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1.
Medicine (Baltimore) ; 100(18): e25799, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950979

RESUMO

ABSTRACT: To investigate the epidemiology and factors associated with the severity of viral acute lower respiratory infection (ALRI) in children hospitalized in Manaus, Amazonas, in 2017 to 2018.Retrospective cohort study of children hospitalized at the Hospital and Emergency Room Delphina Rinaldi Abdel Aziz, in Manaus, from April 01, 2017 to August 31, 2018, with a clinical diagnosis of ALRI and nasopharyngeal aspirates positive for at least 1 respiratory virus.One hundred forty-six children aged 0.2 to 66 months (median 7 months) were included. Patients were divided into 2 groups according to the disease severity classified by an adapted Walsh et al score: moderate disease, score 0-4, n = 66 (45.2%) and severe disease, score 5-7, n = 80 (54.8%). A greater number of viral ALRI cases were observed in the rainiest months. Respiratory syncytial virus was the most prevalent (n = 103, 70.3%), followed by metapneumovirus (n = 24, 16.4%), influenza virus (n = 17, 11.6%), parainfluenza virus (n = 11, 7.5%), and adenovirus (n = 4, 2.7%). Co-detections of 2 to 3 viruses were found in 12 (8.2%) patients. The presence of viral coinfection was an independent risk factor for disease severity (adjusted relative risk [RR] 1.53; 95% CI 1.10-2.14). Twelve patients (8.2%) died, all with severe disease. Risk factors for death were shock (adjusted RR 10.09; 95% CI 2.31-43.90) and need for vasoactive drugs (adjusted RR 10.63; 95% CI 2.44-46.31).There was a higher incidence of viral ALRI in Manaus in the rainy season. Respiratory syncytial virus was the most prevalent virus. The presence of viral coinfection was an independent risk factor for disease severity.


Assuntos
Infecções por Adenovirus Humanos/epidemiologia , Coinfecção/epidemiologia , Influenza Humana/epidemiologia , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Adenoviridae/isolamento & purificação , Infecções por Adenovirus Humanos/diagnóstico , Infecções por Adenovirus Humanos/virologia , Brasil/epidemiologia , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/virologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Influenzavirus A/isolamento & purificação , Influenzavirus B/isolamento & purificação , Masculino , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/diagnóstico , Infecções por Paramyxoviridae/virologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/isolamento & purificação , Respirovirus/isolamento & purificação , Estudos Retrospectivos , Índice de Gravidade de Doença
2.
Vaccine ; 39(22): 2983-2988, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-33931252

RESUMO

BACKGROUND: Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia. METHODS: Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), non-medical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture. RESULTS: 200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140-258), representing a median 16.4% (10.4-22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564-987), meaning that government subsidies covered a median 75.2% (70.2-78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653-1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus. CONCLUSION: These comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines.


Assuntos
Infecções por Vírus Respiratório Sincicial , Infecções Respiratórias , Assistência ao Convalescente , Criança , Hospitalização , Humanos , Lactente , Malásia/epidemiologia , Alta do Paciente , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Fatores Socioeconômicos
3.
BMC Infect Dis ; 21(1): 345, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33849461

RESUMO

BACKGROUND: To guide decision-making on immunisation programmes for ageing adults in Europe, one of the aims of the Vaccines and InfecTious diseases in the Ageing popuLation (IMI2-VITAL) project is to assess the burden of disease (BoD) of (potentially) vaccine-preventable diseases ((P)VPD). We aimed to identify the available data sources to calculate the BoD of (P)VPD in participating VITAL countries and to pinpoint data gaps. Based on epidemiological criteria and vaccine availability, we prioritized (P) VPD caused by Extra-intestinal pathogenic Escherichia coli (ExPEC), norovirus, respiratory syncytial virus, Staphylococcus aureus, and pneumococcal pneumonia. METHODS: We conducted a survey on available data (e.g. incidence, mortality, disability-adjusted life years (DALY), quality-adjusted life years (QALY), sequelae, antimicrobial resistance (AMR), etc.) among national experts from European countries, and carried out five pathogen-specific literature reviews by searching MEDLINE for peer-reviewed publications published between 2009 and 2019. RESULTS: Morbidity and mortality data were generally available for all five diseases, while summary BoD estimates were mostly lacking. Available data were not always stratified by age and risk group, which is especially important when calculating BoD for ageing adults. AMR data were available in several countries for S. aureus and ExPEC. CONCLUSION: This study provides an exhaustive overview of the available data sources and data gaps for the estimation of BoD of five (P) VPD in ageing adults in the EU/EAA, which is useful to guide pathogen-specific BoD studies and contribute to calculation of (P)VPDs BoD.


