Yang Zi-Feng, Zhan Yang-Qing, Wang Yu-Tao, Luo Yi, Zhou Hong, Li Ji-Qiang, Qin Sheng, Guan Wen-da, Liang Zeng-Wei, Zhao Sui-Shan, Huang Qun-di, Mo Zi-Yao, Chen Jing-Xian, Chen Rong-Chang
National Key Laboratory of Respiratory Diseases, the First Affiliated Hospital, Guangzhou Medical College, Guangzhou 510230, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2010 Oct;33(10):742-5.
This study was undertaken to describe the viral etiology and clinical features in patients with influenza-like illness (ILI) in Guangzhou.
The nasopharyngeal and throat swabs were collected from 882 patients presenting with ILI between January and September, 2009. Viral pathogens were cultured and identified by immunofluorescence technique using the Shell-Vial method. The clinical data were statistically analyzed.
(1) Viral etiology. Of the 882 samples, 385 (43.7%) were confirmed to have at least one of the 9 different respiratory viruses detected. Among these viral isolates, 67.3% (259/385) were seasonal influenza A virus, 27.8% (107/385) were influenza B virus, and 1.3% (5/385) were human parainfluenza virus (PHIV) 1, 2, or 3. In addition, 2 cases (0.5%) of each adenovirus, HSV-1, enterovirus and respiratory syncytial virus (RSV) were also found in the samples. Co-infections with more than one virus were revealed in 8 (2.1%) of 385 samples tested, among them 6 samples were mixture of influenza A and influenza B, 1 sample was positive for both influenza B virus and HPIV-3, and 1 was for both adenovirus and RSV. Seasonal influenza B virus appeared endemic between March and May, and seasonal influenza A virus became dominant between June and August. (2) Clinical features. The percentage of patients aged from 18-30 years was much higher than that of other age groups. The most common symptoms were moderate fever and sore throat, followed by cough. The percentage of upper respiratory infection and pneumonia was 88.4% (727/882) and 10.7% (95/882) respectively. Clinical features did not discriminate between patients with seasonal influenza A and those with influenza B virus infection. The average numbers of leukocytes and lymphocytes were lower in the group positive for influenza viruses than in virus negative group. The patients with adenovirus, HPIV and RSV infection were significantly younger. No rash was observed in patients with enterovirus or HSV infection.
(1) Seasonal influenza virus was the major viral etiologic agent of ILI in Guangzhou during the first 9 months in 2009. Influenza B and A viruses seasonally prevailed in spring and summer, respectively, while other viral etiologic agents appeared to be sporadic. (2) The analysis of clinical features in patients with ILI indicated that fever was the most common symptom, with body temperature varying greatly, and may be associated with evident respiratory and occasionally systemic symptoms. Among the cases with viral infection, the upper respiratory presentation was universal, and pneumonia was frequently noticed.
本研究旨在描述广州地区流感样疾病（ILI）患者的病毒病因及临床特征。
收集2009年1月至9月期间882例ILI患者的鼻咽及咽喉拭子。采用壳瓶法免疫荧光技术对病毒病原体进行培养和鉴定。对临床资料进行统计学分析。
（1）病毒病因。在882份样本中，385份（43.7%）被证实至少检测出9种不同呼吸道病毒中的一种。在这些病毒分离株中，67.3%（259/385）为季节性甲型流感病毒，27.8%（107/385）为乙型流感病毒，1.3%（5/385）为人副流感病毒（PHIV）1、2或3。此外，样本中还各发现2例（0.5%）腺病毒、单纯疱疹病毒1型、肠道病毒和呼吸道合胞病毒（RSV）。在385份检测样本中，8份（2.1%）存在多种病毒共感染，其中6份样本为甲型和乙型流感病毒混合感染，1份样本乙型流感病毒和HPIV - 3均为阳性，1份样本腺病毒和RSV均为阳性。季节性乙型流感病毒在3月至5月呈地方流行，季节性甲型流感病毒在6月至8月占主导地位。（2）临床特征。18 - 30岁患者的比例远高于其他年龄组。最常见的症状是中度发热和咽痛，其次是咳嗽。上呼吸道感染和肺炎的比例分别为88.4%（727/882）和10.7%（95/882）。季节性甲型流感患者和乙型流感病毒感染患者的临床特征无明显差异。流感病毒阳性组的白细胞和淋巴细胞平均数量低于病毒阴性组。腺病毒、HPIV和RSV感染患者明显更年轻。肠道病毒或单纯疱疹病毒感染患者未观察到皮疹。
（1）2009年前9个月，季节性流感病毒是广州地区ILI的主要病毒病因。乙型和甲型流感病毒分别在春季和夏季季节性流行，而其他病毒病因则呈散发性。（2）ILI患者临床特征分析表明，发热是最常见症状，体温变化较大，可能伴有明显的呼吸道症状，偶尔有全身症状。在病毒感染病例中，上呼吸道表现普遍，且常并发肺炎。
