Epidemiology[epidi:mi:′ɔlədʒi:] of Respiratory Infectiom

Philip Keith Pattemore and Lance C. Jennings

Teaching Points

• Technological developments molecular [mə'lekjələ]Known viruses are more prevalent ['prevələnt]New viruses continue to be discovered

• The study of morbidity [mɔ ' biditi] and mortality [mɔ'tæliti] …lack of precise definitions and specific, practical diagnostic methds.

• Children in developing countries account for [ə'kauntfər] 70%

• Malnutrition ['mælnju'triʃən], poverty, indoor smoke, and comorbid conditions including malaria [mə'lɛəriə], tuberculosis [tju:bə:kju'ləʊsɪs]etc greatly increase the risks

• Emerging respiratory diseases present an ongoing risk…

Common Respiratory Viruses

• Respiratory syncytial virus ['respərə,tɔ:ri:, ri'spaiərə-]

• Influenza [influ:'enzə] virus type A and B

• Parainfluenza[pærəinflu′enzə]viruses

• Adenoviruses• Rhinoviruses [rainəʊ′vaiərəs]• In younger children, viruses are the cause of 90% of LRTIs …• Symptomatic [simtə'mætik]

substantial [səb'stænʃəl]

Laboratory Detection

• Conventional diagnostic methods - antigen detection, serology[siə'rɔlədʒi]

, culture… Tab 31-1(1976-1981)• Molecular diagnostic [daiəɡ'nɔstik] methods - PCR, three to five times as sensitive as cell culture… - Figure 31-1 viral identification breakdown in three studies: A:

nasal lavage, RT-PCR; B: nasopharyngeal [,neizəufə'rindʒiəl]

swabs,PCR/RT-PCR, immunoflurescence and viral culture; C: not described speciments, immunoassay, culture, PCR

Previously Unkown Viruses

• human metapneumoviruses(hMPV) -2000• new human coronaviruses: - SARS-Cov, hCov NL63, hCo-HKU1• Another viruses: hBoV• nucleic['nju:kliik] acid['æsid]

polymerase['pɔlimə,reis]dominant['dɔminənt]

• 'Relative pro'portion

Multiple infections

• Multiple infection: 1.8-15.8% 27%

- more frequently in young children (less than 4yr)

- experience a median of 4.4 to 5.5

alternatively[ɔ:l'tə:nətivli]

Shedding 脱落 continum 连续区 residual.[ri'zidʒu:əl]

Epidemiology

• Periodicity .[piri:ə'disiti:]Seasonality

• Circulate• biennial.[bai'eni:əl]

两年一次的predominant

• tropical.[‘trɔpikəl]热带

• Latitude 纬度 • colloquially [kə'ləʊkwi:əl]

adj.  口语的 • elucidate.[i'lu:si'deit]

Signs and Symptoms

• resemble.[ri'zembl]vt.  看起来像

• surpass.[sə'pɑ:s]vt.  超过

• Croup• typical.['tipikəl] 典型的 • classic.['klæsik]

febrile.['febrəl, fi:brəl] 发热的• myalgia[mai'ældʒiə]  肌痛

Bronchiolitis obliterans• Ubiquitous .[ju:'bikwitəs]

adj.  普遍存在

ALRTI: Scope and Limitations

• consolidation, parenchyma [pə'reŋkimə] 实质 obliteration [ə,blitə'reiʃən] 闭塞alveolar [ æl'viələ,ælvi'əulə] purulent ['pjuərulənt] 脓的 exudate ['eksjudeit] 渗出物

• Indrawing   [in'drɔ:iŋ] 吸入 , 纳 Grunting   auscultatory [ɔ:'skʌltətəri] 听诊的    crackle [krækəl] 爆裂声    immobility  [iməʊ'biliti] 固定性 , 静止reconciling .['rekənsail]inherent 内在的 facilities expertise [,ekspə'ti:z]

WHO case manage guideline