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Peters L, Greene C, Azziz-Baumgartner E, Zhou S, Lupisan S, Dayan W, Hammond A, Claes F, Mumford E, Dueger E. Strategies for combating avian influenza in the Asia-Pacific. Western Pac Surveill Response J 2018; 9:8-10. [PMID: 31832247 PMCID: PMC6902647 DOI: 10.5365/wpsar.2018.9.5.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Avian influenza viruses have potentially significant impacts for both human and animal populations. Coordination between the human, animal and environmental health sectors on surveillance, information sharing, response and risk reduction are critical to quickly identify and respond to the next emerging threat.
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Affiliation(s)
| | - Carolyn Greene
- United States Centers for Disease Control and Prevention
| | | | - Suizan Zhou
- United States Centers for Disease Control and Prevention
| | - Socorro Lupisan
- Research Institute for Tropical Medicine, Philippine Department of Health
| | - Wang Dayan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention
| | | | - Filip Claes
- Food and Agriculture Organization of the United Nations
| | | | - Erica Dueger
- WHO Regional Office for the Western Pacific
- United States Centers for Disease Control and Prevention
- This work was conducted on behalf of the WHO Health Emergencies Programme of the WHO Regional Office for the Western Pacific
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102
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McMorrow ML, Tempia S, Walaza S, Treurnicht FK, Ramkrishna W, Azziz-Baumgartner E, Madhi SA, Cohen C. Prioritization of risk groups for influenza vaccination in resource limited settings - A case study from South Africa. Vaccine 2018; 37:25-33. [PMID: 30471956 PMCID: PMC6470296 DOI: 10.1016/j.vaccine.2018.11.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality. METHODS In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination. RESULTS Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65 years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted. DISCUSSION An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination.
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Affiliation(s)
- Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; U.S. Public Health Service, Rockville, MD, United States.
| | - Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Wayne Ramkrishna
- Communicable Disease Cluster, National Department of Health, South Africa
| | - Eduardo Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; U.S. Public Health Service, Rockville, MD, United States
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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103
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Baumeister E, Duque J, Varela T, Palekar R, Couto P, Savy V, Giovacchini C, Haynes AK, Rha B, Arriola CS, Gerber SI, Azziz-Baumgartner E. Timing of respiratory syncytial virus and influenza epidemic activity in five regions of Argentina, 2007-2016. Influenza Other Respir Viruses 2018; 13:10-17. [PMID: 30051595 PMCID: PMC6304310 DOI: 10.1111/irv.12596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022] Open
Abstract
Background Within‐country differences in the timing of RSV and influenza epidemics have not been assessed in Argentina, the eighth largest country in the world by area. Objective We aimed to compare seasonality for RSV and influenza both nationally and in each of the five regions to inform Argentina’s prevention and treatment guidelines. Method The Argentine National Laboratories and Health Institutes Administration collected respiratory specimens from clinical practices, outbreak investigations, and respiratory virus surveillance in 2007‐2016; these were tested using immunofluorescence or RT‐PCR techniques. We calculated weekly percent positive (PP) and defined season onset as >2 consecutive weeks when PP exceeded the annual mean for the respective year and region. Median season measures (onset, offset and peak) and the established mean method were calculated for each virus. Results An annual median 59 396 specimens were tested for RSV and 60 931 for influenza; 21–29% tested positive for RSV and 2–7% for influenza. National RSV activity began in April; region‐specific start weeks varied by 7 weeks. Duration of RSV activity did not vary widely by region (16–18 weeks in duration). National influenza activity started in June; region‐specific start weeks varied by 3 weeks. Duration of influenza epidemic activity varied more by region than that of RSV (7–13 weeks in duration). Conclusion In Argentina, RSV and influenza activity overlapped during the winter months. RSV season tended to begin prior to the influenza season, and showed more variation in start week by region. Influenza seasons tended to vary more in duration than RSV seasons.
