Gravedad de infecciones respiratorias agudas bajas por adenovirus en los años 2015 y 2016 en el hospital de niños Roberto del Rio / Severity of acute lower respiratory infections due to adenovirus in the years 2015 and 2016 at the Roberto del Rio children's hospital

OBJETIVO. Comparar la gravedad de las infecciones respiratorias agudas bajas (IRAb) producidas por Adenovirus (ADV) entre los años 2015 y 2016, en el Hospital de Niños Roberto del Río. MÉTODOS. Se identificó a pacientes hospitalizados por IRAb por ADV, y se registró edad, sexo, días de hospitalización, ingreso a unidad de paciente crítico (UPC), necesidad de ventilación mecánica (VM), entre otros. Se comparó la evolución de los pacientes, y se analizó la relación entre gravedad y presencia de infecciones asociadas a atención de salud (IAAS). RESULTADOS. Se identificó 158 pacientes hospitalizados por IRAb por ADV. La relación hombre: mujer fue 6:4, con una edad promedio de 17.4 meses. La media de días de hospitalización fue de 9.88 el 2015 y 16.06 el 2016 (p=0.01). El promedio de días de oxigenoterapia fue de 5.86 el 2015 y 8.76 el 2016. Un 22.8% (n:36) de los pacientes ingresó a UPC, y el 20.25% (n:32) requirió VM. Un 41.8% de los casos (n:66) correspondió a IAAS. 3 pacientes fallecieron. CONCLUSIONES. Durante el 2016 hubo hospitalizaciones más prolongadas en comparación al 2015, sin diferencias estadísticamente significativas en relación a requerimientos de oxigenoterapia, VM y fallecimiento. La prolongación de la hospitalización se podría asociar a mayor presencia de IAAS.

OBJETIVE. To compare the severity of lower respiratory infections produced by Adenovirus between 2015 and 2016 at the Hospital de Niños Roberto del Río. METHODS. We identified patients hospitalized for lower respiratory tract infection for ADV and we recorded age, sex, days of hospitalization, admission to Intensive Care Unit (ICU), need for mechanical ventilation (MV), among others. The evolution of the patients between the two years were compared. The relationship between severity and the presence of nosocomial infections was also analyzed. RESULTS. We identified 158 hospitalized patients for ADV. The male:female ratio was 6:4, with an average age of 17.4 months. The mean of hospitalization days was 9.88 days in 2015 and 16.06 days in 2016 (p = 0.01). The average number of oxygen therapy days was 5.86 in 2015 and 8.76 in 2016. The 22.8% (n: 36) of cases required admission in the ICU, and 20.25% (n: 32) required MV. The 41.8% (n: 66) of cases corresponded to nosocomial infections. 3 patients died. CONCLUSIONS. During 2016, there were longer hospitalizations for adenovirus infections compared to 2015, without significant differences in relation to oxygen therapy, MV requirements and death. The prolongation of the hospitalization could be associated by the greater presence of nosocomial infections.

Estudio clínico-epidemiológico de las infecciones respiratorias agudas bajas causadas por adenovirus en niños hospitalizados. Diecinueve años de vigilancia epidemiológica activa / Clinical and epidemiological study of acute lower respiratory tract infections caused by adenovirus in hospitalized children. Nineteen years of active epidemiological surveillance

Introducción. La infección respiratoria aguda baja por adenovirus es una importante causa de morbimortalidad en niños. Objetivos: Describir el patrón clínico-epidemiológico y los factores asociados en niños hospitalizados.Métodos. Estudio transversal en niños ingresados por infección respiratoria aguda baja al Hospital de Niños Ricardo Gutiérrez, Buenos Aires, en 2000-2018. El diagnóstico viral se realizó mediante inmunofluorescencia indirecta en secreciones nasofaríngeas. Se compararon características clínico-epidemiológicas de infección por adenovirus con otros virus respiratorios (virus sincicial respiratorio, influenza y parainfluenza). Se utilizó regresión logística múltiple para identificar predictores independientes de infección.Resultados. De 16018 pacientes con infección respiratoria aguda baja, 13545 fueron testeados para virus respiratorios y 6047 (el 45 %) fueron positivos. Adenovirus fue el agente menos frecuente [el 4,4 % (265) de los casos]; presentó una tendencia en descenso durante todo el período estudiado (pico en 2003) y circuló durante todo el año (pico en julio). El 63,8 % eran varones; mediana de edad: 11 meses (rango intercuartílico: 6-20). La presentación clínica más frecuente fue neumonía (el 63 %). El 50 % tenía internaciones previas por causa respiratoria; el 15,6 % eran reingresos; el 58,3 % tenía comorbilidades. El 19,2 % requirió asistencia ventilatoria; el 44 %registró complicaciones. La letalidad fue del 7,7 %. La infección por adenovirus se asoció a edad ≥ 12 meses, sexo masculino, presentación clínica de neumonía, internaciones previas por causas respiratorias y reinternaciones.Conclusiones. Los adenovirus fueron detectados con menor frecuencia que los otros virus respiratorios, aunque presentaron un importante perfil de morbimortalidad