Assuntos
Efeitos Psicossociais da Doença , Doenças Preveníveis por Vacina/economia , Envelhecimento , Infecções por Caliciviridae/economia , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/mortalidade , Infecções por Caliciviridae/patologia , Europa (Continente)/epidemiologia , Humanos , Incidência , Pneumonia Pneumocócica/economia , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/mortalidade , Pneumonia Pneumocócica/patologia , Anos de Vida Ajustados por Qualidade de Vida , Infecções por Vírus Respiratório Sincicial/economia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/mortalidade , Infecções por Vírus Respiratório Sincicial/patologia , Inquéritos e Questionários , Doenças Preveníveis por Vacina/epidemiologia , Doenças Preveníveis por Vacina/mortalidade , Doenças Preveníveis por Vacina/patologia
4.
BMC Pediatr ; 21(1): 195, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888063

RESUMO

BACKGROUND: To investigate the impact of protective measures and isolation on respiratory tract infections in children during the COVID-19 outbreak. METHODS: We extracted data on outpatient visits and respiratory infection visits, and tests of respiratory viruses (adenovirus (ADV), influenza A (FluA), influenza B (FluB) and respiratory syncytial virus (RSV)) from electronic healthcare records in Children's Hospital, Zhejiang University School of Medicine during the COVID-19 outbreak (January-April, 2020), compared with those in 2018 and 2019 during the same periods. RESULTS: We found that outpatient visits in January, 2020 was comparable with those in 2018 and 2019, but decreased by 59.9% (288,003 vs. 717,983) and 57.4% (288,003 vs. 676,704), respectively during the period of February-April, 2020, as compared with the same periods in 2018 and 2019. The total number of respiratory tract infections from January to April 2020 decreased by 65.7% (119,532 vs.348,762) and 59.0% (119,532 vs.291,557), respectively compared with the same periods in 2018 and 2019. The proportion of respiratory tract infections during the outbreak also dropped compared with the same periods in 2018 and 2019 (P<0.001). We also found significantly decreased number of completed tests for respiratory viruses and positive cases of ADV, FluA, FluB, and RSV during February-April, 2020. CONCLUSIONS: In this study, we found that outpatient visits and respiratory tract infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent respiratory virus infections in children.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Criança , Surtos de Doenças , Humanos , Lactente , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia
5.
BMC Pediatr ; 21(1): 201, 2021 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-33910510

RESUMO

BACKGROUND: Respiratory Syncytial Virus (RSV) is the commonest cause of acute lower respiratory infections (ALRI) in infants. However, the burden of RSV is unknown in Ethiopia. We aimed to determine the prevalence, seasonality and predictors of RSV infection in young infants with ALRI for the first time in Ethiopia. METHODS: We performed RSV immuno-chromatographic assay from nasopharyngeal swabs of infants, 29 days to 6 months of age. We included the first 10 eligible infants in each month from June 2018 to May 2019 admitted in a tertiary pediatric center. Clinical, laboratory and imaging data were also collected, and chi-square test and regression were used to assess associated factors with RSV infection. RESULTS: Among a total of 117 study children, 65% were male and mean age was 3 months. Bronchiolitis was the commonest diagnosis (49%). RSV was isolated from 26 subjects (22.2%) of all ALRI, 37% of bronchiolitis and 11% of pneumonia patients. Although RSV infection occurred year round, highest rate extended from June to November. No clinical or laboratory parameter predicted RSV infection and only rainy season (Adjusted Odds Ratio (AOR) 10.46 [95%. C.I. 1.95, 56.18]) was independent predictor of RSV infection. CONCLUSIONS: RSV was isolated in a fifth of young infants with severe ALRI, mostly in the rainy season. Diagnosis of RSV infection in our setting require specific tests as no clinical parameter predicted RSV infection. Since RSV caused less than a quarter of ALRI in our setting, the other causes should be looked for in future studies.


