***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : To determine virologically confirmed hospitalization rates associated with respiratory syncytial virus ( RSV ) , adenovirus , and parainfluenza viruses in Hong Kong children . Methods : All patients < 18 years of age living on Hong Kong Isl and ( within Hong Kong SAR ) admitted for a febrile acute respiratory infection to 1 of the 2 public hospitals on 1 fixed day of the week between October 2003 and September 2006 were prospect ively recruited . Hong Kong Isl and has a known population denominator and these 2 hospitals managed 72.5 % of all general pediatric admissions for this population . Nasopharyngeal aspirates were tested for  RSV , adenovirus , and parainfluenzae types 1 , 2 , and 3  by direct antigen detection and culture . Results : The annual hospitalization rate for RSV in infants < 6 months of age was 233.4 to 311.2 per 10,000 . Parainfluenza type 3 had a hospitalization rate of 27.3 to 122.8 per 10,000 in the 1 to < 2 years group . Adenovirus was associated with significant hospitalization in those 6 months to 1 year ( 25.9–77.8 per 10,000 ) , and in those 2 to < 5 years ( 38.1–59.2 per 10,000 ) . The mean duration of hospitalization for RSV was 4.04 ± 2.61 days , significantly longer than the 3.12 ± 1.41 days for adenovirus and the 2.93 ± 2.54 days for parainfluenza infections ( P = 0.013 and P = 0.038 , respectively ) . Conclusion : We documented that the overall pediatric hospitalization burden of RSV was high and comparable to that of influenza . The burden for all the studied viruses was mainly in previously healthy children < 5 years of age OBJECTIVE To explore the distribution and clinical manifestations of rhinovirus infection in wheezing children , and compare the clinical differences between rhinovirus- and respiratory syncytial virus-induced wheezing . MATERIAL S AND METHODS This prospect i ve cohort study was carried out in Children 's Hospital of Soochow University from Dec 2012 to Nov 2014 . We enrolled consecutive hospitalized children < 60 months of age presented with wheezing . Clinical data including cough , fever , dyspnea , crackles were recorded by pediatricians on the first day of admission . Meanwhile , nasopharyngeal aspirates were obtained to test for respiratory viruses , by using polymerase chain reaction method for rhinovirus , human bocavirus , and human metapneumovirus , and direct immunofluorescence assay to test for respiratory syncytial virus , adenovirus , parainfluenza virus types 1 - 3 , and influenza virus types A and B. RESULTS Rhinovirus was a main causative agent isolated in 14.7 % of the hospitalized wheezing children in Suzhou , China , being second to respiratory syncytial virus ( 21.0 % ) . Different from respiratory syncytial virus infection , which peaked in winter months , rhinovirus could be detected all year round , peaked between July and September , and in November . Children with rhinovirus infection were older and presented with more often allergic sensitizations , blood eosinophilia , and leukocytosis than those of respiratory syncytial virus infection . Logistic regression analysis revealed that rhinovirus-infected children experienced earlier wheezing more often than respiratory syncytial virus children ( odds ratio , 3.441 ; 95 % confidence interval , 1.187 - 9.979 ; p=0.023 ) . CONCLUSION Rhinovirus was a main viral pathogen in wheezing children , especially in summer time . Rhinovirus-induced wheezing was different from respiratory syncytial virus , apart from seasonal epidemics ; these two groups differed with regard to age , allergic sensitizations , laboratory test , and history of wheezing episodes Background Human respiratory syncytial virus ( RSV ) is an important community and nosocomial pathogen in developed countries but data regarding the importance of RSV in developing countries are relatively scarce . Methods During a 1-year surveillance study in 2010 , we took serial sample s from children admitted to the Emergency Unit of the Respiratory Ward of Children 's Hospital 1 in Ho Chi Minh City , Vietnam . RSV was detected within 72 hours of admission to the ward in 26 % ( 376/1439 ; RSV A : n = 320 ; RSV B : n = 54 ; and RSV A and B : n = 2 ) . Among those negative in the first 72 hours after admission , 6·6 % ( 25/377 ) acquired nosocomial RSV infection during hospitalization ( RSV A : n = 22 ; and RSV B : n = 3 ) . Results Children with nosocomial RSV infection were younger ( P = 0·001 ) and had a longer duration of hospitalization ( P < 0·001 ) . The rate of incomplete recovery among children with nosocomial RSV infection was significantly higher than among those without ( P < 0·001 ) . Phylogenetic analysis of partial G gene sequences obtained from 79 % ( 316/401 ) of positive specimens revealed the co-circulation of multiple genotypes with RSV A NA1 being predominant ( A NA1 : n = 275 ; A GA5 : n = 5 ; B BA3 : n = 3 ; B BA9 : n = 26 ; and B BA10 : n = 7 ) . The RSV A GA5 and RSV B BA3 genotypes have not been reported from Vietnam , previously . Conclusion Besides emphasizing the importance of RSV as a cause of respiratory infection leading to hospitalization in young children and as a nosocomial pathogen , data from this study extend our knowledge on the genetic diversity of RSV circulating in Vietnam Background and objective Clinical characteristics of human bocavirus ( HBoV ) infection have been studied worldwide , but their importance of those characteristics remains unknown . We investigated distinctive clinical features of  HBoV-positive children with lower respiratory tract infection ( LRTI ) . Methods and results During April 2007–July 2009 , for 402 hospitalized children younger than 2 years with LRTI , we prospect ively examined virus genomes in nasopharyngeal swabs for HBoV , respiratory syncytial virus ( RSV ) , rhinovirus , metapneumovirus , parainfluenzavirus , and adenovirus . The HBoV genomes were identified in 34 patients ( 8.5 % ) . Clinical and laboratory data of HBoV-positive and other virus/bacteria-negative patients ( n = 18 ) were analyzed and compared with data of RSV-single positive patients ( n = 99 ) . The seasonal distribution of HBoV exhibits a concentration