title: Viral aetiology influenza like illnesses in Santa Cruz, Bolivia (2010-2012).
abstract: BACKGROUND
  Acute respiratory infections represent a serious public health issue worldwide but virological aetiologies of Influenza Like Illnesses (ILIs) remain largely unknown in developing countries. This study represents the first attempt to characterise viral aetiologies of ILIs in Bolivia.
  
  
  METHODS
  It was performed in Santa Cruz city from January 2010 to September 2012, based on 564 naso-pharyngeal swabs collected in a National Reference Laboratory and real-time PCR techniques, viral cultures and phylogenetic analyses.
  
  
  RESULTS
  50.2% of samples were positive for at least one virus with influenza viruses (Flu A: ~15%; Flu B: ~9%), rhinoviruses (~8%), coronaviruses (~5%) and hRSV (~4%) being the most frequently identified. The pattern of viral infections varied according to age groups. The elucidation rate was the highest (>60%) amongst patients under 10 yo and the lowest (<40%) amongst patients ≥60 yo. Nearly 3% of samples showed dual viral infections. Epidemiological peaks were associated with a predominant virus but generally included 30-50% of infections by different viruses. Unexpectedly, the frequency of influenza in the 0-4 yo population was very low and a complete hRSV eclipse occurred in 2011. Genetic analyses indicated that distinct evolutionary lineages of Flu A(H1N1)pdm2009, Flu A/H3N2 and Flu B have co-circulated in Bolivia in the study period, originating from Central and North America, Europe, Asia and Australia.
  
  
  CONCLUSIONS
  Our results emphasise the requirement for a reinforced epidemiological and genetic follow-up of influenza and other ILIs in Bolivia to further inform the preparation of vaccines used in the region, guide vaccination campaigns and improve the medical management of patients.
authors.affiliation: IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille Univ, 13005 Marseille, France. jdelangue@gmail.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Delangue
authors.forename: Yelin
authors.initials: Y
authors.lastname: Roca Sanchez
authors.forename: Géraldine
authors.initials: G
authors.lastname: Piorkowski
authors.forename: Maël
authors.initials: M
authors.lastname: Bessaud
authors.forename: Cécile
authors.initials: C
authors.lastname: Baronti
authors.forename: Laurence
authors.initials: L
authors.lastname: Thirion-Perrier
authors.forename: Roxana Loayza
authors.initials: RL
authors.lastname: Mafayle
authors.forename: Cinthia Avila
authors.initials: CA
authors.lastname: Ardaya
authors.forename: Gabriela Añez
authors.initials: GA
authors.lastname: Aguilera
authors.forename: Jimmy Revollo
authors.initials: JR
authors.lastname: Guzman
authors.forename: Javier Lora
authors.initials: JL
authors.lastname: Riera
authors.forename: Xavier
authors.initials: X
authors.lastname: de Lamballerie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001838:Bolivia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000821:virology; D010802:Phylogeny; D060888:Real-Time Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology*; D014776:Virus Cultivation; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology*; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult