Human Rhinovirus Association with Influenza-Like Illness and Symptomatic Treatment for Acute Respiratory Infection in a Brazilian Southern City

Objective: To understand the infection status and molecular types of rhinovirus (RV) among cases of Acute Respiratory Infections (ARIs) in Luohe City, Henan Province, from 2017 to 2022. Methods: From October 2017 to June 2022, clinical and epidemiological data were collected from 2 270 cases of ARIs at Luohe Central Hospital in Henan Province. Throat swab specimens were obtained from these cases. Real-time quantitative polymerase chain reaction (qPCR) was used to screen for RV-positive specimens. Subsequently, the positive samples were subjected to nested reverse transcription polymerase chain reaction (nested RT-PCR) to amplify the full-length VP1 region. Using the MEGA software, along with 169 RV reference strains recommended by the International Committee on Taxonomy of Viruses, a phylogenetic tree was constructed to determine RV types. Results: Among the 2 270 cases of ARIs, there were 1 283 male cases (56.52%). The median age (Q1, Q3) was 3 (1, 6) years, with the population under 5 years old accounting for 68.59% (1 557/2 270). RV was detected in 137 cases (6.04%), of which 68 cases (49.64%) showed co-detection with other viruses, with the most common being co-detection with enterovirus, accounting for 14.60% (20/137). The RV detection rates in the age groups of 0~4 years, 5~14 years, 15~59 years, and≥60 years were 6.42% (100/1 557), 4.69% (21/448), 3.80% (6/158), and 9.35% (10/107), respectively, with no statistically significant differences (χ2=5.310, P=0.150). The overall detection rates of RV before (2017-2019) and during (2020-2022) the COVID-19 pandemic showed no statistically significant difference (χ2=1.823, P=0.177). A total of 109 VP1 sequences were obtained, including 62 types. Among them, RV-A, RV-B, and RV-C had 42, 3, and 17 types respectively. Conclusion: RV is one of the predominant pathogens in ARIs cases in Luohe City, Henan Province, from 2017 to 2022. Multiple types of RV co-circulate without any apparent dominant type.

There is limited surveillance and laboratory capacity for non-influenza respiratory viruses in India. We leveraged the influenza sentinel surveillance of India to detect other respiratory viruses among patients with acute respiratory infection. Six centers representing different geographic areas of India weekly enrolled a convenience sample of 5-10 patients with acute respiratory infection (ARI) and severe acute respiratory infection (SARI) between September 2016-December 2018. Staff collected nasal and throat specimens in viral transport medium and tested for influenza virus, respiratory syncytial virus (RSV), parainfluenza virus (PIV), human meta-pneumovirus (HMPV), adenovirus (AdV) and human rhinovirus (HRV) by reverse transcription polymerase chain reaction (RT-PCR). Phylogenetic analysis of influenza and RSV was done. We enrolled 16,338 including 8,947 ARI and 7,391 SARI cases during the study period. Median age was 14.6 years (IQR:4-32) in ARI cases and 13 years (IQR:1.3-55) in SARI cases. We detected respiratory viruses in 33.3% (2,981) of ARI and 33.4% (2,468) of SARI cases. Multiple viruses were co-detected in 2.8% (458/16,338) specimens. Among ARI cases influenza (15.4%) were the most frequently detected viruses followed by HRV (6.2%), RSV (5%), HMPV (3.4%), PIV (3.3%) and AdV (3.1%),. Similarly among SARI cases, influenza (12.7%) were most frequently detected followed by RSV (8.2%), HRV (6.1%), PIV (4%), HMPV (2.6%) and AdV (2.1%). Our study demonstrated the feasibility of expanding influenza surveillance systems for surveillance of other respiratory viruses in India. Influenza was the most detected virus among ARI and SARI cases.

There is limited surveillance and laboratory capacity for non-influenza respiratory viruses in India. We leveraged the influenza sentinel surveillance of India to detect other respiratory viruses among patients with acute respiratory infection. Six centers representing different geographic areas of India weekly enrolled a convenience sample of 5–10 patients with acute respiratory infection (ARI) and severe acute respiratory infection (SARI) between September 2016-December 2018. Staff collected nasal and throat specimens in viral transport medium and tested for influenza virus, respiratory syncytial virus (RSV), parainfluenza virus (PIV), human meta-pneumovirus (HMPV), adenovirus (AdV) and human rhinovirus (HRV) by reverse transcription polymerase chain reaction (RT-PCR). Phylogenetic analysis of influenza and RSV was done. We enrolled 16,338 including 8,947 ARI and 7,391 SARI cases during the study period. Median age was 14.6 years (IQR:4–32) in ARI cases and 13 years (IQR:1.3–55) in SARI cases. We detected respiratory viruses in 33.3% (2,981) of ARI and 33.4% (2,468) of SARI cases. Multiple viruses were co-detected in 2.8% (458/16,338) specimens. Among ARI cases influenza (15.4%) were the most frequently detected viruses followed by HRV (6.2%), RSV (5%), HMPV (3.4%), PIV (3.3%) and AdV (3.1%),. Similarly among SARI cases, influenza (12.7%) were most frequently detected followed by RSV (8.2%), HRV (6.1%), PIV (4%), HMPV (2.6%) and AdV (2.1%). Our study demonstrated the feasibility of expanding influenza surveillance systems for surveillance of other respiratory viruses in India. Influenza was the most detected virus among ARI and SARI cases.

Acute respiratory tract infections (ARTIs) are an acute inflammation of the upper and lower respiratory tract caused by the infection of microorganisms or bacteria, viruses, without or accompanied by inflammation of the lung parenchyma. The use of antibiotics is one way to treat respiratory diseases. This study aims to determine the level of resistance of levofloxacin antibiotics to clinical isolates from ARTIs patients at the Tasikmalaya Health Center, Indonesia. The stages of the research included rejuvenation of clinical single isolates from ARTIs patients, identification of bacteria, and antibiotic resistance testing using the paper-disc method. The results of resistance tests from 142 single clinical isolates of acute respiratory infections showed that levofloxacin antibiotics had high levels of resistance of 50.0%, 30.95% of resistance with intermediate levels, and 19.04% were still sensitive. Bacterial identification test results showed bacteria that have been resistant to levofloxacin are from the genus Haemophillus, Streptococcus, Corynebacterium, Staphylococcus, and Bordetella. Treatment of ARTIs with the antibiotic levofloxacin shows that there has been a relatively large resistance, where the results of the identification of all bacteria showed the bacteria that cause ARTIs.

History of upper respiratory tract infection in the mother or siblings was associated with higher risk of acute lower respiratory tract infection in cases. Most upper respiratory tract infections were caused by viral pathogens and likely to occur in many members of the family. The study aimed to determine the existence and pattern of relationship between risk of acute respiratory infection (ARI) among infants and exposure to pre-existing maternal/caregiver acute respiratory tract infection. The study was designed as a community-based Nested case-control study of 1100 infants randomly selected from 12 communities out of 6 Local Government Areas of the 3 senatorial districts of Rivers State. A multistage random sampling technique was used in selecting the subjects up to the community level. Descriptive method was used to represent the characteristics of the subjects and the differences in ARI between exposed and unexposed infants were tested in a bivariate logistics regression at 5% level of significance. Odds ratio (OR) was used to interpret the size effect measures of ARI on exposure to pre-existing maternal/caregiver ARI differences. A total of 275 Cases of ARI and 825 controls were included in the study. Among exposed infants (N = 104), ARI cases were found to be higher n = 80 (76.9%) than in control n = 24 (23.1%). Whereas, among unexposed infants N = 991, ARI cases were found to be lower n = 195 (19.7%) than in control n = 796 (80.3%). For the exposed infants, the odds for ARI were 13.5 times significantly higher compared to those of their unexposed counterparts (OR-Unadjusted = 13.52, (p < 0.0001, 95% CI = 0.047 - 0.121)). The findings will widen the horizon in the etiological consideration of ARI among infants vis-à-vis exposure potential to pre-existing maternal/caregiver ARI via nursing care. Therefore, community-based sensitization programme on barrier nursing care techniques and personal hygiene practices should be on focus.

