Survey of severe respiratory syncytial virus infection in Kyoto Prefecture from 2003 to 2007.
BACKGROUND
Respiratory syncytial virus (RSV) infection in infants can develop into a severe condition.


METHODS
A survey of patients with severe RSV infection in hospitals in Kyoto Prefecture was performed from 2003 to 2007. Patients requiring intubation and those with cardiopulmonary arrest on arrival (CPAOA) were considered to have severe RSV infection.


RESULTS
Twenty-five patients with severe infection were identified and detailed data were available for 21 patients, of whom 18 required intubation and three had CPAOA. The male/female ratio was 12/9 and age ranged from 8 days to 19 years (average, 5.2 months; median: 2 months). At admission white blood cell count, lactate dehydrogenase (P < 0.05), and blood glucose (P < 0.01) were higher and Na was lower (P < 0.01) in the 18 patients with severe infection (excluding the CPAOA cases) compared to 18 sex- and age-matched patients with mild RSV infection. The incidence of bacterial infection was also higher in severe cases (P < 0.05). The outcome was death in four patients (19.0%, including two sudden deaths), aftereffects in two (9.5%), hospital discharge with improvement in 14 (66.7%), and an unclear outcome in one patient. Excluding the two sudden death cases, 14 of 19 patients (73.7%) were extubated within 2 weeks. The period of intubation was longer in older patients (P < 0.05).


CONCLUSIONS
Because severe RSV infection led to sudden death in two cases, detection of RSV is important at admission for an infant with CPAOA. Fourteen patients (66.7%), however, had good outcomes and most patients were extubated within 2 weeks.
Ito
Hisato
H
Department of Pediatrics, Nantan General Hospital, Yagiueno25, Yagi-town, Nantan city, Kyoto 629-0197, Japan. hisato527@leto.eonet.ne.jp
Osamura
Toshio
T
Nakajima
Fumiaki
F
Fujiwara
Daisuke
D
Kuwabara
Yasumichi
Y
Yamamoto
Toru
T
Yasuno
Tetsuya
T
Komatsu
Hiroshi
H
Kizaki
Zenrou
Z
Kishida
Kenji
K
Akiyama
Yuichi
Y
Oomae
Tadaki
T
Nakajima
Kouji
K
Nakamura
Akitoshi
A
Kiyosawa
Nobuyuki
N
Nisikomori
Ryuta
R
D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors