Abstract：
OBJECTIVE: As herpes simplex virus (HSV) in infancy is not a mandatory notifiable condition in Australia, completeness of ascertainment by the Australian Paediatric Surveillance Unit (APSU) has been difficult to evaluate to date. We evaluated case capture in Queensland (QLD) and Western Australia (WA) using statewide laboratory and clinical data and complementary surveillance data collected via the APSU.
METHODS: HSV polymerase chain reaction positive results in infants (0-3 months) from 2007 to 2017 were obtained from statewide public pathology providers in QLD and WA. Clinical data were extracted from patient records and compared to APSU reported cases.
RESULTS: A total of 94 cases of HSV disease in infancy (70 QLD; 24 WA) were identified from laboratory data sets, compared to 36 cases (26 QLD; 10 WA) reported to the APSU. In total there was 102 unique cases identified; 28 cases were common to both data sets (seven skin eye mouth (SEM) disease, 13 central nervous system (CNS) disease and eight disseminated disease). Active surveillance captured 35% (36/102) of cases overall including 74% (14/19) of CNS, 71% (10/14) of disseminated and 17% (12/69) of SEM disease cases, respectively. Surveillance reported cases had a higher case-fatality rate compared to those not reported (14% vs. 3%, P = 0.038). Neurological sequelae at discharge were comparable between the groups.
CONCLUSIONS: Active surveillance captures one third of hospitalised HSV cases in QLD and WA, including the majority with severe disease. However, morbidity and mortality remain high. Future studies on HSV will rely on observational studies. Enhanced case ascertainment through combined laboratory and surveillance data is essential for better understanding and improving outcomes.
METHODS: HSV polymerase chain reaction positive results in infants (0-3 months) from 2007 to 2017 were obtained from statewide public pathology providers in QLD and WA. Clinical data were extracted from patient records and compared to APSU reported cases.
RESULTS: A total of 94 cases of HSV disease in infancy (70 QLD; 24 WA) were identified from laboratory data sets, compared to 36 cases (26 QLD; 10 WA) reported to the APSU. In total there was 102 unique cases identified; 28 cases were common to both data sets (seven skin eye mouth (SEM) disease, 13 central nervous system (CNS) disease and eight disseminated disease). Active surveillance captured 35% (36/102) of cases overall including 74% (14/19) of CNS, 71% (10/14) of disseminated and 17% (12/69) of SEM disease cases, respectively. Surveillance reported cases had a higher case-fatality rate compared to those not reported (14% vs. 3%, P = 0.038). Neurological sequelae at discharge were comparable between the groups.
CONCLUSIONS: Active surveillance captures one third of hospitalised HSV cases in QLD and WA, including the majority with severe disease. However, morbidity and mortality remain high. Future studies on HSV will rely on observational studies. Enhanced case ascertainment through combined laboratory and surveillance data is essential for better understanding and improving outcomes.
摘要：
目的：由于单纯疱疹病毒（HSV）在婴儿期不是澳大利亚的强制性报告条件，迄今为止,澳大利亚儿科监测单位(APSU)确定的完整性难以评估.我们使用通过APSU收集的全州实验室和临床数据以及补充监测数据评估了昆士兰州（QLD）和西澳大利亚州（WA）的病例捕获情况。
方法：2007年至2017年婴儿（0-3个月）的HSV聚合酶链反应阳性结果来自QLD和WA的全州公共病理学提供者。从患者记录中提取临床数据，并与APSU报告的病例进行比较。
结果：从实验室数据集中确定了总共94例婴儿期HSV疾病（70QLD；24WA），与APSU报告的36例（QLD26；WA10）相比。总共确定了102例独特病例；这两个数据集共有28例(7例皮肤眼口(SEM)疾病，13个中枢神经系统（CNS）疾病和8个播散性疾病）。主动监测记录了35%(36/102)的病例，包括74%(14/19)的中枢神经系统，71%(10/14)的播散和17%(12/69)的SEM疾病病例，分别。与未报告的病例相比，监测报告的病例死亡率更高(14%vs.3%,P=0.038)。出院时的神经系统后遗症在两组之间具有可比性。
结论：主动监测在QLD和WA捕获了三分之一的住院HSV病例，包括大多数患有严重疾病的人。然而,发病率和死亡率仍然很高。未来对HSV的研究将依赖于观察性研究。通过合并实验室和监测数据来加强病例确定对于更好地理解和改善结果至关重要。
方法：2007年至2017年婴儿（0-3个月）的HSV聚合酶链反应阳性结果来自QLD和WA的全州公共病理学提供者。从患者记录中提取临床数据，并与APSU报告的病例进行比较。
结果：从实验室数据集中确定了总共94例婴儿期HSV疾病（70QLD；24WA），与APSU报告的36例（QLD26；WA10）相比。总共确定了102例独特病例；这两个数据集共有28例(7例皮肤眼口(SEM)疾病，13个中枢神经系统（CNS）疾病和8个播散性疾病）。主动监测记录了35%(36/102)的病例，包括74%(14/19)的中枢神经系统，71%(10/14)的播散和17%(12/69)的SEM疾病病例，分别。与未报告的病例相比，监测报告的病例死亡率更高(14%vs.3%,P=0.038)。出院时的神经系统后遗症在两组之间具有可比性。
结论：主动监测在QLD和WA捕获了三分之一的住院HSV病例，包括大多数患有严重疾病的人。然而,发病率和死亡率仍然很高。未来对HSV的研究将依赖于观察性研究。通过合并实验室和监测数据来加强病例确定对于更好地理解和改善结果至关重要。
