[Diagnostics of viral respiratory infections in hospitalized patients and ambulatory patients from SENTINEL program during 2004/05 season in Poland].
The aim of the study was to evaluate an impact of respiratory infections on the study population, type/subtype of influenza viruses circulating during 2004/05 season within the groups of hospitalised (n=35) and ambulatory patients (n=420) and to determine antigenic affinity of isolated viral strains. Laboratory diagnostics of influenza A and B type, RSV, adenovirus and parainfluenzavirus (type 1, 2 and 3) was performed using direct immunofluorescence test (DIFA), virus isolation on MDCK cell line and RT-PCR assay. Respiratory viruses were detected in about half of hospitalised patients and one fifth of ambulatory patients. Within these groups more than 80% hospitalised patients and 70% ambulatory patients were infected with influenza virus. Two influenza A subtypes (H3N2) and (H1N1) and B type were detected. Influenza ranged from 68,8% (26-45 age group) to 89,5% (15-25 age group) of all laboratory confirmed respiratory infections, only among the youngest children (0-3 years old) one fourth of infections was caused by influenza virus and in 50% samples RSV was detected. Influenza virus was also present in over 80% positive samples from hospitalised patients over 65 years old. Sensitivity of RT-PCR compared to other influenza diagnostic methods was 95% and specificity was > or = 99%. Fast and accurate influenza diagnostics using molecular biology methods enables implementing therapy with the new generation antivirals (neuraminidase inhibitors), that are effective only when administered up to 36-48 h from onset of the illness. In diagnostics of other. respiratory viruses it is necessary to apply more sensitive diagnostic methods e.g. multiplex RT-PCR. Influenza isolates were A/Wyoming/3/2003-like, B/Hong Kong/330/2001-like, A/New Caledonia/20/99-like and B/Jiangsu/10/2003-like strains that were components of influenza vaccines for 2003/04 and/or 2004/05 seasons. Annual vaccination remains the best way to prevent infection in high risk populations. Costs of influenza vaccine and oseltamivir prophylaxis in our country are on average respectively fifty and five times lower than each day of patients' stay at an intensiv care unit. Every year within the confines of global surveillance programs (e.g. SENTINEL), there are monitored circulating influenza viruses, in order to define vaccine composition for the next season and identify new and potentially pandemic strains.
Brydak
Lidia B
LB
Krajowy Ośrodek ds. Grypy, PZH. nic@pzh.gov.pl
Lietzau
Grazyna
G
Machała
Magdalena
M
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D053122:Influenza A Virus, H3N2 Subtype / Q000302:isolation & purification*; D009981:Influenza B virus / Q000302:isolation & purification*; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011044:Poland / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012621:Seasons; D018571:Sentinel Surveillance
D000914:Antibodies, Viral; D004279:DNA, Viral; D007252:Influenza Vaccines