Viruses Thrive In Big Families, In Sickness and In Health

Listen to two interviews about the research on The Scope Radio

研究表明，大家庭在一年中有87%的时间感染病毒. But only half of infections cause illness

盐湖城-大爱（犹他州更好的细菌鉴定-纵向病毒流行病学）研究, led by scientists at the University of Utah School of Medicine, 发现每一束欢乐都会增加整个家庭感染导致感冒的病毒的风险, flu, and other respiratory illnesses.

在这一年中，生活在无子女家庭中的人平均有3-4周感染病毒. In households with one child, that number jumped to 18 weeks, and for those with six children, 一年中，家里有病毒的时间长达45周.

然而，在病毒感染检测呈阳性的人中，平均只有一半出现了典型的咳嗽症状, fever, and stuffy nose, 这对家庭和他们的医疗保健大发娱乐提供者都是一个有益的发现. The results were published in the journal, Clinical Infectious Diseases.

Kids Fill Hearts With Love, And Homes With Illness

When it comes to explaining why big families have more illnesses, all signs point to young kids as the culprits. 五岁以下的儿童在一年中有50%的时间在鼻粘液中检测到至少一种病毒，是大一点的儿童和成人的两倍. And when infected, they were 1.出现症状的可能性高出5倍，包括严重的喘息和发烧.

给家庭带来更大压力的是，孩子们并不孤单. Their parents were sick 1.比没有和小孩住在一起的同龄人频繁5倍.

"A lot families go through wave after wave of illness. In fact, 大发娱乐监测的一些孩子连续出现20到25周的症状," says co-first author Carrie Byington, M.D.他是儿科教授，也是犹他州临床和转化科学中心的联合主任. “这项研究大发娱乐大发娱乐了解幼儿的正常情况, 并且可以大发娱乐大发娱乐确定疾病何时应该引起关注." Andrew Pavia, M.D., professor of pediatrics, is senior author on the study.

It's no secret that children get sick a lot. 但是“大爱”——一项为期一年的犹他州社区调查——是第一个使用现代诊断方法来追踪孩子和其他家庭成员的频率的, both sick and well, have nasal infections of respiratory virus. 未来的研究将确定报告的趋势是否适用于更大、更多样化的人群.

A Positive Test May Not Mean Positively Sick

也许最令人惊讶的发现是参与者携带病毒的频率, and showed no signs of being sick.

PCR-based diagnostics, like those used to test participants' samples in this study, 是否在临床环境中变得越来越普遍，因为它们比旧的测试更敏感和准确, and provide results within hours, not days. 然而，这些发现表明，一些测试结果应该谨慎解读.

而感染流感和副流感病毒的研究参与者大部分时间都生病了, 那些携带鼻病毒（引起普通感冒的原因）的人只有一半的时间生病.

What's more, 结果表明，即使病人从疾病中恢复过来, some viruses persist for weeks afterward. Bocavirus persisted in the nose for as long as 12 weeks, but more commonly viruses persisted for two weeks or less. In an accompanying commentary also published in Clinical Infectious Diseases, Gregory A. Storch, M.D., of Washington University School of Medicine in St. Louis, noted that despite limitations, the research "provides highly useful information,“特别是在每次病毒发作期间基于pcr的检测保持阳性的时间.

If presence of virus doesn't always translate into illness, 那么，即使有人生病了，并且对某种特定病毒的检测呈阳性，这也是合理的, there could be another cause. For example bacteria, or a rare virus not detected by the test. Health care providers should be aware of these limitations.

“如果一个患有严重呼吸道疾病的孩子进入急诊室，并且鼻病毒检测呈阳性, 对医生来说，确保他们没有遗漏其他可能的病因可能是一个聪明的主意," says co-first author and professor of pediatrics Krow Ampofo, M.B., Ch.B.

How Sickness Was Studied

“大爱”是一个研究病毒如何在家庭中传播的项目. Monitoring a community in Utah, the state with the largest number of children per household, 使调查人员能够追踪大家庭和小家庭之间的差异.

调查人员对26个家庭共108人（其中3人在研究期间出生）进行了为期一年的监测. 每个家庭每周收集一次家庭成员的鼻拭子，并记录他们何时出现典型的感冒和流感症状. A PCR-based test, the FilmArray by BioFire Diagnostics, probed swabs for 16 different respiratory viruses, including influenza, rhinovirus, and respiratory syncytial virus (RSV). 4166 samples were analyzed in all. Future studies will examine trends in larger communities, and those in other geographical regions, and of different ethnicities.

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"犹他州家庭间呼吸道病毒的社区监测-纵向病毒流行病学（BIG-LoVE）研究" was published online in Clinical Infectious Diseases online on August 5, 2015

The work was supported by the National Institutes of Health (NIH), The HA and Edna Benning Presidential Endowment, The Primary Children's Hospital Foundation, the Pediatric Clinical and Translational Scholars Program, and the James S. McDonnell Foundation

除了Byington和Ampofo，作者还包括Chris Stockmann， MSc, Frederick R. Adler, Ph.D., Amy Herbener, M.D., , Xiaoming Sheng, Ph.D., Anne J. Blaschke, M.D., Ph.D., and Andrew T. Pavia, M.D. 来自犹他大学的特伦特·米勒和罗伯特·克里斯普博士.D. from BioFire Diagnostics

CB, AJB, KA, XS, 和ATP是美国国立卫生研究院与BioFire Diagnostics公司合作的研究人员. CB和AJB拥有BioFire Diagnostics的知识产权并获得版税. ATP has served as a consultant for BioFire Diagnostics. TM和RC在研究期间都是BioFire Diagnostics的员工

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