2008-2012年武汉市儿童流行性感冒病毒及呼吸道合胞病毒流行特征
2008-2012년무한시인동류행성감모병독급호흡도합포병독류행특정
Epidemiological characteristics of influenza virus and respiratory syncytial virus among children in Wuhan area from 2008 to 2012
  • 万方数据
    中华预防医学杂志 중화예방의학잡지
    CHINESE JOURNAL OF
    2013年 5期 415-419 ,共5页

    王英%张玉%孔雯骅%朱洪浩%林新明%余滨%胡权%缪小平%郭德银

    왕영%장옥%공문화%주홍호%림신명%여빈%호권%무소평%곽덕은

    正黏病毒科%呼吸道合胞体病毒,人%儿童 正黏病毒科%呼吸道閤胞體病毒,人%兒童
    정점병독과%호흡도합포체병독,인%인동
    Orthomyxoviridae%Respiratory syncytial virus,human%Child
    目的 了解2008-2012年武汉市14岁及以下流行性感冒(简称流感)样症状患儿流感病毒和呼吸道合胞病毒(RSV)的感染情况及病毒流行特征.方法 于2008年7月至2012年6月在武汉市某医院门诊和急诊患者中,选择14岁以下的流感样病例作为研究对象,共2854例.研究对象各采集1份咽拭子标本,共采集2854份.从流感样病例咽拭子标本中提取病毒核酸,应用实时荧光定量逆转录PCR (RT-PCR)对流感病毒和RSV进行核酸检测和亚型鉴定,分析两种病毒感染的时间和年龄特征.结果 2854例患儿检测流感病毒阳性758例,阳性率为26.6％.其中,甲型流感病毒阳性547例(19.2％)、乙型流感病毒阳性211例(7.4％).流感病毒每年流行呈双峰特征,即夏季峰和冬春季峰.6～ 14岁组患儿流感病毒检测阳性率为48.0％(275/573),明显高于3～5岁组[26.6％ (213/801)]和3岁以下组[18.3％ (270/1480)],差异有统计学意义(x2=187.432,P＜0.01).患儿中RSV检测阳性219例,阳性率为7.7％,其中,RSV-A阳性108例,RSV-B阳性112例,混合感染1例.RSV流行呈明显的季节性,发病主要集中在秋、冬、春季,占全部发病病例的96.8％(212/219),每年流行情况波动较大.RSV-A、RSV-B交替流行,交替周期为2年,2008年9月至2009年5月及2009年12月至2010年3月以RSV-B感染为主,分别占76.6％(36/47)和96.9％(62/64)；2010年11月至2011年3月及2011年9月至2012年4月以RSV-A感染为主,分别占92.5％(37/40)和100.0％(48/48).但随着年龄的增长,RSV-A和RSV-B阳性率不断下降(RSV-A:x2=36.223,P ＜0.01；RSV-B:x2=36.281,P＜0.01),其中,RSV-A在＜1、1、2、3、4、5 ～9、10～ 14岁年龄组阳性率分别为7.0％ (26/373) 、5.9％ (39/662) 、4.0％ (18/445) 、3.2％ (13/406)、1.3％(3/236)、1.4％(7/517)、0.9％ (2/215)；RSV-B在各年龄组的阳性率分别为6.4％(24/373) 、6.0％(40/662)、4.5％(20/445)、4.4％(18/406)、1.3％(3/236)、1.0％(5/517) 、0.9％(2/215).0～3岁组RSV阳性197例,占RSV阳性患者总数的90.0％(197/219).2009年11月甲型H1N1流感暴发流行时,RSV阳性率为3.0％ (3/100),低于2008、2010、2011年同月份RSV检测阳性率[分别为18.2％ (6/33)、10.8％ (10/93) 、10.0％ (4/40)],差异有统计学意义(x2=8.450,P＜0.05)；2011年1月甲型H1N1流感暴发流行时,RSV阳性率为5.7％(3/53),低于2009、2010、2012年同月份RSV检测阳性率[分别为21.7％(5/23) 、28.6％(22/77)、16.0％(8/50)],差异有统计学意义(x2=11.233,P＜0.05)；2011年9月,流感夏季峰缺失时,RSV检测阳性率为25.0％(10/40),高于2008、2009、2010年同月份RSV检测阳性率[分别为11.4％ (4/35) 、1.7％ (2/118)、0.0％ (0/109)],差异有统计学意义(x2=32.521,P ＜0.01).结论 流感病毒和RSV是武汉地区流感样患儿重要的病原,两种病毒流行的季节性、年龄分布等特征各不相同,流感病毒对RSV的流行存在着一定的抑制作用.
