Proposed Pathway Linking Respiratory Infections with Depression.

Viral respiratory tract infections and asthma: The course ahead

Symptoms often continue for two but rarely for four weeks after onset of respiratory infection.

Association of viruses causing acute respiratory infections with meteorological factors and air pollutants in hospitalised children in Macao: a retrospective analysis

Acute respiratory infections (ARIs) are common during the first two years of life, when infants and young children experience six to eight ARIs annually. In this age group, ARIs are the most commonly managed problems in general practice. Between 3 and 6% of infants are hospitalised in their first year of life with a severe ARI illness. Information about the epidemiology of ARI in children is based on historic community-based studies, cohorts of hospitalised patients, emergency department or primary healthcare presentations, and more recently from birth cohort studies principally involving children at high-risk of asthma. However, these studies do not completely identify the burden of mild-to-moderate ARIs in the community.Recent community-based cohort studies have used sensitive polymerase chain reaction (PCR) assays. However, they have had one or more methodological limitations, including subject selection, length of study, non-representative sample populations, variable sampling frequency, and the lack of a control population. Furthermore, frequent detection of respiratory viruses in asymptomatic individuals questions their clinical and public health significance. Studies reporting the causal effect of individual respiratory viruses in ARI are needed to help address this question.The Observational Research in Childhood Infectious Diseases (ORChID) study was a four year prospective, community-based, longitudinal birth cohort study of ARIs in 158 healthy children from birth to two years of age. ORChID sought to minimise some of the methodological limitations of previous studies. Parents completed a daily symptom diary and collected weekly nasal swabs, which were tested against 17 respiratory viruses. Healthcare-seeking behaviour was recorded in a separate ‘burden’ diary.I found that young children experienced 0.56 (95% confidence interval (CI): 0.54, 0.59) ARIs per child-month. This equated to almost five cumulative months of respiratory symptoms during the first two years. Forty-eight percent of ARIs where a burden diary was completed initiated a visit to a family doctor. ARIs were associated with increasing age, the winter season, and childcare attendance.Studies examining respiratory viruses in neonates have largely been from neonatal units or neonates presenting to hospital with respiratory symptoms. I was able to show that respiratory virus infections were common (0.25 episodes per neonatal period, 95% CI: 0.18, 0.34), with diverse human rhinovirus (HRV) genotypes dominating (21/29; 72% of neonates with positive swabs). Almost 50% of respiratory virus infections in this period were asymptomatic. This subclinical shedding of all respiratory virus types complicates estimates of the true community burden of viral ARI in infants and young children.To explore this further, I investigated the relative contribution of individual respiratory viruses to ARIs by calculating the virus-specific attributable fractions in exposed (AFE) children of ARIs and lower respiratory tract infections (LRTIs). The overall incidence of virus infections was 978 (95% CI: 930, 1029) per 100 child-years in the first two years of life. Viruses were detected in 75% of ARI episodes, while 23% of weekly swabs were positive for viruses during asymptomatic periods. RNA viruses, including HRV, influenza, parainfluenza, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), and human coronaviruses NL63 and OC43 were associated with a significantly increased risk of ARI symptoms. Support for causality was strongest for RSV (AFE 68%, 95% CI: 45%, 82%), and HMPV (AFE 69%, 95% CI: 43%, 83%) in children with LRTIs. In contrast, amongst the DNA viruses tested, only adenoviruses (AFE 29%, 95% CI; 12%, 42%) were significantly associated with an increased risk of ARI symptoms. Of HRV species, only HRV-C had a significant AFE result for LRTIs (AFE 22% (95% CI: 5%, 22%).I went on to examine the timing of detection for each of the 17 respiratory viruses tested for in the ORChID infant cohort. Determining timing of first virus detection episodes (fVDEs) for different respiratory viruses in infants and young children identifies risk periods and informs preventive interventions, including vaccination. The median age for first HRV infections was 2.9 months (25th–75th centiles: 1.6, 5.1), while for all other respiratory viruses combined the median age was >13.9 months. Overall 52% of first HRV detections were symptomatic, compared with 57-83% with the other first virus detections. Thus, infants and young children do not always experience respiratory symptoms with their first viral detection episode, and for some viruses, such as RSV, these commonly occur when maternal vaccines may no longer offer protection.Collectively, these findings highlight the important community-managed disease burden caused by respiratory viruses in early childhood. They also provide a wealth of information about the relationship between respiratory virus infection and symptoms of respiratory illness. The ORChID study uses modern molecular-based techniques over four respiratory seasons to address questions about respiratory virus acquisition and infection.

