Influenza A and B virus infection in infants and young children during the years 1957-1976.

Influenza A virus activity was demonstrated in infants and young children from metropolitan Washington, DC during each of 19 successive August-July respiratory disease years, and during 17 of these years at least 2% of hospitalized respiratory disease patients yielded an influenza A or B virus and/or showed an influenza A or B serum complement-fixing (CF) antibody response. Between October 1957 and July 1976, 14.3% of 860 croup patients and 5.3% of a total of 5655 hospitalized respiratory patients, including croup patients, showed evidence of influenza A or B infection. The mean period of hospitalization with either virus was about 8 days, though serious infection with influenza A virus was 4.5 times more common than with influenza B virus. Both influenza viruses were detected more frequently in respiratory disease outpatients than in respiratory disease inpatients. Patients with serious influenza A virus infections were especially likely to have croup (particularly during the H3N2 era), to be seen during December through February, and to be black male infants. During the peak month of a composite of 13 consecutive influenza A virus outbreaks, influenza A virus infection was demonstrated in 67.6% of croup patients and in 35.6% of all hospitalized respiratory patients including croup patients. During the peak month of a composite of 6 consecutive influenza B virus outbreaks, influenza B virus infection was demonstrated in 36.0% of croup patients and in 10.8% of all hospitalized respiratory disease patients including croup patients.     

儿童甲型和乙型流行性感冒早期血常规特征分析

目的 分析儿童流行性感冒(流感)病例的临床特点, 探讨血常规在甲型流行性感冒(甲流)、乙型流行性感冒(乙流)初期的临床应用价值, 为临床诊疗提供依据。方法 收集2018年12月-2019年4月西安交通大学第二附属医院儿科急诊在流感流行季节接诊的流感样病例, 采集鼻/咽拭子应用流感病毒抗原检测试剂盒(胶体金法)进行抗原检测, 同时对外周静脉血进行血细胞计数、形态分析, 统计分析甲流、乙流与普通感冒的流行特征及不同年龄患儿血常规中不同细胞类型的特点。结果 共收集流感样病例442例, 依据流感胶体金法快速检测结果分为甲流187例, 乙流60例, 上呼吸道感染(上感)195例, 3组一般资料比较差异无统计学意义(P>0.05)。甲流和乙流患儿以高热为主, 而上呼吸道感染则以中等热度多见(χ²＝89.46, P<0.001);不同年龄组间上呼吸道感染患儿白细胞总数、血小板计数、中性粒细胞计数、淋巴细胞计数明显高于甲流和/或乙流患儿, 6岁以下上呼吸道感染患儿单核细胞百分比较甲流患儿低, 6～14岁的上呼吸道感染患儿单核细胞百分比较甲流和(或)乙流患儿低, 婴幼儿流感患者体温越高单核细胞百分比越高, 与中低热组差异统计学意义。结论 与普通上感相比, 流行性感冒患儿发热以高热为主。血细胞分类计数有助于鉴别流行性感冒与上感。     

The black infant's susceptibility to sudden infant death syndrome and respiratory infection in late infancy

Between 2 and 11 months of age, the risk of sudden infant death syndrome (SIDS) declines more slowly in black infants than in infants of other races. This phenomenon might also be a feature of certain non-SIDS causes of death. Identifying these causes may through analogy provide support for the theory that SIDS is a disease of the central nervous system, an unusual consequence of respiratory infection, or a form of suffocation. We used logistic regression analysis on details of infant deaths in the United States, 1985-1991, to examine the difference between the rates of decline with increasing age in the mortality rates of black infants and infants of other races. We defined slower rate of decline in black infants as a positive difference. The magnitude and direction (positive) of the difference for deaths due to respiratory infection were similar to those for SIDS. It is unlikely that this difference in the rates of decline for respiratory infection can be explained by diagnostic cross-misclassification between respiratory infection and SIDS. SIDS appears to be a disease of the respiratory system caused by infection that affects that system's control centers.     

Influenza surveillance by age and target group.

