The Epidemiological Characteristics Of Pediatric Adenovirus Associated Acuate Lower Respiratory Tract Infection In Hangzhou

Background:Acute lower respiratory infection is one of the most common diseases in children. Adenovirus (ADV) infection is one of the intensive diseases in pediatrics, with the clinical manifestations of high fever, coughing, wheezing, may be complicated by respiratory failure, acute respiratory distress syndrome and extrapulmonary manifestations, such as liver dysfunction, myocardial damage, toxic encephalopathy, renal insufficiency, anemia, hyponatremia, enteritis ect, severe ones can leave over of sequelae like bronchiolitis obliterans, bronchiectasis, interstitial fibrosis, which threat to children’s health, and even life-threatening, at the same time bring a heavier financial burden to the family. However, China is a huge geographical country, and there are big gaps in climate and environment between the north and south.The epidemiological characteristics of children, with acute lower respiratory infection, may vary in different areas.Therefore, analysis on the epidemiological characteristics of children’s acute lower respiratory tract adenovirus infection, is helpful to increase the realization of adenovirus infection, and has important clinical significance for the prevention and treatment of adenovirus infection in Hangzhou.Objective:The aim of this study is to explore the regularty of epidemiological characteristics of adenovirus infection of acute lower respiratory tract in children.Method:Continuous monitoring for6years (2006July-2012June) of76518cases of hospitalized in Children’s Hospital Affiliated to Zhejiang University because of acute lower respiratory tract infection, retrospectively analyzing the adenovirus positive479cases of epidemiological characteristics in children.Results:1. The detection rate of ADV and the characteristics of age distribution:There were479cases tested postitive for the ADV of all the samples (0.63%,479/76518)and the proportion of boy to girl was2.24:1. Their median age was16months (1-172months).The number of cases aged<6months was39(8.14%),-24months265(55.32%),-36months66(13.78%),-60months72(15.03%), and≥60months37(7.72%).2. Epidemiological features of adenovirus infection in ALRTI:There were128cases from January to March (26.72%),176cases from April to June (36.74%),124cases from July to September (25.89%) and51cases from October to December (10.65%).The morbidity of adenovirus infection of ALRTI in children during the period from October to December was significantly lower than that from January to March、 April to June and July to September (p<0.05or0.01), however, there was no significant difference among the periods from January to March、April to June and July to September.3. The trends of adenovirus infection in children with ALRTI in Hangzhou:The cases with ADV infection in ALRTI accounted for18.01‰,5.73‰,11.85%o,6.35‰,11.77%o and2.66%o from April to June, During the period from2007to2012, and there was a biennial epidemic tendency.4. Mixed infection of atypical pathogens accounted for18.58%in this study.Conclusion:1. Children aged from6months to24months were more likely to suffer from adenovirus pneumonia.2. Adenoviral pneumonia in children in Hangzhou presented perennial distributed, mainly from January to September.3. Adenovirus pneumonia in children in the region can bring limited epidemics once every two years.4. Antibiotic treatment with azithromycin or erythromycin is necessary in patients with mixed infection of atypical pathogens.