Commentary: Myths and facts on vitamin D amidst the COVID-19 pandemic

Infections, Immunity & their Effects on Asthma

Alterations in Pulmonary Function Following Respiratory Viral Infection

See related article See related correspondence

Acute viral respiratory infections are common causes of febrile episodes in children. There are still limited data about distribution of acute viral respiratory infections in children with cancer. The first aim of this study was to evaluate the viral etiology and seasonality of acute viral respiratory infection in pediatric patients with cancer in a 3-year study. Our second aim was to evaluate the impact of viral infections on delaying the patients' chemotherapy or radiotherapy. This cross-sectional study was conducted from January 2014 to July 2017. Nasopharyngeal aspirates were analyzed in patients younger than 21 years with acute respiratory infections. Patients were treated in the Pediatric Hematology and Oncology Department of Dr. Behçet Uz Children's Hospital with real-time multiplex polymerase chain reaction. Data were analyzed to determine the frequency and seasonality of infections. The χ or the Fisher exact tests were used. A total of 219 samples of nasopharyngeal aspirates and blood were analyzed. The mean patient age was 76.8±59.3 months, with 46.3% female and 53.7% male children in a total of 108 patients. Of this total, 55% (60/108 cases) had multiple acute respiratory infections. Acute lymphoblastic leukemia (48.1%) was the most prevalent disease. The 3 most prevalent viruses were human rhinovirus (HRV) (33.1%), parainfluenza (PI) (18.7%), and coronavirus (CoV) (14.8%). In terms of the seasonal distribution of viruses, PI was most common in winter 2014, HRV in spring 2014, HRV in fall 2014, PI in winter 2015 and summer 2015, CoV in spring 2015, HRV in fall 2015, both influenza and HRV in winter 2016, both human metapneumovirus and bocavirus in spring 2016, HRV in summer 2016, both HRV and PI in fall 2016, both respiratory syncytial virus and influenza in winter 2017, HRV in spring 2017, and both HRV and adenovirus in summer 2017. The mean duration of neutropenia for patients with viral respiratory infection was 17.1±13.8 (range: 2 to 90) days. The mean duration of symptoms of viral respiratory infection was 6.8±4.2 (range: 2 to 31) days. A delay in chemotherapy treatment owing to viral respiratory infection was detected in 73 (33.3%) patients. The mean duration of delay in chemotherapy treatment was 9.6±5.4 (range: 3 to 31) days. In conclusion, we report our 3-year experience about the frequency and seasonality of respiratory viruses in children with cancer.

Objective To analyze the detection results of respiratory viruses in throat swab samples from pediatric patients with acute respiratory infections in Urumqi in 2018, so as to understand the etiological and epidemiological characteristics of the respiratory viruses. Methods Multiple real time fluorescent PCR was used to detect nucleic acids of five common respiratory viruses in 1 935 throat swab samples of pediatric patients with respiratory infections collected from January to December, 2018. The difference of the positive rates in different seasons, ages, genders, and regions was compared. Results For the 1 935 samples, the positive rate of five respiratory viruses was 50.34%. The positive rate of influenza virus nucleic acids (37.73%) was the highest, followed by parainfluenza virus (8.32%). The positive rates of nucleic acids of the other three viruses were about 1%. The differences in the distributions of positive rates of nucleic acids for the five viruses in different genders, ages and seasons were statistically significant. Conclusions Influenza virus and parainfluenza virus were the main pathogens of respiratory tract viral infections among children in Urumqi. The respiratory viral infections among children under 3 years old were more common than that in children of 7-12 years old. The surveillance of respiratory viruses for infants should be strengthened. Key words: Respiratory infection; Respiratory virus; Etiology

