title: Viral aetiology of acute respiratory infections among children and associated meteorological factors in southern China.
abstract: BACKGROUND
  Acute respiratory infections (ARIs) are common in children and mostly caused by viruses, but the significance of the detection of multiple viruses in ARIs is unclear. This study investigated 14 respiratory viruses in ARIs among children and associated meteorological factors in Shantou, southern China.
  
  
  METHODS
  Paired nasal/throat-flocked swabs collected from 1,074 children with ARIs, who visited outpatient walk-in clinics in a tertiary hospital between December 2010 and November 2011, were examined for fourteen respiratory viruses--influenza viruses (FluA, FluB), respiratory syncytial viruses (RSV A and B), human coronaviruses (hCoV: 229E, OC43, HKU1, NL63), human metapneumoviruses (hMPV A and B), parainfluenza viruses (PIV1-4), human rhinoviruses (HRV A, B, C), enteroviruses (EV), adenoviruses (ADV), human bocavirus (hBoV), and human parechoviruses (hPeV)--by multiplex real-time PCR.
  
  
  RESULTS
  We identified at least one virus in 82.3% (884/1,074) and multiple viruses in 38.6% (415/1,074) of patients. EV and HRV were the most frequently detected single viruses (42.3%, 374/884 and 39.9%, 353/884 respectively) and co-detected pair (23.1%, 96/415). Overlapping seasonal trends of viruses were recorded over the year, with dual peaks for EV and single peaks for the others. By logistic regression analysis, EV was positively associated with the average temperature and humidity, hCoV, and PIV4, but negatively with HRV, PIV3, and hBoV. HRV was inversely associated with EV and PIV3.
  
  
  CONCLUSIONS
  This study reports high viral detection and co-detection rates in pediatric ARI cases mainly due to EV and HRV. Many viruses circulated throughout the year with similar seasonal trends in association with temperature, humidity, and wind velocity. Statistically significant associations were present among the viruses. Understanding the polyviral etiology and viral interactions in the cases with multiple viruses warrants further studies.
authors.affiliation: Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China. binglincui@stu.edu.cn.
authors.forename: Binglin
authors.initials: B
authors.lastname: Cui
authors.affiliation: The Research Center of Translational Medicine, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China. danguizhang@stu.edu.cn.
authors.forename: Dangui
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China. michaelpan@stu.edu.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Pan
authors.affiliation: Oncology Research Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China. lemon_fan@163.com.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam. jeremyjfarrar@gmail.com.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.affiliation: Consultant Office, Shantou University Medical College, Shantou, Guangdong, P.R. China. lawf@stu.edu.cn.
authors.forename: Frieda
authors.initials: F
authors.lastname: Law
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam. hrogier@gmail.com.
authors.forename: H Rogier
authors.initials: HR
authors.lastname: van Doorn
authors.affiliation: Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China. 1261305798@qq.com.
authors.forename: Beiyan
authors.initials: B
authors.lastname: Wu
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China. wbathein@stu.edu.cn.|Department of Microbiology and Immunology, Shantou University Medical College, Shantou, Guangdong, 515041, P.R. China. wbathein@stu.edu.cn.
authors.forename: William
authors.initials: W
authors.lastname: Ba-Thein
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008685:Meteorological Concepts; D010045:Outpatients / Q000706:statistics & numerical data; D010614:Pharynx / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D014777:Virus Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D004279:DNA, Viral