一起腺病毒引起的急性呼吸道感染暴发疫情的调查研究

探讨2016年12月深圳市光明新区某小学一起急性呼吸道病毒感染暴发疫情的流行病学及病原学特点。采用相应的流行病学个案调查表对疫情进行现场调查,采集患者咽拭子标本,使用实时荧光定量PCR方法对标本进行流感样病例筛查,筛查后的阴性标本进行呼吸道病毒核酸检测,用腺病毒六邻体蛋白基因作为靶基因对腺病毒初筛阳性标本进行扩增并测序,测序结果在GenBank上进行序列比较后使用BLAST和MEGA 5.0软件进行分析。该起疫情首例病例发病时间为2016年12月2日,末例病例发病时间为2016年12月17日,共发病34例,期间出现3次发病高峰,患者均为学生,其中男女生各17例,男女比例1∶1。患者体温均39℃,大部分有头晕、头痛症状,少数伴有咽痛、咳嗽症状。发病的四个班级间的罹患率差异有统计学意义。共采集8份咽拭子标本,经实时荧光定量PCR检测均为腺病毒阳性,其中1份合并鼻病毒阳性。8份标本用分型引物检测并分析序列确定均为腺病毒E亚属4型。此次急性呼吸道感染暴发疫情为连锁式传播,由腺病毒4型引起,毒株序列与深圳、国内其他城市分离的腺病毒4型毒株序列具有高度同源性,提示该毒株可用于疫苗株筛选。早期发现可疑病例并采取隔离措施是预防腺病毒感染暴发的最佳手段。     

腺病毒7d基因型与7b基因型全基因组比较分析

为了解重庆地区流行的7型腺病毒(Human adenovirus 7,HAdV-7)基因型型别,从全基因组水平探讨HAdV-7b和HAdV-7d可能的致病性差异,收集儿童急性下呼吸道感染患儿的呼吸道分泌物标本分离培养,提取DNA后进行HAdV-7基因型别鉴定、限制性酶切分析和全基因组测序,再利用MEGA6比较分析。本研究在2009年6月~2013年1月间共收集4334份急性下呼吸道感染患儿的鼻咽抽吸物标本,随机选取2411份进行病毒分离培养,共有164份(164/2411,6.8%)鼻咽抽吸物HAdV阳性,其中HAdV-7 87例。限制性酶切分析显示,随机挑选的3株HAdV-7分离株均为HAdV-7d。CQ1198株行全基因组测序并与其他HAdV-7全基因组构建进化树,结果发现16株中国地区的HAdV-7为HAdV-7d基因型,且上述16株HAdV-7与7d2的同源性为99.9%,与7b的同源性为98.2%。相较于ak40株(HAdV-7b),CQ1198共有49处核苷酸替换,其中20处可导致非同义替换;4处核苷酸插入,其中24bp和18bp 2个片段插入分别位于病毒相关RNAⅡ(Virus-associated RNAⅡ,VA RNAⅡ)和L3的pⅥ区域。HAdV-7可有多个基因型致病,且一直处于进化过程中,其主要流行基因型由HAdV-7b变为HAdV-7d。应加强对HAdV分子流行病学监测,明确其进化规律,为HAdV疫苗研发提供分子流行病学依据。     

英国等地不明原因儿童肝炎的暴发情况及病因

2022年3月31日,苏格兰首先报告了5例患有不明原因重症肝炎的儿童。世界卫生组织(World Health Organization,WHO)于4月15日就不明原因儿童肝炎发布指导性意见,对确诊病例、可疑病例和流行病学相关病例进行了定义。截至4月21日,已有12个国家报告169例确诊病例,从1月龄至16岁不等。临床表现为急性肝炎,谷草转氨酶(aspartate aminotransferase,AST)或谷丙转氨酶(alanine aminotransferase,ALT)＞500 IU/L,多数患儿有黄疸、恶心、腹痛、乏力、嗜睡和胃肠道症状,包括腹泻和呕吐,大多数患儿无发热。17例接受了肝移植,至少报告1例死亡。考虑到流行病学特点和患儿的临床特征,感染性因素导致该疾病的可能性更大。病例的实验室检查结果均排除了甲、乙、丙、丁和戊型肝炎,并提示腺病毒可能与不明原因儿童肝炎有关,但其他感染性因素或环境因素仍不能完全排除。本文对此次不明原因儿童肝炎的发展情况及其可能病因进行了介绍。该疾病存在输入性风险,我国应对此早做准备。     

