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Clinical and Epidemiologic Features of Respiratory Syncytial Virus Infection

Journal of the Korean Pediatric Society 1992;35(10):1389-1401.
Published online October 15, 1992.
Clinical and Epidemiologic Features of Respiratory Syncytial Virus Infection
Hoan Jong Lee, Seong Hee Jang
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Respiratory Syncytial Virus 감염증의 임상상 및 유행양상
이환종, 장성희
서울대학교 의과대학 소아과학교실
Abstract
Although lower respiratory tract infection is a major cause of childhood morbidity in Korea and respiratory viruses are presumed to be important pathogens, there have been few studies available. We diagnosed RSV infection by virus isolation and immunofluorescence in children with lower respiratory tract infection, seen at Seoul National University Children's Hospital from Nov. 1990 to Jul. 1991. The results were as follows: 1) RSV infection was diagnosed in 58 (30.5%) out of 190 patients studied. RSV epidemic occured in the spring, and 44.8% of RSV infections occurred during the peak month, April. 2) Hospitalized RSV infections occurred mostly in the first six months of life, with the peak incidence at the 2nd and 3rd months. 3) The underlying diseases were identified in 25 cases (43.1%); congenital heart disease (18 cases), prematurity (3 cases), malignancy (3 cases) and systemic lupus erythematosus ( 1case). 4) The clinical diagnosis at the first examination was pneumonia (54.7%), bronchiolitis (37.7%), pneumonia-bronchiolitis (3.8%) and upper respiratory tract infection (3.8%). 5) Cough developed in 100%, rhinorrhea in 73.9%, fever in 73.5%, chest wall retraction in 60.3% and, cyanosis in 20.7%. 6) Patients with congenital heart disease (16 cases) had significantly more severe illness than those without congenital heart disease (20 cases), as judged by the duration of hospitalization (15.1 days vs. 8.5 days, p<0.01) and requirement for assisted ventilation (3 cases vs. 0 cases, p<0.05). 7) The sensitivity and specificity of immunofluorescence as compared with virus isolation were 85% and 94%, respectively. In concludsion, RSV is an important respiratory apthogen in Korean children. RSV infection occured in epidemic and most hospitalized patients were infant under six month of age. Children with congenital heart disease have more severe course when infected with RSV.
Key Words: Respiratory Syncytial Virus, Lower Respiratory Tract Infection, Bronchiolitis, Pneumonia, Epidemiology


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