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Published on: December 4, 2015
Influenza and other respiratory viruses in three Central American countries
Victor A Laguna-Torres1, José F Sánchez-Largaespada, Ivette Lorenzana
1US Naval Medical Research Center Detachment, Lima, Perú. alberto.laguna@med.navy.mil
Insights
Respiratory viruses, including influenza and RSV, are common causes of influenza-like illness in Central American children. Respiratory syncytial virus (RSV) is particularly linked to severe disease and hospitalization in young children.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health in Central America
Background:
- Limited data exists on the specific viral causes of respiratory diseases in children across Central America.
- Respiratory illnesses represent a significant disease burden for pediatric populations in the region.
Purpose of the Study:
- To identify and analyze the viral agents responsible for influenza-like illness (ILI) in children and adults in El Salvador, Honduras, and Nicaragua.
- To understand the prevalence and characteristics of these viral infections in a multi-country Central American setting.
Main Methods:
- Pharyngeal swabs were collected from 1,756 patients presenting with ILI symptoms between August 2006 and April 2009.
- Viral antigens were detected using indirect and direct immunofluorescence staining on cultured cell monolayers.
- Genetic analysis was performed on influenza isolates to identify specific strains and resistance mutations.
Main Results:
- Viral agents were identified in 24.7% of cases, with one or more viruses detected in 434 patients; 3.9% had dual infections.
- Influenza A virus (7.4%) and respiratory syncytial virus (RSV) (6.9%) were the most frequently isolated viruses.
- RSV was significantly associated with pneumonia and hospitalization in children aged 5 years and younger.
Conclusions:
- Viruses were more frequently isolated from patients aged 5 years or younger compared to older individuals.
- Influenza A and B virus prevalence was similar across age groups, but RSV was the most common pathogen in young children.
- Oseltamivir resistance mutations were detected in influenza A/H1N1 strains, highlighting the need for ongoing surveillance.
Background:
Despite the disease burden imposed by respiratory diseases on children in Central America, there is a paucity of data describing the etiologic agents of the disease.
Aims:
To analyze viral etiologic agents associated with influenza-like illness (ILI) in participants reporting to one outpatient health center, one pediatric hospital, and three general hospitals in El Salvador, Honduras, and Nicaragua Material &
Methods:
Between August 2006 and April 2009, pharyngeal swabs were collected from outpatients and inpatients. Patient specimens were inoculated onto cultured cell monolayers, and viral antigens were detected by indirect and direct immunofluorescence staining.
Results:
A total of 1,756 patients were enrolled, of whom 1,195 (68.3%) were under the age of 5; and 183 (10.4%) required hospitalization. One or more viral agents were identified in 434 (24.7%) cases, of which 17 (3.9%) were dual infections. The most common viruses isolated were influenza A virus (130; 7.4% of cases), respiratory syncytial virus (122; 6.9%), adenoviruses (63; 3.6%), parainfluenza viruses (57; 3.2%), influenza B virus (47; 2.7% of cases), and herpes simplex virus 1 (22; 1.3%). In addition, human metapneumovirus and enteroviruses (coxsackie and echovirus) were isolated from patient specimens.
Discussion:
When compared to the rest of the population, viruses were isolated from a significantly higher percentage of patients age 5 or younger. The prevalence of influenza A virus or influenza B virus infections was similar between the younger and older age groups. RSV was the most commonly detected pathogen in infants age 5 and younger and was significantly associated with pneumonia (p < 0.0001) and hospitalization (p < 0.0001).
Conclusion:
Genetic analysis of influenza isolates identified A (H3N2), A (H1N1), and B viruses. It also showed that the mutation H274Y conferring resistance to oseltamivir was first detected in Honduran influenza A/H1N1 strains at the beginning of 2008. These data demonstrate that a diverse range of respiratory pathogens are associated with ILI in Honduras, El Salvador, and Nicaragua. RSV infection in particular appears to be associated with severe disease in infants in the region.
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