Viruses In Children Research Articles

Clinical and Epidemiological Interventions for Monkeypox Management in Children: A Systematic Review.

This review aims to compile the available literature on monkeypox, identify risk factors for developing the disease, and recommend effective preventative methods to reduce the number of reported cases and fatalities in children and pregnant women. In seeking out pertinent studies on monkeypox virus in children and pregnant women, we searched the literature using the databases Cochrane Library, Google Scholar, PubMed, EMBASE, Web of Science, and Scopus up to 1stFebruary 2023. This study analyzed data from case studies of monkeypox in children and pregnant women. Clinical data and test findings of monkeypox patients less than 18 years old and pregnant women were analyzed. The Newcastle-Ottawa Scale was used to do the quality evaluation. Our record examination spanned the years 1985 to 2023 and found 17 children and five pregnant female patients treated with monkeypox in various hospitals/community centers. Zaire, Gabon, Chicago, Sierra Leone, Central African Republic, Northern DR Congo, Liberia, Cameroon, the Democratic Republic of the Congo, the United Kingdom, the Netherlands, and Florida all contributed to the 14 studies analyzed. There were no studies identified for meta-analysis of selected case studies of hospitalized children and pregnant women who were diagnosed with monkeypox. The incidence, prevalence, clinical characteristics, diagnosis, management, prevention, vaccinations, infant care, and care for expectant mothers are all discussed in this systematic review of monkeypox in children. Our research findings may provide a foundation for further focused research and the development of related recommendations or guidelines.

Wanning rate of maternal-derived antibody against respiratory syncytial virus in children

Wanning rate of maternal-derived antibody against respiratory syncytial virus in children

Risk of early horizontal transmission of hepatitis B virus in children of uninfected mothers in sub-Saharan Africa: a systematic review and meta-analysis

Sub-Saharan Africa is highly endemic for hepatitis B virus (HBV); historically, most people were exposed during childhood through vertical or horizontal transmission. Although all African countries now provide a three-dose infant hepatitis B vaccination starting at age 6-8 weeks, only a third of African countries have introduced birth dose (HepB-BD) vaccine. Adding HepB-BD is fundamental to prevent vertical transmission, but its effectiveness in preventing horizontal transmission, compared with the three-dose infant vaccination alone, is unknown. We aimed to estimate the risk of early horizontal transmission in children of hepatitis B surface antigen (HBsAg)-negative mothers in sub-Saharan Africa stratified according to the vaccination schedule. In this systematic review and meta-analysis we searched MEDLINE, Global Health, Embase, African Index Medicus and African Journals Online from their inception to Oct 24, 2022, for studies reporting HBsAg or HBV DNA, or both, in children (aged 0-5 years) of HBsAg-negative mothers. We excluded studies if children were only tested at birth. Two reviewers independently screened the titles and abstracts of all articles and data were extracted using a standardised pre-piloted data extraction sheet, and authors were contacted if any important information was missing. The primary outcome was the risk of HBV infection in children of HBsAg-negative mothers, stratified by vaccination schedule (no vaccination, first dose at 6-8 weeks, or first dose at birth). We pooled the child risks of HBsAg or HBV DNA-positivity from the age of 0 years to 5 years via a random-effect meta-analysis using a generalised linear mixed model. The study was registered on PROSPERO, CRD42021236203. Of 8856 articles identified, 27 studies evaluating 10 003 children of HBsAg-negative mothers were included. The pooled risks of infection were 6·16% (95% CI 3·05-12·04; 155/1407) in the no vaccination group, 0·21% (0·04-1·15; 10/3425) in children who received their first dose at 6-8 weeks, and 0·05% (0·00-1·32; 3/2902) in children who received their first dose at birth. The difference was not statistically significant in children who received their first dose at 6-8 weeks and children who received their first dose at birth after adjusting for the study period, region, and maternal HIV status (test of moderators p=0·37). In children of HBsAg-negative mothers, the risk of infection might be minimal even with the vaccination starting at 6-8 weeks, without clear additional benefit from HepB-BD. When births take place at home and timely administration of HepB-BD is challenging, antenatal HBsAg screening and selective HepB-BD might allow efficient allocation of resources to mother and child pairs at high risk compared with universal HepB-BD. None. For the French translation of the abstract see Supplementary Materials section.

