КЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ РЕСПИРАТОРНО-СИНЦИТИАЛЬНОЙ ИНФЕКЦИИ У ДЕТЕЙ РАЗНОГО ВОЗРАСТА

The results of comparative analysis of epidemiological, clinical and laboratory indicators in 317 children in the age from 1 month to 5 years with acute respiratory syncytial virus infection (АRSVI) with the lower respiratory tract lesion are presented. All the patients were comprehensively examined for АRSVI. Only 29 children (10% of the surveyed patients) had no RSVI markers. Clinical and laboratory signs of acute RSVI were identified in 220 children (68,7%). In children of the first year of life АRSVI was confirmed by the viral RNA detection in the oropharynx strokes in 65% of cases. In children of the second year of life ARSVI was confirmed by detection of the viral RNA and RSV antigens in the oropharynx strokes equally frequently (52% and 54%). In patients over the age of two years the diagnosis was based on the RSV antigens (66%) and specific IgM (36%) detection. In most hospitalized children the disease has been proceeded in moderate form. Severe forms have been generally detected in children of the first year of life (8,6%). In children of the first year of life ARSVI has been often proceeded with the bronchial obstruction syndrome (63%), and only in this group bronchiolitis has been developed (12%). The frequency of ENT-organs lesion increased in children aged 2 to 5 years and the disease has been proceeded mainly with the pneumonia symptoms. The maximum viral RNA detection in children of the first year of life was recorded in November-February 2012, with the re-increase in May 2012. In patients aged 1,1 to 2,0 years the ARSVI markers have been detected evenly throughout the year of observation, excluding the summer months. In the group of children of the pre-school age (2,1–5,0 years) the hospitalization rate for the RSVI increased significantly in September-October 2011, and the frequent virus excretion was maintained during the summer months in patients with the lesions of the lower respiratory tract.Проведен сравнительный анализ эпидемиологических и клинико-лабораторных показателей у 317 детей в возрасте от 1 месяца до 5 лет, больных острой респираторной вирусной инфекцией (ОРВИ) с симптомами поражения нижних дыхательных путей (НДП). Все пациенты были комплексно обследованы на респираторно-синцитиальную вирусную инфекцию (РСВИ). Оказалось, что только у 29 (10%) детей отсутствовали маркеры РСВИ. У 220 пациентов (68,7%) выявлены клинико-лабораторные признаки острой РСВИ. У детей в возрасте до года заболевание подтверждалось обнаружением вирусной РНК в материалах из ротоглотки (65%). На втором году жизни одинаково часто выявлялись РНК и антиген РСВ в мазках из ротоглотки (52% и 54% соответственно). У пациентов старше двух лет диагноз устанавливался на основании выявления антигена РСВ (66%) и наличия специфических  IgM IgMIgMIgM(36%). У большинства госпитализированных детей клиническое течение заболевания имело среднюю степень тяжести. Тяжелые формы, как правило, регистрировались у лиц первого года жизни (8,6%). На первом году жизни РСВИ в основном протекала с бронхообструктивным синдромом (63%), причем только в этой группе больных встречались бронхиолиты (12%). У детей в возрасте от 2 до 5 лет возрастало количество поражений ЛОР-органов, заболевание протекало преимущественно с симптомами пневмонии. У детей первого года жизни вирусная РНК наиболее часто выделялась в ноябре 2011 г. – феврале 2012 г. с повторным пиком в мае 2012 г. У пациентов в возрасте 1,1–2,0 лет маркеры РСВИ выявлялись равномерно в течение всего года наблюдения, за исключением летних месяцев. В группе детей дошкольного возраста (2,1–5,0 лет) выраженный подъём числа госпитализаций по поводу РСВИ отмечался в сентябре – октябре 2011 г., и сохранялось частое выделение вируса у больных с поражением нижних дыхательных путей в летние месяцы

RESPIRATORY SYNCYTIAL VIRUS INFECTION IN INFANTS

The review focuses on respiratory syncytial virus infection (RSVI) and, based on the literature and authors' own observations, highlights epidemiological aspects and risk factors for RSVI (including severe forms of the infection), the specific clinical manifestations, challenges of laboratory diagnostics, and the benefits of various methods and their relevance in clinical practice. The available types of RSVI therapies are discussed based on meta-analyses of the data. The authors emphasize the importance of palivizumab in the specific passive prevention of respiratory syncytial virus infection in children from risk groups

Clinical and epidemiological features of respiratory syncytial infection in children of different age

The results of comparative analysis of epidemiological, clinical and laboratory indicators in 317 children in the age from 1 month to 5 years with acute respiratory syncytial virus infection (АRSVI) with the lower respiratory tract lesion are presented. All the patients were comprehensively examined for АRSVI. Only 29 children (10% of the surveyed patients) had no RSVI markers. Clinical and laboratory signs of acute RSVI were identified in 220 children (68,7%). In children of the first year of life АRSVI was confirmed by the viral RNA detection in the oropharynx strokes in 65% of cases. In children of the second year of life ARSVI was confirmed by detection of the viral RNA and RSV antigens in the oropharynx strokes equally frequently (52% and 54%). In patients over the age of two years the diagnosis was based on the RSV antigens (66%) and specific IgM (36%) detection. In most hospitalized children the disease has been proceeded in moderate form. Severe forms have been generally detected in children of the first year of life (8,6%). In children of the first year of life ARSVI has been often proceeded with the bronchial obstruction syndrome (63%), and only in this group bronchiolitis has been developed (12%). The frequency of ENT-organs lesion increased in children aged 2 to 5 years and the disease has been proceeded mainly with the pneumonia symptoms. The maximum viral RNA detection in children of the first year of life was recorded in November-February 2012, with the re-increase in May 2012. In patients aged 1,1 to 2,0 years the ARSVI markers have been detected evenly throughout the year of observation, excluding the summer months. In the group of children of the pre-school age (2,1–5,0 years) the hospitalization rate for the RSVI increased significantly in September-October 2011, and the frequent virus excretion was maintained during the summer months in patients with the lesions of the lower respiratory tract