Surveillance for influenza virus infections began in mid-1976, continued through three small influenza A outbreaks (mixed A/Victoria and A/Texas outbreaks in Spring, 1977, and Winter, 1977-1978 and an A/USSR outbreak peaking in March, 1978). Nasopharyngeal specimens were collected for virus isolation from febrile respiratory disease patients coming from four sources: 1) the Sunday walk-in clinic of the Group Health Cooperative of Puget Sound; 2) 200 families under continuous surveillance for respiratory viral infections; 3) patients referred by interested community physicians or self-referred persons in vaccine evaluation studies; and 4) students presenting at the University of Washington health center. Influenza virus isolation rates were as high in children as adults and peaked earlier in adults than in children in all three epidemics. Although referred patients and university students yielded the highest isolation rate, nearly 30%, all four community sources were important in detecting an impending epidemic.     

A comparison of influenza and respiratory syncytial virus infections among infants admitted to hospital with acute respiratory infections.

Among 741 children under 5 years admitted to hospital with respiratory infections during two winters, infection with influenza A virus was diagnosed in 70 (9%), with influenza B virus in 8 (1%), and with respiratory syncytial virus (RSV) in 259 (35%). Both influenza virus and RSV infections were diagnosed most frequently in children under the age of one year, and diagnosed more frequently in males than females. Influenza illnesses were more severe in boys than girls. Both infections occurred more often, but were not more severe, in children from a conurbation than in those from 'rural' areas. Convulsions were the cause of 36% of admissions with influenza A infections, but were rare in RSV infections. Bronchiolitis was the reason for 39% of admissions with RSV infections, but was rare in influenza infections. It is suggested that infants admitted to hospital are a good source of influenza virus strains for monitoring antigenic variation.     

Viral diagnoses using the rapid immunofluorescence technique and epidemiological implications of acute respiratory infections among children in different European countries

From November 1978 to October 1981, a total of 7716 specimens of nasopharyngeal secretions were examined by the rapid immunofluorescence technique to determine the frequency of infections caused by the respiratory syncytial virus (RSV), influenza virus A, and parainfluenza viruses 1 and 3. The tests were carried out in six different virus laboratories located in Newcastle upon Tyne (England), Copenhagen, Oslo, Stockholm, Turku (Finland), and Vienna; laboratories in Lisbon and Paris participated in the study for shorter periods. The specimens were collected from infants and children less than 6 years of age who had been admitted to hospital with an acute respiratory infection. Standardized techniques and quality controlled reagents were used. At least one of the above viruses was detected in 1927 (25%) of the specimens: RSV in 1475, influenza virus A in 123, parainfluenza virus 1 in 110, and parainfluenza virus 3 in 237 specimens. Respiratory syncytial virus dominated in all centres, but in some Scandinavian centres distinct outbreaks due to this virus occurred only once or twice during the 3 years'' study period. Three outbreaks of RSV were observed in Newcastle, but here an unprecedented delay of the first winter''s epidemic occurred. The delay was associated with prolonged school closures in the area, and with a very early outbreak of influenza. Parainfluenza virus 3, which was predominantly a summer virus in Newcastle, was most frequently encountered during the colder months of the year in the other centres.     

The Tecumseh Study of Respiratory Illness. IX. Occurence of influenza in the community, 1966--1971.

The occurrence of types A and B influenza infections was determined by isolation and serology over six years among residents of Tecumseh, Michigan. By isolation, there was evidence of type A infection for a limited period during each year of the study; most rises in titer were detected during the periods of viral isolation, but some also occurred out of season. Outbreaks of type B infection were encountered three times during the six-year period and out of season infections were less frequently seen than with type A. Infection rates with type A were relatively flat over the age range, with high rates seen in infants and small children; in contrast, highest infection rates with type B were observed in the 5--14-year-olds. On examination of illness rates, it was found that some of the outbreaks wound have gone undetected if surveillance techniques for infection had not been in operation. Frequency of respiratory illness with activity restriction was taken as a guide to influenza virus activity during outbreaks; it was found that highest rates of such illnesses occurred among the 1--4-year-olds for type A outbreaks, and among the 5--9-year-olds during mixed or type B outbreaks.     

