Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
J Med Virol. 2009 Dec;81(12):2066-71. doi: 10.1002/jmv.21610.
Limited information is available on the viral etiology of influenza-like illness in southern European countries, and it is still a matter of debate whether certain symptoms can be used to distinguish among the specific viruses that cause influenza-like illness. The main objective of the present study was to identify the demographic and clinical predictors of influenza-like illness due to specific viral agents. The study, which was observational in design, was conducted in Rome and Naples, Italy. Cases of influenza-like illness were defined as individuals with fever >37.5 degrees C and at least one systemic and one respiratory symptom, recruited during the winters of 2004-2005, 2005-2006, and 2006-2007. Influenza and other respiratory viruses were identified using the polymerase chain reaction (PCR), performed on throat swabs. Basic individual information was collected using a standard form. A total of 580 persons were included in the analysis. Viral pathogens were identified in fewer than 50% of the cases. Overall, 240 viral agents were detected: 22.8% were positive for influenza viruses, 10.9% for adenoviruses, 6.0% for parainfluenza viruses, and 1.7% for respiratory syncytial virus. The month of diagnosis, and muscle and joint pain were associated with influenza virus, though the positive predictive value (PPV) was low. Abdominal pain was associated with adenovirus infection. Although the PPV of symptoms for influenza virus infection was low, especially in low activity periods, these findings may help clinicians to improve their ability to perform diagnoses.
有关南欧国家流感样疾病的病毒病因学的信息有限，某些症状是否可以用于区分引起流感样疾病的特定病毒仍存在争议。本研究的主要目的是确定流感样疾病特定病毒病原体的人口统计学和临床预测因素。该研究为观察性研究，在意大利罗马和那不勒斯进行。流感样疾病的病例定义为发热>37.5°C 且至少有一个全身症状和一个呼吸道症状的个体，于 2004-2005 年、2005-2006 年和 2006-2007 年冬季招募。使用聚合酶链反应（PCR）对咽拭子进行检测以鉴定流感和其他呼吸道病毒。使用标准表格收集基本个人信息。共纳入 580 人进行分析。不到 50%的病例确定了病毒病原体。总体而言，共检测到 240 种病毒病原体：22.8%为流感病毒阳性，10.9%为腺病毒阳性，6.0%为副流感病毒阳性，1.7%为呼吸道合胞病毒阳性。诊断月份、肌肉和关节疼痛与流感病毒有关，尽管阳性预测值（PPV）较低。腹痛与腺病毒感染有关。尽管流感病毒感染症状的 PPV 较低，尤其是在活动量低的时期，但这些发现可能有助于临床医生提高诊断能力。
