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Primary and Repeated Respiratory Viral Infections Among Infants in Rural Nepal.

尼泊尔农村婴儿原发性和反复呼吸道病毒感染。

  • 影响因子:1.82
  • DOI:10.1093/jpids/piy107
  • 作者列表:"Boonyaratanakornkit J","Englund JA","Magaret AS","Bu Y","Tielsch JM","Khatry SK","Katz J","Kuypers J","Shrestha L","LeClerq SC","Steinhoff MC","Chu HY
  • 发表时间:2020-02-28
Abstract

BACKGROUND:Respiratory viruses cause significant morbidity and death in infants; 99% of such deaths occur in resource-limited settings. Risk factors for initial and repeated respiratory viral infections in young infants in resource-limited settings have not been well described. METHODS:From 2011 to 2014, a birth cohort of infants in rural Nepal was enrolled and followed with weekly household-based active surveillance for respiratory symptoms until 6 months of age. Respiratory illness was defined as having any of the following: fever, cough, wheeze, difficulty breathing, and/or a draining ear. We tested nasal swabs of infants with respiratory illness for multiple respiratory viruses by using a reverse transcription polymerase chain reaction assay. The risk of primary and repeated infections with the same virus was evaluated using Poisson regression. RESULTS:Of 3528 infants, 1726 (49%) had a primary infection, and 419 (12%) had a repeated infection. The incidences of respiratory viral infection in infants were 1816 per 1000 person-years for primary infections and 1204 per 1000 person-years for repeated infection with the same virus. Exposure to other children and male sex were each associated with an increased risk for primary infection (risk ratios, 1.13 [95% confidence interval (CI), 1.06-1.20] and 1.14 [95% CI, 1.02-1.27], respectively), whereas higher maternal education was associated with a decreased risk for both primary and repeated infections (risk ratio, 0.96 [95% CI, 0.95-0.98]). The incidence of subsequent infection did not change when previous infection with the same or another respiratory virus occurred. Illness duration and severity were not significantly different in the infants between the first and second episodes for any respiratory virus tested. CONCLUSIONS:In infants in rural Nepal, repeated respiratory virus infections were frequent, and we found no decrease in illness severity with repeated infections and no evidence of replacement with another virus. Vaccine strategies and public health interventions that provide durable protection in the first 6 months of life could decrease the burden of repeated infections by multiple respiratory viruses, particularly in low-resource countries.

摘要

背景: 呼吸道病毒在婴儿中引起显著的发病率和死亡率; 99% 的此类死亡发生在资源有限的环境中。在资源有限的环境中,小婴儿初始和重复呼吸道病毒感染的危险因素尚未得到很好的描述。 方法: 2011-2014 年,尼泊尔农村的婴儿出生队列被纳入,并进行每周以家庭为基础的呼吸道症状主动监测,直到 6 个月大。呼吸系统疾病定义为有以下任何一种: 发热、咳嗽、喘息、呼吸困难和/或引流的耳朵。我们用逆转录聚合酶链反应试验检测了呼吸系统疾病婴儿的鼻拭子中多种呼吸道病毒。使用Poisson回归评估原发和重复感染相同病毒的风险。 结果: 3528 例婴儿中,1726 例 (49%) 原发感染,419 例 (12%) 重复感染。发生率呼吸道病毒感染患儿 1816 每 1000 人年原发性感染和 1204 每 1000 人年的反复感染的病毒.暴露于其他儿童和男性均与原发性感染风险增加相关 (风险比,1.13 [95% 置信区间 (CI),1.06-1.20] 和 1.14 [95% CI,分别为 1.02-1.27]),而母亲受高等教育与初次和重复感染风险降低相关(风险比,0.96 [95% CI,0.95-0.98])。当以前感染相同或另一种呼吸道病毒时,随后感染的发生率没有变化。对于检测的任何呼吸道病毒,婴儿在第一次和第二次发作之间的病程和严重程度没有显著差异。 结论: 婴幼儿尼泊尔农村,反复呼吸道病毒感染频繁,我们没有发现任何减少病情严重程度与反复感染,而且没有证据表明替换另一种病毒.在生命头 6 个月内提供持久保护的疫苗战略和公共卫生干预措施可以减轻多种呼吸道病毒反复感染的负担,特别是在资源匮乏的国家。

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发表时间:2020-04-01
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DOI:10.1007/s15010-020-01401-y
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METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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