Epidemiology and Infection

Original Papers

Pneumonia and other respiratory infections

Incidence of respiratory pathogens in persons hospitalized with pneumonia in two provinces in Thailand

S. J. OLSENa1 c1, S. THAMTHITIWATa2, S. CHANTRAa3, M. CHITTAGANPITCHa4, A. M. FRYa5, J. M. SIMMERMANa5, H. C. BAGGETTa2, T. C. T. PERETa6, D. ERDMANa6, R. BENSONa7, D. TALKINGTONa8, L. THACKERa7, M. L. TONDELLAa7, J. WINCHELLa7, B. FIELDSa7, W. L. NICHOLSONa9, S. MALONEYa2, L. F. PERUSKIa2, K. UNGCHUSAKa10, P. SAWANPANYALERTa4 and S. F. DOWELLa11

a1 Division of Emerging Infections and Surveillance Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a2 International Emerging Infections Program, Thailand MOPH – US CDC Collaboration, Nonthaburi, Thailand

a3 Crown Prince Hospital, Sa Kaeo, Thailand

a4 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Thailand

a5 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a6 Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a7 Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a8 Division of Foodborne, Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a9 Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

a10 Bureau of Epidemiology, Ministry of Public Health, Thailand

a11 Division of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

SUMMARY

Although pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking. Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand. Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine. Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died. A recognized pathogen was identified in 42·5% of episodes. Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children. The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100 000 per year) and in persons aged ⩾50 years, influenza virus A (38·8/100 000 per year). These data can help guide health policy towards effective prevention strategies.

(Accepted March 01 2010)

(Online publication March 31 2010)

Correspondence:

c1 Author for correspondence: S. J. Olsen, Ph.D., Centers for Disease Control and Prevention 1600 Clifton Road, MS C12, Atlanta, GA 30333, USA. (Email: SOlsen@cdc.gov)

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