Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Bureau of Communicable Diseases, Wisconsin Division of Public Health, Madison.
Clin Infect Dis. 2018 Aug 1;67(4):493-501. doi: 10.1093/cid/ciy137.
During the 2014-2015 US influenza season, 320 cases of non-mumps parotitis (NMP) among residents of 21 states were reported to the Centers for Disease Control and Prevention (CDC). We conducted an epidemiologic and laboratory investigation to determine viral etiologies and clinical features of NMP during this unusually large occurrence.
NMP was defined as acute parotitis or other salivary gland swelling of >2 days duration in a person with a mumps- negative laboratory result. Using a standardized questionnaire, we collected demographic and clinical information. Buccal samples were tested at the CDC for selected viruses, including mumps, influenza, human parainfluenza viruses (HPIVs) 1-4, adenoviruses, cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex viruses (HSVs) 1 and 2, and human herpes viruses (HHVs) 6A and 6B.
Among the 320 patients, 65% were male, median age was 14.5 years (range, 0-90), and 67% reported unilateral parotitis. Commonly reported symptoms included sore throat (55%) and fever (48%). Viruses were detected in 210 (71%) of 294 NMP patients with adequate samples for testing, ≥2 viruses were detected in 37 samples, and 248 total virus detections were made among all samples. These included 156 influenza A(H3N2), 42 HHV6B, 32 EBV, 8 HPIV2, 2 HPIV3, 3 adenovirus, 4 HSV-1, and 1 HSV-2. Influenza A(H3N2), HHV6B, and EBV were the most frequently codetected viruses.
Our findings suggest that, in addition to mumps, clinicians should consider respiratory viral (influenza) and herpes viral etiologies for parotitis, particularly among patients without epidemiologic links to mumps cases or outbreaks.
在 2014-2015 年美国流感季节期间，向疾病预防控制中心报告了 21 个州的 320 例非流行性腮腺炎性腮腺炎（NMP）病例。我们进行了一项流行病学和实验室调查，以确定在此异常大规模发生期间 NMP 的病毒病因和临床特征。
NMP 定义为腮腺炎实验室结果阴性的患者中持续> 2 天的急性腮腺炎或其他唾液腺肿胀。使用标准化问卷收集人口统计学和临床信息。在疾病预防控制中心，使用颊拭子检测了包括腮腺炎，流感，人类副流感病毒（HPIV）1-4，腺病毒，巨细胞病毒，爱泼斯坦-巴尔病毒（EBV），单纯疱疹病毒（HSV）1 和 2，以及人类疱疹病毒（HHV）6A 和 6B 在内的选定病毒。
在 320 例患者中，65％为男性，中位年龄为 14.5 岁（范围为 0-90），67％报告为单侧腮腺炎。常见的症状包括喉咙痛（55％）和发烧（48％）。在 294 例有足够检测样本的 NMP 患者中，有 210 例（71％）检测到病毒，37 例样本中检测到≥2 种病毒，所有样本共检测到 248 种病毒。其中包括 156 种甲型流感病毒（H3N2），42 种 HHV6B，32 种 EBV，8 种 HPIV2，2 种 HPIV3，3 种腺病毒，4 种 HSV-1 和 1 种 HSV-2。甲型流感病毒（H3N2），HHV6B 和 EBV 是最常共同检测到的病毒。
我们的研究结果表明，除了腮腺炎外，临床医生还应考虑呼吸道病毒（流感）和疱疹病毒病因引起的腮腺炎，尤其是在没有与腮腺炎病例或暴发相关的流行病学联系的患者中。
