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.     

Diagnosis and epidemiological surveillance of influenza and respiratory syncytial virus infections: interest of multiplex PCR

OBJECTIVE: Respiratory infections require a rapid etiological diagnosis for efficient management of cases. We evaluated multiplex PCR used for the diagnosis and the epidemiological surveillance of influenza and respiratory syncytial virus (RSV) infections. PATIENTS AND METHODS: Our study included 278 patients (mean age: 37.2+/-22.9 years) with flu or flu-like syndromes, consulting physicians affiliated with the GROG Poitou-Charentes or hospitalized in the Poitiers teaching hospital. A multiplex PCR detecting A(H3), A(H1) and B influenza viruses, and RSV A and B, was performed with both a direct examination by immunofluorescence and cell-culture. RESULTS: We diagnosed a viral infection in 139 (50.0%) patients: 99 cases of influenza A(H3), 2 cases of influenza A(H1), 28 cases of influenza B and 11 cases of RSV infections. The diagnosis yield in GROG patients (52.3%) was significantly higher than that observed in hospitalized patients (34.5%) (P=0.04). All techniques were correlated in 61% of cases. The multiplex PCR yielded 22.3% more positive samples compared to the conventional techniques. All positive samples by conventional techniques were also positive by multiplex PCR. We observed a perfect correlation between viral types and subtypes determined by PCR and cell-culture. CONCLUSION: Multiplex PCR is a sensitive technique allowing an efficient and rapid diagnosis of respiratory infections due to influenza and RSV.     

6810例儿童呼吸道感染病毒病原学回顾性分析

目的 了解海安市儿童呼吸道病毒病原学特征.方法 回顾性分析南通大学附属海安医院2018年1月至2020年5月急性呼吸道感染6810例患儿临床资料,采用直接免疫荧光法检测7种常见呼吸道病毒抗原.结果 ①6810例送检标本中957例为阳性,总阳性率为14.05％.其中呼吸道合胞病毒(RSV)阳性例数最多,为524例(54....     

2016—2018年53 851例急性呼吸道感染儿童七项病毒检测结果分析

目的 了解2016—2018年湖南省儿童医院就诊病人常见呼吸道病毒感染病原谱及病例流行病学特征。 方法 2016年1月—2018年12月期间,采集湖南省儿童医院门诊和住院病人急性呼吸道感染儿童鼻咽拭子标本,采用直接免疫荧光法对副流感病毒1-3型、呼吸道合胞病毒、流感病毒A与B型和腺病毒共七项呼吸道病毒抗原进行检测,对病例信息进行统计学分析。 结果 共采集检测病例53 851例,总阳性检出率为23.25%(12 519/53 851),副流感病毒1-3型、呼吸道合胞病毒、流感病毒A与B型和腺病毒阳性检出率分别为0.68%、0.10%、5.63%、13.44%、1.51%、0.74%和1.15%,呼吸道合胞病毒阳性率最高(χ²=23 427.78,P<0.001)。不同年份七项呼吸道病毒检出率存在差异(χ²=196.21,P<0.001);总阳性检出率冬季最高,夏季最低;呼吸道合胞病毒和副流感病毒3型阳性检出率随着时间波动较大,存在明显的季节性;年龄越小,总阳性检出率越高,0~1岁阳性检出率最高为29.93%;七项总阳性检出率男性高于女性(P=0.003),呼吸道合胞病毒阳性检出率男性高于女性(P=0.013)其它各项呼吸道病毒阳性检出率没有性别差异(P>0.05)。 结论 2016—2018年急性呼吸道感染儿童七项病毒阳性检出率存在明显差异,不同年份、不同季节、不同年龄、不同性别七项呼吸道病毒检出率亦存在差异,研究有助于临床诊断和制定预防感染的措施。     

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.     

Surveillance of respiratory virus infections in adult hospital admissions using rapid methods

