The Spectrum of Influenza in Children.
The Spectrum of Influenza in Children.
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DOI：
10.1093/cid/ciac734
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发表时间：
2023-02-08
期刊：
影响因子：
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中科院分区：
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儿童是流感负担和社区传播的重要组成部分，但社区一级无症状感染和流感后后遗症的频率知之甚少。在尼加拉瓜马那瓜进行了两项基于社区的前瞻性队列研究(2011-2020年、2017-2020年)和一项病例确证研究(2012-2017年)。通过聚合酶链式反应和血凝抑制试验确定0-14岁感染≥-1流感的非免疫低下儿童。研究中以家庭为基础的部分总共发生了1272例流感感染。84例(6.6%)感染患者无症状，且无症状比例随年龄增长而增加(0-1岁、2-4岁和5-14岁分别为1.7%、3.5%和9.1%；P<；.001)。在无症状儿童中，43名(51.2%)脱毒，而有症状儿童为1099名(92.5%)(P<；.001)。此外，2140例流感病例发生在研究的初级保健部分。流感后遗症很少见，最常见的是肺炎(52例，2.4%)和急性中耳炎(71例，3.3%)。与A/H3N1相比，A/H1N1有更高的年龄调整后的急性中耳炎(优势比[OR]1.99，95%可信区间[CI]：1.14-3.48；P=.015)和住院(OR 3.73，95%CI：1.68-8.67；P=0.002)。B/Victoria比B/Yamagata患肺炎的风险更高(OR 10.99，95%CI：1.34-90.28；P=0.026)。无症状流感感染在儿童中比成人少得多，尽管病毒在无症状儿童中仍会发生。流感后后遗症在社区儿童中很少见，病毒株可能对了解后遗症的风险很重要。儿童流感的全部临床谱系，包括无症状感染和后遗症的频率，知之甚少。我们发现，儿童的无症状感染是罕见的，而且是年龄相关的，后遗症的风险取决于病毒株。
Children constitute an important component of the influenza burden and community transmission, but the frequency of asymptomatic infection and post-influenza sequelae at the community level is poorly understood. Two community-based prospective cohort studies (2011–2020, 2017–2020) and 1 case-ascertained study (2012–2017) were conducted in Managua, Nicaragua. Non-immunocompromised children aged 0–14 years with ≥1 influenza infections, determined by polymerase chain reaction and hemagglutination inhibition assay, were included. A total of 1272 influenza infections occurred in the household-based portion of the study. Influenza infection was asymptomatic in 84 (6.6%) infections, and the asymptomatic fraction increased with age (1.7%, 3.5%, and 9.1% for ages 0–1, 2–4, and 5–14, respectively; P < .001). Of asymptomatic children, 43 (51.2%) shed virus, compared to 1099 (92.5%) symptomatic children (P < .001). Also, 2140 cases of influenza occurred in the primary care portion of the study. Sequelae of influenza were rare, with the most common being pneumonia (52, 2.4%) and acute otitis media (71, 3.3%). A/H1N1 had higher age-adjusted odds of acute otitis media (odds ratio [OR] 1.99, 95% confidence interval [CI]: 1.14–3.48; P = .015) and hospitalization (OR 3.73, 95% CI: 1.68–8.67; P = .002) than A/H3N2. B/Victoria had higher age-adjusted odds of pneumonia (OR 10.99, 95% CI: 1.34–90.28; P = .026) than B/Yamagata. Asymptomatic influenza infection is much less common in children than adults, although viral shedding still occurs in asymptomatic children. Post-influenza sequelae are rare in children in the community setting, and virus strain may be important in understanding the risk of sequelae. The full clinical spectrum of influenza in children, including frequency of asymptomatic infection and sequelae, is poorly understood. We found that asymptomatic infection in children is rare and age-dependent, and that the risk of sequelae depends on virus strain.
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DOI：
10.1038/s41579-021-00642-4
发表时间：
2021-12
期刊：
Nature reviews. Microbiology
影响因子：
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作者：
Koutsakos M;Wheatley AK;Laurie K;Kent SJ;Rockman S
通讯作者：
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影响因子：
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影响因子：
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