Burden of human metapneumovirus infection in young children.
Burden of human metapneumovirus infection in young children.
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DOI：
10.1056/nejmoa1204630
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发表时间：
2013-02-14
期刊：
影响因子：
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通讯作者：
New Vaccine Surveillance Network
中科院分区：
文献类型：
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作者：
Edwards KM;Zhu Y;Griffin MR;Weinberg GA;Hall CB;Szilagyi PG;Staat MA;Iwane M;Prill MM;Williams JV;New Vaccine Surveillance Network
幼儿中人偏肺病毒（HMPV）感染的住院和门诊负担尚未得到很好的确定。我们对2003年至2009年美国三个县5岁以下住院和门诊儿童的急性呼吸道疾病或发热进行了前瞻性、基于人群的监测。从父母和病历中获得临床和人口统计学数据，通过逆转录聚合酶链反应检测HMPV，并确定与HMPV感染相关的基于人群的住院率和门诊就诊率。在3490名住院儿童中有200名（6%）、3257名门诊儿童中有222名（7%）、3001名急诊儿童中有224名（7%）和770名无症状对照儿童中有10名（1%）检测到HMPV。与HMPV感染相关的住院总年发生率为1/1000名5岁以下儿童，3/1000名6个月以下婴儿和2/1000名6至11个月儿童。与未感染HMPV住院的儿童相比，感染HMPV住院的儿童年龄更大，更有可能被诊断为肺炎或哮喘，需要补充氧气，并在重症监护室停留更长时间。与HMPV感染相关的门诊就诊的估计年负担为每1000名儿童55次门诊就诊和13次急诊就诊。大多数HMPV阳性的住院和门诊儿童没有基础的医疗条件，尽管早产和哮喘在HMPV感染的住院儿童中比在没有HMPV感染的儿童中更常见。HMPV感染与儿童在生命的前5年，特别是第一年的住院和门诊就诊的巨大负担相关。大多数感染HMPV的儿童以前都很健康。（由疾病控制和预防中心和国立卫生研究院资助。
The inpatient and outpatient burden of human metapneumovirus (HMPV) infection among young children has not been well established. We conducted prospective, population-based surveillance for acute respiratory illness or fever among inpatient and outpatient children less than 5 years of age in three U.S. counties from 2003 through 2009. Clinical and demographic data were obtained from parents and medical records, HMPV was detected by means of a reverse-transcriptase polymerase-chain-reaction assay, and population-based rates of hospitalization and estimated rates of outpatient visits associated with HMPV infection were determined. HMPV was detected in 200 of 3490 hospitalized children (6%), 222 of 3257 children in outpatient clinics (7%), 224 of 3001 children in the emergency department (7%), and 10 of 770 asymptomatic controls (1%). Overall annual rates of hospitalization associated with HMPV infection were 1 per 1000 children less than 5 years of age, 3 per 1000 infants less than 6 months of age, and 2 per 1000 children 6 to 11 months of age. Children hospitalized with HMPV infection, as compared with those hospitalized without HMPV infection, were older and more likely to receive a diagnosis of pneumonia or asthma, to require supplemental oxygen, and to have a longer stay in the intensive care unit. The estimated annual burden of outpatient visits associated with HMPV infection was 55 clinic visits and 13 emergency department visits per 1000 children. The majority of HMPV-positive inpatient and outpatient children had no underlying medical conditions, although premature birth and asthma were more frequent among hospitalized children with HMPV infection than among those without HMPV infection. HMPV infection is associated with a substantial burden of hospitalizations and outpatient visits among children throughout the first 5 years of life, especially during the first year. Most children with HMPV infection were previously healthy. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health.)