| Background : Influenza-like illness(ILI)refers to fever(body temperature greater than or equal to 38 °C),one with cough or sore throat,and lacks other laboratory diagnostic evidence.It is symptom monitoring and is "monitoring based on syndrome(or syndrome)".The monitoring can shorten the “lagging period” existing in traditional monitoring,track the scale and speed of outbreaks as early as possible,monitor the occurrence and development trend of diseases,and alert public health emergencies through suspicious diseases(or related symptoms).As a result,people are reminded to take effective measures in time and eventually achieve the goal of reducing prevalence and mortality,and reducing economic losses.Severe acute respiratory infection(SARI)is a patient with more serious illness in ILI.Viral etiologies play import role in SARI.However,a large-scale study on the prevalence of viral infections across multiple provinces and seasons has not been previously reported from China.Once SARI breaks out,it will cause serious harm to people's health.So,Reducing the substantial public health burden of acute respiratory infection in children in China remains a major priority and an immense challenge.Despite steady advances in characterizing principal etiologies,incidence,and factors contributing to severe respiratory infection,knowledge gaps persist.Filling these gaps is critical to ensuring that limited available public health resources can be optimally targeted towards feasible,effective interventions.Objective:To understand the viral pathogens,seasonal distribution,clinical characteristics,main diagnosis of children under 15 years old in China with SARI(Severe Acute Respiratory Infection),so as to provide clues for the clinical diagnosis and treatment,prevention and control of SARI cases at China.Methods:From June 2009 to December 2017,cases of respiratory infections below the age of 15 were collected.According to the case monitoring plan for severe acute respiratory infection(2016),the collected infections were analyzed.SARI cases and Flu cases were screened out from the data and related history and clinical features of the children were also collected.SPSS 16.0 was used for data analysis.Results:1.In this study,a total of 6236 children with respiratory tract infections were collected,5347(85.7%)had complete information,and 1694(31.7%)had severe respiratory infections.198 cases(16.3%)of children with influenza virus infection.In the case of influenza,the proportion of men SARI children was higher than that of female,but there was no statistical difference(P > 0.05).In terms of age,Children with flu are mainly concentrated in 0-1 years old children,accounting for 52.0% of the total number of influenza cases,followed by 1-3 years old children,accounting for 29.3%,the number of children aged 6-15 years is relatively low,is 4.0%,but there is no statistical difference between different ages.The proportion of clinical symptoms caused by influenza viruses among children of different ages varies.Children aged 0-1 years have the most cases of cough and cough.Children aged 1-3 years have the highest incidence of cough and fever.The main manifestations of children aged 3-6 years are cough and fever.Children with 6 or more years old had a variety of clinical symptoms,and there was a statistically significant difference in symptom composition between ages,?2=43.150,P=0.001.During the period observed in this study,the number of detected cases of type A and type B influenza was the highest in 2010,followed by 2009(six months),and there were more cases of influenza A viruses detected.The detection rate of influenza B in 2010 was relatively high.The detection rate of influenza C virus detected in 2012 and 2013 was relatively high.In this study,7 out of 198 influenza virus infection cases in SARI were transferred to PICU,6 of them were influenza A virus infection,and 1 was influenza B virus infection.Among 1694 children with SARI,children with viral infections accounted for 1313(77%),the number of cases of concurrent bacterial infections was 1155(66.2%),and the number of bacterial infections was 340(20.7%).In children with SARI,the proportion of males infected with SARI was higher than females,but there was no statistical difference(P > 0.05).In terms of age,children with SARI were mainly concentrated in 0-1 years old,accounting for 65% of the total number of SARI cases,followed by 1-3 years old,accounting for 25.2%.The main symptoms of influenza and non-influenza infections were cough and cough,but statistical analysis revealed no difference between the two groups.The proportion of fever symptoms was also relatively high,with significant differences between influenza and non-influenza children.The proportions were 62.6% and 49.9% respectively.Although the relative proportion of SARI in children with dyspnea is relatively small,there is a significant difference between influenza and non-influenza patients.The main symptoms of SARI are cough and cough,accounting for 97.3% and 72.5% respectively.Fever cases are also relatively high,accounting for 51.4%.The proportion of asthma and diarrhea was also relatively high,reaching 50.1% and 27.6%.The main clinical diagnoses of SARI cases were pneumonia(93.1%),asthma(10.9%),and congenital heart disease(10.4%).Age,fever,dyspnea,birth defects,respiratory failure,and children's transfer to PICU are different between children with flu and non-influenza.The peak of SARI is from January to March and October to December each year.Every year from April to June and December to February of the following year is the high incidence of viral infection.In 2010,SARI and virus-infected children were more throughout the year and far higher than the same month in other years.RSV and HRV virus infections are most common in children each year.The peak period of infection is from October of each year to February of the following year and from August to October of each year.The main infection time of flu-infected children was concentrated in the 3,7 and 11 months of each year.The number of RSV-infected children has not changed much in recent years,and the number of children with HRV and flu has been decreasing this year.Conclusion:This study screened 198 cases of influenza from 1694 children with SARI.The population at risk of influenza infection is 0-3 years old.Among them,the number of influenza cases among females is more than that of males,but there is no statistical difference.In 2010,the number of detected cases of influenza A and B was the highest,followed by 2009(six months),and there were more cases of influenza A viruses detected.The detection rate of influenza B in 2010 was relatively high.The detection rate of influenza C virus detected in 2012 and 2013 was relatively high.Fever,cough,and cough are the main clinical symptoms of influenza infection in children.Some children also experience symptoms such as diarrhea and dyspnea.There was a statistically significant difference in the composition of symptoms among different ages(P<0.05).Although the number of influenza virus infection cases has been decreasing in recent years,the prevention of influenza can not be ignored.In addition to influenza viruses,non-influenza viruses such as bacteria and RSV are also important pathogens causing SARI in children.The study found that the major SARI cases in Chongqing were viral infections,among which 0-1 years old children have a higher probability of being diagnosed with SARI.The clinical symptoms of SARI are mainly cough,sputum,fever,etc.In clinical diagnosis,pneumonia,asthma,and congenital heart disease are mostly present.Age,clinical symptoms of fever and dyspnea,major clinical diagnosis of birth defects and respiratory failure,and children transferred to the PICU,these factors differ between children with influenza and non-influenza.The peak of SARI is from January to March and October to December each year.Every year from April to June and December to February of the following year is the high incidence of viral infection.In 2010,SARI and virus-infected children were more throughout the year and far higher than the same month in other years.RSV and HRV virus infections are most common in children each year.The peak period of infection is from October of each year to February of the following year and from August to October of each year.The main infection time of flu-infected children was concentrated in the 3,7 and 11 months of each year.The number of RSV-infected children has not changed much in recent years,and the number of children with HRV and flu has been decreasing this year. |
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