Introduction. Acute lower respiratory tract infection (ALRTI) caused by adenovirus is a major cause of morbidity and mortality in children.Objectives. To describe the clinical and epidemiological pattern and associated factors in hospitalized children.Methods. Cross-sectional study in children admitted due to ALRTI to Hospital de Niños "Ricardo Gutiérrez," in the Autonomous City of Buenos Aires, between 2000 and 2018. Viral diagnosis was done by indirect immunofluorescence in nasopharyngeal secretions. The clinical and epidemiological characteristics of adenovirus infection were compared to other respiratory viruses (respiratory syncytial virus, influenza, and parainfluenza). A multiple logistic regression was done to identify independent predictors of infection.Results. Out of 16 018 patients with ALRTI, 13 545 were tested for respiratory viruses; 6047 (45 %) had a positive result. Adenovirus was the least common agent (4.4 % [265] of cases); it tended towards a reduction over the study period (peak in 2003) and circulated throughout the year (peak in July). In total, 63.8 % of patients were males; median age: 11 months (interquartile range: 6-20). The most common clinical presentation was pneumonia (63 %). Prior admissions due to respiratory conditions were seen in 50 %; 15.6 %were readmissions; 58.3 % had comorbidities. Ventilatory support was required by 19.2 %and complications were recorded in 44 %. The fatality rate was 7.7 %. Adenovirus infection was associated with age ≥ 12 months, male sex, clinical presentation of pneumonia, prior admissions due to respiratory conditions, and readmissions.Conclusions. Adenoviruses were less common than other respiratory viruses, although their morbidity and mortality were important

Detection of bluetongue virus in Brazilian cervids in São Paulo state / Detecção de vírus da língua azul em cervídeos brasileiros no estado de São Paulo

Viral hemorrhagic diseases in cervids occur worldwide and include epizootic hemorrhagic disease (EHD), bluetongue (BT), and adenoviral hemorrhagic disease (AHD). Since gross lesions in all three hemorrhagic diseases are identical (hemorrhagic enteropathy, pulmonary edema, systemic petechial and suffusion hemorrhages), it is necessary to use accurate techniques for a definitive etiologic diagnosis. Archival material (paraffin blocks) at the Department of Veterinary Pathology of FCAV - Unesp was reviewed for lesions of hemorrhagic disease and 42 captive and free-living Brazilian deer were selected to include in this study. Paraffin-embedded tissues were evaluated using immunohistochemistry and tested negative for adenovirus. Using real time RT-PCR, EHD virus was not detected in paraffin-embedded tissues in any of the cases evaluated. The same technique was used for detection of BT virus and seven positive animals (16,66%) were confirmed after agarose 4% gel electrophoresis and gene sequencing. The main macroscopic changes observed in the positive animals were hemorrhagic intestinal contents, reddish mucous membrane of the gastrointestinal tract, ulcers on tongue and petechiae in various organs. Microscopic changes observed were lymphocytic inflammatory infiltrate in liver, kidney and lungs, hemorrhage, and congestion in various organs. All positive cases were from captive animals, three females (two young and one adult), and four young males. This study demonstrates that the bluetongue virus is involved in hemorrhagic disease outbreaks of deer in Brazil.(AU)

Doenças hemorrágicas virais em cervídeos ocorrem no mundo todo e incluem a doença epizoótica hemorrágica (DEH), língua azul (LA), e doença hemorrágica por adenovírus (DHA). Uma vez que as lesões nas três doenças hemorrágicas são idênticas (enteropatia hemorrágica, edema pulmonar, petéquias sistêmicas e sufusões hemorrágicas), é necessário utilizar técnicas precisas para um diagnóstico etiológico definitivo. Material de arquivo (blocos de parafina) do Departamento de Patologia Veterinária da FCAV - Unesp foi revisado para lesões de doenças hemorrágicas e 42 cervídeos brasileiros de cativeiro e de vida livre foram selecionados e incluídos neste estudo. Tecidos embebidos em parafina foram avaliados usando imunohistoquímica e foram negativos para adenovírus. Usando o RT-PCR em tempo real, o vírus da DEH não foi detectado nos tecidos de nenhum dos casos avaliados. A mesma técnica foi utilizada para detecção do vírus da LA e sete animais positivos (16,66%) foram confirmados após eletroforese em gel de agarose a 4% e sequenciamento genético. As principais alterações macroscópicas observadas nos animais positivos foram conteúdo intestinal hemorrágico, mucosa do trato gastrointestinal avermelhada, úlceras na língua e petéquias em vários órgãos. As alterações microscópicas observadas foram infiltrado inflamatório linfocítico em fígado, rins e pulmões, e hemorragia e congestão em vários órgãos. Todos os casos positivos foram de animais de cativeiro, três fêmeas (dois jovens e um adulto), e quatro jovens do sexo masculino. Este estudo demonstra que o vírus da lingual azul está envolvido nos surtos de doença hemorrágica em veados no Brasil.(AU)

Infección por adenovirus en el Hospital de niños Roberto del Río 2016 / Adenovirus infection at the Roberto del Río children's Hospital 2016

