Seven-fold increase in viral meningo-encephalitis reports in England and Wales during 2004-2013
Seven-fold increase in viral meningo-encephalitis reports in England and Wales during 2004-2013
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DOI：
10.1016/j.jinf.2014.05.012
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发表时间：
2014-10-01
影响因子：
28.2
通讯作者：
Ladhani, Shamez N.
中科院分区：
文献类型：
--
作者：
Kadambari, Seilesh;Okike, Ifeanyichukwu;Ladhani, Shamez N.
目的：在高度免疫的人群中，病毒是导致脑膜脑炎病例比例高得多的原因。这项全国性的研究旨在描述英格兰和威尔士十年来实验室证实的病毒性脑炎报告的人口趋势。方法：对2004- 2013年英格兰和威尔士国家卫生服务医院提交的实验室确诊的病毒性脑膜脑炎病例进行分析。结果：10年来，英格兰和威尔士共发生9941例病毒性脑炎实验室确诊病例。所有年龄组和所有病毒的报告数量从2004年的311例（发病率，0.6/10万）增加到2013年的2168例（发病率，3.9/10万）。诊断时的中位年龄为30.6岁（IQR, 1.3-51.5）岁，其中三分之一的病例为儿童。2013年，3月龄以下婴儿占27%(588/2168)，但发病率最高（329/10万）。肠道病毒占所有病例的52%(5133/9941)，在3个月以下的婴儿中占92%(1952/2121)（2013年发病率为313/100,000，相当于77/100,000活产），其次是单纯疱疹（2885/9941;29%）和水痘带状疱疹（1342/9941;13%），主要发生在bb0 = 45岁的儿童中。结论：分子检测的使用增加导致实验室确诊的病毒性脑膜脑炎报告增加了7倍。大型临床观察性研究是确定病毒性脑膜脑炎负担的必要条件，特别是在婴儿中。(C) 2014年英国感染协会。Elsevier Ltd.出版。版权所有。
Objectives: In highly immunised populations viruses contribute to a substantially higher proportion of meningo-encephalitis cases. This national study aimed to describe population trends in laboratory-confirmed, viral meningo-encephalitis reports in England and Wales over a ten-year period.Methods: Laboratory-confirmed, viral meningo-encephalitis cases submitted by National Health Service hospitals in England and Wales during 2004-13 were analysed.Results: There were 9941 laboratory-confirmed reports of viral meningo-encephalitis in England and Wales over the 10-year period. Number of reports increased across all age-groups and for all viruses from 311 (incidence, 0.6/100,000) in 2004 to 2168 in 2013 (incidence, 3.9/100,000). Median age at diagnosis was 30.6 (IQR, 1.3-51.5) years, with a third of cases diagnosed in children. In 2013, infants aged < 3 months accounted for 27% (588/2168) of cases, but had the highest incidence (329/100,000). Enteroviruses were responsible for 52% (5133/9941) of all cases and 92% (1952/2121) in < 3 month-olds (incidence, 313/100,000 in 2013, equivalent to 77/100,000 live-births) followed by herpes simplex (2885/9941; 29%) and varicella zoster (1342/9941; 13%), mainly among >= 45 year-olds.Conclusion: Increasing use of molecular testing has led to a 7-fold increase in laboratory-confirmed, viral meningo-encephalitis reports. Large clinical-observational studies are necessary to determine the burden of viral meningo-encephalitis, especially in infants. (C) 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.