Search Results (82)

This study explored the distribution and genetic characteristics of respiratory pathogens in outpatients with acute respiratory infections (ARIs) in Yangon, Myanmar, during the 2023 rainy season. Among 267 patients who tested negative for influenza, RSV, and SARS-CoV-2 using rapid diagnostic tests, 84.6% were positive for at least one pathogen according to a multiplex polymerase chain reaction (PCR) assay, the BioFire^® FilmArray^® Respiratory Panel 2.1. The most common viruses detected were rhinovirus/enterovirus (RV/EV) at 37.8%, respiratory syncytial virus (RSV) at 22.4%, and human metapneumovirus (hMPV) at 10.0%. These pathogens co-circulated mainly from July to September, with RV/EV consistently predominant. Symptom comparison among RV/EV-, RSV-, and hMPV-infected patients showed similar clinical features, though fever was more common in hMPV cases. Among RV/EV-positive patients, 59.3% had single infections, while 40.7% experienced co-infections, especially with RSV and adenovirus. Genotyping identified 28 types from five species, primarily RV-A and RV-C, which were genetically diverse. One EV-D68 case was also found, emphasizing its potential risk. This study underscores the genetic diversity and clinical impact of RV/EV and stresses the importance of ongoing molecular surveillance in Myanmar’s post-COVID-19 context to inform effective public health responses. Full article

Acute respiratory tract infections (ARIs) are one of the major causes of morbimortality in children and adulthood. Furthermore, the respiratory syncytial virus (RSV) is the main pathogen in severe lower respiratory tract infections. In Mexico, RSV is the second cause of ARI, affecting mainly children and seniors. RSV infects the airway epithelium, including mesenchymal stem cells (MSCs). These cells express a variety of surface molecules which may function as viral receptors, i.e., Toll-like receptors (TLRs), but the consequences that viral infection has on their biological activities are poorly understood. The aim of this study is to determinate if RSV infection of MSC modifies the expression of stemness biomarkers, TLRs, and the organization of the cytoskeleton. To study the viral infection of MSCs, we determined the mRNA expression using qRT-PCR of SOX2, NANOG, and POU5F1; vimentin and actin; and TLRs 2, 4, and 6. In addition, we determined the cell surface expression of TLR 2 and 4 using flow cytometry. Our results showed that the infection did not change the mRNA expression of SOX2, NANOG, and POU5F1, but increased the mRNA expression of TLR4 and the cell surface expression. Meanwhile, the mRNA in the actin was unchanged, vimentin decreased, and the infection generated a redistribution of the cytoskeleton. Full article

Background: Exposure to household air pollution (HAP) is one of the primary risk factors for acute lower respiratory infection (ARI) morbidity and mortality among children in low-income settings. This study aimed to examine the relative contribution of residing in deprived neighbourhoods and exposure to HAP on the occurrence of ARI among children using data from the 2014–2015 Chad Demographic and Health Survey (DHS). Methods: We applied multilevel modelling techniques to survey data of 2882 children from 372 communities to compute the odds ratio (OR) for the occurrence of ARI between children of respondents exposed to clean fuels (e.g., electricity, liquid petroleum gas, natural gas, and biogas) and respondents exposed to polluting fuel (e.g., kerosene, coal/lignite, charcoal, wood, straw/shrubs/grass, and animal dung). Results: The results showed that children exposed to household polluting fuels in Chad were 215% more likely to develop ARI than those not exposed to household air pollution (OR = 3.15; 95% CI 2.41 to 4.13). Further analysis revealed that the odds of ARI were 185% higher (OR = 2.85; 95% CI 1.73 to 4.75) among children living in rural residents and those born to teenage mothers (OR = 2.75; 95% CI 1.48 to 5.15) who were exposed to household polluting fuels compared to their counterparts who were not exposed. In summary, the results of the study show that the risk of ARI is more common among children who live in homes where household air-polluting cooking fuel is widely used, those living in rural areas, those living in socioeconomically deprived neighbourhoods and from the least wealthy households, and those born to teenage mothers in Chad. Conclusions: In this study, an independent relative contribution of variables, such as HAP from cooking fuel, neighbourhood deprivation, living in rural areas, being from a low-income household, having a mother who is a manual labourer worker, and being given birth to by a teenage mother, to the risk of ARI among children is established. Full article

