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PubMed2006

Role of metapneumovirus in viral respiratory infections in young children.

The contribution of human metapneumovirus (hMPV) relative to that of other respiratory viruses as a cause of respiratory infections in children less than 1 year old has been evaluated. From October 2003 to April 2004, nasopharyngeal samples from 211 children less than 1 year old were analyzed to detect respiratory viruses. Respiratory syncytial virus (RSV) was the predominant virus isolated (96 children [45.5%]), followed by influenza A virus, parainfluenza virus, adenovirus, cytomegalovirus, and herpes simplex virus type 1, which were only occasionally detected. From January 2004 to April 2004, a nested retrotranscription-PCR, using in-house primers directed to the matrix protein gene of hMPV, was carried out on samples in which no other viruses were detected. hMPV was detected in 18 (16.2%) children, indicating that this virus was the second-most-frequent cause of viral respiratory infections in children less than 1 year old. The rate of hospitalization for RSV- and hMPV-infected children was higher than 75%. While RSV had a peak from December to February, hMPV was increasingly detected from January to April. The mean age of hMPV-infected children (6.44 +/- 3.64 [mean +/- standard deviation] months) was significantly higher than that of RSV-infected children (3.99 +/- 2.96 [mean +/- standard deviation] months). On the other hand, 64.3% of the RSV-infected children and 12.5% of the hMPV-infected children showed high levels of C-reactive protein. Although several authors have reported that clinical symptoms of hMPV-positive patients mirrored those of RSV-positive patients, differences between the two viruses can be found.

Age Factors↗
PubMed1993

Utility of a respiratory virus panel containing a monoclonal antibody pool for screening of respiratory specimens in nonpeak respiratory syncytial virus season.

An indirect immunofluorescence respiratory virus panel containing monoclonal antibodies directed against respiratory syncytial virus, parainfluenza virus types 1, 2, and 3, adenovirus, and influenza viruses A and B was used to screen specimens in the nonpeak respiratory syncytial virus seasons in 1989 and 1990. The results indicate that the respiratory virus panel is fairly sensitive (79%) and very specific (99%) for the detection of respiratory viruses directly in clinical specimens during these time periods.

Adenoviruses, Human↗
PubMed2001

Simultaneous detection of influenza viruses A and B using real-time quantitative PCR.

Since influenza viruses can cause severe illness, timely diagnosis is important for an adequate intervention. The available rapid detection methods either lack sensitivity or require complex laboratory manipulation. This study describes a rapid, sensitive detection method that can be easily applied to routine diagnosis. This method simultaneously detects influenza viruses A and B in specimens of patients with respiratory infections using a TaqMan-based real-time PCR assay. Primers and probes were selected from highly conserved regions of the matrix protein gene of influenza virus A and the hemagglutinin gene segment of influenza virus B. The applicability of this multiplex PCR was evaluated with 27 influenza virus A and 9 influenza virus B reference strains and isolates. In addition, the specificity of the assay was assessed using eight reference strains of other respiratory viruses (parainfluenza viruses 1 to 3, respiratory syncytial virus Long strain, rhinoviruses 1A and 14, and coronaviruses OC43 and 229E) and 30 combined nose and throat swabs from asymptomatic subjects. Electron microscopy-counted stocks of influenza viruses A and B were used to develop a quantitative PCR format. Thirteen copies of viral RNA were detected for influenza virus A, and 11 copies were detected for influenza virus B, equaling 0.02 and 0.006 50% tissue culture infective doses, respectively. The diagnostic efficacy of the multiplex TaqMan-based PCR was determined by testing 98 clinical samples. This real-time PCR technique was found to be more sensitive than the combination of conventional viral culturing and shell vial culturing.

Follow-Up Studies↗
PubMed2004

Real-time quantitative PCR assays for detection and monitoring of pathogenic human viruses in immunosuppressed pediatric patients.

A panel of 23 real-time PCR assays based on TaqMan technology has been developed for the detection and monitoring of 16 different viruses and virus families including human polyomaviruses BK virus and JC virus, human herpesviruses 6, 7, and 8, human adenoviruses, herpes simplex viruses 1 and 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, parvovirus B19, influenza A and B viruses, parainfluenza viruses 1 to 3, enteroviruses, and respiratory syncytial virus. The test systems presented have a broad dynamic range and display high sensitivity, reproducibility, and specificity. Moreover, the assays allow precise quantification of viral load in a variety of clinical specimens. The ability to use uniform PCR conditions for all assays permits simultaneous processing and detection of many different viruses, thus economizing the diagnostic work. Our observations based on more than 50,000 assays reveal the potential of the real-time PCR tests to facilitate early diagnosis of infection and to monitor the kinetics of viral proliferation and the response to treatment. We demonstrate that, in immunosuppressed patients with invasive virus infections, surveillance by the assays described may permit detection of increasing viral load several days to weeks prior to the onset of clinical symptoms. In virus infections for which specific treatment is available, the quantitative PCR assays presented provide reliable diagnostic tools for timely initiation of appropriate therapy and for rapid assessment of the efficacy of antiviral treatment strategies.