浙江省2019年儿童腺病毒肺炎流行病学特征分析

为了解浙江地区腺病毒肺炎的流行病学和病原学特征,本研究统计分析了2019年1月至2019年12月浙江大学医学院附属儿童医院腺病毒肺炎患儿的基本临床资料;并前瞻性的通过聚合酶链式反应(PCR)随机对部分的腺病毒阳性的肺炎患儿咽拭子进行基因扩增、测序和分型鉴定;进而构建系统发育树分析其核苷酸序列进化情况。本研究共检测咽拭子标本19650份,其中腺病毒阳性标本有4032份,腺病毒检出率为20.5%;春季和夏季腺病毒肺炎的患病率相对较高,患儿年龄主要在1~7岁。本研究所检测的99株腺病毒阳性标本经与GenBank数据库比对均为HAdV-3,通过Hexon基因全长系统进化分析得出,所检出的HAdV-3腺病毒均为Clade2进化分支。2019年浙江地区存在儿童HAdV-3肺炎的暴发流行,该病毒株未发生大的变异,均为Clade2进化分支。1~7岁的儿童为主要的易感人群。     

人腺病毒的研究进展

人腺病毒(Human adenovirus,HAdV)是引起婴幼儿急性呼吸道感染等多种疾病的重要病原体之一,本文回顾了有关HAdV的分子生物学特征、检测方法及分型、致病机制、相关疾病的临床特征、流行病学特征、HAdV感染的预防和控制研究的文献。迄今为止明确的HAdV有67种不同型别,包括近几年发现的重组变异株。导致急性呼吸道感染的主要流行株为HAdV-3和HAdV-7,属于B亚组,也可以引起其他系统的疾病,所致疾病的临床表现与其他呼吸道病毒相关病毒相似,但多伴消化道症状,其致病机制尚不清楚。对于新发现的变异重组株,其与疾病的相关性研究甚少,需要进一步研究证实。由于没有前瞻性的、大样本的随机对照治疗试验,HAdV感染的治疗目前存在争议。疫苗是降低呼吸道HAdV感染最有效的措施,但还没有上市的产品。     

2010-2019年北京地区腹泻患儿中人腺病毒41型Fiber基因分子特征和进化分析

人腺病毒41型(Human adenovirus 41,HAdV-41)是引起儿童腹泻的重要病原之一.为了解北京地区腹泻儿童中HAdV-41 Fiber基因的分子变异和遗传进化特征,选取2010-2019年首都儿科研究所附属儿童医院门诊腹泻患儿HAdV-41阳性的粪便标本,扩增Fiber全基因,使用多种生物信息学软件进行系统发生、遗传进化、种群演变和选择压力等分析.结果显示HAdV-41本地毒株存在1644碱基(547氨基酸)和1689碱基(562氨基酸)两种长度的Fiber基因,截短的15个氨基酸位于Fiber蛋白纤维轴区.Mann-Whitney U秩和检验提示检测到感染短Fiber基因的HAdV-41的患儿年龄更小(P=0.036).同源性分析结果显示Fiber基因的核苷酸和氨基酸序列同源性均大于97％,主要分为四个进化分支(Ⅰ、Ⅱ、Ⅲ和Ⅳ),其中Ⅰ和Ⅲ是主要的流行分支,分支Ⅰ主要在国内流行,而分支Ⅲ全球均有流行.HAdV-41共祖起源可追溯到1856年,平均进化速率每年为6.81×105碱基替换/位点,10年间理论有效种群一直比较平稳呈缓慢下降趋势.压力选择分析表明,一个正向和三个负向选择位点均位于Fiber蛋白的纤维轴区.上述结果表明2010-2019年间不同进化分支的HAdV-41在北京地区流行,进化速率稳定.Fiber蛋白轴区存在两种不同类型的氨基酸缺失.     