(1) Background: Respiratory viral infections, including those caused by SARS-CoV-2, respiratory syncytial virus (RSV), influenza viruses, rhinovirus, and adenovirus, are major causes of acute respiratory infections (ARIs) in children. Symptom-based predictive models are valuable tools for expediting diagnoses, particularly in primary care settings. This study assessed the effectiveness of machine learning-based models in estimating infection probabilities for these common pediatric respiratory viruses, using symptom data. (2) Methods: Data were collected from 868 children with ARI symptoms evaluated across 14 primary care centers, members of COPEDICAT (Coronavirus Pediatria Catalunya), from October 2021 to October 2023. Random forest and boosting models with 10-fold cross-validation were used, applying SMOTE-NC to address class imbalance. Model performance was evaluated via area under the curve (AUC), sensitivity, specificity, and Shapley additive explanations (SHAP) values for feature importance. (3) Results: The model performed better for RSV (AUC: 0.81, sensitivity: 0.64, specificity: 0.77) and influenza viruses (AUC: 0.71, sensitivity: 0.70, specificity: 0.59) and effectively ruled out SARS-CoV-2 based on symptom absence, such as crackles and wheezing. Predictive performance was lower for non-enveloped viruses like rhinovirus and adenovirus, due to their nonspecific symptom profiles. SHAP analysis identified key symptoms patterns for each virus. (4) Conclusions: The study demonstrated that symptom-based predictive models effectively identify pediatric respiratory infections, with notable accuracy for those caused by RSV, SARS-CoV-2, and influenza viruses. Full article

We study the relationship between tweets referencing Acute Respiratory Infections (ARI) or COVID-19 symptoms and confirmed cases of these diseases. Additionally, we propose a computational methodology for selecting and applying Machine Learning (ML) algorithms to predict public health indicators using social media data. To achieve this, a novel pipeline was developed, integrating three distinct models to predict confirmed cases of ARI and COVID-19. The dataset contains tweets related to respiratory diseases, published between 2020 and 2022 in the state of San Luis Potosí, Mexico, obtained via the Twitter API (now X). The methodology is composed of three stages, and it involves tools such as Dataiku and Python with ML libraries. The first two stages focuses on identifying the best-performing predictive models, while the third stage includes Natural Language Processing (NLP) algorithms for tweet selection. One of our key findings is that tweets contributed to improved predictions of ARI confirmed cases but did not enhance COVID-19 time series predictions. The best-performing NLP approach is the combination of Word2Vec algorithm with the KMeans model for tweet selection. Furthermore, predictions for both time series improved by 3% in the second half of 2020 when tweets were included as a feature, where the best prediction algorithm is DeepAR. Full article

Acute respiratory viral infections (ARIs) represent a significant global health challenge, contributing heavily to worldwide morbidity and mortality rates. Recent efforts to combat ARIs have focused on developing nasal spray formulations that effectively target the nasal mucosa. However, challenges such as irritation, discomfort, and safety concerns highlight the need for natural, eco-friendly ingredients. In this study, we evaluated the efficacy of solubilized sturgeon oil (SSO), prepared as an oil-in-water nanoemulsion from Siberian sturgeon, as an eco-friendly preventive nasal spray agent against ARIs. Intranasal pre-treatment with SSO effectively inhibited respiratory infections caused by SARS-CoV-2, influenza A virus (IAV), and respiratory syncytial virus (RSV). Additionally, it suppressed viral replication in both nasal and lung tissues. This antiviral effect was linked to reduced pulmonary inflammation, characterized by decreased infiltration of Ly-6C⁺ monocytes and Ly-6G⁺ neutrophils, along with lower pro-inflammatory cytokine levels. Histopathological analyses confirmed that nasal SSO administration significantly mitigated lung inflammation progression caused by viral infections. Notably, the protective effects of SSO against SARS-CoV-2, IAV, and RSV persisted for at least six hours following nasal application. These findings highlight SSO as a promising eco-friendly and safe candidate for nasal spray formulations, providing a potential frontline defense against ARIs. Full article

