Symptoms Of Acute Respiratory Infection Research Articles

Human metapneumovirus infection in haematopoietic stem cell transplant recipients: a case series.

Human metapneumovirus (hMPV) is an enveloped virus that causes serious respiratory tract infection among immunocompromised populations especially haematopoietic stem cell transplant (HSCT) recipients. Here, we describe 3 cases of hMPV infection which led to mortality among post HSCT adults. 66 post HSCT adults enrolled between January 2017 and March 2019 at Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, AIIMS, New Delhi, were followed up for a period varying from 16 days to 18 months for any episode of respiratory illness until March 2019. Real time reverse transcriptase polymerase chain reaction (rRT-PCR) was used to detect the virus from appropriate specimens when symptoms of acute respiratory infection appeared. Samples from 88 out of a total of 172 episodes of suspected acute respiratory infection could be tested by rRT-PCR. Of these, 9 episodes were positive for hMPV. Three patients with hMPV associated lower respiratory tract infection (LRTI) expired within 30 days of HSCT. The possible risk factors associated with mortality included LRTI, infection during early post-transplant period (first week following HSCT), absolute lymphocyte count less than 200/µl, absolute neutrophil count less than 500/µl, use of steroid within 30 days prior to infection and need for mechanical ventilation.

Prevalence of olfactory and taste dysfunction in COVID-19 patients: a community care facility study.

PurposeWe aim to study the prevalence of olfactory and taste dysfunction (OTD) in subjects residing in a Community Care Facility (CCF), a center unique to Singapore that is dedicated to isolate foreign workers with COVID-19 infection who have mild disease with minimal or no symptoms.MethodsThis is a cross-sectional study analyzing data prospectively collected from COVID-19-positive subjects who were admitted into a single-center Singapore EXPO CCF from 1st May 2020 to 1st July 2020. The following variables were collected: age, gender, ethnicity, anosmia, ageusia and acute respiratory infection (ARI) symptoms. Symptoms of anosmia and ageusia were self-declared via a mandatory questionnaire administered on admission.ResultsA total of 1983 subjects were included. The overall prevalence of anosmia and ageusia is 3.0% and 2.6%, respectively. 58% of anosmic subjects have co-existent ageusia and 72.6% of anosmic subjects have no concurrent sinonasal symptoms. OTD is less likely to present in subjects who are asymptomatic for ARI, compared to those symptomatic for ARI (anosmia: 2.0% versus 4.4% p = 0.002; ageusia: 1.6% versus 4.2% p < 0.001). There is a difference in the prevalence of OTD between the different ethnic groups (Indian, Chinese, Bangladeshi and Others), with Chinese and Bangladeshi reporting a higher prevalence (p < 0.043)ConclusionThe true prevalence of OTD in COVID-19-positive subjects may be low with aggressive screening of all subjects, including those asymptomatic for ARI.

Herbal medicine for acute sinusitis - current trends

Was to summarize data on the role and place of herbal remedies, in particular, the extract from the roots of Pelargonium sidoides (EPs 7630) in the treatment of acute sinusitis. Materials of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed were used as a data source. The choice of material was carried out according to the keywords: epidemiology of acute sinusitis, modern treatment of acute sinusitis, colds, herbal remedies, Pelargonium sidoides. Analysis of published clinical trial data demonstrates evidence that EPs 7630 is significantly superior to placebo in reducing the duration and severity of symptoms of acute respiratory infection and indicates the advisability of including an extract from Pelargonium sidoides (EPs 7630) roots in OS treatment protocols. The high safety profile and clinically significant efficacy of this drug make EPs 7630 an important component of drug therapy for acute sinusitis.

