Pediatric influenza-associated myositis - Nebraska, 2001-2007
Pediatric influenza-associated myositis - Nebraska, 2001-2007
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DOI：
10.1111/j.1750-2659.2009.00102.x
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发表时间：
2009-11-01
影响因子：
4.4
通讯作者：
Uyeki, Timothy M.
中科院分区：
文献类型：
--
作者：
Buss, Bryan F.;Shinde, Vivek M.;Uyeki, Timothy M.
目的流感相关性肌炎（IAM）是儿童流感的一种并发症，以严重的下肢肌痛和不愿行走为特征。我们调查了2001-2007年内布拉斯加州六个流感季节的IAM。方法：在2006-2007年期间，我们要求报告年龄< 18岁的严重流感疾病，并调查医疗记录，以确定和确认IAM病例，定义为年龄< 18岁的患者在实验室确诊的流感疾病发病后7天内出现血清肌酐激酶水平升高的严重肌痛。通过使用监测数据确定流感活动期，对全州医院出院数据（HDD）进行了审查，以确定2006-2007年和之前5个流感季节的回顾性确诊IAM病例。估计2001-2002年至2006-2007年全州IAM发病率。结果2006-2007年期间，通过加强监测，共确认了13例IAM病例。中位年龄为6岁(范围4-11岁)。通过对6名患者（1名甲型流感和5名乙型流感）进行病毒分离和对7名患者进行快速诊断测试，确定了流感诊断。12例(92%)患者，包括1例死亡，住院时间中位数为3天(范围1-4天)。对HDD的审查确定了2006-2007年期间回顾性确认的12例IAM病例，包括4例未通过加强监测报告的病例，在前5个季节（2003-2004年）只有1例。在2006-2007年和2003-2004年期间，hdd衍生的回顾性确认的全州范围内每10万< 18岁人口的IAM发病率估计分别为2中心点693和0中心点225。结论2006-2007年流感季节内布拉斯加州发生了一次IAM流行。
ObjectiveInfluenza-associated myositis (IAM), characterized by severe lower-extremity myalgia and reluctance to walk, is a complication of influenza among children. We investigated IAM in Nebraska during six influenza seasons, 2001-2007.MethodsDuring 2006-2007, we requested reports of severe influenza illness among persons aged < 18 years and investigated medical records to identify and confirm IAM cases defined as severe myalgia with elevated serum creatinine kinase level in a patient aged < 18 years, occurring within 7 days of laboratory confirmed influenza illness onset. Statewide hospital discharge data (HDD) were reviewed to identify retrospectively confirmed IAM cases during 2006-2007 and five previous seasons, by using surveillance data to define periods of influenza activity. Statewide IAM incidence was estimated for 2001-2002 through 2006-2007.ResultsDuring 2006-2007, a total of 13 IAM cases were confirmed by enhanced surveillance. Median age was 6 years (range, 4-11 years). Influenza diagnosis was established by viral isolation from six patients (one influenza A and five influenza B) and rapid diagnostic tests for seven. Twelve (92%) patients, including one who died, were hospitalized for a median of 3 days (range, 1-4 days). Review of HDD identified 12 retrospectively confirmed IAM cases during 2006-2007, including four not reported through enhanced surveillance, and only one during five previous seasons (2003-2004). The HDD-derived, retrospectively confirmed statewide IAM incidence estimates/1 00 000 population aged < 18 years were 2 center dot 693 and 0 center dot 225 during 2006-2007 and 2003-2004, respectively.ConclusionAn IAM epidemic occurred in Nebraska during the 2006-2007 influenza season.