Seasonal trends of viral respiratory tract infections in the tropics.

To evaluate the seasonal trends of viral respiratory tract infections in a tropical environment, a retrospective survey of laboratory virus isolation, serology and immunofluorescence microscopy in two large general hospitals in Singapore between September 1990 and September 1994 was carried out. Respiratory tract viral outbreaks, particularly among infants who required hospitalization, were found to be associated mainly with respiratory syncytial (RSV) infections (72%), influenza (11%) and parainfluenza viruses (11%). Consistent seasonal variations in viral infections were observed only with RSV (March-August) and influenza A virus (peaks in June, December-January). The RSV trends were associated with higher environmental temperature, lower relative humidity and higher maximal day-to-day temperature variation. Although the influenza A outbreaks were not associated with meteorological factors, influenza B isolates were positively associated with rainfall. These data support the existence of seasonal trends of viral respiratory tract infections in the tropics.     

1 410例儿童呼吸道感染病原体分析

目的了解儿童急性呼吸道感染的病原体及其感染特点。方法选取某院2011年1-12月因急性呼吸道感染收治住院的患儿1 410例,采用直接免疫荧光法检测7种病毒（包括副流感病毒Ⅰ、Ⅱ、Ⅲ型,流感病毒A、B型,呼吸道合胞病毒和腺病毒）,培养法检测细菌。分析不同月份、年龄段儿童病毒感染率及其合并细菌感染情况。结果1 410份标本中,共检出病毒阳性594份（42.13%）,以呼吸道合胞病毒和腺病毒为主;检出细菌阳性258份（18.30%）。3、4、10、11月份病毒检出率较高（均＞50%）,7-9月病毒检出率较低（22.89%~31.40%）;1～3岁组病毒检出率较高（58.04%）,6～14岁组检出率较低（22.15%）。检出病毒混合感染阳性标本22份（1.56%）;单一病毒感染患儿合并细菌感染157例（27.45%）。流感病毒A、B型感染组合并细菌感染率较高,分别为47.06%、47.27%。结论儿童呼吸道病毒感染率与年龄和季节均相关;病毒感染后患儿合并细菌感染率较高,其中流感病毒A、B型感染更易合并细菌感染。     

北京地区2002年秋冬儿童急性上呼吸道感染爆发的病原学调查

目的 了解2002年11～12月北京地区急性上呼吸道感染爆发的病原。方法 收集2002年11～12月北京地区80例患急性上呼吸道感染儿童咽拭子标本,应用经典病毒学方法(病毒分离和血凝试验)进行流行性感冒(流感)病毒、副流感病毒、呼吸道合胞病毒及腺病毒分离鉴定,应用巢式聚合酶链反应方法进行流感病毒、呼吸道合胞病毒、腺病毒及肺炎支原体(Mp)的检测。结果 80例标本中检测到B流感病毒18例(阳性率22.5％)、A3型流感病毒2例(阳性率2.5％)、肺炎支原体13例(阳性率16.3％),未检测到A1型流感病毒、副流感病毒、呼吸道合胞病毒及腺病毒;其中2例同时检测到B型流感病毒与Mp,1例检测到A3型流感病毒与Mp。结论 B型流感病毒是此次儿童上呼吸道感染的首要病原,Mp感染是第二位病原。     

A seasonal association between SIDS deaths and kindergarten absences.

Data from linked birth and death certificates from the State of Oregon were used to determine the monthly distribution of deaths from sudden infant death syndrome (SIDS) for the years 1976 through 1984. The monthly number of SIDS deaths increased in winter and decreased in summer, when schools usually are not in session. Absences from kindergarten were determined from school records for the period 1979-84. School absences, previously shown to reflect incidence of predominantly infectious diseases, were found to be positively correlated with occurrences of SIDS. The role of ordinarily nonlethal infections in occurrences of SIDS has been established by history, histology, and viral isolation. The authors concluded that the seasonality of SIDS is related to the seasonality of respiratory infections and that the seasonality is influenced by respiratory infections being spread from school children to infants during periods when schools are in session.     

