株洲地区一起人鼻病毒感染暴发的状况分析

Analysis of an outbreak of human rhinovirus infection in Zhuzhou area

目的回顾性分析株洲地区2020年5—6月新型冠状病毒肺炎防控期间人鼻病毒(human rhinovirus,HRV)呼吸道感染的流行状况,为今后控制HRV暴发流行提供科学参考。方法对湖南中医药高等专科学校附属第一医院收治出现相关临床症状的患者进行流行病学调查,获取的564份标本进行实时荧光定量PCR检测HRV核酸载量,同时HRV阳性患者进行其他5项常见呼吸道病毒核酸定性检测。结果①检出HRV阳性病例242例(1~17岁),男136例、女106例,男、女阳性率差异无统计学意义(χ^(2)=0.050,P>0.05)。不同年龄组比较,12岁及以下儿童HRV阳性率较高,差异具统计学意义(χ^(2)=8.971,P<0.05),其中1~5岁阳性患者在相应年龄段中检出率最高,为51.28%。6~12岁阳性患者最多,占阳性总数的80.17%。②HRV阳性患者临床首发症状以发热为主(78.10%,189/242),且出现症状2~3 d采样进行HRV核酸检测的阳性率最高(68.18%,165/242)。③合并感染的病毒类型以呼吸道腺病毒为主(58.33%,49/84),其次为呼吸道合胞病毒(26.19%,22/84),且合并感染者HRV病毒载量比单独感染者高(Z=-11.907,P<0.001)。结论此次株洲地区HRV疫情以小学生为主要感染群体,且患者以发热为主要发病症状,合并其他呼吸道病毒感染时患者HRV病毒载量差异可为病情评估提供帮助。

Objective To investigate an outbreak of human rhinovirus(HRV)respiratory tract infection during the prevention and control of new coronavirus pneumonia in Zhuzhou in May and June 2020 for better control of future human rhinovirus outbreaks.Methods An epidemiological survey was conducted for 564 patients with clinical symptoms who were treated in the First Affiliated Hospital of Hunan Traditional Chinese Medical College.The clinical records of patients were reviewed and analyzed to understand the occurrence and development of infection.Real-time fluorescence quantitative PCR was used to detect rhinovirus nucleic acid.The HRVpositive patients were tested for five other common respiratory viruses by qualitative nucleic acid tests.Results HRV was positive in 242 cases,including 136 males and 106 females,1-17 years of age.The prevalence of HRV infection did not show significant difference between males and females(P>0.05).The prevalence of HRV infection was higher in children under 12 years of age(P<0.05).The highest prevalence of HRV infection(51.28%)was found in the age group of 1-5 years.Majority of the cases(80.17%)were identified in the children of 6-12 years old.Fever was the most common clinical symptom(78.10%,189/242)in HRV-positive patients.The nucleic acid assay 2-3 days after onset of symptoms resulted in the highest positive rate(68.18%,165/242).The testing of five other pathogens in HRV-positive patients suggested that respiratory adenovirus was the main co-infecting virus(58.33%,49/84),followed by respiratory syncytial virus(26.19%,22/84).Co-infected patients were associated with higher rhinovirus load than the patients infected with HRV alone(P<0.001).Conclusions This HRV outbreak in Zhuzhou was primarily prevalent among primary school students.Fever was the most common first onset symptom.The difference of HRV load in the patients co-infected with other respiratory pathogen is helpful for evaluating the disease.