Torner Nuria, Soldevila N, Basile L, Mosquera M M, de Molina P, Marcos M A, Martínez A, Jané M, Domínguez A
CIBER Epidemiology and Public Health CIBERESP, Instituto de Salud Carlos III, 28029 Madrid, Spain.
Department of Medicine, University of Barcelona, 08036 Barcelona, Spain.
Microorganisms. 2024 Oct 31;12(11):2200. doi: 10.3390/microorganisms12112200.
During seasonal influenza activity, circulation of other respiratory viruses (ORVs) may contribute to the increased disease burden that is attributed to influenza without laboratory confirmation. The objective of this study was to characterize and evaluate the magnitude of this contribution over 12 seasons of influenza using the Acute Respiratory Infection Sentinel Surveillance system in Catalonia (PIDIRAC).
A retrospective descriptive study of isolations from respiratory samples obtained by the sentinel surveillance network of physicians was carried out from 2008 to 2020 in Catalonia, Spain. Information was collected on demographic variables (age, sex), influenza vaccination status, epidemic activity weeks each season, and influenza laboratory confirmation.
A total of 12,690 samples were collected, with 46% (5831) collected during peak influenza seasonal epidemic activity. In total, 49.6% of the sampled participants were male and 51.1% were aged <15 years. Of these, 73.7% (4298) of samples were positive for at least one respiratory virus; 79.7% (3425 samples) were positive for the influenza virus (IV), with 3067 samples positive for one IV type, 8 samples showing coinfection with two types of IV, and 350 showing coinfection of IV with more than one virus. The distribution of influenza viruses was 64.2% IVA, 35.2% IVB, and 0.1% IVC. Of the other respiratory viruses identified, there was a high proportion of human rhinovirus (32.3%), followed by human adenovirus (24.3%) and respiratory syncytial virus (18; 7%). Four percent were coinfected with two or more viruses other than influenza. The distribution of coinfections with ORVs and influenza by age groups presents a significant difference in proportions for 0-4, 5-14, 15-64 and >64 (21.5%, 10.8%, 8.2% and 7.6%: < 0.001). A lower ORVs coinfection ratio was observed in the influenza-vaccinated population (11.9% vs. 17.4% OR: 0.64 IC 95% 0.36-1.14).
During the weeks of seasonal influenza epidemic activity, other respiratory viruses contribute substantially, either individually or through the coinfection of two or more viruses, to the morbidity attributed to influenza viruses as influenza-like illness (ILI). The contribution of these viruses is especially significant in the pediatric and elderly population. Identifying the epidemiology of most clinically relevant respiratory viruses will aid the development of models of infection and allow for the development of targeted treatments, particularly for populations most vulnerable to respiratory viruses-induced diseases.
在季节性流感流行期间，其他呼吸道病毒（ORV）的传播可能会导致疾病负担增加，而这在未经实验室确诊的情况下会被归因于流感。本研究的目的是利用加泰罗尼亚的急性呼吸道感染哨点监测系统（PIDIRAC），对12个流感季节中这种影响的程度进行描述和评估。
对2008年至2020年西班牙加泰罗尼亚地区医生哨点监测网络采集的呼吸道样本分离物进行回顾性描述性研究。收集了人口统计学变量（年龄、性别）、流感疫苗接种状况、每个季节的流行活动周数以及流感实验室确诊信息。
共收集了12,690份样本，其中46%（5831份）是在流感季节性流行高峰期采集的。在这些样本中，49.6%的参与者为男性，51.1%的参与者年龄小于15岁。其中，73.7%（4298份）的样本至少有一种呼吸道病毒呈阳性；79.7%（3425份样本）的流感病毒（IV）呈阳性，其中3067份样本一种IV型呈阳性，8份样本显示两种IV型共感染，350份样本显示IV与一种以上病毒共感染。流感病毒的分布情况为：IVA占64.2%，IVB占35.2%，IVC占0.1%。在鉴定出的其他呼吸道病毒中，人鼻病毒的比例较高（32.3%），其次是人类腺病毒（24.3%）和呼吸道合胞病毒（18.7%）。4%的样本同时感染了两种或更多种非流感病毒。按年龄组划分，ORV与流感的共感染分布在0 - 4岁、5 - 14岁、15 - 64岁和>64岁组的比例存在显著差异（21.5%、10.8%、8.2%和7.6%：<0.001）。在接种流感疫苗的人群中观察到较低的ORV共感染率（11.9%对17.4%，OR：0.64，IC 95% 0.36 - 1.14）。
在季节性流感流行活动周期间，其他呼吸道病毒无论是单独还是通过两种或更多种病毒的共感染，都对作为流感样疾病（ILI）归因于流感病毒的发病率有很大贡献。这些病毒的贡献在儿童和老年人群中尤为显著。确定大多数临床相关呼吸道病毒的流行病学将有助于开发感染模型，并有助于开发针对性治疗方法，特别是针对最易患呼吸道病毒引起疾病的人群。