Background: Human Bocavirus (hBoV) has recently been identified as a causative agent of acute respiratory infection (ARI) in infant and young children. However, there is little information about its frequency and importance as a cause of lower respiratory tract infection (LRTI) in Iraq. Objective:To assess the frequency of hBoV and co-infection rate in infants and young children with LRTI. Methods: Nasopharyngeal/throat swabs were collected during the peak winter months from 100 hospitalized infants and young children less than 5 years of age with LRTI in Baghdad, Iraq. Five viruses were investigated by Multiplex Real-Time Polymerase Chain Reaction (RT-PCR). Results: It was found that 71 (71%) had a viral infection either single or mixed. Six out of 100 samples (6%) were hBoV positive, 10 (10%) were parainfluenza virus positive, 12 (12%) tested positive for adenovirus, 58 (58%) were rhinovirus positive and none of the samples gave positive results for coronavirus. Sixteen samples showed mixed infection with rhinovirus, eight of these (8%) with parainfluenza virus, 6 (6%) with adenovirus, and 2 (2%) with hBoV. There were no significant differences between the viral infected and non-infected patients with respect to age, gender, crowding status, gestational age, diagnosis at presenting and hospital stay (the average stay of viral-infected patients in the hospital was three days). In contrast, exposure to smoking was significantly more associated with viral-infected children than virus-free children (80% vs. 44.83%, P<0.001). In addition, viral-infected children showed significantly less proportion for need for intensive care unit than virus-free children (15.5% vs. 79.31%, P<0.001). Breastfeeding was found to have significant adverse association with viral infection (P<0.001). About one-third of viral-infected children had a medical history involving a disease other than respiratory infection (P<0.001). Finally, viral-infected children were reported to have longer period of illness before hospital admission (6.32±5.49 days) than virus-free children (6.32±5.49 days vs. 3.38±2.37 days, P<0.01). Conclusion: More than two third of children with respiratory tract infection have been viral infection either single or mixed. Multiplex RT-PCR has the potential for clinical use in the rapid and differential detection of viral infection. Keywords: Viral respiratory tract infection, Children, Multiplex Real Time PCR Citation: Rasheed ZS, Al-Shuwaikh AMA, Issa KR. Multiplex RT-PCR based detection of Human Bocavirus and other respiratory viruses in infants and young children with lower respiratory tract infection. Iraqi JMS. 2019; 17(1): 74-82. doi: 10.22578/IJMS.17.1.11

Current research and future needs in allergic rhinitis and asthma

Objective To study etiological characteristics of common respiratory viruses infection in children under 7 years old in Dongguan city of Guangdong province.Methods The total RNA were extracted from 340 specimens which had been collected from children under 7 years old during February 2007 to October 2007 in Shijie hospital.During the study the respiratory viruses including respiratory syncytial virus A and B(RSV-A and B), influenza A and B(FLU-A and B), parainfluenza 1, 2, 3(PIV-1, 2 and 3) and Human metapneumo virus (hMPV) were detected by reverse transcription-polymerase chain reaction(RT-PCR).Results The common respiratory viruses were demonstrated in 340 children as the positive 50.29%(171/340),including 69 cases (20.29%) with RSV-A infection, 39 cases(11.47%) with FLU-A, 32 cases (9.41%) with hMPV, 22 cases (6. 47%) with PIV-3,9 cases (2.65%) with RSV-A, and 16 cases (9.36% of all viral infection positive cases) with the mixed infection.In these respiratory viruses mixed infection cases,there were 5 hMPV cases coinfected with RSV-A, 4 RSV-A cases with PIV-3, 2 hMPV eases with PIV-3, 2 hMPV cases with FLU-B, 2 cases FLU-A with PIV-3, and 1 ease RSV-A with FLU-A, FLU-B, PIV-1, PIV-2, and multiple mixed infections haven't been detected in this study.Conclusions The data show common respiratory viruses are significant pathogens in acute respiratory infection of paediatric patients under 7 years old in Dongguan city.RSV is still the leading causes of acute respiratory infection in children, the next pathogens respectively are FLU-A and hMPV. Key words: Children; Acute respiratory infection; Respiratory virus; Etiology

Blood MxA protein as a marker for respiratory virus infections in young children

The incidence of influenza and acute respiratory infections (ARI) continues to grow, including due to limited opportunities for immunoprophylaxis of the most common respiratory infections, in particular, acute respiratory viral infections (ARVI). Attempts are being made to reduce the children susceptibility to respiratory pathogens through the rational use of nonspecific immunoprophylactic agents, among which bacterial lysates (BL) occupy a special place. BL key patterns, contributing to the prevention of viral infections, are innate immune response activation, excessive inflammatory response prevention, adaptive immune response stimulation. BL contain fragments of inactivated various pathogenic bacteria strains that are important in the ARI etiology. Obtaining lysates of bacterial strains is possible by mechanical or chemical lysis. The article discusses the results of preclinical and clinical studies on BL, as well as suggests the expediency of further study concerning the BL pharmacodynamic effects within the modern concept of trained immunity. The authors conclude that BL as a trained immunity inducer according to the rationally selected regimen can contribute to the respiratory infections' prevention both during COVID-19 pandemic and post-pandemic period. KEYWORDS: acute respiratory infections, acute respiratory viral infections, influenza, trained immunity, immunoprophylaxis, bacterial lysate. FOR CITATION: Zaplatnikov A.L., Kanner E.V., Kanner I.D., Girina A.A., Farber I.M., Maximov M.L. Promising immunomodulatory effects of bacterial lysates in the prevention and treatment of acute and recurrent respiratory infections in children. Russian Journal of Woman and Child Health. 2023;6(3):290–297 (in Russ.). DOI: 10.32364/2618-8430-2023-6-3-12.