DETECTION OF NON-INFLUENZA VIRUSES IN ACUTE RESPIRATORY INFECTIONS IN CHILDREN UNDER FIVE-YEAR-OLD IN COTE D'IVOIRE (JANUARY - DECEMBER 2013).

BACKGROUND: Influenza sentinel surveillance in Cote d'Ivoire showed that 70% of Acute Respiratory Infections (ARI) cases remained without etiology. This work aims to describe the epidemiological, clinical, and virological pattern of ARI that tested negative for influenza virus, in children under five years old. MATERIALS AND METHODS: one thousand and fifty nine samples of patients presenting influenza Like Illness (ILI) or Severe Acute Respiratory Infections (SARI) symptoms were tested for other respiratory viruses using multiplex RT-PCR assays targeting 10 respiratory viruses. RESULTS: The following pathogens were detected as follows, hRV 31,92% (98/307), hRSV 24.4% (75/329), PIV 20.5% (63/307), HCoV 229E 12,05% (37/307), hMPV 6.2% (19/307), HCoVOC43 1.0% (3/307) and EnV 1.0% (3/307). Among the 1,059 specimens analyzed, 917 (86.6%) were ILI samples and 142 (23.4%) were SARI samples. The proportion of children infected with at least one virus was 29.8% (273/917) in ILI cases and 23.9% (34/142) in SARI cases. The most prevalent viruses, responsible for ILI cases were hRV with 35.89% (98/273) and hRSV in SARI cases with 41.2% (14/34) of cases. Among the 1,059 patients, only 22 (2.1%) children presented risk factors related to the severity of influenza virus infection. CONCLUSION: This study showed that respiratory viruses play an important role in the etiology of ARI in children. For a better understanding of the epidemiology of ARI and improved case management, it would be interesting in this context to expand the surveillance of influenza to other respiratory viruses.

Investigation of an outbreak of acute respiratory disease in côte d'ivoire in april 2007.

BACKGROUND: This study aim was to investigate an outbreak of human cases of unexplained influenza-like illness and fatal acute respiratory infection (ARI), with simultaneous poultry illness and high mortality raising concerns of possible influenza A (H5N1), virus in Cote d'Ivoire in February and March 2007. MATERIALS AND METHODS: To investigate the outbreak, we conducted active surveillance in the community and reviewed health registries. Persons meeting the case definition were asked to provide nasopharyngeal specimens. On the basis of clinical and epidemiological information, specimens were tested using conventional RT-PCR for the M gene of the influenza viruses and hemagglutinin H5 of avian influenza A (H5N1), virus; negative samples were tested for other respiratory viruses. Specimens from healthy animals were also collected. RESULTS: Between October 2006, and February 2007, 104 suspected cases of Acute Respiratory Disease that included; 31 deaths recorded. We collected and tested 73 nasopharyngeal specimens; of which, 2, were positive for human Coronavirus OC43 and 1 for influenza C virus. No pathogens were identified in animal specimens. CONCLUSIONS: The investigation quickly ruled out influenza A (H5N1), virus as the cause and found laboratory-confirmed cases of influenza C virus and human Coronavirus OC 43 for the first time in both Côte d'Ivoire and in a Sub-Saharan African country. However we were not able to show that these viruses caused the outbreak. Monitoring of influenza viruses must be a priority but other respiratory viruses and non-viral causes may be of interest too.

Comparing influenza positivity rates by real-time rt-pcr, elisa and viral culture methods in Cote d'Ivoire, West Africa, in 2009

Detection of circulating influenza strains is a key public health concern especially in limited-resource settings where diagnosis capabilities remain a challenge. As part of multi-site surveillance in Cote d'Ivoire during the 2009 influenza A(H1N1) pandemic; we had the opportunity to test respiratory specimens collected from patients with acute respiratory illness (ARI). We analyzed and compared the percentage of specimens testing positive using three laboratory methods (rtRT-PCR; ELISA; viral culture). From January to October 2009; 1;356 respiratory specimens were collected from patients with acute respiratory illness and shipped at the WHO NIC (Institut Pasteur) Cote d'Ivoire; and 453 (33) tested positive for influenza by one or more laboratory methods. The proportion of positive influenza tests did not differ by the sex or age of the patient or presenting symptoms; but did differ depending on the timing and site of specimen collection. Of the 453 positive specimens; 424 (93.6) were detected by PCR; 199 (43.9) by ELISA and 40 (8.8) by viral culture. While seasonal influenza A(H1N1) virus strains were prominent; only four 2009 pandemic influenza A(H1N1) cases were detected. Use of molecular biology method (rtRT-PCR) increased sensitivity and diagnosis capabilities. Among all three methods used; rRT-PCR was the most sensitive and rapid method. More capacity building is still required for viral culture. Need to collect denominator data in order to have an accurate estimate of the burden of influenza. There was delayed introduction of pandemic influenza A(H1N1)2009 in Cote d'Ivoire