En los meses de invierno, las enfermedades respiratorias representan la primera causa de hospitalización en hospitales pediátricos. La mayoría de estas enfermedades son causadas por virus, dentro de los cuales se encuentra el adenovirus (AdV), el cual puede generar infecciones diseminadas graves, secuelantes e incluso letales y se caracteriza por tener una rápida transmisión entre pacientes, generando brotes intrahospitalarios. Se identificó a 54 pacientes hospitalizados con infección por adenovirus en el periodo de marzo-julio del 2016 con una edad promedio de 18,3 meses, de los cuales 23 casos fueron infecciones asociadas a la atención de salud (IIAS) y 2 tuvieron desenlace fatal. Los casos de IIAS, se asociaron a una mayor tasa de hospitalización prolongada (p= <0.01), ingreso a UPC (p= <0.01) y uso de ventilación mecánica (p= <0.01). No se encontró asociación entre la presencia de antecedentes mórbidos con el desarrollo de IIAS. Las IIAS por adenovirus se asocia a una hospitalización prolongada, ingreso de unidades de alta complejidad y necesidad de uso de ventilación mecánica. Dado que el adenovirus se transmite a través de contactos directo, aerosoles y fómites, las medidas básicas de precaución de contacto y de aislamiento permiten reducir los contagios nosocomiales, recayendo la responsabilidad en todo el equipo de salud a cargo.

Respiratorio deseases are frequent in winter times. being the main cause of hospital admissions. Viral infecciones are the main etiology, and adenovirus infección clould lead to severe disease, with cross infections. We identified 54 patients admitted to the Roberto del Río Childrens hospital in 2016, with a mean age of 18,3 months old; 23 cases where nosocomial infection, and 2 were fatal. Hospital acquired adenovirus infection were associated to long hospital stay (p= <0.01), intensive care admission (p= <0.01) and ventilatory support (p= <0.01). We did not find previous illness conditions. Adenovirus hospital acquired infection is associated with longer hospital stay and dead. Adenovirus is transmitted with direct contact, aerosols and fomites, therefore basic contact precautions are important.

A non-enteric adenovirus A12 gastroenteritis outbreak in Rio de Janeiro, Brazil

A gastroenteritis outbreak that occurred in 2013 in a low-income community in Rio de Janeiro was investigated for the presence of enteric viruses, including species A rotavirus (RVA), norovirus (NoV), astrovirus (HAstV), bocavirus (HBoV), aichivirus (AiV), and adenovirus (HAdV). Five of nine stool samples (83%) from patients were positive for HAdV, and no other enteric viruses were detected. Polymerase chain reaction products were sequenced and subjected to phylogenetic analysis, which revealed four strains and one strain of non-enteric HAdV-A12 and HAdV-F41, respectively. The HAdV-A12 nucleotide sequences shared 100% nucleotide similarity. Viral load was assessed using a TaqMan real-time PCR assay. Stool samples that were positive for HAdV-A12 had high viral loads (mean 1.9 X 107 DNA copies/g stool). All four patients with HAdV-A12 were < 25 months of age and had symptoms of fever and diarrhoea. Evaluation of enteric virus outbreaks allows the characterisation of novel or unique diarrhoea-associated viruses in regions where RVA vaccination is routinely performed.

The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil

OBJECTIVES: Viral conjunctivitis is a common, highly contagious disease that is often caused by an adenovirus. The aim of this study was to evaluate the prevalence of adenoviral conjunctivitis by analyzing data from a prospective clinical study of 122 consecutively enrolled patients who were treated at the Clinical Hospital of the State University of Campinas (UNICAMP) after a clinical diagnosis of infectious conjunctivitis between November 2011 and June 2012. METHODS: Polymerase chain reaction was used to evaluate all cases of clinically diagnosed infectious conjunctivitis and based on the laboratory findings, the prevalence of adenoviral infections was determined. The incidence of subepithelial corneal infiltrates was also investigated. RESULTS: Of the 122 patients with acute infectious conjunctivitis included, 72 had positive polymerase chain reaction results for adenoviruses and 17 patients developed subepithelial corneal infiltrates (13.93%). CONCLUSIONS: The polymerase chain reaction revealed that the prevalence of adenoviral conjunctivitis was 59% in all patients who presented with a clinical diagnosis of infectious conjunctivitis from November 2011 to June 2012. The prevalence of adenoviral conjunctivitis in the study population was similar to its prevalence in other regions of the world.

Prevalência de conjuntivite adenoviral em clínica oftalmológica no município de Viçosa (MG) / Prevalence of adenoviral conjunctivitis at the ophthalmologic clinic on municipality of Viçosa/MG

Objetivo: Avaliar a prevalência de Adenovírus como agente etiológico da conjuntivite, em clínica médica oftalmológica especializada, em Viçosa, Minas Gerais, Brasil. Métodos: Amostras da secreção conjuntival de 91 pacientes clinicamente diagnosticados com conjuntivite foram submetidos à reação em cadeia da polimerase (PCR), utilizando primers degenerados para a região codificadora do gene da proteína estrutural II. Posteriormente as amostras positivas foram submetidas a sequenciamento e genotipagem. Resultados: A análise dos resultados de PCR revelou prevalência de 36,3% de Adenovírus. Não havendo distinção entre os sexos e com maior prevalência na faixa etária de 26 a 65 anos com 60,60% dos casos positivos. O sequenciamento dos casos positivos por Adenovírus revelaram a presença dos sorotipos 3, 4, 7, 8 e 34 circulante na região. Conclusão: No município de Viçosa, dois em cada cinco casos de conjuntivite são de etiologia adenoviral.

