Jelić A, Jelić O
Iz Medicinskog centra u Slavonskom Brodu.
Acta Med Iugosl. 1990;44(3):247-58.
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.
在一年中的典型时期（1986 - 1987年秋冬），发生了由呼吸道合胞病毒（RSV）引起的婴儿毛细支气管炎疫情。该病病程急性、临床症状严重且感染传播迅速，这就需要采用非常快速的技术来检测病原体。对鼻咽分泌物样本应用直接免疫荧光抗体试验（DFTA），发现RSV是此次疫情的病原体。随后，将相同的样本接种到组织培养物中，分离出了RSV。配对血清样本中补体结合抗体效价呈四倍或更高升高，证实了RSV感染。在毛细支气管炎疫情期间，72名15个月以下儿童（只有一名儿童超过1岁）住院治疗。大多数RSV毛细支气管炎病例见于出生后头六个月的婴儿（81.9%，χ² = 31.1，p < 0.01）。男童与女童的比例为1.25:1。由于该病存在支气管阻塞成分，呼吸衰竭是毛细支气管炎临床症状中的主要体征；34.7%的患者无发热，16.7%处于高热状态，48.6%体温高达38℃。吸氧和对症治疗是基本治疗方法。严重病例短期给予皮质类固醇和抗生素。婴儿期典型的毛细支气管炎作为呼吸道器官急性感染中最严重的类型，因其一开始预后较差且有长期后遗症，是一个严重的医学问题。强调了病毒学诊断的重要性和实用性，特别是在呼吸道合胞病毒感染引起的毛细支气管炎流行期间，快速DFTA技术在急性期的应用。
