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2011 - 2019年台湾地区出现病毒性上呼吸道感染聚集性发病的学校的最常见地点

The Most Common Location of Schools with Viral Upper Respiratory Tract Infection Clusters in Taiwan, 2011-2019.

作者信息

Lin Fu-Huang, Chou Yu-Ching, Chien Wu-Chien, Chung Chi-Hsiang, Hsieh Chi-Jeng, Yu Chia-Peng

机构信息

School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan.

Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan.

出版信息

Children (Basel). 2022 May 13;9(5):720. doi: 10.3390/children9050720.

Abstract

Clusters of acute upper respiratory tract infections are mainly caused by type A or B influenza virus. Numerous factors modify the risk of upper respiratory tract infection (URTI) cluster transmission. The purpose of this study was to investigate the epidemiological characteristics, differences, and epidemic trends in influenza viruses and in non-influenza respiratory pathogens, and the distribution of the sites of URTI cluster events in Taiwan from 2011 to 2019. We examined the publicly available annual summary data on 1864 confirmed URTI clusters in the Taiwan Centers for Disease Control (Taiwan CDC) from 2011 to 2019. URTI clusters were mainly divided into 1295 clusters of influenza virus infections, 149 clusters of non-influenza respiratory pathogen infections, 341 clusters of pathogens not detected by routine tests, and 79 clusters of unchecked samples. There were statistically significant differences (p < 0.001) in the event numbers of URTI clusters among influenza and non-influenza respiratory pathogens between 2011 and 2019. There were statistically significant differences (p = 0.01) in instances of URTI clusters among non-influenza respiratory pathogens between 2011 and 2019. There were also statistically significant differences (p < 0.001) in instances of URTI clusters in different locations between 2011 and 2019. In all the pathogens of URTI clusters (odds ratio (OR) = 1.89−2.25, p = 0.002−0.004), most single infections were influenza A viruses (64.9%, 937/1444). Respiratory syncytial virus single infections were most numerous (43.0%, 64/149) among the non-influenza respiratory pathogens of URTI clusters. Of the institutions where URTI clusters occurred, schools had the most cases (50.1%, 933/1864) (OR = 1.41−3.02, p < 0.001−0.04). After the categorization of isolated virus strains by gene sequencing, it was found that, of the seasonal influenza A viruses, the H1N1 subtype viruses were predominantly A/California/07/2009, A/Michigan/45/2015, and A/Brisbane/02/2018, and the H3N2 subtype viruses were predominantly A/Hong Kong/4801/2014, A/Singapore/INFIMH-16−0019/2016, and A/Switzerland/8060/2017, during 2017−2019. Of the influenza B viruses, B/Brisbane/60/2008 (B/Vic) was the dominant type, and some were B/Massachusetts/02/2012 (B/Yam) and B/PHUKET/3073/2013 (B/Yam). This study is the first report of confirmed events of URTI clusters from surveillance data provided by the Taiwan CDC (2011−2019). This study highlights the importance of long-term, geographically extended studies, particularly for highly fluctuating pathogens, for understanding the implications of the transmission of URTI clusters in Taiwanese populations. Knowledge gaps and important data have been identified to inform future surveillance and research efforts in Taiwan.

摘要

急性上呼吸道感染聚集性病例主要由甲型或乙型流感病毒引起。众多因素会改变上呼吸道感染(URTI)聚集性传播的风险。本研究的目的是调查2011年至2019年台湾地区流感病毒和非流感呼吸道病原体的流行病学特征、差异及流行趋势,以及URTI聚集性事件的发病部位分布。我们查阅了台湾疾病控制中心(台湾疾控中心)2011年至2019年1864例确诊URTI聚集性病例的公开年度汇总数据。URTI聚集性病例主要分为1295例流感病毒感染聚集性病例、149例非流感呼吸道病原体感染聚集性病例、341例常规检测未检出病原体的聚集性病例以及79例未检测样本的聚集性病例。2011年至2019年期间,流感和非流感呼吸道病原体导致的URTI聚集性病例数存在统计学显著差异(p<0.001)。2011年至2019年期间,非流感呼吸道病原体导致的URTI聚集性病例情况存在统计学显著差异(p = 0.01)。2011年至2019年期间,不同地区的URTI聚集性病例情况也存在统计学显著差异(p<0.001)。在所有URTI聚集性病例的病原体中(优势比(OR)= 1.89−2.25,p = 0.002−0.004),大多数单一感染为甲型流感病毒(64.9%,937/1444)。在URTI聚集性病例的非流感呼吸道病原体中,呼吸道合胞病毒单一感染最为常见(43.0%,64/149)。在发生URTI聚集性病例的机构中,学校病例最多(50.1%,933/1864)(OR = 1.41−3.02,p<0.001−0.04)。通过基因测序对分离出的病毒株进行分类后发现,在季节性甲型流感病毒中,H1N1亚型病毒主要为A/California/07/2009、A/Michigan/45/2015和A/Brisbane/02/2018,H3N2亚型病毒主要为A/Hong Kong/4801/2014、A/Singapore/INFIMH-16−0019/2016和A/Switzerland/8060/2017,时间为2017 - 2019年。在乙型流感病毒中,B/Brisbane/60/2008(B/Vic)为主要类型,部分为B/Massachusetts/02/2012(B/Yam)和B/PHUKET/3073/2013(B/Yam)。本研究是台湾疾控中心(2011 - 2019年)提供的监测数据中首次关于确诊URTI聚集性病例事件的报告。本研究强调了长期、地域范围广泛的研究的重要性,特别是对于波动较大的病原体,以了解台湾人群中URTI聚集性传播的影响。已确定了知识空白和重要数据,为台湾未来的监测和研究工作提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f74a/9139427/35e262bed293/children-09-00720-g001.jpg

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