Adolescent↗
PubMed1984

Respiratory viruses and sudden infant death.

Viruses were shown to be present in the respiratory tract in 200 of 763 cases of the sudden infant death syndrome studied in the nine years 1974-82. Epidemiological and pathological evidence suggested that the distribution of viruses in the sudden infant death syndrome differs between infants aged 3 months or less and those aged over 3 months: the incidence of detection of virus was 14% in the younger group compared with 39% in the older group. The distribution of the viruses in these two groups was compared with that in 1341 live infants with respiratory virus infections. Adenovirus, influenza virus, parainfluenza virus, and rhinovirus had similar distribution among the victims of the sudden infant death syndrome and live controls. The incidence of detection of respiratory syncytial virus was increased in the older infants dying of the sudden infant death syndrome (90% of the cases detected) compared with the older group of live infants (53%). Antibody studies, detection of virus, and epidemiological data suggest that respiratory syncytial virus may be a precipitating factor of sudden death in older infants.

Age Factors↗
PubMed1993

Respiratory viruses and exacerbations of asthma in adults.

OBJECTIVE: To study the role of respiratory viruses in exacerbations of asthma in adults. DESIGN: Longitudinal study of 138 adults with asthma. SETTING: Leicestershire Health Authority. SUBJECTS: 48 men and 90 women 19-46 years of age with a mean duration of wheeze of 19.6 years. 75% received regular treatment with bronchodilators; 89% gave a history of eczema, hay fever, allergic rhinitis, nasal polyps, or allergies; 38% had been admitted to hospital with asthma. MAIN OUTCOME MEASURES: Symptomatic colds and asthma exacerbations; objective exacerbations of asthma with > or = 50 l/min reduction in mean peak expiratory flow rate when morning and night time readings on days 1-7 after onset of symptoms were compared with rates during an asymptomatic control period; laboratory confirmed respiratory tract infections. RESULTS: Colds were reported in 80% (223/280) of episodes with symptoms of wheeze, chest tightness, or breathlessness, and 89% (223/250) of colds were associated with asthma symptoms. 24% of 115 laboratory confirmed non-bacterial infections were associated with reductions in mean peak expiratory flow rate > or = 50 l/min through days 1-7 and 48% had mean decreases > or = 25 l/min. 44% of episodes with mean decreases in flow rate > or = 50 l/min were associated with laboratory confirmed infections. Infections with rhinoviruses, coronaviruses OC43 and 229E, influenza B, respiratory syncytial virus, parainfluenza virus, and chlamydia were all associated with objective evidence of an exacerbation of asthma. CONCLUSIONS: These findings show that asthma symptoms and reductions in peak flow are often associated with colds and respiratory viruses; respiratory virus infections commonly cause or are associated with exacerbations of asthma in adults.

Adult↗
PubMed1995

The clinical impact of human respiratory virus infections.

Acute respiratory infections are the most frequent illnesses of the human host. Most infections are caused by viruses and bacteria; the proportion caused by viruses is much greater. The viruses most frequently involved are adenoviruses, influenza viruses, parainfluenza viruses, respiratory syncytial viruses, and rhinoviruses. Acute respiratory infections are more common in young children, have rather specific seasonal occurrences, and some agents are associated with specific respiratory syndromes. Risk factors associated with increased incidence or severity of respiratory infections are occurrence in the very young or the elderly; crowding; being male; inhaled pollutants; anatomic, metabolic, genetic or immunologic disorders; and malnutrition, including vitamin or micronutrient deficiency. Respiratory infections are a much greater problem in developing countries than in developed countries and are the leading causes of death in children under 5 yr of age. The same agents cause infections, and the incidence of total respiratory infections is the same as in the developed countries. The precise causes of increased morbidity and mortality in the developing world are unclear, but crowding, inhaled pollutants, and malnutrition are likely candidates. The interactive role of viruses and bacteria is not clear but may play a role in increased severity of respiratory infections.

