2008-2011년 서울 및 경기지역의 파라인플루엔자 바이러스 감염의 역학적 특성
Epidemiologic Features of Parainfluenza Virus Type 1, 2 and 3 Infection in Seoul and a Neighboring Area, 2008-2011
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배경: 파라인플루엔자 바이러스(PIV)는 급성 호흡기 감염의 중요한 원인 중 하나이다. PIV의 역학을 파악하는 것은 PIV의 진단과 치료에 도움을 줄 수 있다. 저자들은 서울과 주변 지역의 PIV 감염의 역학적 특성을 PIV 유형에 따라 알아보고자 이 연구를 계획하였다. 방법: 2008년 11월 1일부터 2011년 5월 30일까지 서울과 경기도의 2개의 대학병원에 내원하여 호흡기 바이러스 검사를 시행한 환자 12,723명을 대상으로 하였다. 그 중 PIV 1, 2, 3형에 양성 결과를 보인 환자들에 대하여 의무기록을 후행적으로 조사하였다. 결과: 12,723명 중 710명(5.6%)에서 PIV가 검출되었다. 1형 PIV 감염은 304명, 2형 PIV는 49명, 3형 PIV는 357명으로 1형과 3형 PIV가 대부분을 차지하였다. PIV 감염은 유형과 상관없이 1세 이전의 영아들에서 가장 높은 발생률을 보였다. PIV 감염에 의해 발생한 질환 중에 폐렴이 가장 흔하였으며 하부 호흡기 감염이 주된 임상양상이었다. 1형과 2형 PIV 감염에서는 크룹이 가장 흔하였으며, 3형 PIV 감염에서는 폐렴이 가장 흔하였다. 계절별 유행 양상을 보면 5, 6월을 전후로는 3형 PIV의 검출률이 높았고 7, 8, 9월에는 1형 PIV가 유행하였다. 2형은 10월과 11월에 높은 동정률을 보였다. 겨울철에는 1, 2, 3형 모두 검출률이 낮았다. 결론: PIV 감염으로 입원한 환자들에서 하부 호흡기 감염이 가장 흔한 질환이었다. PIV 감염에 의한 임상적 특성은 대개 서구의 연구들에 부합된 양상을 보였으나 유행시기에서는 차이를 볼 수 있었다.
Abstract
Background: Parainfluenza virus (PIV) is a significant cause of acute respiratory infections. Epidemiological information on PIV infection could be very helpful for patient management. The aim of this study was to investigate the epidemiology of PIV infection in Seoul and a neighboring area with regard to PIV type. Methods: The diagnosis of PIV infection was made by virus isolation. The R-mix Too cell system (Diagnostic Hybrids, Inc., Athens, OH, USA) and D3 Ultra DFA Respiratory Virus Screening & ID kits (Diagnostic Hybrids, Inc.) were used for virus culture and identification. The medical records of patients with positive virus cultures were reviewed retrospectively. Results: Seven hundred and ten PIV viruses (5.6%) were isolated from 12,723 specimens. The number of subjects with PIV type III, I and II was 357, 304 and 49, respectively. PIV infection showed a peak incidence in the first year of life regardless of subtypes. The most common diagnosis among all PIV subtypes was pneumonia. Lower respiratory tract infections constituted the majority (76.3%) of PIV infections. The most common diagnosis of PIV type I and II was croup and that of PIV type III was pneumonia. A difference in seasonal variation between subtypes was observed. PIV I (62.2%) was mainly isolated from July to September while PIV type III (86.8%) was isolated from April to July. Conclusion: Lower respiratory infection was most commonly found in hospitalized patients with PIV infection. Clinical features of PIV infection were similar those seen in Western PIV reports, with the exception of the seasonal outbreak pattern.
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