July 15, 2008
Study reveals multiple viruses cause respiratory hospitalizations in children
By Tiffany Zulkosky, YKHC Public Relations Staff
Each year during the winter months, a seasonal surge of lung infections caused by RSV, or Respiratory Syncytial Virus, occurs in the Yukon-Kuskokwim Delta.
RSV causes respiratory (lung) Infections in people of all ages, having a severe effect on infants and young children, elders, and those with chronic lung diseases. In fact, it is the number one cause of pneumonia and bronchiolitis in babies. However, RSV isn't the only virus causing children to be hospitalized with lung infections.
In partnership with several institutions, YKHC conducted a study to identify what viruses cause children to be hospitalized with lung infections and what time of year those viruses are present in the region. The Respiratory Virus Study Team has begun compiling findings from the October 2005 to September 2007 study.
A total of 1,072 children from 28 villages and Bethel participated. Four hundred forty children under the age of three years old that were hospitalized with lung infections at the hospital in Bethel or Alaska Native Medical Center provided nose swabs that were tested and documented. The remaining 632 non-hospitalized children were recruited by nurses during village trips and acted as healthy comparisons.
"Even though we know a lot about RSV illness, there is little data on the impact of viruses other than RSV on respiratory hospitalizations in Alaskan children," said Dr. Rosalyn Singleton, with the Arctic Investigations Program for Centers for Disease Control and Prevention (CDC).
It was discovered that RSV is the most important virus causing hospitalization, accounting for 23 percent of the children hospitalized with lung infections. In babies, RSV can lead to bronchiolitis (wheezing) or pneumonia (lung infections).
Parainfluenza, a virus that causes croup, and can cause pneumonia, was present in 18 percent of hospitalized children. Metapneumovirus, a virus similar to RSV that can lead to bronchiolitis and pneumonia, was discovered in 2001 and was present in 15 percent of hospitalized children.
Rhinovirus, the cause of the everyday cold, was present in nearly half (44 percent) of hospitalized children. However, rhinovirus was also present in 33 percent of comparison children because colds are very common.
Most virus-positive hospitalizations for respiratory infections occurred during the winter months, but the peak month varied in each year of the study. During 2005-2006 hospitalizations peaked in January-March. In 2006-2007, hospitalizations peaked in March-April.
The results of the study will be utilized in a number of ways. Medical providers will know what the most common viruses are and the peak times of the year for infections. The study helped lab personnel and providers understand the accuracy of the virus tests for RSV and Flu used by the lab. The information has already been presented at four scientific conferences and the study staff are writing a paper to describe when the different viral infections happen and which children are most affected. Finally, the results will also help YKHC understand the risk factors for respiratory hospitalization.
The institutions involved with the study included YKHC, Arctic Investigations Program-CDC, Alaska Native Tribal Health Consortium, University of Washington, and State of Alaska Public Health Laboratory.
Dr. Rosalyn Singleton was the principal investigator for the study. Under the oversight of Dr. Joseph Klejka, YKHC Corporate Medical Director. Dr. Mehran Mosley, a local pediatrician, worked with research nurses Tania Thomas, Patricia Barrett, and Lori Pruitt to develop the Bethel-based research team. Mary Jackson and Nicolette Nick served as research assistants.
Some important ways to prevent respiratory infections and the common cold:
- Wash your hands frequently
- Keep young infants away from sick people and crowds
- Make sure your young children receive their flu and pneumococcal (Prevnar) vaccinations, which both help prevent pneumonia.
