Survey of severe respiratory syncytial virus infection in Kyoto Prefecture from 2003 to 2007

Ito, Hisato; Osamura, Toshio; Nakajima, Fumiaki; Fujiwara, Daisuke; Kuwabara, Yasumichi; Yamamoto, Toru; Yasuno, Tomohiro; Komatsu, Hiroshi; Kizaki, Zenrou; Kishida, Kenji; Akiyama, Yuichi; Oomae, Tadaki; Nakajima, Kanako; Nakamura, Akitoshi; Kiyosawa, Nobuyuki; Nisikomori, Ryuta

doi:10.1111/j.1442-200x.2009.02962.x

Cited by 6 publications

(10 citation statements)

References 11 publications

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“…Eight (6.8 %) of our 117 sick RSV-infected patients died. This mortality rate was similar to the published data in the UK (8.6 %) [9] but lower than those in Spain and Japan (over 10 %) [10,11]. Prior sick contact might be a risk factor for RSV-associated mortality among our children who required PICU admission.…”

Section: Discussionsupporting

confidence: 88%

“…Bacterial co-infection was present in three of our eight death cases (Table 3). Two recent studies in Asia also reported bacterial co-infections to be associated with severe RSV infections [11,28]. The presence of bacteria in tracheal aspirate might indicate true infection or colonization, but infection biomarkers such as peripheral leucocyte count, lactate dehydrogenase, and C-reactive protein, which were associated with severe RSV infection [16], were not recorded in the case notes from most of our patients.…”

Section: Discussionmentioning

confidence: 65%

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Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children

Leung

Lam

Miu³

et al. 2013

Infection

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The majority of RSV-infected children do not require PICU support. There is winter seasonality for RSV-associated PICU admission in Hong Kong. Prior sick contact is the only risk factor for RSV-associated mortality, whereas the presence of chronic lung disease is associated with longer PICU stay. The current risk-based approach of RSV prophylaxis may not be effective in reducing severe RSV infections.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 65%

Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children

Leung

Lam

Miu³

et al. 2013

Infection

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“…Furthermore, the absence of obvious clinical signs and symptoms suggests peracute deterioration due to respiratory failure after lower respiratory infection involving diffuse bronchiolitis, resulting in sudden unexpected death in infancy . These findings differed from those of other clinical cases . The prevalence of mortality due to RSV bronchiolitis in infants who are otherwise healthy is <1% .…”

Section: Discussioncontrasting

confidence: 98%

“…We detected bacteria, but considered this as being secondary to RSV infection because blood glucose was not decreased. Pulmonary RSV infection, however, might represent a complication in RSV‐positive viral myocarditis, and mixed infection with RSV might be significant in fatalities due to bacterial pneumonia…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical detection of respiratory syncytial virus at autopsy

Ikeda

Tani

Aoki

et al. 2019

Pediatrics International

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Background: Respiratory syncytial virus (RSV) infection can be fatal in infants ≤1 year after birth. Morphological findings associated with infant death, however, are insufficient, and screening procedures are problematic. The aim of the present study was to establish a postmortem diagnosis of RSV pathogenicity. Methods: Serial forensic autopsies of 55 infants who suddenly died ≤1 year after birth due to viral pneumonia (n = 18), bacterial pneumonia (n = 12), or other diseases and trauma (n = 25) were assessed. Causes of viral pneumonia determined on immunochemical screening and histological staining of airway effusions consisted of RSV (n = 8) and other viruses (n = 10). Results: Bronchial epithelial and inflammatory cells in the interstitium around bronchioles and alveoli were immunopositive for RSV. Bronchial epithelium was more frequently positive for RSV (5/8, 62.5%) than for bacterial pneumonia and other causes of death (7/47, 14.9%); and intra-alveolar sites were also more frequently positive for RSV pneumonia (3/8, 37.5%) than for bacterial pneumonia and other causes of death (4/47, 8.5%). Screening immunoassays and immunohistochemical staining for RSV can serve as an index of RSV infection when serum antibody titers, viral identification and polymerase chain reaction (PCR) are not informative. Peribronchiolar interstitial RSV positivity was similar between RSV pneumonia (7/8, 87.5%) and other causes of death (34/47, 72.3%). Conclusions: RSV was the cause of death in only eight infants because RSV infection was difficult to diagnose. Therefore, more deaths associated with RSV need to be investigated. Bronchial epithelium and intra-alveolar cells that are RSV immunopositive might augment RSV pathogenicity in viral pneumonia.

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“…The LoS varied according to patient age [76,77], severity of infection [78,79], body weight [52], presence or absence of wheezing at the time of admission [25], presence or absence of hypoxia [58], season [80], and RSV subgroups [81] (Fig. 4).…”

Section: Hospitalization and Losmentioning

confidence: 99%

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

Nagasawa

Ishiwada

2022

Journal of Infection and Chemotherapy

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Introduction: Respiratory syncytial virus (RSV) is one of the most common causes of lower respiratory tract infections in children aged <5 years and is associated with long-term respiratory morbidities such as recurrent wheezing and asthma, decreased lung function, and allergic sensitization. The objective of this review was to evaluate the epidemiology and burden of RSV infection in the pediatric population in Japan. Methods: Studies indexed in PubMed and ICHUSHI databases during January 2010-December 2020 were manually reviewed. Data on proportion of RSV infections, seasonality, length of stay (LoS), mortality, medical expenses, and palivizumab use were extracted from the selected articles. Results: Ninety-three articles were included (PubMed, 64; ICHUSHI, 29). The proportion of patients/samples with an RSV infection was 5.5%-66.7%, and 6.0%-29.9% in the inpatient and outpatient departments, respectively. RSV infections generally occurred during autumn/winter; however, recently the peak has shifted to summer. The LoS was variable and depended on factors such as age, infection severity, wheezing, and RSV subgroups. Mortality rates varied from <1% to 19% depending on the infection severity. The average daily hospitalization and intensive care unit cost was JPY 34,548 while intensive care unit incurred an additional cost of JPY 541,293. Palivizumab was indicated for high-risk infants and 0%-3% of patients required hospitalization despite palivizumab use. Conclusions: RSV imposes a significant burden on the Japanese healthcare system, suggesting a need to create awareness among caregivers of children, pregnant women and healthcare professionals to ensure early recognition of infection and adequate treatment or prophylaxis. Authorship statementBoth authors have made substantial contributions to all of the following and meet the ICMJE authorship criteria: (1) conception and design of the study and the acquisition, analysis, and interpretation of data; (2) drafting the article and revising it critically for important intellectual content; and (3) final approval of the version to be submitted.

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Survey of severe respiratory syncytial virus infection in Kyoto Prefecture from 2003 to 2007

Abstract: Because severe RSV infection led to sudden death in two cases, detection of RSV is important at admission for an infant with CPAOA. Fourteen patients (66.7%), however, had good outcomes and most patients were extubated within 2 weeks.

Cited by 6 publications

References 11 publications

Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children

Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children

Immunohistochemical detection of respiratory syncytial virus at autopsy

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

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