ABSTRACT
Upper respiratory tract infection (URTI) occurs commonly in both children and adults and is a major cause of mild morbidity. It has a high cost to society, being responsible for absenteeism from school and work and unnecessary medical care, and is occasionally associated with serious sequelae. URTIs are usually caused by several families of virus; these are the rhinovirus, coronavirus, parainfluenza, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus, influenza, enterovirus and the recently discovered bocavirus. This review will mainly focus on the rhinovirus, where significant advances have been made in understanding the epidemiology, natural history and relationship with other pathogens.
ABSTRACT
Although there has been a global decline in the incidence of pertussis in the past four decades; the incidence has increased in developed countries; particularly in preteens; adolescents and adults. These groups provide a major reservoir of the disease for vulnerable unimmunised or incompletely immunised infants. This trend has not yet been documented in South Africa. In young infants; the diagnosis is made on the basis of clinical features. Older age groups do not usually show the typical clinical picture; leading to misdiagnosis and underreporting. The culture of Bordetella pertussis from the posterior nasopharynx remains the gold standard for diagnosis but laboratory diagnosis is complex and unavailable in most settings. Erythromycin; instituted early in the course of illness; remains the treatment of choice although there is now good evidence for the use of other macrolides; particularly in the neonate. Immunisation of young infants remains the best preventative methodagainst the disease. Due to the re-emergence of the disease in older age groups; developed countries are recommending booster vaccines in adolescents