Park, In Ho;Lee, Su Ho;You, Sung Taek;Choi, Du Young
Pediatric Infection and Vaccine
/
v.20
no.3
/
pp.178-185
/
2013
Objective: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. Methods: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. Results: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia ($9.71{\pm}1.09g/dL$); 46 had neutropenia ($803.70{\pm}263.09cells/mm^3$); and 23 had transient thrombocytopenia ($142,434.78{\pm}86,835.18cells/mm^3$). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. Conclusions: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.
Jeong, Jin Woo;Hwang, Youn Ha;Cho, Kyung Soon;Jung, Myung Ju;Min, Sang Kee;Kim, Seong Joon;Chung, Woo Sik
Pediatric Infection and Vaccine
/
v.17
no.2
/
pp.130-136
/
2010
Purpose : The purpose of this study is to identify the viral etiology of acute respiratory illnesses and to determine epidemiology in outpatients in Busan, Korea. Methods : We collected nasal wash samples from 990 patients who visited the hospital for acute respiratory illnesses between January 2007 and December 2008. Extracted DNA or RNA from specimens was used for viral detection by an RT-PCR method. Results : Of a total of 990 samples, viruses were detected in 351 cases (35.5%). The ratio of male to female was 1.6:1 and 93.7% were less than 5 years old. Rhinovirus was detected year-round in 202 cases (57.5%), respiratory syncytial virus from October to March in 57 cases (16.2%), adenovirus year-round in 37 cases (10.5%), influenza virus from December to April in 21 cases (6%), bocavirus from January to August in 15 cases (4.3%), parainfluenza virus from April to July in 9 cases (2.6%), coronavirus from January to July in 7 cases (2%), and enterovirus from June to September in 3 cases (0.9%). Conclusion : We identified the etiology and epidemiology of viruses that caused the acute respiratory diseases that were prevalent in Busan, 2007-2008. Further surveillance will be necessary.
Low pathogenic avian influenza (LPAI; H9N2) and Newcastle disease (ND) are economically important poultry diseases in Korea. In this study, we investigated pathological features and virus distribution in the lymphoid tissues of chicks experimentally infected with H9N2 and/or ND virus. Six-weeks-old SPF chickens were divided into 4 groups, Control (C), H9N2 (E1), NDV (E2), and H9N2+NDV (E3). E1 group was challenged with 0.1 ml A/Kr/Ck/01310/01 (H9N2) $10^{5.6}$$EID_{50}$ intranasally, E2 group was challenged with 0.5 ml KJW (NDV) $10^{5.0}{\sim}10^{6.0}$$ELD_{50}$ intramuscularly, and E3 group was challenged with H9N2, followed 7 days later by NDV. In histopathological examination, E1 group showed depletion and necrosis in bursa of Fabricius, thymus, cecal tonsil, and spleen, whereas E2 and E3 groups were noted severe lymphocyte depletion and necrosis with destruction of lymphoid organs structures. In TUNEL assay, apoptotic bodies were detected in lymphoid organs of all experimental groups, which was most severe in E3 group. H9N2 and ND viruses were predominantly detected in cecal tonsil of E1, E2, and E3 groups by PCR and immunohistochemistry (ICH). In conclusion, co-infection of H9N2 with NDV caused severe pathologic lesions and apoptosis in lymphoid tissues compared to single infections.
Moon, Jeong Hee;Suh, Kyoung Jin;Chung, Eun Hee;Shin, Mee Yong;Lee, Ju Suk;Park, Yong Mean;Lee, Kwang Sin;Ahn, Kang Mo;Lee, Nam Yong;Ma, Sang Hyuk;Lee, Sang Il
Pediatric Infection and Vaccine
/
v.9
no.2
/
pp.193-200
/
2002
Purpose : This study was performed to investigate the epidemiology of viral acute lower respiratory tract infection(ALRI) in two different areas of Korea. Methods : A total of 796 patients hospitalized for ALRI aged 15 years or less from June 2000 to June 2001 in Samsung Seoul hospital(SSH) and Masan Fatima hospital(MFH) were enrolled. Viral etiologies were confirmed using nasopharyngeal aspirates. We compared etiologic agents, age distribution, clinical manifestations, and seasonal occurrence of viral ALRI between the two hospitals. Results : Virus was isolated in 208 patients(26.1%). The proportion of patients aged under 2 years in SSH was 60.2%, while those in MFH was 90.0%(P<0.05). Respiratory syncytial virus(RSV) was more prevalent in MFH, but adenovirus, influenza virus and parainfluenza virus were more prevalent in SSH(P<0.05). Croup and bronchiolitis occurred more frequently in MFH than in SSH(P<0.05). The most frequent viral pathogens causing bronchiolitis and croup were RSV and parainfluenza virus, respectively, in both hospitals. Adenovirus was the main cause of pneumonia in SSH, in contrast to RSV in MFH. In terms of tracheobronchitis, adenovirus was detected most frequently in SSH, whereas influenza virus-type A was mainly isolated in MFH. Similar pattern of seasonal occurrences of RSV, parainfluenza virus and influenza virus-type A was noted in both hospitals. Adenovirus was isolated sporadically throughout the study periods. Conclusion : Seasonal occurrence and clinical syndromes according to viral pathogens showed similar pattern in two areas. However, distribution of offending viruses was different, although this is mainly related to the different age distribution. An annual nationwide surveillance is necessary to understand the viral epidemiology associated with respiratory illnesses in Korea.
