Clinical characteristics of children infected with enterovirus D68 in an outpatient clinic and the association with bronchial asthma
Clinical characteristics of children infected with enterovirus D68 in an outpatient clinic and the association with bronchial asthma
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DOI：
10.1080/23744235.2017.1400176
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发表时间：
2018-01-01
影响因子：
5.8
通讯作者：
Matsuzaki, Yoko
中科院分区：
文献类型：
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作者：
Itagaki, Tsutomu;Aoki, Yoko;Matsuzaki, Yoko
背景：所有与人类肠道病毒D 68（EV-D 68）相关的严重呼吸道疾病增加的报告均来自医院环境。然而，很少有报告描述的临床特征，在不太严重的影响populations.Methods：我们进行了一项回顾性观察研究，从2010年1月至2015年12月在日本山形。采用区域被动监测，从最初因急性呼吸道症状就诊于门诊的儿童中收集了5794份呼吸道标本。结果：2010年8 - 10月和2015年8 - 10月两个流行期共检出EV-D 68 79份，检出率分别为10.2%（31/304）和16.3%（46/282）。在69例EV-D 68阳性儿童中，排除病毒合并感染，39例（57%）有上呼吸道感染，23例（33%）毛细支气管炎或哮喘发作，5例（7%）支气管炎，1例（1%）脑膜炎和1例（1%）急性弛缓性麻痹。在23名喘息儿童中，10名（43%）观察到收缩，6名（26%）被诊断为哮喘急性发作。6名儿童需要住院治疗，5名（83%）是因为哮喘加重。哮喘或喘息史是发生喘息的最重要危险因素（比值比，8.23; 95%CI，2.65-25.50; p
Background: All reports of increases in severe respiratory disease associated with human enterovirus D68 (EV-D68) are from hospital settings. However, there are few reports describing clinical characteristics in less severely affected populations.Methods: We conducted a retrospective observational study from January 2010 to December 2015 in Yamagata, Japan. Using regional passive surveillance, 5794 respiratory specimens were collected from children who initially presented to an outpatient clinic with acute respiratory symptoms. The collected samples were tested for EV-D68 by reverse transcription PCR.Results: EV-D68 was detected in 79 specimens mainly during the two epidemic periods in August-October 2010 and August-October 2015, when detection rates were 10.2% (31 of 304 specimens) and 16.3% (46 of 282 specimens), respectively. Among the 69EV-D68-positive children, excluding those with viral coinfection, 39 (57%) had upper respiratory tract infections, 23 (33%) bronchiolitis or asthma attack, 5 (7%) bronchitis, 1 (1%) meningitis and 1 (1%) acute flaccid paralysis. In 23 children with wheezing, retraction was observed in 10 (43%), and six (26%) were diagnosed with asthma exacerbation. Six children required hospital admission, five (83%) because of asthma exacerbation. A history of asthma or wheezing was the most significant risk factor for the development of wheezing (odds ratio, 8.23; 95% CI, 2.65-25.50; p