Winter peak of respiratory syncytial virus in Islamabad
ABSTRACT A study was carried out on 391 cases of bronchiolitis and pneumonia from different paediatric units in Rawalpindi/Islamabad, Pakistan. A clear winter spike of respiratory syncytial virus (RSV) was noted. It was found that there was a substantial increase of 30-50% in the positivity of RSV from December to February.
SourceAvailable from: 4shared.com[Show abstract] [Hide abstract]
ABSTRACT: To ascertain that antibiotics have no role in the management of bronchiolitis. Multicentre randomized control trial (RCT). Five purposively selected teaching hospitals in Bangladesh. Children under 24 months old with bronchiolitis. Children were randomized into three groups of therapeutic interventions: parenteral ampicillin (P-Ab), oral erythromycin (O-Ab) and no antibiotic (N-Ab) in adjunct to supportive measures. Clinical improvement was assessed using 18 symptoms/signs which were graded on a two-point recovery scale of 'rapid' and 'gradual', indicating improvement within 'four days' and 'beyond four days', respectively. Each intervention group consisted of 98 +/- 1 children having comparable clinico-epidemiological characteristics at the baseline. The trial revealed that most chesty features (features appearing to arise from chest, i.e. cough, breathing difficulty, wheeze, chest indrawing, tachypnoea, tachycardia, rhonchi and crepitation) demonstrated a gradual recovery, beyond 4th admission day and, not differing among the three intervention groups (p > 0.23, p < 0.62, p = 0.54, p < 0.27, p = 0.75, p = 0.76, p = 0.81, p > 0.98, respectively). Most non-chesty features (features appearing to arise away from chest, i.e. feeding/sleeping difficulties, social smile, restlessness, inconsolable crying, nasal flaring, fever and hypoxaemia) demonstrated a rapid recovery, within 4 days, remaining comparable among the three intervention groups (p < 0.07, p = 0.65, p = 0.24, p < 0.61, p = 0.22, p = 0.84, p = 0.29 and p = 0.96, respectively). However, nasal symptoms (runny nose and nasal blockage) also showed no difference among groups (p = 0.36 and p = 0.66, respectively). Thus, the dynamics of clinical outcome obviates that children not receiving antibiotics had similar clinical outcome than those who did. In hospital settings, managing bronchiolitis with only supportive measures but without antibiotics remains preferable.Acta Paediatrica 08/2009; 98(10):1593-9. DOI:10.1111/j.1651-2227.2009.01389.x · 1.84 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: This study was carried out to determine the prevalence, seasonal distribution of RSV, the signs and symptoms associated with it in Jordan. A total of 200 nasopharyngeal aspirates were obtained from hospitalized children (below 2 years old). RSV was detected in 12.5% of patients using direct immunofluorescence technique. Most infections were associated with bronchilolitis, and higher rates of hypoxemia, retractions, tachypnea, hyperinflation and interstitial infiltrates in 1 to 3 months old children. RSV showed a clear temporal periodicity. The epidemic began in December and disappeared in March with a peak of incidence during February 2003 and January 2004. The seasonal distribution showed a significant correlation with temperature, rainfall and relative humidity. This study provides further information on RSV epidemiology which could help in planning of prevention and control programs in Jordan, distinguishing RSV infections on the basis of the clinical picture and considering RSV between December and March each year.Journal of Tropical Pediatrics 09/2006; 52(4):282-7. DOI:10.1093/tropej/fml002 · 0.86 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND: During July 2010, newspapers reported a respiratory disease outbreak in southwestern Bangladesh resulting in the admission of children to a secondary care hospital. We investigated this outbreak to determine the etiology and explore possible risk factors. METHODS: The hospital's physician diagnosed children aged <2 years with cough, tachypnea or dyspnea, and expiratory wheeze as having acute bronchiolitis. We reviewed the hospital records and listed case patients admitted between 26 June and 26 July 2010. We surveyed the case patients and collected nasal and throat swabs to test for respiratory viruses. RESULTS: We identified 101 admitted acute bronchiolitis case patients. Fifty-nine (58%) of these were admitted between 16 and 20 July. Among the 29 case patients surveyed, the median age was 4 months and 65% were males. We identified respiratory syncytial virus (RSV) in 91% (21/23) of the samples, 43% of which had a dual viral infection. Most case patients (90%) were treated with broad-spectrum antibiotics. There were no reported deaths. CONCLUSIONS: The sudden increase in admitted acute bronchiolitis case patients, their median age, and identification of RSV in the majority of samples suggest an outbreak of RSV bronchiolitis. Research to identify strategies to prevent respiratory infections including RSV in low-income settings should be prioritized. Factors that perpetuate antibiotic use in managing this viral syndrome should also be explored.International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 08/2012; 16(12). DOI:10.1016/j.ijid.2012.07.016 · 2.33 Impact Factor