Infection of Epstein-Barr virus in children in NortheasternPoland

<br><b>Introduction:</b> Infectious mononucleosis is an acute, mild infection occurring mainly in childrenand adolescents. A characteristic feature is the presence of a symptomatic which includedfever, cervical or generalized lymphadenopathy, tonsillitis, coryzam and characteristic whitecoating on the surface. Laboratory tests show changes in the amount of leukocytes and theappearance of virocytes in peripheral blood as well as an increase in liver enzymes. The virusmainly infects epithelial cells and B lymphocytes. In B lymphocytes it intensively multiplies,leading to their transformation into plasma cells and, as a result, the production of specificIgM class antibodies. The produced antibodies activate T lymphocytes (CD8+). During theinfection, the humoral response is also activated. It works by producing antibodies directedagainst early antigen (EA), nuclear antigen (EBNA) and capsid antigen (VCA).</br><br><b>Aim:</b> The objective of the current study was to assess the occurrence of IgM and IgG antibodiesagainst the Epstein-Barr virus in children hospitalized in the Podlaskie Voivodeship.</br><br><b>Material and methods:</b> The levels of antibody were determined in serum patients serum usingthe ELFA method (Enyzme Liked Fluorescent Assay) using the VIDAS analyzer.</br><br><b>Results:</b> Based on preliminary studies, it shown that children aged 4-10 and 15-18 are the mostvulnerable group. The analysis of the conducted studies also showed that the acute phase ofinfectious mononucleosis is more often observed in female children.</br><br><b>Conclusions:</b> In order to better illustrate the seroepidemiological status of EBV infection,similar analysis should be performed in children all over Poland. In order to precisely identifythe target age group of children for possible vaccination, these studies should be extended.</br>

The disappearance of respiratory syncytial virus and influenza viruses in children during the second year of the COVID-19 pandemic - are non-pharmaceutical interventions as effective as vaccines?

Respiratory viral diseases are common in children. A viral diagnostic test is necessary, because COVID-19 shows signs and symptoms similar to those of common respiratory viruses. The article aims at analyzing the presence of respiratory viruses that were common before the pandemic in children who were tested for suspected COVID-19, and is also concerned with how common respiratory viruses were impacted by COVID-19 measures during the second year of pandemic. Nasopharyngeal swabs were examined to detect the presence of respiratory viruses. The respiratory panel kit included SARS-CoV-2, influenza A and B, rhinovirus/enterovirus, parainfluenza 1, 2, 3 and 4, coronaviruses NL 63, 229E, OC43, and HKU1, human metapneumovirus A/B, human bocavirus, respiratory syncytial virus (RSV) A/B, human parechovirus, and adenovirus. Virus scans were compared during and after the restricted period. No virus was isolated from the 86 patients. SARS-CoV-2 was the most frequently observed virus, as expected, and rhinovirus was the second, and coronavirus OC43 was the third. Influenza viruses and RSV were not detected in the scans. Influenza and RSV viruses disappeared during the pandemic period and rhinovirus was the second most common virus after the CoVs during and after the restriction period. Non-pharmaceutical interventions should be established as a precaution to prevent infectious diseases even after the pandemic.

Seroprevalence of Hepatitis E virus in children and adolescents living in urban Bogotá: An explorative cross-sectional study.