Objective: The aim of this study was to evaluate the prevalence of Adenovirus as a etiologic agent of conjunctivitis on a ophthalmic clinic in Viçosa, Minas Gerais, Brazil. Methods: Samples of conjunctival secretion from 91 patients clinically diagnosed with conjunctivitis were subjected to polymerase chain reaction (PCR) using degenerate primers targeted to the gene encoding the structural protein II. Positive samples were subsequently subjected to sequencing and genotyping. Results: PCR results showed 36.3% prevalence of Adenovirus. No differences between the sexes and was found to be higher in the age group 26-65 years with 60.60% of the positive cases. Sequencing of positive cases showed the presence of Adenovirus serotypes 3, 4, 7, 8, and 34 circulating in the region. Conclusion: In Viçosa two in five cases of conjunctivitis has Adenovirus as etiologic agent.

Identificación de virus respiratorios en pacientes pediátricos / Identification of respiratory viruses in pediatric patients

Los virus son la principal causa de infecciones respiratorias agudas. Para la detección de los virus respiratorios se emplea la Inmunofluorescencia directa (IFD). Objetivos: Describir los resultados de las IFD positivas según edad de los pacientes y estacionalidad y determinar el porcentaje de positividad. Material y métodos: Estudio descriptivo retrospectivo. Se incluyeron todas las IFD realizadas en pacientes <15 años en el Hospital de Niños de Viña del Mar entre enero 2012 y noviembre 2013. Resultados: Se realizaron 32015 IFD en 9012 pacientes en ambos años. El virus más frecuente es el Virus Respiratorio Sincicial (VRS) (51 por ciento 2012, 63 porciento 2013), obteniendo un mayor número de casos en pacientes menores de 1año. El Adenovirus (ADV) ocupa el segundo lugar con una incidencia uniforme a lo largo del año. Se observó una disminución de los casos de Influenza A y B desde el año 2012 al 2013. El porcentaje de positividad global de los exámenes es muy bajo (4,25 por ciento 2012 y 3,19 por ciento 2013). El VRS alcanza la mayor positividad en invierno (31,8 por ciento 2012 y24,7 por ciento 2013) y llega al 0 por ciento durante el verano. Conclusiones: Nuestros resultados se asemejan a la epidemiología nacional principalmente en la distribución de los virus según edad y estacionalidad. El virus más frecuentemente encontrado es el VRS. Hubo menos casos de Influenza A durante el 2013 en comparación con los resultados en el país. Existe una solicitud aumentada de exámenes lo que lleva a un porcentaje de positividad muy bajo...

The main cause of acute respiratory infections is viral. The direct immunofluorescence (IF) is used in the detection of respiratory viruses. Objectives: To describe the results of positive IF in relationship to the patient´s age and seasonality and to determine the percentage of positive results. Material and Methods: A descriptive retrospective study that includes all IF performed in patients <15 years old in a private clinic in the V region from January 2012 to November 2013. Results: 32015 IF were conducted in 9012 patients during both years. The Respiratory Syncytial Virus (RSV) is the most common virus (51 percent 2012, 63 percent 2013), obtaining a larger number of cases in patients under the age of 1. The second most common virus is Adenovirus (ADV) with a uniform incidence during the year. A decrease in cases of Influenza A and B was observed from 2012 to 2013. The percent positivity of the tests is very low (4.25 percent and 3.19 percent 2012 2013). The RSV positive testing is higher during the winter (31.8 percent and 24.7 percent 2012 2013) and 0 percent during the summer. Conclusions: Our results are similar to the ones obtained by the national epidemiology in terms of age and season relationship. The RSV is the most common virus. There were fewer cases of influenza A in 2013 compared with results in the country. Due to high demand in IF testing, a very low percentage of positive results is observed...

Prevalencia de virus respiratorios en pacientes menores de 2 años internados por infecciones respiratorias bajas en el Hospital de Emergencias Pediátricas durante el año 2011 / Prevalence of respiratory viruses in patients younger than 2 years interned by lower respiratory infections at the Hospital of Pediatric Emergency during the year 2011