Assuntos
Bronquiolite , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Bronquiolite/diagnóstico , Bronquiolite/epidemiologia , Criança , Etiópia/epidemiologia , Feminino , Hospitalização , Humanos , Lactente , Masculino , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia
6.
Medicine (Baltimore) ; 100(16): e25498, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879683

RESUMO

ABSTRACT: We aimed to assess the respiratory virus characteristics and forecasts among young children with acute respiratory tract infection (ARTI) in west China.This retrospective study investigated the epidemic characteristics of respiratory viruses among 11,813 paediatric ARTI patient samples (mean age, 2.25 years) between March 2018 and March 2020.The ratio of boys to girls was 1.36. The 2 predominant viruses were influenza (Flu) A and respiratory syncytial virus (RSV) in both years, with Flu A accounting for 47.3% and 47.5% in the first and second years and RSV accounting for 32.7% and 24.7% of the positive samples in the first and second years, respectively. The Flu B positive rates were 10.9% and 13.1%, and those of the other 4 viruses were <7%. The most common virus was RSV in children below 5 years and Flu A in those between 5 and 10 years. Flu A and RSV demonstrated pronounced seasonality, and their infection rates increased from October. During the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, isolation measures led to a decline in the number of ARTI cases.This study provides surveillance data of the respiratory viruses in west China. It could guide medical staff in implementing necessary prevention and management strategies before future viral outbreaks.


Assuntos
Epidemias , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , COVID-19/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Previsões , Humanos , Vírus da Influenza A , Vírus da Influenza B , Influenza Humana/epidemiologia , Masculino , Infecções por Paramyxoviridae/epidemiologia , Vigilância da População , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estudos Retrospectivos
9.
BMC Infect Dis ; 21(1): 293, 2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33757443

RESUMO

BACKGROUND: Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality in children and adults. Socioeconomic status (SES) is known to influence many health outcomes, but there have been few studies of the relationship between RSV-associated illness and SES, particularly in adults. Understanding this association is important in order to identify and address disparities and to prioritize resources for prevention. METHODS: Adults hospitalized with a laboratory-confirmed RSV infection were identified through population-based surveillance at multiple sites in the U.S. The incidence of RSV-associated hospitalizations was calculated by census-tract (CT) poverty and crowding, adjusted for age. Log binomial regression was used to evaluate the association between Intensive Care Unit (ICU) admission or death and CT poverty and crowding. RESULTS: Among the 1713 cases, RSV-associated hospitalization correlated with increased CT level poverty and crowding. The incidence rate of RSV-associated hospitalization was 2.58 (CI 2.23, 2.98) times higher in CTs with the highest as compared to the lowest percentages of individuals living below the poverty level (≥ 20 and < 5%, respectively). The incidence rate of RSV-associated hospitalization was 1.52 (CI 1.33, 1.73) times higher in CTs with the highest as compared to the lowest levels of crowding (≥5 and < 1% of households with > 1 occupant/room, respectively). Neither CT level poverty nor crowding had a correlation with ICU admission or death. CONCLUSIONS: Poverty and crowding at CT level were associated with increased incidence of RSV-associated hospitalization, but not with more severe RSV disease. Efforts to reduce the incidence of RSV disease should consider SES.


Assuntos
Censos , Hospitalização/economia , Infecções por Vírus Respiratório Sincicial/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Pobreza , Características de Residência , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano , Classe Social , Estados Unidos/epidemiologia , Adulto Jovem
10.
Medicine (Baltimore) ; 100(11): e24315, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33725930

RESUMO

ABSTRACT: Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to summarize and investigate the co-infection of SARS-CoV-2 in children.We retrospectively reviewed the clinical manifestations, laboratory findings, and imaging characteristics of COVID-19 patients in co-infection group (CI, n = 27) and single infection group (SI, n = 54). Samples were tested for multiple pathogens.A high incidence (27/81, 33%) of co-infection in children with COVID-19 was revealed. The most frequent co-infected pathogen was mycoplasma pneumoniae (MP, 20/81, 25%), followed by virus (6/81, 7%), and bacteria (4/81, 5%). No significant difference in clinical characteristics, laboratory examinations, or hospital stay was observed between the patients with co-infections and those with monomicrobial, only lower in white blood cell counts (CI: 5.54 ±â€Š0.36 vs SI: 7.38 ±â€Š0.37, P = .002), neutrophil counts (CI: 2.20 ±â€Š0.20 vs SI: 2.92 ±â€Š0.23, P = .024) and lymphocyte counts (CI: 2.72 ±â€Š0.024 vs SI: 3.87 ±â€Š0.28, P = .006). Compared with the patients with monomicrobial, chest imaging of those with co-infections showed consolidation in more cases (CI: 29.6% vs SI: 11.1%, P = .038) and duration of positive in nucleic acid was shorter (CI: 6.69 ±â€Š0.82 vs SI: 9.69 ±â€Š0.74, P = .015).Co-infection was relatively common in children with COVID-19, almost 1/3 had co-infection, most commonly caused by MP. Co-infection did not cause a significant exacerbation in clinical manifestations.