The majority of Hepatitis E Virus (HEV)-related studies are carried out in adults whereas information about HEV seroprevalence, clinical disease manifestation, molecular epidemiology, and transmission patterns in children is limited. To estimate HEV seroprevalence among scholar children living in an urban setting and to analyze risk factors for an infection, we invited children aged 5-18 years from Bogotá (Colombia) for a cross-sectional survey. We collected self-reported data on demographics, social, clinical, and exposure variables in a structured interview. Venous blood samples were analyzed with two commercially available ELISAs for HEV-specific IgG antibodies. Among the 263 participants, we found three HEV IgG-reactive samples (1.1%) using both assays. We additionally characterized the samples for HEV IgM using a commercially available IgM ELISA and for HEV RNA. Here, we found one IgM-reactive sample, which was also reactive for IgG. In contrast, none of the IgM- and IgG-reactive sera samples showed detectable RNA levels indicating HEV exposure had not been recently. All participants reported access to drinking water and sanitary systems in their households and frequent hand washing routines (76-88%). Eighty percent of children reported no direct contact with pigs, but occasional pork consumption was common (90%). In contrast to the majority of studies performed in Colombian adults, we found a low unadjusted HEV seroprevalence of 1.1% (95% CI: 0.3-3.6%) for both HEV IgG ELISAs in our study population. While the majority of participants reported pork consumption, we speculate in the absence of viral RNA for genotyping in the affected individuals, that existing access to drinking water and sanitary systems within our study group contribute to the low HEV seroprevalence.

Resurgence of Respiratory Syncytial Virus in Children: An Out-of-Season Epidemic in Portugal.

An out-of-season increase in respiratory syncytial virus (RSV) incidence was observed in Portugal from June 2021 onwards, revealing a continuing surge in cases throughout 2021/2022 autumn/winter. We aimed to describe this out-of-season epidemic and define its epidemic period, by analysing RSV incidence from week 40 of 2020 (2020-W40) to week 18 of 2022 (2022-W18). Surveillance data on weekly RSV laboratory confirmed cases, in Portugal, was used to monitor RSV incidence using CUSUM test methodology for count data. In 2021-W23, the CUSUM score identified a significant increase in the risk of RSV. By that time, the percentage of RSV positive tests rose from 1% in 2021-W22 (3/265) to 6% in 2021-W23 (18/298). Despite a sharp decrease in RSV incidence on 2021-W33 and on 2022-W02, the CUSUM score stayed over the limit up to 2022-W07, indicating that the RSV activity remained at an epidemic level. Distinct peaks of RSV cases were observed between 2021-W30 and 2021-W32 (average of 77 RSV cases per week) and between 2021-W39 and 2021-W41 (average of 79 RSV cases per week) with positivity rates around 60%. An out-of-season RSV epidemic was identified, with a longer epidemic period compared with previous seasons. Possible reasons include relaxation of COVID-19 physical distancing measures and a greater proportion of population susceptible to disease. As several factors may change the pattern of RSV activity, countries should implement year-round surveillance RSV surveillance systems. These findings might have an impact on public health planning regarding future RSV surges, namely, on the palivizumab prophylaxis period for high-risk infants.

Neurological sequelae after encephalitis associated with herpes simplex virus in children: systematic review and meta-analysis

BackgroundEncephalitis is an inflammation of the cerebral parenchyma manifested by acute symptoms such as fever, headaches, and other neurological disorders. Its etiology is mostly viral, with herpes simplex virus being a frequent etiological agent in children. The development of neurological sequelae is a serious outcome associated with this infection.ObjectiveTo assess the general prevalence and types of neurological sequelae in children after a case of acute viral encephalitis caused by HSV.MethodsThis systematic review and meta-analysis was developed following the PRISMA guidelines. The literature search was carried out in the MEDLINE, Embase, SciELO, LILACS, Cochrane, CINAHL, PsycINFO, and Web of Science databases. Studies were included of children with confirmed HSV infection and that presented a description of neurological sequelae associated with that infection. For the meta-analysis of general prevalence and of the types of neurological sequelae a random effects model was used.ResultsOf the 2827 articles chosen in the initial search, nine studies were included in the systematic review and meta-analysis. The general prevalence of neurological sequelae was 50.7% (95% CI 39.2–62.2). The most frequent sequelae were related to mental disability, with a 42.1% prevalence (95% CI 30–55.2); on the other hand, the least frequent sequelae were those related with visual impairment, with a 5.9% prevalence (95% CI 2.2–14.6). The included studies presented regular quality and substantial heterogeneity.ConclusionEven with antiviral therapy, half of patients will develop some type of disability.

