Department of Microbiology, Korea University College of Medicine, Seoul, Korea.
PLoS One. 2013 May 22;8(5):e64295. doi: 10.1371/journal.pone.0064295. Print 2013.
A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI) through the first teaching hospital-based surveillance scheme for ILI in South Korea.
Respiratory specimens were obtained from adult patients (≥18 years) who visited the emergency department (ED) with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus.
Among 1,983 patients who visited the ED with ILI, 811 (40.9%) were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983) during the 2011-2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983) and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5%) in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6%) cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes.
This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.
一个构建良好且运行正常的流感监测方案对于公共卫生至关重要。本研究通过韩国首个基于教学医院的ILI 监测方案,评估了呼吸道病毒在ILI 患者中的分布情况。
从 2011 年第 40 周至 2012 年第 22 周期间,在急诊科就诊的ILI 成年患者(≥18 岁)中采集呼吸道标本。采用多重 PCR 方法检测呼吸道病毒:流感病毒、腺病毒、冠状病毒、呼吸道合胞病毒、鼻病毒、人偏肺病毒、副流感病毒、博卡病毒和肠病毒。
在因 ILI 就诊于急诊科的 1983 例患者中,811 例(40.9%)为男性,中位年龄为 43 岁。在 2011-2012 季节,流感疫苗接种率为 21.7%(430/1983)。18%的患者至少存在一种合并症。呼吸道病毒的阳性率为 52.1%(1983 例中有 1033 例),共检测到 1100 种病毒。在所有年龄组中,流感 A 病毒均为主要病原体(677 例,占 61.5%)。在年龄大于 50 岁的患者中,人偏肺病毒的检出率较高,而腺病毒仅在年轻成年人中检出。在 58 例(5.6%)患者中,检测到两种或更多种呼吸道病毒。在血液系统恶性肿瘤或器官移植受者中,合并感染病例更为常见,但与临床结局无关。
本研究通过韩国首个基于教学医院的 ILI 监测系统,对呼吸道病毒在 ILI 患者中的流行病学进行了广泛的实验室监测,具有重要价值。