Human metapneumovirus and respiratory syncytial virus, Brazil

We describe the epidemiologic and clinical characteristics of 111 children attending clinics and hospitals in Aracaju, northeast Brazil, with acute respiratory infections attributable to human metapneumovirus (HMPV), respiratory syncytial virus (RSV), or both in May and June 2002. Fifty-three (48%) children were infected with RSV alone, 19 (17%) with HMPV alone, and 8 (7%) had RSV/HMPV co-infections.     

Brucellosis as a cause of acute febrile illness in Egypt

To develop better estimates of brucellosis incidence, we conducted population-based surveillance for acute febrile illness (AFI) in Fayoum governorate (population 2347249), Egypt during two summer periods (2002 and 2003). All hospitals and a representative sample of community healthcare providers were included. AFI patients without obvious etiology were tested for brucellosis by culture and serology. Incidence estimates were calculated adjusting for sampling methodology and study period. Of 4490 AFI patients enrolled, 321 (7%) met the brucellosis case definition. The estimated annual incidence of brucellosis per 100000 population was 64 and 70 in 2002 and 2003, respectively. The median age of brucellosis patients was 26 years and 70% were male; 53% were initially diagnosed as typhoid fever. Close contact with animals and consumption of unpasteurized milk products were associated with brucellosis. The high incidence of brucellosis in Fayoum highlights its public health importance, and the need to implement prevention strategies in humans and animals.     

Human metapneumovirus and respiratory syncytial virus disease in children, Yemen

Factors increasing the severity of respiratory infections in developing countries are poorly described. We report factors associated with severe acute respiratory illness in Yemeni children (266 infected with respiratory syncytial virus and 66 with human metapneumovirus). Age, indoor air pollution, and incomplete vaccinations were risk factors and differed from those in industrialized countries.     

Human metapneumovirus detection in patients with severe acute respiratory syndrome

We used a combination approach of conventional virus isolation and molecular techniques to detect human metapneumovirus (HMPV) in patients with severe acute respiratory syndrome (SARS). Of the 48 study patients, 25 (52.1%) were infected with HMPV; 6 of these 25 patients were also infected with coronavirus, and another 5 patients (10.4%) were infected with coronavirus alone. Using this combination approach, we found that human laryngeal carcinoma (HEp-2) cells were superior to rhesus monkey kidney (LLC-MK2) cells commonly used in previous studies for isolation of HMPV. These widely available HEp-2 cells should be included in conjunction with a molecular method for cell culture followup to detect HMPV, particularly in patients with SARS.     

Early childhood lower respiratory illness and air pollution

BACKGROUND: Few studies of air pollutants address morbidity in preschool children. In this study we evaluated bronchitis in children from two Czech districts: Teplice, with high ambient air pollution, and Prachatice, characterized by lower exposures. OBJECTIVES: Our goal was to examine rates of lower respiratory illnesses in preschool children in relation to ambient particles and hydrocarbons. METHODS: Air monitoring for particulate matter < 2.5 microm in diameter (PM(2.5)) and polycyclic aromatic hydrocarbons (PAHs) was conducted daily, every third day, or every sixth day. Children born May 1994 through December 1998 were followed to 3 or 4.5 years of age to ascertain illness diagnoses. Mothers completed questionnaires at birth and at follow-up regarding demographic, lifestyle, reproductive, and home environmental factors. Longitudinal multivariate repeated-measures analysis was used to quantify rate ratios for bronchitis and for total lower respiratory illnesses in 1,133 children. RESULTS: After adjustment for season, temperature, and other covariates, bronchitis rates increased with rising pollutant concentrations. Below 2 years of age, increments in 30-day averages of 100 ng/m(3) PAHs and of 25 microg/m(3) PM(2.5) resulted in rate ratios (RRs) for bronchitis of 1.29 [95 % confidence interval (CI), 1.07-1.54] and 1.30 (95% CI, 1.08-1.58), respectively; from 2 to 4.5 years of age, these RRs were 1.56 (95% CI, 1.22-2.00) and 1.23 (95% CI, 0.94-1.62), respectively. CONCLUSION: Ambient PAHs and fine particles were associated with early-life susceptibility to bronchitis. Associations were stronger for longer pollutant-averaging periods and, among children > 2 years of age, for PAHs compared with fine particles. Preschool-age children may be particularly vulnerable to air pollution-induced illnesses.     

