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Respiratory viruses in hospital patients on the Witwatersrand. A 7-year study
Insights
Malnourished Black children experienced more severe influenza and adenovirus infections. Respiratory syncytial virus peaked in autumn, unlike other respiratory viruses studied in diverse populations.
Area of Science:
- Virology
- Epidemiology
- Pediatric Infectious Diseases
Background:
- Respiratory diseases pose a significant health burden, particularly in vulnerable populations.
- Understanding viral etiology and epidemiological patterns is crucial for public health interventions.
- Previous studies have established general trends, but specific population and seasonal variations require further investigation.
Purpose of the Study:
- To investigate the virology of respiratory diseases in hospitalized patients.
- To compare the prevalence and severity of viral infections across different demographic groups (Black children, White children, Black miners).
- To identify seasonal patterns and potential secondary infections associated with specific viruses.
Main Methods:
- Virological investigations conducted on 4,151 hospitalized patients over a six-year period (May 1966 - April 1972).
- Analysis of viral infections including influenza, adenovirus, Herpesvirus hominis type 1, respiratory syncytial (RS) virus, and parainfluenza viruses.
- Comparison of infection patterns and disease severity across Black children, White children, and Black miners.
Main Results:
- Influenza, adenovirus, and Herpesvirus hominis type 1 infections were more common and severe in malnourished Black children.
- Adenoviruses were identified as secondary invaders, often following measles or influenza.
- Respiratory syncytial (RS) virus exhibited a peak occurrence in autumn, contrasting with previously reported winter peaks.
- Parainfluenza virus types 1 and 2 predominantly affected older children (12-48 months) causing laryngotracheobronchitis, while type 3 affected younger children (0-23 months) causing pneumonia.
- Black miners showed a high prevalence of influenza A, with strains persisting longer due to community structure.
Conclusions:
- Malnutrition significantly exacerbates the severity of certain viral respiratory infections in children.
- Distinct epidemiological patterns exist for different respiratory viruses, influenced by age, population characteristics, and season.
- The study highlights the need for targeted public health strategies considering nutritional status and specific viral behaviors.
Abstract:
Virological investigations were carried out on 4 151 patients with respiratory disease hospitalized between May 1966 and April 1972. The groups examined were Black and White children and Black miners. Influenza viruses were more common among malnourished Black children and tended to cause more severe disease. This was also true of adenovirus and Herpesvirus hominis type 1 infections. Adenoviruses appear to be secondary invaders, frequently after a measles or influenza attack. A generalized epidemic of adenovirus type 7 occurred in 1967, the longest, coldest and most humid winter during the survey. The season of peak occurrence for respiratory syncytial (RS) virus is autumn, not winter as found elsewhere. The parainfluenza viruses differ from each other, types 1 and 2 being commoner in older children (12--48 months), mainly causing laryngotracheobronchitis (LTB), whereas type 3 is commoner in younger children (0--23 months), mainly causing pneumonia. The miners showed a preponderance of influenza A infections. The miners' origin from remote villages and high turnover rate create a situation where a given strain will persist at a moderate level for long periods, unlike in the general population where an outbreak lasts for only about 6--8 weeks. As opposed to other closed communities, adenovirus infections were rare. The reason for this is obscure.