This is first report to examine the role of different RV species in ARIs in children admitted to paediatric ICU. Our study found that RV-C is the most common RV species in paediatric intensive care respiratory admissions.http://ow.ly/P6EN30k9UnX
Introduction: It is unclear if children with a rhinovirus (RV)-induced wheezing exacerbation are more susceptible to viruses longitudinally, and whether a parental history of asthma and/or allergy impacts their susceptibility. The objective of this study was to determine if RV, RV-A and RV-C related wheezing exacerbations in children were associated with prior or subsequent viral detections and investigate the role of parental history of asthma and allergy. Materials and methods: Children presenting to hospital with acute wheeze were prospectively recruited and tested for respiratory viruses. Data on viruses detected in other respiratory samples (May 1997 to December 2012) were collected from hospital microbiology records and additional RV testing was performed on stored hospital respiratory samples (September 2009 to December 2012). A positive parental history was defined as either parent with self-reported asthma and/or allergy. Results: At recruitment, RV was detected in 69.2% of samples from children with an acute wheezing episode (n=373, 0–16 years of age), with RV-C the most common virus (65.5%). Children with a history of parental asthma and/or allergy and RV at recruitment had a 14-fold increased incidence rate ratio (IRR) of subsequent RV detection (IRR 14.0, 95% CI 1.9–104.1; p=0.01) compared with children without RV at recruitment. Children without this parental history had a reduced incident rate ratio for samples assessed during this time (IRR 0.5, 95% CI 0.3–0.9; p=0.03). Conclusion: Children with a parental history of asthma and/or allergy may become more susceptible to recurrent symptomatic RV infections.
Febrile seizures are common in young children. Annual peaks in incidence mirror increased respiratory virus activity during winter. Limited virological data are available using modern diagnostic techniques for children with febrile seizures. We aimed to determine the frequency of detection of specific viral pathogens in children with febrile seizures, to describe risk factors including recent vaccination and clinical features associated with specific etiologies. An observational study was performed. Children aged 6 months to 5 years presenting to the Emergency Department of a tertiary children's hospital in Western Australia with febrile seizures were enrolled between March 2012 and October 2013. Demographic, clinical data and vaccination history were collected, and virological testing was performed on per-nasal and per-rectal samples. One hundred fifty one patients (72 female; median age 1.7y; range 6 m-4y9m) were enrolled. Virological testing was completed for 143/151 (95%). At least one virus was detected in 102/143 patients (71%). The most commonly identified were rhinoviruses (31/143, 22%), adenovirus (30/151, 21%), enteroviruses, (28/143, 20%), influenza (19/143, 13%) and HHV6 (17/143, 12%). More than one virus was found in 48/143 (34%). No significant clinical differences were observed when children with a pathogen identified were compared with those with no pathogen detected. Febrile seizures occurred within 14 days of vaccine administration in 16/151 (11%). At least one virus was detected in over two thirds of cases tested (commonly picornaviruses, adenovirus and influenza). Viral co-infections were frequently identified. Febrile seizures occurred infrequently following immunization.
Viral respiratory infections are a major cause of pediatric illness. It is not known whether seasonality of viruses differs between Aboriginal and non-Aboriginal children of varying ages.We extracted data on respiratory syncytial virus (RSV), influenza viruses A and B, parainfluenza virus types 1, 2, and 3 and adenovirus identified through cell culture or direct immunofluorescence between 1997 and 2005 from nasopharyngeal or throat specimens at Western Australia's only pediatric hospital. We used harmonic analysis in generalized linear models to examine the variations in seasonality of these viruses with Aboriginality and age.A respiratory virus was identified in 32% of 32 741 specimens. RSV (18.6%), influenza virus A (5.1%), and parainfluenza virus 3 (4.0%) were most common. The median age at time of identification was lower in Aboriginal children than non-Aboriginal for all viruses except RSV. Seasonality differed between all viruses and varied with age for RSV, influenza viruses and adenovirus. Influenza viruses A and B activity peaked earlier in Aboriginal than non-Aboriginal children during 1997, 1998, and 2002.All viruses showed distinct seasonality. Variability with age and different seasonal patterns for influenza viruses in Aboriginal children compared with non-Aboriginal children has to be taken into account when identifying target groups and timing for vaccination and other interventions.
Introduction: Respiratory viruses account for a significant proportion of acute admissions to the paediatric intensive care unit (PICU). Acute respiratory illnesses (ARI) represent 10-15% of all admissions to PICU. Recent studies have shown that human rhinovirus (HRV) was the most frequent virus detected in severe cases of ARI admitted to a PICU. There has been no study to date examining the prevalence of HRV groups (including the newly discovered HRVC group) in children admitted to a PICU. Aim: The aim of this study was to determine the prevalence of different HRV groups in children with respiratory illnesses admitted to a tertiary PICU. Methods: Nasopharyngeal aspirates (NPA) and clinical information were obtained from children admitted with respiratory illnesses to PICU between March 2009 and July 2011. RNA was extracted from NPA, and reversed transcribed. From cDNA, a 2-step PCR of the HRV 5′NCR was used for HRV detection, and sequencing for typing. Results: NPA from 229 children admitted to PICU were analysed. HRV was the commonest virus, being present in 93 (40.6%) samples examined, followed by respiratory syncytial virus (RSV) which was identified in 50 (21.8%) samples. Of the 77 NPA available for HRV typing, HRVC was found to be the commonest HRV group detected, representing 42 (54.5%) of the samples identified. HRVA group was found in 32 (41.5%) and HRVB in 3 (4%) of the samples analysed. Conclusions: This study demonstrated that HRV is the commonest virus identified in children admitted to a tertiary PICU with a respiratory illness. In addition, HRVC was the commonest HRV group detected across all respiratory illnesses.
ABSTRACT Enterovirus 71 (EV71) is a frequent cause of hand, foot, and mouth disease (HFMD) epidemics associated with severe neurological sequelae in a small proportion of cases. There has been a significant increase in EV71 epidemic activity throughout the Asia-Pacific region since 1997. Recent HFMD epidemics in this region have been associated with a severe form of brainstem encephalitis associated with pulmonary edema and high case fatality rates. In this study, we show that four genetic lineages of EV71 have been prevalent in the Asia-Pacific region since 1997, including two previously undescribed genogroups (B3 and B4). Furthermore, we show that viruses belonging to genogroups B3 and B4 have circulated endemically in Southeast Asia during this period and have been the primary cause of several large HFMD or encephalitis epidemics in Malaysia, Singapore, and Western Australia.
Employees who work alone are at greater risk of workplace violence. One of the higher‐risk lone worker occupations in North America is truck driving. Drawing on interviews with 158 truck drivers across the United States and Canada, this article examines how truck drivers interpret and experience both interpersonal and impersonal forms of workplace violence. Rather than rely on police enforcement and safety regulations, the truck drivers in this study believed that they were primarily on their own with regard to workplace violence. As a result, truck drivers described how they continually engage in informal personal safety strategies in order to decrease their chances of being victimized. These findings reveal how neoliberal responsibilization approaches to health and safety serve to conceal structural patterns of power and risk by containing individual responsibility for safety at the frontline. Overall, this study points to the need for law and policy to better incorporate the frontline experiences of workers when attempting to decrease the risk of workplace violence.
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