Real time-PCR, ELISA, as an identification methods for Detection respiratory syncytial virus in children

The study have been done to detecting HRSV infections among hospitalized children under 10 years old in Salahaldin Governorate, in addition to compare different diagnostic methods for detection of this virus.
 Nasopharyngeal Swabs (NPS) and whole blood samples were taken from 400 hospitalized children between end of August 2013, to the end of May 2014, each sample was analyzed for HRSV by Real time –PCR, IgM and IgG specific to HRSV determining from blood specimens in serum using enzyme linked immune sorbent assay (ELISA) technique.
 Nasopharyngeal Swab was more sensitive than the whole blood specimens for the detection of HRSV ,which is found in 1% by RT-PCR, in 81.9% by IgM –anti HRSV antibodies and in79.5% by IgG-HRSV antibodies. Autumn – winter periodwas considered as the most common time for HRSV infections with peak in September and February.

Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis.

Globally, the respiratory syncytial virus (RSV) is the most common etiologic agent of acute respiratory illnesses in children. However, its burden has not been well addressed in developing countries. We aimed to estimate the molecular epidemiology of RSV in children less than 18 years of age with acute respiratory infections in Africa by conducting a systematic review and meta-analysis. We systematically searched PubMed, Scopus, CINAHL, and Global Index Medicus databases to identify studies published from January 1, 2002, to April 27, 2022, following the PRISMA 2020 guideline. We assessed the study quality using the Joanna Brigg's Institute (JBI) critical appraisal checklists. We conducted a qualitative synthesis by describing the characteristics of included studies and performed the quantitative synthesis with random effects model using STATA-14. We checked for heterogeneity with Q statistics, quantified by I2, and determined the prediction interval. We performed subgroup analyses to explain the sources of heterogeneity and assessed publication biases by funnel plots augmented with Egger's test. Eighty-eight studies with 105 139 participants were included in the review. The overall pooled prevalence of RSV in children <18 years of age was 23% (95% confidence interval (CI) = 20, 25%). Considerable heterogeneity was present across the included studies. The adjusted prediction interval was found to be 19%-27%. Heterogeneities were explained by subgroups analyses. The highest prevalence of RSV was found among inpatients, 28% (95% CI = 25, 31%) compared with inpatients/outpatients and outpatients, with statistically significant differences (P < 0.01). The RSV estimate was also highest among those with acute lower respiratory tract illnesses (ALRTIs), 28% (95% CI = 25, 31%) compared with acute upper respiratory tract illnesses (AURTIs) and both acute upper/lower respiratory manifestations, with statistically different prevalence (P < 0.01). RSV infection estimates in each sub-region of Africa were statistically different (P < 0.01). There were no statistically significant differences in RSV infections by designs, specimen types, and specimen conditions, despite them contributing to heterogeneity. We found a high prevalence of RSV in pediatric populations with acute respiratory tract illnesses in Africa, highlighting that the prevention and control of RSV infections in children deserve more attention. PROSPERO CRD42022327054.

A multicentre study on the incidence of respiratory viruses in children with community-acquired pneumonia requiring hospitalization in the setting of the zero-COVID policy in China

