽

Anna K Tietjen ◽

Iain Campbell ◽

Emily Moran ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Developing Countries ◽

Respiratory Syncytial Virus ◽

Hospital Admission ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Disease Burden ◽

Hospital Deaths ◽

Syncytial Virus

AbstractRespiratory syncytial virus–associated acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in older adults aged ≥65 years. We aimed to identify all studies worldwide investigating the disease burden of RSV-ARI in this population. We estimated the community incidence, hospitalization rate, and in-hospital case-fatality ratio (hCFR) of RSV-ARI in older adults, stratified by industrialized and developing regions, using data from a systematic review of studies published between January 1996 and April 2018 and 8 unpublished population-based studies. We applied these rate estimates to population estimates for 2015 to calculate the global and regional burdens in older adults with RSV-ARI in the community and in hospitals for that year. We estimated the number of in-hospital deaths due to RSV-ARI by combining hCFR data with hospital admission estimates from hospital-based studies. In 2015, there were about 1.5 million episodes (95% confidence interval [CI], .3 million–6.9 million) of RSV-ARI in older adults in industrialized countries (data for developing countries were missing), and of these, approximately 14.5% (214 000 episodes; 95% CI, 100 000–459 000) were admitted to hospitals. The global number of hospital admissions for RSV-ARI in older adults was estimated at 336 000 hospitalizations (uncertainty range [UR], 186 000–614 000). We further estimated about 14 000 in-hospital deaths (UR, 5000–50 000) related to RSV-ARI globally. The hospital admission rate and hCFR were higher for those aged ≥65 years than for those aged 50–64 years. The disease burden of RSV-ARI among older adults is substantial, with limited data from developing countries. Appropriate prevention and management strategies are needed to reduce this burden.

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P0571 / #307: ASSOCIATION BETWEEN SEVERE ACUTE RESPIRATORY INFECTION BY HUMAN METAPNEUMOVIRUS, RAINFALL SEASON AND CLINICAL OUTCOMES IN CHILDREN

Pediatric Critical Care Medicine ◽

10.1097/01.pcc.0000740624.70182.a2 ◽

2021 ◽

Vol 22 (Supplement 1 3S) ◽

pp. 283-284

Author(s):

J. Fernández-Sarmiento ◽

E. Obando ◽

D. Montoya ◽

J. Arroyave ◽

O. Gamboa ◽

...

Keyword(s):

Clinical Outcomes ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Human Metapneumovirus ◽

Rainfall Season ◽

Severe Acute Respiratory Infection

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Recommendations for respiratory syncytial virus surveillance at national level

European Respiratory Journal ◽

10.1183/13993003.03766-2020 ◽

2021 ◽

pp. 2003766

Author(s):

Anne C. Teirlinck ◽

Eeva K. Broberg ◽

Are Stuwitz Berg ◽

Harry Campbell ◽

Rachel M. Reeves ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Young Children ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Global Analysis ◽

National Level ◽

Common Cause ◽

Severe Acute Respiratory Infection ◽

Syncytial Virus ◽

Tract Infections

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections (ALRI) and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants below 6 months of age. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among the elderly. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations to develop a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance, and passive laboratory surveillance, using the EU acute respiratory infection (ARI) and WHO extended severe acute respiratory infection (SARI) case definitions. Furthermore, we recommend the use of quantitative reverse transcription polymerase chain reaction (qRT-PCR) based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for a good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and estimation of the RSV burden and impact of the future immunisation programmes.

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Capturing respiratory syncytial virus season in Belgium using the influenza severe acute respiratory infection surveillance network, season 2018/19

Eurosurveillance ◽

10.2807/1560-7917.es.2020.25.39.1900627 ◽

2020 ◽

Vol 25 (39) ◽

Author(s):

Lorenzo Subissi ◽

Nathalie Bossuyt ◽

Marijke Reynders ◽

Michèle Gérard ◽

Nicolas Dauby ◽

...

