ABSTRACT
The purpose of this study was to identify the rate of infections due to RSV and other viruses in children. In addition we have analyzed demographic data and clinical characteristics of the RSV-positive patients comparing with patients infected by other respiratory viruses. We also described the seasonality of the RSV occurrence in a hospital in São Paulo. Children below 5 years old admitted in Santa Casa de São Paulo Hospital between February 2005 and September 2006 due to acute respiratory infections (ARI) were included. A nasopharyngeal specimens were obtained with sterile No. 5 French feeding catheters as soon as possible (usually within 24 h). Specimens were kept refrigerated at 4ºC and transported to Adolfo Lutz Institute, where the indirect immunofluorescent assay was performed. Virus identified by these assay included RSV, Adenovirus, Influenza A and B virus and Parainfluenza 1, 2, and 3. Clinical data from each group was compared. Four hundred and fifty five cases were included in the study, with 30 percent positive for some type of virus. Viruses that were identified included Respiratory Syncytial Virus (73.03 percent), Influenza (8.42 percent), Parainfluenza (8.42 percent) and Adenovirus (3.37 percent). We divided the subjects in 3 groups: Group 1 RSV-Positive, Group 2 Other Positive Viruses and Group 3 Negative for Respiratory Virus. Mean age (months) was of 7.5 for RSV-positive children, 7.6 for other viruses, and 8 for negative for respiratory virus. The RSV-Positive Group was significantly younger than the Group Negative for Respiratory Virus (p<0.05). Signs of UAI were more present in the Positive RSV Group (p<0.05). General mortality was of 2.41 percent. There was a higher incidence of RSV between the months of March and August in the two years of the study. Our study indicates RSV as the most prevalent viral agent in children admitted due to (ARI), especially in infants below 3 months old. We have also found that infections...
Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Tract Infections/virology , Brazil/epidemiology , Hospitalization , Incidence , Nasopharynx/virology , Prospective Studies , Respiratory Tract Infections/epidemiology , SeasonsABSTRACT
Recent measles outbreaks in different countries led to an increase of laboratory measles diagnosis. Thus, we developed the IgM-Measles ELISAIAL, using measles virus antigens obtained from cell cultured in microcarriers in order to supply reagent kits to Brazilian public health laboratories. A batch of antigenic reagent was produced and evaluated in the enzyme immunoassay in comparison with clinical diagnosis and with as reference assay (IgM Capture ELISA(CDC)) data. This study was performed in a positive panel with 70 serum samples from patients with measles, and a negative panel with 132 samples from patients with unrelated diseases and without recent measles or vaccination history. In relation to other diagnostic methods, the IgM ELISAIAL presented sensitivity higher than 97.1 per cente, specificity and precision of 97 per cente, and agreement kappa (k) index higher than 0.94 (P < 0.05). Moreover, the IgM antibody profile from measles acute phase revealed by the assay was similar to the reference assay. A practical analysis system for checking the quality of new reagent batches was proposed based on the diagnostic features and agreement kappa index. Our findings suggest that measles antigenic reagents can be produced with reliable quality control system, and supplied to public health laboratories for routine serodiagnosis or population surveys.
Subject(s)
Immunoglobulin M , Seroepidemiologic Studies , Laboratory Chemicals , Measles virus/pathogenicity , Enzyme-Linked Immunosorbent Assay , Culture Media , Serologic TestsABSTRACT
A clinical and laboratory evaluation of 11 childrens and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases), scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.