COVID-19 and cerebral stroke

To analyze mortality rates, rehabilitation potential, and features of the course of stroke in patients with COVID-19. The study included 50 patients in the acute period of stroke who were diagnosed with a new coronavirus infection during treatment. For comparison, we selected a group of 50 patients who had stroke during this period. In the study group, the virus was identified in 38 (76%) patients by polymerase chain reaction (PCR). The onset of symptoms of acute respiratory viral infection or fever was observed on average 11 days after the onset of neurological symptoms. Only in 10 (20%) patients, a PCR smear showed a positive result in the first 24 hours after the development of a stroke. In the main group, death was observed in 30% (n=15) of cases; in the comparison group - in 6% (n=3) cases. Also, in the main group of patients, a lower degree of recovery of impaired neurological functions was noted on the National Institutes of Health Stroke Scale (NIHSS). At discharge from the hospital, 33 (66%) patients had moderate and severe disabilities according to the modified Rankin scale (3-4 points). The differences were statistically significant, as in the main group there was more pronounced disability than in the control group. Lymphopenia was noted in 26 (52%) patients of the main group on admission. Increased mortality rate, decreased recovery of neurological functions and severe disabilities are observed in the group of patients with stroke who were infected by COVID-19. Lymphopenia in a patient with stroke can serve as a prognostic marker of the possible presence of COVID-19 and the degree of lung tissue damage.

Clinical and Laboratory Comparison of Covid-19 and Influenza A/B in Children.

The clinical picture of COVID-19 shows significant similarity with influenza. In this study, it was aimed to compare the clinical and laboratory findings between pediatric patients diagnosed with COVID-19 and those with influenza A or B, and to obtain data on the differential diagnosis of COVID-19 from influenza in children. The study included 104 patients with COVID-19, 140 patients with influenza A and 135 patients with in-fluenza B (379 patients in total) who were admitted to our tertiary hospital with symptoms of acute respiratory tract infection. Fever, cough, runny nose, and pharyngeal hyperemia rates were significantly lower in patients with COVID-19 than in those with influenza A/B. The highest leukocytosis and lymphocytosis rates were seen in influenza A patients. Eosinophil levels were found significantly lower in the influenza A/B patients compared to the COVID-19 group. C-reactive protein levels were significantly higher in the influenza A/B group when compared with the COVID-19 group. The mean PDW value was significantly higher in the COVID-19 patients compared to influenza A/B. Our study data show that low body temperature and loss of taste and smell support the diagnosis of COVID-19, and fever, cough, pharyngeal hyperemia, and runny nose support the diagnosis of influenza. While leukocytosis and increased C-reactive protein suggest influenza, high PDW and eosinophil levels support COVID-19.

1714. Influenza C Virus in U.S. Children with Acute Respiratory Infection 2016-2019

BackgroundInfluenza C virus (ICV) is associated with acute respiratory infection (ARI); however, the burden of ICV is not well-described. We sought to determine the burden and characteristics of ICV in a prospective, population-based cohort.MethodsThe study was conducted within the New Vaccine Surveillance Network (NVSN), a CDC-led, seven-site network that performs population-based surveillance for ARI in children < 5 years. Nasal/throat swabs were collected from emergency department (ED) or inpatient children with ARI, or healthy controls in clinic, between 12/05/2016-10/31/2019 and tested by real-time RT-PCR for ICV and other respiratory viruses. Preliminary data were extracted and demographic/clinical features of ICV+ cases analyzed. We sequenced the hemagglutinin-esterase (HE) gene from ICV+ Pittsburgh samples.ResultsAmong 19,321 children with ARI or healthy controls enrolled and tested for ICV from 2016-2019, 115/17,668 (0.7%) ARI cases and 8/1653 (0.5%) healthy controls tested positive for ICV. The median age of ICV+ ARI subjects was 19 months (IQR 10,46) and 81(70%) were ≤36 months. 42.6% (49) were white, 33.9% (39) black, and 16.5% (19) Hispanic, with the remainder Asian or unknown; 56.5% (62) attended daycare. Among ICV+ ARI cases, 67.8% (78) had fever, 94.8% (109) cough, and 60.8% (70) wheezing. 45.2% (52) ICV+ cases occurred in 2016-17, 6.5% (8) in 2017-2018, and 47.8% (55) in 2018-19 (Table). 40% (46) of ICV+ cases were seen in the ED, while the remainder were inpatients. Median length of stay was 2d (IQR,1-3) with 15 admitted to ICU. 67.8% (78/115) ARI cases had 1 or 2 co-detected pathogens, with rhinovirus (26), respiratory syncytial virus (26), and adenovirus (14) most frequently co-detected. ARI symptoms including fever, myalgias, chills, and wheezing did not differ significantly between coinfected subjects and those who were only ICV+. HE sequences were in the two currently circulating Kanagawa and Sao Paulo lineages.ICV+ Cases by Site and Year ConclusionICV was an uncommon cause of ARI symptoms leading to healthcare encounters in young children. The prevalence varied year-to-year and between different geographic regions. Most children infected with ICV were ≤3 years old and had co-detected pathogens. ICV was similarly rarely detected in healthy controls.Disclosures Christopher J. Harrison, MD, GSK (Grant/Research Support, Infant menigiciccal B conjugate vaccine trial)Merck (Research Grant or Support, Infant pneumococcal conjugate vaccine trial) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support) John V. Williams, MD, GlaxoSmithKline (Advisor or Review Panel member)IDConnect (Advisor or Review Panel member)Quidel (Advisor or Review Panel member)

