Two-year periodicity of respiratory syncytial virus epidemics in Switzerland
Two-year periodicity of respiratory syncytial virus epidemics in Switzerland
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DOI：
10.1007/s15010-002-3124-8
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发表时间：
2003-03-01
期刊：
影响因子：
7.5
通讯作者：
Aebi, C
中科院分区：
文献类型：
--
作者：
Duppenthaler, A;Gorgievski-Hrisoho, M;Aebi, C
背景：呼吸道合胞病毒（RSV）每年的流行在时间和严重程度上有所不同。本研究的目的是：(1)描述瑞士RSV流行的时间相关模式，(2)推断对高危患者实施预防措施的最有效时间段。患者和方法：描述性研究：(1)1997年至2001年在一家儿科医院为100万人口服务的RSV住院情况；(2)1988年至1999年诊断实验室报告的全国RSV检出率。结果：分析了4次和12次流行期间分别发生的497例RSV住院病例和8574例RSV检测报告。在RSV感染的数量（2 - 4倍）、演变（从发病到高峰的中位间隔为13周，范围为4-13周vs 8周，范围为7-10周，p = 0.065）和中位持续时间（26周，范围为24-29周vs 19.5周，范围为18-21周，p = 0.005）方面存在轻微和主要流行的固定交替。据估计，如果在第50周开始使用单克隆抗RSV抗体帕利珠单抗的标准五剂量方案，最多可覆盖85.6%（范围，79.4-86.6%）的年度RSV感染。在大流行期间，最有效的起始时间为第43周（88.7%；范围81.9-94.6%）。结论：瑞士RSV流行病学具有固定的两年变化特征。在缺乏主动RSV监测的情况下，这种周期性对于安排RSV预防和医院资源管理是有用的。
Background: The annual respiratory syncytial virus (RSV) epidemics vary in time and severity. The aims of this study were (1) to describe the time-related pattern of RSV epidemics in Switzerland and (2) to deduce the most effective time period for administration of prophylactic measures to high-risk patients.Patients and Methods: Descriptive study of (1) RSV hospitalizations between 1997 and 2001 at a pediatric hospital serving a population of 1 million and (2) of national RSV detection rates reported by diagnostic laboratories between 1988 and 1999.Results: 497 RSV hospitalizations and 8,574 reported RSV detections occurring during four and 12 epidemics, respectively, were analyzed. There was fixed alternation of minor and major epidemics differing in the number of RSV infections (two to fourfold), evolution (median interval from onset to peak 13 weeks, range 4-13 weeks vs 8 weeks, range 7-10 weeks; p = 0.065) and median duration (26 weeks, range 24-29 weeks vs 19.5 weeks, range 18-21 weeks; p = 0.005). For minor epidemics it was estimated that a maximum of 85.6% (range, 79.4-86.6%) of annual RSV infections could be covered by a standard five-dose regimen of the monoclonal anti-RSV antibody palivizumab, if initiated in week 50. During major epidemics the most effective time of initiation would be week 43 (88.7%; range 81.9-94.6%).Conclusion: RSV epidemiology in Switzerland is characterized by fixed biannual variation. In the absence of active RSV surveillance, such periodicity is useful for scheduling RSV prophylaxis and for hospital resources management.