Open Access Highly Accessed Research article

Respiratory viruses from hospitalized children with severe pneumonia in the Philippines

Akira Suzuki1*, Socorro Lupisan2, Yuki Furuse1, Naoko Fuji1, Mariko Saito3, Raita Tamaki3, Hazel Galang2, Lydia Sombrero2, Melisa Mondoy2, Rapunzel Aniceto3, Remigio Olveda2 and Hitoshi Oshitani1

Author Affiliations

1 Department of Virology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan

2 Research Institute for Tropical Medicine, Department of Health Compound, FILINVEST Corporate City, Alabang, Muntinlupa City, Philippines

3 Collaborating Research Center for Emerging and Reemerging Infectious Diseases, Department of Health Compound, FILINVEST Corporate City, Alabang, Muntinlupa City, Philippines

For all author emails, please log on.

BMC Infectious Diseases 2012, 12:267  doi:10.1186/1471-2334-12-267

Published: 23 October 2012



Pneumonia remains a leading cause of child death in developing countries. The viruses in severe pneumonia remain poorly defined.


The study was conducted at the Eastern Visayas Regional Medical Center in Tacloban City, Philippines from May 2008 to May 2009. Patients aged 8 days to 13 years old who were admitted to the Department of Pediatrics with severe pneumonia were enrolled for the study. Upon admission, polymerase chain reaction was performed using nasopharyngeal swabs and blood cultures to detect respiratory viruses and bacteria, respectively.


Among the 819 patients enrolled, at least one virus was detected in 501 cases (61.2%). In addition, 423 cases were positive for a single virus while bacteria were detected in the blood culture sample of 31 cases. The most commonly detected viruses were human rhinoviruses (n = 189), including types A (n = 103), B (n = 17), and C (n = 69), and respiratory syncytial virus (RSV) (n = 165). Novel viruses such as human metapneumovirus, human coronavirus NL63, human bocavirus, and human polyomaviruses WU and KI were also detected. There were 70 deaths, and one or more viruses were detected in 35 (50%) of these cases. Positivity only for influenza A virus (OR = 4.3, 95% CI = 1.3-14.6) was significantly associated with fatal outcome. From the blood culture, Burkholderia cepacia group (n = 9), Streptococcus pneumoniae (n = 4), Staphylococcus aureus (n = 4), Haemophilus influenzae (n = 1), and Salmonella C1 (n = 1) were also isolated.


Viruses were commonly detected in children with severe pneumonia in the Philippines. Hence, viral etiologies should be considered while developing better effective strategies to reduce child pneumonia-related deaths in developing countries.