Onset Of Acute Respiratory Infection Research Articles

Особенности клиники сочетанных форм гриппа у детей

Aim: to identify the clinical laboratory features of coinfection with flu and other respiratory viral infections. Patients and Methods: case records (inpatient files) of 139 children aged 2 months — 18 years who were admitted to Moscow hospitals from October 2017 to February 2020 with the clinical manifestations of acute respiratory infections (ARI) were analyzed. All children were divided into two groups. Group 1 included children with coexisted flu and other ARI (n=31). Group 2 included children with flu alone (n=108). The etiology of ARI was discovered by polymerase chain reaction (oral or nasal smears and/or discharge, sputum) and enzyme immunoassay (antibodies to herpesvirus type 1, 2, and 6, cytomegalovirus, Epstein-Barr virus, Chlamydia, and Mycoplasma). Results: respiratory syncytial virus and rhinovirus were the most common viruses coexisted with flu (8/31 and 5/31, respectively). The onset of ARI occurred 2.60±1.6 days before hospital admission in group 1 and 3.35±1.72 days before hospital admission in group 2 (p>0.05). In group 1, febrile temperature lasted for 4.72±1.25 days that is almost 2 days longer than in group 2 (p<0.01). The rate of complications in coinfection with flu and ARI vs. flu alone was different, i.e., acute (catarrhal, medium) otitis was diagnosed in 35.5% and 8.3.% (p<0.01), respectively, acute sinusitis in 12.9% and 8.3%, respectively, and pneumonia in 22.6% and 7.4%, respectively. Conclusion: in children, coinfection with flu and other respiratory virus is generally more severe as demonstrated by higher temperature, more severe intoxication symptoms, more common complications (e.g., otitis, sinusitis, pneumonia etc.), and a greater need in infusion therapy. Co-infected children are admitted to hospital more rapidly and stay in hospital for a longer period. KEYWORDS: acute respiratory infections, flu, rhinovirus, children, fever, intoxication, severity. FOR CITATION: Nikolaeva S.V., Usenko D.V., Shabalina S.V. et al. Clinical presentation of flu coinfections in children. Russian Medical Inquiry. 2020;4(11):665–669. DOI: 10.32364/2587-6821-2020-4-11-665-669.

Влияние нутритивного статуса на течение и исходы острых респираторных заболеваний у детей, протекающих с поражением нижних отделов респираторного тракта

The article discusses the effects of nutrition in children on the course and outcomes of acute respiratory infections (ARIs) affecting the lower respiratory tract. The clinical pathogenic aspects of the severe course of respiratory infections (including community-acquired pneumonia) in infants younger than 1 year of age with protein-energy malnutrition based on the recent foreign published data are addressed. The data on the association between nutrition prior to the onset of ARI and the course of bronchiolitis are uncovered. It was demonstrated that a child’s organism experiences protein deficiency during the acute fever resulting from reduced nutritional intake, increased protein loss, and the changes in protein metabolism. This leads to immune dysfunction. The authors report that all children older than 1 year of age who were admitted to hospitals with ARIs are underweight. Considering this, the development of diet correction algorithms using sipine products in children older than 1 year of age with the acute stage of respiratory infections is a relevant and littleknown issue. In addition to the correction of protein, fat, and carbohydrate composition of nutrition, a complex approach using vitamin mineral complexes, probiotics, and prebiotics is required. KEYWORDS: nutritional status, acute respiratory infections, community-acquired pneumonia, children older than 1 year of age, proteinenergy malnutrition. FOR CITATION: Kremplevskaya S.P., Muzyka A.D., Melekhina E.V. et al. Effect of nutritional status on the course and outcomes of acute respiratory infections in children affecting the lower respiratory tract. Russian Medical Inquiry. 2020;4(11):691–697. DOI: 10.32364/2587-6821-2020-4-11-691-697.