Retrospective Evaluation of the Prevelance and Seasonal Distribution of Coronaviridae Positivity Before the COVID-19 Pandemic (2016-2020)

Introduction: Coronaviruses are the agents of viral respiratory infections and cause severe respiratory infections, especially in the elderly, those with chronic disease and immunocompromised patients. The aim of this study was to determine the positive and common types of Coronaviridae family in patients admitted to our hospital in the four-year period before the COVID 19 pandemic (2016-2020) and to investigate the distribution of coronavirus positivity by age groups, months, seasons and years. Materials and Methods: Between February 2016 and January 2020, clinical samples of 1164 female (45%) and 1428 (55%) male patients were sent to the molecular virology laboratory from the various clinics of Gazi University, Faculty of Medicine Hospital due to symptoms of acute respiratory tract infection. Coronaviridae family positivity was investigated retrospectively in clinical samples of 2592 patients aged 0-101 years. Nucleic acid extraction from the clinical samples was performed with the ‘EZ1 Virus Mini Kit’. For viral DNA amplification, it was performed by multiplex Real-Time PCR method using ‘FTD Respiratory Pathogen 21’ test. Statistical analysis of the distribution of coronavirus positivity by age groups, months, seasons and years was done by SPSS 20.0 computer program. Results: Two hundred and twenty-nine (8.8%) of the clinical samples were found to be positive for any Coronavirus type. The most common type of Coronavirus was found to be CoV-229E with 52% (119/229). The distribution of other coronavirus types including CoV-HKU1, CoV-OC43 and CoV-NL63 was determined as 19.2% (44/229), 17.4% (40/229) and 14% (32/229) respectively, and the most common type of Coronavirus changed from year to year. Single Coronavirus positivity was found to be 48.1%, its association with other viruses was 51.9%. The highest coinfection of Coronavirus was found in Rhinovirus (35.3%) and influenza A virus (19.3%). Patients over 60 years of age were found to have a higher rate (30.6%) positivity compared to other age groups (p&lt; 0.05). The highest rate of Coronavirus positivity was observed in January (17.4%) and the lowest rate in June (1.7%). It was observed that the highest rate of positivity (44.2%) was in winter and the lowest rate (8.2%) was in summer (p&lt; 0.05). Coronaviruses were found to be detected at higher rates in winter with seasonal variation (p&lt; 0.05). Conclusion: Since it is not possible to diagnose viral respiratory tract infections based on clinical findings, viral respiratory panel and Multiplex real time PCR test is a fast and useful method in routine diagnosis for early diagnosis and treatment and to prevent unnecessary use of antibiotics. Coronaviridae family positivity is seen in patients over 60 years of age and in seasonal variation, with higher rates in winter.