Objetivos: Determinar la prevalencia de Virus en Infecciones Respiratorias Bajas en los pacientes internados en el Hospital de Emergencias Pediátricas. Material y métodos: Se realizó un estudio descriptivo, retrospectivo transversal. Se revisaron 274 historias clínicas de pacientes menores de 2 años que ingresaron al Servicio de Hospitalización Pediátrica del Hospital de Emergencias Pediátricas con diagnóstico de Infección Respiratoria Baja y a los que se les realizó algún Tipo de prueba para identificar Virus Respiratorios. Resultados: El 56.6 por ciento de los pacientes fueron del sexo masculino, y el 43.4 por ciento fueron del sexo femenino. Hubo una mayor frecuencia de virus sincicial respiratorio en el 18.6 por ciento de los casos seguido de adenovirus (14.2 por ciento), virus parainfluenza 3 (12 por ciento). El 94.2 por ciento de los casos se detecto con inmunofluorescencia indirecta. El 40.9 por ciento de los pacientes tenían edades entre los 6 a 12 meses. Hubo una mayor frecuencia de internamiento en el mes de Agosto en el 17.2 por ciento de los casos. El diagnóstico de ingreso de mayor frecuencia fue el de síndrome de obstrucción bronquial aguda con un 42 por ciento. El 51.8 por ciento de los casos tuvo una estancia de 4 a 7 días. El hallazgo radiológico de mayor frecuencia fue atrapamiento de aire con un 38.7 por ciento de los casos. El 7.3 por ciento de los pacientes ingresaron a fa UCI. El 41.2 por ciento de los pacientes recibieron tratamiento antibiótico. El 65 por ciento de los pacientes recibieron tratamiento con beta dos agonistas. El 53.6 por ciento recibieron tratamiento con corticoides. El 5.1 por ciento padecían de enfermedad cardiaca. El 4 por ciento tenían el antecedente de prematuridad. El 4.4 por ciento tenían el antecedente de enfermedad pulmonar crónica. La complicación más frecuente fue la atelectasia con un 7.3 por ciento de los casos. Conclusiones: La prevalencia de Virus en Infecciones Respiratorias Bajas en los pacientes...

Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en México / Frequency of respiratory viruses and clinical characteristics in children attending a care center in Mexico City

OBJETIVO. Describir la frecuencia de virus respiratorios y características clínicas en niños con cuadros respiratorios de un hospital de tercer nivel en México. MATERIAL Y MÉTODOS. Se incluyeron niños con diagnóstico de infección respiratoria y un resultado positivo por inmunofluorescencia de enero 2004 a octubre 2006. RESULTADOS. De 986 muestras nasofaríngeas, 138 (14 por ciento) fueron positivas. La frecuencia fue: 80 por ciento virus sincicial respiratorio (VSR), 8 por ciento parainfluenza 1, 5 por ciento parainfluenza3, 2 por ciento adenovirus, 2 por ciento influenza A, 1 por ciento parainfluenza 2 y 1 por ciento influenza B. CONCLUSIONES. La frecuencia de virus respiratorios fue de 14 por ciento. El VSR se identificó asociado con más frecuencia, a neumonía y bronquiolitis en menores de 3 años.

OBJECTIVE. To describe the frequency of respiratory viruses and clinical characteristics in children with respiratory signs and symptoms in a tertiary care center in Mexico. MATERIAL AND METHODS. Patients with a clinical diagnosis of respiratory infection and a positive immunofluorescence result (Light Diagnostics) from January 2004 to October 2006 were included. RESULTS. From the 986 nashopharyngeal samples, 138 (14 percent) were positive by immunofluorescence. The frequency was: 80 percent RSV, 8 percent parainfluenza 1, 5 percent parainfluenza 3, 2 percent adenovirus, 2 percent influenza A, 1 percent parainfluenza 2 and 1 percent influenza B. CONCLUSIONS. Respiratory viruses were detected in 14 percent of samples tested. RSV was the most frequently identified virus and was associated with pneumonia and bronchiolitis in children younger than 3 years old.

Prevalence of rotavirus, adenovirus, and astrovirus infections among patients with acute gastroenteritis in, Northern Iran

The aim of the study was to determine the incidence of non-bacterial acute gastroenteritis associated with diarrheal diseases in Mazandaran Province, northern Iran. A total of 400 symptomatic cases from patients with acute gastroenteritis from Mazandaran Province in Iran were screened using EIA method for the presence of rotavirus, adenovirus and astrovirus during 2005-2006. Chi-square tests were used for testing relationships between different variables. Rotavirus, adenovirus and astrovirus were detected in 62%, 2.3%, and 3% of samples, respectively. The maximum rate of rotaviruses was detected in the<1-year-old age group, while minimum rate was found in the 10 years and older age group. Astrovirus and adenovirus were detected predominantly in the 2-5-year-old age group of children, with a prevalence of 8.3% and 3.5% respectively. All studied viral gastroenteritis peaked in the winter, and minimum rate were found in summer. Our statistical analyzes indicated that viral gastroenteritis, especially Rota-viral, had the highest number of occurrences in colder seasons notably in winter and more frequently were observed among younger children

Rotavirus infection in children and adult patients attending in a tertiary Hospital of São Paulo, Brazil

During the period of January 2003 to December 2005, 3,768 stool samples were received in the Microbiology Laboratory for rotavirus antigen detection from outpatients and inpatients of Albert Einstein Hospital, SP. Fresh stool samples from children and adults were analyzed by two methodologies: during 2003 and 2004 by latex agglutination (Slidex Rotavirus, Biomerieux) and 2005 by an immunochromatographic assay for the combined detection of rotavirus and adenovirus (Vikia Rota-Adeno, Biomerieux). Rotavirus group A was detected in 755 (20 percent) samples. The annual prevalence was 19.8 percent in 2003, 21.7 percent in 2004, and 18.7 percent in 2005. Rotavirus was detected every month during the period of the study, with peak of positivity between June and August (>35 percent). The prevalence in hospitalized patients was 26.1 percent (352/1,350) and in outpatients was 16.7 percent (403/2,418). For hospitalized patients most of the rotavirus infections were diagnosed in Pediatric setting, age range of 0 to 10 years (prevalence of 55.3 percent, 295/534). Overall positivity was up to 30 percent in patients between six months and five years of age (67 percent of all positive patients), all other age groups had at least 10 percent positive tests. Rotavirus infection is common in Sao Paulo, and besides the expected higher frequency in children it is also frequent in adults.

