Influenza and other respiratory viruses in three Central American countries

Abstract

Please cite this paper as: Laguna‐Torres et al. (2011) Influenza and other respiratory viruses in three Central American countries. Influenza and Other Respiratory Viruses 5(2), 123–134. Background Despite the disease burden imposed by respiratory diseases on children in Central America, there is a paucity of data describing the etiologic agents of the disease. Aims To analyze viral etiologic agents associated with influenza‐like illness (ILI) in participants reporting to one outpatient health center, one pediatric hospital, and three general hospitals in El Salvador, Honduras, and Nicaragua Material & Methods Between August 2006 and April 2009, pharyngeal swabs were collected from outpatients and inpatients. Patient specimens were inoculated onto cultured cell monolayers, and viral antigens were detected by indirect and direct immunofluorescence staining. Results A total of 1,756 patients were enrolled, of whom 1,195 (68.3%) were under the age of 5; and 183 (10.4%) required hospitalization. One or more viral agents were identified in 434 (24.7%) cases, of which 17 (3.9%) were dual infections. The most common viruses isolated were influenza A virus (130; 7.4% of cases), respiratory syncytial virus (122; 6.9%), adenoviruses (63; 3.6%), parainfluenza viruses (57; 3.2%), influenza B virus (47; 2.7% of cases), and herpes simplex virus 1 (22; 1.3%). In addition, human metapneumovirus and enteroviruses (coxsackie and echovirus) were isolated from patient specimens. Discussion When compared to the rest of the population, viruses were isolated from a significantly higher percentage of patients age 5 or younger. The prevalence of influenza A virus or influenza B virus infections was similar between the younger and older age groups. RSV was the most commonly detected pathogen in infants age 5 and younger and was significantly associated with pneumonia (p < 0.0001) and hospitalization (p < 0.0001). Conclusion Genetic analysis of influenza isolates identified A (H3N2), A (H1N1), and B viruses. It also showed that the mutation H274Y conferring resistance to oseltamivir was first detected in Honduran influenza A/H1N1 strains at the beginning of 2008. These data demonstrate that a diverse range of respiratory pathogens are associated with ILI in Honduras, El Salvador, and Nicaragua. RSV infection in particular appears to be associated with severe disease in infants in the region.

Respiratory Viral Test Results in Children

“…Our data generally support the epidemiological features related to age and respiratory viral infections. Laguna-Torres et al (32) reported that RSV was the most common pathogen detected in children less than five years old in three countries. Further, RSV has a high prevalence, hospitalization, and mortality rates (33,34).…”

Etiología y estacionalidad de las infecciones respiratorias virales en menores de cinco años en Bucaramanga, Colombia

“…Algunos de los estudios disponibles en la región proceden de Uruguay (12) y el sur de Brasil (13), donde la estacionalidad de los virus es diferente a la de los países del trópi-co como Colombia. Otros trabajos que han informado estacionalidad provienen de México y recientemente de Nicaragua, el Salvador y Honduras (14)(15)(16). En todos estos trabajos los patrones de estacionalidad de los virus respiratorios son diferentes, lo que justifica aún más el fortalecimiento de la vigilancia.…”

“…De manera similar este virus fue identificado en Italia como el segundo más frecuente después del VSR en las neumonías virales adquiridas en la comunidad en niños menores de 14 años (20). Por el contrario, este agente no fue común en la IRA viral de niños en México y Centroamérica (14,15), lo que probablemente esté relacionado con la capacidad diagnóstica de las pruebas utilizadas.…”

“…Esta proporción es mayor que la reportada en países de Centroamérica y en México (14,15). Este virus da cuenta de alrededor del 7 % de las hospitalizaciones por IRA en niños menores de cinco años en Estados Unidos (23) y está presente durante todo el año con picos en otoño (24), por lo cual se ha señala-do la necesidad de buscar una vacuna efectiva.…”

Human Metapneumovirus Pediatric Respiratory Infections: Comparing Direct Immunofluorescence versus Polymerase Chain Reaction

“…Since its first description in 2001, hMPV has been detected in all continents independent of the economic status of different countries (1)(2)(3). The prevalence of hMPV in children with acute respiratory tract infection (ARTI) has been estimated as 5% to 15% (4), making it the 2nd or 3rd most prevalent pathogen in children with ARTI, with only human respiratory syncytial virus (hRSV) and possibly rhinovirus being more prevalent (5,6).…”