US Naval Medical Research Center Detachment, Lima, Perú.
Influenza Other Respir Viruses. 2011 Mar;5(2):123-34. doi: 10.1111/j.1750-2659.2010.00182.x. Epub 2010 Nov 3.
Despite the disease burden imposed by respiratory diseases on children in Central America, there is a paucity of data describing the etiologic agents of the disease.
To analyze viral etiologic agents associated with influenza-like illness (ILI) in participants reporting to one outpatient health center, one pediatric hospital, and three general hospitals in El Salvador, Honduras, and Nicaragua Material &
Between August 2006 and April 2009, pharyngeal swabs were collected from outpatients and inpatients. Patient specimens were inoculated onto cultured cell monolayers, and viral antigens were detected by indirect and direct immunofluorescence staining.
A total of 1,756 patients were enrolled, of whom 1,195 (68.3%) were under the age of 5; and 183 (10.4%) required hospitalization. One or more viral agents were identified in 434 (24.7%) cases, of which 17 (3.9%) were dual infections. The most common viruses isolated were influenza A virus (130; 7.4% of cases), respiratory syncytial virus (122; 6.9%), adenoviruses (63; 3.6%), parainfluenza viruses (57; 3.2%), influenza B virus (47; 2.7% of cases), and herpes simplex virus 1 (22; 1.3%). In addition, human metapneumovirus and enteroviruses (coxsackie and echovirus) were isolated from patient specimens.
When compared to the rest of the population, viruses were isolated from a significantly higher percentage of patients age 5 or younger. The prevalence of influenza A virus or influenza B virus infections was similar between the younger and older age groups. RSV was the most commonly detected pathogen in infants age 5 and younger and was significantly associated with pneumonia (p < 0.0001) and hospitalization (p < 0.0001).
Genetic analysis of influenza isolates identified A (H3N2), A (H1N1), and B viruses. It also showed that the mutation H274Y conferring resistance to oseltamivir was first detected in Honduran influenza A/H1N1 strains at the beginning of 2008. These data demonstrate that a diverse range of respiratory pathogens are associated with ILI in Honduras, El Salvador, and Nicaragua. RSV infection in particular appears to be associated with severe disease in infants in the region.
尽管中美洲儿童的呼吸道疾病带来了沉重负担，但有关这些疾病病因的资料却很少。
分析在萨尔瓦多、洪都拉斯和尼加拉瓜的一家门诊保健中心、一家儿科医院和三家综合医院就诊的患者中，与流感样疾病（ILI）相关的病毒病因。
2006 年 8 月至 2009 年 4 月期间，采集门诊和住院患者的咽拭子标本。将患者标本接种于培养的细胞单层，通过间接和直接免疫荧光染色检测病毒抗原。
共纳入 1756 例患者，其中 1195 例（68.3%）年龄在 5 岁以下；183 例（10.4%）需要住院治疗。434 例（24.7%）患者确定了一种或多种病毒病原体，其中 17 例（3.9%）为双重感染。最常见的分离病毒为甲型流感病毒（130 例；占病例的 7.4%）、呼吸道合胞病毒（122 例；6.9%）、腺病毒（63 例；3.6%）、副流感病毒（57 例；3.2%）、乙型流感病毒（47 例；占病例的 2.7%）和单纯疱疹病毒 1 型（22 例；占 1.3%）。此外，从患者标本中分离出人偏肺病毒和肠道病毒（柯萨奇和埃可病毒）。
与其他人群相比，5 岁或以下患者中分离出病毒的比例显著更高。5 岁及以下年龄组和 5 岁以上年龄组流感 A 病毒或流感 B 病毒感染的发生率相似。呼吸道合胞病毒是 5 岁及以下婴儿中最常检测到的病原体，与肺炎（p<0.0001）和住院（p<0.0001）显著相关。
对流感分离株进行基因分析，发现了 A（H3N2）、A（H1N1）和 B 型病毒。还表明，在 2008 年初，洪都拉斯甲型 H1N1 流感株中首次检测到对奥司他韦具有耐药性的 H274Y 突变。这些数据表明，中美洲的呼吸道病原体与洪都拉斯、萨尔瓦多和尼加拉瓜的 ILI 有关。呼吸道合胞病毒感染似乎与该地区婴儿的严重疾病有关。