Background: Respiratory syncytial virus (RSV) is a common cause of acute respiratory infection (ARI). The risk of severe RSV outcomes is higher among older adults (OAs) and individuals with chronic diseases (high risk, HR). AS01_E-adjuvanted RSV preFusion protein 3 OA vaccine (adjuvanted RSVPreF3 OA is approved for the prevention of lower respiratory tract disease [LRTD] due to RSV in OAs). The objective of this study was to assess the potential public health impact of an RSV vaccination program using adjuvanted RSVPreF3 OA in adults ≥75 years (y) and HR adults ≥60 y in Italy. Methods: A static multi-cohort Markov model was used to estimate the number of RSV cases and associated health outcomes projected in adults ≥75 y and HR adults ≥60 y with no RSV vaccination or with a single dose of adjuvanted RSVPreF3 OA. Epidemiological, healthcare resource use and cost data were obtained from the scientific literature. Vaccine efficacy and waning inputs were based on results from the AReSVi-006 phase III clinical trial. Several scenarios for vaccine coverage were explored. Results: Assuming the target vaccination rate for influenza vaccination in Italy (75%), the model predicted that vaccinating Italian adults ≥75 y and the HR population ≥ 60 y with adjuvanted RSVPreF3 OA would reduce the number of RSV-LRTD events by 43%, leading to a reduction in associated emergency department visits, hospitalizations, complications, deaths, and direct healthcare costs over a 3-year period. Conclusions: The vaccination of Italians aged ≥ 75 y and HR individuals aged ≥ 60 y using the adjuvanted RSVPreF3 OA vaccine has the potential to offer substantial public health benefits by reducing the burden of RSV disease. Full article

Background: Immunosuppressive therapy (methotrexate and biological agents) for juvenile idiopathic arthritis (JIA) is associated with an increased risk of severe infections, higher infection rates, treatment interruptions, failure to achieve disease remission, and recurrent disease flares. Our study aimed to evaluate the safety and efficacy of simultaneous immunization with 13-valent polysaccharide conjugate vaccines (PCV13) against S. pneumoniae (SP) and Hemophilus influanzae type b infections (HibV) in children with JIA without systemic manifestations. Methods: A total of 371 non-systemic JIA patients who received 13PCV and HibV were included in this prospective cohort study. In every patient, we evaluated clinical, laboratory, anti-SP, and anti-Hib IgG antibodies before vaccination, three weeks after, and six months after, and all adverse events (AEs) were collected during the study. The number and duration of acute respiratory infection (ARI) episodes and requirements for antibacterial treatment and AE six months before and after the baseline were collected. Results: The levels of the Ig G anti-SP and anti-Hib antibodies increased in the 3 weeks after vaccination; then, anti-SP antibodies slightly decreased and anti-Hib antibodies remained increased during the whole study, as well as in a part of the patients with a protective titer. During the study, there were no patients with significant flares, and the main JIA outcomes gradually decreased during the trial. The number of patients with uveitis remained equal, as well as the part of the patients with active, low-active, and inactive uveitis. There was no significant rise in the hs-CRP or S100 protein after the vaccination. Previous or ongoing treatment with non-biological (p = 0.072) and biological (p = 0.019) disease-modified anti-rheumatic drugs affected the Hib and did not affect the anti-SP protective titer at the end of the study. Within 6 months following vaccination, the number of ARI episodes (p < 0.001) and the number of courses of antibacterial treatment (p < 0.0001) decreased twice. The median duration of ARI episodes decreased four times (p < 0.0001). Mild AEs (injection site reactions and short-term fever episodes) were found in 58 (15.6%) patients with JIA, and 1 patient (0.2%) developed an SAE. Conclusions: Simultaneous vaccination against pneumococcal and Hib infections reduces the frequency and duration of episodes of ARI, as well as the number of courses of antibacterial drugs, and does not lead to significant JIA flares. The number of reported AEs is consistent with what was expected. Full article

Acute respiratory infections (ARIs) caused by viruses such as SARS-CoV-2, influenza viruses, and respiratory syncytial virus (RSV), pose significant global health challenges, particularly for the elderly and immunocompromised individuals. Substantial evidence indicates that acute viral infections can manipulate the host’s epigenome through mechanisms like DNA methylation and histone modifications as part of the immune response. These epigenetic alterations can persist beyond the acute phase, influencing long-term immunity and susceptibility to subsequent infections. Post-infection modulation of the host epigenome may help distinguish infected from uninfected individuals and predict disease severity. Understanding these interactions is crucial for developing effective treatments and preventive strategies for viral ARIs. This review highlights the critical role of epigenetic modifications following viral ARIs in regulating the host’s innate immune defense mechanisms. We discuss the implications of these modifications for diagnosing, preventing, and treating viral infections, contributing to the advancement of precision medicine. Recent studies have identified specific epigenetic changes, such as hypermethylation of interferon-stimulated genes in severe COVID-19 cases, which could serve as biomarkers for early detection and disease progression. Additionally, epigenetic therapies, including inhibitors of DNA methyltransferases and histone deacetylases, show promise in modulating the immune response and improving patient outcomes. Overall, this review provides valuable insights into the epigenetic landscape of viral ARIs, extending beyond traditional genetic perspectives. These insights are essential for advancing diagnostic techniques and developing innovative treatments to address the growing threat of emerging viruses causing ARIs globally. Full article