BackgroundStringent nonpharmaceutical interventions (NPIs) have been implemented worldwide to combat the COVID-19 pandemic, and the circulation and seasonality of common respiratory viruses have subsequently changed. There have been few multicentre studies or comparisons of the prevalence of respiratory viruses accounting for community-acquired pneumonia (CAP) in hospitalized children between the pre-COVID period and the period after community and school reopening in the setting of the zero-COVID policy.MethodsWe included 1543 children with CAP who required hospitalization from November 1, 2020 to April 30, 2021 (period 1), and 629 children with the same conditions from November 1, 2018, to April 30, 2019 (period 2), in our study. All respiratory samples from these patients were screened for six respiratory viruses (respiratory syncytial virus [RSV], adenovirus [ADV], influenza A virus [Flu A], influenza B virus [Flu B], parainfluenza virus type 1 [PIV1], and parainfluenza virus type 3 [PIV3]) using a multiplex real-time PCR assay.Results and conclusionsThe median ages of the enrolled patients at the time of diagnosis were 1.5 years and 1.0 years for period 1 and period 2, respectively. In period 1, viral pathogens were detected in 50.3% (776/1543) of the enrolled patients. The most frequently identified viral pathogen was RSV (35.9%, 554/1543), followed by PIV3 (9.6%, 148/1543), PIV1 (3.6%, 56/1543), ADV (3.4%, 52/1543), Flu A (1.0%, 16/1543), and Flu B (0.8%, 13/1543). The total detection rates of these six viruses in the peak season of CAP were at the pre-COVID level. The prevalence of Flu A decreased dramatically, and circulation activity was low compared to pre-COVID levels, while the incidence of PIV3 increased significantly. There were no significant differences in the detection rates of RSV, ADV, Flu B, and PIV1 between the two periods. Our results showed that respiratory viruses accounted for CAP in hospitalized children at pre-COVID levels as communities and schools reopened within the zero-COVID policy, although the prevalence aetiology spectrum varied.

Frequency and Seasonal Variations of Viruses Causing Respiratory Tract Infections in Children Pre- and Post-COVID-19 Pandemic in Riyadh (2017-2022).

Introduction The COVID-19 pandemic has had a major impact on healthcare systems throughout the world. As the clinical and epidemiological features of COVID-19 share many similarities with other respiratory viruses in children, ensuring optimal management of different viral respiratory diseases is critical. The precautions taken to prevent COVID-19 have seemingly had an indirect effect on the seasonal variations of viral diseases and the frequency of relevant viruses.The seasonal irregularity of and uncertainty surrounding these infection peaks may affect the clinical prediction and management resources. Therefore, the aim of this study is to evaluate the impact of the COVID-19 pandemic on the frequency and seasonal variation of common respiratory viruses in children pre- and post-pandemic. Methodology This study utilizes a descriptive cross-sectional retrospective approach. A total of 726 samples collected from children below 14 years of age and admitted to King Abdulla bin Abdulaziz University Hospital between March 2017 and February 2022 were included in the present study to evaluate the impact of the COVID-19 pandemic on the frequency and seasonal variation of common respiratory viruses in children pre- and post-pandemic. The samples taken beforeMarch 15, 2020, were considered pre-COVID-19, and those taken fromMarch 15, 2020, onward were considered post-COVID-19. The seasons were divided based on the months of the year as per the Saudi climate website (winter: December-February, spring: March-April, summer: May-August, and autumn: September-November). Results Allnasopharyngeal swabs (NPS) for viral Polymerase chain reaction (PCR) multiplexthat were done for all admitted children of age up to 14 years were included, and the total samples amounted to 726,There were 686 (94.4%) positive samples for viruses and 40 (5.5%) negative samples. The number of positive samples pre-COVID-19 pandemic was 494 (72%), and the number of positive samples post-COVID-19 pandemic was 192 (28%). The frequency of different viruses has decreased post-COVID-19 and seasonality has changed; Although Adenovirus, and influenza viruses have no big changes, but HumanRhino/enterovirus (HRE) has increased frequency post-COVID-19 (49%), while post-COVID-19 it was (29.1%). The seasonal peak for Respiratory Syncytial Virus (RSV) pre-COVID-19 showed mainly in winter (49%), while post-COVID-19it showed no peak. Conclusion The frequency of most types of viruses is noted to be lesser in the post-COVID-19 period, most likely due to precautions followed during the pandemic. This is not the case for HRE which showed increasing frequency in post-COVID-19; However, there are clinically and statistically significant differences among seasonal peaks in Respiratory RSV, HRE, and Parainfluenza viruses (PIV) pre- and post-COVID-19 pandemic. RSV showed no peak in different seasons post-COVID-19, although its peak pre-COVID-19 was in winter and autumn; Additionally typical trend of HRE peak changed to be in Autumn and spring post-COVID-19 instead of winter pre-COVID-19.

The effects of measures taken during the COVID-19 pandemic on the seasonal dynamics of respiratory viruses in children.

