784. Etiology and Seasonality of Viral Respiratory Infections in Rural Honduran Children
Session: Oral Abstract Session: Travel/Tropical Medicine and Parasitology
Friday, October 21, 2011: 4:00 PM
Room: 204AB
Background: Limited data are available in Honduras describing the etiology and seasonality of childhood acute respiratory infections (ARIs), and better data may lead to improved therapeutic and preventative strategies.  We conducted a prospective sentinel clinic surveillance study to determine the viral etiology of ARIs in rural Honduran children less than 5 years of age to characterize the spectrum and seasonality of viruses associated with acute respiratory infections.
Methods: Nasopharyngeal samples were obtained via flocked swab and shipped to the U.S. in both universal transport medium (UTM) on dry ice and nucleic acid stabilizing buffer at room temperature.  Samples were tested for 14 respiratory viruses using a PCR respiratory viral panel.
Results: 267 samples were collected from February 2010 – March 2011; 13.9% were positive for influenza, 7.9% for metapneumovirus, 7.5% for respiratory syncytial virus (RSV), 7.1% for parainfluenza and 2.2% for adenovirus.  At least one virus was identified in 194 (72.7%) cases, of which 16 (6.0%) were co-infections.  Influenza rose from 1.8% of isolates in February through June to 25.7% of isolates in July through October.  No cases of influenza were identified from November 2010 through February 2011.  Influenza was present for 5 out of 12 months, and influenza correlated with monthly rainfall in millimeters (R² = 0.2857).  Including all tested respiratory viruses except enterovirus/rhinovirus, the presence of a respiratory virus positively correlated with average monthly precipitation (R² = 0.2863).  Dry ice and room temperature results for influenza correlated well (K = 0.767, p<0.0001). 
Conclusion:  These unique results suggest that the spectrum of viruses in rural Honduran children is similar to those found in the U.S., though the seasonality is tropical.  This region of rural Honduras demonstrated one large peak in influenza positivity prior to the peak in the U.S., and influenza and respiratory viruses in general correlated with average monthly rainfall.  Nucleic acid stabilization at room temperature is an effective shipping method for subsequent isolation of influenza as compared to UTM.  Further research is needed to determine the best methods of prevention and treatment of these viral respiratory infections.

Subject Category: T. Travel/tropical medicine and parasitology

Elizabeth P. Schlaudecker, M.D., M.P.H.1, Joan P. Heck2, Elizabeth MacIntyre, B.A.3, Mary A. Staat, MD, MPH1, Ruben Martinez, M.D.3, Jeffery E. Heck, M.D.4, Douglas R. Morgan, M.D., M.P.H.5 and Mark C. Steinhoff, M.D.6, (1)Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (2)Harvard University, Cambridge, MA, (3)Shoulder to Shoulder, Santa Lucia, Intibuca, Honduras, (4)Department of Family Medicine, University of North Carolina, Asheville, NC, (5)Division of Gastroenterology, University of North Carolina, Chapel Hill, NC, (6)Global Health Center, Cincinnati Children's Hospital, Cincinnati, OH


E. P. Schlaudecker, None

J. P. Heck, None

E. MacIntyre, None

M. A. Staat, None

R. Martinez, None

J. E. Heck, None

D. R. Morgan, None

M. C. Steinhoff, None

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