Assuntos
/epidemiologia , Coinfecção/epidemiologia , Infecções por Adenoviridae/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Coinfecção/microbiologia , Coinfecção/virologia , Feminino , Humanos , Influenza Humana/epidemiologia , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Infecções por Moraxellaceae/epidemiologia , Mycoplasma pneumoniae , Infecções Pneumocócicas/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estudos Retrospectivos
11.
PLoS One ; 16(3): e0248932, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33765037

RESUMO

Few studies have examined the effects of inbound overseas travelers and meteorological conditions on the shift in human respiratory syncytial virus (HRSV) season in Japan. This study aims to test whether the number of inbound overseas travelers and meteorological conditions are associated with the onset week of HRSV epidemic season. The estimation of onset week for 46 prefectures (except for Okinawa prefecture) in Japan for 4-year period (2014-2017) was obtained from previous papers based on the national surveillance data. We obtained data on the yearly number of inbound overseas travelers and meteorological (yearly mean temperature and relative humidity) conditions from Japan National Tourism Organization (JNTO) and Japan Meteorological Agency (JMA), respectively. Multi-level mixed-effects linear regression analysis showed that every 1 person (per 100,000 population) increase in number of overall inbound overseas travelers led to an earlier onset week of HRSV epidemic season in the year by 0.02 week (coefficient -0.02; P<0.01). Higher mean temperature and higher relative humidity were also found to contribute to an earlier onset week by 0.30 week (coefficient -0.30; P<0.05) and 0.18 week (coefficient -0.18; P<0.01), respectively. Additionally, models that included the number of travelers from individual countries (Taiwan, South Korea, and China) except Australia showed that both the number of travelers from each country and meteorological conditions contributed to an earlier onset week. Our analysis showed the earlier onset week of HRSV epidemic season in Japan is associated with increased number of inbound overseas travelers, higher mean temperature, and relative humidity. The impact of international travelers on seasonality of HRSV can be further extended to investigations on the changes of various respiratory infectious diseases especially after the coronavirus disease 2019 (COVID-19) pandemic.


Assuntos
Infecções por Vírus Respiratório Sincicial/patologia , Viagem , Epidemias , Humanos , Umidade , Japão/epidemiologia , Modelos Teóricos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estações do Ano , Temperatura
13.
Artigo em Inglês | MEDLINE | ID: mdl-33533808

RESUMO

Respiratory syncytial virus (RSV) is the main cause of lower respiratory disease in infants and children under five years of age. As there is no specific treatment for RSV infections, prophylaxis with the specific monoclonal antibody palivizumab (PVZ) has been widely recommended for high-risk cases during the RSV season. The present study aimed to evaluate the effectiveness of a public prophylaxis program with palivizumab on the incidence of hospitalizations for lower respiratory tract infections and RSV in children at high risk for severe RSV infections. A retrospective cohort study was carried out with preterm children or children under two years of age with chronic lung disease or hemodynamically significant congenital heart disease; the children were selected on the basis of their exposure status, which was defined as the prophylactic use of palivizumab during the RSV season. Children were enrolled retrospectively in two hospitals located in Southern Brazil, from May 2009 to August 2016. In a sample of 129 children, 69 (53.5%) received palivizumab and adherence to three or more doses was observed in 78%; 60 (46.5%) children did not receive palivizumab. PVZ prophylaxis was independently associated with a 66% reduction in hospitalizations for any cause (26/69 - 37.7%) in the PVZ group and 34/60 (56.7%) in the control group). A 52% reduction in hospitalizations due to lower respiratory tract infection was observed in the PVZ group (15/69 -21.7%) and 25/60 (41.7%) in the control group. These findings suggest that, for the group of studied patients, the adoption of an RSV prophylaxis scheme reached the same effectiveness as those described in previous clinical trials.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antivirais/uso terapêutico , Hospitalização/estatística & dados numéricos , Palivizumab/uso terapêutico , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Avaliação de Programas e Projetos de Saúde , Saúde Pública , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Estudos Retrospectivos
14.
Epidemiol Infect ; 149: e55, 2021 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33568242

RESUMO

In Japan, respiratory syncytial virus (RSV) infection generally has occurred during autumn and winter. However, a possible change in the seasonal trend of RSV infection has been observed recently. The current study was conducted to determine whether the epidemic season of RSV infection in Japan has indeed changed significantly. We used expectation-based Poisson scan statistics to detect periods with high weekly reported RSV cases (epidemic cluster), and the epidemic clusters were detected between September and December in the 2012-2016 seasons while those were detected between July and October in the 2017-2019 seasons. Non-linear and linear ordinary least squares regression models were built to evaluate whether there is a difference in year trend in the epidemic seasonality, and the epidemic season was shifted to earlier in the year in 2017-2019 compared to that in 2012-2016. Although the reason for the shift is unclear, this information may help in clinical practice and public health.


