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Diagnostics and Epidemiology of Respiratory Syncytial Virus Infections

In Croatia, respiratory viral infections have, from a diagnostic and epidemiological aspect, been intensively researched from the early 1980s, at which time projects at the Ministry of Science were started. Using direct virology diagnostic methods in the 1980s has shown that respiratory viruses were the causative agents of 47.2% of all acute respiratory tract infections (ARTI). Respiratory syncytial virus (RSV) is the most common cause of severe lower respiratory tract infections (LRTI) in infants. In Croatia, RSV epidemics have been monitored since 1983. During the larger RSV epidemic of 1986/87, 33.6% of the ARTI patients were diagnosed with an RSV infection. In the study period of 11 consecutive years (1994-2005), 3, 435 inpatients with ARTI who were newborn to 10 years of age and were residing in Zagreb County were tested for infection with RSV and other respiratory viruses at the Virology Department, Croatian National Institute of Public Health. RSV was identified in nasopharyngeal secretions of these patients by isolation in cell culture and/or detection with monoclonal antibodies using a direct fluorescence assay. RSV was the most common causative agent of ARTI (42.2% ; 658/1, 559) for the infants 0-6 months of age. It was also the etiologic agent of LRTI in 49% (495/1, 010) of infants of similar age. RSV was demonstrated in 56.5% (382/676) of infants with bronchiolitis, and in 36.5% (49/134) of those with pneumonia in this age group. RSV was found to be the most common cause of bronchiolitis occurring throughout childhood (52.7% ; 482/913). In the Zagreb area, RSV outbreaks were proven to vary in a two-year cycle, which was repeated every 23-25 months. Knowledge of this biennial pattern should be useful in predicting the onset of RSV outbreaks in Croatia, and would facilitate planning for the prevention and control of RSV infections in the region.

Diagnostics; Epidemiology; Respiratory Syncytial Virus

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