Etiology of acute pneumonia occurring against a background of influenza and other acute respiratory viral infections

The etiology of acute pneumonia (AP) was studied in 229 patients who had the disease simultaneously with influenza (106 patients), other viral and mycoplasmal infections (48 patients), and without concomitant acute viral infections (75 patients). The use of the quantitative microbiological method and the indirect immunofluorescence test with autostrains or Streptococcus pneumoniae strains of serotypes 2, 3, and 6, prevailing in Leningrad in patients with acute inflammatory diseases of the lungs, made it possible to find out the pneumococcal etiology of AP in 95% of patients irrespective of the presence of acute respiratory viral infections. The etiological role of opportunistic bacteria was revealed in 13 AP patients (5.7%); in 2 of them the causative agent of AP was Staphylococcus aureus and in 11, various species of Gram-negative enterobacteria. The latter were the cause of complications in 8 cases of pneumococcal pneumonia.     

Mixed respiratory viral infections during influenza A epidemics

Mixed respiratory viral infections occurring in the course of 8 influenza A epidemics in the Estonian SSR between 1969 and 1978 were investigated. A total of 1638 patients were followed up. The IF method, serological test CFR and HIR and isolation of the virus on tissue cultures and chick embryos were used. Mixed infections were found in 0-77.7% of laboratory-confirmed cases, depending on the epidemic. A combination of influenza A + parainfluenza was observed most frequently during the influenza epidemics in 1971-1977 and a combination of influenza A + influenza B during the 1977-1978 epidemic.     

Cycloferon--a new domestic preparation for the prophylaxis of influenza and other acute respiratory viral infections

The results of the placebo-controlled multicenter study of the epidemiological efficiency of the preparation Cycloferon for the prophylaxis of acute respiratory viral infections in children and adolescents are presented. A total of 16,000 children and adolescents were selected for the study. The epidemiological efficiency of the preparation manifested in 1.5- 2.9-fold decreased morbidity level with a protection index equal to 41 - 90%, was demonstrated.     

Evaluation of amyxin effect in prophylaxis of acute respiratory viral infections

The results of the evaluation of the oral inductor of endogenic interferon (amyxin), manufactured in Russia are presented. The use of amyxin was found to produce a drop in morbidity in acute respiratory virus infections (ARVI) among medical workers 3.4 times, i.e. the preparation exhibited a pronounced prophylactic effect with respect to ARVI. The use of the preparation was accompanied by a decrease in the number of manifest forms of ARVI. Persons given the preparation often had ARVI in a mild or asymptomatic form.     

Epidemiological and economic effectiveness of immunization of adult and children against influenza and acute respiratory viral infections with the vaccine Grippol

Materials on the characterization of the vaccine Grippol, indications for its use and the results of mass use are presented. Analysis of the morbidity level in influenza and acute respiratory viral infections (ARVI) among the vaccinated persons are indicative of considerably decreased level. The coefficient of the epidemiological effectiveness of Grippol in the immunization of children has proved to be 75-95%. The conclusion has been made that the vaccine Grippol is sufficiently effective and safe for use by Russian public health service.     

Epidemiologic features of acute viral respiratory infections in familial foci]

A study was made of the epidemiological peculiarities of viral respiratory infections of various etiology in the familial foci with the use of a methodical approach permitting to detect the true spread of infection in the familial foci, with consideration to the subclinical forme fruste of the disease and "carrier state". It appeared that in the familial foci the infectiousness of the majority of respiratory viral infections was greater than in the closed collective bodies uniting persons of the same age. The age composition of the family influences the manifestness (particularly in parainfluenza infection) and the intensity of the epidemic process characterized by the coefficient of the secondary affections. The type of the apartment, the floor on which it is located, and the number of persons residing in it had no significant influence on the spread of the viral infections in the familial foci. A definite role in this process is played by the level of specific serum antibodies in the members of the family surrounding the patient. The association of morbidity level with the antibody level proved to be the most distinct in children with influenza and adenoviral infection; this association was less significant in adults.     