The problem of prevention and treatment of acute respiratory infections of the upper respiratory tract remains extremely at the top. Although viruses are the etiological factor in more than 90% of acute respiratory infections, the fact of the active use of antibiotics in the treatment of patients with this patology, along with the lack of effective antiviral agents can cause increasing concern, since this is assocatied with an increase in bacterial resistance, sensitization and inflammatory diseases and therefore requires the development of completely different alternative methods of treatment. Since the discovery of the human microbiome over the past two decades, not only the microbiota as a participant in the infectious process, but also probiotics as a factor in managing the immune responses of the macroorganism in viral infections have been actively studied. In addition, the antiviral activity of different probiotic strains has been demonstrated in the scientific literature, which explains the interest of the scientific community in the use of probiotics in acute respiratory infections, especially since probiotics have shown not only efficacy, but aalso high safety in patients of different age groups, including infants. Thus, the literature review showed that the currently available data both from clinical studies and experimental work on the use of probiotics in acute respiratory infections indicate the potential of such an innovative strategy not only for the prevention but also for the treatment of the acute period of the disease, which should be the basis for its wider use in real practice.

This study aims to analyze the relationship between climate variability and acute respiratory infection (ARI) cases in Semarang City over the period 2015-2023. This issue is becoming increasingly relevant as climate change continues to influence weather patterns and environmental conditions, potentially affecting public health outcomes, particularly respiratory health. Method: The research method used is descriptive observational with an ecological study approach according to time which aims to see climate variability with ARI cases. Analyses were conducted to test the correlation between ARI cases and various climatic parameters, so as to obtain a comprehensive understanding of climatic factors that can affect the incidence of ARI. Results: The results of univariate analysis showed that during the period 2015 - 2023 the average ARI cases amounted to 9,815 cases / month, the average temperature was 28.31˚C, the average humidity was 73.49%, the average rainfall was 12.52 mm / month, the average length of sunshine was 7.42 hours, and the average wind speed was 2.55 km / hour. The correlation test results show that, maximum temperature (p = 0.002), average temperature (p = 0.003), average humidity (p = 0.008), wind direction with maximum speed (p = 0.000) have a significant relationship with ARI cases in Semarang City. While the average rainfall parameter (p = 0.681) and the length of sunshine parameter (p = 0.752) have no relationship with ARI cases in Semarang City in 2015 – 2023. Conclusion: Maximum temperature parameter, average temperature parameter, average humidity parameter, and wind direction parameter at maximum speed have a significant relationship with ARI cases. Promotive and preventive efforts need to be made to reduce the risk of ARI transmission, especially at the turn of the season and the density of activities carried out in the community.

Since the initial discovery of RSV-A ON1 in Canada in 2010, ON1 has been reported worldwide, yet information regarding its clinical impact and severity has been controversial. To investigate the clinical relevance of RSV-A ON1,acute respiratory infection (ARI) cases enrolled to our population-based prospective pediatric ARI surveillance at Khanh Hoa General Hospital, Central Vietnam from January 2010 through December 2012 were studied. Clinical-epidemiological information and nasopharyngeal samples were collected. Multiplex PCR assays were performed for screening 13 respiratory viruses. RSV-positive samples were further tested for subgroups (A/B) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region. Statistical analysis was performed to evaluate the clinical-epidemiological characteristics of RSV-A ON1. A total of 1854 ARI cases were enrolled and 426 (23.0%) of them were RSV-positive. During the study period, RSV-A and B had been co-circulating. NA1 was the predominant RSV-A genotype until the appearance of ON1 in 2012. RSV-related ARI hospitalization incidence significantly increased after the emergence of ON1. Moreover, multivariate analysis revealed that risk of lower respiratory tract infection was 2.26 (95% CI: 1.37–3.72) times, and radiologically-confirmed pneumonia was 1.98 (95% CI: 1.01–3.87) times greater in ON1 compared to NA1 cases. Our result suggested that ON1 ARI cases were clinically more severe than NA1.

