Respiratory syncytial virus infection and bronchial hyperreactivity in children up to two years of age in correlation with atopy.

BACKGROUND/AIM: Bronchiolitis in early childhood caused by respiratory syncytial virus (RSV) is considered to be important risk factor of the recurrent wheezing and asthma development. The aim of this study was to examine the frequency of RSV infection and atopy in children up to two years of age and to determine their correlation with bronchial hyperreactivity. METHODS: The study included 175 children aged 5-24 months. The presence of RSV infection was identified by serum levels of IgA and IgG determined by ELISA. Bronchial hyperreactivity (BHR) has been defined as the existence of chronic bronchial disease and/or three or more previous suspected diagnosis of acute bronchial disease. Atopy was confirmed by detection of the specific serum IgE using quantitative multitest Phadiatop infant (cut off 0.35 kUA/L). RESULTS: The children with atopy were more frequently infected with RSV (43.3%) than those without atopy (22.8%; p = 0.02). The higher frequency of RSV infection was found in children with BHR in comparison with those without it but only in the group who also had atopy (77.8% vs. 28.6%, p = 0.018). In the female children, BHR and RSV infection were associated in 62.5% of cases, regardless the atopy. In the male children with atopy, RSV infection was associated with BHR in 83.3% of the cases, while in those without atopy, RSV infection with BHR was found in only 17.4% of the cases. CONCLUSION: Children up to two years of age with atopy are more frequently infected with RSV (43.3%) than nonatopic children. Every third child with atopy develops BHR and 77.8% of them also have RSV infection. Atopic children are at higher risk for development of BHR when infected with RSV also.

Characteristics of norovirus infection in Serbia.

BACKGROUND/AIM: Norovirus (NoV), formerly Norwalk-like virus is the most common cause of acute gastroenteritis in humans of all ages. It is known that 90% of viral gastroenteritis and about 60-85% of all outbreaks of gastroenteritis, especially in the territory of United States of America, Europe and Japan are caused by this virus. For the countries of the northern hemisphere, individual cases and outbreaks of acute NoV gastroen teritis appear in seasonal pattern, mainly during the winter months. The aim of this study as to describe characteristics of acute gastroenteritis with the established NoV etiology in Serbia. METHODS: The study group included 88 patients with the symp toms of acute gastroenteritis, throughout the year 2010 and 2011. From all the patients, stool samples were taken less than three days from the onset of symptoms. Detection of NoV in stool samples was performed by commercial qualitative immunochromatography assay. Statistical analysis included application of x2 test, Mann-Whitney U-test, Kruskal-Wallis's test, Spearman's rank correlation test and logistic regression analysis. RESULTS: Outbreaks of acute gastroenteritis caused by NoV were recorded to be the most common in children with the incidence of infection of 50% in the age group 0-15 years. Analysis of individual symptoms in the NoV proven infection, showed that diarrhea was the most common symptom, followed by vomiting espe cially in small children, while abdominal pain was most common in elderly (> 65 years). The presence of frequent vomiting, more than 4 times/day, indicated NoV infection in the women, while for men the infection was always presented with diarrhea. CONCLUSION: The obtained results confirmed that small children and elderly are,the most susceptible to NoV infection and that outbreaks are more frequent in the winter months. Those who consumed food in restaurants and other public facilities were not at higher risk for NoV infection.

Campylobacter jejuni infection and IgE sensitization in up to 2-year-old infants.

BACKGROUND/AIM: The "hygiene hypothesis" addresses the correlation between the occurrence of atopy and the frequency of infections in the earliest age, explaining an increase in the incidence of atopic diseases by living in good, infection-free, hygienic conditions. The aim of our study was to determine the conection between atopy and Camplobacter infection, and to analyze the association between serum concentrations of total IgE and Campyobacter infection in relation to atopy in children up to two years. METHODS: A case control study was conducted with the sample of 98 infants of the average age of 8 months. Total serum IgE and Phadiatop infant multi-test were determined on Immunocap-100 (Phadia AB, Uppsala, Sweden). The presence of atopy was determined by detection of serum-specific IgE > 0.35 kUA/L (Phadiatop infant positive) and serum IgM, IgA, IgG levels against C j uni were determined by a quantitative immuno-enzyme test--SERION ELISA classic. RESULTS: Total IgE cut-off values > 15 kU/L point to atopy in infants, and tIgE cut-off values > or = 8.1 kU/L pointed to a Cj/uni infection in infants. Within the group of atopic children, tIgE levels > 29.8 kU/L point to C. jejuni infection, and within the group of non-atopic children, tIgE levels > or = 5.9 kU/L point to infection. Enteritis is not a predictor of C jejuni infection, because of a high frequency of asymptomatic cases of infection. The risk factors for C. jejuni infection are age and tIgE, and the protective factors are breastfeeding and atopy. CONCLUSION: C. jejuni infection increases the total serum IgE level, which is pre- dictive of infection, regardless of the presence of atopy. The presence of symptomatic C. jejuni infection reduces the risk of atopy in a child of the age of 5-24 months by the factor of 10.