Citation: Mengjia Liu, Xinyu Wang, Linlin Zhang, Guoshuang Feng, Yueping Zeng, Ran Wang, Zhengde Xie. Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China: A nationwide retrospective study .VIROLOGICA SINICA, 2022, 37(5) : 637-645.  http://dx.doi.org/10.1016/j.virs.2022.07.007

Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China: A nationwide retrospective study

  • Epstein-Barr virus (EBV) is very common, with the infection rate in adults over 90% worldwide. Infectious mononucleosis (IM) is caused by primary infection with EBV. Most IM patients are generally considered to have a favorable prognosis, but a few patients will also develop complications. Children with severe symptoms will require hospitalization. However, the disease burden of children hospitalized with IM in China has been rarely described. In this study, we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st, 2016 to Dec 31st, 2020, and medical information such as gender, age, region, time of admission, length of stay and expenditure were extracted. There were 24,120 IM cases, which accounted for 0.42% (24,120/5,693,262) of all hospitalized cases during this period. The ratio of male to female was 1.48:1. Hospitalization for IM in the 4–6 years age group was the highest among inpatients of all age groups. Case numbers increased year by year between 2016 and 2020, and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year. Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients. The median length of stay was 8 days, and the median cost of hospitalization was 970.59 US dollars. This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.

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    1. Chabay, P.A., Preciado, M.V., 2013. EBV primary infection in childhood and its relation to B-cell lymphoma development:a mini-review from a developing region. Int. J.Cancer 133, 1286-1292.

    2. Chan, C.W., Chiang, A.K., Chan, K.H., Lau, A.S., 2003. Epstein-Barr virus-associated infectious mononucleosis in Chinese children. Pediatr. Infect. Dis. J. 22, 974-978.

    3. Chinn, I.K., Eckstein, O.S., Peckham-Gregory, E.C., Goldberg, B.R., Forbes, L.R., Nicholas, S.K., Mace, E.M., Vogel, T.P., Abhyankar, H.A., Diaz, M.I., Heslop, H.E., Krance, R.A., Martinez, C.A., Nguyen, T.C., Bashir, D.A., Goldman, J.R., StrayPedersen, A., Pedroza, L.A., Poli, M.C., Aldave-Becerra, J.C., McGhee, S.A., AlHerz, W., Chamdin, A., Coban-Akdemir, Z.H., Jhangiani, S.N., Muzny, D.M., Cao, T.N., Hong, D.N., Gibbs, R.A., Lupski, J.R., Orange, J.S., McClain, K.L., Allen, C.E., 2018. Genetic and mechanistic diversity in pediatric hemophagocytic lymphohistiocytosis. Blood 132, 89-100.

    4. Devkota, K., He, M., Liu, M.Y., Li, Y., Zhang, Y.W., 2018. Increasing Epstein-Barr virus infection in Chinese children:a single institutional based retrospective study.F1000Res 7, 1211.

    5. Dunmire, S.K., Hogquist, K.A., Balfour, H.H., 2015. Infectious mononucleosis. Curr. Top.Microbiol. Immunol. 390, 211-240.

    6. Dunmire, S.K., Verghese, P.S., Balfour Jr., H.H., 2018. Primary Epstein-Barr virus infection. J. Clin. Virol. 102, 84-92.

    7. Feng, G., Zeng, Y., Tian, J., Wang, X., Tai, J., Song, F., Zhang, X., Xu, X., Chen, J., Shi, T., Ni, X., Futang Research Center of Pediatric, D., 2019. Disease spectrum analysis of hospitalized children in China:a study of 18 tertiary children's hospitals. Pediatr Investig 3, 159-164.

    8. Fernbach, D.J., Starling, K.A., 1972. Infectious mononucleosis. Pediatr. Clin. 19, 957-968.

    9. Fourcade, G., Germi, R., Guerber, F., Lupo, J., Baccard, M., Seigneurin, A., Semenova, T., Morand, P., Epaulard, O., 2017. Evolution of EBV seroprevalence and primary infection age in a French hospital and a city laboratory network, 2000-2016. PLoS One 12, e0175574.

    10. Gao, L.W., Xie, Z.D., Liu, Y.Y., Wang, Y., Shen, K.L., 2011. Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China. World J Pediatr 7, 45-49.

    11. Grotto, I., Mimouni, D., Huerta, M., Mimouni, M., Cohen, D., Robin, G., Pitlik, S., Green, M.S., 2003. Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults. Epidemiol. Infect. 131, 683-689.

    12. Guo, K., Wang, X.Y., Feng, G.S., Tian, J., Zeng, Y.P., Ma, S.X., Ni, X., Futang Research Center of Pediatric, D., 2021. The epidemiology of blood transfusion in hospitalized children:a national cross-sectional study in China. Transl. Pediatr. 10, 1055-1062.

    13. Heath Jr., C.W., Brodsky, A.L., Potolsky, A.I., 1972. Infectious mononucleosis in a general population. Am. J. Epidemiol. 95, 46-52.

    14. Hu, H., Deng, H., Bi, J., Xu, Y., Li, S., Xie, Y., Sun, X., Wang, D., Li, X., Ouyang, W., Hu, B., Zhang, Y., Tang, H., Fang, C., Zhang, H., Guo, L., Wang, C., Wang, T., Yang, F., Jiang, T., Xie, Z., Liu, G., 2021. Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China:a multicenter retrospective study. Pediatr Investig 5, 188-194.

    15. Imashuku, S., Morimoto, A., Ishii, E., 2021. Virus-triggered secondary hemophagocytic lymphohistiocytosis. Acta Paediatr. 110, 2729-2736.

