Aspectos clínicos e epidemiológicos de pneumonias infantis associadas aos quatro tipos de vírus para influenza em Fortaleza-CE

Abstract

Pneumonia are public health problems worldwide, especially in children younger than five years old. Human parainfluenza virus (HPIV-1, 2 and 3) are common agents of pneumonia, little was know about the involvement of HPIV-4 due to difficulties of isolation in cell culture, the absence of antigens specific for this virus in panels routine detection of respiratory viruses, and are associated only with cases of mild respiratory infections. The aim of this study is to describe the clinical and epidemiological profile of pneumonia caused by four types of HPIV in the study population, from January 2013 to December 2014. To this end, nasopharyngeal aspirates of 542 children under five treated at Hospital Infantil Albert Sabin (HIAS), who were diagnosed with pneumonia, were subjected to RT-PCR for the detection of HPIV-1, 2, 3 and 4. These samples had been previously analyzed by indirect immunofluorescence for respiratory syncytial virus (RSV), influenza (A and B), adenovirus, and HPIV (1, 2 and 3). The HPIV were detected in 165 cases, followed by RSV (136), adenovirus (34) and influenza (30). Clinical and epidemiological characteristics of pneumonia by HPIV were analyzed in 104 samples with isolated infection with one of four types of HPIV. The HPIV most frequently detected, in descending order, were the HPIV-3 types (64.42%), HPIV-4 (19.23%), HPIV-1 (14.42%) and HPIV-2 (1.92 %). The HPIV-4 was the most associated with co-infection. The HPIV-4 was the only HPIV whose circulation was associated with the rainy season of two years of study (p <0.0001). The HPIV-3 and HPIV-1 had a circulation peak associated with the dry season. The HPIV are frequent agents of pneumonia in children younger than five years in the city of Fortaleza.