儿童呼吸道病毒感染的流行病学特点
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摘要
呼吸系统感染是儿童门诊就诊最为常见的病因,也是造成<5岁儿童死亡的首要原因。病毒是儿童时期呼吸道感染最为常见的病原,需要引起儿科医师关注。该文讨论了常见呼吸道病毒的流行病学特征,着重介绍了呼吸道合胞病毒、流感病毒、鼻病毒和腺病毒等较为常见的呼吸道病毒的好发年龄、好发季节、流行区域等流行病学特点。同时,也简要介绍了副流感病毒、偏肺病毒和冠状病毒等近期新发现的病毒的流行病学特征,并回顾了病毒共感染的相关信息。
Respiratory tract infection is a leading cause of out?patient treatment and mortality in children under 5 years. Re?spiratory virus is the most common pathogen in children with respiratory tract infection,which should be paid attention to in pediatricians. The review discusses epidemiologic characteristics of common respiratory virus,focusing on respiratory syncytial virus(RSV),influenza virus,human rhinovirus(HRV)and human adenoviruses(HADV). The paper also briefly introduces the epidemiological characteristics of the newly discovered viruses,such as parainfluenza virus(PIV),human metapneumovirus (HMPV),human coronavirus(HCoV). At last,the information of viral-viral coinfections in children is reviewed.
Respiratory tract infection is a leading cause of out?patient treatment and mortality in children under 5 years. Re?spiratory virus is the most common pathogen in children with respiratory tract infection,which should be paid attention to in pediatricians. The review discusses epidemiologic characteristics of common respiratory virus,focusing on respiratory syncytial virus(RSV),influenza virus,human rhinovirus(HRV)and human adenoviruses(HADV). The paper also briefly introduces the epidemiological characteristics of the newly discovered viruses,such as parainfluenza virus(PIV),human metapneumovirus (HMPV),human coronavirus(HCoV). At last,the information of viral-viral coinfections in children is reviewed.
引文
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[25]Feng L,Li Z,Zhao S,et al.Viral etiologies of hospitalized acute lower respiratory infection patients in China,2009-2013[J].PLo S One,2014,9(6):e99419.
[26]Liu C,Xiao Y,Zhang J,et al.Adenovirus infection in children with acute lower respiratory tract infections in Beijing,China,2007 to 2012[J].BMC Infect Dis,2015,15:408.
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[28]Zeng SZ,Xiao NG,Zhong LL,et al.Clinical features of human metapneumovirus genotypes in children with acute lower respi?ratory tract infection in Changsha,China[J].J Med Virol,2015,87(11):1839-1845.
[29]Kin N,Miszczak F,Lin W,et al.Genomic analysis of 15 human coronaviruses OC43(HCo V-OC43s)circulating in France from2001 to 2013 reveals a high intra-specific diversity with new recombinant genotypes[J].Viruses,2015,7(5):2358-2377.
[30]Guan Y,Zheng BJ,He YQ,et al.Isolation and characterization of viruses related to the SARS coronavirus from animals in southern China[J].Science,2003,302(5643):276-278.
[31]Kan B,Wang M,Jing H,et al.Molecular evolution analysis and geographic investigation of severe acute respiratory syndrome coronavirus-like virus in palm civets at an animal market and on farms[J].J Virol,2005,79(18):11892-11900.
[32]Ge XY,Li JL,Yang XL,et al.Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor[J].Nature,2013,503(7477):535-538.
[33]Chan JF,Lau SK,To KK,et al.Middle East respiratory syndrome coronavirus:another zoonotic betacoronavirus causing SARS-like disease[J].Clin Microbiol Rev,2015,28(2):465-522.
[34]Sly PD,Jones CM.Viral co-detection in infants hospitalized with respiratory disease:is it important to detect?[J].J Pediatr(Rio J),2011,87(4):277-280.
[35]Nascimento MS,Souza AV,Ferreira AV,et al.High rate of viral identification and coinfections in infants with acute bronchiol?itis[J].Clinics(Sao Paulo),2010,65(11):1133-1137.