非核苷类抗病毒药-盐酸阿比朵尔

流感是由流感病毒引起的一种危害人类健康的急性呼吸道传染病,发病率占有所呼吸道传染病的首位,往往造成季节性全球或局部地区大流行.流感还可引起很多合并症,如继发细菌感染,引起咽喉炎、中耳炎、鼻窦炎和支气管炎.严重感染者可引起病毒性肺炎,尤其是对老年人、慢性病人和小孩.流感还可使原有的慢性病加重,包括心脏病、肺病、肾脏疾病和...     

儿童社区获得性肺炎病原学研究

目的研究郑州地区儿童社区获得性肺炎（community acquired pneumonia,CAP）的病原学种类及分布,为儿童CAP的预防和控制提供科学依据。方法对368例CAP患儿行痰培养及病毒检测并进行分析比较。结果368例痰液标本中病原体检出率为76．3％（281例）,其中细菌感染139例,病毒感染95例,细菌、病毒混合感染47例;细菌感染中以流感嗜血杆菌和肺炎链球菌为主;病毒感染则以呼吸道合胞病毒和流感病毒为主,3岁以下儿童呼吸道合胞病毒和流感病毒是其主要致病原,且于秋冬季节多发。结论郑州地区儿童CAP主要是由细菌感染引起的,流感杆菌是主要的致病菌,病毒感染则以呼吸道合胞病毒和流感病毒为主,3岁下儿童易患CAP。     

呼和浩特地区急性呼吸道病毒感染的病原学构成调查

目的:调查呼和浩特地区急性呼吸道病毒感染的病原学构成情况。方法:收集呼和浩特地区2009年-2011年急性呼吸道感染病例标本561份,采用多重PCR方法检测15种急性呼吸道感染常见病毒。结果:检测的561份样本中171份为阳性,阳性检出率为30.48%;8份为混合感染病例,占阳性样本的4.68%。阳性样本中以流感病毒和腺病毒为主,一年四季中均可检出。病毒检出率最高的是4月-6月份。呼吸道病毒的检出率在散居儿童中较高,达到48.15%。结论:近3年来,引起呼和浩特地区急性呼吸道疾病的主要病原以流感病毒为主,其次是腺病毒。     

Epidemiologic comparisons of the sudden infant death syndrome with other major components of infant mortality

All 1998 resident infant deaths in the 1969--1977 King County, Washington birth cohort of 139,132 resident live births comprise the data base for epidemiologic comparisons of the sudden infant death syndrome (SIDS) with eight other major infant mortality components: hyaline membrane disease; respiratory distress syndrome; asphyxia of the newborn; immaturity; birth injury; congenital malformation; infection; and "all other." These components were compared with respect to age at death; sex; race; prior fetal loss; prior live-born, now dead; birth plurality; birth weight; maternal age; birth order; marital status; prenatal care; and season of death in an attempt to determine the uniqueness of these purported SIDS risk factors. Only the age at death distribution unequivocally distinguished SIDS from the other components. The combination of low maternal age and multiparity was demonstrated to be putatively synergistic for risk of SIDS, hyaline membrane disease, and respiratory disease syndrome. Only deaths from infection exhibited seasonal variation similar to SIDS. These observations probably reflect secondary associations with as yet unidentified primary risk factors relatable to maternal experience.     

