Alt solunum yolu enfeksiyonları, özellikle 5 yaşın altındaki çocuklarda hastaneye yatışların en önemli sebeplerinden olmakla birlikte; ciddi bir mortalite ve morbidite nedenidir.
5 yaşın altındaki ASYE erkek çocuklarda kız çocuklara göre, anatomik yapı ve havayollarının daha dar olması nedeniyle daha sık görülmektedir ancak prognoz açısından her iki cinsiyet arasında anlamlı fark izlenmemiştir.
Yapılan birçok çalışmada 6 ayın altında olmak kötü prognoz açısından bir risk faktörü olarak kabul edilmektedir. Bizim çalışmamızda ise ağır klinik seyir gösteren hasta grubunun ortalama yaşı 13 ay civarında saptanmıştır. Bunun sebebinin 1 ay-5 yaş arası geniş bir yaş grubunu çalışmamıza dahil etmemiz olabileceği düşünülmekle birlikte, yine de literatür ile de uyumlu şekilde 2 yaşın altındaki çocuklarda daha dikkatli olunması gerektiği görülmüştür.
Hastanın ilk başvuru anında yapılan fizik muayenesinde takipne, hırıltılı solunum ve morarma izlenmesi, ateşin yüksek olması ve SpO2’nin <%92 olması; daha önce yapılan birçok çalışmayı da destekler şekilde ağır klinik seyir açısından uyarıcı olmalıdır.
Hastanın daha önce ASYE geçirmiş olması da, ağır klinik seyir açısından dikkat edilmesi gereken bulgulardandır. Çalışmamızda da ağır klinik grupta, orta – ağır ve hafif seyreden gruba göre daha önce geçirilmiş atak sayısı anlamlı olarak daha yüksek bulunmuştur.
Kronik akciğer hastalığı, konjenital kalp hastalığı, nörometabolik hastalıklar, immun yetmezlikler gibi komorbid hastalığı olan çocuklarda, ASYE klinik seyiri de daha ağır olmakta, bu çocukların hastanede yatış süreleri de daha uzun olmaktadır.
Alt solunum yolu enfeksiyonu nedeniyle hastaneye başvuruda bakılan tam kan sayımında nötrofili ve lenfopeni izlenmesi, akut faz reaktanlarından CRP ve PCT değerlerinin yüksek olması da hastalığın klinik seyirinin daha ağır olacağını gösterebilmektedir.
Tüm bunların yanında ASYE en sık nedeni solunum virüsleridir. Solunum virüsleri coğrafya ve iklime göre değişmekle birlikte yılın belli zamanlarında özellikle daha sık enfeksiyonlara yol açabilmektedir. Virüsün tipine göre de klinik seyir değişmektedir. Bizim çalışmamızda da FLUB, HBoV ve Adenovirüs saptanan hastaların, diğer virüslerin saptandığı hastalara göre anlamlı şekilde daha ağır klinik seyir gösterdiği izlenmiştir.
KAYNAKLAR
1. Health Organization W, Aahman E, Abou-Zahr C, Amoako Johnson F, Arnold F, Bacci A, et al. Make every mother and child count The World Health Report 2005.
2. Waters D, Theodoratou E, Campbell H, Rudan I, Chopra M. Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low-and middle- income countries. J. Glob Health. 2012 Dec; 2(2): 020402.
3. Štampar’’ A, Lukšić I, Kearns PK, Scott F, Rudan I, Campbell H, et al. Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age-a systematic review and meta-analysis. Croat Med J 2013Apr; 54(2):122-134
4. Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Vol. 377, The Lancet. Lancet Publishing Group; 2011. p. 1264–75.
5. Korppi M. Community-Acquired Pneumonia in Children: Issues in Optimizing Antibacterial Treatment. Vol. 5, Pediatric Drugs. 2003. p. 821–32.
6. Pavia AT. Viral infections of the lower respiratory tract: Old viruses, new viruses, and the role of diagnosis. Clin Infect Dis. 2011 May 1;52.
