Perrotta D M, Decker M, Glezen W P
Am J Epidemiol. 1985 Sep;122(3):468-76. doi: 10.1093/oxfordjournals.aje.a114128.
Current measures of the health impact of epidemic influenza focus on analyses of death certificate data which may underestimate the true health effect. Previous investigations of influenza-related morbidity either have lacked virologic confirmation of influenza virus activity in the community or were not population-based. Community virologic surveillance in Houston, Texas has demonstrated that influenza viruses have produced epidemics each year since 1974. This study examined the relationship of hospitalizations with acute respiratory disease to the occurrence of influenza epidemics. Discharge records of 13,297 acute respiratory disease hospitalizations that occurred between July 1978 and June 1981 were obtained from 11 hospitals with 48.4% of hospital beds available in Harris County (metropolitan Houston). The correlation of adult acute respiratory disease hospitalizations with established indices of community acute respiratory disease morbidity was strong (r = 0.74) and indicated that the peak of adult acute respiratory disease hospitalizations followed the peak of influenza virus isolations by one week. Only 23.2% of persons hospitalized were 65 years of age or older, compared to 60-70% of persons who die during influenza epidemics. Although the highest rates of acute respiratory disease hospitalizations occurred among infants and persons aged 65 years or older, the rates for adults 45-64 years and preschool children aged 1-4 years were greater than 1 per 1,000 persons. Surveillance of acute respiratory disease hospitalizations can improve the measurement of serious morbidity associated with epidemic influenza, and can better define the characteristics of persons at risk for development of illness requiring hospitalization.
目前对流行性感冒健康影响的衡量方法主要集中在对死亡证明数据的分析上，而这可能低估了其对健康的真实影响。以往对流感相关发病率的调查，要么缺乏社区流感病毒活动的病毒学确认，要么不是基于人群的。德克萨斯州休斯顿的社区病毒学监测表明，自1974年以来，流感病毒每年都会引发疫情。本研究调查了急性呼吸道疾病住院率与流感疫情发生之间的关系。我们从哈里斯县（大休斯顿地区）11家医院获取了1978年7月至1981年6月期间13297例急性呼吸道疾病住院病例的出院记录，这些医院提供了哈里斯县48.4%的病床。成人急性呼吸道疾病住院率与已确定的社区急性呼吸道疾病发病率指标之间的相关性很强（r = 0.74），这表明成人急性呼吸道疾病住院高峰在流感病毒分离高峰后一周出现。住院患者中只有23.2%的人年龄在65岁及以上，而在流感疫情期间死亡的人中这一比例为60 - 70%。尽管急性呼吸道疾病住院率最高的人群是婴儿和65岁及以上的人，但45 - 64岁的成年人和1 - 4岁的学龄前儿童的住院率也超过了每1000人中有1人。对急性呼吸道疾病住院情况的监测可以改进对与流行性感冒相关的严重发病率的衡量，并能更好地确定有发展成需要住院治疗疾病风险的人群特征。