Context: Pneumonia is the leading killer of children worldwide. AIMS: To study clinical and epidemiological factors associated with Acute Respiratory Infection (ARI) cases and find the case fatality rate. Setting and Design: Hospital-based cross-sectional study. Materials And Methods: Detailed clinical examination of all ARI cases were done in children below 12 years of age. The relevant socio-demographic and epidemiological information of the cases were collected by interviewing the parents/guardians of the children through a pre-tested proforma. Duration of the study was one year. Statistical Analysis Used: χ² test, P < 0.05 was considered as statistically significant. Results: There were 539 (11.3%) ARI cases from a total of 4,764 admissions. There were 317 males and 222 females. Out of 539 ARI cases, 455 (84.4%) were in the age group of 0-5 years. Malnutrition was associated with 360 (79.1%) of the 455 under-five cases. A total of 283 (62.2%) cases were incompletely immunized for age. Case fatality rate was 3.8% in males and 8.1% in females. Conclusion: Children who were incompletely immunized for age suffered from severe forms of ARI, and this was statistically significant. The case fatality rate was much higher in females, and this was statistically significant. The comorbid factors/illnesses with ARI, which were statistically significantly associated with mortality, were malnutrition, acute diarrheal illness, septicemia, meningitis, and congenital anomaly.

Objective To analyze the viral etiology of acute respiratow infection,and to study the activity and epidemiological characteristic of main pathogens,so as to establish pathogen spectrum of acute respiratory infection in Fengtai district of Beijing.Methods Basic information and throat swabs of acute respiratory infection cases during 2010-2012 were collected.Influenza virus,respiratory syncytial virus,adenovirus,parainfluenza virus,metapneumovirus,coronavirus,rhinovirus,human Boca virus and mycoplasma pneumonia were detected by multiplex PCR and RT-PCR.SPSS 17.0 was used for data analysis.Results 154 were positive in all of the 254 samples,the positive ratio was 60.63％.Influenza viruses,parainfluenza virus and mycoplasma pneumoniae were the most frequently detected pathogens in winter and spring.Parainfluenza and mycoplasma were the only detected pathogens in summer.There was no significant difference in positive rate between male and female patients.Influenza viruses and parainfluenza virus were the major viral pathogens of influenza-like illness,mycoplasma pneumoniae was the major pathogen of pneumonia patients.Influenza A was dominate during 2010-2011,while influenza B as the major one during the 2011-2012 influenza season.Conclusions Influenza virus,mycoplasma pneumoniae,and parainfluenza virus were the main pathogens leading to acute respiratory infection during 2010-2012 in Fengtai district of Beijing.The major pathogens were different in different seasons. Key words: Acute respiratory tract infection; Pathogen spectrum; Viral etiology

The leading infectious cause of death in children worldwide is lower acute respiratory infection (LARI), particularly pneumonia. We enrolled a total of 538 acute respiratory infection (ARI) cases according to WHO criteria and age-sex matched 514 controls in the Forcibly Displaced Myanmar National (FDMN) refugee camps in Cox's Bazar, Bangladesh, between June 2018 and March 2020 to investigate the role of bacteria, viruses, and their co-infection patterns and observe Streptococcus pneumoniae (S. pneumoniae) serotype distribution. According to the etiological findings, children ≤5 years of age have a higher bacterial positivity (90%) and viral positivity (34%) in nasopharyngeal samples (NPS) compared to those >5 years of age, in both ARI cases as well as for the control group. Among the bacteria, S. pneumoniae was predominant in both cases and controls (85% and 88%). Adenovirus (ADV)(34), influenza virus A and B (IFV-A, B)(32,23), and respiratory syncytial virus (RSV)(26) were detected as the highest number among the viruses tested for the ARI cases. The total number of viruses was also found higher in ≤5 years of age group. Within this group, positive correlation was observed between bacteria and viruses but negative correlation was observed between bacteria. Both single and co-infection for viruses were found higher in the case group than the control group. However, co-infection was significantly high for Streptococcus aureus (S. aureus) and Haemophilus influenzae b (H. influenza b) (p<0.05). Additionally, semi-quantitative bacterial and viral load was found higher for the ARI cases over control considering Cycle threshold (Ct)≤30. Pathogen identification from blood specimens was higher by qRT-PCR than blood culture (16% vs 5%, p<0.05). In the S. pneumoniae serotype distribution, the predominant serotypes in ARI cases were 23F, 19A, 16F, 35B, 15A, 20 and 10F, while 11A, 10A, 34, 35A and 13 serotypes were predominant in the control group. Pathogen correlation analysis showed RSV positively correlated with human metapneumovirus (HMPV), S. aureus and H. influenza b while S. pneumoniae was negatively correlated with other pathogens in ≤5 years age group of ARI cases. However, in >5 years age group, S. aureus and H. influenza b were positively correlated with IFVs, and S. pneumoniae was positively correlated with HMPV and ADV. Logistic regression data for viruses suggested among the respondents in cases were about 4 times more likely to be RSV positive than the control. Serotype distribution showed 30% for PCV10 serotypes, 41% for PCV13 and 59% for other serotypes. Also, among the 40 serotypes of S. pneumoniae tested, the serotypes 22F, Sg24, 9V, 38, 8, and 1 showed strong positive correlation with viruses in the case group whereas in the control group, it was predominant for serotypes 14, 38, 17F and 39 ARI cases were prevalent mostly in monsoon, post-monsoon, and winter periods, and peaked in September and October. Overall these region-specific etiological data and findings, particularly for crisis settings representing the FDMNs in Cox's Bazar, Bangladesh, is crucial for disease management and disease prevention control as well as immunization strategies more generally in humanitarian crisis settings.

Background:Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under-five children of the developing world. The prevalence of ARIs is determined individually or collectively by a number of factors which may be prevalent in our environment.Aim:The present study is aimed to determine the risk factors that affect the prevalence of ARIs in under-five children in Enugu.Subjects and Methods:A cross-sectional study of 436 under-five children diagnosed with ARI was carried out in three hospitals in Enugu. Participants were consecutively enrolled after being diagnosed as a case of ARI. Structured pro foma was used to collect sociodemographic characteristics, anthropometric data and risk profile. Data were analyzed using Epi info version 6.0 and significant probability value was 5%.Results:A total of 436 patients were enrolled for the study 224 males and 212 females M: F 1.06:1. The mean age of the population was 18.75(13.38) months and there were 31.6%(138/436) cases of pneumonia 6.9%(30/436) cases of bronchiolitis and 61.5%(268/436) cases of acute upper respiratory tract infections. Children less than 20 months accounted for 60.9% (84/138 cases) of pneumonia, 86.7% (26/30 cases) of bronchiolitis, and 64.5% (173/268 cases) of acute upper respiratory tract infections. Pneumonia was noted in about 75.7% (56/74) of inadequately nourished children compared to 22.6% (82/362) in adequately nourished children. Other risk factors identified in the study include inadequate breast feeding, poor immunization statues, attendance to daycare centers, large family size, poor parental educational statues, parental smoking, living in the urban area and use of biofuels.Conclusion:ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple strategies. It is recommended that control program for ARIs should be multifaceted with a strong political will.