Keyword(s):

Older Adults ◽

Respiratory Syncytial Virus ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Case Definition ◽

World Health ◽

Surveillance Network ◽

Severe Acute Respiratory Infection ◽

Respiratory Syncytial Virus Season ◽

Syncytial Virus

Background Respiratory syncytial virus (RSV) is a common cause of severe respiratory illness in young children (< 5 years old) and older adults (≥ 65 years old) leading the World Health Organization (WHO) to recommend the implementation of a dedicated surveillance in countries. Aim We tested the capacity of the severe acute respiratory infection (SARI) hospital network to contribute to RSV surveillance in Belgium. Methods During the 2018/19 influenza season, we started the SARI surveillance for influenza in Belgium in week 40, earlier than in the past, to follow RSV activity, which usually precedes influenza virus circulation. While the WHO SARI case definition for influenza normally used by the SARI hospital network was employed, flexibility over the fever criterion was allowed, so patients without fever but meeting the other case definition criteria could be included in the surveillance. Results Between weeks 40 2018 and 2 2019, we received 508 samples from SARI patients. We found an overall RSV detection rate of 62.4% (317/508), with rates varying depending on the age group: 77.6% in children aged < 5 years (253/326) and 34.4% in adults aged ≥ 65 years (44/128). Over 90% of the RSV-positive samples also positive for another tested respiratory virus (80/85) were from children aged < 5 years. Differences were also noted between age groups for symptoms, comorbidities and complications. Conclusion With only marginal modifications in the case definition and the period of surveillance, the Belgian SARI network would be able to substantially contribute to RSV surveillance and burden evaluation in children and older adults, the two groups of particular interest for WHO.

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Viral Surveillance of Children with Acute Respiratory Infection in Two Main Hospitals in Northern Jordan, Irbid, during Winter of 2016

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-1692972 ◽

2019 ◽

Vol 15 (01) ◽

pp. 001-010 ◽

Cited By ~ 1

Author(s):

Samah Awad ◽

Yousef Khader ◽

Moa'th Mansi ◽

Dawood Yusef ◽

Salah Alawadin ◽

...

Keyword(s):

Developing Countries ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Severe Disease ◽

Acute Lower Respiratory Infection ◽

X Rays ◽

History Of ◽

Syncytial Virus ◽

Viral Surveillance ◽

Northern Jordan

AbstractAcute lower respiratory infection (ALRI) is a major cause of morbidity and mortality worldwide. Data regarding the etiology of acute respiratory infection (ARI) is scarce in developing countries. The aim of this study was to identify the viral etiology of ARI/ALRI in hospitalized children and factors associated with increased length of stay (LoS) and severe disease presentation in Northern Jordan. This was a prospective viral surveillance study using real-time reverse transcriptase-polymerase chain reaction in children younger than 5 years admitted with ARI to two main hospitals in Northern Jordan during the winter of 2016. Nasopharyngeal swabs were obtained and tested for respiratory syncytial virus (RSV) and other viruses. Demographic and clinical characteristics of RSV-positive patients were compared with those of RSV-negative patients. There were 479 patients hospitalized with ARI. Their mean age (standard deviation) was 10.4 (11.6) months. 53.9% tested positive for at least one virus, with RSV being the most commonly detected virus (34%). Compared with RSV-negative patients, RSV-positive patients were younger, more likely to have chronic lung disease, and more likely to present with cough, rhinorrhea, difficulty in breathing, retraction, flaring, grunting, wheezing, and a higher respiratory rate. Prematurity, presence of a chronic illness, oxygen saturation < 90%, and atelectasis and consolidation on chest X-rays were significantly associated with an increased mean LoS. Patients with a history of prematurity had higher risk of severe disease (odds ratio = 2.6; 95% confidence interval: 1.5, 4.7; p = 0.001). Compared with patients 6 months old and younger, patients aged 6.1 to 12 months were less likely to have severe disease. Human metapneumovirus (HMPV)-positive ALRI was associated with increased odds of severe disease. Viruses are recognized as etiological agent of ARI/ALRI-associated morbidity in developing countries that need more attention and implementation of targeted strategies for prevention and detection. HMPV can be a cause of severe ALRI.

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