The clinical spectrum of respiratory syncytial virus disease in The Gambia.

ABSTRACT

PIP: Respiratory syncytial virus (RSV) is a well-recognized cause of lower respiratory tract infections during early childhood in industrialized countries. The study of 4 RSV infection outbreaks which occurred during 1993-96 in The Gambia led to the identification of RSV infection in 574 children through the immunofluorescent staining of nasopharyngeal aspirate samples among children of median age 3-8 months who presented with respiratory infections at 3 hospitals in the Western region of the country. 13 children had conditions thought to increase the risk of severe RSV infection, with crepitations heard during physical examinations in 80% of children admitted to the hospital and wheezes heard in 39%. 80 children were given oxygen because of hypoxemia. 9 of 255 blood cultures were positive for the following pathogens: 4 Streptococcus pneumoniae, 2 Haemophilus influenzae type b, 2 Staphylococcus aureus, and 1 Enterobacter agglomerans. 13 children died. 90% of isolates typed during year 1 were RSV subgroup A, 25% in the second year of study, 75% in year 3, and 95% in year 4. These findings demonstrate that RSV is a significant cause of lower respiratory tract infection in young children in The Gambia, causing epidemics of bronchiolitis. It is most likely cost-effective to prevent RSV infection through vaccination.