[Prevalence of rota, adeno and astrovirus in children with acute gastroenteritis in Babol, Iran]

Viral gastroenteritis is associated with significant cause of morbidity and is a common cause of hospitalization in worldwide. This study was performed to assess the role of rota, adeno and astroviruses in children presenting with acute diarrhea in the main Children's Medical Hospital in Babol-Iran. Stool specimens from 208 children suffering from diarrhea were tested for the presence of rota, adeno and astroviruses by ELISA test during winter 2004 to autumn 2005. Data were then analyzed by the Chi-square and Fisher exact test with SPSS-10 software. Rota, adeno and astrovirus antigens were detected in 61.1%, 2.9% and 2.4% of patients. Infants between 6 and 12 months of age were most frequently affected with rotavirus [29.8%], [p < 0.05]. Rotavirus infection was significantly less frequent in summer and spring than winter and autumn [p < 0.05]. Fever and vomiting were present in 55.1% and 51.7% of children, respectively. There was not significant correlation between rotavirus infection and gender of patients. This study showed that rotavirus can be regarded as a major etiologic agent of winter acute diarrhea in children under 2-years old in Babol. Therefore, it is suggested to provide proper vaccination to immunize the children

frequency distribution of parainfluenza, adeno and respiratory syncytial virus infections in children below 2 years old with bronchiolititis, by multiplex polymerase chain reaction method, afzalipoor hospital, kerman, 2006

Acute respiratory infections are common cause of mortality during childhood. This study was designed to determine the incidence of adenovirus, parainfluenza virus and respiratory syncytial virus in respiratory infections by Multiplex PCR method. This study included 168 children under 2 years of age with clinical diagnosis of bronchiolitis. Nasopharyngeal specimens were taken and transferred to the virology laboratory in VTM transport medium. Following extraction of viral DNA and RNA, Multiplex RT-PCR was performed. From 168 specimens, 33 cases [19.6%] were infected with parainfluenza viruses, 18 cases [10.7%] with adenovirus and 63 cases [37.5%] with RSV. The rest of the specimens were negative for these viruses, which indicated that these specimens had been probably infected with other viral agents not investigated in this study, or with mycoplasma. No significant correlation was found between WBC count, ESR values, degree of air trapping, coryza, fever, cough, retraction rale, wheezing and the type of viral infection. Also no significant correlation was found based on age, sex or general condition of patients. Major causes of viral infections in this study were respectively respiratory syncytial virus [RSV], parainfluenza and adenovirus

[Diagnosis of rotavirus and adenovirus type 40/41 in children with acute diarrhea by immunochromatography in Mofid Children Hospital]

Acute diarrhea is one of the leading causes of worldwide mortality and morbidity; four millions annual deaths. The aim of this study is to investigate the prevalence of rotavirus and adenovirus among children with acute diarrhea and to evaluate their clinical and laboratory findings. 199 children aged 1 to 168 months with acute diarrhea were studied in "Mofid" Children Hospital for a one year period. Clinical and laboratory findings including stool culture and WBC and RBC counts in their stool samples were analyzed. From 199 children with diarrhea, 14 cases [7%] were positive for viruses; 11 [5.5%] rotaviruses and 3[1.5%] adenoviruses. In Rotavirus and adenovirus, male to female ratio were 1.2/1 and 2/1, and the mean age were 40.8 and 20.4 months, respectively. Clinical findings comprised frequency, dehydration, fever, vomiting and watery diarrhea. Stool culture was negative and no RBC and WBC were detected. High prevalence of rotavirus and adenovirus in former studies and low prevalence of rotavirus in this study seems to be caused by the diagnostic method we used. Since a fast laboratory process is necessary for immunochromatography, other methods as EIA and PCR are recommended

Virus Respiratorios en Menores de Diez Años con Infección Respiratoria en el Hospital Militar Central de Bogotá 2000-2001 / Respiratory virus in children aged less than 10 years old suffering from respiratory infection in the Hospital Militar Central in Bogota from 2000-2001

