Severity of respiratory signs and symptoms and virus profiles in Japanese children with acute respiratory illness

Abstract

Associations between the severity of respiratory signs and symptoms and the respiratory viruses identified in 214 Japanese children with acute respiratory illness (ARI) enrolled between January and December 2012 were studied. Respiratory rate, wheezing, cyanosis, and the use of accessory muscles were used as indices of respiratory severity and phylogenetic analysis of the viruses identified in these children was performed. Respiratory viruses such as respiratory syncytial virus (RSV), human rhinovirus (HRV), human parainfluenza virus (HPIV), and human metapneumovirus (HMPV) were prevalent, being detected in approximately 70% of the patients (151/214 patients). Co-detection of viruses occurred in about 9% of patients. RSV was identified more frequently in cases scored as moderate/severe than in those scored as mild (P < 0.05). Severity scores of patients with RSV were significantly higher than those of cases with HPIV. Moreover, severity scores in patients with mild disease and co-detections were higher than in those in whom only HPIV or adenovirus was detected. Phylogenetic analysis showed that many genotypes of HRV-A and -C with wide genetic divergence were associated with acute respiratory illness (ARI). On the other hand, only a limited number of genotypes of RSV were associated with ARI. HPIV and HMPV were associated with ARI at similar frequencies. These results suggest that different respiratory viruses with unique genetic characteristics can be found in patients with mild to severe ARI.

Viral aetiology and clinical outcomes in hospitalised infants presenting with respiratory distress

“…The relative severity of RSV infection with respect to other respiratory viruses has been stated by many other papers . Predominance of males has been demonstrated in other studies .…”

“…The role of viral co‐infections has been examined in several series with diverse outcomes. While an Italian series showed less severe clinical features , others studies could not identify any clinical differences , and in a series from Mozambique co‐infections were associated with a more severe clinical picture .…”

Pathogen profiles and molecular epidemiology of respiratory viruses in Japanese inpatients with community-acquired pneumonia

“…This indicates that viruses such as HMPV, RSV, and HPIV could have been associated with over 10% of CAP inpatients. Although we found no correlation between the phylogenies of these viruses and disease severity, the estimate was inferred from the seasonal prevalence of these strains [35]. Regarding CMV detection, it is not possible to distinguish between active respiratory infection and asymptomatic/latent infection, especially in clinically ill patients [36,37].…”

An Outbreak of Acute Respiratory Infections due to Human Respiratory Syncytial Virus in a Nursing Home for the Elderly in Ibaraki, Japan, 2014

“…As a result, 2 amino acid substitutions (T259I and T281A) were found. These substitutions might be unique, although further studies are warranted (2,5).…”