Prevalence of respiratory virus infection with regard to age, sex, and seasonality factors: A single center experience against children hospitalized during the 10 years

Seung Jin Lee; Shin Hae Lee; Eun Kyo Ha; Youn Ho Sheen; Myong Soon Sung; Young-Ho Jung; Kyung Suk Lee; Hye Mi Jee; Man Yong Han

doi:10.4168/aard.2017.5.6.320

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Lee, Lee, Ha, Sheen, Sung, Jung, Lee, Jee, and Han: Prevalence of respiratory virus infection with regard to age, sex, and seasonality factors: A single center experience against children hospitalized during the 10 years

Original Article

Allergy, Asthma & Respiratory Disease 2017; 5(6): 320-325.

Published online: 30 November 2017

DOI: https://doi.org/10.4168/aard.2017.5.6.320

Prevalence of respiratory virus infection with regard to age, sex, and seasonality factors: A single center experience against children hospitalized during the 10 years

Seung Jin Lee¹, Shin Hae Lee¹, Eun Kyo Ha¹, Youn Ho Sheen², Myong Soon Sung³, Young-Ho Jung¹, Kyung Suk Lee¹, Hye Mi Jee¹, Man Yong Han¹

¹Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

²Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.

³Department of Pediatrics, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea.

Correspondence to: Man Yong Han. Department of Pediatrics, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-6262, Fax: +82-31-780-5239, drmesh@gmail.com

Received 28 February 2017 Revised 13 September 2017 Accepted 15 September 2017

The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Purpose

It is well known that respiratory viral infection has epidemiological characteristics, including season. This study aimed to investigate the patterns of the prevalence of common respiratory viruses during a period of 10 years with regard to age, sex, and season in Korean children.

Methods

From June 2006 to November 2016, we obtained 11,798 specimens from patients aged less than 18 years who were admitted with lower respiratory infections. Ten respiratory viruses were detected using multiplex reverse transcription-polymerase chain reaction.

Results

Of 11,798 specimens, at least 1 virus was detected in 4,845 (41.1%). Respiratory syncytial virus (RSV, 18.9%) was the most common virus detected, followed by human rhinovirus (HRV, 14.8%), adenovirus (9.5%), and human bocavirus (HBoV, 7.4%). The detection rate of HRV was higher in male subjects (male 60.0% vs. female 40.0%, P=0.004), but the other viruses had no significant differences with regard to sex. The subjects who were positive for RSV test were youngest (median, 10.5 months; interquartile range, 3.0–25.0 months), followed by human coronavirus (median, 13.0 months), HRV (median, 14 months), and parainfluenza (median, 14 months). HBoV was most commonly detected in spring (29.3%), enterovirus in summer (25.8%), HRV in fall (22.6%), and RSV in October and winter (22.6%).

Conclusion

We found that the prevalence of respiratory viruses in Korean children during a period of 10 years was associated with age, sex, and season when the infection occurred. Further nationwide data is warranted to infer clinical implication of our results.

Keywords: Respiratory virus, Prevalence, Seasonality, Child

Figures and Tables

Fig. 1

Distribution of age groups for each respiratory viruses. ADV, adenovirus; IFV A, influenza virus A; IFV B, influenza virus B; hMPV, human metapneumovirus; HRV, human rhinovirus; HCoV, human coronavirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus; HBoV, human bocavirus; HEV, human enterovirus.

Table 1

Detection rate of respiratory viruses and sex distribution of total 11,798 patients hospitalized during the study period

Respiratory virus	No. of subjects	Positive cases, n (%)	Sex, n (%)^†
Respiratory virus	No. of subjects	Positive cases, n (%)	Male	Female	P-value
RSV	11,798	2,230 (18.9)	1,303 (58.4)	927 (41.6)	0.058
Rhinovirus	9,497	1,409 (14.8)	845 (60.0)	564 (40.0)	0.004^*
Adenovirus	11,798	1,124 (9.5)	634 (56.4)	490 (43.6)	0.869
Bocavirus	2,858	212 (7.4)	123 (58.0)	89 (42.0)	0.429
Parainfl	11,798	830 (7.0)	496 (59.8)	334 (40.2)	0.060
Influenza A viruss	11,798	626 (5.3)	366 (58.5)	260 (41.5)	0.342
Enterovirus	2,858	131 (4.6)	73 (55.7)	58 (44.3)	0.943
Metapneumovirus	11,798	493 (4.2)	286 (58.0)	207 (42.0)	0.529
Coronavirus	5,159	133 (2.6)	80 (60.2)	53 (39.8)	0.356
Influenza B virus	11,798	129 (1.1)	80 (62.0)	49 (38.0)	0.215
Total	11,798	4,845 (41.1)	2,822 (58.3)	2,023 (41.8)	0.003^*

^*P<0.05, statistically significant. ^†Percentage of males and females in subjects who were tested positive for each virus by polymerase chain reaction test.