We aimed to evaluate the effects of public health measures taken during the COVID-19 pandemic on respiratory viruses. The study was conducted between February 1, 2021 and December 1, 2022. Patients aged 1 month to 18 years hospitalized for infectious diseases were tested for SARS-CoV-2 and respiratory viruses by multiplex PCR. Of the total 1173 patients, 56.2% were male and 43.8% were female, and 47.5% of the patients were under 24 months of age. The viruses detected were SARS-CoV-2 31.9%, human rhinovirus/enterovirus 19.4%, respiratory syncytial virus (RSV) 9.3%, parainfluenza virus 7%, adenovirus 6%, seasonal coronavirus 5.2%, bocavirus 3.8%, influenza 3.1%, and metapneumovirus 2.8%. Among the patients, 386 were hospitalized with lower respiratory tract infections, 238 with upper respiratory tract infections, 202 to evaluate fever etiology, 111 with acute gastroenteritis and 236 with other diagnoses. Of these patients, 113 were admitted to the intensive care unit. Intensive care unit admission rates were statistically significantly higher for bocavirus and RSV, in those hospitalized between July 1, 2021 and July 1, 2022 (first period when schools were held full-time face-toface at all grades) and in children aged 1-24 months. Public health measures taken during the COVID-19 pandemic have affected the seasonal distribution of respiratory viruses and the severity of illness in children.

Значение герпесвирусов в постковидном периоде у детей

Aim: to assess the prevalence of detection of confirmed herpes virus infections (HVI) in children who had a previous COVID-19 infection, characterize specific clinical manifestations of the disease under the new conditions (post-COVID syndrome), and to provide a rationale for the administration of drug therapy. Patients and Methods: of 456 patients who received medical consultations from September 2021 to July 2022, the authors selected 72 (15.8%) children (42 boys and 30 girls) who had a previous SARS-CoV-2 infection confirmed by serological tests or polymerase chain reaction and in whom herpes viruses were found during serological evaluation. Results: most of the children (81.4%) visited the polyclinic within the first six months after the COVID-19 infection. Epstein-Barr virus (EBV) was the most prevalent finding among herpesviruses detected in children with post-COVID-19 sequela — it was detected in 44 (61.1%) cases. Human herpesvirus (HHV) 6 and cytomegalovirus (CMV) were less common in this group and found in 41 (56.9%) and 30 (41.7%) children, respectively. HHV-1 and HHV-2 were detected more rarely — in 11 (15.3%) children. Monoinfection was diagnosed in 41 (56.9%) cases and a combination of viruses was found in 31 children, in 22 (71.0%) of them it comprised two viruses, in 6 (19.3%) — three viruses, and in 3 (9.7%) — four viruses. The presence of herpesvirus infections underpinned the main reasons why parents of the ill children were seeking for outpatient care, in particular: a prolonged subfebrile condition (18.0%), fatigue and sleep disorders (27.7%), rashes (16.6%), lymphadenopathy (16.7%), ENT diseases (33.3%), more frequently occurring respiratory diseases (33.3%), and the increase in seizure activity in children with epilepsy (8.3%). In addition to herpes viruses, pathogenic agents were detected in 18% of patients, including intracellular pathogens, which were found in 13.9% of 72 children. Taking into consideration the obtained results and established clinical diagnoses, the authors conducted a review and provided a rationale for the administered drug therapy, including medications for herpes treatment. Conclusion: a prior COVID-19 infection induces immunosuppression and, as a result, the activation of herpesvirus infections as long-term effects of COVID-19 (post-COVID conditions). The presence of mixed viral and bacterial pathogens is an indication for administering antivirals, immunomodulators, antibacterial agents, and probiotics. KEYWORDS: post-COVID conditions, herpesvirus infections, children, clinical symptoms, treatment. FOR CITATION: Savenkova M.S., Sotnikov I.A., Afanasieva A.A. et al. Importance of herpes viruses in children with post-COVID conditions. Russian Journal of Woman and Child Health. 2023;6(1):39–44 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-39-44.