Клиническая эффективность препарата Энисамия Йодид в комплексном лечении ОРВИ

The list of etiotropic drugs recommended for the treatment of influenza and other acute respiratory viral infections is not very large and requires sufficient justification for rational tactics of their use. In accordance with the WHO strategy for combating influenza and SARS, it is necessary to continue research to study the clinical efficacy of antiviral drugs with a combined effect - etiotropic, pathogenetic and symptomatic. Enisamium iodide is one of such drugs for etiotropic and pathogenetic therapy of ARVI. Aim. To evaluate the clinical efficacy of the drug enisamium iodide (amizone) in the complex therapy of acute respiratory viral infections (ARVI). Material and methods. The randomized study included 40 patients who were treated during the epidemic season of influenza and ARVI 2019. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The clinical efficacy of treatment was assessed by the duration of the main clinical symptoms of ARVI, the proportion of patients who developed complications requiring antibiotics. Statistical processing of the obtained data was carried out using the SPSS 12.0.2 software for Windows. Results and discussion. The results of a randomized study showed the clinical efficacy and safety of amizone (enisamium iodide) in the complex treatment of acute respiratory viral infections of various etiologies, compared with the use of only symptomatic therapy drugs. The duration of fever and the main clinical symptoms of acute respiratory viral infections were statistically significantly less in the study group than in the control group. Accordingly, the proportion of patients whose body temperature returned to normal on days 2–3 of treatment was statistically significantly higher in the group of patients taking enisamium iodide. Complications requiring antibiotic prescription have been reported only in control patients. Also, the drug was well tolerated and there were no side effects during its use. Conclusions. The results obtained confirmed that enisamium a iodide (amizon) has a good clinical effect in ARVI, reduces the likelihood of complications in patients. The high sensitivity of various respiratory viruses to the drug allows it to be used without etiological decoding of ARVI. Keywords: acute respiratory viral infections (ARVI), influenza, enisamium iodide (amizone), antiviral therapy, clinical efficacy, safety.

Magnitude of Streptococcus pneumoniae Among Under-Five Children with Symptom of Acute Respiratory Infection at Hiwot Fana Specialized University Hospital, Harar, Ethiopia: Associated Risk Factors and Antibacterial Susceptibility Patterns.

PurposeStreptococcus pneumoniae is the major cause of pneumoniae infection among under-five children that leads to high morbidity and mortality. Thus, the aim of this study was to determine the magnitude of Streptococcus pneumoniae in under-five children of an acute respiratory infection, assess its antimicrobial susceptibility patterns, and define the associated factors.MethodsAn institutional-based cross-sectional study was conducted on a total of 384 under-five children of acute respiratory infection attending outpatient department of Hiwot Fana Specialized University Hospital, Harar, Ethiopia, from March 1 to 30, 2020. Socio-demographic and clinical data were collected from the study participants using a structured questionnaire. Sputum samples were collected and processed to identify Streptococcus pneumoniae pathogen using the culture and biochemical tests as per the standard procedures. The Kirby–Bauer disk diffusion method was used for antimicrobial susceptibility testing. Data were entered into Epi-data version 3.1 and analyzed by using Statistical Product and Service Solutions version 22.ResultsThe proportion of Streptococcus pneumoniae in under-five children with acute respiratory infection was 11.2%. About 50% of isolated Streptococcus pneumoniae was resistant to tetracycline and cotrimoxazole, whereas more than 90% of it was susceptible to Ceftriaxone and amoxicillin-clavulanate. Children who lived in rural areas were 3.6 times more likely to have S. pneumoniae compared to children who lived in urban areas (AOR: 3.6, 95% CI: 1.2–11) and children with familysmokers in a house were 3 times at risk to be infected with S. pneumoniae (AOR: 3, 95% CI: 1.8–8.0).ConclusionHigh antimicrobial resistance of S. pneumoniae against tetracycline and cotrimoxazole was observed and children who lived in rural areas and live with a family of cigarette smoker are factors associated with Streptococcus pneumoniae. Therefore, providing health educations to the family of children rural residents and isolating smokers from the house where children lived are recommended actions to reduce bacteria caused by Streptococcus pneumoniae.

Comparative in vitro analysis of inhibition of rhinovirus and influenza virus replication by mucoactive secretolytic agents and plant extracts

