• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.358-364
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• 2010

Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.75-82
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• 2024

Purpose: As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022. This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city. Methods: In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed. Results: A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics. Conclusions: This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.266-275
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• 2005

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.102-113
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• 2003

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTI) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus (PIV), influenza virus(INF), adenovirus(ADV), etc. Our purpose of this study was to examine the seasonal occurrence, clinical and laboratory features of each viral infections. Methods : Nasopharyngeal aspirates(NPA) were collected from 913 hospitalized children on the first day of admission. They were all admitted to Hangang Sacred Heart hospital and diagnosed as LRTIs. The study period was from September 1998 to August 2002. Specimens were inoculated onto HEp-2 cell, LLC-MK2 cell and MDCK cell. Viruses were detected by immunofluorescent method performed at day 10 postinoculation. Respiratory viruses were detected in 251(27%) cases. Medical records of 208 cases diagnosed as acute LRTIs were all taken reviewed and analyzed. Results : The identified pathogens were RSV 122 cases(58%), PIV 30 cases(14%), INFA 20 cases(10%), INFB 21 cases(11%) and ADV 15 cases(7%) during the study period. Outbreaks of RSV infections occurred every year but mostly on December, 1998 and November, 1999. LRTIs by PIV and ADV occurred during all seasons of the year. INFA was isolated moslty on March, 1999 and January, 2000. INFB infections occurred largely on April, 2002. The clinical diagnoses were bronchiolitis 88 cases(43%), pneumonia 87 cases(42%), croup 19 cases(9%) and tracheobronchitis 14 cases(6%). Common symptoms and signs were cough, rhinorrhea, sputum and fever. WBC counts in peripheral blood showed normal findings in 123 cases(59%). Each viral infections also showed some differences in auscultatory findings and chest X-ray findings. Conclusion : We learned that viruses are one of the major and important etiologic agents of acute LRTIs of children in Korea. However, we still need to find out more about its characteristic clinical features and continue studying on their seasonal occurrence to focus on their management and also prevention.

• Journal of Dairy Science and Biotechnology
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• v.41 no.2
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• pp.57-66
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• 2023

Majority of the respiratory infectious diseases that are generally prevalent in Korea from autumn to winter are caused by viruses such as respiratory syncytial virus and influenza A virus. Therefore, there is rapidly rising interest in determining the antiviral effects of probiotics against respiratory viruses and elucidating the probable mechanism behind it. Various human clinical trials as well as animal experiments have shown that some probiotics potentially have antiviral activity based on their immunomodulatory effect. Hence, this review describes in detail the various possibilities of using probiotics as antiviral agents against respiratory viruses and their potential effects. Also, it provides basic data regarding the availability of different probiotics relevant for their production by dairy and food industries.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.269-276
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• 2009

Viruses are the most common cause of lower respiratory tract infections (LRTIs) in infants and young children and are a major public health problem in this age group. Viruses were identified in 54.9-70.4% of hospitalized infants and children with LRTIs in Korea. The viral pathogens identified included respiratory syncytial virus (RSV) A and RSV B, influenza (Inf) A, Inf B, parainfluenza (PIV)1, PIV2, human bocavirus (hBoV), human rhinovirus (hRV), adenovirus (ADV), human metapneumovirus (hMPV), human coronavirus (hCoV)-OC 43, hCoV-229E, hCoV-NL63, hCoV-HKU1, and human enterovirus (hEV). Coinfections with ${\geq}$2 viruses were observed in 11.5-22.8% of children. The occurrence of LRTIs was the highest in the first year of life. The specific viruses are frequently associated with specific clinical syndromes of LRTIs. LRTIs caused by RSV were predominant among younger infants. hRV accounted for a larger proportion of LRTIs in young infants than ADV and hBoV. hMPV was frequently detected in children >24 months old. The number of hMPV infections peaked between February and May, whereas hRV was detected throughout the year. Thus far, hCoV is a less common respiratory pathogen in cases of ALRI and URI in Korean children.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.178-185
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• 2013

Objective: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. Methods: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. Results: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia ($9.71{\pm}1.09g/dL$); 46 had neutropenia ($803.70{\pm}263.09cells/mm^3$); and 23 had transient thrombocytopenia ($142,434.78{\pm}86,835.18cells/mm^3$). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. Conclusions: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.723-730
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• 2005