of cases during March – September , with most RSV cases occurring during winter in Japan . The minimum age of HBoV-positive patients was 5 months , although 44 patients ( 44 % ) with RSV were younger than 6 months . The main clinical features were respiratory distress and hypoxia . Hypoxia advances within 3 days after onset . The mean oxygen saturation on arrival was 92.8 % , which was significantly lower than that in patients with RSV ( p < 0.001 ) . White blood cell counts were similar among groups . However , the percentage of neutrophils in white blood cells were significantly higher in HBoV-positive patients ( 62 vs. 45 % , p < 0.001 ) . Their prognoses were good . Their hospital stays were 6.6 days . Conclusions HBoV-single positive patients show several clinical characteristics , such as seasonality , age , hypoxia , and neutrophilia , which differ from those with RSV infection Summary In a multicenter , prospect i ve case-control study involving 1758 children aged < 5 years in developing and emerging countries , the main microorganisms associated with pneumonia were Streptococcus pneumoniae , human metapneumovirus , rhinovirus , and respiratory syncytial virus Background The dominant viral etiologies responsible for acute respiratory infections ( ARIs ) are poorly understood , particularly among hospitalized children in re source -limited tropical countries where morbidity and mortality caused by ARIs are highest . Improved etiological insight is needed to improve clinical management and prevention . Objectives We conducted a three-year prospect i ve descriptive study of severe respiratory illness among children from 2 months to 13 years of age within the largest referral hospital for infectious diseases in southern Vietnam . Methods Molecular detection for 15 viral species and subtypes was performed on three types of respiratory specimens ( nose , throat swabs and nasopharyngeal aspirates ) using a multiplex RT-PCR kit ( Seeplex ™ RV detection , Seegene ) and additional monoplex real-time RT-PCRs . Results A total of 309 children were enrolled from November 2004 to January 2008 . Viruses were identified in 72 % ( 222/309 ) of cases , including respiratory syncytial virus ( 24 % ) , influenza virus A and B ( 17 % ) , human bocavirus ( 16 % ) , enterovirus ( 9 % ) , human coronavirus ( 8 % ) , human metapneumovirus ( 7 % ) , parainfluenza virus 1–3 ( 6 % ) , adenovirus ( 5 % ) , and human rhinovirus A ( 4 % ) . Co-infections with multiple viruses were detected in 20 % ( 62/309 ) of patients . When combined , diagnostic yields in nose and throat swabs were similar to nasopharyngeal aspirates . Conclusion Similar to other parts in the world , RSV and influenza were the predominant viral pathogens detected in Vietnamese hospitalized children . Combined nasal and throat swabs are the specimens of choice for sensitive molecular detection of a broad panel of viral agents . Further research is required to better underst and the clinical significance of single versus multiple viral coinfections and to address the role of bacterial (co-)infections involved in severe respiratory illness Since the initial discovery of RSV-A ON1 in Canada in 2010 , ON1 has been reported worldwide , yet information regarding its clinical impact and severity has been controversial . To investigate the clinical relevance of RSV-A ON1,acute  respiratory infection ( ARI ) cases enrolled to our population -based prospect i ve pediatric ARI surveillance at Khanh Hoa General Hospital , Central Vietnam from January 2010 through December 2012 were studied . Clinical -epidemiological information and nasopharyngeal sample s were collected . Multiplex PCR assays were performed for screening 13 respiratory viruses . RSV-positive sample s were further tested for subgroups ( A/B ) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region . Statistical analysis was performed to evaluate the clinical -epidemiological characteristics of RSV-A ON1 . A total of 1854 ARI cases were enrolled and 426 ( 23.0 % ) of them were RSV-positive . During the study period , RSV-A and B had been co-circulating . NA1 was the predominant RSV-A genotype until the appearance of ON1 in 2012 . RSV-related ARI hospitalization incidence significantly increased after the emergence of ON1 . Moreover , multivariate analysis revealed that risk of lower respiratory tract infection was 2.26 ( 95 % CI : 1.37–3.72 ) times , and radiologically-confirmed pneumonia was 1.98 ( 95 % CI : 1.01–3.87 ) times greater in ON1 compared to NA1 cases . Our result suggested that ON1 ARI cases were clinical ly more severe than NA1 BACKGROUND Respiratory syncytial virus ( RSV ) is the most important viral pathogen in infants and children . It is important to analyze RSV epidemic patterns and related relevant factors in order to prevent further infections and related complications . OBJECTIVE To explore the relationship between RSV infection rate in hospitalized children from Suzhou area and climatic factors . STUDY DESIGN 42,664 nasopharyngeal specimens from hospitalized children with acute respiratory infections were screened for RSV antigens using direct immunofluorescence .  472 RSV positive sample s were r and omly selected and performed real-time PCR to identify RSV subtype . Monthly meteorological data in Suzhou area was collected ( average temperature , relative humidity , precipitation , total sunshine , and average wind speed ) from 2001 to 2011 . The relation between RSV infections and climatic factors was evaluated using correlation and stepwise regression analyses . RESULTS The annual RSV infection rate in hospitalized children in Suzhou from 2001 to 2011 varied between 11.85 % and 27.30 % . The highest monthly infection rates occurred from November to April . The time interval from November to April was considered the infection season . Seasonal RSV infection rates from 2001 to 2010 were 40.75 % , 22.72 % , 39.93 % , 27.37 % , 42.71 % , 21.28 % , 38.57 % , 19.86 % , and 29.73 % . 
    Output:
    
The seasonality of RSV in the WPR countries follows the latitude , with the peak of RSV season occurring in the winter in temperate countries , and during the rainy season in tropical countries .