儿童SARS血清流行病学调查及其依从性初步分析

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目的①了解儿童严重急性呼吸综合征(severeacuterespiratorysyndrome,SARS)患者SARS相关冠状病毒(SARSCoV)特异抗体水平;初步调查与成人SARS患者密切接触的儿童及与SARS患儿密切接触的家长中隐性感染情况。②了解本次血清流行病调查的依从性。方法①对开展本研究中的电话联系过程及结果予以记录和分析。②入户收集流行病学资料和采集标本。③采用间接免疫荧光(IFA)方法对北京市24例恢复期儿童SARS患者;与SARS成人患者密切接触的30名儿童和与上述SARS患儿密切接触的29位家长进行血清SARSCoV特异IgG检测。结果①在试图联系的527户家庭中,共与431个家庭进行了有效通话,其中191户因不符合条件被排除研究;176户拒绝参加本项研究;在193个符合条件的家庭中,最终64户同意纳入研究(33.2%)。②儿童SARS患儿血清SARSCoVIgG阳性者10例(42%)。③儿童患者抗体阳性组中有明确SARS接触史的患儿所占比例为8/10,而在抗体阴性组的比例为1/14(P<0.05)。④与成人SARS患者接触的儿童标本中1份SARSCoVIgG阳性(1/30,3%);SARS患儿的家长中一位(患儿的祖母)SARSCoVIgG为阳性(1/29,3%),该患儿的祖父为SARS患者。结论①本次儿童SARS血清流行病调查依从性较低。②临床诊断为SARS的患儿中有42%经血清学证实为SARSCoV感染。③有SARS接触史的患儿在抗体阳性组的比例较之在抗体阴性组的比例明显增高。④在与成人SARS患者密切接触的儿童和成人中可能存在隐性感染。未能证实与儿童SARS患儿接触的成人中存在隐性感染。 Objectives ① To understand SARS-associated coronavirus (SARSCoV) specific antibody levels in children with severe acute respiratory syndrome (SARS); to investigate the prevalence of latent infection among children who are in close contact with adults with SARS and with parents who have close contact with children with SARS . ② understanding of the epidemiological survey of compliance. Methods ① Conduct the recording and analysis of the telephone connection process and the results in this study. ② household collection of epidemiological data and collection of specimens. (3) Serum SARSCoV-specific IgG was detected by indirect immunofluorescence (IFA) in 24 children with convalescent childhood SARS in Beijing; 30 children in close contact with adult patients with SARS and 29 parents who were in close contact with the children with SARS. RESULTS ① Among the 527 families trying to contact, 431 families conducted effective telephone conversation, of which 191 were excluded from the study due to non-compliance; 176 refused to participate in the study; and among the 193 eligible families, the final 64 households agree to be included in the study (33.2%). ② Serum SARSCoVIgG positive in children with SARS in 10 cases (42%). ③ The proportion of children with positive history of SARS exposure in the antibody positive group was 8/10, while it was 1/14 in the antibody negative group (P <0.05). (1) SARSCoVIgG was positive (1/30, 3%) in one of the children with adult SARS; SARSCoVIgG was positive (1/29, 3%) in one of the parents of the children with SARS The grandfather’s children are SARS patients. Conclusion ① The investigation of SARS seroprevalence in children is less compliant. 42% of the children with clinically diagnosed SARS were serologically confirmed as SARSCoV infection. ③ The proportion of children with history of SARS exposure in antibody-positive group was significantly higher than that in antibody-negative group. ④ There may be a latent infection in children and adults who are in close contact with adult SARS patients. There is no evidence of a latent infection in adults exposed to children with childhood SARS.
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