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RSV (bronchitis and viral pneumonia) in infants associated with low vitamin D and antibiotics – Aug 2015

Natural history and epidemiology of respiratory syncytial virus infection in the Middle East: Hospital surveillance for children under age two in Jordan

Vaccine, In Press, Uncorrected Proof, Available online 24 August 2015
Natasha Halasa, John Williams, Samir Faouri, Asem Shehabi, Sten H. Vermund, Li Wang, Christopher Fonnesbeck, Najwa Khuri-Bulos

Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and viral pneumonia in infants and young children worldwide. In the Middle East and Arab countries, the burden of RSV-associated hospitalizations is not well characterized. We sought to determine the burden and clinical/epidemiological characteristics of RSV hospitalization in young children in Amman, Jordan. We investigated risk factors for severity including vitamin D levels.

Methods: We conducted viral surveillance with clinical and demographic data in children <2 years admitted with respiratory symptoms and/or fever at the Al-Bashir Government Hospital from March16, 2010 to March 31, 2013. Nasal/throat swabs were obtained and placed into lysis buffer, and frozen at −80 °C until testing by real-time RT-PCR for 11 respiratory viruses. Heel stick blood or sera samples for 25-hydroxyvitamin D 25(OH)D levels were obtained and sent to a central laboratory for mass spectrometry.

Results: Of the 3168 children, >80% testing positive for one virus, with RSV the most common virus detected (44%). The RSV-associated hospitalization rate was highest in children <6 months with an annual range of 21.1–25.9 per 1000, compared to 6.0–8.0 in 6–11-month-olds and 1.6–2.5 in 12–23-month-olds. RSV-positive children compared with RSV-negative were more likely to be previously healthy without underlying medical conditions, less likely to be born prematurely, had a higher frequency of supplemental oxygen use, and had lower median vitamin D levels. Risk factors for oxygen use in RSV-positive children included underlying medical conditions, lack of breastfeeding, younger age, and higher viral load.

Conclusion: RSV is a major cause of illness in hospitalized Jordanian children and is associated with increased severity compared to other respiratory viruses. Children with RSV in the Middle East would benefit from future RSV vaccines and antiviral therapy.

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RSV detection more often when vitamin D levels are typically low

RSV strongly associated with previous use of antibiotics as well as low vitamin D

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Low vitamin D in children is associated with a wide range of breathing problems

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  • R.S.V.? She Hadn’t Heard of It. Then Her Child Was Hospitalized New York Times Jan 2018
    "While it affects both children and adults, it is most dangerous — and can even be fatal — in babies who are born prematurely and people with weak immune systems, heart disease or lung disease. But even babies who were born full-term and healthy can develop severe symptoms . . "
    "Each year, on average, the virus results in more than 57,000 hospitalizations among children younger than 5, according to the Centers for Disease Control."
    "There is no antiviral therapy for R.S.V., and there isn’t a vaccine: Children are typically treated with hydration, nasal suctioning and oxygen."
    An immunoglobulin therapy called Synagis costing $5,000 provides some degree of protection
    Protection by Vitamin D is not mentioned in the article

Attached files

ID Name Comment Uploaded Size Downloads
5867 RSV T2B.jpg admin 01 Sep, 2015 14:53 4.92 Kb 722
5866 RSV T2A.jpg admin 01 Sep, 2015 14:52 31.22 Kb 897
5865 RSV F1.jpg admin 01 Sep, 2015 14:52 20.77 Kb 916
5864 RSV.pdf PDF 2015 admin 01 Sep, 2015 14:51 499.40 Kb 963