80例住院患儿腺病毒呼吸道感染的流行病学特点和临床特征分析

通过分析急性呼吸道感染(Acute respiratory tract infection,ARTI)患儿腺病毒(Adenovirus,ADV)的流行病学特点及其临床特征,为临床早期诊治提供理论依据。2011年1月至2012年12月在常州市第二人民医院住院的3480例ARTI患儿,采集鼻咽部分泌物,采用直接免疫荧光法检测ADV抗原。两年共检出ADV阳性病例80例,阳性率为2.30%(80/3 480);2011年感染率显著高于2012年。ADV夏秋季感染率较高,冬春季感染率较低;1岁以内ADV感染率较低,仅为1.14%,其他年龄段感染率明显升高。ADV是常州地区ARTI患儿重要病原体,在1岁以上儿童中多发,呈常年散发状态,夏秋季节感染率高;ADV感染临床表现多,重症患儿多,危害大。     

人腺病毒41型(HAdV-41)在293TE细胞中的形态发生研究

为研究人腺病毒41型(Human adenovirus type 41,HAdV-41)的形态发生过程,将其接种于293TE细胞,收获细胞制作超薄切片并染色,通过透射电子显微镜进行观察。结果显示HAdV-41可以通过非网格蛋白陷窝、网格蛋白陷窝及直接穿入的方式进入细胞;细胞微绒毛可参与HAdV-41进入细胞的过程;进入细胞的HAdV-41包裹于囊泡内、溶酶体内或游离于细胞浆内;HAdV-41最终以游离状态靠近细胞核核孔,并释放核糖核蛋白(Ribonucleoprotein,RNP)进入细胞核;子代HAdV-41最先出现在细胞核内;在HAdV-41复制过程中出现纤维丝状包涵体、致密包涵体及条索状致密包涵体,包涵体结构与HAdV-41的形态发生过程有关;最终,HAdV-41以裂解细胞方式释放。本研究揭示了HAdV-41形态发生的部分过程,进一步丰富了HAdV-41的生物学信息。     

辽宁省首次从急性弛缓性麻痹(AFP)病例分离的一株人腺病毒1型重组株的全基因组序列特征分析

人腺病毒(Humanmastadenoviruses,HAdV)是一种常见的病毒病原体,在儿科患者中普遍存在.本研究首次报道了 2017年从辽宁省急性弛缓性麻痹(AFP)病例的粪便标本中分离到的一株人腺病毒1型重组株LN2017,并对其全基因组进行测序和分析.我们首先测定了 LN2017的全基因组序列,并将其与从GenBank数据库中下载的来自8个国家的38个参考株一起,构建了基于全基因组、Hexon基因,Penton base基因,Fiber基因和E3基因的系统发育树,并用RDP4.97和SimPlot3.5.1软件进行了重组分析.结果显示,LN2017病毒为HAdV-C亚属,其Hexon,Penton base和Fiber基因与HAdV-1高度相似,但是其E3基因和HAdV-2、HAdV-6高度相似.重组分析显示毒株LN2017是一个重组病毒,在E3基因区域和HAdV-2发生了重组,重组区域位于28045-31042.本研究首次证实了LN2017与 GenBank 中的 JX173080(埃及株 E13)、MH183293(上海株 SH2016)和 MH121110(德国株43C1)具有相同的重组方式,在HAdV-1内构成一个独立的分支.未来,有必要对该分支人腺病毒1型重组株的致病性和临床特征进行进一步研究,并继续加强对HAdV的分子流行病学监测.     

戊型肝炎病毒感染实验室诊断方法研究进展

戊型肝炎是由戊型肝炎病毒(Hepatitis E Virus,HEV)引起的急性病毒性肝炎,已经成为威胁人群健康的公共卫生问题。HEV主要通过消化道传播,但随着HEV输血传播病例的报道,HEV给输血安全带来的风险也受到人们的重视。通过分析戊型肝炎现有的诊断手段,以对献血员的HEV筛查提供借鉴作用,这对输血安全中戊型肝炎的预防和控制具有重大意义。目前常用的戊型肝炎检测指标主要包括:HEV RNA、HEV抗原、抗-HEV IgM、抗-HEV IgG。核酸检测是戊型肝炎诊断的"金标准",对于慢性戊型肝炎患者、免疫缺陷人群及无肝炎症状的HEV感染者都有着特别优势。HEV抗原作为HEV现症感染指标,对于血站HEV筛查和急性戊型肝炎诊断有很好的应用价值。抗-HEV IgM是HEV近期感染的标志,不能作为HEV现症感染的单一指标。而抗-HEV IgG只能指示HEV既往感染,不适用于急性戊型肝炎的诊断。目前,献血员HEV检测主要以核酸检测为基础,而HEV抗原检测可能弥补HEV RNA的检测不足。在未来,抗原检测和抗体检测对于献血员HEV筛查的价值还有待更多的研究评价。     

Non-A to E hepatitis in children: Detecting a novel viral epidemic during the COVID-19 pandemic

