Acute Respiratory Viral Infections In Children Research Articles

The Common Cold and Influenza in Children: To Treat or Not to Treat?

The common cold, which is mostly caused by respiratory viruses and clinically represented by the symptoms of acute respiratory viral infections (ARVI) with mainly upper respiratory tract involvement, is an important problem in pediatric practice. Due to the high prevalence, socio-economic burden, and lack of effective prevention measures (except for influenza and, partially, RSV infection), ARVI require strong medical attention. The purpose of this descriptive literature review was to analyze the current practical approaches to the treatment of ARVI to facilitate the choice of therapy in routine practice. This descriptive overview includes information on the causative agents of ARVI. Special attention is paid to the role of interferon gamma as a cytokine with antiviral and immunomodulatory effects on the pathogenesis of ARVI. Modern approaches to the treatment of ARVI, including antiviral, pathogenesis-directed and symptomatic therapy are presented. The emphasis is on the use of antibody-based drugs in the immunoprophylaxis and immunotherapy of ARVI. The data presented in this review allow us to conclude that a modern, balanced and evidence-based approach to the choice of ARVI treatment in children should be used in clinical practice. The published results of clinical trials and systematic reviews with meta-analyses of ARVI in children allow us to conclude that it is possible and expedient to use broad-spectrum antiviral drugs in complex therapy. This approach can provide an adequate response of the child's immune system to the virus without limiting the clinical possibilities of using only symptomatic therapy.

Features of the immune response in children with acute respiratory infections caused by DNA and RNA viruses

The issues of immunopathogenesis of acute respiratory viral infections (ARVI) remain relevant, despite a long history of study. The aim of the study was to investigate the characteristics of the content of some cytokines in the blood serum of children with ARVI caused by DNA and RNA-containing viruses. Material and methods. We examined 92 children with ARVI at the age from 1 to 15 years, hospitalized in the hospital of the Children’s Clinical Hospital No. 6 (Novosibirsk). In order to determine the etiological factor, a study was carried out using the RT-PCR method (test systems AmpliSensORVI-screen-FL, “InterLabService”, Russia) of mucus from the nose and throat for the presence of genetic material of viruses that cause ARVI. Determination of the content of IL-8, IL-17, IFN-γ in the blood serum in children of all groups was carried out by the method of solid-phase ELISA using commercial test systems of LLC “Cytokin” (Russia). Results and discussion. 4 groups were formed: group I ( n = 20) children with ARVI caused by DNA-containing viruses (group B, C, E adenoviruses, bocaviruses); group II ( n = 53) children with ARVI caused by RNA viruses (RS virus, metapneumovirus, parainfluenza viruses 1, 2, 3, 4, rhinovirus and coronoviruses); group III ( n = 12) children with ARVI caused by mixed infection; group IV ( n = 7) – the genetic material of the pathogen has not been isolated. Concentration of IL-8, IL-17, IFN-γ was significantly increased in all groups compared to the normative values. Higher values of IFN-γ and IL-8 were revealed in patients with DNA viruses compared with the group with RNA-containing viruses, although the excess of IFN-γ was not statistically significant. Differences in the content of IFN-γ, IL-8 and IL-17 were noted for various etiological viral agents, but they were not significant. Conclusions. The results obtained can serve as confirmation that the functional characteristics of the response of the immune system in children with ARVI are determined not so much by the etiological factor as by its individual state. With ARVI in children, the presence of genetic material from more than one virus, apparently, is not a significant potentiating factor in the activation of the immune response. At the same time, a negative PCR result with a detailed clinical picture of ARVI does not exclude the viral genesis of the disease.

Comparative clinical efficacy of medicine in non-specific prevention of influenza and acute respiratory viral infections in children during the period of seasonal increase incidence

Objective: comparative open-label randomized study of the safety and efficacy of the drugs Alpha-glutamyl-tryptophan + Ascorbic acid + Bendazole («Cytovir-3«) and Umifenovir for prophylactic influenza and acute respiratory viral infectionsin children aged over 6 in organized groups. Materials and methods . 207 healthy children ≥ 6 years old of organized educational groups. According to study protocol they were divided into 2 groups: 102 children were randomizes to receive Alpha-glutamyl-tryptophan + Ascorbic acid + Bendazole (Сytovir-3, Group 1), capsules (JSC MBSPC «Cytomed«, Russia) while 105 children were randomizes to receive Umifenovir 100 mg (Group 2) capsules (Pharmstandart Leksredstva, Russia). The frequency of adverse reactions on drugs and adverse events was assessed while taking drugs and within 3 weeks after. Efficiency was assessed by calculate value of prophylactic efficiency index in comparison groups. Efficacy was analyzed on the basis of the comparative incidence of children included in the study with a total incidence in Saint-Petersburg. Results : the studied drugs showed a high safety profile and match preventive clinical efficacy against influenza and acute respiratory viral infections. Both drugs during prophylactic administration stimulated the production of secretory IgA. A tendency to a decrease in the incidence of acute respiratory viral infections in groups of children taking the studied drugs was revealed and compared with general indicators reflecting the integrated epidemic situation of influenza and other acute respiratory viral infections in Saint-Petersburg during the study. The data obtained allow us to recommend the use of the drug Alpha-glutamyl-tryptophan + Ascorbic acid + Bendazole («Сytovir-3«) (dosage form – capsules) for the prevention of respiratory diseases in organized children’s groups during the period of seasonal increase in the incidence of influenza and acute respiratory viral infectionsin.

