Abstract
BackgroundAcute lower respiratory infections (ALRIs) are an important cause of acute illnesses and mortality worldwide and in China. However, a large-scale study on the prevalence of viral infections across multiple provinces and seasons has not been previously reported from China. Here, we aimed to identify the viral etiologies associated with ALRIs from 22 Chinese provinces.Methods and FindingsActive surveillance for hospitalized ALRI patients in 108 sentinel hospitals in 24 provinces of China was conducted from January 2009-September 2013. We enrolled hospitalized all-age patients with ALRI, and collected respiratory specimens, blood or serum collected for diagnostic testing for respiratory syncytial virus (RSV), human influenza virus, adenoviruses (ADV), human parainfluenza virus (PIV), human metapneumovirus (hMPV), human coronavirus (hCoV) and human bocavirus (hBoV).We included 28,369 ALRI patients from 81 (of the 108) sentinel hospitals in 22 (of the 24) provinces, and 10,387 (36.6%) were positive for at least one etiology. The most frequently detected virus was RSV (9.9%), followed by influenza (6.6%), PIV (4.8%), ADV (3.4%), hBoV (1.9), hMPV (1.5%) and hCoV (1.4%). Co-detections were found in 7.2% of patients. RSV was the most common etiology (17.0%) in young children aged <2 years. Influenza viruses were the main cause of the ALRIs in adults and elderly. PIV, hBoV, hMPV and ADV infections were more frequent in children, while hCoV infection was distributed evenly in all-age. There were clear seasonal peaks for RSV, influenza, PIV, hBoV and hMPV infections.ConclusionsOur findings could serve as robust evidence for public health authorities in drawing up further plans to prevent and control ALRIs associated with viral pathogens. RSV is common in young children and prevention measures could have large public health impact. Influenza was most common in adults and influenza vaccination should be implemented on a wider scale in China.
Highlights
Acute lower respiratory infections (ALRIs) continue to be an important cause of acute illnesses and mortality worldwide [1,2,3,4]
Our findings could serve as robust evidence for public health authorities in drawing up further plans to prevent and control ALRIs associated with viral pathogens
Respiratory syncytial virus (RSV) is common in young children and prevention measures could have large public health impact
Summary
Acute lower respiratory infections (ALRIs) continue to be an important cause of acute illnesses and mortality worldwide (especially in infants and young children) [1,2,3,4]. Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) estimates that there were 2.8 million deaths due to lower respiratory infections globally in 2010 (5.3% of the total deaths) [4]. In China, ALRIs were the most frequent cause of child mortality in 2008, despite an astonishing 66% reduction in pneumonia-specific mortality rates between 2002–2007 (from about 9?4 to 3?2 per 1000 live births) [11]. Acute lower respiratory infections (ALRIs) are an important cause of acute illnesses and mortality worldwide and in China. We aimed to identify the viral etiologies associated with ALRIs from 22 Chinese provinces
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