Building The Platform Of Viral Pneumonia Database And Research Of Measles Viral Pneumonia Clinical Features And Identification Tool

Background: CAP(community-acquired pneumonia)is a serious threat to people of all ages,especially virus associated pneumonia.Measles in setting with high vaccination coverage shows new situation.Vaccinated individuals with measles infection can be misdiagnosed for absences of specific Ig M and nodular pneumonia.An effective identification tool is needed.Methods:China-Japan Friendship Hospital,Chinese center for disease control and prevention and other 34 hospital established the Network for Adolescent and Adult Community Acquired Pneumonia in China.During October 2015 to 30 June 2017,patients with community acquired pneumonia were prospective enrolled into the database and analyzed.In the spring of 2016,nine hospital healthcare workers developed nodular pneumonia within a week period.Their contagious disease results were negative,except for measles Ig M in two cases.To investigate the pathogen,another seven patients with measles-like symptoms,admitted from the community during the same period,were also investigated.Swab and blood samples were collected immediately and sent to the Chinese center for disease control and prevention.Results: Network for Adolescent and Adult Community Acquired Pneumonia in China was successfully built and a prospective registration trial was conducted according to international standard with 2373 cases successfully enrolled.Measles virus was detected in 16 cases by RT-PCR.Nodules were found in 10 patients with a chest CT scan,and they were defined as the nodular group(n=10).The remaining without nodules were defined as the control group(n=6).Measles-specific Ig G titers in the nodular group were high(3618.3-5000 m IU/m L),and Ig M were low(< 25 m IU/m L);Ig G titers in the control group were low(241.4-2560.3 m IU/m L),while Ig M were high(137-5000 m IU/m L).Conclusions: In the presence of measles,nodular pneumonia was only evident in those patients with an Ig G/Ig M ratio> 20.In measles outbreaks,the Ig G/Ig M ratio may be useful to identify nodular pneumonia.