Human coronavirus OC43 causes influenza-like illness in residents and staff of aged-care facilities in Melbourne, Australia

Three outbreaks of respiratory illness associated with human coronavirus HCoV-OC43 infection occurred in geographically unrelated aged-care facilities in Melbourne, Australia during August and September 2002. On clinical and epidemiological grounds the outbreaks were first thought to be caused by influenza virus. HCoV-OC43 was detected by RT-PCR in 16 out of 27 (59%) specimens and was the only virus detected at the time of sampling. Common clinical manifestations were cough (74%), rhinorrhoea (59%) and sore throat (53%). Attack rates and symptoms were similar in residents and staff across the facilities. HCoV-OC43 was also detected in surveillance and diagnostic respiratory samples in the same months. These outbreaks establish this virus as a cause of morbidity in aged-care facilities and add to increasing evidence of the significance of coronavirus infections.     

A seven-year study of WHO virus laboratory reports on respiratory viruses

In 1963 the World Health Organization established a system for the collection and distribution of information on viruses. By 1973 laboratories in 45 countries were participating in this scheme. The present study is an analysis of the reports on adenovirus, influenza viruses A, B, and C, parainfluenza virus, respiratory syncytial (RS) virus, rhinovirus, and Mycoplasma pneumoniae during 1967-73. In the northern hemisphere, from which over 95% of the reports were received, a clear pattern of the seasonal incidence of different respiratory tract infections emerged. Over 70% of the total number of reported adenovirus infections, over 80% of the parainfluenza virus infections, and over 90% of the RS virus infections were in children. M. pneumoniae infections were most frequently reported in adults. Influenza A virus infection was predominant in the adult population, with a high proportion in those aged 60 years and over. Influenza B infections were reported equally in adults and children, but over one third were in children of school age. The proportion of lower respiratory infections to total respiratory infections varied from one virus to another, and ranged from less than half for adenovirus to over four fifths for mycoplasma infections. Nonlocalizing fever was usually the second principal clinical condition reported in association with respiratory viruses.     

Sudden infant death syndrome: does winter affect poor and rich babies equally?

STUDY OBJECTIVE--The aim was to investigate whether the winter increase in risk of sudden infant death was similar across social classes. DESIGN--This was an unmatched case-control study using routine data. SETTING--Cases and controls were selected from files holding routine birth and death certificate data for England and Wales for 1986. SUBJECTS--Cases were deaths in the first year of life occurring in the summer or the winter of 1986 with mention of sudden infant death or SIDS in the death certificate. Controls were a 1% random sample of all children born in the same year. Only children whose parents were married or living together at the time of birth registration were included. MAIN RESULTS--Data on age and season of death for cases, and on date of birth, social class of father, and birth weight were abstracted from the file. Season of birth and birth weight were treated as confounding variables. The increase in risk of SIDS in winter was calculated for each age group and social class. The winter increase in SIDS was more marked among the higher social classes for all ages, but not to a statistically significant degree: the p values for heterogeneity were 0.26 for age 0-3 months, 0.42 for 4-7 months, and 0.41 for 8-12 months. CONCLUSIONS--There is no direct association between seasonal variation in sudden infant death and social class.     

Ten years of viral and non-bacterial serology in adults with cystic fibrosis

Viral infections are associated with pulmonary exacerbations in children with cystic fibrosis (CF), but few studies have addressed the frequency in adults. This paper investigates the frequency and impact of viral infections in adults with CF receiving intravenous antibiotics. Pre- and post-treatment spirometry, inflammatory markers and antibody titres against influenza A, influenza B, adenovirus, respiratory syncytial virus, Mycoplasma pneumoniae, Chlamydia psittaci, and Coxiella burnetti were analysed over a 10-year period. Non-bacterial infections were identified in 5.1% of 3156 courses of treatment. The annual incidence of admissions per patient associated with viral infection was 4.9%. The presence of viral infection in association with a pulmonary exacerbation did not adversely affect lung function or inflammatory markers in the short term. Adults with CF have a lower incidence of respiratory viral infections associated with pulmonary exacerbations requiring intravenous antibiotics compared to children and infants with CF.     

Upper respiratory tract infection in children, domestic temperatures, and humidity.

STUDY OBJECTIVE--The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN--Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING--The study was carried out in one general practice of 10,000 patients. PATIENTS--297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS--Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS--No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required.