[A bronchiolitis epidemic caused by respiratory syncytial viruses].

Abstract

In the typical period of the year (autumn-winter 1986-1987) an outbreak of bronchiolitis in infants caused by respiratory syncytial virus (RSV) occurred. The acute course of the illness, a severe clinical picture, and a very fast spread of infection called for the very rapid techniques for detecting the etiological agent. Applying the direct immunofluorescent antibody test (DFTA) in samples of nasopharyngeal secretions, RSV was found to be responsible for the epidemic. Later the same samples of the material were inoculated into tissue cultures and RSV was isolated. Fourfold or higher titres of complement fixing antibodies in paired serum samples confirmed the infection with RSV. During the outbreak of bronchiolitis 72 children aged under 15 months (only one child was older than one year) were hospitalized. The majority of cases of RSV bronchiolitis was noticed in infants in the first six months of life (81.9%, chi 2 = 31.1, p less than 0.01). Boys against girls were in relation as 1.25:1. Because of the broncho-obstructive component of the illness, respiratory failure was the dominant sign in the clinical picture of bronchiolitis; 34.7% of the patients were afebrile, 16.7% were in the state of hyperpyrexy and 48.6% with temperature up to 38 degrees C. Oxygen and symptomatic therapy were the basic treatment. In severe cases corticosteroids and antibiotic were administered for a short time. The classical type of bronchiolitis in infancy as the most severe among acute infections of respiratory organs because of its poor prognosis at the very beginning and the long-term sequels is a serious medical problem. Emphasis is laid on the importance and usefulness of the virologic diagnosis, especially the application of rapid DFTA techniques in the acute stages of bronchiolitis caused by infections with respiratory syncytial virus during the epidemic occurrence of this agent.