7. Sieminska A, Kuziemski K. Respiratory bronchiolitis-interstitial lung disease. Orphanet J Rare Dis. 2014 Dec 11;9(1):106. Available from: http://ojrd.biomedcentral.com/articles/10.1186/s13023-014-0106-8
8. Colby T V. Bronchiolitis: Pathologic considerations. Vol. 109, American Journal of Clinical Pathology. American Society of Clinical Pathologists; 1998. p. 101–9.
9. Bialy L, Foisy M, Smith M, Fernandes RM. Evidence-Based Child Health: A Cochrane Review. The Cochrane Library and the Treatment of Bronchiolitis in Children: An Overview of Reviews. J Evid-Based Child Heal. 2011;6:258–75.
10. NCC-WCH Commissioned by the National Institute for Health and Care Excellence Bronchiolitis in children Contents. 2015.
11. Mansbach JM, Piedra PA, Teach SJ, Sullivan AF, Forgey T, Clark S, et al. Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med. 2012 Aug;166(8):700–6.
12. Mansbach JM, McAdam AJ, Clark S, Hain PD, Flood RG, Acholonu U, et al. Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department. Acad
Emerg Med. 2008 Feb;15(2):111–8.
13. Midulla F, Scagnolari C, Bonci E, Pierangeli A, Antonelli G, De Angelis D, et al. Respiratory syncytial virus, human bocavirus and rhinovirus bronchiolitis in infants. Arch Dis Child. 2010 Jan;95(1):35–41.
14. Richard N, Komurian-Pradel F, Javouhey E, Perret M, Rajoharison A, Bagnaud A, et al. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J. 2008;27(3):213–7.
15. Fitzgerald DA, Kilham HA. Bronchiolitis: assessment and evidence-based management. Med J Aust. 2004 Apr 19;180(8):399–404.
16. King VJ, Viswanathan M, Bordley WC, Jackman AM, Sutton SF, Lohr KN, et al. Pharmacologic Treatment of Bronchiolitis in Infants and Children: A Systematic Review. Vol. 158, Archives of Pediatrics and Adolescent Medicine. 2004. p. 127–37.
17. Diagnosis and Management of Bronchiolitis Subcommittee on Diagnosis and Management of Bronchiolitis. 2006
18. Shay DK, Holman RC, Roosevelt GE, Clarke MJ, Anderson LJ. Bronchiolitis-Associated Mortality and Estimates of Respiratory Syncytial Virus-Associated Deaths among US Children, 1979-1997. J İnfect Dis. 2001 Jan 1;183(1):16-22
19. Holman RC, Shay DK, Curns AT, Lingappa JR, Anderson LJ. Risk factors for bronchiolitis-associated deaths among infants in the United States. Pediatr Infect Dis J. 2003 Jun 1;22(6):483–9.
20. Oymar K, Skjerven HO, Mikalsen IB. Acute Bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014 Apr 3;22:23.
21. Cortés Alvarez N, Martín Mateos MA, Plaza Martín AM, Giner Muñoz MT, Piquer M, Sierra Martínez JI. Risk factors of developing asthma in children with recurrent wheezing in the first three years of life. Allergol Immunopathol (Madr);35(6):228–31
22. Martinez FD, Wright AL, Taussing LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and Wheezing In The First Six Years of Life. N Engl J Med. 1995 Jan;332(3):133-8.
23. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis. Vol. 134, Pediatrics. American Academy of Pediatrics; 2014. p. e1474–502.
Kliniği Ç, -Türkiye İ. Çocuklarda Toplum Kökenli Pnömoniye Yaklaşım: Amerikan Çocuk Enfeksiyon Derneği Rehberi. Med Bull Şişli Etfal Hosp. 2015;3(3):49.
25. Margolis P, Gadomski A. Does this infant have pneumonia? J Am Med Assoc. 1998 Jan 28;279(4):308–13.
26. Nazan ŞEN D, Hikmet ÖZHAN M. PNÖMONİ TÜSAD Eğitim Kitapları Serisi.Pnömoni. 2016.
27. Drummond P, Clark J, Cant A, Wheeler J, Galloway A, Freeman R. Community acquired pneumonia - A prospective UK study. Arch Dis Child. 2000;83(5):408–12.