Hubungan antara Hotspot Dan Kebakaran Terhadap Timbulnya Penyakit Infeksi Saluran Pernapasan Akut (ISPA) di Kabupaten Kubu Raya, Kalimantan Barat

Kalimantan is one of the Islands that often have forest and land fires where almost the entire province of Borneo ever burning. This negatively impact to the environment and human beings. This study aims to measure the correlation between distribution of hotspots as a sign of forest and land fire with the onset of Acute Respiratory Infections. In this study, was conducted a descriptive analysis on the improvement of the health impact which is limited to Acute Respiratory Infections based on age and gender. The highest amount of hotspots is in subdistrict of Sungai Raya about 144 hotspots, whereas the lowest amount of hotspots is in the Sub District of Sungai Kakap 8 hotspots. Sub-district which have the widest acreage burned was Batu Ampar sub-district which reach 5 881.46 hectares, whereas the slightest acreage burned was in subdistrict of Sungai Kakap, about 4.18 hectares have been burned. The largest amount of sufferers of ISPA patients were in district of Sungai Raya, about 11 302 patients, whereas the lowest amount of sufferers of Acute Respiratory Infections patients were in the Teluk Pakedai Sub-district that is about 1129 sufferers of Acute Respiratory Infections patients. Result of statistical analysis showed the amount of sufferers patients with the amount of Hotspots has positive correlation (r = 0.507). The value of the correlation between the amount of Acute Respiratory Infections patients with burning land area also has a positive correlation (r = 0.377). As for the correlation between the amount of hotspots with acreage burned has a positive correlation (r = 0.938). The result of R square trial obtained regression equation Y = 2 240 + 19.3 X which is not relevant to be used in determining the correlation between the increase of Acute Respiratory Infections patients with amount of hotspots. The most Patient of Acute Respiratory Infections in Kubu Raya found on classes age 1-4 years old and based on the type of gender, the difference in the amount of patients between men and women do not indicate significant differences.
 Key words: Acute Respiratory Infections (ARI), Forest and Land Fires, Hotspot, West Kalimantan

Predicting acute respiratory infection in Chinese healthy individuals: A effective way of patient care

Several anti-infective agents are available in the treatment of acute respiratory infection. Use of anti-infective agents has hardly been directed by laboratory finding. We hypothesis the clinical fore casters of acute respiratory can assist in making right treatment decision and avoid needless use of antibiotic. This nurse led care research designed to observe predictive factors this can assist in making right treatment decision and avoid needless use of antibiotic. In this retrospective study, medical records of adults and who were suffering from acute respiratory infection and had influenza like symptoms which includes high body temperature, body ache, muscle pain, cough, and sore throat. Based on the signs and symptoms, patients were subjected in laboratory examination and culture test. Medical records of Chinese patients with confirm diagnosis of influenza was selected. We also assessed the medical records of patients with no influenza based on laboratory investigation. Correlation of signs and symptoms with laboratory examination was performed to identify the best predictive factors of acute respiratory infection which can assist in making right treatment decision and avoid needless use of antibiotic. Medical records of 1220 adults who were suffering from influenza like symptoms at baseline were reviewed by nurse. Of total subjects, a total of 824 (67.5%) were identified to have acute respiratory infection (influenza). We observed significantly higher incidence of cough, high body tem (fever) and both was noted among the patients who had acute respiratory infection (influenza) compared to those patients with no acute respiratory infection (influenza). Mixed model analysis revealed high correlation of two symptoms (cough and fever) with acute respiratory infection (influenza). The results of this nurse led care research suggested that Chinese patients who experienced cough and fever within first 48 h of onset of acute respiratory infection are more likely to have influenza, and thus appropriate antiviral therapy is recommended in patients with acute respiratory infection (influenza). Prediction of acute respiratory infection based on early symptoms is one of the effective ways of patient care. Our study results will assist in making right treatment decision and avoid needless use of antibiotic.