[36]Drews AL,Atmar RL,Glezen WP,et al.Dual respiratory virus infections[J].Clin Infect Dis,1997,25(6):1421-1429.
[37]Asner SA,Science ME,Tran D,et al.Clinical disease severity of respiratory viral co-infection versus single viral infection:a systematic review and meta-analysis[J].PLo S One,2014,9(6):e99392.
[38]Lim FJ,de Klerk N,Blyth CC,et al.Systematic review and metaanalysis of respiratory viral coinfections in children[J].Respi?rology,2016,21(4):648-655.
[2]GBD 2013 Mortality and Causes of Death Collaborators.Global,regional,and national age-sex specific all-cause and causespecific mortality for 240 causes of death,1990-2013:a systematic analysis for the global burden of disease study 2013[J].Lancet,2015,385(9963):117-171.
[3]Bush A.Recurrent respiratory infections[J].Pediatr Clin North Am,2009,56(1):67-100,x.
[4]de Benedictis FM,Bush A.Recurrent lower respiratory tract in?fections in children[J].BMJ,2018,362:k2698.
[5]WHO.Research needs for the Battle against Respiratory Viruses(BRa Ve),2013[EB/OL][2018-10-10]http://www.who.int/in?fluenza/patient_care/clinical/brave/en/index.html.
[6]Turunen R,Koistinen A,Vuorinen T,et al.The first wheezing episode:respiratory virus etiology,atopic characteristics,and illness severity[J].Pediatr Allergy Immunol,2014,25(8):796-803.
[7]Jackson DJ,Gangnon RE,Evans MD,et al.Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children[J].Am J Respir Crit Care Med,2008,178(7):667-672.
[8]Ralston SL,Lieberthal AS,Meissner HC,et al.Clinical practice guideline:the diagnosis,management,and prevention of bron?chiolitis[J].Pediatrics,2014,134(5):e1474-e1502.
[9]Shi T,Mc Allister DA,O'Brien KL,et al.Global,regional,and national disease burden estimates of acute lower respiratory in?fections due to respiratory syncytial virus in young children in 2015:a systematic review and modelling study[J].Lancet,2017,390(10098):946-958.
[10]《中华儿科杂志》编辑委员会,中华医学会儿科学分会呼吸学组.毛细支气管炎诊断、治疗与预防专家共识(2014年版)[J].中华儿科杂志,2015,53(3):168-171.
[11]Campbell H,Nair H.A manual for estimating disease burden associated with seasonal influenza[M].Geneva:World Health Organization,2015:8-9.
[12]Yu H,Alonso WJ,Feng L,et al.Characterization of regional in?fluenza seasonality patterns in China and implications for vac?cination strategies:spatio-temporal modeling of surveillance data[J].PLo S Med,2013,10(11):e1001552.
[13]Jackson DJ.The role of rhinovirus infections in the development of early childhood asthma[J].Curr Opin Allergy Clin Immunol,2010,10(2):133-138.
[14]To KKW,Yip CCY,Yuen KY.Rhinovirus-from bench to bed?side[J].J Formos Med Assoc,2017,116(7):496-504.
[15]Miller EK,Edwards KM,Weinberg GA,et al.A novel group of rhinoviruses is associated with asthma hospitalizations[J].JAllergy Clin Immunol,2009,123(1):98-104.
[16]Ning G,Wang X,Wu D,et al.The etiology of community-acquired pneumonia among children under 5 years of age in mainland China,2001-2015:A systematic review[J].Hum Vaccin Im?munother,2017,13(11):2742-2750.
[17]Zheng XY,Xu YJ,Guan WJ,et al.Regional,age and respirato?ry-secretion-specific prevalence of respiratory viruses associ?ated with asthma exacerbation:a literature review[J].Arch Vi?rol,2018,163(4):845-853.
[18]Lehtinen P,Ruohola A,Vanto T,et al.Prednisolone reduces re?current wheezing after a first wheezing episode associated with rhinovirus infection or eczema[J].J Allergy Clin Immunol,2007,119(3):570-575.
