Respiratory syncytial virus (RSV) is well recognized as the most important pathogen causing acute respiratory disease in infants and

The main viruses involved in acute respiratory diseases among children are: respiratory syncytial virus (RSV), influenzavirus (FLU), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV). The purpose of the present study was to identify respiratory viruses that affected children younger than five years old in Uberlândia, Midwestern Brazil. Nasopharyngeal aspirates from 379 children attended at Hospital de Clínicas (HC/UFU), from 2001 to 2004, with acute respiratory disease, were collected and tested by immunofluorescence assay (IFA) to detect RSV, FLU A and B, PIV 1, 2, and 3 and AdV, FLU A and B in 9.5% (36/379), PIV 1, 2 and 3 in 6.3% (24/ 379) and AdV in 3.7% (14/379). HRV were detected in 29. 6% (112/379) Viruses are the most frequent agents that cause acute respiratory infections (ARIs) and are responsible for a considerable percentage of childhood mortality (Williams et al. 2002). In Brazil, some reports from different geographical areas has revealed the viruses as the main cause of respiratory infections, as related in the cities of Fortaleza (Arruda et al. 1991), Rio de Janeiro (Nascimento et al. 1991), São Paulo (Miyao et al. 1999, Vieira et al. 2001), and Curitiba (Tsuchiya et al. 2005.The most important viruses involved in ARI are: respiratory syncytial virus (RSV), influenzaviruses types A and B (FLU A/B), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV) (Miyao et al. 1999, Kuiken et al. 2003, Tsuchiya et al. 2005). The last one was recently identified by Hoogen et al. (2001).RSV is the main cause of viral lower respiratory tract illness in children (Miyao et al. 1999), particularly in those younger than six months old (mo.) (Queiróz et al. 2002. In addition, RSV infections are responsible for most cases of severe symptoms such as bronchiolitis with recurrent wheezing and pneumonia (Calegari et FLU is a serious public health problem worldwide, were children constitute the age group most affected (Neuzil et al. 2002). Although many infections caused by FLU could be prevented by effective vaccination program, it has been predicted that a pandemic is likely to emerge in a near future (Cox et al. 2003), caused by a virus variant not covered by the current vaccine, requiring, thus, a constant epidemiological surveillance.PIV seems to have pattern of seasonal occurrence and is considered an important cause of respiratory illnesses, particularly among young children (Monto 2002).AdV infections are common in all age groups, causing both hospital-and community-acquired epidemics. Moreover, AdV has been associated with hospitalizations of near-fatal asthma patients (Tan et al. 2003) and with cases of acute otitis media in children younger than two years old (Monobe et al. 2003).HRV is responsible for the majority of common colds during winter, causing upper respiratory infections (Arruda et al. 1991, Savolainen et al. 2003 and is considered a risk factor for acute otitis media (Monobe at al. 2003). ...

Respiratory syncytial virus (RSV) is a major cause of acute respiratory disease in infants and young children. Considering that several aspects of the humoral immune response to RSV infection remain unclear, this study aimed to investigate the occurrence, levels, and avidity of total IgG, IgG1, and IgG3 antibodies against RSV in serum samples from children ≤5 years old. In addition, a possible association between antibody avidity and severity of illness was examined. The occurrence and levels of RSV-specific IgG depended on age, with infants <3 months old displaying high levels of antibodies, which were probably acquired from the mother. Children ≥24 months old also showed frequent occurrence and high levels of IgG, which was produced actively during infection. In addition, the avidity assay showed that the avidity of RSV-specific total IgG and IgG1 was lower in infants <3 months old who had acute respiratory disease than in age-matched controls. The avidity of RSV-specific IgG detected in children ≥24 months old with lower respiratory infection was lower than that in children with upper respiratory infection. These results indicate that the presence of high avidity RSV-specific IgG antibodies may lead to better protection against RSV infection in children <3 months old, who may have a lower probability of developing disease of increased severity. In addition, children ≥24 months old with RSV-specific IgG antibodies of low avidity tended to develop more severe RSV illness. These findings may be helpful in establishing vaccination schedules when a vaccine becomes available.

The innate immune response facilitates the quality of the adaptive immune response and is critical to an individual's susceptibility to infection and disease. Mannose-binding lectin (MBL) is a plasma protein with anti-microbial properties that binds a wide range of pathogens to flag them for immune destruction independent of antibodies. In this study, serum MBL levels were measured in 81 children <5 years old experiencing acute respiratory syncytial virus infection and in 40 control children to determine the association with disease severity. Almost 70% of all RSV-infected children had low to intermediate MBL levels (<500 ng/ml) compared to controls, and most of the <6 months old RSV interned patients had low to intermediate levels. No differences were detected in MBL levels between case and control children <1 month old. Analysis of the T-cell compartment in peripheral blood mononuclear cells (PBMC) from acute RSV-infected and control children showed that the percent CD4+ T cells was statistically lower in RSV-infected children > or =6 months old compared to controls, while the percent CD8+ T cells in RSV-infected and control PBMC was generally similar. These results suggest that low serum MBL levels may be a marker of RSV disease severity in children and that MBL may be important in limiting RSV disease pathogenesis.