Acute Disease↗
PubMed1980

Association of viral and Mycoplasma pneumoniae infections with acute respiratory illness in patients with chronic obstructive pulmonary diseases.

The relative importance of respiratory virus and M. pneumoniae infections as causes of acute respiratory illnesses was studied over an 8 yr period in 150 subjects who were normal or who had varying degrees of chronic obstructive pulmonary disease (COPD). Viral or M. pneumoniae infections were associated with 186 of 1,030 (18%) illnesses studied, whereas these infections were detected in only 86 of 1,398 (6%) illness-free periods (P less than 0.01). Rhinoviruses, influenza viruses, parainfluenza viruses and coronaviruses were each significantly associated with acute respiratory illnesses. The occurrence of acute respiratory illnesses and viral infections was the same in subjects with moderate to severe COPD as it was in subjects who were normal or who had mild disease.

Acute Disease↗
PubMed1998

Broad-spectrum antiviral activity and mechanism of antiviral action of the fluoroquinolone derivative K-12.

The fluoroquinolone derivatives have been shown to inhibit human immunodeficiency virus (HIV) replication at the transcriptional level. We confirmed the anti-HIV activity of the most potent congener, 8-difluoromethoxy-1-ethyl-6-fluoro-1,4-dihydro-7-[4-(2- methoxyphenyl)-1-piperazinyl]-4-quinolone-3-carboxylic acid (K-12), in both acutely and chronically infected cells. K-12 was active against different strains of HIV-1 (including AZT- and ritonavir-resistant HIV-1 strains), HIV-2 and simian immunodeficiency virus, in MT-4, CEM, C8166 and peripheral blood mononuclear cells. In all of these antiviral assay systems, K-12 showed a similar activity (EC50 0.2-0.6 microM). K-12 inhibited Moloney murine sarcoma virus-induced transformation of C3H/3T3 cells with an EC50 of 6.9 microM. Also, K-12 proved inhibitory to herpesvirus saimiri, human cytomegalovirus, varicella-zoster virus and herpes simplex virus types 1 and 2 (in order of decreasing sensitivity), but was not inhibitory (at subtoxic concentrations) to human herpesvirus type 8 (as evaluated in BCBL-1 cells), vaccinia virus, Sindbis virus, vesicular stomatitis virus, respiratory syncytial virus, Coxsackie virus, Punta Toro virus, parainfluenza virus or reovirus. Time-of-addition experiments and quantitative transactivation bioassays indicated that K-12 inhibits the Tat-mediated transactivation process in HIV-infected cells.

Anti-HIV Agents↗
PubMed1978

Cell-mediated immunity to measles virus in multiple sclerosis: correlation with disability.

The blastogenic transformation of lymphocytes on exposure to antigen was used to investigate cell-mediated immune responses to viruses implicated in the pathogenesis of multiple sclerosis. In 12 patients with "early" multiple sclerosis, lymphocyte reactivity to measles virus, parainfluenza virus, and vaccinia virus did not differ significantly from reactivity in a healthy control group. However, there was a significant inverse correlation between the lymphocyte blastogenic response to measles and vaccinia viruses and the predetermined degree of disability from multiple sclerosis. A deficient cellular response to measles virus, and possibly to other common viruses, is therefore probably a consequence of the disease itself, and not a causal factor.

Adult↗
PubMed2006

Coronavirus HKU1 infection in the United States.

In 2005, a new human coronavirus, HCoV-HKU1, was identified in Hong Kong. We screened respiratory specimens collected from December 16, 2001, to December 15, 2002, from children <5 years of age who tested negative for respiratory syncytial virus, parainfluenza viruses, influenza virus, and adenovirus for HCoV-HKU1 by reverse transcription-polymerase chain reaction. Overall, 1,048 respiratory specimens from 851 children were tested, and 9 HCoV-HKU1-positive children (1%) were identified, 2 of whom had 2 positive specimens. Children who had HCoV-HKU1 infection had evidence of either upper or lower respiratory tract infection or both. Two patients had disease beyond the respiratory tract. HCoV-HKU1 was identified from December 2001 to February 2002. Sequence analyses suggest that a single strain was circulating. HCoV-HKU1 is therefore likely circulating in the United States and is associated with upper and lower respiratory tract disease.

Coronavirus↗
PubMed2000

Surveillance for outbreaks of respiratory tract infections in nursing homes.

