Kaneko M, Watanabe J, Kuwahara M, Ueno E, Hida M, Kinoshita A, Sone T
Department of Pediatrics, Shizuoka Red Cross Hospital, Japan.
J Infect. 2002 May;44(4):240-3. doi: 10.1053/jinf.2002.0981.
Respiratory syncytial virus (RSV) is the most important viral pathogen for lower respiratory tract infection (LRI) in infants and children. An RSV-specific monoclonal antibody has been developed to provide prophylaxis against RSV associated LRI (RSV-LRI). The objective of this study was to determine the impact of RSV as a cause of LRI in children younger than 3 years of age to provide data to aide in the implementation of forthcoming prophylaxis against RSV.
We analyzed the viral etiology of LRI in hospitalized Japanese children younger than 3 years of age admitted to Shizuoka Red Cross Hospital from July, 1997 to June, 2000.
A total of 535 patients younger than 3 years of age were hospitalized with LRI at Shizuoka Red Cross Hospital from July 1, 1997 to June 30, 2000. Of these, a positive diagnosis of RSV infection was made in 168 patients (31.4%). Most of the patients with RSV infection had been well and had had no underlying disease that was defined as risk factor of RSV infection (94.0%). The peak incidence of LRI was observed in the winter each year and the number of LRI was strongly associated with the epidemic of RSV (r=0.700, P<0.0001). The number of patients with LRI younger than 6 months of age was 116 (21.7%). Of these 116 patients younger than 6 months with LRI, 55 patients (47.4%) were confirmed to have RSV infection. The proportions of RSV infection to total LRI was greatest in early infants younger than 6 months (P<0.0001). The number of patients with which RSV infection was detected in LRI patients younger than 3 years was highest during the first five months of life and there was a dramatic decrease in incidence of RSV infection with increasing age thereafter.
The incidence of LRI hospitalization is highly affected by RSV infection epidemic. The proportion of RSV infections among early infants younger than 6 months is greater than that of older patients. The prophylaxis against RSV will be needed to be toward early infants.
呼吸道合胞病毒（RSV）是婴幼儿下呼吸道感染（LRI）最重要的病毒病原体。已研发出一种RSV特异性单克隆抗体用于预防RSV相关的下呼吸道感染（RSV-LRI）。本研究的目的是确定RSV作为3岁以下儿童LRI病因的影响，以提供数据帮助实施即将开展的RSV预防措施。
我们分析了1997年7月至2000年6月入住静冈红十字医院的3岁以下住院日本儿童LRI的病毒病因。
1997年7月1日至2000年6月30日，共有535名3岁以下儿童因LRI入住静冈红十字医院。其中，168名患者（31.4%）被确诊为RSV感染。大多数RSV感染患者此前健康，无被定义为RSV感染危险因素的基础疾病（94.0%）。每年冬季观察到LRI的发病高峰，LRI的数量与RSV流行密切相关（r=0.700，P<0.0001）。6个月以下LRI患儿有116名（21.7%）。在这116名6个月以下LRI患儿中，55名（47.4%）被确诊为RSV感染。RSV感染占总LRI的比例在6个月以下的早期婴儿中最高（P<0.0001）。3岁以下LRI患者中检测到RSV感染的患者数量在出生后的前五个月最高，此后随着年龄增长RSV感染发病率急剧下降。
LRI住院发病率受RSV感染流行的高度影响。6个月以下早期婴儿中RSV感染的比例高于年龄较大的患者。需要针对早期婴儿开展RSV预防措施。
