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Establishment of Viral Infection and Analysis of Host-Virus Interaction in Drosophila Melanogaster
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Primary and Repeated Respiratory Viral Infections Among Infants in Rural Nepal.

Jim Boonyaratanakornkit1, Janet A Englund2, Amalia S Magaret3,4

  • 1Division of Allergy and Infectious Diseases, University of Washington, Seattle.

Journal of the Pediatric Infectious Diseases Society
|November 14, 2018
PubMed
Summary

Repeated respiratory virus infections are common in infants in Nepal, with no reduced severity. Interventions offering durable protection are needed to reduce the burden of these infections in low-resource settings.

Keywords:
RSVcoronavirusinfantsinfluenza virusparainfluenza virusrespiratory virusesrhinovirus

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Respiratory viruses cause significant infant morbidity and mortality, predominantly in resource-limited settings.
  • Risk factors for initial and recurrent respiratory viral infections in young infants in low-resource environments are not well understood.

Purpose of the Study:

  • To describe the incidence and risk factors for primary and repeated respiratory viral infections in infants in rural Nepal.
  • To evaluate the impact of prior infections on subsequent illness severity.

Main Methods:

  • A birth cohort of 3528 infants in rural Nepal was monitored via weekly household surveillance for respiratory symptoms until 6 months of age.
  • Nasal swabs from infants with respiratory illness were tested for multiple respiratory viruses using reverse transcription polymerase chain reaction (RT-PCR).
  • Poisson regression was used to analyze the risk of primary and repeated infections.

Main Results:

  • Nearly half (49%) of infants experienced a primary infection, and 12% had a repeated infection.
  • Incidences were 1816/1000 person-years for primary and 1204/1000 person-years for repeated infections.
  • Exposure to other children and male sex increased primary infection risk; higher maternal education decreased risk for both primary and repeated infections. Prior infection did not alter subsequent infection incidence or severity.

Conclusions:

  • Repeated respiratory virus infections are frequent in infants in rural Nepal.
  • No decrease in illness severity or evidence of viral replacement was observed with repeated infections.
  • Public health interventions and vaccines providing durable protection in early infancy are crucial for reducing the burden of respiratory viral infections in low-resource countries.