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Role of respiratory viruses in childhood mortality
Abstract:
Respiratory viruses have been identified at necropsy in the lungs of 13 out of 24 children who died with observed acute respiratory illness. The histological appearances of the lungs supported the association between virus and death in each of these 13 children and suggested an unidentified virus aetiology in a further five cases. Histological appearances compatible with bacterial infection were found in the lungs of only two of the 24 children. Similar virus and histological findings have been reported in about one-third of victims of the sudden infant death syndrome (cot deaths), indicating a rapid unobserved respiratory virus infection as the most likely mode of death in this group. Evidence that respiratory viruses may be involved in a larger proportion of sudden unexpected deaths, perhaps as antigens in a hypersensitivity reaction, is discussed. Respiratory viruses seem the major identifiable agents contributing to the maintenance of the postneonatal mortality rate since acute respiratory illness and the sudden infant death syndrome together account for about two-thirds of deaths at this age.
Insights
Respiratory viruses were found in the lungs of over half of children who died from acute respiratory illness. These findings suggest respiratory viruses are a major cause of postneonatal deaths, including sudden infant death syndrome.
Area of Science:
- Pediatric Pathology
- Virology
- Public Health
Background:
- Acute respiratory illness and sudden infant death syndrome (SIDS) are leading causes of postneonatal mortality.
- The specific etiological agents responsible for many of these deaths remain unidentified.
Purpose of the Study:
- To investigate the role of respiratory viruses in postneonatal deaths.
- To determine the prevalence of viral and bacterial infections in children with acute respiratory illness.
Main Methods:
- Necropsy and histological examination of lung tissue from 24 children who died with acute respiratory illness.
- Identification of viral and bacterial pathogens in lung samples.
Main Results:
- Respiratory viruses were identified in 13 of 24 children with acute respiratory illness.
- Histological findings supported a viral cause of death in these 13 cases and suggested a viral etiology in an additional five cases.
- Bacterial infection was identified in only two cases, while findings in SIDS cases showed similarities to viral respiratory infections.
Conclusions:
- Respiratory viruses are a significant identifiable cause of postneonatal mortality.
- Rapid, unobserved respiratory virus infections are the likely cause of death in SIDS.
- Respiratory viruses may play a role in a larger proportion of sudden unexpected deaths, potentially through hypersensitivity reactions.