Table 2

Monthly incidence of respiratory virus isolation

Season	Month	No.	Positive cases, n (%)	Positive cases of respiratory viruses, n (%)
Season	Month	No.	Positive cases, n (%)	ADV	IFV A	IFV B	hMPV	HRV	HCoV	PIV	RSV	HBoV	HEV
Spring	Mar	900	332 (36.9)	56 (6.2)	50 (5.6)	62 (6.9)^*	82 (9.1)	103 (14.8)	11 (2.5)	18 (2.0)	110 (12.2)	28 (11.5)	0 (0)
	Apr	1,224^‡	428 (35.0)	130 (10.6)	95 (7.8)	46 (3.8)	188 (15.4)^*	164 (14.8)	13 (2.5)	84 (6.9)	75 (6.1)	66 (25.3)	2 (0.8)
	May	1,166	424 (36.3)	161 (13.8)	36 (3.1)	4 (0.3)	109 (9.3)	186 (19.9)	12 (2.6)	223 (19.1)^*	37 (3.2)	68 (29.3)^*	12 (5.2)
Summer	Jun	756	262 (34.7)	93 (12.3)	6 (0.8)	0 (0)	30 (4.0)	123 (20.0)	10 (3.1)	141 (18.7)	7 (0.9)	20 (11.3)	23 (13)
	Jul	635	219 (34.5)	43 (6.8)	3 (0.5)	1 (0.2)	12 (1.9)	104 (20.4)	3 (1.0)	102 (16.1)	16 (2.5)	2 (1.1)	48 (25.8)^*
	Aug	782	221 (28.3)	137 (17.5)^*	3 (0.4)	0 (0)	4 (0.5)	73 (11.9)	2 (0.5)	76 (9.7)	37 (0.7)	4 (1.6)	21 (8.6)
Fall	Sep	996	263 (26.5)	137 (13.8)	21 (2.1)	0 (0)	4 (0.4)	120 (15.8)	2 (0.5)	67 (6.7)	97 (9.7)	0 (0)	6 (3.0)
	Oct	1,198	514 (42.9)	114 (9.5)	48 (4.0)	0 (0)	11 (0.9)	207 (22.3)^*	12 (1.9)	59 (4.9)	271 (22.6)	9 (2.5)	13 (3.6)
	Nov	1,357^‡	725 (53.4)^†	98 (7.2)	89 (6.6)	0 (0)	5 (0.4)	121 (11.9)	12 (1.8)	30 (2.2)	555 (40.9)	2 (0.6)	5 (1.5)
Winter	Dev	1,050	580 (55.3)^†	54 (5.1)	55 (5.2)	1 (0.1)	2 (0.2)	97 (9.8)	26 (7.4)^*	10 (1.0)	477 (45.4)^*	1 (0.4)	0 (0)
	Jan	967	533 (55.1)^†	67 (6.9)	128 (13.2)^*	5 (0.5)	15 (1.6)	58 (7.2)	22 (6.6)	9 (0.9)	347 (35.9)	5 (2.9)	0 (0)
	Feb	767	342 (44.6)	34 (4.4)	92 (12.0)^*	10 (1.3)	31 (4.0)	53 (8.1)	8 (2.9)	11 (1.4)	201 (26.2)	7 (4.3)	1 (0.6)
	Total	11,798	4,118 (34.9)	1,124 (9.5)	626 (5.3)	129 (1.1)	493 (4.2)	1,409 (14.8)	133 (2.6)	830 (7.0)	2,230 (18.9)	212 (7.4)	131 (4.6)

Numbers in parenthesis is the positive percentage of each viruses.

No., number of respiratory aspirations collected; ADV, adenovirus; IFV A, influenza virus A; IFV B, influenza virus B; hMPV, human metapneumovirus; HRV, human rhinovirus; HCoV, human coronavirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus; HBoV, human bocavirus; HEV, human enterovirus.

^*Month when the prevalence of disease caused by respiratory virus was highest. ^†Month when the isolation of respiratory virus was highest. ^‡Month when the number of collected samples were highest.

