CORRESPONDENCE
BRIEWE

The season cometh ... yet again!

Dhamend Lutchman

Abbott Laboratories PO Box 7208 Weltevreden Park Roodepoort 1715. dhamend.lutchman@abbott.com

To the Editor: Although respiratory viral infections are much studied and their impact on health care is well understood in developed countries, there is an information hiatus regarding their burden in developing countries.¹ From the public health point of view, it would be valuable to know which viruses are the most common causative agents, what their disease manifestations are, how frequently viruses alone cause severe respiratory infection, what interplay occurs between viruses and bacteria, and how severe lower respiratory infections could be prevented.²

Studies on respiratory viruses in developing countries focus mainly on influenza and respiratory syncytial virus (RSV). A study by Nokes et al.³ provides valuable information on RSV in the developing world, but data on other respiratory viral infections in child and adult populations are needed. These data are important for planning intervention strategies because respiratory viruses also cause substantial morbidity and mortality, and the populations of resource-poor countries may be vulnerable to respiratory viral infections because of co-morbidities.²

Rhinoviruses and enteroviruses are the most common cause of respiratory infections in developed countries, but remarkably few data are available on the role of these picornaviruses in respiratory tract infections in the developing world. It is now time to plan studies to determine the burden of the range of respiratory viruses in the developing world, including South Africa. The World Health Organization (and by default, the South African Department of Health) should have on its priority list, in addition to influenza, other major respiratory viruses, including RSV, rhinovirus, enteroviruses and picornaviruses.

However, setting priorities in health research investments in South Africa is sometimes nebulous because the criteria of relevance to scientists and technical experts, whose knowledge and technical expertise is usually central to the process of research, may not be appropriate to specific contexts and in accordance with the views and values of those who invest in health research, those who benefit from it, or wider society as a whole. And while this may be the prevailing sad truth, nearly 100 000 children under 5 years of age continue to die each year in South Africa.⁴