Duration of shedding of respiratory syncytial virus in a community study of Kenyan children
Duration of shedding of respiratory syncytial virus in a community study of Kenyan children
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DOI：
10.1186/1471-2334-10-15
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发表时间：
2010-01-22
影响因子：
3.7
通讯作者：
Nokes, D. James
中科院分区：
文献类型：
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作者：
Okiro, Emelda A.;White, Lisa J.;Nokes, D. James
背景资料：我们的理解呼吸道合胞病毒（RSV）感染的传播动力学将更好地了解与改进的数据脱落的情况下，不仅限于入院admissions.Methods模式：在一项家庭研究中，儿童测试RSV阳性的直接免疫荧光抗体试验（DFA）被招募。立即安排洗鼻，然后每三天一次，直至第14天，每7天一次，直至第28天，每2周一次，直至最多16周，或直至第一份DFA阴性RSV标本。采用考克斯回归方法对宿主因素、疾病严重程度和病毒脱落之间的关系进行了研究。结果：从151个家庭中，共招募了193名儿童，中位年龄为21个月（范围1 - 164个月），10%为婴儿，46%为男性。感染恢复率为0.22/人/天（95% CI 0.19 - 0.25），相当于平均排毒持续时间为4.5天（95% CI 4.0 - 5.3），中位排毒持续时间为4天（IQR 2 - 6，范围1 - 14）。有RSV感染史的儿童的恢复率增加40%，即病毒脱落持续时间缩短（风险比1.4，95% CI 1.01 - 1.86）。根据感染的严重程度或年龄，男性和女性之间脱落的停止率没有显著差异。结论：我们提供了脱落持续时间和感染史之间关系的证据，这可能与原发性与再感染在RSV传播中的相对作用有关。
Background: Our understanding of the transmission dynamics of respiratory syncytial virus (RSV) infection will be better informed with improved data on the patterns of shedding in cases not limited only to hospital admissions.Methods: In a household study, children testing RSV positive by direct immunofluorescent antibody test (DFA) were enrolled. Nasal washings were scheduled right away, then every three days until day 14, every 7 days until day 28 and every 2 weeks until a maximum of 16 weeks, or until the first DFA negative RSV specimen. The relationship between host factors, illness severity and viral shedding was investigated using Cox regression methods.Results: From 151 families a total of 193 children were enrolled with a median age of 21 months (range 1-164 months), 10% infants and 46% male. The rate of recovery from infection was 0.22/person/day (95% CI 0.19-0.25) equivalent to a mean duration of shedding of 4.5 days (95% CI 4.0-5.3), with a median duration of shedding of 4 days (IQR 2-6, range 1-14). Children with a history of RSV infection had a 40% increased rate of recovery i.e. shorter duration of viral shedding (hazard ratio 1.4, 95% CI 1.01-1.86). The rate of cessation of shedding did not differ significantly between males and females, by severity of infection or by age.Conclusion: We provide evidence of a relationship between the duration of shedding and history of infection, which may have a bearing on the relative role of primary versus re-infections in RSV transmission in the