Acute transverse myelitis (ATM) in most patients is characterized by an abrupt onset of progressive weakness and sensory disturbance in the lower extremities with a preceding viral infection such as Epstein-Barr, herpes simplex, influenza, mumps and Varicella-zoster viruses (VZV). Although less frequent, some residual deficits including bladder dysfunction or weakness in the lower extremities may follow ATM, from which recovery usually begins within the first week of the onset of symptoms. In this report, we describe the case of a 9-year-old girl who experienced ATM following chickenpox and had bladder dysfunction as a sequela.
Highly Pathogenic Avian Influenza (HPAI) is a very acute systemic disease in poultry, particularly in chickens and turkeys caused by HPAI viruses. An outbreak of HPAI caused by subtype H5N1, was first reported in a broiler breeder farm on December 10, 2003 in Korea, although there had been twenty one outbreaks of the disease reported in the world before. Since mid-December 2003, eight Asian countries have confirmed outbreaks of HPAI due to the same subtype. The outbreak has also resulted in at least twenty three fatal human cases in Vietnam and Thailand as of May 17, 2004 according to the WHO. Regarding the first outbreak of recent Asian HPAI, it has been suspected that some Asian countries with the exception of Korea and Japan veiled the fact of HPAI outbreaks since the last half of 2003, even though it was first reported in Korea. There have been total nineteen outbreaks of HPAI among chicken and duck farms in 10 provinces in Korea since Dec. 2003 and approximately 5,280,000 birds were slaughtered from 392 farms for eradication of the disease and preemptive culling. The origin of the H5Nl HPAI virus introduced into the country are unknown and still under epidemiological investigation. Current status of outbreaks and characteristics of HPAI will be reviewed and discussed on the basis of genetic, virological, clinicopathological, and ecological aspect, as well as future measures for surveillance and prevention of the disease in Korea.
Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.
The transcription of mRNA of avian influenza virus is regulated temporally during infection. Therefore, the measurement of transcript level in host cells should be performed before viral release from host cells because errors can occur in the analysis of the transcript levels if the viruses released from the infected cells re-infect cells. In this study, the timing of viral release was determined by measuring the level of viral RNA from viruses released from H9N2-infected chicken fibroblast cell line UMNSAH/DF-1 by semi-quantitative RT-PCR. The viral genomic RNA was isolated together with mouse total RNA which was added to the collected medium as carrier to monitor the viral RNA recovery and to use its GAPDH as an internal control for normalizing reverse transcription reaction as well as PCR reaction. It was found that viral release of H9N2 in the chicken fibroblast cell line UMNSAH/DF-1 took between 16 and 20 h after infection. We measured all 8 viral mRNA levels. Of the 8 transcripts, 7 species of viral mRNAs (each encoding HA, NA, PB1, PB2, NP, M, NS, respectively) except PA mRNA showed robust amplification, indicating these mRNA can be used as targets for amplification to measure transcript levels. These results altogether suggest that the method in this study can be used for screening antiviral materials against viral RNA polymerase as a therapeutic target.
In this study, a new triplex real-time quantitative reverse transcription polymerase chain reaction (tqRT-PCR) assay was developed for the rapid and differential detection of three feline viral pathogens including feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), and influenza A virus (IAV) in a single reaction. The assay specifically amplified three targeted viral genes with a detection limit of below 10 copies/reaction. The assay showed high repeatability and reproducibility, with intra- and inter-assay coefficients of variation of less than 1%. Based on the diagnostic results of the assay using 120 clinical samples obtained from cats with feline respiratory disease complex (FRDC)-suspected signs, the prevalence of FCV, FHV-1, or IAV was 43.3%, 22.5%, or 0%, respectively, indicating that the diagnostic sensitivity was comparable or superior to those of previously reported monoplex qRT-PCR/qPCR assays. The dual infection rate for FCV and FHV-1 was 8.3%. These results indicate that FCV and FHV-1 are widespread and that co-infection with FCV and FHV-1 frequently occur in the Korean cat population. The developed tqRT-PCR assay will serve as a promising tool for etiological and epidemiological studies of these three bacterial pathogens, and the prevalence data for three feline viruses obtained in this study will contribute to expanding knowledge about the epidemiology of FRDC in the current Korean cat population.
Purpose:The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections. Methods:Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children's Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively. Results:The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P>0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05). Conclusion:Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.
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