Frequent respiratory pathogens of respiratory tract infections in children attending daycare centers
Caroline Measso do BonfimMaurício Lacerda NogueiraPaulo Vitor Marques SimasLuiz Gustavo GardinassiEdison Luíz DurigonPaula RahalFátima Pereira de Souza
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Rhinovirus
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Respiratory syncytial virus (RSV) and rhinovirus (RV) are predominant viruses associated with lower respiratory tract infection in infants. We compared the symptoms of lower respiratory tract infection caused by RSV and RV in hospitalized infants. RV showed the same symptoms as RSV, so on clinical grounds, no difference can be made between these pathogens. No relation between polymerase chain reaction cycle threshold value and length of hospital stay was found.
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In recent years, the incidence and mortality rate of pediatric respiratory infection have been increasing globally, with rhinovirus being of particular correlation to pediatric respiratory infection.In addition to upper respiratory tract infection, rhinovirus RNA is also found in the lower respiratory tract during the infection period.The epithelial cells of the upper respiratory tract are the target cells of rhinovirus.In recent years, studies done on the relationship between rhinovirus infection and upper respiratory tract infection have provided evidence for clinical treatment.Further investigation is needed on the pathological mechanisms of rhinovirus-induced respiratory infections.
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Rhinovirus; Respiratory tract infection; Children
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Respiratory infections are common disease and one of the major complaints in children. Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems and genetic factors (such as family history)and environmental factors (such as exposure to pollution and pathogens) also render certain age groups of children more vulnerable to infection. Pratishyaya is one of the simple and recurrent conditions frequently encountered in day to day practice and it is also a symptom of various diseases of respiratory system. Recurrent attacks of these problems may lead to adverse effects in the routine activities of the children. According to the site, respiratory infections are divided into two categories, i.e. Upper respiratory tract (URT) infections and lower respiratory tract infections. The most common and first symptom of the respiratory diseases are cold and cough irrespective of the causative organism. Respiratory diseases such as Sinusitis, Common cold, Rhinitis, Influenza,…
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Thirty preschool children presenting with recurrent respiratory infections and their unaffected siblings were observed prospectively for a year. The index children experienced more episodes of acute respiratory infection than their siblings. Respiratory viruses were the major cause of respiratory infections. The index children had lower respiratory tract disease, predominantly wheeze, during 34% of proved respiratory virus infections compared with 11% of such infections experienced by the control children (p less than 0.02). Atopic children had an increased tendency to wheeze that did not reach significance, but atopy was not associated with increased susceptibility to respiratory infections.
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Chauhan AJ, Inskip HM, Linaker CH. Lancet. 2003;361:1939–1944Nitrogen dioxide (NO2) exposure has been linked to respiratory tract illness. This study examined the relationship between the level of personal exposure to NO2 and the severity of asthma exacerbations caused by respiratory viral infections.The subjects were 114 asthmatic children, 8 to 11 years of age (63 male subjects and 51 female subjects).The cohort of 114 children collected daily upper and lower respiratory tract symptom scores and peak expiratory flow (PEF) values for up to 13 months. During this time, NO2 collection tubes were worn on the children’s outer clothing, placed in the subjects’ bedrooms at night, and changed weekly. Symptom scores determined the likelihood of an upper respiratory tract infection and prompted the collection of nasal aspirates, for assessment of the presence of common respiratory viruses and atypical bacteria with reverse transcription-polymerase chain reaction assays. NO2 exposure levels were divided into tertiles of low (<7.5 μg/m3), medium (7.5–14 μg/m3), and high (>14 μg/m3). Exposure levels in the week before or after an upper respiratory tract infection were analyzed in relation to the severity of asthma in the week after an infection.Two hundred nineteen episodes of upper respiratory tract infection occurred among 99 subjects. Lower respiratory tract symptom scores were increased and PEF values were decreased with increasing personal exposure to NO2 in the week before infection for all upper respiratory tract infections combined and for piconavirus and respiratory syncytial virus individually. There was no significant change in lower respiratory tract symptom scores or PEF values with high NO2 exposure in the week after infection.Higher levels of NO2 exposure in the week before the beginning of a respiratory tract infection were associated with increases in the severity of resulting asthma exacerbations.NO2 exposure may be derived from indoor sources, such as gas-burning stoves or wood-burning fireplaces. The levels of NO2 in this study were well within the standards for air quality safety. NO2 exposure itself, in the range experienced by the study cohort, was not associated with adverse symptom scores or lower PEF values. The highest levels of exposure were associated with worsening of asthma symptoms and decreased PEF values in the presence of upper respiratory tract infection. The results should be interpreted with caution, however, because there were no control aspirates from subjects with stable symptom scores and PEF values.
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ABSTRACT. From September 1984 to May 1986, nasopharyngeal secretions were obtained from 519 children with some form of respiratory tract infection. The nasal secretions were screened for respiratory syncytial virus (RSV), rhinoviruses, adenoviruses, parainfluenza virus types 1, 2,3, influenza virus types A and B, and enteroviruses by tissue culture virus isolation technique and/or enzyme-linked immunosorbent assay. A uniform questionnaire gave information about age, sex, individual signs and symptoms, findings of the physical examination and clinical diagnosis of the patients. RSV was detected in 119 (23%) specimens and was thus the most frequent causative agent of respiratory infections. After RSV, rhinoviruses were the most frequently recovered pathogens accounting for 60 (12%) cases of acute respiratory disease. A comparison of the individual signs and symptoms, the findings of the physical examination and the clinical diagnosis of RSV and rhinovirus infected children revealed that there was no characteristic clinical pattern associated with either of the two viral respiratory pathogens. According to our results, rhinovirus infections were a major cause of lower respiratory tract infections in hospitalized children ≤3 years old.
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Rhinoviruses are the major cause of the common cold and a trigger of acute asthma exacerbations. Whether these exacerbations result from direct infection of the lower airway or from indirect mechanisms consequent on infection of the upper airway alone is currently unknown. Lower respiratory infection was investigated in vitro by exposing primary human bronchial epithelial cells to rhinoviruses and in vivo after experimental upper respiratory infection of human volunteers. Bronchial infection was confirmed by both approaches. Furthermore, rhinoviruses induced production of interleukin-6, -8, and -16 and RANTES and were cytotoxic to cultured respiratory epithelium. This evidence strongly supports a direct lower respiratory epithelial reaction as the initial event in the induction of rhinovirus-mediated asthma exacerbations. The frequency of infection and the nature of the inflammatory response observed are similar to those of the upper respiratory tract, suggesting that rhinovirus infections may be one of the most important causes of lower in addition to upper respiratory disease.
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