This article is devoted to the analysis of consumer preferences in the context of treatment of acute respiratory viral infections (ARVI) using homeopathic medicines. The study covers various aspects such as patients' main motivations for choosing homeopathy, their level of satisfaction with the results of treatment, and factors influencing the use of homeopathic remedies in complex therapy. The authors of the article review data from social surveys conducted on Google Forms portal, medical research, and literature reviews to provide a comprehensive overview of current trends in the use of homeopathic remedies in the treatment of acute respiratory infections. Special attention is paid to the influence of sociocultural and educational factors on patients' decision-making regarding treatment choices. The results of the study may be useful for health professionals, pharmacists and public health organizations, helping to better understand consumer preferences for homeopathy and to develop individualized approaches to the treatment of acute respiratory infections. The aim of the study is to analyse consumer preferences in the use of homeopathic medicines in the complex treatment of acute respiratory viral infections. Materials: Questionnaires and Surveys: Development of structured questionnaires to collect information from patients about their preferences, motivations and experiences of using homeopathic medicines for ARVI. The survey was conducted anonymously on Google Forms platform, which allowed systematisation of the data obtained. Internet resources: Analysis of discussions and reviews on medical forums and social networks related to homeopathy and treatment of acute respiratory infections. Methods: Statistical analysis: Processing data from questionnaires using statistical techniques such as frequency and correlation analyses. Qualified interviews: Conducting interviews with patients, doctors to gain a deeper understanding of motivations and experiences of using homeopathic medicines. Systematic literature review: Examining existing scientific articles and publications related to homeopathy and ARVI to obtain additional data and context. Comparative analysis: Comparison of questionnaire results with literature review and interviews to identify trends and influence of consumer preferences on the use of homeopathic medicines. Results. The study found that homeopathic medicines have the potential to be in demand in the comprehensive treatment of acute respiratory infections. Scope of the findings: the results of the study may be useful for health professionals, pharmacists and public health organisations, helping to better understand consumer preferences for homeopathy and to develop individualised approaches to the treatment of ARVI.

The article presents a modern view of amoxicillin in the treatment of acute respiratory infections in children from point of view of a microbiologist and clinical pharmacologist. Modern microbiological methods have changed the idea of the microbiota of the respiratory tract, however, the etiology of acute bacterial infections of the respiratory tract has not undergone significant changes – Streptococcus pneumoniae and Haemophilus influenzae are still the most common pathogens. Amoxicillin remains the drug of choice for most respiratory infections of bacterial etiology. Inhibitor-protected aminopenicillins (amoxicillin/clavulanate etc.) do not have advantages over amoxicillin in most cases of acute respiratory tract infections, but increase the risk of adverse events. Current data on macrolides, which are widely used in clinical practice, indicate the need to limit their use in acute infections of the respiratory tract due to the increase in resistance of S. pneumoniae and the absence of clinically significant activity against H. influenza. Current information on the resistance of S. pneumoniae and H. influenzae, as well as available data on the pharmacokinetics of amoxicillin, require a review of dosing approaches. The daily dose of amoxicillin in children with acute respiratory infections should not be less than 45–60 mg/kg, and in many cases (acute otitis media, infections caused by H. influenzae or penicillin-resistant S. pneumoniae strains), more than 90 mg/kg/day is required. Amoxicillin has a wide therapeutic range, and therefore the use of high doses of the drug is not associated with a decrease in the safety of therapy.

To evaluate a community education program about treatment of acute respiratory infection (ARI). First, community case definitions for severe and mild ARI were developed. The intervention was then evaluated using a controlled before-and-after design. Household surveys collected data about ARI treatment in 20 clusters, each based around a school and health facility. Treatment indicators included percentages of cases attending health facilities and receiving antibiotics. The intervention consisted of an education program in schools culminating in street theater performances, discussions with mothers after performances and training for community leaders and drug retailers by paramedics. The intervention was conducted in mid-2003. Indicators were measured before the intervention in Nov/Dec 2002 and again in Dec 2003/Jan 2004. Two thousand and seven hundred and nineteen households were surveyed and 3654 under-fives were identified, of whom 377 had severe ARI. After implementing the intervention, health post (HP) attendance rose by 13% in under-fives with severe ARI and fell by 9% in under-fives with mild ARI (test of interaction, P = 0.01). Use of prescribed antibiotics increased in under-fives with severe ARI by 21% but only by 1% in under-fives with mild ARI (test of interaction, P = 0.38). Irrespective of ARI severity, the use of non-prescribed antibiotics dropped by 5% (P = 0.002), and consultation with female community health volunteers (FCHVs)and use of safe home remedies increased by 6.7% (P not estimated) and 5.7% (P = 0.008) respectively. The intervention was implemented using local structures and in difficult circumstances, yet had a moderate impact. Thus it has the potential to effect large scale changes in behaviour and merits replication elsewhere.