Острый диссеминированный менингоэнцефалит на фоне хронической стрептококковой инфекции

The XXI century is a century of viral infections, but bacterial infections are still important in the development of infectious pathology. The clinical case reflects the features of neuroinfections in children with chronic Herpes virus and streptococcal infections. The disease progression is described in a child with an unfavorable premorbid background and the causes are discussed. The role of streptococcal infections is presented: chronic course and development of poststreptococcal disorders are typical. It is possible a reactivation of varicella zoster virus in children who had chickenpox, which can contribute the progression of nervous system disorder. Therapy includes antiviral and antibacterial medicines and Cytoflavin – a medicament with a complex mechanism of pathogenetic action, which achieves a successful outcome with the recovery of patient with acute disseminated meningoencephalitis. Key words: meningoencephalitis, streptococcus, Herpes viruses, children, Cytoflavin

Encephalitis and cytokine storm secondary to respiratory viruses in children: Two case reports

Encephalitis and cytokine storm secondary to respiratory viruses in children: Two case reports

Zastupljenost respiratornih virusa u infekcijama donjih partija respiratornog trakta u dečjem uzrastu

Introduction: Acute viral infections of the lower respiratory tract are of great importance for mortality in children worldwide. The most common causative agents include human respiratory syncytial virus (HRSV), human metapneumovirus, parainfluenza virus, influenza virus and adenoviruses. The application of molecular methods has significantly contributed to the identification and determination of the frequency of respiratory viruses in these infections. Aim: The aim of this study was to determine the frequency of different viruses that cause lower respiratory tract infections in the pediatric population using panel PCR test from bronchoalveolar lavage samples. Material and methods: Eighteen samples of bronchoalveolar lavage of children younger than 5 years with a diagnosis of pneumonia and antigenic confirmation of the presence of HRSV were analyzed. Virus detection was performed by real-time chain polymerization using the commercial FTlyoTM Respiratory Pathogens 21 kit (Fast Track Diagnostics, Luxembourg) to simultaneously detect the genomes of 18 different viruses and 1 bacterium. Results: Respiratory viruses were detected in all 18 samples, with HRSV identified in all samples, human bocavirus (HBoV) in 7 and human rhinovirus (HRV) in one sample. Coinfections were detected in 38.9% of samples. The HRSV and HBoV co-infection was proven in 33.33% of samples, while the presence of all three viruses in only one sample. Conclusion: The results of this study show the presence of HRSV, HBoV and HRV in bronchoalveolar lavage using multiplex RT-PCR method. Both HRSV and HBoV were the most common viral coinfections. Additional research is needed to more accurately estimate the frequency and distribution of respiratory viruses in children.

Preventing Respiratory Syncytial Virus in Children in France: A Narrative Review of the Importance of a Reinforced Partnership Between Parents, Healthcare Professionals, and Public Health Authorities.

The highly contagious respiratory syncytial virus (RSV) is responsible for up to approximately 50,000 hospitalisations during each RSV season in children aged under 5years in France, with the burden greatest in infants younger than 1year who were born at term. There is a need for a strategy to universally protect young children from RSV infection, and thereby reduce the pressure that RSV places every year on RSV-infected children, their parents, and French healthcare systems. Potential strategies currently undergoing clinical investigation include passive immunisation via maternal vaccination or administration of long-acting monoclonal antibodies at or soon after birth, followed by vaccination later in infancy or childhood. An ongoing partnership and collaboration between parents, public health authorities, and frontline primary healthcare will need to be reinforced once these new RSV prevention strategies are available, to facilitate their use and ensure that all children receive adequate protection from the start of their first RSV season.

