REVIEW ON A MICROBIOLOGICAL SURVEY AND LI TERATURE - VIRAL ETIOLOGY OF COLD, PHARYNGITIS AND OTITIS-MEDIA IN INFANTS - A PROSPECTIVE-STUDY (WINTER 1995-96) RESULTS

The viral aetiology of cold, pharyngitis and otitis media was evaluate d in children under 5 years of age, in a prospective study carried out in Lyon and Bordeaux during winter 1995-96. Nasal and pharyngeal swab s were collected from sick outpatients and mailed for laboratory exami nation (Ag detection and culture). Patients examined in general practi ce through the GROG network (regional groups for observation of influe nza) were added to 116 patients enrolled in the survey (ORPHE) mainly children in hospital consultation. 34.4% of patients (n=285) suffering from febrile cold and pharyngitis were infected with a virus (Influen za A, B, RSV, Parainfluenza, Adeno, Rhino, Echo and HSV), and 29.1% of patients (n=141) with AMO or otalgia. Otitis associated with influenz a A and RSV coincided with outbreaks. The results confirm the little d ata found in literature. Differences in viral incidence are related to : the inclusion of the children, their age, the epidemiological variat ions, and the performance of laboratory tests. Gene amplification test s (PCR or RT.PCR) would improve their efficacy. The presence of virus in MEF, experimental infections in animals and adults volunteers reinf orce the hypothesis of AMO pathogenicity. The virus alone is able to p roduce AMO; frequently they are associations between virus and pathoge nic bacteria (suppuration is rarely seen). The viral infection initiat es the bacterial infection by destroying cilia on ciliated cells, and allowing bacterial colonization. The prevention of viral infection in children (i.e. influenza) through vaccination, significantly reduced t he incidence oi AMO during the epidemic period of influenza. Mycoplasm a pneumoniae was associated to pharyngitis and otitis (3.5%) and was f requently present in viral infection. Chlamydia pneumoniae was rarely detected (3 cases).