Horton Katherine C, Dueger Erica L, Kandeel Amr, Abdallat Mohamed, El-Kholy Amani, Al-Awaidy Salah, Kohlani Abdul Hakim, Amer Hanaa, El-Khal Abel Latif, Said Mayar, House Brent, Pimentel Guillermo, Talaat Maha
Global Disease Detection Center, U.S. Centers for Disease Control and Prevention, Cairo, Egypt.
Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt.
PLoS One. 2017 Jul 13;12(7):e0180954. doi: 10.1371/journal.pone.0180954. eCollection 2017.
Little is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region.
Sentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1-3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death.
At least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens-influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease.
Viral respiratory pathogens are common among SARI patients in the Eastern Mediterranean Region. Ongoing surveillance is important to monitor changes in the etiology, seasonality and severity of pathogens of interest.
关于病毒性呼吸道病原体在东地中海地区严重急性呼吸道感染（SARI）的病因、季节性或严重程度方面所起的作用，人们了解甚少。
2007年12月至2014年2月期间，在埃及、约旦、阿曼、卡塔尔和也门的20家医院开展了SARI哨点监测。从符合SARI病例定义的住院患者中采集鼻咽和口咽拭子，分析是否感染流感病毒、呼吸道合胞病毒（RSV）、腺病毒（AdV）、人偏肺病毒（hMPV）以及1-3型人副流感病毒（hPIV1-3）。我们分析监测数据，以计算病毒性呼吸道病原体的阳性率，描述这些病原体的季节性，并确定哪些病原体导致了需要通气和/或重症监护和/或导致死亡的更严重后果。
在检测至少一种病原体的8753/28508（30.7%）份样本中，至少检测到一种病毒性呼吸道病原体；在检测所有病原体的3497/9315（37.5%）份样本中，流感病毒感染率为3345/28438（11.8%），RSV感染率为3942/24503（16.1%），AdV感染率为923/9402（9.8%），hMPV感染率为617/9384（6.6%），hPIV1感染率为159/9402（1.7%），hPIV2感染率为85/9402（0.9%），hPIV3感染率为365/9402（3.9%）。在检测所有病原体的9316名参与者中，501/9316（5.4%）被鉴定出感染了多种病原体。所有病原体均观察到月度变化，表明感染水平存在季节性差异。与未感染hMPV的参与者和五岁以上的参与者相比，感染hMPV的参与者和五岁以下的参与者分别发生严重后果的可能性显著降低，而与无既往慢性病报告的参与者相比，有既往慢性病的参与者发生严重后果的风险增加。
病毒性呼吸道病原体在东地中海地区的SARI患者中很常见。持续监测对于监测相关病原体的病因、季节性和严重程度变化很重要。