    목적 료해2008-2012년무한시14세급이하류행성감모(간칭류감)양증상환인류감병독화호흡도합포병독(RSV)적감염정황급병독류행특정.방법 우2008년7월지2012년6월재무한시모의원문진화급진환자중,선택14세이하적류감양병례작위연구대상,공2854례.연구대상각채집1빈인식자표본,공채집2854빈.종류감양병례인식자표본중제취병독핵산,응용실시형광정량역전록PCR (RT-PCR)대류감병독화RSV진행핵산검측화아형감정,분석량충병독감염적시간화년령특정.결과 2854례환인검측류감병독양성758례,양성솔위26.6％.기중,갑형류감병독양성547례(19.2％)、을형류감병독양성211례(7.4％).류감병독매년류행정쌍봉특정,즉하계봉화동춘계봉.6～ 14세조환인류감병독검측양성솔위48.0％(275/573),명현고우3～5세조[26.6％ (213/801)]화3세이하조[18.3％ (270/1480)],차이유통계학의의(x2=187.432,P＜0.01).환인중RSV검측양성219례,양성솔위7.7％,기중,RSV-A양성108례,RSV-B양성112례,혼합감염1례.RSV류행정명현적계절성,발병주요집중재추、동、춘계,점전부발병병례적96.8％(212/219),매년류행정황파동교대.RSV-A、RSV-B교체류행,교체주기위2년,2008년9월지2009년5월급2009년12월지2010년3월이RSV-B감염위주,분별점76.6％(36/47)화96.9％(62/64)；2010년11월지2011년3월급2011년9월지2012년4월이RSV-A감염위주,분별점92.5％(37/40)화100.0％(48/48).단수착년령적증장,RSV-A화RSV-B양성솔불단하강(RSV-A:x2=36.223,P ＜0.01；RSV-B:x2=36.281,P＜0.01),기중,RSV-A재＜1、1、2、3、4、5 ～9、10～ 14세년령조양성솔분별위7.0％ (26/373) 、5.9％ (39/662) 、4.0％ (18/445) 、3.2％ (13/406)、1.3％(3/236)、1.4％(7/517)、0.9％ (2/215)；RSV-B재각년령조적양성솔분별위6.4％(24/373) 、6.0％(40/662)、4.5％(20/445)、4.4％(18/406)、1.3％(3/236)、1.0％(5/517) 、0.9％(2/215).0～3세조RSV양성197례,점RSV양성환자총수적90.0％(197/219).2009년11월갑형H1N1류감폭발류행시,RSV양성솔위3.0％ (3/100),저우2008、2010、2011년동월빈RSV검측양성솔[분별위18.2％ (6/33)、10.8％ (10/93) 、10.0％ (4/40)],차이유통계학의의(x2=8.450,P＜0.05)；2011년1월갑형H1N1류감폭발류행시,RSV양성솔위5.7％(3/53),저우2009、2010、2012년동월빈RSV검측양성솔[분별위21.7％(5/23) 、28.6％(22/77)、16.0％(8/50)],차이유통계학의의(x2=11.233,P＜0.05)；2011년9월,류감하계봉결실시,RSV검측양성솔위25.0％(10/40),고우2008、2009、2010년동월빈RSV검측양성솔[분별위11.4％ (4/35) 、1.7％ (2/118)、0.0％ (0/109)],차이유통계학의의(x2=32.521,P ＜0.01).결론 류감병독화RSV시무한지구류감양환인중요적병원,량충병독류행적계절성、년령분포등특정각불상동,류감병독대RSV적류행존재착일정적억제작용.