During the COVID-19 pandemic, two further novel viral epidemics were described in 2022, monkeypox virus infections in men having sex with men and non-A to E hepatitis in children. The latter occurred in the first half of 2022 with about 1000 cases worldwide, necessitating liver transplantation in 5% and causing death in 2% of patients. It took some effort to clarify the cause of the novel hepatitis epidemic. Researchers were confronted with a polymicrobial viral infection consisting of an adenovirus-associated virus type 2 (AAV2) infection, co-occurring with either human adenovirus type 41 (HAdV41) or herpesvirus infections; most prominently human herpesvirus type 6 (HHV-6). AAV-2, a small Dependovirus of the Parvovirus family, needs these helper viruses for its replication. AAV2 is used as a vector for liver-targeting gene therapy but was not previously known to cause acute hepatitis. HAdV41 and HHV-6 are mostly known to cause diarrhoea and febrile illnesses associated with skin rashes in children, respectively. Except for a few case reports of HHV-6 hepatitis, HAdV and HHV-6 are mostly known as major pathogens in immunosuppressed transplantation patients. A potential role of SARS-CoV-2 has also been discussed but the most popular hypothesis involves an indirect role of the COVID-19 pandemic for this novel disease. Exposure to HHV-6 infections occurs nearly quantitatively during the first year of life. Social distancing measures, followed by the lifting of these measures in 2022 might have caused a delayed exposure to multiple, normally benign childhood viral infections eliciting a dysregulated immune response with pathological effects for liver cells. In the fall of 2022, when these conditions were not longer met, case numbers dwindled. The hypothesis of an unequilibrated immune response instead of intrinsic cytopathic activity of the implicated viruses is further supported by the enrichment of a particular HLA allele in cases over controls.     

Application of Human Adenovirus Genotyping by Phylogenetic Analysis in an Outbreak to Identify Nosocomial Infection

Nosocomial infections are common in pediatric patients and can be fatal in infants and immunocompromised patients. In September 2018, a high positive rate of human adenovirus HAdV was occurred among hospitalized children in the Children's Hospital Affiliated to the Capital Institute of Paediatrics in Beijing. To investigate whether this outbreak of HAdV was related to nosocomial infections or the result of community infections, we collected respiratory specimens from patients with acute respiratory infections in a respiratory ward during June to December 2018, and screened for respiratory viruses. Among 1,840 cases included, 95(5.2%, 95/1840) were positive for HAdV and 81 were genotyped based on phylogenetic analysis, including seven as HAdV-1(8.6%), 30 HAdV-3(37.0%), two HAdV-6(2.5%), and 42 HAdV-7(51.9%). More HAdV-positive samples were collected in August(4.7%, 12/255), September(15.0%, 41/274) and October(6.9%, 17/247), with a peak in September 2018. By combining the results of HAdV phylogenetic analysis with clinical data of patients, there were 77 cases(4.2%, 77/1840; 81.1%, 77/95) excluded from nosocomial infections, eight cases representing possible infections transmitted by visitors or attending parents, three cases without sequences that might have been due to infection transmitted by roommates positive for HAdV, one case of a roommate without an HAdV sequence, and six cases that shared highly homologous sequences with those of their roommates, for which nosocomial infections might be considered. In conclusion, genotyping of HAdVs based on phylogenetic analysis combined with clinical information provides a powerful method to distinguish nosocomial infections from community acquired infection, especially when tracing the origins of nosocomial infections.     

The role of respiratory tract viruses in the etiology of obstructive bronchitis in infants

Out of 524 children with acute respiratory infections in 141 obstructive bronchitis was diagnosed (OZO). Seventy cases could be linked to viral infection. Viral infections tested (influenza virus A, B, parainfluenza typ 1-3, RSV, adenoviruses) were more frequently associated with OZO than other acute respiratory infections of unknown etiology. Majority infections induced by influenza virus A and parainfluenza virus typ 2 were accompanied by OZO symptoms. Of the highest risk of acquiring OZO despite of viral infection participation, were children of 4-12 months of age. OZO associated viral infections prevailed during autumn-winter season, while in spring-summer period undetermined factors were the major cause of OZO. In serum samples of children with OZO, despite of etiology of the disease, higher level of IgE was found than in a group of children without the symptoms. In the case of OZO of unestablished etiology the level of serum IgE was significantly higher than in the cases when viral etiology of the disease was found.     

