Vabret A, Dina J, Cuvillon-Nimal D, Nguyen E, Gouarin S, Petitjean J, Brouard J, Freymuth F
Laboratoire de virologie, CHU de Caen, avenue Georges-Clémenceau, 14033 Caen, France.
Pathol Biol (Paris). 2010 Apr;58(2):e51-7. doi: 10.1016/j.patbio.2010.01.009. Epub 2010 Mar 19.
Seasonal flu is caused by influenza viruses A and B. These enveloped viruses have a genome made up of seven or eight RNA fragments. The different subtypes are determined by the nature of the two surface glycoproteins HA and NA. Seasonal flu is an epidemic wintertime illness occurring in temperate climate zones. Its epidemiology is linked to the great variability of the virus in time, necessitating an alert system that detects dominating circulating variants each year and that determines the vaccination composition. Clinical flu symptoms are not sufficiently specific to allow for diagnosis with virological tests. This is especially true during non-epidemic periods as well as in subjects older than 65 and younger than five. Children are especially vulnerable to influenza virus infections. Hospitalization occurs more frequently, the younger the child. In children younger than two years, the infection can be pauci-symptomatic and is sometimes detected from non-respiratory symptoms such as lethargy, convulsions, and dizziness. In all cases of respiratory syndrome compatible with influenza virus infection in hospitalized subjects, virological flu diagnosis is of utmost interest. Several tools are available to allow for direct viral detection in respiratory specimens: cell culture isolation, antigenic detection, RNA molecular detection. Choice of method is based on the characteristics of the test: sensibility, specificity, speed and ease of realization, and cost.
季节性流感由甲型和乙型流感病毒引起。这些包膜病毒的基因组由七个或八个RNA片段组成。不同的亚型由两种表面糖蛋白HA和NA的性质决定。季节性流感是一种在温带气候区冬季流行的疾病。其流行病学与病毒随时间的巨大变异性有关,因此需要一个警报系统,每年检测主要的流行变异株并确定疫苗接种成分。临床流感症状不够特异,无法通过病毒学检测进行诊断。在非流行期以及65岁以上和5岁以下的人群中尤其如此。儿童特别容易感染流感病毒。年龄越小,住院频率越高。在两岁以下的儿童中,感染可能症状轻微,有时可从嗜睡、惊厥和头晕等非呼吸道症状中发现。在住院患者中,所有与流感病毒感染相符的呼吸道综合征病例中,病毒学流感诊断至关重要。有几种工具可用于直接检测呼吸道标本中的病毒:细胞培养分离、抗原检测、RNA分子检测。方法的选择基于检测的特性:敏感性、特异性、速度和实现的难易程度以及成本。