Acute viral bronchiolitis in South Africa: Intensive care management for severe disease

Morrow, Brenda; Feldman, Charles; Green, Robin

doi:10.7196/samj.2016.v106i5.10436

Cited by 3 publications

(2 citation statements)

References 29 publications

(39 reference statements)

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“…[4] However, more recent studies suggest that RV may be more sinister. [5] All three types of RV have been identified in SA, although RV-A and RV-C are more common than RV-B. RV is associated with symptomatic respiratory illness; however, there is no association between RV type and disease severity.…”

Section: Rvmentioning

confidence: 99%

Acute viral bronchiolitis in South Africa: Viral aetiology and clinical epidemiology

et al. 2016

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DefinitionBronchiolitis is a viral-induced lower respiratory tract infection (LRTI) that occurs predominantly in children <2 years of age, particularly infants.[1] Causative organismsThe most frequent cause of severe bronchiolitis is respiratory syncytial virus (RSV) infection, with other respiratory viruses (para-influenza virus (PIV), influenza virus, human metapneumovirus (hMPV) and measles virus) being less common or for which definitive attribution is yet to be established (e.g. rhinovirus (RV), bocavirus and coronavirus) ( Table 1). EpidemiologyEpidemiological studies on bronchiolitis often include all children presenting with physician-diagnosed LRTI, and may overestimate the true incidence of bronchiolitis alone.In a prospective, hospital-based surveillance study of 8 723 child ren under-5 with physician-diagnosed LRTI, from five sites in four provinces in South Africa (SA), from 2009 to 2012 (severe acute respiratory illness (SARI) programme), the overall prevalence of respiratory viruses was 78%. The viruses that were isolated included RV in 37%, RSV in 26%, adenovirus in 26%, influenza virus in 7% and hMPV in 5%.[2] In 2009 and 2010, this surveillance study evalua ted respiratory viruses by a 10-plex real-time reverse-transcription polymerase chain reaction (rRT-PCR).[3] Respiratory viral co-infections among cases enrolled indicated 39.6% with single viral infections, while 17.4% had ≥2 viral co-infections. RVMany studies show RV to be associated with bronchiolitis; however, the high prevalence of RV in healthy asymptomatic children limits definitive attribution of its role in the pathogenesis of bronchio litis. Early studies have suggested that oxygen saturation is generally not as low in children with RVassociated bronchiolitis as in those with RSV-associated bronchio litis.[4] However, more recent studies suggest that RV may be more sinister.[5] All three types of RV have been identified in SA, although RV-A and RV-C are more common than RV-B. RV is associated with symptomatic respiratory illness; however, there is no association between RV type and disease severity. [6] RV-D has subsequently been identified. [7] Bronchiolitis is a viral-induced lower respiratory tract infection that occurs predominantly in children <2 years of age, particularly infants. Many viruses have been proven or attributed to cause bronchiolitis, including and most commonly the respiratory syncytial virus (RSV) and rhinovirus. RSV is responsible for more severe disease and complications (including hospitalisation) in bronchiolitis patients. Whereas bronchiolitis is exclusively due to respiratory viral infections, with little evidence of bacterial co-infection, the former could nevertheless predispose to superimposed bacterial infections. Although data support an interaction between RSV and pneumococcal superimposed infections, it should be noted that this specifically refers to children who are hospitalised with RSV-associated pneumonia, and not to children with bronchiolitis or milder outpatient RSV-associated illness. As...

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Section: Rvmentioning

confidence: 99%

Acute viral bronchiolitis in South Africa: Viral aetiology and clinical epidemiology

et al. 2016

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“…[11,12] Management for all cases of bronchiolitis, mild to severe, remains supportive. [13,14] Treatment goals include managing hypoxia, pyrexia and optimising nutrition. [13,14] The present study aimed to determine and compare clinical characteristics, risk factors, co-infections and outcomes for children admitted with RSV-positive and RSV-negative bronchiolitis at two state tertiary hospital centres in Johannesburg.…”

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RSV bronchiolitis in 2018: A descriptive study of children admitted to two Johannesburg tertiary hospitals

Cleak,

Ballot,

Moshesh

et al. 2023

S Afr J Child Health

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Background. Respiratory syncytial virus (RSV) is the most common cause of severe bronchiolitis in children worldwide.Objectives. To describe clinical characteristics and outcomes of children hospitalised with bronchiolitis and to compare those with RSVbronchiolitis with children with other viral causes of bronchiolitis.Methods. A retrospective study of children admitted with virally screened bronchiolitis to Charlotte Maxeke Johannesburg AcademicHospital (CMJAH) and Nelson Mandela Children’s Hospital (NMCH) from 1 February to 31 August 2018 was conducted, where RSVpositive and -negative children were compared. These children were identified by the National Health Laboratory Service as havingundergone respiratory viral multiplex molecular assay analysis and hospital charts were retrospectively reviewed.Results. A total of 131 children admitted with bronchiolitis from CMJAH and NMCH were compared in this study, 58 from CMJAHand 73 from NMCH. In the sample group, 65 (49.6%) children had RSV in comparison with 66 (50.4%) children without RSV. Childrenwith RSV comprised 55 (42%) children with RSV only and 10 (7.6%) children with RSV in combination with another respiratory virus.Rhinovirus was the second most common virus detected in this cohort of children (n=17, 12.9%) followed by adenovirus (n=12, 9.2%)and coronavirus (n=9, 6.9%). A statistically significant risk factor noted in children requiring hospitalisation for RSV bronchiolitis wasage less than six months (p<0.001).Conclusions. Bronchiolitis is a common disease in children. Respiratory syncytial virus is the most common cause of severe bronchiolitis in hospitalised infants less than six months of age.

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Viral Lower Respiratory Tract Infections

Green

Zar

White

et al. 2017

Viral Infections in Children, Volume II

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Acute viral bronchiolitis in South Africa: Intensive care management for severe disease

Cited by 3 publications

References 29 publications

Acute viral bronchiolitis in South Africa: Viral aetiology and clinical epidemiology

Acute viral bronchiolitis in South Africa: Viral aetiology and clinical epidemiology

RSV bronchiolitis in 2018: A descriptive study of children admitted to two Johannesburg tertiary hospitals

Viral Lower Respiratory Tract Infections

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