BACKGROUND: Outbreaks of respiratory tract infections are common in long-term care facilities for older people. The objective of our study was to determine both the frequency of such outbreaks and their clinical and epidemiological features. METHODS: Prospective surveillance for outbreaks of respiratory tract infections and a retrospective audit of surveillance records were conducted in 5 nursing homes in metropolitan Toronto over 3 years. The clinical manifestations of infected residents were identified and microbiological investigations for causal agents were conducted. RESULTS: Sixteen outbreaks, involving 480 of 1313 residents, were identified prospectively during 1 144 208 resident-days of surveillance, for an overall rate of 0.42 infections per 1000 resident-days. Another 30 outbreaks, involving 388 residents, were identified retrospectively. Outbreaks occurred year-round, with no seasonal pattern. Pathogens included influenza virus, parainfluenza virus, respiratory syncytial virus, Legionella sainthelensi and Chlamydia pneumoniae. Multiple pathogens were detected in 38% (6/16) of the prospectively identified outbreaks. Of the 480 residents in the prospectively identified outbreaks 398 (83%) had a cough, 194 (40%) had fever and 215 (45%) had coryza. Clinical findings were nonspecific and could not be used to distinguish between causal agents. Pneumonia developed in 72 (15%) of the 480 residents, and 58 (12%) required transfer to hospital. The case-fatality rate was 8% (37/480). INTERPRETATION: Our findings emphasize the importance of adequate surveillance for outbreaks of respiratory tract infections in nursing homes and of early diagnosis so that appropriate interventions can be promptly instituted.

Aged↗
PubMedDate not supplied

[The etiological structure of the morbidity from influenza and other ARDs on the territory of Russia in the season of 1997-1998].

The antigenic properties of 51 strains of influenza virus A(H1N1), isolated in different cities of Russia during the epidemic of 1998, were studied. Most of these strains (49) proved to be similar to virus A/Bern/07/95 in the antigenic structure of hemagglutinin, but 2 strains isolated in Ulan-Ude were found to be closely related to new antigenic variants of this virus: A/Beijing/262/95 and A/Fukuoka/c7/98. The analysis of the antigenic structure of influenza-like diseases (ILD) in different cities of Russia revealed that adenoviruses causing up to 10.9-14.6% of all acute respiratory virus infections dominated at the pre- and post-epidemic periods. RS-viruses, parainfluenza viruses of types 2 and 3 circulated during the whole season (their proportion was 5.1-6.6%). The intensity of the circulation of influenza viruses A(H1N1) and A(H3N2) increased, starting from January, and continued till April 1998; its peak was observed in February-March in most of the cities of Russia (up to 37.5-41.6% according to the results of immunofluorescent diagnostics and 53-73% of ILD according to the results of the hemagglutination inhibition test). The occurrence of influenza B during this season was very low.

Acute Disease↗
PubMed2000

[Establishment and application of Z-HL16C cell line].

OBJECTIVE: Human embryonic lung fibroblasts at 8th passage was presented to us by the Institute of Virology. At its 16th passage,under the culture condition of our laboratory, the lung fibroblasts changed into epithelial like cells. We attempted to establish a cell line and applied it for virus isolation. METHODS: The cells were continuously passaged, cloned, the cell morphology, growth capacity and chromosome number were determined. RESULTS: The cell size appeared uniform, cell boundary was distinct, the cell recovery rate after frozen storing was above 90%. The cell replicated permanently and now it has been passaged 136 times. The chromosome number has changed from 46 to 110. We named this cell line the ZHL16C. It proved to be sensitive to these viruses tested: enteroviruses (Polio, Cox, Echo), influenza viruses, parainfluenza viruses, adenoviruses, measles virus, herpes simplex and herpes zoster viruses, cytomegalovirus, rubella virus and respiratory syncytial virus. When using Z-HL16C cell to isolate virus from 29 adenovirus swab samples collected from 29 soldiers with epidemic high fever in a new military, adenovirus type 3,7 coxsackie virus types B1, B5, B5, B5, B5 were isolated. CONCLUSIONS: The cell line HL16C has been stably established, it has a broad spectrum in sensitivity for viruses.

Cell Culture Techniques↗
PubMedDate not supplied

Update on the development and use of viral and bacterial vaccines for the prevention of acute otitis media.