28. Bonzel L, Tenenbaum T, Schroten H, Schildgen O, Schweitzer-Krantz S, Adams O. Frequent detection of viral coinfection in children hospitalized with acute respiratory tract infection using a real-time polymerase chain reaction. Pediatr Infect Dis J. 2008 Jul;27(7):589–94.
29. Hamano-Hasegawa K, Morozumi M, Nakayama E, Chiba N, Murayama SY, Takayanagi R, et al. Comprehensive detection of causative pathogens using real-time PCR to diagnose pediatric community-acquired pneumonia. J Infect Chemother. 2008;14(6):424–32.
30. Michelow IC, Olsen K, Lozano J, Rollins NK, Duffy LB, Ziegler T, et al. Epidemiology and Clinical Characteristics of Community-Acquired Pneumonia in Hospitalized Children. Pediatrics. 2004 Apr;113(4 I):701–7.
31. Murphy CG, van de Pol AC, Harper MB, Bachur RG. Clinical Predictors of Occult Pneumonia in the Febrile Child. Acad Emerg Med. 2007 Mar;14(3):243–9.
32. Pocket Book Of Hospital Care For Children WHO. 2013 edition;978 92 4 154837 3
33. Türk Toraks Derneği Akut Bronşşiyolit Tanı Ve Tedavi Uzlaşı Raporu. 2009;10 (June):3.
34. Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: Update 2011. Vol. 66, Thorax. 2011.
35. Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, et al. The Management of Community-Aquired Pneumonia in Infants and Children Older than 3 Months of Age: Clinical Practice Guidelindes by the Pediatric. Clin Infect Dis. 2018;53(7):25–76.
36. Peltola V, Mertsola J, Ruuskanen O. Comparison of total white blood cell count and serum C-reactive protein levels in confirmed bacterial and viral infections. J Pediatr. 2006 Nov;149(5):721–4.
37. Gereige RS, Laufer PM. Pneumonia. Pediatr Rev.2013 Oct;34(10):438–56; quiz 455–6.
38. Subramony A, Zachariah P, Krones A, Whittier S, Saiman L. Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogens on Healthcare Resource Utilization for Pediatric Inpatients. J Pediatr. 2016 ;173:196-201.e2.
39. Kumar P, McKean MC. Evidence based paediatrics: review of BTS guidelines for the management of community acquired pneumonia in children. J Infect. 2004 Feb;48(2):134– 8.
40. Frei CR, Restrepo MI, Mortensen EM, Burgess DS. Impact of guideline-concordant empiric antibiotic therapy in community-acquired pneumonia. Am J Med. 2006 Oct;119(10):865–71.
41. Örün, Emel, S. Songül Yalçın KY. Çocuk Sağlığı ve Hastalıkları Dergisi. 2007;Vol:50,Number:1
42. Villenave R, Shields MD, Power UF. Respiratory syncytial virus interaction with human airway epithelium. Trends Microbiol. 2013 May;21(5):238–44.
43. Piedimonte G, Perez MK. Respiratory syncytial virus infection and bronchiolitis. Pediatr Rev. 2014 Dec 1;35(12):519–30.
44. Roglić S. Respiratory syncytial virus infection in children. Vol. 62, Paediatria Croatica, Supplement. Croatian Pediatric Society; 2018. p. 236–41.
45. Pickering LK, Baker CJ, Long SS KD. 2015 Report of the Committee on Infectious Diseases RED BOOK ®. 2015.
46. Stensballe LG, Devasundaram JK, Simoes EAF. Respiratory syncytial virus epidemics: The ups and downs of a seasonal virus. In: Pediatric Infectious Disease Journal. 2003 Feb;22:S21-32.
47. Boyce TG, Mellen BG, Mitchel EF, Wright PF, Griffin MR. Rates of hospitalization for respiratory syncytial virus infection among children in medicaid. J Pediatr. 2000 Dec;137(6):865–70.