BackgroundRhinoviruses and influenza viruses cause millions of acute respiratory infections annually. Symptoms of mild acute respiratory infections are commonly treated with over-the-counter products like ambroxol, bromhexine, and N-acetyl cysteine, as well as of thyme and pelargonium extracts today. Because the direct antiviral activity of these over-the-counter products has not been studied in a systematic way, the current study aimed to compare their inhibitory effect against rhinovirus and influenza virus replication in an in vitro setting.MethodsThe cytotoxicity of ambroxol, bromhexine, and N-acetyl cysteine, as well as of thyme and pelargonium extracts was analyzed in Madin Darby canine kidney (MDCK) and HeLa Ohio cells. The antiviral effect of these over-the-counter products was compared by analyzing the dose-dependent inhibition (i) of rhinovirus A2- and B14-induced cytopathic effect in HeLa Ohio cells and (ii) of influenza virus A/Hong Kong/68 (subtype H3N2)- and A/Jena/8178/09 (subtype H1N1, pandemic)-induced cytopathic effect in MDCK cells at non-cytotoxic concentrations. To get insights into the mechanism of action of pelargonium extract against influenza virus, we performed time-of-addition assays as well as hemagglutination and neuraminidase inhibition assays.ResultsN-acetyl cysteine, thyme and pelargonium extract showed no or only marginal cytotoxicity in MDCK and HeLa Ohio cells in the tested concentration range. The 50% cytotoxic concentration of ambroxol and bromhexine was 51.85 and 61.24 μM, respectively. No anti-rhinoviral activity was detected at non-cytotoxic concentrations in this in vitro study setting. Ambroxol, bromhexine, and N-acetyl cysteine inhibited the influenza virus-induced cytopathic effect in MDCK cells no or less than 50%. In contrast, a dose-dependent anti-influenza virus activity of thyme and pelargonium extracts was demonstrated. The time-of addition assays revealed an inhibition of early and late steps of influenza virus replication by pelargonium extract whereas zanamivir acted on late steps only. The proven block of viral neuraminidase activity might explain the inhibition of influenza virus replication when added after viral adsorption.ConclusionThe study results indicate a distinct inhibition of influenza A virus replication by thyme and pelargonium extract which might contribute to the beneficial effects of these plant extracts on acute respiratory infections symptoms.

Distribution of SARS-CоV-2 seroprevalence among residents of the Tyumen Region during the COVID-19 epidemic period. Journal of microbiology, epidemiology and immunobiology

Introduction. In late 2019 - early 2020, an outbreak of infection caused by a novel strain of beta coronavirus SARS-CoV-2 was reported. The World Health Organization defined the disease as coronavirus disease 2019 (COVID-19). In the Tyumen Region, the first case of COVID-19 was diagnosed on 31/1/2020. The source of infection was a female student who came from Jinan, Shandong province (China). The number and rate of cases were steadily increasing from the 16th week through 28th week in 2020. The highest rate was 36.87 cases per 100 thousand people. Afterwards, the cumulative incidence kept increasing gradually, but not as quickly.The purpose of the seroepidemiological study was to measure the level and to identify the structure of herd immunity against the SARS-CoV-2 virus among the population of the Tyumen Region during the rapid spread of the COVID-19 outbreak.Materials and methods. Volunteers for participation in the study were selected through questionnaire surveys and random sampling. The exclusion criterion was an active COVID-19 infection at the time of the survey. A total of 2,758 individuals were tested for SARS-CoV-2 specific antibodies. The age of the surveyed volunteers ranged from 1 year to 70 years and older.Results of the study. During the active phase of the COVID-19 incidence, the population of the Tyumen Region showed moderate (24.5%) seroprevalence of SARS-CoV-2. At the same time, the tests revealed a high (97.8%) rate of asymptomatic infection cases in seropositive individuals who had never been diagnosed with COVID-19 and did not have history of positive PCR test results or acute respiratory infection symptoms on the day of testing. The maximum level of herd immunity was identified in children aged 1-6 years (34.7%), which was significantly higher compared to the average level of seroprevalence in the entire cohort. In recovered COVID-19 patients, antibodies were detected in 68.2%. In individuals with positive PCR test results, antibodies were detected in 64%. Conclusion. The results of the assessment of the level of herd immunity against the SARS-CoV-2 virus are crucial for prediction of the development trend of the epidemic and for planning specific and non-specific COVID-19 prevention measures.