人偏肺病毒感染诊疗方案(2023年版)

<正>人偏肺病毒感染是人体感染人偏肺病毒(Human metapneumovirus, hMPV)后引起的一种急性呼吸道传染病,全年散发,多发生于冬末及春初。hMPV感染大多表现为轻度自限性疾病,部分患者因出现毛细支气管炎、肺炎、慢性阻塞性肺疾病(COPD)急性加重和支气管哮喘急性发作等并发症需要住院治疗,免疫功能低下者可进展为重症肺炎,出现急性呼吸窘迫综合征(ARDS)或多器官功能不全等,甚至导致死亡。     

Human metapneumovirus infections in children

Human metapneumovirus (hMPV) is an important cause of lower respiratory tract infections in hospitalized children, but the age-related incidence and effect of hMPV in unselected children in the community have not been evaluated. We studied a cohort of 1,338 children <13 years of age throughout 1 respiratory season in Finland during 2000-2001. We examined children and obtained a nasal swab for viral detection at any sign of respiratory infection. hMPV was detected in 47 (3.5%) of the 1,338 children. The age-related incidence of hMPV infection was highest (7.6%) in children <2 years of age, in whom hMPV accounted for 1.7% of all infections during the season. During the epidemic peak, hMPV caused 7.1% of all respiratory infections in the cohort. Acute otitis media developed in 61% of hMPV-infected children <3 years of age. Our findings demonstrate that the effect of hMPV in the community is greatest in children <2 years of age.     

Human metapneumovirus infections in hospitalized children

We evaluated the percentage of hospitalizations for acute respiratory tract infections in children < or =3 years of age attributable to human metapneumovirus (HMPV) and other respiratory viruses in a prospective study during winter and spring 2002. We used real-time polymerase chain assays and other conventional diagnostic methods to detect HMPV, human respiratory syncytial virus (HRSV), and influenza viruses in nasopharyngeal aspirates of children. HMPV was detected in 12 (6%) of the 208 children hospitalized for acute respiratory tract infections, HRSV in 118 (57%), and influenza A in 49 (24%). Bronchiolitis was diagnosed in 8 (68%) and pneumonitis in 2 (17%) of HMPV-infected children; of those with HRSV infection, bronchiolitiss was diagnosed in 99 (84%) and pneumonitis in 30 (25%). None of the HMPV-infected children was admitted to an intensive-care unit, whereas 15% of those with HRSV or influenza A infections were admitted. HMPV is an important cause of illness in young children with a similar, although less severe, clinical presentation to that of HRSV.     

Febrile illness associated with Rickettsia conorii infection in dogs from Sicily

We report serologic and molecular evidence of acute, febrile illness associated with Rickettsia conorii in 3 male Yorkshire terriers from Sicily (Italy).     

Experience of respiratory and allergic illness in children attending childcare

OBJECTIVES: To describe previous illness for children attending two types of formal childcare (130 family daycare homes and 11 child daycare centres). DESIGN: A questionnaire was completed by the parents of 846 children, which provided information about previous illness and associated factors. The questionnaire was conducted in Perth, Western Australia. RESULTS: Of all children, 39% had experienced otitis media, 11% glue ear and 26% allergies; 18% had been diagnosed with asthma; 10% had been admitted to hospital with respiratory illness, and 9% had experienced more than six respiratory conditions in the previous year. Attending centre daycare compared with family daycare was more likely to be associated with some of the previous illness outcomes (more than six respiratory illnesses in the past year, asthma, otitis media and glue ear) but, for all children, the major predisposing factors associated with these illnesses were a family history of atopy or bronchitis. CONCLUSIONS: Children with a history of respiratory illness or otitis media are more likely to be attending centre than family daycare, but family history of respiratory illness is an important risk factor for all children in childcare.     

