Sha Jianping, Dong Wei, Liu Shelan, Chen Xiaowen, Zhao Na, Luo Mengyun, Dong Yuanyuan, Zhang Zhiruo
Department of Endocrinology, The 421 Hospital of Chinese People's Liberation Army, Guangzhou, China.
School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China.
PLoS One. 2016 Oct 3;11(10):e0161925. doi: 10.1371/journal.pone.0161925. eCollection 2016.
The difference between childhood infections with avian influenza viruses A(H5N1) and A(H7N9) remains an unresolved but critically important question. We compared the epidemiological characteristics of 244 H5N1 and 41 H7N9 childhood cases (<15 years old), as well as the childhood cluster cases of the two viruses. Our findings revealed a higher proportion of H5N1 than H7N9 childhood infections (31.1% vs. 6.4%, p = 0.000). However, the two groups did not differ significantly in age (median age: 5.0 vs. 5.5 y, p = 0.0651). The proportion of clustered cases was significantly greater among children infected with H5N1 than among children infected with H7N9 [46.7% (71/152) vs. 23.6% (13/55), p = 0.005], and most of the childhood cases were identified as secondary cases [46.4% (45/97) vs. 33.3% (10/30), p = 0.000]. Mild status accounted for 79.49% and 22.66%, severe status for 17.95% and 2.34%, and fatal cases for 2.56% and 75.00% of the H7N9 and H5N1 childhood infection cases (all p<0.05), respectively. The fatality rates for the total, index and secondary childhood cluster cases were 52.86% (37/70), 88.5% (23/26) and 33.33% (15/45), respectively, in the H5N1 group, whereas no fatal H7N9 childhood cluster cases were identified. In conclusion, lower severity and greater transmission were found in the H7N9 childhood cases than in the H5N1 childhood cases.
儿童感染甲型H5N1和甲型H7N9禽流感病毒之间的差异仍是一个未解决但至关重要的问题。我们比较了244例H5N1和41例H7N9儿童病例（<15岁）的流行病学特征，以及这两种病毒的儿童聚集性病例。我们的研究结果显示，H5N1儿童感染比例高于H7N9（31.1%对6.4%，p = 0.000）。然而，两组在年龄上无显著差异（中位年龄：5.0对5.5岁，p = 0.0651）。H5N1感染儿童中聚集性病例的比例显著高于H7N9感染儿童[46.7%（71/152）对23.6%（13/55），p = 0.005]，且大多数儿童病例被确定为二代病例[46.4%（45/97）对33.3%（10/30），p = 0.000]。在H7N9和H5N1儿童感染病例中，轻症分别占79.49%和22.66%，重症分别占17.95%和2.34%，死亡病例分别占2.56%和75.00%（所有p<0.05）。H5N1组中，儿童聚集性病例总数、首例和二代病例的病死率分别为52.86%（37/70）、88.5%（23/26）和33.33%（15/45），而未发现H7N9儿童聚集性死亡病例。总之，H7N9儿童病例的严重程度低于H5N1儿童病例，传播性高于H5N1儿童病例。