Acute otitis media (AOM) is the most frequent diagnosis in physician offices among children 1-4 years of age. Viruses that cause upper respiratory tract infections (i.e., respiratory syncytial virus [RSV], influenza virus, parainfluenza virus [PIV], and others) play an important role in the development of AOM. Prevention of infections with these viral pathogens likely would reduce the incidence of AOM. In three previous studies, influenza virus vaccines showed 30-36% efficacy against the development of AOM. Vaccines to prevent infections with RSV and PIV type 3 are undergoing clinical testing at this time. The three major bacterial pathogens causing AOM are Streptococcus pneumoniae, nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis. Pneumococcal conjugate vaccine, licensed in the United States in 2000, was shown in two pivotal trials to reduce the incidence of all causes of AOM by 6%, pneumococcal AOM by 34%, and pneumococcal AOM caused by serotypes contained in the vaccine by 57%. Currently, vaccines against NTHi and M. catarrhalis are under development.

Acute Disease↗
PubMedDate not supplied

Virus-provoked rhinitis in patients who have allergies.

The most common illnesses in humans are the respiratory tract infections caused by viruses. When limited to the upper respiratory region, these infections often are designated as "a common cold." Viruses commonly associated with these upper respiratory infections (URI) include rhinoviruses (RVs), respiratory syncytial virus, influenza virus, parainfluenza virus, corona virus, and adenoviruses. Clinical observations have suggested that patients with allergic rhinitis and asthma experience more pronounced symptoms during a viral URI than patients who do not have allergies and who are infected with the same virus under similar circumstances. Using an experimental virus infection model in human volunteers with and without allergic rhinitis, several groups of clinical investigators have studied the effects of experimental RV infections. These observations indicate that the experimental virus infection may induce host responses that provoke enhanced immunoglobulin E (IgE) synthesis. Whether this translates into enhanced symptoms has been suggested in one study but not in another. This article will review these studies, which suggest that it is the host response to the virus and not the virus itself that plays the major role in symptom pathogenesis.

Humans↗
PubMed2005

[Microbiologic diagnosis of acute upper respiratory tract infections].

The main aim of the microbiological diagnosis is to detect the etiologic agent of an infection. In case of bacteria it means to check the susceptibility to antibiotics. It can be difficult to find the etiological agent of respiratory tract infections due to wide range of potential pathogens both viral and bacterial. Culture methods are the most frequently used while in case of atypical and viral pathogens rather serological methods based on specific antibody level checking are recommended. In high standard level laboratories molecular biology methods are more widely used. They allow to detect in short time the existence of typical bacteria like Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, atypical ones like Mycoplasma, Chlamydia, and viral pathogens like influenza virus, parainfluenza virus, adenovirus, RSV and rhinovirus. In fact it is very difficult in Poland to get access to high level laboratories for primary care physicians. This is the reason why the treatment of respiratory tract infections is mainly empirical and based on guidelines developed by experts.

Acute Disease↗
PubMed2006

Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children.

Acute pharyngotonsillitis is one of the most common infections encountered by pediatricians and family physicians. According to the US Vital Health Statistics report, acute pharyngotonsillitis is responsible for more than 6 million office visits each year by children younger than 15 years of age and an additional 1.8 million visits by adolescents and young adults aged 15 to 24 years. Most children with acute pharyngotonsillitis have symptoms that can be attributed to infection with a respiratory virus, such as adenovirus, influenza virus, parainfluenza virus, rhinovirus, and respiratory syncytial virus. However, in approximately 30% to 40% of cases, acute pharyngotonsillitis is of bacterial etiology. Group A beta-hemolytic streptococci (GABHS) are responsible for most bacterial cases of acute pharyngotonsillitis, although other pathogens, such as Neisseria gonorrhoeae, Arcanobacterium haemolyticum, Mycoplasma pneumoniae, and Chlamydia pneumoniae, may be the causative agents in sporadic cases. Pharyngotonsillitis caused by these latter pathogens can sometimes be distinguished from that caused by GABHS by considering the patient's medical history in concert with the clinical presentation. In some cases, acute pharyngotonsillitis may have an idiopathic etiology. An accurate diagnosis of GABHS infection is important because it is the only common form of acute pharyngotonsillitis for which antibiotic therapy is definitely indicated. Antibiotic therapy can shorten the clinical course of GABHS pharyngotonsillitis, reduce the rate of transmission, and prevent suppurative and nonsuppurative complications, such as peritonsillar abscess and acute rheumatic fever. Although the threat of rheumatic fever is much lower for children in the United States than in developing nations, preventing rheumatic fever and the spread of disease is the primary goal of antibiotic therapy in GABHS pharyngotonsillitis treatment and a cornerstone of practice guidelines.

Acute Disease↗