Massage Therapy for Infants and Toddlers With Acute Respiratory Infections: A Literature Review

Acute respiratory infection (ARI) is a health problem that causes morbidity and mortality in Indonesia. This infectious disease most often affects infants and toddlers . Massage therapy that aims to relax and overcome various health problems in infants and toddlers. Massage therapy is the initial treatment of minor ailments such as coughs, colds, and lack of appetite. This literature review aims to analyze the benefits of massage therapy in ISPA infants. The research method used by the author is a literature review using a database through Pubmed, Science Direct, Ebsco, and Google Scholar from 2009 to 2019 This article discusses massage therapy in ARI infants with upper respiratory infections and lower respiratory tract infections. Literature search results show that massage therapy provides recovery benefits for ARI symptoms such as overcoming fever, overcoming sleep difficulties, improving the immune system, improving the work of the respiratory system, blood circulation, increasing concentration etc.

Раціональний вибір мукоактивних фітопрепаратів у педіатрії: комплексна фармакологічна дія, ефективність, безпечність

Cough is one of the most common symptoms of acute respiratory viral infections in childhood. In the treatment of acute respiratory infections accompanied by cough in children, the main task is to stop the cough by improving the rheological properties of bronchial secretions for their early withdrawal. Cough can be effectively treated only by improving the discharge of mucus from the respiratory tract. For this purpose, mucoactive drugs are used: secretolytics, capable of thinning mucus (mucolytic action), and secretomotor drugs, which improve its output (expectorant effect). Among the many mucoactive drugs in pediatrics, preference is given to herbal drugs, which have a milder expectorant effect compared to synthetic drugs, and are better tolerated. On the Ukrainian pharmaceutical market there is Gederin Ivy Syrup, a preparation with ivy extract. Among the complex of effects of the ivy leaf extract (expectorant, secretolytic, anti-inflammatory), the unique action that distinguishes it from other herbal and synthetic drugs is bronchospasmolytic one. Taking this into account, preparations with ivy extract can be recommended for respiratory infections accompanied by obstruction. These can be both acute and chronic conditions occurring with reversible narrowing of the airways. Due to its natural composition, the drug is safe. Side effects from Gederin Ivy syrup are very rare. In patients with hypersensitivity to the components of the drug some allergic reactions (mainly rash), as well as gastrointestinal disorders are possible. It should not be administered to patients suffering from fructose intolerance. Sorbitol, which is a component of the syrup, can cause a slight laxative effect. Thus, the combination of such effects of ivy extract in the preparation Gederin Ivy – expectorant (mucokinetic and secretolytic), bronchospasmolytic and anti-inflammatory – predetermines its expressive clinical efficacy in the treatment of cough, as well as good tolerance. And this allows it to be widely used in the complex therapy of bronchitis in pediatric practice. No conflict of interest was declared by the authors. Key words: Mucoactive phytopreparations, children, treatment, ivy extract, efficacy, safety.

Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

BackgroundThe COVID-19 pandemic is predicted to significantly affect patients with lung cancer, owing to its rapid progression and high mortality. Studies on lung cancer diagnosis and treatment during an epidemic are lacking. We analyzed the impact of COVID-19 on lung cancer diagnosis in Korea, where lung cancer incidence continues to rise.MethodsThe number of newly diagnosed lung cancer cases in three university-affiliated hospitals during the pandemic and their clinical features were compared with lung cancer cases diagnosed during the same period in the past 3 years. The effectiveness of measures taken by the study hospitals to prevent nosocomial transmission was reviewed.ResultsA total of 612 patients were diagnosed with lung cancer from February through June, 2017–2020. During the pandemic, the number of patients who sought consultation at the division of pulmonology of study hospitals dropped by 16% from the previous year. Responding to the pandemic, the involved hospitals created physically isolated triage areas for patients with acute respiratory infection symptoms. Wide-range screening and preventive measures were implemented, thus minimizing the delay in lung cancer diagnosis. No patient acquired COVID-19 due to hospital exposure. The proportion of patients with stage III–IV non-small-cell lung cancer (NSCLC) significantly increased (2020: 74.7% vs. 2017: 57.9%, 2018: 66.7%, 2019: 62.7%, p = 0.011). The number of lung cancers diagnosed during this period and the previous year remained the same.ConclusionsThe proportion of patients with advanced NSCLC increased during the COVID-19 pandemic.

