2004-2013 年期间英格兰和威尔士病毒性脑膜脑炎报告数量增加了 7 倍。

Seven-fold increase in viral meningo-encephalitis reports in England and Wales during 2004-2013.

机构信息

Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK.

Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.

出版信息

J Infect. 2014 Oct;69(4):326-32. doi: 10.1016/j.jinf.2014.05.012. Epub 2014 Jun 2.

DOI:10.1016/j.jinf.2014.05.012

PMID:24887614

Abstract

OBJECTIVES

In highly immunised populations viruses contribute to a substantially higher proportion of meningo-encephalitis cases. This national study aimed to describe population trends in laboratory-confirmed, viral meningo-encephalitis reports in England and Wales over a ten-year period.

METHODS

Laboratory-confirmed, viral meningo-encephalitis cases submitted by National Health Service hospitals in England and Wales during 2004-13 were analysed.

RESULTS

There were 9941 laboratory-confirmed reports of viral meningo-encephalitis in England and Wales over the 10-year period. Number of reports increased across all age-groups and for all viruses from 311 (incidence, 0.6/100,000) in 2004 to 2168 in 2013 (incidence, 3.9/100,000). Median age at diagnosis was 30.6 (IQR, 1.3-51.5) years, with a third of cases diagnosed in children. In 2013, infants aged <3 months accounted for 27% (588/2168) of cases, but had the highest incidence (329/100,000). Enteroviruses were responsible for 52% (5133/9941) of all cases and 92% (1952/2121) in <3 month-olds (incidence, 313/100,000 in 2013, equivalent to 77/100,000 live-births) followed by herpes simplex (2885/9941; 29%) and varicella zoster (1342/9941; 13%), mainly among ≥45 year-olds.

CONCLUSION

Increasing use of molecular testing has led to a 7-fold increase in laboratory-confirmed, viral meningo-encephalitis reports. Large clinical-observational studies are necessary to determine the burden of viral meningo-encephalitis, especially in infants.

摘要

目的

在高免疫人群中，病毒导致的脑膜炎病例占比大幅上升。本项全国性研究旨在描述英格兰和威尔士十年来实验室确诊病毒性脑膜炎病例的人群趋势。

方法

分析英格兰和威尔士的国民保健服务医院于 2004 年至 2013 年期间提交的实验室确诊病毒性脑膜炎病例。

结果

在十年间，英格兰和威尔士共报告了 9941 例实验室确诊病毒性脑膜炎病例。各年龄段和各种病毒的报告数量均有所增加，从 2004 年的 311 例（发病率为 0.6/100000）增至 2013 年的 2168 例（发病率为 3.9/100000）。诊断中位年龄为 30.6（IQR，1.3-51.5）岁，三分之一的病例发生在儿童中。2013 年，3 个月以下的婴儿占病例的 27%（588/2168），但发病率最高（329/100000）。肠道病毒占所有病例的 52%（5133/9941），3 个月以下婴儿的占 92%（1952/2121）（2013 年发病率为 313/100000，相当于每 100000 例活产中有 77 例），其次是单纯疱疹病毒（2885/9941；29%）和水痘-带状疱疹病毒（1342/9941；13%），主要发生在≥45 岁人群中。