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Human influenza A and B viruses, parainfluenza viruses 1, 2, 3, 4, respiratory syncytial virus, Coronavirus, Metapneumovirus, and Rhinovirus are enveloped RNA viruses responsible for infection of upper and lower respiratory tract with significant health consequences to children, elderly, and immune compromised patients. They all cause bronchiolitis and pneumonia.

Respiratory viral diseases account for approximately 200,000 hospitalizations during the flu season (November through to March) and an average of 23,600 deaths.1 These diseases most commonly affect infants and young children and can be fatal, especially in infants less than 1 year of age; adults may also be affected with the highest risk for disease severity and mortality among the elderly. 2 Among immune compromised patients respiratory viral disease can result in increased heart and lung-related hospitalizations and other influenza-related complications, ultimately resulting in death.3

Human Adenovirus, a non-enveloped DNA virus, is a frequent cause of acute upper respiratory tract infections and affects babies and young children much more frequently than adults. It also causes a number of other types of infection: conjunctivitis, keratoconjunctivitis, gastroenteritis. However, most infections are asymptomatic.

Severe adenovirus infections have been reported in immune compromised patients, such as transplant patients and those with inherited and acquired immunodeficiency states.

Mycoplasma pneumoniae is recognized as a common cause of community-acquired pneumonia (CAP). It also causes tracheobronchitis or bronchiolitis, often accompanied by upper respiratory tract manifestations. Large outbreaks of Mycoplasma pneumoniae tend to occur in late summer and autumn, accounting for as many as 50% of all pneumonias.4

1. FLU.gov. (2011). The Current Flu Situation. Retrieved from http://www.flu.gov/individualfamily/about/current/index.html
2. Centers for Disease Control and Prevention [CDC]. (2011). CDC Features: Flu Season is Here Vaccinate. Retrieved from http://www.cdc.gov/Features/FLU/
3. Centers for Disease Control and Prevention [CDC]. (2011). Seasonal Influenza (Flu). People at High Risk of Developing Flu-Related Complications. Retrieved from http://www.cdc.gov/flu/about/disease/high_risk.htm
4. McCormack WM. Infections due to Mycoplasmas. In: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison's Principles of Internal Medicine. 16th ed. New York: McGraw-Hill; 2005:1008-11, 159.

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