Archives of Virology

, Volume 161, Issue 7, pp 1907–1913 | Cite as

Epidemiological and clinical characteristics of respiratory viral infections in children in Shanghai, China

Original Article


Acute respiratory tract infections (ARTIs) due to various viruses are not only the most common causes of upper and lower respiratory infection but are also major causes of morbidity and mortality in children. In this study, we investigated the prevalence and clinical characteristics of children with virus-related ARTIs and determined the spectrum of respiratory viruses and their correlation with meteorological variables in Jiading District, Shanghai, China. Nasopharyngeal swabs from 2819 children with ARTIs were collected from August 2011 to December 2014, and used for detection of respiratory viruses by multiplex RT-PCR. Seventeen respiratory viruses were detected among 691 (24.5 %) of 2819 patients. The highest prevalence of respiratory viruses was detected in the age group of less than 1 year (29.0 %), and the prevalence decreased with age. This suggests that children less than one year old are the most susceptible to infection. Influenza virus (IFV) was the most frequently detected virus (5.8 %), followed by parainfluenza virus (PIV) (5.7 %), enterovirus (EV) (4.3 %), and respiratory syncytial virus (RSV) (3.6 %). Statistical analysis showed that epidemics of IFV, PIV and EV had distinct seasonal variations. Mean monthly temperature appeared to be the only meteorological factor associated with IFV and PIV infection. These findings will provide valuable information for decision-making, prevention and treatment of ARTIs in children.


Financial support

This work was supported by grants from the China National Mega-projects for Infectious Diseases (2012ZX10004211-002 and 2013ZX10004101-005), and Health Bureau Key Disciplines in Jiading District of Shanghai-Pediatric Respiratory Specialty (ZD03).

Compliance with ethical standards

Conflict of interest


Supplementary material

705_2016_2866_MOESM1_ESM.docx (14 kb)
Supplementary material 1: Fig. 1 Seasonal distribution of respiratory viruses (DOCX 13 kb)


