Erat Tuğba, Özdemir Halil, Taşkınoğlu Tutku, İnce Erdal, Çiftçi Ergin
Ankara University Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey.
Duzen Laboratories Group, Microbiology Laboratory, Ankara, Turkey.
Mikrobiyol Bul. 2020 Apr;54(2):318-325. doi: 10.5578/mb.69358.
Influenza is an important cause of respiratory illness in children and is still an important cause of morbidity and mortality in children. The influenza virus subtypes determine the prevalence of the epidemic and pandemic influenza, the hospitalization and mortality rates in children each year. Surveillance of the circulation of different influenza virus strains is important in ensuring a good strain con-cordance for the composition of the annual influenza vaccine. The Global Influenza Hospital Surveillance Network® (GIHSN) is an international institution in which tertiary hospitals from many countries participate and where epidemiological surveillance of influenza disease is conducted. Six centers from Turkey participated in the study organized by GIHSN during the influenza season 2016 2017. The aim of this study was to demonstrate the frequency of influenza, virus types, clinical characteristics and vaccination rates in children admitted to our hospital with influenza-like symptoms in the influenza season 2016-2017. Informed consents were obtained from patients. 217 pediatric patients were screened with in the 24th and 48th hours of the hospitalization. Then a nasal/nasopharyngeal swab were collected from 184 patients who met the inclusion criteria. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) was used to obtain laboratory results. Influenza virus, influenza virus subtypes were studied by rRT-PCR. The 83.3% of the patients with positive influenza was under 5 years of age. The rate of influenza positivity was 16.3% (n= 30 patients). Influenza A (H3N2) was the predominant strain in children. The 70% of isolates were influenza A (H3N2) and the 30% were influenza B (Yamagata). There were no case of influenza A (H1N1) or influenza B (Victoria). In 30% of cases with influenza positivity, there was an underlying disease. The most prevalent of them were neuromuscular disease followed by cardiovascular disease and asthma. Tobacco exposure was 86.6% in influenza positive cases. The empirical oseltamivir prescription rate was 28.2%. The vaccination rate of the influenza vaccine was very low (1.6%). The out of 3 patients with influenza positivity were admitted to pediatric intensive care unit, and 2 of them required mechanical ventilation. None of these patients required extracorpereal membrane oxygenation and did not die. Our results highlight the importance of surveillance for influenza and in particular, influenza vaccination rates of groups with risk for morbidity and mortality, such as children, need to be increased.
流感是儿童呼吸道疾病的重要病因，仍是导致儿童发病和死亡的重要原因。流感病毒亚型决定了每年流感流行和大流行的发生率、儿童的住院率和死亡率。监测不同流感病毒株的传播情况对于确保年度流感疫苗成分与流行毒株良好匹配非常重要。全球流感医院监测网络（GIHSN）是一个有许多国家的三级医院参与并开展流感疾病流行病学监测的国际机构。2016 - 2017年流感季节，来自土耳其的6个中心参与了由GIHSN组织的研究。本研究的目的是阐明2016 - 2017年流感季节我院收治的有流感样症状儿童的流感发病率、病毒类型、临床特征和疫苗接种率。已获得患者的知情同意书。在住院的第24小时和48小时对217名儿科患者进行了筛查。然后从184名符合纳入标准的患者中采集鼻/鼻咽拭子。采用实时逆转录聚合酶链反应（rRT-PCR）获得实验室结果。通过rRT-PCR研究流感病毒、流感病毒亚型。流感检测呈阳性的患者中83.3%年龄在5岁以下。流感阳性率为16.3%（n = 30例患者）。甲型（H3N2）流感是儿童中的主要毒株。分离株中70%为甲型（H3N2）流感，30%为乙型（山形）流感。没有甲型（H1N1）流感或乙型（维多利亚）流感病例。在30%的流感阳性病例中，存在基础疾病。其中最常见的是神经肌肉疾病，其次是心血管疾病和哮喘。流感阳性病例中接触烟草的比例为86.6%。经验性使用奥司他韦的处方率为28.2%。流感疫苗接种率非常低（1.6%）。3例流感阳性患者中有3例被收入儿科重症监护病房，其中2例需要机械通气。这些患者均不需要体外膜肺氧合，也没有死亡。我们的结果凸显了流感监测的重要性，特别是对于儿童等有发病和死亡风险的群体，需要提高流感疫苗接种率。