Background/Objectives: Respiratory syncytial virus (RSV) represents a significant cause of acute respiratory infections (ARIs) in adults aged 60 years and older, often leading to severe clinical outcomes and high healthcare costs. This study aimed to evaluate the clinical and economic burden of RSV compared to other ARIs, focusing on specific age groups, comorbidities, and demographic factors. Methods: A retrospective observational study was conducted using the electronic medical records of adults aged ≥60 years hospitalized for ARIs, including RSV, in Spain. Direct costs related to hospitalizations, intensive care unit (ICU) admissions, and treatments were analyzed. The study also assessed demographic, clinical, and comorbidity-related factors influencing the economic burden. Results: RSV infections resulted in significantly higher direct costs compared to other ARIs, particularly in patients aged 70–80 years. Comorbidities such as asthma and smoking history were associated with increased costs in RSV cases. Although ICU costs were comparable between groups, hospitalizations for RSV required longer stays and more intensive treatments, amplifying the overall economic burden. Differences in costs by age and sex highlighted the need for tailored clinical management strategies. Conclusions: RSV poses a substantial economic and clinical burden on adults aged 60 years and older, particularly in those with comorbidities. Preventive measures, such as vaccination, could reduce healthcare costs and improve outcomes in this vulnerable population. These findings support the inclusion of RSV vaccines in immunization programs, especially in aging populations like Spain, to alleviate healthcare pressures during peak respiratory disease seasons. Full article

Acute respiratory infections (ARIs) are a leading cause of death in children under five globally. The seasonal trends and profiles of respiratory viruses vary by region and season. Due to limited information and the population’s vulnerability, we conducted the hospital-based surveillance of respiratory viruses in Eastern Uttar Pradesh. Throat and nasal swabs were collected from outpatients and inpatients in the Department of Paediatrics, Baba Raghav Das (BRD) Medical College, Gorakhpur, between May 2022 and April 2023. A total of 943 samples from children aged 1 to 60 months were tested using multiplex real-time PCR for respiratory viruses in cases of ARI and SARI. Out of 943 samples tested, the highest positivity was found for parainfluenza virus [105 (11.13%) PIV-1 (79), PIV-2 (18), PIV-4 (18)], followed by adenovirus [82 (8.7%), RSV-B, [68 (7.21%)], influenza-A [46(4.9%): H1N1 = 29, H3N2 = 14), SARS CoV-2 [28 (3%)], hMPV [13(1.4%), RSV-A [4 (0.42%), and influenza-B (Victoria lineage) 1 (0.10%). The maximum positivity of respiratory viruses was seen in children between 1 to 12 months. The wide variation in prevalence of these respiratory viruses was seen in different seasons. This study enhances understanding of the seasonal and clinical trends of respiratory virus circulation and co-infections in Eastern Uttar Pradesh. The findings highlight the importance of targeted interventions to reduce the burden of respiratory infections in this region. Full article

Background: The influenza virus’s high mutation rate requires the annual reformulation and administration of the vaccine. Therefore, its vaccine effectiveness (VE) must be evaluated annually. Aim: Estimate the effectiveness of the influenza vaccine and analyze the impact of age, seasonal variations, and the vaccination to sample collection interval on VE. Methods: The study used a test-negative case–control (TNCC) design to collect data from patients under 18 years of age who presented with acute respiratory infection (ARI) symptoms and underwent influenza virus testing at a national children’s regional medical center in Guangdong Province between October 2021 and January 2024, spanning three influenza seasons. VE was estimated using unconditional logistic regression. Results: A total of 27,670 patient data entries were analyzed. The VE against all influenza viruses across the three seasons was 37% (95% CI: 31–43), with the lowest VE of 24% (95% CI: 8–37) observed in the 2021–2022 season. In children aged 0.5 to <3 years, the VE was 32% (95% CI: 19–43). The effectiveness for samples collected at intervals of 0.5–2 months, 3–6 months, and over 6 months after vaccination was 39% (95% CI: 32–46), 30% (95% CI: 19–40), and 28% (95% CI: 5–46). Conclusions: Across three influenza seasons, at least one-third of vaccinated individuals were protected from influenza in outpatient settings. Given that children are at high risk, improving vaccination management is recommended, and parents should be encouraged to vaccinate their children before each influenza season. Full article