Data on the study of the epidemiology of rotavirus infection in Leningrad

The results obtained in the study of rotavirus infection in Leningrad in 1984-1987 are presented. Enzyme immunoassay techniques were used for the examination of 4,715 children aged 0-14 years and 1,162 adults with diagnosed acute enteral infection of unknown etiology, as well as the control group of 556 of healthy children aged 0-6 years and 77 healthy adults. The rotavirus antigen was detected in 1.210 sick children (25.7%) and 133 sick adults (11.4%), as well as in 6 healthy children (1.1%), but not detected in healthy adults. The following epidemiological regularities of rotavirus infection were established: the highest sick rate among children aged 0-2 years and a low level of rotavirus carriership among healthy persons; the seasonal character of rotavirus infection, its outbreaks occurring in winter and the epidemic periods varying in their character and duration in different years; the prevailing role of rotaviruses in the development of winter rises of acute enteral infection of unknown etiology in the city among children aged 0-2 years. The problem of the respiratory syndrome in rotavirus diarrhea is discussed. The rotavirus antigen was detected in 39 out of 144 children (27%) with diagnosed acute respiratory virus diseases and in 4 out of 99 nasopharyngeal washings (4%) from diarrhea patients. Adenoviruses were shown to play an insignificant role in the etiology of diarrhea (10% of cases).     

Patterns in the spread and serovirological diagnosis of serous meningitis

The epidemiological and clinico-etiological study of cases of acute serous meningitis with unknown etiology in children was carried out in a large industrial city at the period of a considerable morbidity rise caused by this infection. The maximum morbidity was registered among younger children under school age attending children's institutions. In 26 closed groups of children group morbidity was revealed (4 cases and more), in 5 such groups small local outbreaks were registered. The clinico-instrumental methods of study permitted one to differentiate the groups of children having serous meningitis of supposedly enteroviral etiology, and sero virological studies carried out with the use of a wide range of diagnostic reagents revealed the etiological role of group B Coxsackie virus, mainly type 4, in 20.6% of cases, ECHO virus, serotypes 3 and 11, in 20.7% of cases, and parotitis virus in 5.3% of cases.     

Acute gastroenteritis and enteric viruses in hospitalised children in southern Brazil: aetiology,seasonality and clinical outcomes

Viral acute gastroenteritis (AG) is a significant cause of hospitalisation in children younger than five years. Group A rotavirus (RVA) is responsible for 30% of these cases. Following the introduction of RVA immunisation in Brazil in 2006, a decreased circulation of this virus has been observed. However, AG remains an important cause of hospitalisation of paediatric patients and only limited data are available regarding the role of other enteric viruses in these cases. We conducted a prospective study of paediatric patients hospitalised for AG. Stool samples were collected to investigate human adenovirus (HAdV), RVA, norovirus (NoV) and astrovirus (AstV). NoV typing was performed by nucleotide sequencing and phylogenetic analysis. From the 225 samples tested, 60 (26%) were positive for at least one viral agent. HAdV, NoV, RVA and AstV were detected in 16%, 8%, 6% and 0% of the samples, respectively. Mixed infections were found in nine patients: HAdV/RVA (5), HAdV/NoV (3) and HAdV/NoV/RVA (1). The frequency of fever and lymphocytosis was significantly higher in virus-infected patients. Phylogenetic analysis of NoV indicated that all of these viruses belonged to genotype GII.4. The significant frequency of these pathogens in patients with AG highlights the need to routinely implement laboratory investigations.     

Analysis of severe human adenovirus infection outbreak in Guangdong Province,southern China in 2019

During 2018-2019, a severe human adenovirus (HAdV) infection outbreak occurred in southern China. Here, we screened 18 respiratory pathogens in 1704 children (≤ 14 years old) hospitalized with acute respiratory illness in Guangzhou, China, in 2019. In total, 151 patients had positive HAdV test results; 34.4% (52/151) of them exhibited severe illness. HAdV infection occurred throughout the year, with a peak in summer. The median patient age was 3.0 (interquartile range:1.1-5.0) years. Patients with severe HAdV infection exhibited increases in 12 clinical indexes (P ≤ 0.019) and decreases in four indexes (P ≤ 0.007), compared with patients exhibiting nonsevere infection. No significant differences were found in age or sex distribution according to HAdV infection severity (P > 0.05); however, the distributions of comorbid disease and HAdV co-infection differed according to HAdV infection severity (P < 0.05). The main epidemic types were HAdV-3 (47.0%, 71/151) and HAdV-7 (46.4%, 70/151). However, the severe illness rate was significantly higher in patients with HAdV-7 (51.4%) than in patients with HAdV-3 (19.7%) and other types of HAdV (20%) (P < 0.001). Sequencing analysis of genomes/capsid genes of 13 HAdV-7 isolates revealed high similarity to previous Chinese isolates. A representative HAdV-7 isolate exhibited a similar proliferation curve to the curve described for the epidemic HAdV-3 strain Guangzhou01 (accession no. DQ099432) (P > 0.05); the HAdV-7 isolate exhibited stronger virulence and infectivity, compared with HAdV-3 (P < 0.001). Overall, comorbid disease, HAdV co-infection, and high virulence and infectivity of HAdV-7 were critical risk factors for severe HAdV infection; these data can facilitate treatment, control, and prevention of HAdV infection.     

