Evaluation of epidemiological and clinical features of influenza and other respiratory viruses

Abstract

Aim: In our study, we aimed to clinically and epidemiologically evaluate respiratory tract infections the viral agents of which were detected by molecular methods and to compare influenza and other respiratory tract viruses in this context. Material and Methods:The records of 178 patients aged above 2 years who presented to pediatric emergency outpatient clinic with fever and respiratory tract infection findings between December 2013 and April 2014 were examined retrospectively. Results: At least one respiratory tract pathogen was detected by polymerase chain reaction in 78.6% (n=140) of the patients: influenza A 33.5%, influenza B 16.4%, respiratory syncytial virus 9.2%, adenovirus 7.8%, rhinovirus 7.1%, coronavirus 7.1%, human metapneumovirus 5.7%, human bocavirus 5.7%, parainfluenza virus 3.5%, coinfection 2.8%. The mean age of the patients was 6.3±3.6 years. Sixty-nine patients (49.2%) were aged between 2 and 5 years. Seventy-one patients (50.7%) were aged 5 years and above. Upper respiratory tract infection was found with a rate of 65.7% and lower respiratory tract infection was found with a rate of 34.2%. It was observed that the distribution of respiratory tract viruses showed variance by age groups. Influenza A infection was observed with the highest rate in both age groups. Influenza B was the second leading agent (p=0.008) above the age of 5 years and respiratory syncytial virus was the second leading agent in the 2-5 year age group (p=0.003). Influenza viruses were detected in 55.9% of 118 patients who were found to be compatible with the definition of "influenza-like illness" specified in the Center for Disease Control and Prevention guidelines and other viral agenst were detected in 44%. No difference could be found between the clinical pictures and radiological findings caused by influenza and other respiratory tract viruses. Conclusions: In this study, it was concluded that influenza and other respiratory viruses can not be differentiated definitely by clinical and radiological findings, though there are some differences. (Turk Pediatri Ars 2015; 50: 217-25)

Prognostic value of hematological parameters

“…NLR and PLR are good markers of systemic infection. These ratios have also been confirmed as prognostic and predictive factors in various viral diseases [17,18,19]. A study was conducted in patients with chronic hepatitis B (CHB) [18].…”

“…However, rates of neutrophil/lymphocyte were significantly higher at the time of admission to the hospital [23]. The neutrophil/lymphocyte ratio is a practical systemic inflammation indicator and has been studied as a prognostic factor [17,23]. To the best of our knowledge, MPV in patients with influenza infections has not been previously studied.…”

“…The neutrophil-to-lymphocyte ratio (NLR) and the plateletto-lymphocyte ratio (PLR) are accepted as good predictors of systemic infection. Both NLR and PLR have been proven to be prognostic and predictive factors in a number of viral diseases [17,18,19]. In influenza, hemophagocytic lymphohistiocytosis occurs because of an increase in proinflammatory cytokines, which increase hemophagocytic macrophage proliferation and activation in the reticuloendothelial system.…”

“…This study evaluates changes in MPV levels, and NRL and PLR ratios in patients who have been diagnosed with influenza in order to determine whether these factors might be predictors for the duration of hospitalization or mortality. 17 (40.5%) adults)) healthy individuals were included in the study. The subjects in the control group did not have flu symptoms and had no history of contact with any of the influenza patients.…”

Respiratory Viral Test Results in Children

“…In their study Influenza viruses (A and B) was found to be highest (50%) among their patients. RSV was the second leading agent in the 2-5 year age group (35).…”