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Background: Limited data are available in Honduras describing the etiology and
seasonality of childhood acute respiratory infections (ARIs), and better data may lead to
improved therapeutic and preventative strategies.
Objective: We conducted a prospective sentinel clinic surveillance study to determine
the viral etiology of ARIs in rural Honduran children less than 5 years of age to
characterize the spectrum and seasonality of viruses associated with acute respiratory
Methods: We gathered data on age, sex, medical history, symptoms, demographics,
geographic setting, vital signs, and physical exam findings. Nasopharyngeal samples
were obtained via flocked swab and shipped to the U.S. in both universal transport
medium (UTM) on dry ice and PrimeStore
nucleic acid stabilizing buffer at room
temperature. Samples were tested for 14 respiratory viruses using the Luminex
Diagnostics polymerase chain reaction (PCR) respiratory viral panel (RVP ID-Tag
Results: 267 samples were collected from February 2010 – March 2011; 13.9% were
positive for influenza, 7.9% for human metapneumovirus, 7.5% for respiratory syncytial
virus (RSV), 7.1% for parainfluenza and 2.2% for adenovirus. At least one virus was
identified in 194 (72.7%) cases, of which 16 (6.0%) were co-infections. Influenza rose
from 1.8% of isolates in February through June to 25.7% of isolates in July through
October. No cases of influenza were identified from November 2010 through February
2011. Influenza was present for 5 out of 12 months, and influenza correlated with
monthly rainfall in millimeters (R² = 0.2857). Including all tested respiratory viruses
except enterovirus/rhinovirus, the presence of a respiratory virus positively correlated
with average monthly precipitation (R² = 0.2863). UTM and PrimeStore
influenza correlated well (K = 0.767, p<0.0001).
Conclusions: These unique results suggest that the spectrum of viruses in rural Honduran
children is similar to those found in the U.S., though the seasonality is tropical. This
region of rural Honduras demonstrated one large peak in influenza positivity prior to the
peak in the U.S., while monthly influenza results from the Pan American Health
Organization (PAHO) obtained in the capital of Honduras demonstrated two clear peaks.
Influenza and respiratory viruses in general correlated with average monthly rainfall.
at room temperature is an effective shipping method for subsequent isolation
of influenza as compared to UTM on dry ice. Further research is needed to determine the
best methods of prevention and treatment of these viral respiratory infections.
Key words: viral respiratory infections; influenza; seasonality; Honduras