    Objective To investigate the infection status and epidemiological characteristics of influenza virus and respiratory syncytical virus (RSV) in influenza-like illness (ILI) of children ≤14 years) in Wuhan area from 2008 to 2012.Methods A total of 2854 cases of ILI patients ≤ 14 years) in a hospital of Wuhan were recruited in the study from July 2008 to June 2012.The sample of pharyngeal swab was collected from each patient,to extract the virus nucleic acids.Real-time fluorescent quantitation reverse transcription PCR (RT-PCR) method was applied to detect the subtypes of influenza virus and RSV,and then analyzed the time and age characteristics.Results Out of the 2854 cases,758 (26.6％) were positive for influenza virus,including 547 (19.2％) influenza A virus positive samples and 211 (7.4％) influenza B virus positive samples.Usually,there were two peaks present in the annual curve of influenza virus,namely summer peak and winter/spring peak.The positive rate of influenza virus in 6-14 years old children (48.0％,275/573) was significantly higher than that in 3-5 years old children (26.6％,213/801) and that under 3 years old children (18.3％,270/1480).The difference showed statistical significance (x2 =187.432,P ＜0.01).A total of 219 (7.7％) cases were positive for RSV,including 108 RSV-A positive samples and 112 RSV-B positive samples (1 co-infection).The epidemic of RSV showed an obvious seasonal pattern with peaks in autumn,winter and spring,which accounted for 96.8％ (212/219) of all the cases; however,the annual incidence of RSV fluctuated greatly.The predominant subtype shifted every 2 years.RSV-B predominated during September 2008 and May 2009,December 2009 and March 2010,accounting for 76.6％ (36/47) and 96.9％ (62/64) respectively.RSV-A predominated during November 2010 and March 2011,September 2011 and April 2012,accounting for 92.5％ (37/40) and 100.0％ (48/48) respectively.With the increase of the age,the positive rate of RSV-A and RSV-B decreased gradually (RSV-A:x2 =36.223,P ＜ 0.01 ; RSV-B:x2 =36.281,P ＜0.01).The positive rates of RSV-A in children ＜ 1,1,2,3,4,5-9 and 10-14 years old were 7.0％(26/373),5.9％ (39/662),4.0％ (18/445),3.2％ (13/406),1.3％ (3/236),1.4％ (7/517)and 0.9％ (2/215) respectively; while,the positive rates of RSV-B in each age group were 6.4％ (24/373),6.0％ (40/662),4.5％ (20/445),4.4％ (18/406),1.3％ (3/236),1.0％ (5/517)and 0.9％(2/215) respectively.The children aged 0-3 years old were more susceptible for RSV infection,aceounting for 90.0％ (197/219) of the total positive samples.During the outbreak of influenza A H1N1 in November 2009,the positive rate of RSW was 3.0％ (3/100),lower than that in the same month of 2008,2010 and 2011,which were separately 18.2％ (6/33),10.8％ (10/93) and 10.0％ (4/40).The difference showed statistical significance (x2 =8.450,P ＜ 0.05).During the outbreak of influenza A (H1N1) in January 2011,the positive rate of RSV was 5.7％ (3/53),lower than those in the same month of 2009,2010 and 2012,which was separately 21.7％ (5/23),28.6％ (22/77) and 16.0％ (8/50).The difference showed statistical significance (x2 =11.233,P ＜ 0.05).During the period of less influenza happened in September 2011,the RSV positive rate was 25.0％ (10/40),higher than those in the same month of 2008,2009 and 2010,which was separately 11.4％ (4/35),1.7％ (2/118) and 0.0％ (0/109).The difference showed statistical significance (x2 =32.521,P ＜ 0.01).Conclusion Both influenza virus and RSV were important etiological agents of ILI of children in Wuhan.The characteristics of seasonal and age distributions of the two viruses were notably different; meanwhile,a certain inhibitional effect of influenza virus on RSV could be observed.
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문