Synchrony of clinical and laboratory surveillance for influenza in Hong Kong.
Synchrony of clinical and laboratory surveillance for influenza in Hong Kong.
复制标题
香港流感的临床和实验室监测同步。
DOI：
10.1371/journal.pone.0001399
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发表时间：
2008-01-02
期刊：
影响因子：
3.7
通讯作者：
Peiris, Joseph S. M.
中科院分区：
文献类型：
--
作者：
Yang, Lin;Wong, Chit Ming;Lau, Eric H. Y.;Chan, King Pan;Ou, Chun Quan;Peiris, Joseph S. M.
门诊流感样疾病（ILI）的就诊率被认为是社区流感病毒活动的良好指标。由于ILI样症状可能由流感以外的病因引起，并且热带和亚热带地区的流感病毒活性比温带地区更难预测，因此热带和亚热带地区ILI与流感病毒活性之间的相关性不太明确。在这项研究中，我们使用小波分析，调查流感病毒活动的季节性和ILI的咨询率分别报告的普通科门诊诊所（GOPC）和全科医生（GP）之间的关系。在1998-2000年和2002-2003年期间，流感病毒活动呈现出年度和半年周期，一个高峰在冬季，另一个高峰在春末或初夏。但在2001年和2004-2006年期间，只能清楚地确定年度周期。普通科门诊和普通科门诊的ILI就诊率具有类似的非平稳季节模式。我们发现GOPC中的ILI与流感病毒活性在年度周期中具有高度一致性，但仅在1998-1999年和2002-2006年期间具有显著性（p<0.05）。对于半年周期，在1998-1999年和2003年期间也发现高一致性（p<0.05），当时流感的两个高峰是明显的。同样，GP环境中的ILI也与流感病毒的年度和半年周期活动相关。平均而言，GP中ILI和GOPC中ILI的振荡分别在流感病毒分离之前约4周和2周。我们的研究结果表明，ILI的咨询率至少提前两个星期的实验室监测的振荡，可以作为一个预测流感流行在香港。我们的模型对其他热带地区的有效性需要探索。
Consultation rates of influenza-like illness (ILI) in an outpatient setting have been regarded as a good indicator of influenza virus activity in the community. As ILI-like symptoms may be caused by etiologies other than influenza, and influenza virus activity in the tropics and subtropics is less predictable than in temperate regions, the correlation between of ILI and influenza virus activity in tropical and subtropical regions is less well defined. In this study, we used wavelet analysis to investigate the relationship between seasonality of influenza virus activity and consultation rates of ILI reported separately by General Out-patient Clinics (GOPC) and General Practitioners (GP). During the periods 1998–2000 and 2002–2003, influenza virus activity exhibited both annual and semiannual cycles, with one peak in the winter and another in late spring or early summer. But during 2001 and 2004–2006, only annual cycles could be clearly identified. ILI consultation rates in both GOPC and GP settings share a similar non-stationary seasonal pattern. We found high coherence between ILI in GOPC and influenza virus activity for the annual cycle, but this was only significant (p<0.05) during the periods 1998–1999 and 2002–2006. For the semiannual cycle high coherence (p<0.05) was also found significant during the period 1998–1999 and year 2003 when two peaks of influenza were evident. Similarly, ILI in GP setting is also associated with influenza virus activity for both the annual and semiannual cycles. On average, oscillation of ILI in GP and of ILI in GOPC preceded influenza virus isolation by approximately four and two weeks, respectively. Our findings suggest that consultation rates of ILI precede the oscillations of laboratory surveillance by at least two weeks and can be used as a predictor for influenza epidemics in Hong Kong. The validity of our model for other tropical regions needs to be explored.
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