RISK FACTORS - INFLUENCING THE HEALTH OF PRESCHOOL CHILDREN

Purpose: to study the risk factors of recurrent acute respiratory viral infection (ARVI) in preschool children living in ecologically different districts of Perm. Methods. Retrospectively 710 records of 5-6 year old children with recurrent diseases of ARVI living in Ordzhonikidze district (group 1, n = 350) and Industrial district (group 2, n = 360) were evaluated. The study assessed the socio-biological risk factors of recurrent SARS and developed a prognostic factor by the method of Wald. Results. In group 2 children in the first year of life were more likely to have anemia 39.0 (95 % CI: 167.6-112.4) %, rickets 55.6 (95 % CI: 234.9-165.1) %, atopic dermatitis 55.6 (95 % CI: 272.9-127.1) %. In group 1, these diseases were less common - anemia 28.6 (95 % CI: 117.3-82.7) %, rickets 43 (95 % CI: 167.3-132.7) %, atopic dermatitis 28.6 (95 % CI: 148.8-51.2) %. Biologically significant risk factors for the formation of recurrent ARVI are: Smoking of the mother, the incidence of ARVI in the 1st half of pregnancy, etc. Mother's Smoking was more common in group 2 - 30.6 (95 % CI: 174.1-45.9) % against 3.4 in group 1 (95 % CI: 16.4-7.6) %. In the group 2 pregnant women were frequently sick with colds in the 1st half of pregnancy was 50.0 (95 % CI: 228.9-131.1) % against 22.9 per cent (95 % CI: 122.5-37.5) % in the 1 group. A prognostic index was calculated for each factor. In terms of sum of prognostic index a forecast of frequent ARVI was determined in children up to 5 years. Conclusions. Biologically significant risk factors for frequent ARVI in children were identified in two Perm districts. The risk factors were: smoking of the mother, ARVI incidence in the 1st and 2nd half of pregnancy, anemia, medical abortions and the risk of termination of pregnancy. Depending on the size of Wald's prognostic index children get in to a favorable zone (from +0.87 to +3.11), an unfavorable zone (from -0.06 to -9.62) and a border zone (from -0.06 to +0.87).

TREATMENT OF ACUTE RESPIRATORY VIRAL INFECTIONS AND INFLUENZA IN CHILDREN: THE MINIMAL SUFFICIENCY PRINCIPLE

Acute respiratory viral infections (ARVI) occupy a special place in pediatric practice. This is due to several factors including high incidence, increased morbidity, frequently severe course and risk of complications especially in children with premorbidities, as well as a significant economic and social burden [1]. It should be specifically noted that ARVI in children is the main reason for seeking medical care on an outpatient basis, accounting for more than 90% of all doctor visits during the epidemic outbreak of the disease [2].

ESSENTIAL OILS INHALATIONS IN COMPLEX TREATMENT AND PROPHYLAXIS OF ACUTE RESPIRATORY VIRAL INFECTIONS IN CHILDREN

The prevalence of respiratory tract infections in children of the Russian Federation is high. That is why the questions of prophylaxis and treatment of acute respiratory viral infections (ARVI) are always of a great interest of paediatricians. During epidemic outbreaks essential oils inhalations become a new perspective in treatment of such conditions. In the period of time since September 2011 till February 2012 the research workers of Paediatrics department of Tyumen State Medical Academy have estimated the oil «Dyshi» («Breathe») efficacy in complex treatment of ARVI in children. The usage of this medicine for the prophylaxis of respiratory infections decreased the morbidity rate to 35% during the observation period, while each child in the comparison group had at least one episode of ARVI. The usage of this drug in the group of frequently ill children at the first symptoms of ARVI allowed to relieve the severity of disease and to prevent complications. Furthermore, the oil «Dyshi» has a number of other advantages: it is not irritating and habit-forming, it does not dry the nasal mucous membrane, it is safe for children and can be used for a long period of time.