Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study

Objectives To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.Design Prospective, cross-sectional study.Setting 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Particip...

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Main Authors: L Gayani Tillekeratne, Ajith Nagahawatte, Ruvini Kurukulasooriya, Christopher W Woods, Sky Vanderburg, Gaya Wijayaratne, Nayomi Danthanarayana, Jude Jayamaha, Bhagya Piyasiri, Chathurangi Halloluwa, Tianchen Sheng, Sujeewa Amarasena, Bradly P Nicholson, Joseph S M Peiris, Gregory C Gray, Sunethra Gunasena, Champica K Bodinayake, Vasantha Devasiri
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e040612.full
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author L Gayani Tillekeratne
Ajith Nagahawatte
Ruvini Kurukulasooriya
Christopher W Woods
Sky Vanderburg
Gaya Wijayaratne
Nayomi Danthanarayana
Jude Jayamaha
Bhagya Piyasiri
Chathurangi Halloluwa
Tianchen Sheng
Sujeewa Amarasena
Bradly P Nicholson
Joseph S M Peiris
Gregory C Gray
Sunethra Gunasena
Champica K Bodinayake
Vasantha Devasiri
author_facet L Gayani Tillekeratne
Ajith Nagahawatte
Ruvini Kurukulasooriya
Christopher W Woods
Sky Vanderburg
Gaya Wijayaratne
Nayomi Danthanarayana
Jude Jayamaha
Bhagya Piyasiri
Chathurangi Halloluwa
Tianchen Sheng
Sujeewa Amarasena
Bradly P Nicholson
Joseph S M Peiris
Gregory C Gray
Sunethra Gunasena
Champica K Bodinayake
Vasantha Devasiri
author_sort L Gayani Tillekeratne
collection DOAJ
description Objectives To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.Design Prospective, cross-sectional study.Setting 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Participants 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018.Results We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality.Conclusions This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.
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institution Kabale University
issn 2044-6055
language English
publishDate 2020-11-01
publisher BMJ Publishing Group
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series BMJ Open
spelling doaj-art-ca59f8d5311243c79c9216daba05a47f2024-11-25T20:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-040612Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional studyL Gayani Tillekeratne0Ajith Nagahawatte1Ruvini Kurukulasooriya2Christopher W Woods3Sky Vanderburg4Gaya Wijayaratne5Nayomi Danthanarayana6Jude Jayamaha7Bhagya Piyasiri8Chathurangi Halloluwa9Tianchen Sheng10Sujeewa Amarasena11Bradly P Nicholson12Joseph S M Peiris13Gregory C Gray14Sunethra Gunasena15Champica K Bodinayake16Vasantha Devasiri17Duke Global Health Institute, Durham, North Carolina, USADuke Global Health Institute, Durham, North Carolina, USADepartment of Microbiology, University of Ruhuna Faculty of Medicine, Galle, Southern, Sri LankaDuke Clinical Research Institute, Durham, North Carolina, USAMedicine, Duke University School of Medicine, Durham, North Carolina, USAFaculty of Medicine, University of Ruhuna, Galle, Sri LankaTeaching Hospital Karapitiya, Galle, Sri LankaMedical Research Institute Sri Lanka, Colombo, Sri LankaTeaching Hospital Karapitiya, Galle, Sri LankaFaculty of Medicine, University of Ruhuna, Galle, Sri LankaRuhuna-Duke Centre for Infectious Diseases, University of Ruhuna Faculty of Medicine, Galle, Southern, Sri LankaFaculty of Medicine, University of Ruhuna, Galle, Sri LankaRuhuna-Duke Centre for Infectious Diseases, University of Ruhuna Faculty of Medicine, Galle, Southern, Sri LankaHong Kong University, Hong Kong, ChinaMedicine, Duke University School of Medicine, Durham, North Carolina, USAFaculty of Medicine, University of Ruhuna, Galle, Sri LankaDepartment of Medicine, University of Ruhuna Faculty of Medicine, Galle, Southern, Sri LankaRuhuna-Duke Centre for Infectious Diseases, University of Ruhuna Faculty of Medicine, Galle, Southern, Sri LankaObjectives To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.Design Prospective, cross-sectional study.Setting 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Participants 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018.Results We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality.Conclusions This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.https://bmjopen.bmj.com/content/10/11/e040612.full
spellingShingle L Gayani Tillekeratne
Ajith Nagahawatte
Ruvini Kurukulasooriya
Christopher W Woods
Sky Vanderburg
Gaya Wijayaratne
Nayomi Danthanarayana
Jude Jayamaha
Bhagya Piyasiri
Chathurangi Halloluwa
Tianchen Sheng
Sujeewa Amarasena
Bradly P Nicholson
Joseph S M Peiris
Gregory C Gray
Sunethra Gunasena
Champica K Bodinayake
Vasantha Devasiri
Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
BMJ Open
title Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
title_full Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
title_fullStr Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
title_full_unstemmed Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
title_short Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
title_sort outbreak of severe acute respiratory infection in southern province sri lanka in 2018 a cross sectional study
url https://bmjopen.bmj.com/content/10/11/e040612.full
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