85 KB229 KB25 KB200220262008Sočan, Majaštevilka:1letnik:477 stranistr. 1-7ISSN:0351-0026COBISSID:1972709URN:URN:NBN:SI:doc-YRTSVUYZslInštitut za varovanje zdravja Republike SlovenijeZdravstveno varstvochilddihalainfekcijelaboratorijska diagnostikaotrocirespiratorni sincicijski virusUvedba laboratorijskega spremljanja respiratornega sincicijskega virusa v Sloveniji| Introduction of laboratory-based surveillance of respiratory syncytial virus in Slovenia|Background: Respiratory syncytial virus (RSV) is the most common causative agent of acute lower respiratory tract infections in infants and young children worldwide. RSV causes bronchiolitis with life-threatening complications. The majority of RSV infections occur in the winter period. A humanized monoclonal antibody palivizumab was developed to prevent RSV diseaseand RSV hospitalization in high-risk children. The availability of palivizumab for preventing RSV infection stresses the importance of RSV surveillance, which should involve monitoring the onset, peak and termination of the RSV season, and determining optimal time for palivizumab administrationin children who fulfill the criteria for RSV prophylaxis. Material and methods: In Slovenia, laboratory RSV surveillance was introduced in the 2006/2007 RSV season. All public health laboratories in the country agreed to participate in the programme. RSV surveillance is implemented in the following laboratories: regional public health institutes of Maribor, Celje, Kranj, Koper and Novo mesto, the laboratory of virology of the Institute of Public Health, the microbiology laboratory of the Nova Gorica Hospital and the laboratory of the Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana. All these laboratories enter the number of patients tested and the number of RSV positive cases on a password-protected web site on a weekly basis. Results: From October 2006 to April 2007, 3,796 patients were tested for RSV infection, and 719 (18.9 %) were found to be positive. The first RSV positive samples were confirmed in week 42. The percentage of positive samples was steadly increasing and reachedits peak at the end of January/beginning of February (week 5, year 2007). The highest incidence rate of acute respiratory infections in children less than four years of age was recorded in the same week. Three weeks later, during the period of intensive circulation of influenza A virus, acute respiratory infections in this age group reached approximately the same incidence rate as during the full-blown RSV epidemic. Conclusion: Laboratory based RSV surveillance has an important supportive role in defining the timingof palivizumab administration in children who fulfill the criteria for prophylaxis. We plan to continue RSV surveillance in forthcoming seasonsIzhodišča: Respiratorni sincicijski virus (RSV) je najpogostejši povzročitelj akutnih okužb spodnjih dihal dojenčkov in majhnih otrok v prvem letu življenjain pogost povzročitelj bronhiolitisa z življenjsko nevarnimi zapleti.Pojavlja se v zimskem času. S humaniziranim monoklonskim protitelesompalivizumabom je možno preprečiti okužbo z RSV in posledično hospitalizacijo pri otrocih z visokim tveganjem. Z epidemiološkim spremljanjemRSV je potrebno ugotoviti začetek, obdobje kroženja in prenehanje sezone RSV ter določiti optimalen čas za dajanje palivizumaba pri otrocih, ki izpolnjujejo merila za prejemanje palivizumaba. Material in metode: V Sloveniji smo pričeli v sezoni 2006/2007 z laboratorijskim spremljanjem okužb z RSV. Vsi mikrobiološki laboratoriji, ki izvajajo testiranje na RSV v Sloveniji, vnesejo podatek o številu testiranih bolnikov (RSV pozitivnih in RSV negativnih) na spletno stran, ki je dostopna preko gesla. Podatke vnašajo:Inštitut za mikrobiologijo in imunologijo Medicinske fakultete v Ljubljani, mikrobiološki laboratoriji zavodov za zdravstveno varstvo Maribor, Celje, Kranj, Koper, Novo mesto in laboratorija Splošne bolnišnice v Novi Gorici ter Laboratorij za viruse Inštituta za varovanje zdravja. Rezultati: V Sloveniji je bilo od oktobra 2006 do začetka aprila 2007 testiranih 3796 bolnikov. RSV okužbo smo potrdili pri 719 (18,9 %) bolnikih. V tej sezoni smo prve primere RSV okužbe opazili že v 42. tednu, delež pozitivnih je postopno naraščal in dosegel vrh v zadnjih dneh januarja in začetku februarja (5. teden2007). V istem obdobju smo zaznali najvišjo incidenco akutnih okužb dihalpri otrocih do 4. leta starosti. Skoraj enako visoka incidenca akutnih okužb dihal je bila pri otrocih te starostne skupine tri tedne kasneje, ko je intenzivno krožil virus influence. Zaključki: Ugotavljamo, da je laboratorijsko spremljanje RSV pomembna podpora odločitvi o začetku dajanja palivizumaba otrokom, ki izpolnjujejo merila, zato želimo v prihodnje s tem nadaljevatiTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaInštitut za varovanje zdravja RS