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Original ArticleOpen Access
Clinical and Epidemiological Characteristics of Respiratory Syncytial Virus and Influenza Virus Associated Hospitalization in Urban Thai Infants
Suntarattiwong P 
,
Sojisirikul K ,
Sitaposa P ,
Sojisirikul K ,
Pornpatanangkoon A ,
Chittaganpitch M ,
Srijuntongsiri S ,
Chotpitayasunondh T
,
Sojisirikul K ,
Sitaposa P ,
Sojisirikul K ,
Pornpatanangkoon A ,
Chittaganpitch M ,
Srijuntongsiri S ,
Chotpitayasunondh T Background: Respiratory syncytial virus (RSV) and influenza infections are among the leading cause of hospitalized lower
respiratory tract infections (LRTI) in children especially among those younger than 1 year of age. Few descriptions of these
2 important viruses in Thai children less than 1 year of age have been published.
Material and Method: The authors conducted a prospective study of children 1-12 months old hospitalized at a pediatric
tertiary-care hospital in Bangkok with LRTI during the period December 2007 to August 2009. Respiratory specimens were
tested for influenza A/B virus and RSV using a reverse-transcriptase polymerase chain reaction (RT-PCR).
Results: Twenty-six (7.3%) had RT-PCR positive for influenza and 104 (29.4%) for RSV from 354 infants. Clinical diagnoses
included pneumonia (73.4%), bronchiolitis (17.5%), croup (6.5%) and bronchitis (2.5%) and were similar among groups
except the proportion of croup was significantly lower in RSV (p = .018). The proportion of RSV infection was highest between
July and October (42-76%). RSV patients were more likely to present with higher temperature than the negative RT-PCR
patients (p = .031). Oseltamivir was prescribed in 7.7% of influenza infections. Intravenous antibiotics were prescribed in
69.2%, 56.7% and 60.7% of the influenza, RSV and negative group respectively (p = .736). Percentages of patients requiring
mechanical ventilation were 3.8, 6.7 and 6.3% among the influenza, RSV, and negative group respectively (p = .861). Three
patients died: 2 from RSV and 1 from the negative group. All three fatality cases had existing co-morbidity.
Conclusion: A high proportion of RSV was detected in infants hospitalized with LRTI especially during July to October. High
proportion of antibiotic prescription and relatively low rate of oseltamivir treatment were identified. Surveillance data and the
availability of a rapid and reliable viral diagnostic test may help guide treatment, thereby improve outcome of this vulnerable
population.
Keywords: Influenza, Respiratory syncytial virus, Hospitalized, Lower respiratory tract infection, Infant, Thailand
respiratory tract infections (LRTI) in children especially among those younger than 1 year of age. Few descriptions of these
2 important viruses in Thai children less than 1 year of age have been published.
Material and Method: The authors conducted a prospective study of children 1-12 months old hospitalized at a pediatric
tertiary-care hospital in Bangkok with LRTI during the period December 2007 to August 2009. Respiratory specimens were
tested for influenza A/B virus and RSV using a reverse-transcriptase polymerase chain reaction (RT-PCR).
Results: Twenty-six (7.3%) had RT-PCR positive for influenza and 104 (29.4%) for RSV from 354 infants. Clinical diagnoses
included pneumonia (73.4%), bronchiolitis (17.5%), croup (6.5%) and bronchitis (2.5%) and were similar among groups
except the proportion of croup was significantly lower in RSV (p = .018). The proportion of RSV infection was highest between
July and October (42-76%). RSV patients were more likely to present with higher temperature than the negative RT-PCR
patients (p = .031). Oseltamivir was prescribed in 7.7% of influenza infections. Intravenous antibiotics were prescribed in
69.2%, 56.7% and 60.7% of the influenza, RSV and negative group respectively (p = .736). Percentages of patients requiring
mechanical ventilation were 3.8, 6.7 and 6.3% among the influenza, RSV, and negative group respectively (p = .861). Three
patients died: 2 from RSV and 1 from the negative group. All three fatality cases had existing co-morbidity.
Conclusion: A high proportion of RSV was detected in infants hospitalized with LRTI especially during July to October. High
proportion of antibiotic prescription and relatively low rate of oseltamivir treatment were identified. Surveillance data and the
availability of a rapid and reliable viral diagnostic test may help guide treatment, thereby improve outcome of this vulnerable
population.
Keywords: Influenza, Respiratory syncytial virus, Hospitalized, Lower respiratory tract infection, Infant, Thailand
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