Tan Xin Quan, Zhao Xiahong, Lee Vernon J, Loh Jin Phang, Tan Boon Huan, Koh Wee Hong Victor, Ng Sock Hoon, Chen Mark I-Cheng, Cook Alex Richard
Biodefence Centre, Ministry of Defence, Singapore, Singapore.
BMC Infect Dis. 2014 Apr 15;14:204. doi: 10.1186/1471-2334-14-204.
Few studies have comprehensively described tropical respiratory disease surveillance in military populations. There is also a lack of studies comparing clinical characteristics of the non-influenza pathogens with influenza and amongst themselves.
From May 2009 through October 2012, 7733 consenting cases of febrile respiratory illness (FRI) (temperature [greater than or equal to]37.5 degrees C with cough or sorethroat) and controls in the Singapore military had clinical data and nasal washes collected prospectively. Nasal washes underwent multiplex PCR, and the analysis was limited to viral mono-infections.
49% of cases tested positive for at least one virus, of whom 10% had multiple infections. 53% of the FRI cases fulfilled the definition of influenza-like illness (ILI), of whom 52% were positive for at least one virus. The most frequent etiologies for mono-infections among FRI cases were Influenza A(H1N1)pdm09 (13%), Influenza B (13%) and coxsackevirus (9%). The sensitivity, specificity, positive predictive value and negative predictive value of ILI for influenza among FRI cases were 72%, 48%, 40% and 69% respectively. On logistic regression, there were marked differences in the prevalence of different symptoms and signs between viruses with fever more prevalent amongst influenza and adenovirus infections than other viruses.
There are multiple viral etiologies for FRI and ILI with differing clinical symptoms in the Singapore military. Influenza and coxsackevirus were the most common etiology for FRI, while influenza and adenoviruses displayed the most febrile symptoms. Further studies should explore these differences and possible interventions.
很少有研究全面描述军事人群中的热带呼吸道疾病监测情况。此外，也缺乏对非流感病原体与流感之间以及它们自身临床特征的比较研究。
从2009年5月至2012年10月，新加坡军队中7733例同意参与的发热性呼吸道疾病（FRI）（体温≥37.5摄氏度且伴有咳嗽或喉咙痛）病例及对照者前瞻性地收集了临床数据和鼻洗液。鼻洗液进行多重PCR检测，分析限于病毒单感染。
49%的病例至少检测出一种病毒呈阳性，其中10%有多重感染。53%的FRI病例符合流感样疾病（ILI）的定义，其中52%至少检测出一种病毒呈阳性。FRI病例中单感染最常见的病因是甲型（H1N1）pdm09流感病毒（13%）、乙型流感病毒（13%）和柯萨奇病毒（9%）。FRI病例中ILI对流感的敏感性、特异性、阳性预测值和阴性预测值分别为72%、48%、40%和69%。经逻辑回归分析，不同病毒之间在不同症状和体征的患病率上存在显著差异，发热在流感和腺病毒感染中比其他病毒更普遍。
新加坡军队中FRI和ILI存在多种病毒病因，临床症状各异。流感和柯萨奇病毒是FRI最常见的病因，而流感和腺病毒表现出最常见的发热症状。进一步的研究应探索这些差异及可能的干预措施。