Objetivo: Se llevo a cabo un estudio en niños que consultaban por infección respiratoria aguda al Hospital Militar (Hosmil) de Bogota, Colombia, con el objetivo de estimar la frecuencia de enfermedad respiratoria aguda en esa institución producida por algunos virus respiratorios. Métodos: Durante 18 meses, de Marzo de 2000 a Septiembre de 2001, se seleccionaron semanalmente tres a cinco niños con infección respiratoria de aquellos que consultaban al servicio de emergencia o de consulta ambulatoria del Hospital. De cada uno de ellos se obtuvo muestras nasofaringeas que fueron examinadas por inmunofluorescencia para virus sincitial respiratorio (VSR), influenza, adenovirus y parainfluenza. Resultados: Se estudiaron 139 niños de los cuales el 40 por ciento fue positivo para alguno de los virus estudiados. El agente viral mas frecuentemente encontrado fue el VSR (27 por ciento), seguido por el virus de la influenza (5 por ciento) y adenovirus (3 por ciento). La circulación de VSR coincidía con los picos de hospitalizaciones por IRA y por neumonía y del hospital, era mas frecuente en los niños menores de 3 años y se encontraba presente durante todo el año. Conclusiones: Los virus respiratorios causan gran parte de la enfermedad respiratoria moderada o severa en el Hosmil y el VSR es el agente más importante entre ellos.

Objective: A study was carried out on children seeking medical care at the Hospital Militar (Hosmil) in Bogota due to acute respiratory infection; it was aimed at estimating the frequency of respiratory virus-associated acute respiratory disease (ARD) in children aged under 10. Methods: Three to five children aged less than 10 years old were selected every week from the hospital's emergency ward or ambulatory services over an 18-month period from March 2000 to September 2001. Nasopharyngeal samples were obtained from them and processed using indirect immunofluorescence. The relative frequency of respiratory syncytial virus (RSV), influenza, adenovirus and parainfluenza were calculated. Results: Around 40 percent of the 139 children examined proved positive for at least one respiratory virus. RSV was the most frequently found virus (27 percent positivity: 38 patients) followed by influenza (5 percent: 7 patients) and adenovirus (3 percent: 4 patients). RSV circulation peaks coincided with peaks related to ARD and pneumonia in the hospital: it was found most frequently in children aged less than 3 and was present throughout the year. Conclusion: Respiratory viruses were an important cause of moderate to severe respiratory illness in children seeking health care at Hosmil; RSV was the leading agent amongst such viruses.

Adenovirus en Niños Menores de Cinco Años: patrones de Circulación, Características Clínicas y Epidemiológicas en Colombia, 1997-2003 / Adenovirus in children under five years of age: circulation patterns and clinical and epidemiological characteristics in Colombia, 1997-2003

Objetivo: Desde 1997 el Instituto Nacional de Salud vigila la ocurrencia de algunos virus respiratorios con el fin de identificar sus patrones de circulación y el papel que tienen en la ocurrencia de enfermedad respiratoria moderada o severa, en niños menores de 5 años. Métodos: La vigilancia está basada en hospitales centinela de Bogotá y Manizales en los que todas las semanas se recolectan 4 a 8 muestras nasofaríngeas, de niños menores de cinco años que consultan por enfermedad respiratoria alta o baja. Las muestras son procesadas por inmunofluorescencia indirecta. Resultados: De Enero de 1997 a Diciembre de 2003 se examinaron 1 743 pacientes y se encontraron virus respiratorios en 35 por ciento de las muestras procesadas. El adenovirus se encontró en 47 casos (2,6 por ciento, IC95 por ciento 1,4-3,5 por ciento) y fue detectado durante todos los meses, excepto enero, con picos en marzo, julio, octubre y diciembre. La mayoría de los pacientes requirieron hospitalización (50 a 87 por ciento) y soporte con oxigeno y la razón muerte/caso fue de 7 por ciento. Los serotipos de adenovirus encontrados fueron B7, 2, C1 y B3. Conclusiones: Los datos del presente estudio datos sugieren que en nuestro medio los adenovirus no son los agentes mas frecuentes de enfermedad respiratoria pero, cuando están presentes, producen enfermedad severa.

Objective: The Colombian National Institute of Health has been studying the epidemiology of several respiratory viruses since 1997 to identify their circulation patterns and the role they play as pathogenic agents of acute and/or moderate respiratory infection (RI) in children aged less than 5. Methods: The study used sentinel surveillance methods in sentinel hospitals in Bogotá and Manizales. Four to eight nasopharyngeal samples were collected every week in the sentinel hospitals from children aged less than five consulting for low or high RI. Nasopharyngeal samples were processed by indirect immunofluorescence. Results: 1 743 children were examined from January 1997 to December 2003; 35 percent were found to be positive for respiratory viruses. Respiratory syncytial virus was found more frequently while adenovirus was found in 47 patients (2,6 percent of the sample; 1,4-2,5 percent 95 percentCI). Adenovirus was detected throughout the year (excepting January) but peaks occurred in March, July, October and December. Most patients were hospitalised (50-87 percent) and were in need of oxygen support. Fatality:case ratio was 7 percent; B7, 2, C1, and B3 serotypes were identified. Conclusion: The data suggested that respiratory infection due to adenovirus was a low frequency event amongst the children seeking medical care at the sentinel hospitals. However, when respiratory disease was caused by adenovirus, it was severe.