Respiratory syncytial virus infections in children 0–24 months of age in the community

ObjectivesRespiratory syncytial virus (RSV) is a major cause of hospitalization in young children, but there are little data on RSV infections in early childhood in the community. We conducted a prospective population-based birth-cohort study to determine the rates and characteristics of RSV infections in young children. MethodsWe followed 923 children for acute respiratory infections (ARIs) from birth to age 24 months with daily diaries and study clinic visits. Nasal swab samples were obtained at the onset of ARIs and analyzed for RSV by RT-PCR and antigen tests. The rates of RSV infections and associated outcomes were estimated. ResultsRSV was detected in 289 (6%) of 4728 ARIs with a nasal sample. The mean estimated annual rate of RSV infections was 37 (95% confidence interval [CI], 35–38) per 100 children at age 0–24 months. For RSV-associated outcomes, the estimated annual rates per 100 children were 34 (95% CI, 32–37) physician visits, 16 (95% CI, 15–17) antibiotic treatments, 12 (95% CI, 11–13) acute otitis media, and 6 (95% CI, 4–7) wheezing illnesses. The prevalence of RSV was 0.6% in asymptomatic children. ConclusionsRSV infections impose a high burden of disease in healthy young children in the community.

Influenza virus infections from 0 to 2 years of age: A birth cohort study.

Influenza vaccine has been recommended in Finland since 2007 for all children of 6-35 months of age and in 2009 for those ≥6 months against pandemic influenza. We investigated the incidence of influenza and vaccine effectiveness in a birth cohort of children in 2008-2011. We followed 923 children from birth to 2 years of age for respiratory tract infections. A nasal swab sample for PCR for influenza A and B viruses was taken at the onset of acute respiratory infections. Samples were collected either at the study clinic or at home by parents. Vaccination data was retrieved from the health registries. Vaccination coverage of children aged 6-23 months was 22-47% against seasonal influenza and 80% against the A(H1N1)pdm09 virus in the pandemic season 2009-2010. During 3 influenza seasons, 1607 nasal swab samples were collected. Influenza was confirmed in 56 (6.1%) of 923 children (16 A(H1N1), 14 A(H3N2), and 26B viruses). The incidence of influenza was 5.1% in 2008-2009, 2.7% in 2009-2010, and 5.0% in 2010-2011. Effectiveness of the adjuvanted vaccine against the pandemic influenza A(H1N1)pdm09 was 97% (95% confidence interval, 76-100%). Three children with influenza were hospitalized. The yearly incidence of seasonal influenza was 5% in this cohort of very young children with variable influenza vaccine coverage. Adjuvanted vaccine against the pandemic influenza was highly effective. Both seasonal and pandemic influenza cases were mostly non-severe.

Neutrophil extracellular traps in bronchial aspirates: a quantitative analysis

Neutrophil extracellular traps (NETs) are structures composed of DNA and granular proteins, which rapidly trap and kill pathogens. The formation of NETs has been detected during infection in animal experiments, but their role in humans is unclear. The purposes of this study were to quantitatively evaluate the production of NETs during acute respiratory infection and to study the relationship between the NET length and various inflammatory mediators. We examined bronchial aspirates collected from nine intubated patients in an intensive care unit. Samples were collected at the onset of acute respiratory infection (day 0) and on days 1, 3-5, and 6-8. The NET length was visualised by immunohistochemistry and quantified using computer tracing software. The NET length was measured and compared at each time point. The length differed significantly between time points (p<0.001). NETs were significantly longer on day 1 than on day 0 (p<0.001). Neutrophils released NETs abundantly in response to respiratory infection and regression analysis showed that NET length correlated with six clinical parameters (white blood cells, platelets, lactate, CXC ligand-2, interleukin-8, and procalcitonin) as the explanatory variables. NETs in bronchial aspirates may reflect disease progression of respiratory infections. Quantification of NETs in bronchial aspirates may provide a new indicator of inflammation.

