Infections with Respiratory Syncytial and Influenza Viruses in Hospitalized Children with Influenza-Like Syndrome

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Resident, Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

3 Student of Medicine, School of Medicine, Iranian Students Society for Cancer and HIV Research (ISCH), Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Different respiratory viruses cause influenza-like syndrome. The aim of this study was to determine the contribution of respiratory syncytial virus (RSV) and influenza viruse in hospitalized children with influenza-like syndrome. Methods: during November 2010-May 2011, we enrolled 66 patients (1 months to 17 years old) with clinical evidence of influenza-like syndrome who were admitted in Aliasghar Pediatrics Hospital in Tehran, Iran. Oseltamivir (30-75 mg bid) was prescribed after taking nasopharyngeal specimens for polymerase chain reaction (PCR) detection of influenza A and B, and RSV A and B. The collected data was analyzed by Fisher's exact test, and analysis of variance in SPSS16. Findings: Viral agents were identified from 28 cases (42.4%). The most commonly detected viruses were the flu A virus (19.7%), RSV A (10.6%), and RSV B (9.1%). The highest mean age belonged to the flu A cases (9.25 years). Children with RSV B infections had the lowest mean age (4.5 months) (P = 0.007). The most notable clinical finding was respiratory distress (83.3%). Wheezing was more in favor of flu A and RSV B infections (P = 0.03). The longest duration of fever after receiving oseltamivir was seen in patients with flu A virus infection (43 hours). Estimated sedimentation rate (ESR) more than 30 was only diagnosed in RSV A cases with a prevalence rate of 8.1% (P = 0.035). Chest X ray revealed bilateral reticulonodular and infiltration to be more prevalent in flu A and RSV B cases. However, these two viruses could not be differentiated from each other (P = 0.07). Conclusion: Based on our findings, in patients with influenza-like syndrome, specimens should be taken for PCR. Antiviral drugs need to be initiated. However, continuing the regimen depends on PCR results. Keywords: Influenza-like syndrome, Virus, Polymerase chain reaction, Oseltamivir