Respiratory viral pathogens among Singapore military servicemen 2009 – 2012: epidemiology and clinical characteristics

BMC Infectious Diseases

Alex Richard Cook³  Mark I-Cheng Chen²  Sock Hoon Ng¹  Wee Hong Victor Koh¹  Boon Huan Tan¹  Jin Phang Loh¹  Vernon J Lee⁵  Xiahong Zhao⁵  Xin Quan Tan⁴ 

[1] Defence Medical and Environmental Research Institute, Singapore, Singapore;Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore;Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore;Preventive Medicine Residency Programme, National University Health System, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

关键词: Respiratory viruses;    Respiratory infections;    Influenza;    Epidemiology;    Surveillance;    Influenza like-illness-ILI;   

Others  :  1134091
DOI  :  10.1186/1471-2334-14-204

 received in 2013-10-23, accepted in 2014-04-08,  发布年份 2014

【 摘 要 】

Background

Few studies have comprehensively described tropical respiratory disease surveillance in military populations. There is also a lack of studies comparing clinical characteristics of the non-influenza pathogens with influenza and amongst themselves.

Methods

From May 2009 through October 2012, 7733 consenting cases of febrile respiratory illness (FRI) (temperature [greater than or equal to]37.5degreesC with cough or sorethroat) and controls in the Singapore military had clinical data and nasal washes collected prospectively. Nasal washes underwent multiplex PCR, and the analysis was limited to viral mono-infections.

Results

49% of cases tested positive for at least one virus, of whom 10% had multiple infections. 53% of the FRI cases fulfilled the definition of influenza-like illness (ILI), of whom 52% were positive for at least one virus. The most frequent etiologies for mono-infections among FRI cases were Influenza A(H1N1)pdm09 (13%), Influenza B (13%) and coxsackevirus (9%). The sensitivity, specificity, positive predictive value and negative predictive value of ILI for influenza among FRI cases were 72%, 48%, 40% and 69% respectively. On logistic regression, there were marked differences in the prevalence of different symptoms and signs between viruses with fever more prevalent amongst influenza and adenovirus infections than other viruses.

Conclusion

There are multiple viral etiologies for FRI and ILI with differing clinical symptoms in the Singapore military. Influenza and coxsackevirus were the most common etiology for FRI, while influenza and adenoviruses displayed the most febrile symptoms. Further studies should explore these differences and possible interventions.

【 授权许可】

   
2014 Tan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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