Prevalence of Acute Respiratory Infection (ARI) and Its Different Correlates among Under-five Children of a Slum of Kolkata

Background: ARI is a major cause of morbidity and mortality of the most vulnerable age group; the under-fives. Previous studies had already identified different risk factors of ARI in slums; however, the findings are hard to generalize as there is diversity among slum populations. Moreover Kolkata (M Corp.) has second highest proportion (29.6%) of slum households among million plus cities in India which necessitates studying the ARI morbidity among under-fives of slums of Kolkata. Objective: To find out the prevalence of ARI and its different correlates among under-fives of a slum of Kolkata. Methods: A cross-sectional study was conducted in the month of May, 2015 among under-fives of the Bagbazar slum area of Kolkata. Total enumeration of under-five children residing in the selected slum was done and sample size came to 68. Data were collected by house to house visit. Chi-square test was applied for statistical significance. Results: Prevalence of ARI was 66.2% among the under-five children studied. Prevalence was higher for males (74.4%). Highest prevalence (100%) was noted among infants. Ventilation, over-crowding, type of family, parenteral smoking, type of cooking fuel used, location of kitchen and presence of symptoms of ARI among mothers were found to be significantly associated with ARI among under-fives (p &lt;0.05). Conclusion: The present study showed a very high prevalence of ARI among under-five children of Bagbazar slum area and also identified many correlates of such a high prevalence.

Respiratory Syncytial Virus Disease Severity in Young Children.

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infections (ARIs) in hospitalized children. Although prematurity and underlying medical conditions are known risk factors, most of these children are healthy, and factors including RSV load and subgroups may contribute to severity. Therefore, we aimed to evaluate the role of RSV in ARI severity and determine factors associated with increased RSV-ARI severity in young children. Children aged <5 years with fever and/or ARI symptoms were recruited from the emergency department (ED) or inpatient settings at Vanderbilt Children's Hospital. Nasal and/or throat swabs were tested using quantitative reverse-transcription polymerase chain reaction for common respiratory viruses, including RSV. A severity score was calculated for RSV-positive children. From November 2015 through July 2016, 898 participants were enrolled, and 681 (76%) had at least 1 virus detected, with 191 (28%) testing positive for RSV. RSV-positive children were more likely to be hospitalized, require intensive care unit admission, and receive oxygen compared with children positive for other viruses. Higher viral load, White race, younger age, and higher severity score were independently associated with hospitalization in RSV-positive children. No differences in disease severity were noted between RSV A and RSV B. RSV was associated with increased ARI severity in young children enrolled from the ED and inpatient settings, but no differences in disease severity were noted between RSV A and RSV B. These findings emphasize the need for antiviral therapy and/or preventive measures such as vaccines against RSV in young children.

Are functional gastrointestinal disorders a clinically significant comorbid factor for acute respiratory infection in children?

Rationale: Functional gastrointestinal disorders (FGID) are highly prevalent in children worldwide. Current concept of FGID pathophysiology implies contributions from various mechanisms. Information in the role of acute respiratory infections in the development of FGID in children is lacking.Aim: To determine the prevalence of FGID in children hospitalized to the department of infectious diseases with acute respiratory tract infections (ARTI) and their association with demographic, medical biological factors and clinical manifestations.Materials and methods: We performed observational and cross-sectional study with continuous patient sampling. The study included 180 ARTI patients, whose mothers agreed to fill in the proposed questionnaire of 41 items. The diagnosis of FGID during in-hospital stay was made based on clinical data in accordance with the Rome criteria IV (2016) and by standard collection of the information from the parents. The stool characteristics were assessed with the Bristol scale. The rate of recurrent ARTI was assessed by the resistance index of above 0.5. We considered clinical symptoms of ARTI at the admittance, the rates of bacterial complications and the need in antibacterial treatment.Results: The prevalence of FGID in hospitalized children with ARTI below 4 years of age (n = 134) was 35.1% (95% confidence interval [CI]) 27.0– 43.9); they had higher rates of functional diarrhea (14.9%, 95% CI 9.4–22.1) and constipation (14.2%, 95% CI 8.8–21.3). Among those above 4 years of age (n = 46), FGID were diagnosed in 50% (95% CI 34.9–65.1) of the cases; with most frequent symptoms being abdominal pain (39.1%, 95% CI 25.1–54.6) and irritable bowel syndrome (10.8%). Irrespective of their age, the children with FGID had higher rates of ARTI recurrence (by 34.0%, 95% CI 20.0–48.1; relative risk 1.98, 95% CI 1.47–2.69; odds ratio 4.13, 95% CI 2.18–7.85) and intestinal infections in their past history, compared to those without any gastrointestinal symptoms during the index hospitalization. In children with FGID, ARTI were more frequently complicated by otitis and they had higher requirement in antibiotics. The mothers of the infants and toddlers with FGID had lower educational level (smaller proportion of those with high school education) and were less satisfied with their home and living conditions, whereas their fathers were older and more frequently employed in vehicle operations and less frequently were occupied in communication-related professions.Conclusion: Acute respiratory infections, especially recurring, may plaу a significant role in the development and maintenance of FGID in children. Further studies are necessary, which may result in useful information for the development of tailored strategies to treatment and prevention.