Assuntos
Epidemias/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Humanos , Japão/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano , Estações do Ano , Fatores de Tempo
15.
BMC Geriatr ; 21(1): 120, 2021 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579210

RESUMO

BACKGROUND: Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce. METHODS: RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed. RESULTS: Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak's cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died. CONCLUSIONS: This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.


Assuntos
Infecção Hospitalar , Infecções por Vírus Respiratório Sincicial , Idoso , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Hospitais , Humanos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estudos Retrospectivos
16.
Int J Infect Dis ; 105: 442-447, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33582375

RESUMO

OBJECTIVE: The emergence of a novel coronavirus, SARS-CoV-2, and its subsequent spread outside of Wuhan, China, led to the human society experiencing a pandemic of coronavirus disease 2019 (COVID-19). While the development of vaccines and pharmaceutical treatments are ongoing, government authorities in China have implemented unprecedented non-pharmaceutical interventions as primary barriers to curb the spread of the deadly SARS-CoV-2 virus. Although the decline of COVID-19 cases coincided with the implementation of such interventions, we searched for evidence to demonstrate the efficacy of these interventions, since artifactual factors, such as the environment, the pathogen itself, and the phases of epidemic, may also alter the patterns of case development. METHODS: We surveyed common viral respiratory infections that have a similar pattern of transmission, tropism, and clinical manifestation, as COVID-19 under a series of non-pharmaceutical interventions during the current pandemic season. We then compared this data with historical data from previous seasons without such interventions. RESULTS: Our survey showed that the rates of common respiratory infections, such as influenza and respiratory syncytial virus infections, decreased dramatically from 13.7% (95% CI, 10.82-16.58) and 4.64% (95% CI, 2.88-7.64) in previous years to 0.73% (95% CI, 0.02-1.44) and 0.0%, respectively, in the current season. CONCLUSIONS: Our surveillance provides compelling evidence that non-pharmaceutical interventions are cost-effective ways to curb the spread of contagious agents, and may represent the only practical approach to limit the evolving epidemic until specific vaccines and pharmaceutical treatments are available.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/virologia , Viroses/epidemiologia , Adulto Jovem
17.
Euro Surveill ; 26(6)2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33573711

RESUMO

BackgroundBronchiolitis caused by respiratory syncytial virus (RSV) is a major cause of mortality and morbidity in infants.AimTo describe RSV epidemiology in children in the community in a high-income setting.MethodsWe used stored blood samples from the United Kingdom Born in Bradford cohort study that had been collected at birth, age 1 and 2 years old, tested for IgG RSV postfusion F antibody and linked to questionnaires and primary and hospital care records. We used finite mixture models to classify children as RSV infected/not infected according to their antibody concentrations at age 1 and 2 years. We assessed risk factors for primary RSV infection at each age using Poisson regression models.ResultsThe study cohort included 700 children with cord blood samples; 490 had additional blood samples taken at both ages 1 and 2 years old. Of these 490 children, 258 (53%; 95% confidence interval (CI): 48-57%) were first infected with RSV at age 1, 99 of whom (38%; 95% CI: 33-43%) had been in contact with healthcare during peak RSV season (November-January). Having older siblings, birth in October-June and attending formal childcare were associated with risk of RSV infection in infancy. By age 2, a further 164 of 490 children (33%; 95% CI: 29-38%) had been infected.ConclusionOver half of children experienced RSV infection in infancy, a further one third had evidence of primary RSV infection by age 2, and one in seven remained seronegative by their second birthday. These findings will inform future analyses to assess the cost-effectiveness of RSV vaccination programmes in high-income settings.