上海市浦东新区363例老年流感样病例及严重呼吸道感染病例病毒病原谱特征分析

目的 了解上海市浦东新区老年流感样病例(ILI)和严重急性呼吸道感染(SARI)病例的流行病学及病毒病原谱特征,为制定老年人群流感防治策略提供依据。方法 在浦东新区设立4家医疗机构监测点开展老年ILI和SARI病例监测,每周采集部分病例呼吸道标本进行病毒核酸检测,检测项目包括人流感病毒(A、B、C型)、鼻病毒、人副流感病毒(1~4型)、呼吸道合胞病毒(A、B型)、人偏肺病毒、人腺病毒、人冠状病毒(hCoVs-229E,OC43,NL63,and HKU1)及人博卡病毒;同时调查每个采样病例的基本信息。采用用卡方检验或Fisher确切概率法比较不同人群的病原体检出情况。结果 2014年1月1日-2016年6月30日,共363例老年ILI/SARI病例纳入监测,其中男性202例(55.65%),年龄中位数为70岁;任一病毒阳性率为39.12%(142/363),人流感病毒阳性率最高,为20.94%(76/363),ILI的流感阳性率(29.83%)显著高于SARI病例(12.09%,P=0.000),冬季(12月-2月)和夏季(7-9月)的流感阳性率显著高于其他月份。结论 人流感病毒为本地区老年ILI/SARI病例的优势病原体,全年呈现冬季和夏季2个流行高峰。建议制定针对老年人群的流感疫苗接种等相关政策,降低重症和死亡风险。     

Human metapneumovirus, Australia, 2001-2004

We examined 10,025 respiratory samples collected for 4 years (2001-2004) and found a 7.1% average annual incidence of human metapneumovirus. The epidemic peak of infection was late winter to spring, and genotyping showed a change in predominant viral genotype in 3 of the 4 years.     

Endemic work-related febrile respiratory illness among construction workers

Construction workers building Denver International Airport (DIA) reported work-related respiratory and flulike symptoms of several months duration. We performed a cross-sectional interview study of 495 randomly selected DIA workers from six contractors in comparison with preplacement workers. We defined cases as workers with two work-attributed lower respiratory symptoms and one work-attributed systemic symptom. Case rates were significantly higher among DIA workers (34%) compared with those who had never worked at DIA (2%). Risk factors for illness included exposure to fireproofing (OR, 4.21; 95% CI, 1.95–9.08), work in tunnels and adjoining areas (OR, 3.07; 95% CI, 1.84–5.12), length of DIA employment (OR, 0.65; 95% CI, 0.46–0.92), and preexisting bronchitis (OR, 2.43; 95% CI, 1.17–5.05). Our industrial hygiene investigation revealed alkaline dust (pH 11) present at a worksite associated with elevated risk of illness, and we identified airborne Penicillium mold widely distributed indoors at DIA. Clinical evaluation of 26 self-identified symptomatic DIA employees, including bronchoalveolar lavage and biopsy in 10, revealed work-related asthma in three workers and histologic evidence of chronic bronehitis in four who had never smoked. We concluded that future investigations of endemic work-related febrile respiratory illness among construction workers should evaluate its association with indoor exposure to dusts from alkaline fireproofing, Penicillium mold, mycotoxins, and bacterial bioaerosols.     

Human metapneumovirus and severity of respiratory syncytial virus disease

We screened 23 children with severe respiratory syncytial virus (RSV) disease and 23 children with mild RSV disease for human metapneumovirus (HMPV). Although HMPV was circulating in Connecticut, none of the 46 RSV-infected patients tested positive for HMPV. In our study population, HMPV did not contribute to the severity of RSV disease.     

Effect of statin use on the risk of medically attended acute respiratory illness among influenza vaccinated elderly

ObjectivesThe immunomodulatory effects of statins may reduce the immune response induced by influenza vaccines. However, evidence regarding the effect of statin use on the effectiveness of seasonal influenza vaccines against medically attended acute respiratory illness (MAARI) in the elderly remains scarce.MethodsWe conducted a retrospective cohort study using data from Taiwan’s National Health Insurance Research Database. Elderly adults aged ≧ 66 years who were vaccinated with seasonal influenza vaccines during the 2007–2008 to 2012–2013 influenza seasons were enrolled for this analysis. We compared the risk of MAARI between statin and non-statin users. Propensity score matching and conditional logistic regression models were used to analyze the data.ResultsA total of 440,180 elderly were included in this study. In general, the risk of MAARI was higher in statin users than non-statin users (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.02–1.05). Statin exposure after vaccination was associated with a higher risk of MAARI (OR: 1.05, 95% CI: 1.02–1.07). Among different statin agents, simvastatin and lovastatin use was associated with a significant increase in the risk of MAARI (OR_simvastatin: 1.14, 95% CI: 1.10–1.18; OR_lovastatin: 1.18, 95% CI: 1.12–1.25).ConclusionsStatin exposure, especially simvastatin and lovastatin, was associated with a higher risk of MAARI in the seasonal influenza vaccinated elderly. Future studies exploring the differences between individual statins and mechanisms of their immunomodulatory effects are necessary.