Etiology of acute viral respiratory infections common in Pakistan: A review.

Respiratory infections, especially those of the lower respiratory tract, remain a foremost cause of mortality and morbidity of children greater than 5 years in developing countries including Pakistan. Ignoring these acute-level infections may lead to complications. Particularly in Pakistan, respiratory infections account for 20% to 30% of all deaths of children. Even though these infections are common, insufficiency of accessible data hinders development of a comprehensive summary of the problem. The purpose of this study was to determine the prevalence rate in various regions of Pakistan and also to recognize the existing viral strains responsible for viral respiratory infections through published data. Respiratory viruses are detected more frequently among rural dwellers in Pakistan. Lower tract infections are found to be more lethal. The associated pathogens comprise respiratory syncytial virus (RSV), human metapneumovirus (HMPV), coronavirus, enterovirus/rhinovirus, influenza virus, parainfluenza virus, adenovirus, and human bocavirus. RSV is more dominant and can be subtyped as RSV-A and RSV-B (BA-9, BA-10, and BA-13). Influenza A (H1N1, H5N1, H3N2, and H1N1pdm09) and Influenza B are common among the Pakistani population. Generally, these strains are detected in a seasonal pattern with a high incidence during spring and winter time. The data presented include pneumonia, bronchiolitis, and influenza. This paper aims to emphasise the need for standard methods to record the incidence and etiology of associated pathogens in order to provide effective treatment against viral infections of the respiratory tract and to reduce death rates.

COVID-19 Shuts Doors to Flu but Keeps Them Open to Rhinoviruses.

It is well known that rhinoviruses are distributed across the globe and are the most common cause of the common cold in all age groups. Rhinoviruses are widely considered to be harmless because they are generally perceived as respiratory viruses only capable of causing mild disease. However, they may also infect the lower respiratory tract, inducing chronic obstructive pulmonary disease and exacerbations of asthma, bronchiolitis, etc. The role of rhinoviruses in pathogenesis and the epidemiological process is underestimated, and they need to be intensively studied. In the light of recent data, it is now known that rhinoviruses could be one of the key epidemiological barriers that may influence the spread of influenza and novel coronaviruses. It has been reported that endemic human rhinoviruses delayed the development of the H1N1pdm09 influenza pandemic through viral interference. Moreover, human rhinoviruses have been suggested to block SARS-CoV-2 replication in the airways by triggering an interferon response. In this review, we summarized the main biological characteristics of genetically distinct viruses such as rhinoviruses, influenza viruses, and SARS-CoV-2 in an attempt to illuminate their main discrepancies and similarities. We hope that this comparative analysis will help us to better understand in which direction research in this area should move.

Infections respiratoires aigües virales chez les enfants de moins de 15 ans à Conakry: étiologies et prise en charge / Acute viral respiratory infections of children aged 0-15 years in the city of Conakry: aetiologies and management

Introduction. Les infections respiratoires aiguës (IRA) sont des pathologies ubiquitaires très fréquentes, touchant aussi bien les adultes que les enfants. L'inclusion des vaccins conjugués, contre les pneumocoques et l'Haemophilus influenzae type B a modifié l'épidémiologie en réduisant la prévalence de ces bactéries dans les atteintes infectieuses respiratoires, la prédominance virale est devenue la règle. Notre travail avait pour objectif d'identifier les principaux virus responsables d'IRAS chez les enfants au service de pédiatrie de Donka de décrire la prise en charge des enfants. Patients et méthodes. Étude descriptive prospective de 6 mois allant du 01 Avril au 30 Septembre 2022 incluant les enfants admis au service pour IRAS dont une PCR a été réalisée sur prélèvement nasopharyngé. Résultats. Une proportion de 3,3% des 1584 enfants avaient une IRA virale. 51,1% avaient moins de 5 ans. La proportion des filles était de 63,05% et 76,09% des enfants étaient vaccinés selon le programme élargi de vaccination (PEV). Les motifs de consultation les plus fréquents étaient : fièvre, difficulté respiratoire, asthénie physique, myalgie et toux. La bronchiolite était le diagnostic le plus fréquent. Le diagnostic clinique et radiologique était dominé par la bronchiolite, la bronchopneumonie et la pneumonie. La PCR était positive dans 3,26% des cas dont 2/3 pour le virus influenza et 1/3 pour le coronavirus. Le paracétamol, l'oxygénation, l'antibiothérapie et le sérum physiologique dominaient le traitement. Conclusion. La prévalence des IRA reste élevée avec une faible implication virale. Une étude plus poussée comprenant la microbiologie des prélèvements nasopharyngés et la PCR est nécessaire

Introduction. Acute respiratory infections (ARI) are very common ubiquitous pathologies, affecting both adults and children. The inclusion of conjugate vaccines, against pneumococci and Haemophilus influenzae type b, has changed the epidemiology by reducing the prevalence of these bacteria in respiratory infectious diseases, viral predominance has become the rule. The aim of our study was to identify the main viruses responsible for ARI in children at the Donka Pediatric Department and to secribe the management of patients. Patients and methods. This was a prospective descriptive study of 6 months from 01 April to 30 September 2022 including children admitted to the service for IRAS whose PCR was performed on nasopharyngeal swab. Results. A proportion of 3.3% of the 1584 children had viral SARI. 51.1% were under 5 years of age. The proportion of girls was 63.05% and 76.09% of children were vaccinated according to the EPI. The most common reasons for consultations were fever, difficulty breathing, physical asthenia, myalgia and cough. Bronchiolitis was the most common diagnosis, Clinical and radiological diagnosis was dominated by bronchiolitis, bronchopneumonia and pneumonia. PCR was positive in 3.26% of cases including 2/3 for influenza virus and 1/3 for coronavirus. Paracetamol, oxygenation, antibiotic therapy and saline dominated treatment. Conclusion. The prevalence of SARI remains high with low viral involvement. Further study including bacteriology of nasopharyngeal specimens and PCR is needed

Differentiating early adult dengue from acute viral respiratory infections – A comparative analysis.

The clinical presentations of dengue disease in adults are not fully described. Differentiating dengue from other acute viral respiratory infections (ARIs) is important. We conducted a prospective study from January 2008 to March 2010, recruiting subjects with early febrile illness presenting within the first 72 hours of illness at primary care outpatient clinics. This study evaluates cases enrolled to identify distinguishing clinical features of early dengue infection from ARIs. Acute and convalescent venous blood and nasal swab specimens were collected. Dengue was confirmed by RT-PCR, virus isolation, IgM/IgG seroconversion or fourfold IgG titre increase in paired blood samples. Non-dengue cases were tested for respiratory viruses from nasal swabs by RT-PCR. Dengue was confirmed in 49 patients along with 151 cases of influenza, 10 of parainfluenza and 29 patients of other viruses. The demographics between dengue (n=49) and PCR-positive viral ARI cases (n=190) did not differ significantly except by age (mean 39.1 years vs 33.7 years respectively; P