臺灣孩童上呼吸道腸病毒感染之實驗室監視系統

Laboratory-based Surveillance of Upper Respiratory Infection due to Enterovirus in Children in Taiwan

針對臺灣12歲以下的上呼吸道感染病童，分析患者腸病慣檢出情形，提供腸病毒流病學資料，以了解台灣呼吸道感染中各型別腸病毒檢出率與月份、年齡與性別的相關性。1997年1月1日至1999年6月30日期間，收集臺北、臺中及臺南三地區各級醫療院所，12歲以下之上呼吸道感染患者的咽喉拭子檢體。藉由MDCK及H292細胞進行病毒培養並以免疫螢光染色方法確認腸病毒及鑑定病毒型別。病毒檢出率24.3%，其中腸病毒檢出率為3.2%，腸病毒陽性檢體數為111件。不同規模醫療院所的檢出率並沒有顯著的差異。確定病例中，7歲以下的孩童佔多數。腸病毒全年都可能被分離出來，5月6月及7月有較高的檢出率，以6月份的檢出率最高為8.8%。在可鑑定的腸病毒型別中，克沙奇病毒B型檢出率為26.1%佔最高。實驗室診斷為基礎的監視系統，顯示全年都可以自呼吸道感染病童分離出腸病毒，說明腸病毒是臺灣12歲以下孩童，罹患急性上呼吸道的感染重要原因之一。

This study analyzes the enterovirus isolation rate of upper respiratory tract infection in patients under 12 years old in Taiwan. The purpose of this epidemiological study is to present the interrelationship of enterovirus isolation rate of month, patient age, and gender. Throat swab of upper respiratory infection was taken from patients under 12 years old in Northern, Middle, and Southern Taiwan form January 1, 1997 to June 30, 1999. Madin Darby Canine Kidney (MDCK) and H292 cell line were sued for viral isolation; immunofluorescence stain was used to verify enterovirus and determine the virus type. Among 24.3% viral positive specimens, 111 were enteroviuses; the average isolation rate was 3.2%. The isolation rates showed no significant difference between hospitals. Among confirmed cases, children below the age of 7 showed the highest ratio. Enterovirus can be isolated year around, yet the isolation rate is high in May, June, July, and peaks in June at 8.8%. Coxsackie B viruses have the highest isolation rate of 26.1%. The surveillance results based on laboratory diagnosis suggest that enterovirus is one of the important pathogen to children below 12 year old with upper respiratory tract infection.