    16. Ishii, E., 2016. Hemophagocytic lymphohistiocytosis in children:pathogenesis and treatment. Front Pediatr 4, 47.

    17. Jenson, H.B., 2000. Acute complications of Epstein-Barr virus infectious mononucleosis.Curr. Opin. Pediatr. 12, 263-268.

    18. Kimura, H., Cohen, J.I., 2017. Chronic active epstein-barr virus disease. Front. Immunol. 8, 1867.

    19. Klutts, J.S., Ford, B.A., Perez, N.R., Gronowski, A.M., 2009. Evidence-based approach for interpretation of Epstein-Barr virus serological patterns. J. Clin. Microbiol. 47, 3204-3210.

    20. Kuri, A., Jacobs, B.M., Vickaryous, N., Pakpoor, J., Middeldorp, J., Giovannoni, G., Dobson, R., 2020. Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom. BMC Publ. Health 20, 912.

    21. Lennon, P., Crotty, M., Fenton, J.E., 2015. Infectious mononucleosis. BMJ 350, h1825.

    22. Levine, H., Mimouni, D., Grotto, I., Zahavi, A., Ankol, O., Huerta-Hartal, M., 2012. Secular and seasonal trends of infectious mononucleosis among young adults in Israel:1978-2009. Eur. J. Clin. Microbiol. Infect. Dis. 31, 757-760.

    23. Liu, Y., Yan, J., Guan, X., Ai, J., Xie, Z., 2012. Serological epidemiology investigation of Epstein-barr virus infection based on 733 children to be operated (in Chinese). Chin.J. Evid. Based Pediatr. 7, 450-453.

    24. Naughton, P., Healy, M., Enright, F., Lucey, B., 2021. Infectious Mononucleosis:diagnosis and clinical interpretation. Br. J. Biomed. Sci. 78, 107-116.

    25. Newell, K.W., 1957. The reported incidence of glandular fever; an analysis of a report of the public health laboratory service. J. Clin. Pathol. 10, 20-22.

    26. Odumade, O.A., Hogquist, K.A., Balfour Jr., H.H., 2011. Progress and problems in understanding and managing primary Epstein-Barr virus infections. Clin. Microbiol.Rev. 24, 193-209.

    27. Oumei, H., Xuefeng, W., Jianping, L., Kunling, S., Rong, M., Zhenze, C., Li, D., Huimin, Y., Lining, W., Zhaolan, L., Xinmin, L., Hua, X., Zhiyan, J., Yanning, L., Yan, H., Baoqing, Z., Xiaochun, F., Chunhui, H., Yonghong, J., Xue, Z., Wei, W., Zi, W., 2018. Etiology of community-acquired pneumonia in 1500 hospitalized children. J. Med.Virol. 90, 421-428.

    28. Qiang, Q., Zhengde, X., Shuang, Y., Kunling, S., 2012. Prevalence of coinfection in children with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis.J. Pediatr. Hematol. Oncol. 34, e45-48.

    29. Shi, T., Huang, L., Tian, J., 2022. Prevalence of Epstein-Barr Viral DNA among children at a single hospital in Suzhou, China. J. Pediatr. 98, 142-146.

    30. Shurin, S.B., 1979. Infectious mononucleosis. Pediatr. Clin. 26, 315-326.

    31. Son, K.H., Shin, M.Y., 2011. Clinical features of Epstein-Barr virus-associated infectious mononucleosis in hospitalized Korean children. Korean J Pediatr 54, 409-413.

    32. Subspecialty Group of Infectious Diseases tSoP, Chinese Medical Association, Children NGoE-BVADi, 2016. Principle suggestions for diagnosis and treatment of main nontumorous Epstein-Barr virus-associated diseases in children (in Chinese). Chinese Journal of Pediatrics 54, 563-568.

    33. Xie, Z., Liu, C., Ai, J., 2018. Expert consensus on laboratory diagnosis and clinical application of Epstein-Barr virus infection (in Chinese). Chin. J. Exp. Clin. Virol. 32, 2-8.

    34. Xiong, G., Zhang, B., Huang, M.Y., Zhou, H., Chen, L.Z., Feng, Q.S., Luo, X., Lin, H.J., Zeng, Y.X., 2014. Epstein-Barr virus (EBV) infection in Chinese children:a retrospective study of age-specific prevalence. PLoS One 9, e99857.

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    Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China: A nationwide retrospective study

      Corresponding author: Ran Wang, randall@mail.ccmu.edu.cn
      Corresponding author: Zhengde Xie, xiezhengde@bch.com.cn
    • a Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;
    • b Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China;
    • c Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;

    Abstract: Epstein-Barr virus (EBV) is very common, with the infection rate in adults over 90% worldwide. Infectious mononucleosis (IM) is caused by primary infection with EBV. Most IM patients are generally considered to have a favorable prognosis, but a few patients will also develop complications. Children with severe symptoms will require hospitalization. However, the disease burden of children hospitalized with IM in China has been rarely described. In this study, we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st, 2016 to Dec 31st, 2020, and medical information such as gender, age, region, time of admission, length of stay and expenditure were extracted. There were 24,120 IM cases, which accounted for 0.42% (24,120/5,693,262) of all hospitalized cases during this period. The ratio of male to female was 1.48:1. Hospitalization for IM in the 4–6 years age group was the highest among inpatients of all age groups. Case numbers increased year by year between 2016 and 2020, and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year. Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients. The median length of stay was 8 days, and the median cost of hospitalization was 970.59 US dollars. This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.

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