Monto Arnold S, Malosh Ryan E, Petrie Joshua G, Thompson Mark G, Ohmit Suzanne E
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Infect Dis. 2014 Dec 1;210(11):1792-9. doi: 10.1093/infdis/jiu327. Epub 2014 Jun 6.
The household has traditionally been the site for studying acute respiratory illnesses (ARIs). Most studies were conducted many years ago, and more broadly sensitive laboratory methods to determine ARI etiology are now available.
We recruited and followed households with children over 3 annual surveillance periods and collected respiratory tract specimens from subjects with reported ARI. Virus etiology was determined by real-time reverse-transcription polymerase chain reaction (RT-PCR) analysis.
Individuals in larger households (defined as households with >4 members) and those in households with children aged <5 years had significantly higher ARI frequencies than others. ARI frequency generally declined with increasing age. Virus etiology was most likely to be determined in young children, who were also most likely to have virus coinfection. Overall, 16% of ARIs with 1 virus identified had ≥1 coinfecting virus. Rhinoviruses and coronaviruses were the most frequently identified agents of ARI in all age categories. Influenza virus and adenovirus were less frequently identified but were most likely to cause ARI that required medical attention.
Longitudinal studies in families remain a valuable way to study respiratory infections. RT-PCR has increased the sensitivity of virus detection, including coinfecting viruses, and expanded our ability to detect viruses now known to cause ARI.
家庭一直是研究急性呼吸道疾病(ARI)的场所。大多数研究是多年前进行的,而现在已有更广泛灵敏的实验室方法来确定ARI的病因。
我们在3个年度监测期内招募并跟踪有儿童的家庭,并从报告患有ARI的受试者中收集呼吸道标本。通过实时逆转录聚合酶链反应(RT-PCR)分析确定病毒病因。
大家庭(定义为成员超过4人的家庭)中的个体以及有5岁以下儿童的家庭中的个体,其ARI发病率明显高于其他人。ARI发病率通常随着年龄的增长而下降。病毒病因最有可能在幼儿中确定,幼儿也最有可能发生病毒合并感染。总体而言,在已鉴定出1种病毒的ARI中,16%有≥1种合并感染病毒。鼻病毒和冠状病毒是所有年龄组中最常鉴定出的ARI病原体。流感病毒和腺病毒较少被鉴定出,但最有可能导致需要医疗护理的ARI。
对家庭进行纵向研究仍然是研究呼吸道感染的一种有价值的方法。RT-PCR提高了病毒检测的灵敏度,包括对合并感染病毒的检测,并扩大了我们检测目前已知可引起ARI的病毒的能力。