Influenza and the rates of hospitalization for respiratory disease among infants and young children.
Influenza and the rates of hospitalization for respiratory disease among infants and young children.
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DOI：
10.1056/nejm200001273420402
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发表时间：
2000-01-27
影响因子：
158.5
通讯作者：
Fukuda, K
中科院分区：
文献类型：
--
作者：
Izurieta, HS;Thompson, WW;Fukuda, K
背景：幼儿感染流感病毒后发生严重并发症的风险可能增加。然而，在基于人群的研究中，很难将流感病毒的影响与呼吸道合胞病毒的影响分开。呼吸道合胞病毒经常与流感病毒一起传播，是婴幼儿下呼吸道感染住院治疗的最常见原因。我们研究了在流感病毒的传播超过呼吸道合胞病毒的传播期间，婴儿和儿童急性呼吸道疾病的住院率。方法：在1992年至1997年期间的10月至5月的每个季节，我们使用当地病毒监测数据来确定华盛顿州和北方加州流感病毒流行占主导地位的时期而不是呼吸道合胞病毒我们计算了因急性呼吸道疾病住院的比率、流感病毒所致的超额比率以及所有参加北方加州Kaiser Permanente医疗保健计划或普吉特海湾团体健康合作社的18岁以下婴儿和儿童的发病率比率。没有使他们处于流感并发症高风险的条件的儿童中因急性呼吸道疾病住院的比率（例如，哮喘、心血管疾病或早产）和年龄小于2岁的儿童在北方加州Kaiser研究中心（1993 - 1997年）为231/100，000人-月，在Group Health Cooperative研究中心（1992 - 1997年）为193/100，000人-月。这些比率大约是5至17岁没有高风险状况的儿童的比率的12倍（北方加州Kaiser研究中心为19/100，000人月，000人月），并接近5至17岁患有慢性健康状况的儿童的比率（分别为386/100，000人月和216/100，000人月）。结论：没有慢性或严重医疗状况的婴幼儿在流感季节住院的风险增加。应考虑对这些儿童进行常规流感疫苗接种。（N Engl J Med 2000;342：232-9.）（C）2000年，马萨诸塞州医学会。
Background: Young children may be at increased risk for serious complications from influenzavirus infection. However, in population-based studies it has been difficult to separate the effects of influenzavirus from those of respiratory syncytial virus. Respiratory syncytial virus often circulates with influenzaviruses and is the most frequent cause of hospitalization for lower respiratory tract infections in infants and young children. We studied the rates of hospitalization for acute respiratory disease among infants and children during periods when the circulation of influenzaviruses predominated over the circulation of respiratory syncytial virus.Methods: For each season from October to May during the period from 1992 to 1997, we used local viral surveillance data to define periods in Washington State and northern California when the circulation of influenzaviruses predominated over that of respiratory syncytial virus. We calculated the rates of hospitalization for acute respiratory disease, excess rates attributable to influenzavirus, and incidence-rate ratios for all infants and children younger than 18 years of age who were enrolled in either the Kaiser Permanente Medical Care Program of Northern California or the Group Health Cooperative of Puget Sound.Results: The rates of hospitalization for acute respiratory disease among children who did not have conditions that put them at high risk for complications of influenza (e.g., asthma, cardiovascular diseases, or premature birth) and who were younger than two years of age were 231 per 100,000 person-months at Northern California Kaiser sites (from 1993 to 1997) and 193 per 100,000 person-months at Group Health Cooperative sites (from 1992 to 1997). These rates were approximately 12 times as high as the rates among children without high-risk conditions who were 5 to 17 years of age (19 per 100,000 person-months at Northern California Kaiser sites and 16 per 100,000 person-months at Group Health Cooperative sites) and approached the rates among children with chronic health conditions who were 5 to 17 years of age (386 per 100,000 person-months and 216 per 100,000 person-months, respectively).Conclusions: Infants and young children without chronic or serious medical conditions are at increased risk for hospitalization during influenza seasons. Routine influenza vaccination should be considered in these children. (N Engl J Med 2000;342:232-9.) (C)2000, Massachusetts Medical Society.