48. Hoffman SJ, Laham FR, Polack FP. Mechanisms of illness during respiratory syncytial virus infection: the lungs, the virus and the immune response. Microbes Infect. 2004 Jul;6(8):767–72.
49. Meissner HC, Rennels MB, Pickering LK, Hall CB. Risk of severe respiratory syncytial virus disease, identification of high risk infants and recommendations for prophylaxis with palivizumab. Pediatr Infect Dis J. 2004 Mar;23(3):284–5.
50. Welliver TP, Garofalo RP, Hosakote Y, Hintz KH, Avendano L, Sanchez K, et al. Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses. J Infect Dis. 2007 Apr 15;195(8):1126–36.
51. Hacking D, Hull J. Respiratory syncytial virus - Viral biology and the host response. Vol. 45, Journal of Infection. W.B. Saunders Ltd; 2002. p. 18–24.
52. Kimpen JLL. Prevention and treatment of respiratory syncytial virus bronchiolitis and postbronchiolitic wheezing. Respir Res. 2002 Jun 24;3.
53. Previewer P. Long : Principles and Practice of Pediatric Infectious Diseases , 4th ed . Clinical Diagnosis and Radiographic Manifestations Radiographic Likely Pathogens Pattern Viruses (CMV , RSV , Mycoplasma Diagnostic Approach Rapid viral , mycoplasmal , or chlamyd.) 2012;9–11.
54. Johnston SL, Siegel CS. Evaluation of direct immunofluorescence, enzyme immunoassay, centrifugation culture, and conventional culture for the detection of respiratory syncytial virus. J Clin Microbiol. 1990 Nov;28(11):2394–7.
55. Çolak M, Altay A, Erten Y, Özkurt ZN, Özkan S, Pınar A, et al. Investigation of BK and JC Virus DNA Positivities by Real-Time Polymerase Chain Reaction in Immunosuppressive Patients. Türk Mikrobiyoloji Cemiy Derg. 2015.
56. Cruz AT, Cazacu AC, Greer JM, Demmler GJ. Performance of a rapid assay (Binax Now) for detection of respiratory syncytial virus at a Children’s Hospital over a 3-year period. J Clin Microbiol. 2007 Jun;45(6):1993–5.
57. Collins CL, Pollard AJ. Respiratory syncytial virus infections in children and adults. J Infect. 2002 Jul;45(1):10–7.
58. Hartling L, Fernandes RM, Bialy L, Milne A, Johnson D, Plint A, et al. Steroids and bronchodilators for acute bronchiolitis in the first two years of life: Systematic review and meta-analysis. Vol. 342, BMJ. 2011.
59. Gadomski AM, Scribani MB. Bronchodilators for bronchiolitis. Cochrane database Syst Rev. 2014 Jun 17;(6):CD001266.
60. Schuh S, Coates AL, Binnie R, Allin T, Goia C, Corey M, et al. Efficacy of oral dexamethasone in outpatients with acute bronchiolitis. J Pediatr. 2002 Jan;140(1):27–32.
61. Barr R, Green CA, Sande CJ, Drysdale SB. Respiratory syncytial virus: diagnosis, prevention and management. Ther Adv Infect Dis.2019 Jul 29;6:2049936119865798.
62. Roquéi Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C, Vilaró J. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Vol. 2016, Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd; 2016.
63. Hodge D, Chetcuti PAJ. RSV: Management of the acute episode. In: Paediatric Respiratory Reviews. September 2000;Vol:1:3,215-220.
64. Ventre K, Randolph AG. Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children. Cochrane Database of Systematic Reviews. 2004 Oct 18;(4):CD000181.
65. Fuller H, Del Mar C. Immunoglobulin treatment for respiratory syncytial virus infection. Cochrane Database of Systematic Reviews. 2006 Oct 18;(4):CD004883.
66. Jun S, Sebastianski M, Featherstone R, Robinson J. Palivizumab and prevention of childhood respiratory syncytial viral infection: protocol for a systematic review and meta- analysis of breakthrough infections. BMJ Open. 2019;9:29832.
67. Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection. Pediatrics. 2014 Aug 1;134(2):e620–38.
68. Jacobs SE, Lamson DM, St. George K, Walsh TJ. Jacobs, Samantha E Lamson, Daryl M St. George, Kirsten Walsh, Thomas J. Clin Microbiol Rev. 2013;26(1):135–62.
69. Atmar RL. Uncommon(ly considered) manifestations of infection with rhinovirus, agent of the common cold. Clin Infect Dis. 2005 Jul 15;41(2):266–7.
70. Lau SKP, Yip CCY, Lin AWC, Lee RA, So L-Y, Lau Y-L, et al. Clinical and molecular epidemiology of human rhinovirus C in children and adults in Hong Kong reveals a possible distinct human rhinovirus C subgroup. J Infect Dis. 2009 Oct 1;200(7):1096–103.
71. Savolainen-Kopra C, Korpela T, Simonen-Tikka M-L, Amiryousefi A, Ziegler T, Roivainen M, et al. Single treatment with ethanol hand rub is ineffective against human rhinovirus--hand washing with soap and water removes the virus efficiently. J Med Virol. 2012 Mar;84(3):543–7.
72. Papadopoulos NG, Bates PJ, Bardin PG, Papi A, Leir SH, Fraenkel DJ, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000 Jun;181(6):1875–84.
73. Miller EK, Avila PC, Khan YW, Word CR, Pelz BJ, Papadopoulos NG, et al. Wheezing Exacerbations in Early Childhood: Evaluation, Treatment, and Recent Advances Relevant to the Genesis of Asthma. J Allergy Clin Immunol Pract. 2014;2(5):537–43.
74. Vandini S, Biagi C, Fischer M, Lanari M. Impact of Rhinovirus Infections in Children. Viruses 2019 Jun; 11(6): 521.
75. International Committee on Taxonomy of Viruses (ICTV)
76. Nayak DP, Balogun RA, Yamada H, Zhou ZH, Barman S. Influenza virus morphogenesis and budding. Vol. 143, Virus Research. 2009. p. 147–61.
77. Structure of influenza virus. Virology Blog. 2009 Apr 30.
78. Peiris M, Yuen KY, Leung CW, Chan KH, Ip PL, Lai RW, et al. Human infection with influenza H9N2. Lancet (London, England). 1999 Sep 11;354(9182):916–7.
79. Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, et al. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med [Internet]. 2010 May 6;362(18):1708–19.
80. Hunt M,. Microbiology and Immunology Online.Influenza Virus. 2016 Oct 30.
81. Kamps BS, Hoffmann C. Influenza Report 2006. Zanamivir 2006;5–11.
82. Lahti E, Peltola V, Virkki R, Ruuskanen O. Influenza pneumonia. Pediatr Infect Dis J. 2006 Feb;25(2):160–4.
83. Harper SA, Bradley JS, Englund JA, File TM, Gravenstein S, Hayden FG, et al. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management. IDSA endorsed. 2009;48(8):1003–32.
84. Cooper NJ, Sutton AJ, Abrams KR, Wailoo A, Turner D, Nicholson KG. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials. BMJ. 2003 Jun 7;326(7401):1235.
85. Smith JR, Rayner CR, Donner B, Wollenhaupt M, Klumpp K, Dutkowski R. Oseltamivir in seasonal, pandemic, and avian influenza: a comprehensive review of 10-years clinical experience. Adv Ther. 2011 Nov;28(11):927–59.
86. Fiore AE, Uyeki TM, Broder K, Finelli L, Euler GL, Singleton JA et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Rec- ommendations and reports: Morbidity and mortality weekly report Recommendations and reports. Centers Dis Control. 2010;1-62.
87. Pan Y, Zhang Y, Shi W, Peng | Xiaomin, Cui S, Zhang D, et al. Human parainfluenza virus infection in severe acute respiratory infection cases in Beijing, 2014 2016: A molecular epidemiological study. 2017;11:564–8.