Prophylactic efficacy of reaferon in viral hepatitis A and acute respiratory infections in children

Reaferon, the analog of human alpha 2-interferon obtained by gene engineering techniques, was studied with a view to its use for the prevention of hepatitis A. The study involved children of preschool age in Tashkent. In a strictly controlled trial children aged 2-6 years received the preparation orally in a dose of 1 X 10(6) I. U. or the diluent alone used as placebo. The preparation was administered to 1,100 children and the placebo to 1,078 children. The preparation and placebo were administered twice a week for two months. On the whole, during that period hepatitis A morbidity in both test and control groups of children was the same (5.1% and 4.9% respectively), but among children of nursery age receiving Reaferon the incidence of hepatitis A and acute respiratory viral infections was lower than among those receiving the placebo, though this difference was statistically significant only for cases of acute respiratory infections.     

Characteristics of acute respiratory viral infections in children under conditions of technogenic environmental pollution

The results of observations on children with acute virus respiratory infections (ARVI) and who had long been residents of zones with different levels of technogenic pollution of the atmospheric air are presented. The technogenic pollution of the environment has been found to exert influence on the spread and clinical course of ARVI in children, this influence being the more pronounced, the higher is the level of xenobiotics in the atmospheric air. The severity of the disease is noted to depend on the development of a number of syndromes, aggravating the course of ARVI, such as the neurotoxic and bronchoobstructive syndromes. Bronchical and ENT lesions are the most frequent complication of the main disease. The child population residing under the conditions of high technogenic environmental pollution should be regarded as a group of risk subject to the aggravated course of ARVI, and the examination of sick children should be made with due regard to this circumstance.     

Etiological structure of acute respiratory viral infections in children hospitalized in 1981-1999

The role of influenza and parainfluenza viruses, respiratory syncytial viruses and adenoviruses in the etiological structure of morbidity in acute respiratory virus infections (ARVI) in children hospitalized during the 19 year period is analyzed. As the result of examination of 56,287 patients by direct immunofluorescent test, respiratory viruses were detected in 21% of cases. The seasonal character, periodicity and level of ARVI morbidity were established. According to medical records, in the 1990s ARVI took a more severe course in children than that observed in the 1980s. In addition, the data on morbidity among children regarding rotavirus infection and ARVI were found to be similar.     

The cotton rat model of respiratory viral infections

Development of successful vaccines against human infectious diseases depends on using appropriate animal models for testing vaccine efficacy and safety. For some viral infections the task is further complicated by the frequently changing genetic make-up of the virus, as in the case of influenza, or by the existence of the little-understood phenomenon of vaccine-enhanced disease, as in the case of respiratory syncytial virus (RSV). The cotton rat Sigmodon hispidus has been used for years as an excellent small animal model of the RSV vaccine-enhanced disease. Recently, using cotton rats, we have demonstrated that vaccination against another paramyxovirus, human metapneumovirus (hMPV), can also lead to vaccine-enhanced disease. In addition to the study of paramyxoviruses, S. hispidus presents important advantages for the study of orthomyxoviruses such as influenza. The cotton rat is susceptible to infection with unadapted human influenza strains, and heterosubtypic immunity to influenza can be evoked in S. hispidus. The mechanisms of influenza, RSV, and hMPV pathogenesis and immunity can now be investigated in the cotton rat with the development of species-specific reagents for this animal model.     

Prevalence and structure of acute respiratory virus infections

Information on epidemiology of acute respiratory virus infections (ARVI) is reviewed and analyzed. In addition to influenza viruses, the role of respiratory syncytial viruses (RSV), rhino- and adenoviruses, as well as other viruses, in the development of respiratory diseases, especially in newborns, young children and elderly persons, is emphasized. A high proportion of RSV in the etiology the severe forms of ARVI and in the development of intrauterine infection is pointed out. The conclusion has been made that the identification of the causative agents of ARVI with the use of modern methods makes it possible to determine the real role of each of the pathogens in the formation of the severe forms of diseases, as well as the expediency of vaccinal prophylaxis.     

A simple cellular automaton model for influenza A viral infections

Viral kinetics have been extensively studied in the past through the use of spatially homogeneous ordinary differential equations describing the time evolution of the diseased state. However, spatial characteristics such as localized populations of dead cells might adversely affect the spread of infection, similar to the manner in which a counter-fire can stop a forest fire from spreading. In order to investigate the influence of spatial heterogeneities on viral spread, a simple 2-D cellular automaton (CA) model of a viral infection has been developed. In this initial phase of the investigation, the CA model is validated against clinical immunological data for uncomplicated influenza A infections. Our results will be shown and discussed.