Both influenza and respiratory syncytial virus (RSV) cause epidemics of respiratory illness of variable severity during the winter season. Influenza in particular has been blamed for hospital winter bed pressures, although it is thought that RSV may also play a role. Human metapneumovirus (hMPV) is a new respiratory virus reported to be important in children; only a limited number of studies are available for adult populations. We aimed to determine initially the burden of virologically confirmed infections, i.e. influenza, RSV and hMPV using polymerase chain reaction (PCR) technology and, in addition, to assess the feasibility of this approach as a surveillance tool for these respiratory viruses. Adult patients admitted to hospital in the previous 24 hours with onset of acute respiratory symptoms in the last 14 days were asked to participate. Informed written consent was obtained and nose and throat swabs taken. Multiplex PCR for influenza A (H1N1 and H3N2), influenza B and RSV A and B were carried out together with a separate PCR for hMPV. A total of 219 patients in 2001-2002 and 216 in 2002-2003 were tested and the combined results for both seasons were: 8 positive for influenza A/H1N1, 14 for influenza A/H3N2, 2 for influenza B, 14 for RSV A and 6 for RSV B. Most patients (261/435) were >65 years and most positives (30/44) were found within this age group. A number of patients aged >65 years who were positive for influenza (12/15) reported having had vaccine. In total, 373 samples were tested for hMPV and 20 were found positive across all age groups except the 45-54 years age group. As influenza activity was low during the study period the impact of infection on admissions could not be assessed. Nevertheless the viruses studied accounted for 15% of hospital admissions for respiratory infection. Most patients were aged >65 years, as expected. In the two years studied RSV and hMPV were each responsible for as many hospitalized cases of respiratory infection as influenza. Influenza infection must be considered even in those who give a history of vaccination. The molecular methods used in this study showed that surveillance of these respiratory viruses can be conducted and may help in the management of patients.     

婴幼儿急性下呼吸道感染的病原学研究

目的探婴幼儿急性下呼吸道感染(ALRI)的病毒病原学.方法采用直接免疫荧光法检测2209例急性下呼吸道感染患儿呼吸道诱导痰中脱落纤毛柱状上皮细胞中的呼吸道合胞病毒、流感病毒A型及B型、副流感病毒l、2、3型、腺病毒.结果2209例ALRI患儿中,病毒感染阳性率46.22%,其中主要为呼吸道合胞病毒(RSV)感染,其次为流感病毒和副流感病毒.婴幼儿病毒性ALRI好发于冬春季节.结论病毒感染在本地区ALRI中占重要地位.RSV是冬春季节婴幼儿ALRI的主要病原体,其次是流感病毒和副流感病毒.     

多重逆转录聚合酶链反应检测主要上呼吸道病毒

目的：建立用多重逆转录聚合酶链反应（mRT-PCR）检测甲1型、甲3型、乙型流感病毒以及呼吸道全胞病毒（RSV）A型、B型等主要上呼吸道病毒的方法，以快速检测上呼吸道感染主要病毒及对甲型、甲亚型、乙型流感病毒在上海地区人群感染、流行情况设计。方法：采用经MDCK细胞接种培养的甲3型、乙型流感病毒和Hep-2细胞接种培养的RSV A型、B型标准毒株病毒液，以及甲1型、甲3型、乙型流感病毒和RSV A型、B型混合毒株病毒液，使用5组引物，分别为HA1-5al和Hal-3al（甲1型流感病毒）、HA3-5al和HA3-3al和HA3-3al（甲3型流感病毒）、NP-5b1和NP-3bl（乙型流感病毒）、RSVAF和RSVAR(RSVA型)、RSVBF和RSVBR(RSVB型)，经mRT-PCR，琼脂糖凝胶电泳，于紫外灯下观察上述病毒特异核苷酸条带。结果：甲1型、甲3型、乙型流感病毒，RSVA型、B型分别在431，210，390，334，183bp处出现清晰的5条DNA条带。结论：应用5组引物，mRT-PCR可用于快速检测临床上呼吸道感染标本中的流感病毒和RSV，并可对其进行分型，对上呼吸道病毒感染性疾病的诊断和流感的监测方面是非常重要的。     

Respiratory syncytial virus infection and meningococcal disease.

Although viral respiratory tract infections may predispose to meningococcal disease, strong evidence that they do so exists only for influenza. Data on laboratory reported cases of respiratory syncytial virus (RSV) infections and meningococcal disease in England and Wales from mid-1989 to mid-1994 were analysed. Although the rise in RSV cases preceded the rise in meningococcal disease cases each winter, the interval between the rise and fall of the two diseases was inconsistent, no association was found between time series after removal of the seasonal component, and there was no evidence that more cases of meningococcal disease occurred in winters with more RSV disease. RSV may have less effect on the two most likely mechanisms whereby influenza predisposes to meningococcal disease, namely lowered immunity and impaired pharyngeal defences.     

420例患者感染7种常见呼吸道病毒抗原的检测

摘要:目的　探讨呼吸道感染患者病毒的分布情况,为临床早期诊断呼吸道病毒感染提供病原学依据。方法　采用直接免疫荧光法检测420例急性呼吸道感染患者的鼻咽深部分泌物,检测常见的合胞病毒（RSV）、腺病毒（ADV）、流感病毒A型（IVA）、流感病毒B型（IVB）、副流感病毒1、2、3（PIV1、2、3）。结果　在420例呼吸道感染患者鼻咽拭子中,检出呼吸道病毒92例,阳性率为21.9%,其中PIV3阳性率最高,为36.96%,其次是PIV2为22.83%、RSV为19.57%、PIV1为9.75%、ADV为5.43%、IVA为3.26%、IVB为2.17%。从季节分布来看,冬季阳性率最高,占63.04%,其次是秋季占21.74%,春季占10.87%,夏季占4.34%。从年龄来看,儿童组呼吸道病毒阳性率是32.23%,青少年和成年组病毒阳性率是17.73%,两组阳性率差异有统计学意义（P＜0.05）。结论　呼吸道病毒在冬季感染率最高,以PIV3为主;儿童呼吸道病毒感染率高于青少年和成年组,也是以PIV3为主。因此PIV3是本院呼吸道感染患者的主要病毒。     

