Viral etiology and clinical profiles of children with severe acute respiratory infections in China

Chen Zhang; Na Zhu; Zhengde Xie; Roujian Lu; Bin He; Chunyan Liu; Xuejun Ma; Wenjie Tan

doi:10.1371/journal.pone.0072606

Viral etiology and clinical profiles of children with severe acute respiratory infections in China

PLoS One. 2013 Aug 22;8(8):e72606. doi: 10.1371/journal.pone.0072606. eCollection 2013.

Authors

Chen Zhang¹, Na Zhu, Zhengde Xie, Roujian Lu, Bin He, Chunyan Liu, Xuejun Ma, Wenjie Tan

Affiliation

¹ Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Centers for Disease Control and Prevention (CDC), Beijing, China.

Abstract

Background: No comprehensive analysis is available on the viral etiology and clinical characterization among children with severe acute respiratory infection (SARI) in China during 2009 H1N1 pandemic and post-pandemic period.

Methods: Cohort of 370 hospitalized children (1 to 72 months) with SARI from May 2008 to March 2010 was enrolled in this study. Nasopharyngeal aspirate (NPA) specimens were tested by a commercial assay for 18 respiratory viral targets. The viral distribution and its association with clinical character were statistically analyzed.

Results: Viral pathogen was detected in 350 (94.29%) of children with SARI. Overall, the most popular viruses were: enterovirus/rhinovirus (EV/RV) (54.05%), respiratory syncytial virus (RSV) (51.08%), human bocavirus (BoCA) (33.78%), human parainfluenzaviruse type 3 (PIV3) (15.41%), and adenovirus (ADV) (12.97%). Pandemic H1N1 was the dominant influenza virus (IFV) but was only detected in 20 (5.41%) of children. Moreover, detection rate of RSV and human metapneumovirus (hMPV) among suburb participants were significantly higher than that of urban area (P<0.05). Incidence of VSARI among suburb participants was also significant higher, especially among those of 24 to 59 months group (P<0.05).

Conclusion: Piconaviruses (EV/RV) and paramyxoviruses are the most popular viral pathogens among children with SARI in this study. RSV and hMPV significantly increase the risk of SARI, especially in children younger than 24 months. Higher incidence of VSARI and more susceptibilities to RSV and hMPV infections were found in suburban patients.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
China / epidemiology
Female
Humans
Infant
Male
Nasopharynx / virology
Respiratory Tract Infections / pathology*
Respiratory Tract Infections / virology*
Seasons
Severity of Illness Index

Grants and funding

The study was funded by grants from the State Megaproject for Infectious Disease Research of China (2011ZX10004-001，2013ZX1004601) and National 863 Project of China (2007AA02Z464). The Sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.