PEDIATRICS Vol. 36 No. 1 July 1965, pp. 21-39
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ACUTE RESPIRATORY DISEASE IN INFANCY AND CHILDHOOD: PRESENT UNDERSTANDING AND PROSPECTS FOR PREVENTION

E. Mead Johnson Address, October, 1964

Robert M. Chanock M.D.1 and Robert H. Parrott M.D.2

1 Department of Health, Education and Welfare, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Laboratory of Infectious Diseases, Bethesda, Maryland.
2 Research Foundation, Children's Hospital of the District of Columbia

DURING the past ten years there has been an exponential increase in our understanding of the etiology and epidemiology of acute respiratory disease. Unfortunately development of the means for control of these illnesses has not kept pace with etiologic or epidemiologic understanding. In this presentation an attempt will he made to summarize the role of a number of viruses and mycoplasmas in acute respiratory disease of infancy and childhood. In addition the ecology of such infections will be discussed, particularly those aspects of infection which have relevance to the problem of immunoprophylaxis.

Much of the information to be discussed is derived from studies at the Children's Hospital of D.C. and the Junior Village Welfare Nursery of D.C. In many instances similar findings have been reported from other localities so that the conclusions which can be drawn from the Washington, D.C., studies would appear to have more than local significance. Since the Washington D.C., studies represent the longest continuous inquiry into the nature of acute pediatric respiratory disease primary emphasis will be placed on the interpretation of these findings.

Bacteria

Although group A beta hemolytic streptococci play an important role in upper respiratory tract disease it would appear that these organisms are relatively unimportant in the more serious types of illness in which lower respiratory tract involvement occurs. The careful studies of Babe, Beem, and co-workers indicate that pathogenic bacteria are not important primary etiologic agents in lower respiratory tract disease of infancy and childhood. For this reason major emphasis in this presentation will be given to the role of viruses and mycoplasmas in respiratory disease.




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