88. Moscona A. Entry of parainfluenza virus into cells as a target for interrupting childhood respiratory disease. Vol. 115, Journal of Clinical Investigation. 2005. p. 1688–98.
89. Weinberg GA, Hall CB, Iwane MK, Poehling KA, Edwards KM, Griffin MR, et al. Parainfluenza virus infection of young children: estimates of the population-based burden of hospitalization. J Pediatr. 2009 May;154(5):694–9.
90. Fry AM, Curns AT, Harbour K, Hutwagner L, Holman RC, Anderson LJ. Seasonal trends of human parainfluenza viral infections: United States, 1990-2004. Clin Infect Dis. 2006 Oct 15;43(8):1016–22.
91. Schmidt AC, Schaap-Nutt A, Bartlett EJ, Schomacker H, Boonyaratanakornkit J, Karron RA, et al. Progress in the development of human parainfluenza virus vaccines. Vol. 5, Expert Review of Respiratory Medicine. 2011. p. 515–26.
92. Suzuki T, Portner A, Scroggs RA, Uchikawa M, Koyama N, Matsuo K, et al. Receptor specificities of human respiroviruses. J Virol. 2001 May;75(10):4604–13.
93. Glezen WP, Frank AL, Taber LH, Kasel JA. Parainfluenza virus type 3: seasonality and risk of infection and reinfection in young children. J Infect Dis. 1984 Dec;150(6):851–7.
94. DeByle C, Bulkow L, Miernyk K, Chikoyak L, Hummel KB, Hennessy T, et al. Comparison of nasopharyngeal flocked swabs and nasopharyngeal wash collection methods for respiratory virus detection in hospitalized children using real-time polymerase chain reaction. J Virol Methods. 2012 Oct;185(1):89–93.
95. Falsey A. Current management of parainfluenza pneumonitis in immunocompromised patients: a review. Infect Drug Resist. 2012 Aug;121.
96. Russell KF, Liang Y, O’Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011 Jan 19;
97. Fox TG, Christenson JC. Influenza and Parainfluenza Viral Infections in Children. Pediatr Rev. 2014 June;35(6):217-27 .
98. Guido M, Tumolo MR, Verri T, Romano A, Serio F, De Giorgi M, et al. Human bocavirus: Current knowledge and future challenges. Vol. 22, World Journal of Gastroenterology. Baishideng Publishing Group Co., Limited; 2016. p. 8684–97.
99. Bocaparvovirus. ViralZone page. NCBI Taxonomy Browser
100. Allander T, Tammi MT, Eriksson M, Bjerkner A, Tiveljung-Lindell A, Andersson B. Cloning of a human parvovirus by molecular screening of respiratory tract samples. Proc Natl Acad Sci U S A. 2005 Sep 6;102(36):12891–6.
101. Kesebir D, Vazquez M, Weibel C, Shapiro ED, Ferguson D, Landry ML, et al. Human Bocavirus Infection in Young Children in the United States: Molecular Epidemiological Profil and Clinical Characteristics of a Newly Emerging Respiratory Virus. J İnfect Dis. 2006 Nov 1;194(9):1276-82.
102. Jartti T, Hedman K, Jartti L, Ruuskanen O, Allander T, Söderlund-Venermo M. Human bocavirus-the first 5 years. Rev Med Virol. 2012 Jan;22(1):46–64.
103. Schildgen O. Human bocavirus: Lessons learned to date. Vol. 2, Pathogens. MDPI AG; 2013. p. 1–12.
104. Jartti T, Söderlund-Venermo M, Allander T, Vuorinen T, Hedman K, Ruuskanen O. No efficacy of prednisolone in acute wheezing associated with human bocavirus infection. Pediatr Infect Dis J. 2011 Jun;30(6):521–3.
105. Hamelin M-E, Abed Y, Boivin G. Human metapneumovirus: a new player among respiratory viruses. Clin Infect Dis. 2004 Apr 1;38(7):983–90.
