Dual Respiratory Virus Infections

Abstract

We retrospectively reviewed eight prospective epidemiological studies conducted between 1991 and 1995 for dual respiratory virus infection (DRVI) to determine the frequency, associated comorbid conditions, clinical presentations, and morbidity related to DRVI among immunocompetent persons. Two viruses were identified as the cause of 67 (5.0%) of 1,341 acute respiratory virus infections. DRVI was detected in patients from õ1 year to 79 years of age, in both sexes, and in many races. Forty-two percent of patients with DRVI were £4 years old. Fifty-eight percent of patients with DRVI had underlying chronic lung disease. DRVI was associated with upper respiratory tract illness; lower respiratory tract illness, including pneumonia; systemic influenza-like illnesses; and exacerbations of asthma or chronic obstructive pulmonary disease. All of the common acute respiratory viruses were identified; picornaviruses and influenzavirus A were the most common. The rate of DRVI (11.6%) was highest in the epidemiological studies in which cell culture, serology, and polymerase chain reaction were used together. Patients with DRVI were hospitalized significantly more often than those with respiratory infection due to a single virus (46.3% vs. 21.7%; P õ .01). The percentage of DRVIs increased proportionally with the number of diagnostic methods used. Respiratory illness associated with multiple viral pathogensMaterials and Methods has been reported infrequently. The majority of the studies have Study design. We retrospectively reviewed the charts inbeen published in the pediatric literature, with most infections cluded in epidemiological studies of community-acquired resreported to be due to respiratory syncytial virus (RSV) and a piratory virus infections conducted at our institution between second respiratory virus [1 -8]. The frequency of dual respira-1991 and 1995. A DRVI was defined as an acute respiratory tory virus infection (DRVI) varies widely in the literature, and virus infection and any combination of culture(s), serological the clinical relevance of DRVI is unresolved. Some authors test(s), or PCR(s) positive for two different viruses. An SRVI have found that the morbidity associated with DRVI is higher was defined as an acute respiratory virus infection caused by than that associated with single respiratory virus infection a single virus detected by either culture, positive serology, or (SRVI) [3], while other authors have not found that DRVIs PCR. The charts of all patients with DRVI in these epidemioare more severe than SRVIs [2, 5, 8 -12]. We performed a logical studies were reviewed by one of us (A.L.D.), and data retrospective review of prospective epidemiological studies of on demographics, comorbid conditions, date of onset of the respiratory virus infection carried out by the Acute Viral Respiacute respiratory illness, results of viral diagnostic tests, and ratory Disease Unit at Baylor College of Medicine between clinical presentation were recorded. A computerized database 1991 and 1995. We examined the inc...

Molecular Investigations of an Outbreak of Parainfluenza Virus Type 3 and Respiratory Syncytial Virus Infections in a Hematology Unit

“…Dual PIV-3 and RSV infections are uncommon, especially in adults (8), and reports of simultaneous nosocomial outbreaks of both viruses are correspondingly rare. Such an outbreak of RSV and PIV-3 was reported in a newborn nursery, in which seven infants were infected with RSV, five with PIV-3, and two with both RSV and PIV-3 (20).…”

Detection of Rhinoviruses by Tissue Culture and Two Independent Amplification Techniques, Nucleic Acid Sequence-Based Amplification and Reverse Transcription-PCR, in Children with Acute Respiratory Infections during a Winter Season

“…The prevalence of mixed infections (10,46) is influenced by multiple factors, including differences in patient populations (e.g., differences in age and comorbid conditions), time of study (e.g., winter versus summer or during epidemics of respiratory virus infections), and diagnostic methods used. Their prevalence increases with the range of diagnostic methods applied.…”

Human rhinovirus in the lower respiratory tract infections of young children and the possible involvement of a secondary respiratory viral agent

“…Scientists have questioned whether or not HRV co-infections lead to more severe clinical syndromes, cause longer hospitalisations and affect younger children more frequently (Drews et al 1997, Papadopoulos et al 2002, Calvo et al 2007, 2008, Gerna et al 2009, Midulla et al 2010.…”