The aim of our research was to evaluate and analyze serum 25(OH) vitamin D and parathyroid hormone (PTH) levels to investigate whether vitamin D deficiency serves as a risk factor for an increased incidence of acute respiratory infections (ARI) in children. Serum PTH levels were used as an indicator of vitamin D sufficiency, as normal PTH levels require an optimal concentration of 25(OH) vitamin D. The study included 129 children, divided into five subgroups: children with acute bronchopneumonia (n = 42), acute laryngotracheitis (n = 7), acute bronchiolitis (n = 32), acute bronchitis (n = 18), and a control group (n = 30). No statistically significant differences in 25(OH)D levels were observed between the overall population of children with ARI and the control group (p = 0.073). However, significant differences in 25(OH)D levels were identified between the control group and children with bronchopneumonia, acute bronchitis, and laryngotracheitis (p < 0.01, p < 0.05). Regarding PTH levels, statistical significance was found between the control group and the acute bronchiolitis group, due to the high percentage of children with hypervitaminosis in this subgroup. These results highlight the crucial role of vitamin D in the onset and progression of acute respiratory tract infections in children, emphasizing its impact on their overall respiratory health. Full article

Sierra Leone has the fourth-highest child mortality rate in Sub-Saharan Africa. This retrospective study aimed to estimate the nationwide prevalence of fever, acute respiratory infection (ARI), and diarrhea in children under 5 years in Sierra Leone, and to identify the risk factors associated with these diseases. We extracted patient information from the 2019 Sierra Leone Demographic and Health Survey data. Data were analyzed using multivariate logistic regression. In total, 8659, 8652, and 8650 children were included in the analyses of fever, ARI, and diarrhea, respectively. The analysis revealed that the nationwide prevalence rates of fever, ARI, and diarrhea were 16.8%, 14.2%, and 7.2%, respectively. Children aged 12–23 months were found to be the most susceptible. Compared to children consuming unimproved water, the highest prevalence rates of fever, ARI, and diarrhea were observed among children residing in households with tube wells or boreholes. The adjusted odds ratio for diarrhea prevalence among children drinking water from household tube wells or boreholes was 1.47 (95% confidence interval: 1.17–1.84, p < 0.001). This study has several limitations, including recall bias due to parental reporting. We suspect that the diseases may be associated with potential water contamination in tube wells or boreholes. We recommend national-level periodic inspections of water quality and community-level education on water supply management. Full article

COVID-19 infection caused by SARS-CoV-2 continues to cause significant mortality and morbidity. ACE2 is a key regulator of the renin–angiotensin–aldosterone system (RAAS). Differences in COVID-19 severity are thought to be due to the imbalance of RAAS/ACE mutations. This retrospective study evaluated the detection and genetic susceptibility to SARS-CoV-2 infection in 202 children ≤3 years of age living in the Amazon region in 2021. The angiotensin-converting enzyme ACE I/D (rs4646994) and ACE2 G8790A (rs2285666) polymorphisms were detected by SYBR GREEN real-time PCR and PCR-RFLP/Alul digestion, respectively. SARS-CoV-2 detection was performed by RT-qPCR in feces and saliva samples collected simultaneously from the same children presenting acute gastroenteritis (AGE) or acute respiratory infection (ARI). The frequency of SARS-CoV-2 detected by qRT-PCR in children was low (5.9%, 12/202), although higher in the group of children with AGE (8.9%, 9/101) than with ARI (2.9%, 3/101). Susceptibility to SARS-CoV-2 infection was not verified due to the low frequency. Homozygous II (rs4646994) children were the majority (87.1%, 176/202). Boys with genotype A (rs2285666) were more susceptible to ARI and pneumonia symptoms than AGE (OR = 3.8, 95% CI 1.4–10.3, p 0.007). Boys with genotype G (rs4646994) or the combination II + G were more susceptible to acquiring AGE. Surveillance, along with understanding their causes, is crucial to controlling ARI and COVID-19 in children living in low-income countries. Full article