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Affiliation(s)
- Elsa Baumeister
- Servicio Virosis Respiratorias, Instituto Nacional de Enfermedades Infecciosas, INEI-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Jazmin Duque
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,Battelle Atlanta, Atlanta, Georgia
| | - Teresa Varela
- Sistema Nacional de Vigilancia por Laboratorio, Sistema Nacional de Vigilancia de la Salud, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Rakhee Palekar
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,Pan American Health Organization, Washington, District of Columbia
| | - Paula Couto
- Pan American Health Organization, Washington, District of Columbia
| | - Vilma Savy
- Servicio Virosis Respiratorias, Instituto Nacional de Enfermedades Infecciosas, INEI-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | | | - Amber K Haynes
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carmen S Arriola
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,U.S. Public Health Service, Rockville, Maryland
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104
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Hirsch A, Katz MA, Laufer Peretz A, Greenberg D, Wendlandt R, Shemer Avni Y, Newes-Adeyi G, Gofer I, Leventer-Roberts M, Davidovitch N, Rosenthal A, Gur-Arie R, Hertz T, Glatman-Freedman A, Monto AS, Azziz-Baumgartner E, Ferdinands JM, Martin ET, Malosh RE, Neyra Quijandría JM, Levine M, Campbell W, Balicer R, Thompson MG. Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI): study protocol. BMC Infect Dis 2018; 18:550. [PMID: 30400834 PMCID: PMC6220521 DOI: 10.1186/s12879-018-3444-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/16/2018] [Indexed: 01/04/2023] Open
Abstract
Background The Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI) prospectively follows a cohort of healthcare personnel (HCP) in two hospitals in Israel. SHIRI will describe the frequency of influenza virus infections among HCP, identify predictors of vaccine acceptance, examine how repeated influenza vaccination may modify immunogenicity, and evaluate influenza vaccine effectiveness in preventing influenza illness and missed work. Methods Cohort enrollment began in October, 2016; a second year of the study and a second wave of cohort enrollment began in June 2017. The study will run for at least 3 years and will follow approximately 2000 HCP (who are both employees and members of Clalit Health Services [CHS]) with routine direct patient contact. Eligible HCP are recruited using a stratified sampling strategy. After informed consent, participants complete a brief enrollment survey with questions about occupational responsibilities and knowledge, attitudes, and practices about influenza vaccines. Blood samples are collected at enrollment and at the end of influenza season; HCP who choose to be vaccinated contribute additional blood one month after vaccination. During the influenza season, participants receive twice-weekly short message service (SMS) messages asking them if they have acute respiratory illness or febrile illness (ARFI) symptoms. Ill participants receive follow-up SMS messages to confirm illness symptoms and duration and are asked to self-collect a nasal swab. Information on socio-economic characteristics, current and past medical conditions, medical care utilization and vaccination history is extracted from the CHS database. Information about missed work due to illness is obtained by self-report and from employee records. Respiratory specimens from self-collected nasal swabs are tested for influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, and coronaviruses using validated multiplex quantitative real-time reverse transcription polymerase chain reaction assays. The hemagglutination inhibition assay will be used to detect the presence of neutralizing influenza antibodies in serum. Discussion SHIRI will expand our knowledge of the burden of respiratory viral infections among HCP and the effectiveness of current and repeated annual influenza vaccination in preventing influenza illness, medical utilization, and missed workdays among HCP who are in direct contact with patients. Trial registration NCT03331991. Registered on November 6, 2017. Electronic supplementary material The online version of this article (10.1186/s12879-018-3444-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Avital Hirsch
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.
| | - Mark A Katz
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,School of Public Health, Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alon Laufer Peretz
- Rabin Medical Center, Occupational Medicine Department, Petah Tikva, Israel
| | - David Greenberg
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | | | - Yonat Shemer Avni
- Clinical Virology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Ilan Gofer
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Maya Leventer-Roberts
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Anat Rosenthal
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Rachel Gur-Arie
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Tomer Hertz
- Department of Microbiology Immunology and Genetics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.,Vaccine and Infectious Disease Division, Fred Hutch Cancer Research Center, Seattle, WA, USA
| | - Aharona Glatman-Freedman
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | | | - Emily Toth Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ryan E Malosh
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Min Levine
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Ran Balicer
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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105
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Chow EJ, Davis CT, Abd Elal AI, Alabi N, Azziz-Baumgartner E, Barnes J, Blanton L, Brammer L, Budd AP, Burns E, Davis WW, Dugan VG, Fry AM, Garten R, Grohskopf LA, Gubareva L, Jang Y, Jones J, Kniss K, Lindstrom S, Mustaquim D, Porter R, Rolfes M, Sessions W, Taylor C, Wentworth DE, Xu X, Zanders N, Katz J, Jernigan D. Update: Influenza Activity - United States and Worldwide, May 20-October 13, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:1178-1185. [PMID: 30359347 PMCID: PMC6290813 DOI: 10.15585/mmwr.mm6742a3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
During May 20-October 13, 2018,* low levels of influenza activity were reported in the United States, with a mix of influenza A and B viruses circulating. Seasonal influenza activity in the Southern Hemisphere was low overall, with influenza A(H1N1)pdm09 predominating in many regions. Antigenic testing of available influenza A and B viruses indicated that no significant antigenic drift in circulating viruses had emerged. In late September, the components for the 2019 Southern Hemisphere influenza vaccine were selected and included an incremental update to the A(H3N2) vaccine virus used in egg-based vaccine manufacturing; no change was recommended for the A(H3N2) component of cell-manufactured or recombinant influenza vaccines. Annual influenza vaccination is the best method for preventing influenza illness and its complications, and all persons aged ≥6 months who do not have contraindications should receive influenza vaccine, preferably before the onset of influenza circulation in their community, which often begins in October and peaks during December-February. Health care providers should offer vaccination by the end of October and should continue to recommend and administer influenza vaccine to previously unvaccinated patients throughout the 2018-19 influenza season (1). In addition, during May 20-October 13, a small number of nonhuman influenza "variant" virus infections† were reported in the United States; most were associated with exposure to swine. Although limited human-to-human transmission might have occurred in one instance, no ongoing community transmission was identified. Vulnerable populations, especially young children and other persons at high risk for serious influenza complications, should avoid swine barns at agricultural fairs, or close contact with swine.§.
