Weigl J A I, Puppe W, Schmitt H J
Department of General Paediatrics, University of Kiel, University of Mainz, Germany.
Epidemiol Infect. 2002 Dec;129(3):525-33. doi: 10.1017/s0950268802007707.
Since new vaccines and anti-viral drugs for influenza have become available, collation of actual and country-specific epidemiological data is essential. Since respiratory syncytial virus (RSV) is a well known paediatric airway pathogen and some epidemiological data exist already, a comparison between influenza and RSV seems warranted. From July 1996 to June 2001 the naso-pharyngeal aspirates (NPA) of children from birth to 16 years of age, admitted to one of the two paediatric hospitals in Kiel, Germany, were investigated by a nine-valent multiplex reverse transcriptase PCR assay. NPA were investigated in 60.8 % of 3,469 children admitted with an acute respiratory tract infection. Community-acquired or nosocomial infections (in parentheses) due to influenza A were diagnosed in 122 (10) children, due to influenza B in 14 (2) and due to RSV in 325 (24) cases. Patients with influenza A (median 752 days) and influenza B (median 966 days) were older than patients with RSV (median 168 days). The spectrum of disease presentation was broader in influenza than in RSV. In each winter, admissions with influenza were less common than those with RSV. Influenza B only occurred in 2 of the 5 years. The cumulative, population-based incidences per 100,000 children 0-16 (0-5, >5-16) years of age were 53 (123, 22) for influenza A, 16 (30, 9) for influenza B and 165 (453, 4) for RSV. Cardiac conditions and asthma were the major risk factors for admission to hospital with influenza A (RR 9.8, 4.1) and RSV (8.5, 2.1) infections. Underlying conditions were most common in influenza B. Low gestational age doubled the risk for admission to hospital with influenza A infection, but did not show a dose-effect relationship as in RSV. The burden of influenza-positive hospitalizations was about one third that of RSV. The incidence was similar to reports from the United States. Targeting children with underlying conditions, especially cardiac conditions and asthma in the German immunization programme is appropriate, as long as no policy for vaccination of the general paediatric population exists.
自从有了新型流感疫苗和抗病毒药物以来，整理实际的和特定国家的流行病学数据至关重要。由于呼吸道合胞病毒（RSV）是一种众所周知的儿科气道病原体且已有一些流行病学数据，因此对流感和RSV进行比较似乎是有必要的。1996年7月至2001年6月，对德国基尔两家儿科医院之一收治的出生至16岁儿童的鼻咽抽吸物（NPA）采用九价多重逆转录酶PCR检测法进行了研究。在3469例因急性呼吸道感染入院的儿童中，60.8%的儿童进行了NPA检测。确诊为甲型流感导致的社区获得性感染或医院感染（括号内为医院感染）的儿童有122例（10例），乙型流感导致的有14例（2例），RSV导致的有325例（24例）。甲型流感患者（中位年龄752天）和乙型流感患者（中位年龄966天）比RSV患者（中位年龄168天）年龄大。流感的疾病表现谱比RSV更广泛。每年冬季，因流感入院的情况比因RSV入院的情况少见。乙型流感仅在5年中的2年出现。每10万名0至16岁（0至5岁、大于5至16岁）儿童的累积人群发病率，甲型流感为53（123、22），乙型流感为16（30、9），RSV为165（453、4）。心脏疾病和哮喘是因甲型流感（相对危险度9.8、4.1）和RSV（8.5、2.1）感染入院的主要危险因素。潜在疾病在乙型流感中最为常见。低胎龄使甲型流感感染入院风险增加一倍，但不像RSV那样呈现剂量效应关系。流感阳性住院病例的负担约为RSV的三分之一。发病率与美国的报告相似。在德国免疫规划中，针对有潜在疾病的儿童，尤其是患有心脏疾病和哮喘的儿童是合适的，前提是尚无针对普通儿科人群的疫苗接种政策。