Seguimiento clínico y factores de riesgo en niños con enfermedades respiratorias por adenovirus / Clinical evaluation and risk factors analysis in children with adenovirus respiratory infections

Introducción: El adenovirus es un importante agente etiológico en infecciones respiratorias en niños, que en ocasiones puede producir una gran morbimortalidad. Objetivo: Describir las características clínicas y epidemiológicas de las infecciones respiratorias por ADV e identificar posibles factores de riesgo asociados a gravedad, mortalidad y secuelas broncopulmonares. Pacientes y Metodos: Se revisaron las fichas clínicas de los pacientes con diagnóstico de infección respiratoria por adenovirus mediante IFI durante 2004; se registraron datos epidemiológicos y clínicos; se evaluaron factores de riesgo y se calculó la tasa de ataque. Resultados: Se incluyeron 57 niños, 68,4 por ciento varones, mediana de edad de 10 meses, 67 por ciento menores de 1 año. 89,5 por ciento fueron hospitalizados; 26,3 por ciento evolucionó grave, 8,8 por ciento falleció y 47,3 por ciento presentó secuelas broncopulmonares. En este período se produjeron 2 brotes intrahospitalarios, con una tasa de ataque de 16,5 por ciento. Se identificaron como factores de riesgo para enfermedad grave: edad entre 4 y 10 meses y adquirir el ADV durante un brote intrahospitalario; para mortalidad el antecedente de enfermedad subyacente, y para secuelas pulmonares la edad entre 4 y 10 meses. Conclusiones: Los factores de riesgo identificados deben llamar nuestra atención en niños hospitalizados con diagnóstico de adenovirus ya que pueden predecir una evolución desfavorable.

Adenovirus: neumonía, enfermedad pulmonar crónica y asma / Adenovirus: pneumonia, chronic lung disease and asthma

Las infecciones por ADV ocurren primariamente en niños menores de cinco años y dan cuenta del 2 a 5 por ciento de las infecciones respiratorias pediátricas y 4 a 10 por ciento de las neumonías. La severidad de las infecciones respiratorias bajas por ADV varía de acuerdo al serotipo involucrado y a factores del huésped como edad, respuesta inmune, factores socioeconómicos y ambientales. La fase aguda de la neumonía por ADV es con condensaciones pulmonares extensas, semejante a una neumonía bacteriana, acompañada de compromiso sistémico y de múltiples órganos muy severa, asociándose a morbilidad y mortalidad importantes. La fase crónica se caracteriza por sibilancias, crepitaciones y dificultad respiratoria, y a veces con dependencia de ventilación mecánica o de oxigeno de curso prolongado. Histológicamente esto corresponde a una Bronquiolitis Obliterante. Entre el 14 y el 50 por ciento de los pacientes pueden desarrollarla. Radiológicamente hay hiperinsuflación, hernias mediastínicas, atelectasias cambiantes y en TC mosaico y bronquiectasias. La evolución de los primeros años es tormentosa. Hacia la edad escolar se estabilizan con compromisos variables de la función pulmonar y persistencia del compromiso obstructivo hasta la adolescencia, edad en la que pueden aparecer nuevas complicaciones y evolucionan como las EPOC de los adultos. Otro grupo de pacientes desarrolla síntomas de asma. Los ADV gatillas crisis de asma y su ADN se ha encontrado en lavados broncoalveolares de asma persistente, todo lo cual lo ubica como un patógeno relevante.

Perfil clínico-epidemiológico de las infecciones por virus respiratorios en adultos hospitalizados durante la estación de influenza 2004 / Clinical and epidemiological characteristics of respiratory virus infections among adults hospitalized during 2004 influenza season

El comportamiento epidemiológico del virus influenza (FLU) en la comunidad se refleja en el hospital, es planteable que la actividad comunitaria de otros virus respiratorios también se traduzca en un alza de las internaciones por estos agentes. Objetivo: describir la presencia y características clínico-epidemiológicas de infecciones por virus respiratorios no-FLU (virus respiratorio sincicial-VRS, parainfluenza y adenovirus-ADV) entre adultos hospitalizados durante la temporada de influenza y establecer una comparación con virus influenza-A (IA) o -B (IB). Pacientes y Método: Adultos internados en Hospital Clínico Universidad Católica, de mayo a julio de 2004, con infección por IA o IB, y VRS, parainfluenza (1-2-3) o ADV demostrada por test rápido o inmunofluorescencia directa. Resultados: Se identificaron 86 casos: 73,5 por ciento FLU (48,2 por ciento, IA y 25,3 por ciento IB) y 26,5 por ciento no-FLU. (15,7 por ciento parainfluenza-2; 8,4 por ciento VRS, 1,2 por ciento parainfluenza-3 y 1,2 por ciento ADV). El grupo con FLU presentó más frecuentemente mialgias, tos, hospitalización por síndrome febril, mayores valores de PCR y porcentaje de baciliformes (p < 0,05). Conclusiones: Durante la temporada de influenza 2004, 26,5 por ciento de las infecciones entre adultos hospitalizados fueron causadas por virus no-FLU. La dificultad en diferenciar infecciones por virus FLU de no-FLU, plantea la necesidad de ampliar el estudio de la etiología viral incluso durante la temporada de FLU.