Molecular Typing and Epidemiology Profiles of Human Adenovirus Infection among Paediatric Patients with Severe Acute Respiratory Infection in China

Background

Human adenoviruses (HAdVs) have been recognised as pathogens that cause a broad spectrum of diseases. The studies on HAdV infection among children with severe acute respiratory infection (SARI) are limited.

Objective

To investigate the prevalence, epidemiology, and genotype of HAdV among children with SARI in China.

Study Design

Nasopharyngeal aspirates (NPAs) or induced sputum (IS) was collected from hospitalised children with SARIs in Beijing (representing Northern China; n = 259) and Zhejiang Province (representing Eastern China; n = 293) from 2007 to 2010. The prevalence of HAdV was screened by polymerase chain reaction (PCR), followed by sequence typing of PCR fragments that targeted the second half of the hexon gene. In addition, co-infection with other human respiratory viruses, related epidemiological profiles and clinical presentations were investigated.

Results and Conclusions

In total, 76 (13.8%) of 552 SARI patients were positive for HAdV, and the infection rates of HAdV in Northern and Eastern China were 20.1% (n = 52) and 8.2% (n = 24), respectively. HAdV co-infection with other respiratory viruses was frequent (infection rates: Northern China, 90.4%; Eastern China, 70.8%). The peak seasons for HAdV-B infection was winter and spring. Additionally, members of multiple species (Human mastadenovirus B, C, D and E) were circulating among paediatric patients with SARI, of which HAdV-B (34/52; 65.4%) and HAdV-C (20/24, 83.3%) were the most predominant in Northern and Eastern China, respectively. These findings provide a benchmark for future epidemiology and prevention strategies for HAdV.     

西安市2010-2015年0-5岁儿童HBV感染状况的流行病学研究

摘要 目的：总结西安市2010-2015年 0-5岁儿童乙肝病毒感染的发病趋势和流行病学特征,寻找高危人群。通过随访研究获取HBV感染儿童疾病转归及乙肝监测系统存在的问题,为乙肝监测系统完善及制定防治策略提供科学依据。方法：采用描述性流行病学方法对西安市2010-2015年的0-5岁儿童乙肝患者进行三间分布描述分析;采用前瞻性队列研究方法,检测母亲及儿童的外周血HBV病毒学情况,获得母亲感染状况和患儿转归。结果：6年间,西安市0-5岁儿童共上报乙肝病例175例,年均HBV感染率为6.05/10万,2013年最高,为9.73/10万,以散发为主;0-1岁为高发年龄段,男童发病多于女童;未央区、雁塔区为高发地区。截止2016年8月,随访HBV感染学龄前儿童139例,仅17例完成流行病学调查和体检检测,失访率高达87.7%,17例HBV感染儿童中HBsAg慢性化高达88.2%,其中14例(82.3%)母亲为HBsAg阳性者。结论：西安市0-5岁儿童HBV感染的高危人群为HBsAg阳性母亲的儿童,与宫内感染/母婴传播有关。0-5岁HBV感染儿童转归结局不良,建议加强HBV宫内阻断,并对高危新生儿进行乙肝抗体监测。     

Serological and epidemiological characteristics of acute pneumonias caused by Mycoplasma pneumoniae in Belgorod

The etiology of the outbreaks of acute pneumonia in Belgorod was established and their epidemiological features were studied. The mycoplasmal etiology of all cases of acute pneumonia in children and adults, appearing alongside acute respiratory infections resulting from the preceding outbreaks caused by influenza viruses A/Prague/, B/Leningrad/369/75, and all types of parainfluenza viruses, was shown. The droplet mechanism of the transfer of infection was established, which was confirmed by the severity of the outbreak and a high rate of infection of the medical staff at hospitals for children and adults, where patients with mycoplasma-induced pneumonia were treated.