Outbreak Of Respiratory Syncytial Virus Infection Research Articles

A surge in respiratory syncytial virus infection-related hospitalizations associated with the COVID-19 pandemic: An observational study at pediatric emergency referral hospitals in Tokushima Prefecture.

The outbreak of coronavirus disease (COVID-19) resulted in implementation of social distancing and other public health measures to control the spread of infection and improve prevention, resulting in a decrease in respiratory syncytial virus (RSV) and pediatric respiratory tract infection rates. However, there was a rapid and large re-emergence of RSV infection in Japan. Notably, we were faced with a difficult situation wherein there was a shortage of hospital beds. This study aimed to examine the epidemiological patterns of RSV-related hospitalizations among children before and after the COVID-19 pandemic onset at two pediatric emergency referral hospitals covering the entire Tokushima Prefecture. Data were extracted from electronic medical records of children hospitalized with RSV infection between January 1, 2018, and December 31, 2021. All patients meeting the eligibility criteria were included in this study. The rates of study outcomes were documented annually during 2018-2021 and compared between the 2018-2020 and 2021 periods. In 2020, there was no RSV infection outbreak. Hospitalizations at the peak week in 2021 were 2.2- and 2.8-fold higher than those in 2018 and 2019, respectively. Hospitalizations in 2021 were concentrated within a short period. In addition, there was a significant increase in hospitalizations among children aged 3-5 months and those older than 24 months. The high-flow nasal cannula (HFNC) use rate nearly doubled in 2021. A new pandemic in the future may cause an outbreak of RSV infection that can result in an intensive increase in the number of hospitalizations of pediatric patients requiring respiratory support, especially in infants aged <6 months. There is an urgent need to improve the preparedness of medical systems, particularly in terms of the number of inpatient beds and the immediate availability of HFNC.

Detection of influenza vaccine effectiveness among nursery school children: Lesson from a season with cocirculating respiratory syncytial virus

In the winter influenza epidemic season, patients with respiratory illnesses including respiratory syncytial virus (RSV) infections increase among young children. Therefore, we evaluated the effectiveness of influenza vaccine against influenza-like illness (ILI) using a technique to identify outbreaks of RSV infection and to distinguish those patients from ILI patients. The study subjects were 101 children aged 12 to 84 months attending nursery school. We classified the cases into 6 levels based on the definitions of ILI for outcomes. We established observation periods according to information obtained from regional surveillance and rapid diagnostic tests among children. Multivariate odds ratios (ORs) for each case classification were obtained using a logistic regression model for each observation period. For the entire observation period, ORs for cases with fever plus respiratory symptoms were reduced marginally significantly. For the local influenza epidemic period, only the OR for the most serious cases was significantly decreased (0.20 [95%CI: 0.04-0.94]). During the influenza outbreak among the nursery school children, multivariate ORs for fever plus respiratory symptoms decreased significantly (≥ 38.0°C plus ≥ one symptoms: 0.23 [0.06-0.91), ≥ 38.0°C plus ≥ 2 symptoms: 0.21 [0.05-0.85], ≥ 39.0°C plus ≥ one symptoms: 0.18 [0.04-0.93] and ≥ 39.0°C plus ≥ 2 symptoms: 0.16 [0.03-0.87]). These results suggest that confining observation to the peak influenza epidemic period and adoption of a strict case classification system can minimize outcome misclassification when evaluating the effectiveness of influenza vaccine against ILI, even if influenza and RSV cocirculate in the same season.

Outbreak of Respiratory Syncytial Virus Infection in Postpartum Nursing Home, Changhua County, 2014

Respiratory syncytial virus (RSV) is one of the major pathogens that cause neonatal bronchiolitis and pneumonia. We report an outbreak of RSV infection among neonates in a postpartum care center. A total of 33 infants (attack rate 73%)and 3 health care (attack rate 8%)workers were infected with RSV. The index neonate contracted RSV through contact of the ill family. The following RSV transmission was associated with inadequate infection control practice. Our report highlights the importance of infection control in the postpartum care center. Health care workers are recommended stringently to follow the infection control guideline for the postpartum care.

Respiratory Syncytial Virus (RSV) Infections in Immunocompromized Children.

Eleven children who were immunocompromized due to chemotherapy were infected with respiratory syncytial virus (RSV) during an outbreak of RSV infection in the Pediatric Oncology Unit of Queen Mary Hospital, The University of Hong Kong. The clinical symptoms, effect on treatment regimen, outcome of infection and viral clearance had been followed prospectively in all 11 children. Viral clearance was documented by immunofluorescence and PCR studies of nasopharyngeal aspirates or nasal/throat swabs. Eight of the 11 children had upper respiratory symptoms with the remaining 3 patients progressing to lower respiratory tract infections (LRTI). All except one had protracted viral symptoms but eventually recovered without the need for specific anti-viral treatment or intensive support. However, the chemotherapy regimen or scheduled BMT had been significantly interrupted. One patient developed progressively severe pneumonia which was further complicated by adenovirus reactivation causing bone marrow failure and severe sepsis resulting in death of this patient. The viral clearance of RSV was delayed in all patients with median of 20 days (range 9–81 days). One patient had recurrence of RSV detected by PCR 35 days after intial documentation of clearance, after a BMT procedure. The delayed viral clearance correlated with protracted viral symptoms. In conclusion, RSV clearance is delayed in immunocompromized hosts causing protracted viral symptoms, progression to LRTI and interruption to chemotherapy treatment. The delay in viral clearance appears proportional to the degree of immunosuppression of the individual.

The clinical spectrum of respiratory syncytial virus disease in The Gambia.

Respiratory syncytial virus (RSV) is a well-recognized cause of lower respiratory tract infections in early childhood in industrialized countries, but less is known about RSV infection in developing countries. Four outbreaks of RSV infection that occurred between 1993 and 1996 in The Gambia, West Africa, were studied. RSV was sought by immunofluorescent staining of nasopharyngeal aspirate samples among young children who presented with respiratory infections at three hospitals in the Western Region of the country. Five hundred seventy-four children with RSV infection were identified. The median ages of children seen in 1993 through 1996 were 3, 7, 8 and 5 months, respectively. Sixty-two percent of children <6 months old were boys. Thirteen children (2.4%) had conditions considered to increase the risk of severe RSV infection. On physical examination crepitations were heard in 80% of the children admitted to hospital, whereas wheezes were heard in only 39%. Eighty (16%) children received oxygen because of hypoxemia. Nine of 255 blood cultures (3.5%) were positive: 4 Streptococcus pneumoniae; 2 Haemophilus influenzae type b; 2 Staphylococcus aureus; and 1 Enterobacter agglomerans. Thirteen children died (2.4%). During the 4 study years 90, 25, 75 and 95% of isolates typed were RSV Subgroup A, respectively. RSV is a significant cause of lower respiratory tract infection in young children in The Gambia, causing epidemics of bronchiolitis. It poses a significant burden on the health system, especially through the demand for supplementary oxygen. The clinical spectrum of RSV disease in The Gambia is similar to that seen in developed countries; concomitant bacterial infections are uncommon.