Ciruela P, Izquierdo C, Oviedo M, Domínguez A
Direcció General de Salut Pública. Departament de Sanitat i Seguretat Social. Barcelona. España.
Vacunas. 2004;5(1):16-23. doi: 10.1016/S1576-9887(04)70351-9. Epub 2013 Apr 3.
Rotavirus is the main cause of severe diarrhea in children aged less than 5 years, leading to elevated morbidity and mortality worldwide. The aim of the present study was to determine the etiology of enteric viruses reported to the Catalan Microbiology Notification System (CMNS) (rotavirus and adenovirus 40-41) and to evaluate the importance of these viruses in enteric disease.
We retrospectively reviewed the notifications made from 1995-2002 by the laboratories of hospitals participating in the CMNS. Cases of acute gastroenteritis (AGE) were diagnosed by antigen detection in stools. The variables analyzed were: age, sex, month, and year of isolation. Statistical analysis was performed using the X test and Fisher's test and proportions were compared using the binomial test. The level of statistical significance was set at 0.05.
Rotavirus was detected in 6708 cases of AGE (94.3%) and adenovirus 40-41 in 409 (5.7%). Viral AGE produced greater morbidity in children aged less than 2 years with 76% of cases caused by rotavi-rus and 68% of those caused by adenovirus 40-41 occurring in this age group. Rotavirus was isolated mainly in winter (68%), while adenovi-rus, although stable throughout the seasons, was more frequent in autumn (35.2%). Of cases of bacterial and viral enteritis detected by the CMNS, rotavirus was the second etiological agent and adenovirus the fourth in children aged less than 5 years after Campylobacter and Salmonella.
Of the various viruses that can cause AGE, some are highly frequent, such as calcivirus and astrovirus, which are not systematically detected and consequently the frequencies reported in the present study should be interpreted with caution. Nevertheless, rotavirus is the main cause of viral AGE, affecting small children, especially infants aged 1-11 months, with a clear predominance in winter. Adenovirus 40-41 mainly affects children aged less than 2 years and is more frequent in autumn. Vaccination against rotavirus should be a priority to reduce the high rates of morbidity and mortality caused by this disease.
轮状病毒是5岁以下儿童严重腹泻的主要病因,在全球范围内导致发病率和死亡率上升。本研究的目的是确定向加泰罗尼亚微生物通报系统(CMNS)报告的肠道病毒(轮状病毒和腺病毒40 - 41型)的病因,并评估这些病毒在肠道疾病中的重要性。
我们回顾性分析了1995年至2002年参与CMNS的医院实验室所做的通报。通过粪便中的抗原检测诊断急性胃肠炎(AGE)病例。分析的变量包括:年龄、性别、分离月份和年份。使用X检验和费舍尔检验进行统计分析,并使用二项式检验比较比例。统计学显著性水平设定为0.05。
在6708例AGE病例中检测到轮状病毒(94.3%),在409例中检测到腺病毒40 - 41型(5.7%)。病毒性AGE在2岁以下儿童中发病率更高,其中76%的病例由轮状病毒引起,68%由腺病毒40 - 41型引起的病例发生在该年龄组。轮状病毒主要在冬季分离到(68%),而腺病毒虽然全年稳定,但在秋季更常见(35.2%)。在CMNS检测到的细菌性和病毒性肠炎病例中,轮状病毒是5岁以下儿童仅次于弯曲杆菌和沙门氏菌的第二大病因,腺病毒是第四大病因。
在可引起AGE的各种病毒中,有些病毒非常常见,如杯状病毒和星状病毒,但未进行系统检测,因此本研究报告的频率应谨慎解读。尽管如此,轮状病毒是病毒性AGE的主要病因,影响幼儿,尤其是1至11个月大的婴儿,在冬季明显占优势。腺病毒40 - 41型主要影响2岁以下儿童,在秋季更常见。接种轮状病毒疫苗应作为优先事项,以降低该疾病导致的高发病率和死亡率。