title: Bronchiolitis outbreak caused by respiratory syncytial virus in southwest Bangladesh, 2010.
abstract: BACKGROUND
  During July 2010, newspapers reported a respiratory disease outbreak in southwestern Bangladesh resulting in the admission of children to a secondary care hospital. We investigated this outbreak to determine the etiology and explore possible risk factors.
  
  
  METHODS
  The hospital's physician diagnosed children aged <2 years with cough, tachypnea or dyspnea, and expiratory wheeze as having acute bronchiolitis. We reviewed the hospital records and listed case patients admitted between 26 June and 26 July 2010. We surveyed the case patients and collected nasal and throat swabs to test for respiratory viruses.
  
  
  RESULTS
  We identified 101 admitted acute bronchiolitis case patients. Fifty-nine (58%) of these were admitted between 16 and 20 July. Among the 29 case patients surveyed, the median age was 4 months and 65% were males. We identified respiratory syncytial virus (RSV) in 91% (21/23) of the samples, 43% of which had a dual viral infection. Most case patients (90%) were treated with broad-spectrum antibiotics. There were no reported deaths.
  
  
  CONCLUSIONS
  The sudden increase in admitted acute bronchiolitis case patients, their median age, and identification of RSV in the majority of samples suggest an outbreak of RSV bronchiolitis. Research to identify strategies to prevent respiratory infections including RSV in low-income settings should be prioritized. Factors that perpetuate antibiotic use in managing this viral syndrome should also be explored.
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. farhanahaque@icddrb.org
authors.forename: Farhana
authors.initials: F
authors.lastname: Haque
authors.forename: M Mushtuq
authors.initials: MM
authors.lastname: Husain
authors.forename: Kazi Mohammad Hassan
authors.initials: KM
authors.lastname: Ameen
authors.forename: Refat
authors.initials: R
authors.lastname: Rahima
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Hossain
authors.forename: A S M
authors.initials: AS
authors.lastname: Alamgir
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001459:Bangladesh / Q000453:epidemiology; D001988:Bronchiolitis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D000900:Anti-Bacterial Agents