Severe acute respiratory syndrome (SARS) in children: epidemiology, presentation and management.
Severe acute respiratory syndrome (SARS) in children: epidemiology, presentation and management.
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DOI：
10.1016/s1526-0542(03)00088-5
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发表时间：
2003-12-01
影响因子：
5.8
通讯作者：
Fok, T F
中科院分区：
文献类型：
--
作者：
Leung, T F;Wong, G W K;Fok, T F
严重急性呼吸系统综合症(SARS)是一种新发现的高传染性呼吸道感染，由一种新的冠状病毒株引起。这种疾病可导致成人进行性呼吸衰竭，据报道死亡率为8-15%。这种感染通过飞沫传播传播，儿童似乎通过与受感染成年人的密切家庭接触而感染SARS。然而，在儿科年龄组中，疾病的严重性要轻得多。感染儿童和青少年的常见实验室表现包括淋巴减少和乳酸脱氢酶和肌酸磷酸激酶水平升高。空隙固缩在病程中是常见的，尽管有一半的病例胸部X线片表现正常。SARS的病理生理学似乎与对冠状病毒感染作出反应的免疫失调有关。儿童SARS的最佳治疗方案仍有待确定。尚未有感染儿童死亡病例的报告。及早和适当地隔离受感染的成年人、在医院内采取细致的感染控制措施、彻底的接触者追踪和检疫措施，是防止疾病在医护人员中传播和进入社区的重要步骤。目前正在开发一种敏感、快速的早期诊断检测方法。需要进一步的对照试验来确定儿童这种感染的最佳治疗方法。
Severe acute respiratory syndrome (SARS) is a newly recognised and highly contagious respiratory infection caused by a new strain of coronavirus. The disease can result in progressive respiratory failure in adults and the mortality rate has been reported to be 8-15%. This infection spreads by droplet transmission and children appear to acquire SARS through close household contact exposure to infected adults. Disease severity is, however, much milder in the paediatric age group. The common laboratory findings in infected children and adolescents include lymphopaenia and elevated levels of lactate dehydrogenase and creatinine phosphokinase. Air space consolidation is commonly seen during the course of the illness although chest radiographs are normal on presentation in half of the cases. The pathophysiology of SARS appears to be related to immunological dysregulation in response to the coronavirus infection. The optimal treatment of SARS in children remains to be determined. No case fatality in infected children has been reported. The early and proper isolation of infected adults, meticulous infection control measures in the hospital setting, exhaustive contact tracing and quarantine measures are important steps in preventing the spread of the disease among health care workers and into the community. The development of a sensitive and rapid test for early diagnosis is underway. Further controlled trials are necessary to define the optimal treatment of this infection in children.