Longitudinal Study of Influenza Molecular Viral Shedding in Hutterite Communities

The nature of influenza viral shedding during naturally acquired infection is not well understood. A cohort study was conducted in Hutterite colonies in Alberta, Canada. Flocked nasal swabs were collected during 3 influenza seasons (2007-2008 to 2009-2010) from both symptomatic and asymptomatic individuals infected with influenza. Samples were tested by real-time reverse-transcription polymerase chain reaction for influenza A and influenza B, and the viral load (VL) was determined for influenza A positive samples. Eight hundred thirty-nine participants were included in the cohort; 25% (208) tested positive for influenza viruses. They experienced 238 episodes of viral shedding, of which 23 (10%) were not accompanied by symptoms. For seasonal and pandemic H1N1, VL peaked at or before onset of acute respiratory infection. For H3N2, VL peaked 2 days after the onset of acute respiratory infection, which corresponded to peaks in systemic and respiratory symptom scores. Although the duration of shedding was shorter for asymptomatic participants, the peak level of VL shedding was similar to that of symptomatic participants. Viral loads for children and adults revealed similar patterns. Molecular viral shedding values follow symptom scores, but timing of peak VL varies by subtype. Asymptomatic infections are infrequent.

Prospective hospital-based case–control study to assess the effectiveness of pandemic influenza A(H1N1)pdm09 vaccination and risk factors for hospitalization in 2009–2010 using matched hospital and test-negative controls

BackgroundWe performed a case–control study to estimate vaccine effectiveness (VE) for prevention of hospitalization due to pandemic influenza A(H1N1)pdm09 (pH1N1) and to identify risk factors for pH1N1 and acute respiratory infection (ARI) in 10 hospitals in Berlin from December 2009 to April 2010.MethodsCases were patients aged 18–65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1) matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2) ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio) for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis.ResultsOf 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%). The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100%) in the matched multivariate analysis and 46% (95%CI: -376-100%) in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI.ConclusionsThough limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted the integrated assessment of risk factors for pH1N1-infection. To increase statistical power and to permit stratified analyses (e.g. VE for specific risk groups), the authors suggest pooling of future studies assessing effectiveness of influenza vaccines for prevention of severe disease from different centres.

Pediatric Population Size Is Associated With Geographic Patterns of Acute Respiratory Infections Among Adults

We measure the association between proportion of children and specific pediatric age groups in a local population with the timing and rate of adult emergency department (ED) utilization for influenza and other acute respiratory infections. We performed an ecologic study on a time-series of adult patients presenting to Massachusetts EDs and residing in the greater Boston area from October 1, 2001, to September 30, 2005. Patients presenting with acute respiratory infection, used as a marker for influenza, were aggregated by home address ZIP code. We measured geographic patterns of timing and rate of adult respiratory infection-related ED utilization. We performed correlation analysis of rates and peaks identified in this analysis with pediatric population data from the US census (including specific pediatric age groups) by Poisson regression. One hundred fifty seven thousand five hundred forty two adult respiratory infection-related ED visits (30 visits per 1,000 adults per year) were analyzed. Visits were distributed across 55 of ZIP codes, in which proportions of children (aged 0 to 18 years) ranged from 2.7% to 34.9% in these communities. Proportion of children in a ZIP code was directly associated with timing of seasonal onset of acute respiratory infections among adults (univariate Poisson regression rate ratio [RR] 0.985; 95% confidence interval [CI] 0.977 to 0.993). The proportion of children also explained the patterns of adult acute respiratory infection-related ED utilization rates (RR 1.035; 95% CI 1.024 to 1.047). Three- to 4-year-olds were found to be the most significant predictors of adult illness rate (RR 1.380; 95% CI 1.238 to 1.539) and timing of onset (RR 0.881; 95% CI 0.816 to 0.952). We demonstrate a positive correlation between the timing and rate of ED utilization by adults and the proportion of children in the population. These findings add to a growing body of evidence supporting a critical role played by children in community-wide transmission of acute respiratory infections.