应用系列呼吸道病毒单克隆抗体快速检测分泌物中的病毒抗原

应用系列主要时吸道病毒［呼吸道合胞病毒（ＲＳＶ），甲型流感（ＦｌｕＡ）、乙型流感（ＦｌｕＢ）、副流感１、３型（ＰＩＶ１．３）、副流感２型（ＰＩＶ２）病毒共６种］单克隆抗体（ＭｃＡｂ），联接ＡＰＡＡＰ桥联技术，深入部队对２６０例呼吸道感染青年战士的鼻咽部脱落细胞中的抗原进行检测。检出ＦｌｕＡ抗原１８例，ＰＩＶ２抗原１０例，ＦｌｕＢ和ＲＳＶ各１例。以上结果经间接免疫荧光（ＩＦＡ）以及阻断和替代试验，证实系列单克隆抗体检出抗原结果是特异的。笔者认为本方法是临床快速诊断以及流行病学调查的有效手段。     

冬春季住院患儿急性下呼吸道感染病毒学分析

目的:了解冬春季住院患儿急性下呼吸道感染(ARI)的病毒感染状况,为临床儿童急性呼吸道感染提供病毒病原学诊断依据。方法:选择2008年11月～2009年4月在九江市妇幼保健院呼吸内科住院的急性下呼吸道感染患儿,取其入院当天的静脉血,进行呼吸道病毒IgM检测,包括呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感病毒(IV)、副流感病毒(PIV),并对检测标本阳性的病例进行统计分析。结果:在151例患儿送检标本中,阳性37例,占24.5%(37/151)。阳性标本中呼吸道合胞病毒32例(86.5%),腺病毒1例(2.7%),流感病毒2例(5.4%),副流感病毒2例(5.4%)。RSV的发病高峰在12月至次年的1、2月份,RSV感染多见于3岁以下儿童,发病高峰年龄为6个月以下儿童,男、女发病比例为1.9∶1。结论:九江市妇幼保健院2008年11月～2009年4月住院患儿中,引起急性下呼吸道感染的病毒病原体以RSV为主,IV和PIV次之。     

某部急性呼吸道感染病原谱的流行特征

目的调查了解某部队急性呼吸道感染病原体流行情况,为疫情防控提供依据。方法采集该部队急性呼吸道症候群病例咽拭子、血清等标本,采用荧光定量PCR检测呼吸道常见病毒。结果 2年共检测呼吸道感染病例标本801份,阳性299份,阳性率为37.3%。其中2014年检测536份,阳性率为39.9%,病原体主要为季节性H3N2病毒(占57.5%)、腺病毒55型(占40.6%)和乙型流感病毒(占1.9%)。2015年检测265份,阳性率为32.08%,病原体主要为乙型流感病毒(占30.1%)、腺病毒7型(占27.1%)和甲型H1N1病毒(占23.5%),其他为冠状病毒OC43型(占16.5%)和NL63型(占1.2%)。结论当前该部急性呼吸道感染病原体以甲、乙型流感病毒、腺病毒为主,也有冠状病毒检出。做好部队呼吸道病原监测工作,对部队传染病的防控有重要意义。     

Surveillance of respiratory viral infections by rapid immunofluorescence diagnosis, with emphasis on virus interference

During the 7-year period from September 1978 to August 1985, smear specimens of nasopharyngeal secretions from 3132 patients mainly hospitalized children, taken in different regions in Norway, were examined for respiratory viruses by the rapid immunofluorescence (IF) technique. A positive diagnosis for respiratory syncytial virus (RSV), parainfluenza virus type 1, 2 and 3 or influenza A and B virus was made for 896 patients (29%). The greatest prevalence for all these viruses was observed during the colder months with only sporadic cases during the summer months. A relative increase in parainfluenza virus activity, involving several parainfluenza virus types, was observed in every second autumn and during these periods only sporadic cases of RSV infection were diagnosed. Also both RSV and parainfluenza viruses were less frequently found during influenza virus epidemics and regional differences in RSV activity were observed. During the four autumn periods 1982-85 the monthly number of positive virus identifications by IF followed an epidemic curve, while the corresponding number of negative samples was relatively constant. The results of this study suggest interference between RSV, parainfluenza viruses and influenza virus in reaching their epidemiological peaks. It is suggested that interferon might be a mediator of this effect.     