Epidemiological and clinical features of acute respiratory infections occurring in St. Petersburg during the 2017–2018 and 2018–2019 epidemic seasons

Objective: to analyze the epidemiological and clinical features of acute respiratory infections occurring during the St. Petersburg 2017–2018 and 2018–2019 epidemic seasons.Materials and methods: the study included 457 patients, treated in St. Petersburg clinics from 2017–2019, displaying symptoms of acute respiratory infection (ARI), including evaluation of their clinical histories. Pathogen types were determined by polymerase chain reaction (PCR). Data analysis was carried out using mathematical statistics methods using the Statistica 10 software package (StatSoft Inc.).Results: in this study, we examined the epidemiological and clinical features of acute respiratory infections in St. Petersburg occurring during two epidemic seasons, 2017–2018 and 2018–2019. The 2017–2018 season was characterized by a prevalence of infections caused by influenza B viruses and influenza A subtype H3N2 viruses. In the 2018–2019 season, there was a greater number of acute respiratory viral infections (ARVIs) and infections caused by influenza A subtype H1N1pdm; influenza B virus was detected only in isolated cases. In the 2017–2018 sore throats and muscle aches were a characteristic symptom of influenza A H1N1pdm infections, of bacterial infections – only sore throats. It was shown that throat pain and vasodilation of the scleral and soft palate vessels were significantly more frequent in the 2017–2018 season, compared to the 2018–2019 season. Cough and redness of the posterior pharyngeal wall were hallmark signs of ARVIs in the 2018–2019 season.Conclusion: according to the data, each epidemic season is characterized not only by its own type-specific acute respiratory infection frequencies, but also by different clinical manifestation frequencies. For global monitoring, treatment effectiveness evaluation, and refined study of acute respiratory infection clinical features, it is advisable to use approaches which incorporate accurate, specific, and rapid molecular biological methods capable of identifying a broad range of pathogens.

Secure Health Care Workers' Health and Safety Methodically During COVID-19 Epidemic in Taiwan.

The aim of this article is to assess the effectiveness of 3 measures of COVID-19 (coronavirus disease) containment for securing health care workers' (HCWs) safety and health at 5 medical university-affiliated hospitals in Taiwan. Three measures were to enforce the reporting of HCWs with unknown fever, acute respiratory illness, and other symptoms; to conduct ongoing surveillance to obtain early warning of potential contagion exposure; and to perform epidemiological investigation and outbreak management. A 17-week surveillance data were collected, 374 (6.17%) HCWs with unknown fever or acute respiratory infection symptoms detected by online body temperature surveillance system were reported, there were no cases of nosocomial infection of COVID-19 among HCWs. Via contact tracing and reporting system, 133 (2.19%) HCWs reported footprints in different epidemic events, but no HCWs were infected. No onward transmission to HCWs occurred after containment measures were formulated. Integrated measures of surveillance, managing epidemic transmission chain, and encouraging individual responsibility have been effective approaches among HCWs in the ongoing COVID-19 epidemic. Despite the absence of ongoing local transmission, vigilance and compliance must be maintained to prevent spread of health care-associated infections in all areas and in social mingling among HCWs outside hospitals. These 3 methodical measures secured HCWs' health and safety successfully and preserved health care delivery continuously.

Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study.

Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years. This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930). We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms. This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.