在流感疫情别忘了RSV在年幼的孩子

呼吸道合胞病毒的发现导致更多的急救科就诊和住院比季节性流感

2009年11月23日

波士顿，大众。—流感，特别是甲型H1N1流感，这可以理解引起了公众健康官员、媒体和公众的关注。然而，分析波士顿儿童医院在最近的几次流感季节，在急诊科的患者出现了另一种病毒—呼吸道合胞病毒（RSV）--需要一个更大的疾病人数在年幼的儿童并不比季节性流感。

虽然数据来自pre-h1n1流感时期，分析，由杂志在线发表儿科11月23日，是一个提醒，呼吸道合胞病毒可引起婴幼儿严重疾病。之前的研究显示，3岁，近百分之100的儿童呼吸道合胞病毒感染。根据CDC，RSV是美国1岁以下儿童毛细支气管炎和肺炎的最常见原因

这项研究由佛罗伦萨资产阶级，MD，MPH，和Kenneth M和l, MD, MPH，这两个孩子的急诊医学科和 the儿童医院信息学计划, looked at acute respiratory illnesses in children aged 7 和 younger, 和 found that patients infected with RSV had more than twice as many ED visits 和 six times more hospitalizations than those infected with seasonal flu。 RSV-related illnesses were also twice as likely to lead to additional primary care clinic visits 和 to antibiotic treatment。 The parents of children with RSV missed almost three times more workdays than parents of children with the flu, 和 parents of children under age 2 were nearly five times more likely to miss work when their child had RSV。

“呼吸道合胞病毒已被低估，说：”资产阶级，他也是哈佛医学院附属。”有不成比例的关注流感，尽管我们的数据显示发病率从RSV是非常高的。根据我们的数据，更应该做的预防措施。”

The RSV season begins in October, but generally doesn't peak until January 和 lasts through April/May, so it will become more visible in the coming months, she adds。

Bourgeois 和 colleagues prospectively studied children aged 7 和 under visiting the 波士顿儿童医院 ED with acute respiratory illnesses during five consecutive seasons (2001-2006) - an average of 5,288 visits each year。 A subgroup of children underwent viral testing; 23。6 percent were found to have RSV 和 11。2 percent had influenza。 To quantify additional healthcare visits 和 missed school 和 work days， researchers conducted st和ardized interviews with 210 parents whose children had documented RSV or flu。

Using census data 和 data on pediatric acute respiratory illness from the National Hospital 和 Ambulatory Medical Care Survey, Bourgeois 和 colleagues were able to extrapolate their data nationally 和 determine population-based rates of RSV 和 flu illnesses。 They estimate that 21。5 ED visits per 1,000 children were attributable to RSV, as compared with 10。2 per 1,000 for seasonal flu。 Children under age 2 with RSV had the most visits - 64。4 per 1,000。 Estimated hospitalization rates were 8。5 per 1000 for RSV, versus 1。4 per 1000 for flu。 Nationally, caregivers missed an estimated 716,404 workdays each year for RSV 和 246,965 for flu。

Although the study only looked at children age 7 和 younger， researchers believe their findings are relevant to older age groups, since young children drive transmission of viral infections， researchers say。 Recent hospitalization 和 mortality data indicate that, like flu, RSV disproportionately affects elderly persons。*

While H1N1 may change the equation this year - there are indications that it's causing a greater burden of illness than seasonal flu - we shouldn't relax our public-health vigilance once that epidemic starts to wane, says Bourgeois。 "Many of the prevention measures people are following for H1N1 - such as frequent h和washing, using alcohol-based h和-sanitizers, 和 staying home when they're sick - should apply every winter, to every viral season," she says。

这项研究是由国家医学图书馆，National Institute of Child Health 和 Human Development，马萨诸塞州公共卫生部，General Clinical Research Center at 波士顿儿童医院, 和 theAgency for Healthcare Research 和 Quality。 Clarissa Valim, MD, ScD, of 波士顿儿童医院's Clinical Research Program 和 the Harvard School of Public Health, 和 Alex和er J。 McAdam, MD, PhD, of the Department of Laboratory Medicine at Children's, were co-authors。

*作进一步的背景，见：

Falsey AR; et al。 Respiratory syncytial virus infection in elderly 和 high-risk adults。N Engl J Med4月28日2005；3 52（17）：1749-59。

Thompson WW; et al。 Mortality associated with influenza 和 呼吸道合胞病毒 in the United States。日本汽车制造商协会1月8日2003；289（2）：179-86。

Hall CB; et al。 The burden of 呼吸道合胞病毒 infection in young children。N Engl J Med2月5日2009；360（6）：588。

触点：
艾琳的长跑冠军
波士顿儿童医院
617-919-3110
erin。mccolgan@childrens。harvard。edu

Founded in 1869 as a 20-bed hospital for children, 波士顿儿童医院 today is one of the nation's leading pediatric medical centers， primary pediatric teaching hospital of Harvard Medical School, 和 the largest provider of health care to Massachusetts children。 In addition to 396 pediatric 和 adolescent inpatient beds 和 more than 100 outpatient programs, Children's houses the world's largest research enterprise based at a pediatric medical center, where its discoveries benefit both children 和 adults。 More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine 和 13 members of the Howard Hughes Medical Institute comprise Children's research community。 For more information about the hospital visit:www。childrenshospital。org\/newsroom。

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