  1. 1.
    Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C (2002) Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis 2:25–32CrossRefPubMedGoogle Scholar
  2. 2.
    Sloots TP, Whiley DM, Lambert SB, Nissen MD (2008) Emerging respiratory agents: new viruses for old diseases? J Clin Virol 42:233–243CrossRefPubMedGoogle Scholar
  3. 3.
    Kusel MM, de Klerk NH, Holt PG, Kebadze T, Johnston SL, Sly PD (2006) Role of respiratory viruses in acute upper and lower respiratory tract illness in the first year of life: a birth cohort study. Pediatr Infect Dis J 25:680–686CrossRefPubMedGoogle Scholar
  4. 4.
    Brittain-Long R, Nord S, Olofsson S, Westin J, Anderson LM, Lindh M (2008) Multiplex real-time PCR for detection of respiratory tract infections. J Clin Virol 41:53–56CrossRefPubMedGoogle Scholar
  5. 5.
    Peng J, Kong W, Guo D, Liu M, Wang Y, Zhu H, Pang B, Miao X, Yu B, Luo T, Hu Q, Zhou D (2012) The epidemiology and etiology of influenza-like illness in Chinese children from 2008 to 2010. J Med Virol 84:672–678CrossRefPubMedGoogle Scholar
  6. 6.
    Wang W, Cavailler P, Ren P, Zhang J, Dong W, Yan H, Mardy S, Cailhol J, Buchy P, Sheng J, Fontanet A, Deubel V (2010) Molecular monitoring of causative viruses in child acute respiratory infection in endemo-epidemic situations in Shanghai. J Clin Virol 49:211–218CrossRefPubMedGoogle Scholar
  7. 7.
    Zhang G, Hu Y, Wang H, Zhang L, Bao Y, Zhou X (2012) High incidence of multiple viral infections identified in upper respiratory tract infected children under three years of age in Shanghai, China. PLoS One 7:e44568CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Zhang HY, Li ZM, Zhang GL, Diao TT, Cao CX, Sun HQ (2009) Respiratory viruses in hospitalized children with acute lower respiratory tract infections in harbin, China. Jpn J Infect Dis 62:458–460PubMedGoogle Scholar
  9. 9.
    Huang G, Yu D, Mao N, Zhu Z, Zhang H, Jiang Z, Li H, Zhang Y, Shi J, Zhang S, Wang X, Xu W (2013) Viral etiology of acute respiratory infection in Gansu Province, China, 2011. PLoS One 8:e64254CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Jin Y, Zhang RF, Xie ZP, Yan KL, Gao HC, Song JR, Yuan XH, Cheng WX, Hou YD, Duan ZJ (2012) Newly identified respiratory viruses associated with acute lower respiratory tract infections in children in Lanzou, China, from 2006 to 2009. Clin Microbiol Infect 18:74–80CrossRefPubMedGoogle Scholar
  11. 11.
    Cai XY, Wang Q, Lin GY, Cai ZW, Lin CX, Chen PZ, Zhou XH, Xie JC, Lu XD (2014) Respiratory virus infections among children in South China. J Med Virol 86:1249–1255CrossRefPubMedGoogle Scholar
  12. 12.
    Li H, Wei Q, Tan A, Wang L (2013) Epidemiological analysis of respiratory viral etiology for influenza-like illness during 2010 in Zhuhai, China. Virol J 10:143CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Huo X, Qin Y, Qi X, Zu R, Tang F, Li L, Hu Z, Zhu F (2012) Surveillance of 16 respiratory viruses in patients with influenza-like illness in Nanjing, China. J Med Virol 84:1980–1984CrossRefPubMedGoogle Scholar
  14. 14.
    Liu J, Mu Y, Dong W, Yao F, Wang L, Yan H, Lan K, Zhang C (2014) Genetic variation of human respiratory syncytial virus among children with fever and respiratory symptoms in Shanghai, China, from 2009 to 2012. Infect Genet Evol 27:131–136CrossRefPubMedGoogle Scholar
  15. 15.
    Tsukagoshi H, Ishioka T, Noda M, Kozawa K, Kimura H (2013) Molecular epidemiology of respiratory viruses in virus-induced asthma. Front Microbiol 4:278CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, Li T, Qin K, Wu J, Liu Y (2015) Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. PLoS One 10:e0119170CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Qin X, Zhang C, Zhao Y, Zhao X (2013) Genetic variability of subgroup A and B respiratory syncytial virus strains circulating in southwestern China from 2009 to 2011. Arch Virol 158:1487–1495CrossRefPubMedGoogle Scholar
  18. 18.
    Zhang ZY, Du LN, Chen X, Zhao Y, Liu EM, Yang XQ, Zhao XD (2010) Genetic variability of respiratory syncytial viruses (RSV) prevalent in Southwestern China from 2006 to 2009: emergence of subgroup B and A RSV as dominant strains. J Clin Microbiol 48:1201–1207CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Henrickson KJ (2003) Parainfluenza viruses. Clin Microbiol Rev 16:242–264CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Zhang C, Zhu N, Xie Z, Lu R, He B, Liu C, Ma X, Tan W (2013) Viral etiology and clinical profiles of children with severe acute respiratory infections in China. PLoS One 8:e72606CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Rodriguez-Martinez CE, Sossa-Briceno MP, Acuna-Cordero R (2015) Relationship between meteorological conditions and respiratory syncytial virus in a tropical country. Epidemiol Infect 143:2679–2686CrossRefPubMedGoogle Scholar
  22. 22.
    Noyola DE, Mandeville PB (2008) Effect of climatological factors on respiratory syncytial virus epidemics. Epidemiol Infect 136:1328–1332CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Pediatric DepartmentShanghai Nanxiang HospitalShanghaiChina
  2. 2.Pathogen Diagnostic Center, Institut Pasteur of ShanghaiChinese Academy of ScienceShanghaiChina

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