Zhang W Q, Chen L L, Cheng F F, Dai Z R, Feng S, Zhang J, Tian J M, Zhang T, Zhao G M
Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China.
Department of Infectious Disease Prevention and Control, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Jun 10;42(6):1044-1049. doi: 10.3760/cma.j.cn112338-20200831-01113.
To study the influencing factors of influenza-associated severe acute respiratory illness (SARI) in children younger than 5 years of old in Suzhou, and to provide evidence to support the improvement of prevention and control strategies for influenza in children. We conducted a prospective influenza surveillance for hospitalized SARI and outpatient influenza-like illness (ILI) at Children's Hospital of Soochow University from April 2011 to March 2017. We compared the clinical and other characteristics of influenza-positive patients with SARI to those with ILI to find the differences and to identify influencing factors of influenza-associated SARI, using test and unconditional logistic regression. We found 786 cases of influenza-associated ILI and 413 cases of influenza-associated SARI during the study period. Cough, runny nose, shortness of breath, asthma or wheezing were more common in influenza-associated SARI than in influenza-associated ILI (<0.01). Univariate and multivariate logistic regression showed that the influencing factors which significantly associated with increased risk of influenza-associated SARI were as follows: younger age (<6 months 3.6, 6-23 months a=2.5), respiratory infection history within 3 months (a=4.5), chronic lung disease history (=3.4), fever above 39.0 ℃ (39.0-39.9 ℃ a=2.4, ≥40.0 ℃ a=6.0), and the presence of A/H1N1 (a=2.3), A/H3N2 (a=1.9). Children younger than 2 years old, with a history of chronic lung disease, a history of respiratory infection within 3 months, or with a fever peak above 39.0 ℃ should seek medical advice as soon as possible or receive annual influenza vaccination to reduce the incidence of influenza-associated serious outcomes.
为研究苏州地区5岁以下儿童流感相关重症急性呼吸疾病（SARI）的影响因素，为改进儿童流感防控策略提供依据。2011年4月至2017年3月，我们在苏州大学附属儿童医院对住院SARI患儿及门诊流感样疾病（ILI）进行了前瞻性流感监测。我们比较了流感阳性SARI患者与ILI患者的临床及其他特征，以发现差异并确定流感相关SARI的影响因素，采用检验和非条件logistic回归分析。研究期间，我们共发现786例流感相关ILI病例和413例流感相关SARI病例。流感相关SARI患者咳嗽、流涕、呼吸急促、哮喘或喘息症状比流感相关ILI患者更为常见（<0.01）。单因素和多因素logistic回归分析显示，与流感相关SARI风险增加显著相关的影响因素如下：年龄较小（<6个月a=3.6，6-23个月a=2.5）、3个月内有呼吸道感染史（a=4.5）、有慢性肺病病史（a=3.4）、体温高于39.0℃（39.0-39.9℃a=2.4，≥40.0℃a=6.0）以及感染A/H1N1（a=2.3）、A/H3N2（a=1.9）。2岁以下儿童、有慢性肺病病史、3个月内有呼吸道感染史或发热峰值高于39.0℃的儿童应尽快就医或每年接种流感疫苗，以降低流感相关严重后果的发生率。