Table 3

Positive rate of respiratory viruses in each age group

Age (yr)	Positive, %	Positive rate of respiratory viruses, %
Age (yr)	Positive, %	ADV	IFV A	IFV B	hMPV	HRV	HCoV	PIV	RSV	HBoV	HEV
<1	43.4	5.4	3.7	0.6	4.2	15.3^*	3.6	7.3	24.5^*	6.0	5.3
1	45.2	12.0^*	5.1	0.8	5.4	16.3^*	3.4	10.2^*	19.2^*	16.5^*	4.2
2	43.1	15.4^*	4.3	1.6	6.4	16.7^*	2.4	8.5	17.4^*	9.6	5.9
3–4	36.6	15.0^*	6.4	2.1	4.0	13.0^*	0.9	4.9	12.6^*	4.1	4.8
5–7	34.6	9.4	10.1^*	1.4	1.2	12.4^*	1.9	3.0	11.4^*	2.0	3.8
8–17	26.3	5.3	9.1	1.7	0.4	9.7	0.6	1.6	8.1	1.4	0.9
Total	41.1	9.5	5.3	1.1	4.2	14.8	2.6	6.5	18.9	7.4	4.6

Total of positive rates may be smaller than the sum of positive rate of each virus due to coinfection.

ADV, adenovirus; IFV A, influenza virus A; IFV B, influenza virus B; hMPV, human metapneumovirus; HRV, human rhinovirus; HCoV, human coronavirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus; HBoV, human bocavirus; HEV, human enterovirus.

^*Positive rate of 10% and above.

Table 4

Annual number of the respiratory viruses isolated from children with acute respiratory tract infection

Year	No.	Positive cases, n (%)	Positive cases of respiratory viruses, n (%)
Year	No.	Positive cases, n (%)	ADV	IFV A	IFV B	hMPV	HRV	HCoV	PIV	RSV	HBoV	HEV
2006	607	182 (30.0)	14 (2.3)	2 (0.3)	0 (0)	0 (0)	-	10 (1.6)	47 (7.7)	129 (21.3)	-	-
2007	1,303	319 (24.5)	136 (10.4)	51 (3.9)	1 (0.1)	73 (5.6)	-	15 (1.2)	104 (8.0)	152 (11.7)	-	-
2008	853	366 (42.9)	27 (3.2)	34 (4.1)	24 (2.8)	16 (1.9)	41 (8.9)	12 (3.1)	45 (5.3)	254 (29.8)	-	-
2009	1,503	708 (47.1)	151 (10.0)	324 (21.6)	0 (0)	73 (4.9)	239 (15.8)	-	131 (8.7)^†	316 (21.0)	-	-
2010	654	347 (53.7)^*	48 (7.3)	47 (7.2)	8 (1.2)	25 (3.8)	81 (12.4)	-	31 (4.7)	283 (43.3)^†	-	-
2011	367	146 (39.8)	8 (2.2)	15 (4.1)	1 (0.3)	14 (3.8)	51 (13.9)	-	22 (6.0)	109 (29.7)	-	-
2012	414	210 (50.7)^*	20 (4.8)	26 (6.3)	5 (1.2)	16 (3.9)	39 (9.4)	-	29 (7.0)	154 (37.2)	-	-
2013	652	258 (39.6)	50 (7.7)	12 (1.8)	0 (0)	16 (2.5)	52 (8.0)	-	36 (5.5)	211 (32.4)	-	-
2014	1,438	431 (30.0)	37 (2.6)	5 (0.3)	1 (0.1)	83 (5.8)^†	105 (7.3)	-	96 (6.7)	334 (23.2)	-	-
2015	1,809	582 (32.2)	122 (6.7)	49 (27)^†	15 (0.8)	79 (4.4)	310 (17.1)	27 (4.1)	146 (8.1)	228 (12.6)	8 (1.2)	15 (2.3)
2016	2,198	1,290 (58.7)^*	511 (23.2)^†	61 (2.8)	74 (3.4)^†	98 (4.5)	492 (22.4)	69 (3.1)	143 (6.5)	60 (2.7)	204 (9.3)	116 (5.3)
Total, %		34.9	9.5	5.3	1.1	4.2	14.8	2.6	7.0	18.9	7.4	4.6

^*Year when the isolation of respiratory virus were highest. ^†Year when the prevalence of disease caused by respiratory virus were highest.

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ORCID iDs: Man Yong Han
https://orcid.org/0000-0002-9077-5779
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