Investigation of an outbreak of acute respiratory disease in Côte d'Ivoire in april 2007

Background: This study aim was to investigate an outbreak of human cases of unexplained influenza-like illness and fatal acute respiratory infection (ARI); with simultaneous poultry illness and high mortality raising concerns of possible influenza A (H5N1); virus in Cote d'Ivoire in February and March 2007. Materials and Methods: To investigate the outbreak; we conducted active surveillance in the community and reviewed health registries. Persons meeting the case definition were asked to provide nasopharyngeal specimens. On the basis of clinical and epidemiological information; specimens were tested using conventional RT-PCR for the M gene of the influenza viruses and hemagglutinin H5 of avian influenza A (H5N1); virus; negative samples were tested for other respiratory viruses. Specimens from healthy animals were also collected. Results: Between October 2006; and February 2007; 104 suspected cases of Acute Respiratory Disease that included; 31 deaths recorded. We collected and tested 73 nasopharyngeal specimens; of which; 2; were positive for human Coronavirus OC43 and 1 for influenza C virus. No pathogens were identified in animal specimens. Conclusions: The investigation quickly ruled out influenza A (H5N1); virus as the cause and found laboratory-confirmed cases of influenza C virus and human Coronavirus OC 43 for the first time in both Cote d'Ivoire and in a Sub-Saharan African country. However we were not able to show that these viruses caused the outbreak. Monitoring of influenza viruses must be a priority but other respiratory viruses and non-viral causes may be of interest too

Comparing Influenza Positivity Rates by Real-Time RT-PCR, Elisa and Viral Culture Methods in Côte D'Ivoire, West Africa, in 2009.

Detection of circulating influenza strains is a key public health concern especially in limited-resource settings where diagnosis capabilities remain a challenge. As part of multi-site surveillance in Côte d'Ivoire during the 2009 influenza A(H1N1) pandemic, we had the opportunity to test respiratory specimens collected from patients with acute respiratory illness (ARI). We analyzed and compared the percentage of specimens testing positive using three laboratory methods (rtRT-PCR, ELISA, viral culture). From January to October 2009, 1,356 respiratory specimens were collected from patients with acute respiratory illness and shipped at the WHO NIC (Institut Pasteur) Cote d'Ivoire, and 453 (33%) tested positive for influenza by one or more laboratory methods. The proportion of positive influenza tests did not differ by the sex or age of the patient or presenting symptoms, but did differ depending on the timing and site of specimen collection. Of the 453 positive specimens, 424 (93.6%) were detected by PCR, 199 (43.9%) by ELISA and 40 (8.8%) by viral culture. While seasonal influenza A(H1N1) virus strains were prominent, only four 2009 pandemic influenza A(H1N1) cases were detected. Use of molecular biology method (rtRT-PCR) increased sensitivity and diagnosis capabilities. Among all three methods used, rRT-PCR was the most sensitive and rapid method. More capacity building is still required for viral culture. Need to collect denominator data in order to have an accurate estimate of the burden of influenza. There was delayed introduction of pandemic influenza A(H1N1)2009 in Cote d'Ivoire.

Sentinel surveillance for influenza and other respiratory viruses in Côte d'Ivoire, 2003-2010.

BACKGROUND: Many countries in Africa have lacked sentinel surveillance systems for influenza and are under-represented in data used for global vaccine strain selection. OBJECTIVES: We describe 8 years of sentinel surveillance data and the contribution of influenza and other viruses to medically attended influenza-like illness (ILI) in Côte d'Ivoire. METHODS: Sentinel surveillance was established in 2003. Nasopharyngeal (NP) specimens and epidemiologic data are collected from persons of all ages presenting with ILI at sentinel sites. Respiratory specimens have been tested for influenza using various viral and molecular diagnostic methods. A subset of 470 specimens collected from children aged 0-5 years were tested for multiple respiratory viruses using RT-PCR. RESULTS: From 2003 to 2010, 5074 NP specimens were collected from patients with ILI. Overall, 969/5074 (19%) of these specimens tested positive for influenza. Seasonal influenza A(H1N1) viruses predominated during 5 years and influenza A(H3N2) viruses predominated during 3 years. Influenza B viruses cocirculated with influenza A viruses during each year from 2004 to 2010. Seasonal peaks in influenza circulation were observed during the months of May, June, and October, with the largest peak corresponding with the primary rainfall season. Of 470 specimens collected from children under aged 5 who were tested for multiple respiratory viruses, a viral respiratory pathogen was detected in 401/470 (85%) of specimens. Commonly detected viruses were RSV (113 of 470 specimens, 24%), rhinoviruses (85/470, 18%), influenza (77/470, 16%), and parainfluenza (75/470, 16%). CONCLUSION: In Côte d'Ivoire, there is a significant annual contribution of influenza and other respiratory viruses to medically attended ILI.