Bronchiolitis in tropical South India

Article Abstract:

Acute bronchiolitis, inflammation of the bronchioles, is the most common infection of the lower respiratory tract in infants in North America and Europe. It is caused by the respiratory syncytial virus (RSV) and occurs as outbreaks in winter and spring. Although acute bronchiolitis also occurs in developing countries in the tropics, there is limited knowledge about its causes and epidemiology in tropical regions of the world. Previous studies have shown that RSV infection was prevalent between July and October and caused 20 to 60 percent of cases of acute bronchiolitis. The clinical features and causes of acute bronchiolitis in tropical South India were assessed in 328 children under 5 years of age with acute lower respiratory infections. One hundred and fourteen children were diagnosed with acute bronchiolitis, including 87 children less than a year old and 107 less than 2 years old. Tachypnea, a respiratory rate greater than 50 breaths per minute, developed in 95 percent of the children; subcostal retraction or abnormal movement of the chest during respiration was observed in 93 percent. Pneumonia was present in 30 of 88 children who had chest X-rays; pneumonia could not be diagnosed by clinical signs and symptoms alone. Viruses were detected in 81 children, including 65 patients with RSV and 12 patients with parainfluenza viruses. In South India, acute bronchiolitis tended to occur in outbreaks between August and November, and coincided with RSV outbreaks. These findings suggest that bronchiolitis is a viral rather than bacterial disease. Eight children died, including five infants with pneumonia and three with other complications. All of the children who died had been treated with antibiotics. In caring for infants and children with bronchiolitis, X-ray findings should be considered before antibiotics are prescribed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Demographic aspects, India, Bronchiolitis

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Severe respiratory syncytial virus infection in older children

Article Abstract:

Respiratory syncytial virus (RSV) is one of the most common causes of lower respiratory infection in children. This infection frequently affects infants and may be severe enough to require hospitalization. There has been little research concerning RSV infection in children over 12 months of age. Over a three-year-period, the incidence, risk factors, clinical features, and outcome of RSV infection were studied in 282 children. All of these children were hospitalized with pneumonia or bronchiolitis and RSV infection was confirmed. Of the total group, 62 children (22 percent) were over 12 months; this represents a higher rate of infection in this age group than indicated by previous studies. This subgroup was then matched for sex, hospital location, and onset of illness with children who were under 12 months of age at the time of RSV infection. Of the 62 older children, 47 (76 percent) had an underlying disease, most often of a pulmonary or cardiac nature. The second most frequently noted underlying problems were gastrointestinal and genetic disorders. Fourteen of the 62 children (almost 25 percent) had a prior history of RSV infection. Of the total group, four children died (three percent), making the mortality rate relatively low. However, three of the four deceased children were over 12 months and had a severe congenital heart condition. It was concluded children over 12 months who have an underlying disease, in particular, pulmonary, cardiac, chronic gastrointestinal or genetic disorders, should be considered a high risk group for RSV infection. Early treatment with the antiviral medication known as ribavirin is recommended for children with RSV infection histories. Parents should be informed of the potential seriousness of RSV infection if their child is in a high risk category. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Ribavirin

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Preterm twins and triplets: a high-risk group for severe respiratory syncytial virus infection

Article Abstract:

Premature multiple-birth infants may have a higher risk of developing severe respiratory syncytial virus (RSV) infections and pneumonia than infants born alone (singletons). Severe RSV infections are a frequent cause of premature babies reentering the hospital, especially if they were born with bronchopulmonary abnormalities. A study compared the incidence of RSV infections among 14 sets of twins and two sets of triplets to that among 34 singleton infants. Fifty-three percent of the multiple-birth infants developed a RSV infection, compared with 24% of the singleton infants. Twenty-four percent of the multiple-birth infants developed pneumonia, compared with 6% of the singleton infants. Thirty-two percent of the twins and triplets needed to be hospitalized, compared with 18% of the singleton infants. Multiple-birth infants are often born prematurely and automatically are exposed to more infants susceptible to RSV in the home.

Diseases, Infants (Premature), Premature infants, Disease transmission, Twins, Triplets

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