Viral etiologies and epidemiology of patients with acute respiratory infections based on sentinel hospitals in Gansu Province, Northwest China, 2011‐2015

Abstract

Understanding etiological role and epidemiological profile is needed to improve clinical management and prevention of acute respiratory infections (ARIs). A 5-year prospective study about active surveillance for outpatients and inpatients with ARIs was conducted in Gansu province, China, from January 2011 to November 2015. Respiratory specimens were collected from patients and tested for eight respiratory viruses using polymerase chain reaction (PCR) or reverse transcription polymerase chain reaction (RT-PCR). In this study, 2768 eligible patients with median age of 43 years were enrolled including pneumonia (1368, 49.2%), bronchitis (435, 15.7%), upper respiratory tract infection or URTI (250, 9.0%), and unclassified ARI (715, 25.8%). Overall, 29.2% (808/2768) were positive for any one of eight viruses, of whom 130 cases were identified with two or more viruses. Human rhinovirus (HRV) showed the highest detection rate (8.6%), followed by influenza virus (Flu, 7.3%), respiratory syncytial virus (RSV, 6.1%), human coronavirus (hCoV, 4.3%), human parainfluenza (PIV, 4.0%), adenovirus (ADV, 2.1%), human metapneumovirus (hMPV, 1.6%), and human bocavirus (hBoV, 0.7%). Compared with URTI, RSV was more likely identified in pneumonia (χ = 12.720, P < 0.001) and hCoV was more commonly associated with bronchitis than pneumonia (χ = 15.019, P < 0.001). In patients aged less than 5 years, RSV showed the highest detection rate and hCoV was the most frequent virus detected in adults and elderly. The clear epidemical seasons were observed in HRV, Flu, and hCoV infections. These findings could serve as a reference for local health authorities in drawing up further plans to prevent and control ARIs associated with viral etiologies.

Baseline characteristics and clinical symptoms related to respiratory viruses identified among patients presenting with influenza-like illness in primary care

“…Presence of dyspnoea was associated with RSV infection and absence of dyspnoea was related to IV detection, as previously reported [16]. This is consistent with the biology of these viruses: typically, IV infections predominantly involve the upper respiratory tract and trachea [18,19], as human strains of IV primarily target cells of the upper airway [20], unlike RSV infections, which are more commonly associated with lower respiratory tract infections such as bronchiolitis and pneumonia [21,22]. Headache was associated with an increased risk of IV detection and a lower risk of RSV and HMPV detection, consistent with previous studies [7,16,23].…”

Viral and Atypical Pathogens Epidemiology of a Large Cohort of Patients with Acute Respiratory Tract Infections in Shaanxi Province, Northwest China

“…[9][10][11] At present, several studies on the epidemiology and etiology of respiratory pathogens of children in different areas have been reported, 7,16,[20][21][22][23] The result of this study shows that the top three most prevalent pathogens were MP (18.12%, 2816/5597),Flu B (11.65%, 1811/5597) and CP (7.00%, 1088/5597). The total positive detection rate is 36.01% (5597/15443) in Xi'an, which was similar with the previous study in Turkey (33.4 ) and Shandong province in China (35.75 ), 12,18 and signi cantly higher than that reported in Beijing (5.64%), Shenzhen (14.55%), Suzhou (13.6%) and Gansu province in China (29.2%), [13][14][15][16] but lower than that reported in north China (39.3%). 17 The nding also illustrates that the mixed infections rate is 9.13% (1419/15543) in northwest China, which is signi cant lower than that in Shandong province (15.67%), 18 but higher than that in Beijing (2.13%), Gansu province (4.70%) and north China (7.6%).…”

“…17 The nding also illustrates that the mixed infections rate is 9.13% (1419/15543) in northwest China, which is signi cant lower than that in Shandong province (15.67%), 18 but higher than that in Beijing (2.13%), Gansu province (4.70%) and north China (7.6%). 13,14,17 Similar to the studies in Turkey, other area in China including Suzhou, Shandong and Gansu province, 12,14,15,18 Flu B is the most common respiratory virus in Xi'an, Shaanxi, in which children are mainly infected. However, RSV, ADV and PIV are common in Shenzhen, 16 RSV and rhinovirus infection are the main pathogens in north China.…”

“…The infection rate of Flu B was the highest, followed by MP and RSV in minors (<18years), which was similar to the previous research results in Turkey, eastern China and north China. 12,14,18 It may be associated with immature immune system in children and adolescents. What's more, malnutrition, exposure to crowded conditions, indoor air pollution, lack of breastfeeding and low birth weight can increase the risk of ARIs in children.…”

“…Although several epidemiological studies on ARIs have been reported in other countries and other area in China, the epidemiological characteristics of common pathogens of ARIs are different due to inclusion criteria, climate, environmental pollution, population and other factors. [12][13][14][15][16][17][18] Moreover, most of these studies only conducted epidemiological analysis on children or single pathogens, and did not include the data of this study.…”