106. van den Hoogen BG, de Jong JC, Groen J, Kuiken T, de Groot R, Fouchier RA, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001 Jun;7(6):719–24.
107. Schuster JE, Williams J V. Human Metapneumovirus Report of a Case. Pediatr Rev. 2013;34558.
108. Kim S, Sung H, Im HJ, Hong SJ, Kim MN. Molecular epidemiological investigation of a nosocomial outbreak of human metapneumovirus infection in a pediatric hemato- oncology patient population. J Clin Microbiol. 2009 Apr;47(4):1221–4.
109. Oliveira DBL, Durigon EL, Carvalho ACL, Leal AL, Souza TS, Thomazelli LM, et al. Epidemiology and genetic variability of human metapneumovirus during a 4-year-long study in Southeastern Brazil. J Med Virol. 2009 May;81(5):915–21.
110. Shafagati N, Williams J. Open Peer Review Human metapneumovirus-what we know now [version 1; referees: 2 approved]. 2018;
111. Edwards KM, Zhu Y, Griffin MR, Weinberg GA, Hall CB, Szilagyi PG, et al. Burden of human metapneumovirus infection in young children. N Engl J Med. 2013 Feb 14;368(7):633–43.
112. Schildgen V, van den Hoogen B, Fouchier R, Tripp RA, Alvarez R, Manoha C, et al. Human metapneumovirus: Lessons learned over the first decade. Vol. 24, Clinical Microbiology Reviews. 2011. p. 734–54.
113. Papenburg J, Hamelin M-È, Ouhoummane N, Carbonneau J, Ouakki M, Raymond F, et al. Comparison of risk factors for human metapneumovirus and respiratory syncytial virus disease severity in young children. J Infect Dis. 2012 Jul 15;206(2):178–89.
114. Webster DL, Gardner AH, Dye TJ, Chima RS. Status epilepticus: a possible association with human metapneumovirus infection. Pediatrics. 2014 Mar;133(3):e747-50.
115. Williams J V, Harris PA, Tollefson SJ, Halburnt-Rush LL, Pingsterhaus JM, Edwards KM, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med. 2004 Jan 29;350(5):443–50.
116. Côté S, Abed Y, Boivin G. Comparative evaluation of real-time PCR assays for detection of the human metapneumovirus. J Clin Microbiol. 2003 Aug 1;41(8):3631–5.
117. Shah DP, Shah PK, Azzi JM, El Chaer F, Chemaly RF. Human metapneumovirus infections in hematopoietic cell transplant recipients and hematologic malignancy patients: A systematic review. Vol. 379, Cancer Letters. Elsevier Ireland Ltd; 2016. p. 100–6.
118. MacPhail M, Schickli JH, Tang RS, Kaur J, Robinson C, Fouchier RAM, et al. Identification of small-animal and primate models for evaluation of vaccine candidates for human metapneumovirus (hMPV) and implications for hMPV vaccine design. J Gen Virol. 2004 Jun;85(Pt 6):1655–63.
119. Caddle S. Enteroviruses. Pediatr Rev. 2003;24(10).
120. Zaoutis T, Klein JD. Enterovirus Infections. Pediatr Rev. 1998 Jun 1;19(6):183–91.
121. Poliovirus History, Structure, Types, Life cycle, Symptoms and Transmission. Jot Scroll. 2018 Mar 20.
122. Yu FY, Zhu RN, Deng J, Song QW, Jia LP, Liu LY, et al. [Pathogen spectrum in enteroviral infections among children in Beijing from 2010 to 2016]. Zhonghua er ke za zhi = Chinese J Pediatr. 2018 Aug 2;56(8):575–81.
123. Woo PCY, Lau SKP, Chu C, Chan K, Tsoi H, Huang Y, et al. Characterization and complete genome sequence of a novel coronavirus, coronavirus HKU1, from patients with pneumonia. J Virol. 2005 Jan;79(2):884–95.
124. Hijawi B, Abdallat M, Sayaydeh A, Alqasrawi S, Haddadin A, Jaarour N, et al. Novel