Respiratory Viral Infections among Pediatric Inpatients and Outpatients in Taiwan from 1997 to 1999

Abstract

The present study examined the association of specific virus infections with acute respiratory tract conditions among hospitalized and outpatient children in a subtropical country. A total of 2,295 virus infections were detected in 6,986 patients between 1997 and 1999, including infections caused by respiratory syncytial virus (RSV) (1.7%), parainfluenza virus (2.0%), influenza B virus (2.6%), adenovirus (4.0%), herpes simplex virus type 1 (4.4%), influenza A virus (5.5%), and enterovirus (12.7%). There were 61 mixed infections, and no consistent seasonal variation was found. One or more viruses were detected among 24.8% of hospitalized patients and 35.0% of outpatients. The frequencies and profiles of detection of various viruses among in-and outpatients were different. The occurrence of enterovirus infections exceeded that of other viral infections detected in 1998 and 1999 due to outbreaks of enterovirus 71 and coxsackievirus A10. RSV was the most prevalent virus detected among hospitalized children, whereas influenza virus was the most frequently isolated virus in the outpatient group. Most respiratory viral infections (39.3%) occurred in children between 1 and 3 years old. RSV (P < 0.025) and influenza A virus (P < 0.05) infections were dominant in the male inpatient group. In addition, most pneumonia and bronchiolitis (48.4%) was caused by RSV among hospitalized children less than 6 months old. Adenovirus was the most common agent associated with pharyngitis and tonsilitis (45.5%). These data expand our understanding of the etiology of acute respiratory tract viral infections among in-and outpatients in a subtropical country and may contribute to the prevention and control of viral respiratory tract infections.Viruses, including respiratory syncytial virus (RSV), parainfluenza viruses, influenza viruses, adenoviruses, rhinoviruses, and enteroviruses, are a frequent cause of respiratory tract infections in children (2, 6, 11). In hospitalized children, RSV infections occur at greater frequency than other viral infections of the lower respiratory tract (1,7,15,23,28). Symptoms of RSV infections include coughing, wheezing, hypoxia, bronchiolitis, and pneumonia (18,21). Recently, several strategies for prophylaxis and treatment of RSV infection have been developed (8,20,21). Passive immunization using RSV immunoglobulin and monoclonal antibodies for prevention of RSV disease in premature infants have provided effective forms of prophylactic intervention for high-risk groups (8,20,21). A combination of RSV immunoglobulin and the antiviral agent ribavirin given to bone marrow transplant recipients infected with RSV has also been shown to result in higher survival compared to untreated patients (31). Influenza virus is the most frequent cause of acute respiratory illness, which results in local, regional or worldwide epidemics with various degrees of severity each year (16). Although the new antiviral drug zanamivir for influenza A and B and live attenuated intranasal influenza vaccine were shown to be highly eff...

Antigenic and genomic characterization of adenovirus associated to respiratory infections in children living in Northeast Brazil

“…This finding differs from data reported by other Brazilian and South American studies, which indicate Ad as the second most prevalent virus in ARI observed in hospitalized children (Nascimento et al 1991, Kajon et al 1999, Larrañaga et al 2000, Straliotto et al 2002. In this study the rate of ARI by Ad in hospitalized patients was 1.6%, while in other studies this rate ranged from 3.3% to 12.6% (Larrañaga et al 2000, Hong et al 2001, Tsai et al 2001, Chen et al 2004. Respiratory infections by Ad are generally characterized as self-limited mild URTI, however LRTI can occur, and some cases present as severe pneumonia followed by respiratory failure, serious sequelae or fatal outcome (Kajon & Wadell 1994, Farng et al 2002.…”

“…Respiratory infections by Ad are generally characterized as self-limited mild URTI, however LRTI can occur, and some cases present as severe pneumonia followed by respiratory failure, serious sequelae or fatal outcome (Kajon & Wadell 1994, Farng et al 2002. In other similar studies, Ad was seen to act as an agent of URTI (Tsai et al 2001, Echavarria et al 2006. In a recent study, Ad was detected in 9.4% of nasal swab samples collected from outpatients with flu-like symptoms (Echavarria et al 2006).…”

Parainfluenza virus infections in a tropical city: clinical and epidemiological aspects

“…Although less sensitive than conventional cell culture, IFA has been uniformly specific, less expensive, and faster than conventional cell culture, allowing viral diagnosis in a few hours [19,24,25]. The predominance of HPIV-3 among the three subtypes of HPIV analyzed in this study was also demonstrated in several studies [6][7][8][18][19][20]26,27]. In an Italian study of ARI in hospitalized children, using nasal wash as the clinical sample and molecular techniques for thirteen respiratory viruses, HPIV-3 was the only HPIV found, representing 7.5% of identified viruses [21].…”

Frequent respiratory pathogens of respiratory tract infections in children attending daycare centers

“…De acordo com Fiterman et al 22 , a idade é um fator de risco para a mortalidade por doenças respiratórias. Em um estudo realizado em Taiwan, das 523 crianças infectadas por algum vírus, 32,5% eram menores de 1 ano de idade, 37,7% tinham entre 1 e 3 anos, e 17,2% entre 3 e 6 anos 23 . As crianças acometidas por RVH normalmente apresentam idade superior à daquelas acometidas por outros vírus como o VSRH, por exemplo, que são geralmente detectados em crianças menores de 1 ano 24,25 .…”