oa Detection of Early Infection with Flu Viruses in Patients with Bronchial Asthma and COPD in Winter Season in the State of Qatar

Flu infections are viral infections of the upper and lower respiratory tract which are an important cause of morbidity in patients with bronchial asthma, chronic obstructive pulmonary disease (COPD), old age and other chronic medical conditions, usually occur in outbreaks mainly during the winter season, and require inpatient and outpatient care. Objectives: 1) understanding the viral etiologies of respiratory tract infection among patients who presented to chest clinic during the winter season from first October 2008-31 March 2009 with the diagnosis of asthma and/or COPD. 2) While Hamad Medical Corporation laboratory uses Immune Fluorescent Assay (IFA) to test for five viruses: Respiratory syncytial virus (RSV), influenza A & B virus, Para-influenza virus and Adenovirus, an objective of this study was to develop and evaluate a new diagnostic test using Real-time PCR to detect 15 viruses simultaneously. Those are: Flu A&B; Corona viruses (Cor63, 229 & 43), Parainfluenza viruses (para1,2,3&4), Human metapneumovirus (Hump A and B), Rhinovirus (rhino), RSV(A & B) and adenovirus (AV)). Methods: Nasal swabs were collected (to detect upper respiratory viruses). Patient's personal data as well as diagnosis and medical history were gathered using questionnaires filled by the doctor treating the patients at the time of the nasal swab. These questionnaires were analyzed using SPSS V.14. Results: The sample size consisted of 200 patients, 18 years of age or older, with asthma and/or COPD. Out of the 200 patients, 190 had asthma and 10 had COPD. However, only 36 patients had viruses related to respiratory tract infection; 31 of which had asthma and 5 had COPD. It was found that the Rhino viruses are the most predominant respiratory viruses. Additionally, using Real-time PCR enabled the detection of more than five viruses at the same time with similar sensitivity and specificity when compared to the Immune Fluorescent Assay.

Conclusions: To our knowledge, this is the first report of respiratory tract viral infections from Qatar. Detection of these infections may have significant clinical implications in the study population. Additionally, it was found that the new diaginostic-respiratory detection by real-time PCR technique was able to detect more than five viruses at the same time compared with the (IFA) with similar sensitivity and specificity.