title: Etiology, seasonality, and clinical characterization of viral respiratory infections among hospitalized children in Beirut, Lebanon.
abstract: Acute respiratory tract viral infections occur worldwide and are one of the major global burdens of diseases in children. The aim of this study was to determine the viral etiology of respiratory infections in hospitalized children, to understand the viral seasonality in a major Lebanese hospital, and to correlate disease severity and the presence of virus. Over a 1-year period, nasal and throat swabs were collected from 236 pediatric patients, aged 16-year old or less and hospitalized for acute respiratory illness. Samples collected were tested for the presence of 17 respiratory viruses using multiplex real-time RT-PCR. Pathogens were identified in 165 children (70%) and were frequently observed during fall and winter seasons. Co-infection was found in 37% of positive samples. The most frequently detected pathogens were human Rhinovirus (hRV, 23%), Respiratory Syncytial Virus (RSV, 19%), human Bocavirus (hBov, 15%), human Metapneumovirus (hMPV, 10%), and human Adenovirus (hAdV, 10%). A total of 48% of children were diagnosed with bronchiolitis and 25% with pneumonia. While bronchiolitis was often caused by RSV single virus infection and hAdV/hBoV coinfection, pneumonia was significantly associated with hBoV and HP1V1 infections. No significant correlation was observed between a single viral etiology infection and a specific clinical symptom. This study provides relevant facts on the circulatory pattern of respiratory viruses in Lebanon and the importance of using PCR as a useful tool for virus detection. Early diagnosis at the initial time of hospitalization may reduce the spread of the viruses in pediatric units. J. Med. Virol. 88:1874-1881, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Faculty of Health Sciences, University of Balamand, Beirut, Lebanon.
authors.forename: Mayda
authors.initials: M
authors.lastname: Finianos
authors.affiliation: Faculty of Health Sciences, University of Balamand, Beirut, Lebanon.
authors.forename: Randi
authors.initials: R
authors.lastname: Issa
authors.affiliation: Public Health England Clinical Microbiology Laboratory, Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Curran
authors.affiliation: Faculty of Medicine, University of Balamand, Saint Georges University Medical Centre, Beirut, Lebanon.
authors.forename: Claude
authors.initials: C
authors.lastname: Afif
authors.affiliation: Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rajab
authors.affiliation: Faculty of Medicine, University of Balamand, Saint Georges University Medical Centre, Beirut, Lebanon.
authors.forename: Jihad
authors.initials: J
authors.lastname: Irani
authors.affiliation: Faculty of Medicine, University of Balamand, Saint Georges University Medical Centre, Beirut, Lebanon.
authors.forename: Noha
authors.initials: N
authors.lastname: Hakimeh
authors.affiliation: Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
authors.forename: Amal
authors.initials: A
authors.lastname: Naous
authors.affiliation: Faculty of Medicine, University of Balamand, Saint Georges University Medical Centre, Beirut, Lebanon.
authors.forename: Marie-Joelle
authors.initials: MJ
authors.lastname: Hajj
authors.affiliation: Faculty of Medicine, University of Balamand, Saint Georges University Medical Centre, Beirut, Lebanon.
authors.forename: Pierre
authors.initials: P
authors.lastname: Hajj
authors.affiliation: Laboratory Medicine, Makassed General Hospital, Beirut, Lebanon.
authors.forename: Tamima
authors.initials: T
authors.lastname: El Jisr
authors.affiliation: Faculty of Health Sciences, University of Balamand, Beirut, Lebanon.
authors.forename: Mira
authors.initials: M
authors.lastname: El Chaar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001988:Bronchiolitis / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000821:virology; D005260:Female; D006760:Hospitalization; D056661:Human bocavirus / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007223:Infant; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification / Q000472:pathogenicity; D060885:Multiplex Polymerase Chain Reaction; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification / Q000472:pathogenicity; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D012229:Rhinovirus / Q000302:isolation & purification / Q000472:pathogenicity; D012621:Seasons; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology*; D014780:Viruses / Q000302:isolation & purification / Q000472:pathogenicity
keywords: Lebanon; epidemiology; hospitalized children; multiplex PCR; respiratory viruses