Institute for Frontier Life and Medical Sciences, Kyoto University, Japan.
Hakubi Center for Advanced Research, Kyoto University, Japan.
J Infect Dis. 2019 Jan 7;219(2):197-205. doi: 10.1093/infdis/jiy515.
Acute respiratory infection (ARI) is of great concern in public health. It remains unclear whether viral infections can affect the host's susceptibility to subsequent ARIs.
A prospective cohort study on ARIs of children below 5 years old was conducted in the Philippines from 2014 to 2016. The respiratory symptoms were recorded daily, and nasopharyngeal swabs were collected at both household and health facilities. The specimens were tested for respiratory viruses. We then determined whether viral etiology was associated with the severity of the present ARI and whether previous viral infections was associated with subsequent ARIs.
A total of 3851 children and 16337 ARI episodes were enrolled and recorded, respectively. Samples were collected from 24% of all ARI episodes; collection rate at the healthcare facilities was 95%. Enterovirus D68, rhinovirus species C, and respiratory syncytial virus were significantly associated with severe ARIs. The risk for subsequent ARIs was significantly enhanced after infections with adenovirus, influenza A virus, parainfluenza virus type 4, and rhinovirus species C.
This study revealed that viral etiology plays a significant role in the severity of the present ARI and that viral infection affects the host's susceptibility to subsequent ARIs.
急性呼吸道感染（ARI）是公共卫生领域的一个重要关注点。目前尚不清楚病毒感染是否会影响宿主对随后发生的 ARI 的易感性。
本研究在 2014 年至 2016 年期间在菲律宾开展了一项针对 5 岁以下儿童 ARI 的前瞻性队列研究。每日记录呼吸道症状，并在家庭和医疗机构采集鼻咽拭子。对标本进行呼吸道病毒检测。然后，我们确定病毒病因是否与当前 ARI 的严重程度相关，以及先前的病毒感染是否与随后发生的 ARI 相关。
共纳入 3851 名儿童和 16337 例 ARI 发作，分别进行记录。采集了 24%的所有 ARI 发作样本；医疗机构的采集率为 95%。肠道病毒 D68、鼻病毒 C 种和呼吸道合胞病毒与严重 ARI 显著相关。感染腺病毒、甲型流感病毒、副流感病毒 4 型和鼻病毒 C 种后，随后发生 ARI 的风险显著增加。
本研究表明，病毒病因在当前 ARI 的严重程度中起重要作用，病毒感染会影响宿主对随后发生的 ARI 的易感性。
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