河北省2013-2015年急性上呼吸道感染病毒病原学构成研究

目的 了解河北省2013-2015年引起急性上呼吸道感染（acute upper respiratory infection,AURI）的病原学构成和流行病学特征,为呼吸道感染的诊断和防治工作提供科学依据。方法 采集河北省4家医院门诊就诊的AURI患者的咽拭子标本1 551份,提取核酸后采用多重实时荧光定量聚合酶链式反应（polymerase chain reaction,PCR）方法检测15种呼吸道病毒。结果 采集1 551份临床咽拭子标本,检测出阳性标本714例,阳性率为46.03%,其中鼻病毒阳性率最高,为186（11.99%）例,其次为副流感病毒3型167（10.77%）例、呼吸道合胞病毒122（7.87%）例、腺病毒108（6.96%）例、乙型流感病毒56（3.61%）例、人偏肺病毒40（2.58%）例、甲型流感病毒39（2.51%）例、人博卡病毒38（2.45%）例、副流感病毒1型35（2.26%）例、冠状病毒229E/NL63型33（2.13%）例、肠道病毒32（2.06%）例、副流感病毒4型31（2.00%）例、冠状病毒OC43型30（1.93%）例、副流感病毒2型11（0.71%）例。病毒混合感染病例176例,检出率为11.35%。5岁以下年龄组病毒阳性率最高为56.07%（337/601）。结论 河北省AURI主要以鼻病毒、副流感病毒3型、呼吸道合胞病毒、腺病毒、流感病毒为主,各病毒有各自的流行特征。     

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。     

Coronavirus-related nosocomial viral respiratory infections in a neonatal and paediatric intensive care unit: a prospective study

The incidence of nosocomial viral respiratory infections (NVRI) in neonates and children hospitalized in paediatric and neonatal intensive care units (PNICU) is unknown. Human coronaviruses (HCoV) have been implicated in NVRI in hospitalized preterm neonates. The objectives of this study were to determine the incidence of HCoV-related NVRI in neonates and children hospitalized in a PNICU and the prevalence of viral respiratory tract infections in staff. All neonates (age< or =28 days) and children (age>28 days) hospitalized between November 1997 and April 1998 were included. Nasal samples were obtained by cytological brush at admission and weekly thereafter. Nasal samples were taken monthly from staff. Virological studies were performed, using indirect immunofluorescence, for HCoV strains 229E and OC43, respiratory syncytial virus (RSV), influenza virus types A and B, paramyxoviruses types 1, 2 and 3 and adenovirus. A total of 120 patients were enrolled (64 neonates and 56 children). Twenty-two samples from 20 patients were positive (incidence 16.7%). In neonates, seven positive samples, all for HCoV, were detected (incidence 11%). Risk factors for NVRI in neonates were: duration of hospitalization, antibiotic treatment and duration of parenteral nutrition (P<0.01). Monthly prevalence of viral infections in staff was between 0% and 10.5%, mainly with HCoV. In children, 15 samples were positive in 13 children at admission (seven RSV, five influenza and three adenovirus) but no NVRI were observed. In spite of a high rate of community-acquired infection in hospitalized children, the incidence of NVRI with common respiratory viruses appears low in neonates, HCoV being the most important pathogen of NRVI in neonates during this study period. Further research is needed to evaluate the long-term impact on pulmonary function.     

广州地区儿童呼吸道病毒感染流行情况及混合感染调查

目的:了解广州地区儿童呼吸道感染的病毒流行特征及病毒混合感染的病原学构成。方法:2006年9月～2009年8月共收集720例起病3天内的呼吸道感染患儿鼻、咽拭子,应用荧光定量PCR方法检测标本中流感病毒(Flu)、副流感病毒(HPIV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、鼻病毒(HRV)、偏肺病毒(MPV)及冠状病毒(HCoV)等7种病毒的核酸。结果:①病毒总检出率为69.7%(502/720),检出率最高的前3种病毒为RSV(19.4%)、Flu(16.9%)和HRV(14.2%)。不同年龄组患儿同种病毒检出率比较差异有统计学意义(P<0.05)。②502例阳性标本中,83例(16.5%)检出两种病毒混合感染,7例(1.4%)检出3种病毒混合感染。不同年龄组患儿混合感染发生率比较差异有统计学意义(P<0.05)。③病毒混合感染高峰季节是春季和夏季,其中春季以RSV、HRV、Flu和MPV混合感染为主,夏季则以Flu、HRV和ADV混合感染为主。结论:RSV、Flu和HRV是广州地区儿童呼吸道感染的主要病原体,病毒混合感染以RSV和Flu最为常见,随不同年龄、不同季节有一定变化规律。