2009—2021年中国九省份发热呼吸道症候群监测病例中常见病毒感染情况分析

Analysis of common viral infection in surveillance cases of febrile respiratory syndrome in 9 provinces of China from 2009 to 2021

目的了解我国九省份发热呼吸道症候群(FRS)监测病例中常见病毒感染情况。方法研究资料来源于中国疾病预防控制中心"传染病监测技术平台信息管理系统"中九省份(安徽、北京、广东、河北、湖南、吉林、山东、陕西和新疆)2009年1月至2021年6月间的FRS病例监测数据,最终将具有8种病毒[人流感病毒(HIFV)、人呼吸道合胞病毒(HRSV)、人腺病毒(HAdV)、人副流感病毒(HPIV)、人鼻病毒(HRV)、人偏肺病毒(HMPV)、人冠状病毒(HCoV)以及人博卡病毒(HBoV)]核酸检测结果的8 243例FRS监测病例纳入研究。采用χ2检验/Fisher确切概率法分析不同年龄组、不同地区和不同季节病例的病毒检出率差异。结果 8 243例FRS病例年龄M(Q1,Q3)为4(1,18)岁,<5岁以下儿童占56.56%(4 662例);男性占58.1%(4 792例);病例主要来源于门、急诊病例和住院病例,其中门急诊病例数为2 043例,住院病例数为6 200例。FRS病例的病毒检出率从高到低依次为HRSV、HIFV、HPIV、HRV、HAdV、HMPV、HCoV和HBoV。有524例病例同时检出两种及两种以上病毒,占病毒检测阳性病例数的15.66%。不同年龄组中病毒检出率的差异具有统计学意义(均P<0.05),<5岁以下儿童的病毒检出率较高(49.96%)。南方任一病毒阳性检出率高于北方(P<0.001)。FRS病毒阳性病例全年均有检出,HRSV检出率在秋、冬季较高,HIFV检出率在冬季较高,HMPV检出率在冬、春季较高;而HPIV、HRV、HCoV和HBoV的检出率在夏、秋季节较高,而HAdV在不同季节检出率的差异无统计学意义。与2009—2019年相比,2020—2021年的任一病毒阳性检出率有所下降,由原来的41.37%下降至37.86%;HIFV检出率由原来的10.62%急剧下降至1.37%;HPIV检出率由原来的8.24%下降至5.88%。而HRV和HBoV的检出率则由原来的5.43%和1.79%,分别上升至9.67%和3.19%。结论 2009—2021年中国九省份FRS病例以HRSV和HIFV感染较为常见,8种常见呼吸道病毒的流行特征存在年龄、地区和季节差异。

Objective To understand the common viral infection among the surveillance cases of fever respiratory syndrome(FRS)in nine provinces in China.Methods The research data were obtained from nine provinces(Anhui,Beijing,Guangdong,Hebei,Hunan,Jilin,Shandong,Shaanxi and Xinjiang)in the"Infectious Disease Surveillance Technology Platform Information Management System"of the Chinese Center for Disease Control and Prevention from January 2009 to June 2021.Finally,8243 FRS cases with nucleic acid detection results of eight viruses[human influenza virus(HIFV),human respiratory syncytial virus(HRSV),human adenovirus(HAdV),human parainfluenza virus(HPIV),human rhinovirus(HRV),human metapneumovirus(HMPV),human coronavirus(HCoV)and human Boca virus(HBoV)]were included in the study.Theχ2 test/Fisher exact probability method was used to analyze the difference of virus detection rate in different age groups,regions and seasons.Results The M(Q1,Q3)age of 8243 FRS cases was 4(1,18)years old,and 56.56%(4662 cases)were children under 5 years old.Males accounted for 58.1%(4792 cases)of all cases.All cases were from outpatient/emergency department(2043 cases)and inpatient department(6200 cases).The virus detection rates of FRS cases from high to low were HRSV,HIFV,HPIV,HRV,HAdV,HMPV,HCoV and HBoV.Two or more viruses were detected simultaneously in 524 cases,accounting for 15.66%of virus-positive cases.The difference of the virus detection rate in different age groups was statistically significant(all P values<0.05),and the virus detection rate in children<5 years old was higher(49.96%).The positive rate of any virus in south China was higher than that in north China(P<0.001).The virus-positive FRS cases were detected throughout the year.The detection rate of HRSV was higher in autumn and winter.The detection rate of HIFV was higher in winter.The detection rate of HMPV was higher in winter and spring.The detection rates of HPIV,HRV,HCoV and HBoV were higher in summer and autumn,while there was no significant difference in the detection rate of HAdV in different seasons.Compared with 2009-2019,the detection rate of any virus in 2020-2021 decreased from 41.37%to 37.86%.The detection rate of HIFV decreased sharply from 10.62%to 1.37%.The detection rate of HPIV decreased from 8.24%to 5.88%.The detection rate of HRV and HBoV increased from 5.43%and 1.79%to 9.67%and 3.19%,respectively.Conclusion HRSV and HIFV infections are more common among FRS cases in nine provinces in China from 2009 to 2021,and the epidemiological characteristics of eight common respiratory viruses vary in different age groups,regions and seasons.