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 Original Articles |
| Epidemiologic and Clinical Characteristics of Subgroup A and B of Respiratory Syncytial Virus |
| Bo Young Yun, Jin Young Park, Hoan Jong Lee, Chong Ku Yun |
| Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea |
Vol.28 Num.6 (p481~491)
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Background : Respiratory syncytial virus(RSV) is the most important cause of respiratory tract infections in infants and young children. RSV can be classified into two major subgroups based on their reactivity with monoclonal antibodies, and relative frequency of each subgroup may differ by geographic location and epidemic year. It has been suggested that severity of infection may differ depending on the subgroup of RSV
Methods : RSV infection was diagnosed by indirect immunofluorescent staining and viral culture employing HEp-2 cell line in patients with lower respiratory tract infections who were admitted to the Seoul National University Children's Hospital. RSV strains isolated over four successive outbreaks from November 1990 to April 1994 were typed by indirect immunofluorescence with subgroup-specific monoclonal antibodies. Clinical characteristics of RSV infection were reviewed retrospectively, with special emphasis on comparison between two subgroups of RSV.
Results : RSV was detected in 219(27%) of 804 episodes of lower respiratory tract infections. One hundred and thirty four strains(61.2%) of 219 RSV strains were serogrouped. Ninety-nine(739%) strains were identified as subgroup A, 34(25.3%) strains as subgroup B, and 1 strain was neither subgroup A nor subgroup B. Three patterns of yearly outbreaks existed: (1) only subgroup A strains(1991~92) or strong predominance of subgroup A strains(1992~93 with 93% A strains), (2) relatively equal proportions of subgroup A and B strains(1990~91), (3) only subgroup B strains in 1993~94. Eleven(11%) of 99 subgroup A infection and 3(9%) of 34 RSV subgroup infection required assisted ventilation, the difference of which was not significant statistically. Ten of 219 patients expired, all of whom had underlying diseases. Four of them were infected by subgroup A, while 6 infections were not serogrouped.
Conclusion : These data shows that RSV is an smportant cause of lower respiratory tract infection in Korean children. Comparison of this study with similar studies from other geographic locations about RSV subgroups indicates that the pattern of RSV subgroup prevalence is a localized phenomenon, and whether or not there is a difference in clinical severity of disease caused by the two RSV subgroups is uncertain. Possible significance of the geographic difference in the prevalence of each subgroup should be considered in the future vaccine development.
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Keywords : Respiratory infection, Respiratory syncytial virus, Subgroup |
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