Korematsu Seigo, Nagashima Kengo, Sato Yasunori, Nagao Mizuho, Hasegawa Shunji, Nakamura Haruna, Sugiura Shiro, Miura Katsushi, Okada Kenji, Fujisawa Takao
Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
Chiba University Hospital Clinical Research Center, Chiba, Japan.
Allergol Int. 2018 Jan;67(1):55-60. doi: 10.1016/j.alit.2017.04.003. Epub 2017 Apr 25.
In September 2015, Japan experienced an unusual increase in acute asthma hospitalizations of children that coincided with an enterovirus D68 (EV-D68) epidemic. The objective of this study is to investigate whether EV-D68 had a causal relationship with the spike in asthma hospitalizations.
A nation-wide retrospective survey of asthma hospitalizations of children was performed for the period from January 2010 through October 2015. The Japanese Society of Pediatric Allergy and Clinical Immunology asked its affiliated hospitals to report monthly numbers of hospitalizations, ICU admissions and mechanical ventilations due to acute asthma exacerbation. The data were retrieved from medical databases using predefined search criteria: diagnosis of asthma or asthmatic bronchitis, admission, and age <20 years. Monthly numbers of EV-D68 detection were also obtained from the Infectious Disease Surveillance Center of Japan. A Granger causality test was used to analyze the association of EV-D68 detections for asthma exacerbation.
A total of 157 hospitals reported 87,189 asthma hospitalizations, including 477 ICU admissions and 1193 mechanical ventilations, during the survey period of 5 years and 10 months. The numbers of these events increased drastically in September 2015. The Granger causality test verified the association between EV-D68 and asthma hospitalizations/mechanical ventilations. The most-affected age group was 3-6 years old.
The spike in pediatric asthma hospitalizations in Japan in September 2015 was found to be associated with the EV-D68 epidemic. Respiratory pathogens can cause "epidemics" of asthma exacerbation. Coordinated surveillance of infectious diseases and asthma may be beneficial for prevention and better control of both illnesses.
2015年9月，日本儿童急性哮喘住院人数异常增加，与此同时肠道病毒D68（EV-D68）流行。本研究的目的是调查EV-D68与哮喘住院人数激增之间是否存在因果关系。
对2010年1月至2015年10月期间儿童哮喘住院情况进行全国性回顾性调查。日本儿科过敏与临床免疫学会要求其附属医院每月报告因急性哮喘加重导致的住院人数、重症监护病房（ICU）收治人数和机械通气人数。使用预定义的搜索标准从医学数据库中检索数据：哮喘或喘息性支气管炎诊断、入院以及年龄<20岁。还从日本传染病监测中心获取每月EV-D68检测数量。采用格兰杰因果检验分析EV-D68检测与哮喘加重之间的关联。
在5年零10个月的调查期内，共有157家医院报告了87189例哮喘住院病例，其中包括477例ICU收治病例和1193例机械通气病例。这些病例数在2015年9月急剧增加。格兰杰因果检验证实了EV-D68与哮喘住院/机械通气之间的关联。受影响最严重的年龄组为3至6岁。
发现2015年9月日本儿科哮喘住院人数激增与EV-D68流行有关。呼吸道病原体可引发哮喘加重的“流行”。对传染病和哮喘进行协同监测可能有助于预防和更好地控制这两种疾病。
