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Bronchiolitis in Inuit children from a Canadian central arctic community, 1995-1996
1Department of Medicine, University of Manitoba, Canada. porr@hsc.mb.c
Insights
Two bronchiolitis outbreaks in Inuit children in Arviat revealed high attack rates and significant healthcare demands. Respiratory syncytial virus (RSV) and parainfluenza virus type 3 were identified as key pathogens.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bronchiolitis poses a significant health burden, particularly in vulnerable populations.
- The Canadian Arctic presents unique environmental and demographic factors influencing pediatric respiratory illnesses.
Purpose of the Study:
- To investigate the epidemiology and clinical characteristics of two bronchiolitis outbreaks in Inuit children in Arviat.
- To identify causative agents and risk factors associated with severe bronchiolitis in this population.
Main Methods:
- Retrospective chart review of all bronchiolitis cases from September 1, 1995, to August 31, 1996.
- Viral isolation for respiratory syncytial virus (RSV) and parainfluenza virus type 3.
- Statistical analysis to determine attack rates, incidence, and risk factors.
Main Results:
- An overall annual attack rate of 57% and incidence of 1.25 cases per child-year at risk were observed.
- Respiratory syncytial virus (RSV) was linked to a winter outbreak with a 38% hospitalization rate and 3.3% mortality.
- Parainfluenza virus type 3 was identified during a smaller summer outbreak; bottle-feeding was associated with hospitalization.
Conclusions:
- Bronchiolitis outbreaks in Arviat Inuit children are frequent and place high demands on healthcare resources.
- RSV is a major cause of severe winter bronchiolitis, necessitating targeted prevention strategies.
- Further research into agent, host, and environmental factors is crucial for developing effective prevention strategies.
Abstract:
During the winter and summer of 1996 two outbreaks of bronchiolitis occurred among Inuit children in the Canadian arctic community of Arviat. The epidemiology and clinical features of these epidemics were studied through a chart review of bronchiolitis cases occurring from September 1, 1995 to August 31, 1996. The attack rate over the year was 57% and the incidence was 1.25 cases per child-year at risk. The median age of cases was 9 months. Children developing bronchiolitis were more likely to be male (p = 0.006). Respiratory syncytial virus (RSV) was isolated from 17 cases occurring in January/February. The hospitalization rate during those two months was 38%, mortality was 3.3%, and demands upon local health care resources were high. Parainfluenza virus type 3 was isolated from 8 cases occurring during a second smaller outbreak in July/August. Hospitalized children were more likely to be bottle-fed (p = 0.01), and duration of hospitalization was greater for RSV positive versus negative children (p = 0.002). Among those hospitalized 22% required a second admission for the same illness. Identification of prevention strategies awaits an improved understanding of the role of agent, host and environmental factors in the pathophysiology of bronchiolitis in this population.