2205. Potential Causative Association between Respiratory Viruses and Pneumococcus-Associated Disease in Young Children in Israel: Lessons from the COVID-19 Pandemic

Abstract Background During the early Covid-19 pandemic, we observed a close-to-full disappearance of the activity of 4 respiratory viruses (RSV, hMPV, influenza, and parainfluenza), followed by an off-season sequential re-emergence in 2021. Surprisingly, a striking similarity between the dynamics of pneumococcus-associated disease (PAD; namely community-acquired alveolar pneumonia [CAAP; often considered pneumococcal] and bacteremic-pneumococcal pneumonia [IPD-Pneumonia]), was also observed. In contrast, adenovirus and rhinovirus activities did not change during COVID-19. We examined the association between PAD and RSV, hMPV, influenza, and parainfluenza (PAD-viruses). Methods Surveillance of CAAP and IPD-Pneumonia incidences and viral activity in children &amp;lt; 5 years was described in detail previously [Danino D. et al. Clin Infect Dis. 2022, https://doi.org/10.1093/cid/ciab1014]. We extended the observations until December 2021, to capture the sequential re-emergence of the 4 PAD-viruses. A hierarchical linear regression model was used to quantify the association between PAD-viruses (each virus individually and combined), adenovirus and PAD. After fitting the models, the contribution of each virus was estimated. Results The Figure shows striking similarities in the dynamics of CAAP, IPD-Pneumonia, and PAD-viruses both before and during the COVID-19 pandemic. During the expected peak season (Oct 2020 – Apr 2021) PAD episodes were extremely low. However, off-season peaks were seen during May – Dec 2021. Overall, 78% and 25% of all CAAP and IPD-Pneumonia episodes, respectively, were attributable to these viruses in children &amp;lt; 5 (Table). In CAAP, cases were attributable to each of the 4 PAD-viruses individually throughout the first 5 years of life: RSV and hMPV combined contributed 80%, 63%, and 42% of all CAAP episodes in children aged &amp;lt; 1, 1, and 2-4 years, respectively. The respective figures for influenza and parainfluenza combined were 13%, 21%, and 22%. Only RSV significantly contributed to IPD-Pneumonia (19%). Adenovirus did not contribute to PAD episodes. Conclusion Our model suggests an important causative association between RSV, hMPV, influenza, and parainfluenza viruses and CAAP, and between RSV and IPD-Pneumonia. Disclosures All Authors: No reported disclosures.

2165. Surveillance of Severe Viral Respiratory Infections among Children Presenting to Hôpital Saint Damien in Haiti

Abstract Background Learning the burden and seasonality of respiratory viral infections in children in resource-limited settings is critical for hospital infection care and prevention and national public health programs. We built a prospective surveillance program of severe acute respiratory illness (SARI) in hospitalized children at Hôpital Saint Damien - Nos Petits Frères et Soeurs to gather local evidence and support informed clinical and policy decision-making. The COVID-19 pandemic erupted as we were launching our project, requiring the use of available point-of-care diagnostics. Methods Children &amp;lt; 18 years of age with cough, history of fever ≥ 38 C°, of &amp;lt; 10 days evolution, and requiring hospitalization were included in the study. We obtained a nasopharyngeal swab and collected demographic and clinical data for eligible patients. Samples were tested using antigen test on-site for influenza A (Flu A) and B (Flu B), respiratory syncytial virus (RSV), and SARS-CoV-2. Afterwards, all specimens (both negative and positive) were stored and shipped for molecular studies. Results We obtained and tested 167 samples from patients since April 30, 2021, through January 31, 2022. Single isolates were detected in 88 samples (53%), multiple isolates in 20 samples (12%), and no isolates in 59 samples (35%). Positive cases for RSV, Flu A, and Flu B peaked between November and January. Rhinovirus 1A (RhV) was detected throughout the study period, with peaks around August-September and was the most often detected viral isolate (49, 38%), followed by RSV (37, 29%). Co-infections were seen with RSV, Flu A, RhV, and SARS-CoV-2. Molecular studies detected 7 isolates of Flu A not detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. However, it failed to detect 2 isolates of Flu A detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. Conclusion Our study captured circulating respiratory viruses in children with SARI in Haiti during the COVID-19 pandemic. Preliminary data suggest an increase in respiratory viruses between August and January. Improving point-of-care diagnostics can better inform providers of the local epidemiology of respiratory viruses and support clinical decision-making, such as good use of antibiotics. However, we confirmed the sensitivity of molecular testing. Disclosures All Authors: No reported disclosures.