Purpose : This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections(LRI). Methods : Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI(253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively. Results : Ninety two cases(36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus(RSV, 76.0%), adenovirus(ADV, 12.0%), influenza virus type A(INFA, 9.8 %), influenza virus type B(INFB, 1.1%) and parainfluenza virus(PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia(56.5%), bronchiolitis(35.9%), tracheobronchitis(4.3%) and croup(3.3%). The clinical symptoms and signs were cough(98.8%), rhinorrhea(82.6%), fever(70.7%), rale(67.4%), wheezing(29.3%), chest retraction(28.3%) and cyanosis(4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of $38.5^{\circ}C$ or higher and their most common etiologic agent was INFA(66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA(77.8%). The elevated WBC count($>14{\times}10^3/{\mu}L$) was in 14.1%, and common etiologic agents were INFA(22.2%) and ADV(18.2%). C-reactive protein(CRP >4.0 mg/dL) was increased in 13.0%, and common in ADV(63.6 %). Increased aspartate aminotransferase(AST)/alanine aminotransferase(ALT) was detected in 10.9%, and the most common etiologic agent was RSV(12.9%). Conclusion : The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.99-111
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• 2019

Purpose: Respiratory syncytial virus (RSV) and human rhinovirus (hRV) are the most common causes of child respiratory viral infections. We aimed to investigate epidemiological and clinical characteristics of RSV and hRV single infections and coinfections. Methods: Nasopharyngeal aspirates of hospitalized children aged <5 years were tested using multiplex reverse transcription polymerase chain reaction (RT-PCR) from October 2014 to April 2017. Their medical records were retrospectively reviewed. Results: RSV or hRV was detected in 384 patients who divided into 3 groups: patients with RSV (R group, n=258); patients with hRV (H group, n=99); and patients with both (RH group, n=27). The R group (median age, 6 months) consisted of 248 (96.1%) patients with lower respiratory tract infection (LRTI), and 14 (5.4%) needed oxygen inhalation. Infants aged <12 months (63.2%) had respiratory difficulty and were supplied oxygen more often. The H group (median age, 16 months) consisted of 56 (56.6%) patients with LRTI, 4 (4%) required oxygen inhalation, and 1 (1.0%) required mechanical ventilation. Infants (40.4%) showed longer hospitalization compared to patients aged ${\geq}12$ months (5 vs. 4 days, P<0.05). The RH group consisted of 24 (88.9%) patients with LRTI, and 2 (7.4%) needed oxygen inhalation. Hospitalization days and oxygen inhalation and mechanical ventilation rates did not differ between single infections (R and H groups) and coinfections (RH group). Conclusions: RSV was detected more often in younger patients and showed higher LRTI rates compared to hRV. Single infections and coinfections of RSV and hRV showed no difference in severity.

• Korean Journal of Agricultural Science
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• v.48 no.2
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• pp.251-264
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• 2021

Bovine respiratory syncytial virus (BRSV) and bovine viral diarrhea virus (BVDV) are the main viral contributors to bovine respiratory disease (BRD) with high mortality and morbidity. BRD control measures include vaccination that modulates immunological profiles reflected in blood cells, serum, and body secretions, such as milk. This study evaluated the immune responses to an inactivated BRD vaccine in lactating cows reared in a natural environment on a dairy farm. The cows were intramuscularly inoculated with the vaccine, and serum, blood, and milk were collected pre-and post-vaccination. Our study revealed a prominent increase in BRSV-specific antibodies both in serum and milk, while the change in BVDV-specific antibodies was insignificant. Serum interleukin (IL)-1β and IL-6 levels significantly decreased, but this change was not reflected in milk. Evaluation of pattern recognition receptors (PRRs) via RT-qPCR revealed downregulation of nucleotide-binding oligomerization domain 2 (NOD2). The concentrations of BRSV antibodies, BVDV antibodies, IL-2, and IL-17A in serum and milk were strongly correlated, implying a concurrent influence on both body fluids. Thus, immunological factors modulated as a result of vaccination generally measured in serum were reflected in milk, demonstrating the suitability of milk evaluation as an alternative approach for immunological observations. Furthermore, the correlation between BRSV antibodies and NOD2 and that between BVDV antibodies and toll-like receptor (TLR) 2, TLR3, TLR4, and TLR5 imply the possible role of PRRs for the assessment of the immune response developed in immunized cows reared on the farm.