Assuntos
Registros Eletrônicos de Saúde , Infecções por Vírus Respiratório Sincicial , Criança , Pré-Escolar , Estudos de Coortes , Inglaterra/epidemiologia , Hospitalização , Humanos , Lactente , Recém-Nascido , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Reino Unido
18.
Med Sci Monit ; 27: e929783, 2021 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-33388738

RESUMO

BACKGROUND This retrospective study aimed to investigate co-infections with common respiratory pathogens and SARS-CoV-2 and laboratory biochemistry findings in patients with COVID-19 in the Zhuzhou area of China, in order to provide a reference for the disease assessment and clinical treatment of COVID-19. MATERIAL AND METHODS The clinical data of COVID-19 patients admitted to the hospital of Zhuzhou City from January 28 to March 15, 2020, as well as laboratory test results for respiratory pathogens and biochemical indicators, were collected to conduct correlation analyses. All patients were diagnosed based on fluorescence-based PCR assay for SARS-CoV-2. RESULTS Eleven of the 78 patients (14.1%) were co-infected with other respiratory pathogens, among which Mycoplasma pneumoniae (n=5, 45.5%) and respiratory syncytial virus (n=4, 36.4%) were the most frequent. There were 8 patients co-infected with 1 other pathogen and 3 patients co-infected with 2 other pathogens. Compared with mono-infected COVID-19 patients, patients with co-infections had significantly higher levels of procalcitonin (P=0.002). CONCLUSIONS The findings showed that Mycoplasma pneumonia and respiratory syncytial virus were the most common co-infections in patients with COVID-19 pneumonia. Increased levels of PCT in patients with COVID-19 pneumonia were associated with co-infection.


Assuntos
/epidemiologia , Coinfecção/epidemiologia , Pandemias , Infecções Respiratórias/epidemiologia , /isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/uso terapêutico , Biomarcadores , Proteína C-Reativa/análise , /diagnóstico , Criança , Pré-Escolar , China/epidemiologia , Creatina Quinase/sangue , Estudos Transversais , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/epidemiologia , Pró-Calcitonina/sangue , Infecções por Vírus Respiratório Sincicial/sangue , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/sangue , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
19.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(1): 67-73, 2021 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-33476540

RESUMO

OBJECTIVE: To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI). METHODS: Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed. RESULTS: A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (P=0.030). A total of 298 samples were detected with single RSV, 148 were detected with RSV mixed with other viruses, 389 were detected with other viruses, and 241 were detected negative for viruses. Compared with the other viruses and negative virus groups, the single RSV group had a significantly younger age and significantly higher incidence rates of dyspnea, respiratory failure, and severe lower respiratory tract infection (P < 0.0083). The RSV-A positive group had a significantly higher proportion of boys than the RSV-B positive group (P=0.004), but there were no significant differences in clinical manifestations between the two groups. CONCLUSIONS: In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Criança , Criança Hospitalizada , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Masculino , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia
20.
Viruses ; 13(1)2021 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-33477301

RESUMO

Human respiratory syncytial virus (RSV) is the most common cause of upper and lower respiratory tract infections in infants and young children. It is actively evolving under environmental and herd immunity influences. This work presents, for the first time, sequence variability analysis of RSV G gene and G protein using St. Petersburg (Russia) isolates. Viruses were isolated in a cell culture from the clinical samples of 61 children hospitalized (January-April 2014) with laboratory-confirmed RSV infection. Real-time RT-PCR data showed that 56 isolates (91.8%) belonged to RSV-A and 5 isolates (8.2%) belonged to RSV-B. The G genes were sequenced for 27 RSV-A isolates and all of them belonged to genotype ON1/GA2. Of these RSV-A, 77.8% belonged to the ON1(1.1) genetic sub-cluster, and 14.8% belonged to the ON1(1.2) sub-cluster. The ON1(1.3) sub-cluster constituted a minor group (3.7%). Many single-amino acid substitutions were identified in the G proteins of St. Petersburg isolates, compared with the Canadian ON1/GA2 reference virus (ON67-1210A). Most of the amino acid replacements were found in immunodominant B- and T-cell antigenic determinants of G protein. These may affect the antigenic characteristics of RSV and influence the host antiviral immune response to currently circulating viruses.


Assuntos
Variação Genética , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/fisiologia , Proteínas do Envelope Viral/genética , Genótipo , História do Século XXI , Humanos , Filogenia , Vigilância em Saúde Pública , Infecções por Vírus Respiratório Sincicial/história , Vírus Sincicial Respiratório Humano/classificação , Vírus Sincicial Respiratório Humano/isolamento & purificação , Federação Russa/epidemiologia , Análise de Sequência de DNA , Proteínas do Envelope Viral/metabolismo
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