[19]Foong Ng K,Kee Tan K,Hong Ng B,et al.Epidemiology of ad?enovirus respiratory infections among hospitalized children in Seremban,Malaysia[J].Trans R Soc Trop Med Hyg,2015,109(7):433-439.
[20]Ng OT,Thoon KC,Chua HY,et al.Severe pediatric adenovirus7 disease in Singapore linked to recent outbreaks across Asia[J].Emerg Infect Dis,2015,21(7):1192-1196.
[21]Yu P,Ma C,Nawaz M,et al.Outbreak of acute respiratory disease caused by human adenovirus type 7 in a military training camp in Shaanxi,China[J].Microbiol Immunol,2013,57(8):553-560.
[22]Hong JY,Lee HJ,Piedra PA,et al.Lower respiratory tract in?fections due to adenovirus in hospitalized Korean children:epi?demiology,clinical features,and prognosis[J].Clin Infect Dis,2001,32(10):1423-1429.
[23]Murtagh P,Giubergia V,Viale D,et al.Lower respiratory infec?tions by adenovirus in children.Clinical features and risk fac?tors for bronchiolitis obliterans and mortality[J].Pediatr Pulm?onol,2009,44(5):450-456.
[24]Lim LM,Woo YY,de Bruyne JA,et al.Epidemiology,clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur,Malaysia[J].PLo S One,2018,13(10):e0205795.
[25]Feng L,Li Z,Zhao S,et al.Viral etiologies of hospitalized acute lower respiratory infection patients in China,2009-2013[J].PLo S One,2014,9(6):e99419.
[26]Liu C,Xiao Y,Zhang J,et al.Adenovirus infection in children with acute lower respiratory tract infections in Beijing,China,2007 to 2012[J].BMC Infect Dis,2015,15:408.
[27]Wang HP,Zheng YJ,Deng JK,et al.Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen,China[J].Virol J,2016,13:39.
[28]Zeng SZ,Xiao NG,Zhong LL,et al.Clinical features of human metapneumovirus genotypes in children with acute lower respi?ratory tract infection in Changsha,China[J].J Med Virol,2015,87(11):1839-1845.
[29]Kin N,Miszczak F,Lin W,et al.Genomic analysis of 15 human coronaviruses OC43(HCo V-OC43s)circulating in France from2001 to 2013 reveals a high intra-specific diversity with new recombinant genotypes[J].Viruses,2015,7(5):2358-2377.
[30]Guan Y,Zheng BJ,He YQ,et al.Isolation and characterization of viruses related to the SARS coronavirus from animals in southern China[J].Science,2003,302(5643):276-278.
[31]Kan B,Wang M,Jing H,et al.Molecular evolution analysis and geographic investigation of severe acute respiratory syndrome coronavirus-like virus in palm civets at an animal market and on farms[J].J Virol,2005,79(18):11892-11900.
[32]Ge XY,Li JL,Yang XL,et al.Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor[J].Nature,2013,503(7477):535-538.
[33]Chan JF,Lau SK,To KK,et al.Middle East respiratory syndrome coronavirus:another zoonotic betacoronavirus causing SARS-like disease[J].Clin Microbiol Rev,2015,28(2):465-522.
[34]Sly PD,Jones CM.Viral co-detection in infants hospitalized with respiratory disease:is it important to detect?[J].J Pediatr(Rio J),2011,87(4):277-280.
[35]Nascimento MS,Souza AV,Ferreira AV,et al.High rate of viral identification and coinfections in infants with acute bronchiol?itis[J].Clinics(Sao Paulo),2010,65(11):1133-1137.
[36]Drews AL,Atmar RL,Glezen WP,et al.Dual respiratory virus infections[J].Clin Infect Dis,1997,25(6):1421-1429.
[37]Asner SA,Science ME,Tran D,et al.Clinical disease severity of respiratory viral co-infection versus single viral infection:a systematic review and meta-analysis[J].PLo S One,2014,9(6):e99392.
[38]Lim FJ,de Klerk N,Blyth CC,et al.Systematic review and metaanalysis of respiratory viral coinfections in children[J].Respi?rology,2016,21(4):648-655.