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MESH Headings
- Disease Outbreaks
- Drug Resistance, Viral
- Global Health/statistics & numerical data
- Humans
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H1N2 Subtype/drug effects
- Influenza A Virus, H1N2 Subtype/genetics
- Influenza A Virus, H1N2 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/drug effects
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Influenza Vaccines/chemistry
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Population Surveillance
- Seasons
- United States/epidemiology
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106
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Thapa B, Roguski K, Azziz-Baumgartner E, Siener K, Gould P, Jamtsho T, Wangchuk S. The burden of influenza-associated respiratory hospitalizations in Bhutan, 2015-2016. Influenza Other Respir Viruses 2018; 13:28-35. [PMID: 30137672 PMCID: PMC6304319 DOI: 10.1111/irv.12605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/31/2018] [Accepted: 08/19/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Influenza burden estimates help provide evidence to support influenza prevention and control programs. In this study, we estimated influenza-associated respiratory hospitalization rates in Bhutan, a country considering influenza vaccine introduction. METHODS Using real-time reverse transcription-polymerase chain reaction laboratory results from severe acute respiratory infection (SARI) surveillance, we estimated the proportion of respiratory hospitalizations attributable to influenza each month among patients aged <5, 5-49, and ≥50 years in six Bhutanese districts for 2015 and 2016. We divided the sum of the monthly influenza-attributed hospitalizations by the total of the six district populations to generate age-specific rates for each year. RESULTS In 2015, 10% of SARI patients tested positive for influenza (64/659) and 18% tested positive (129/736) in 2016. The incidence of influenza-associated hospitalizations among all age groups was 50/100 000 persons (95% confidence interval [CI]: 45-55) in 2015 and 118/100 000 persons (95% CI: 110-127) in 2016. The highest rates were among children <5 years: 182/100 000 (95% CI: 153-210) in 2015 and 532/100 000 (95% CI: 473-591) in 2016. The second highest influenza-associated hospitalization rates were among adults ≥50 years: 110/100 000 (95% CI: 91-130) in 2015 and 193/100 000 (95% CI: 165-221) in 2016. CONCLUSIONS Influenza viruses were associated with a substantial burden of severe illness requiring hospitalization especially among children and older adults. These findings can be used to understand the potential impact of seasonal influenza vaccination in these age groups.
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Affiliation(s)
- Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Katherine Roguski
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Karen Siener
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Philip Gould
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.,Regional Office for South East Asia, World Health Organization, New Delhi, India
| | - Thinley Jamtsho
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
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107
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Dawood FS, Hunt D, Patel A, Kittikraisak W, Tinoco Y, Kurhe K, Soto G, Hombroek D, Garg S, Chotpitayasunondh T, Gonzales O, Bhargav S, Thompson MG, Chotpitayasunondh B, Florian R, Prakash A, Arriola S, Macareo L, Das P, Cabrera S, La Rosa S, Azziz-Baumgartner E. The Pregnancy and Influenza Multinational Epidemiologic (PRIME) study: a prospective cohort study of the impact of influenza during pregnancy among women in middle-income countries. Reprod Health 2018; 15:159. [PMID: 30241481 PMCID: PMC6150986 DOI: 10.1186/s12978-018-0600-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/05/2018] [Indexed: 11/23/2022] Open
Abstract
Background The World Health Organization identifies pregnant women as at high-risk for severe influenza, but influenza vaccines are underutilized among pregnant women. Data on influenza burden during pregnancy are largely limited to high-income countries and data on the impact of influenza on birth and perinatal outcomes are scarce. Methods/design This prospective, longitudinal cohort study of pregnant women in middle-income countries is designed to address three primary objectives: 1) to evaluate the effect of laboratory-confirmed influenza during pregnancy on pregnancy and perinatal outcomes; 2) to estimate the incidences of all-cause acute respiratory illness and laboratory-confirmed influenza during pregnancy; and 3) to examine the clinical spectrum of illness associated with influenza viruses. Through a multi-country network approach, three sites aim to enroll cohorts of 1500–3000 pregnant women just before local influenza seasons. Women aged ≥ 18 years with expected delivery dates ≥ 8 weeks after the start of the influenza season are eligible. Women are followed throughout pregnancy through twice weekly surveillance for influenza symptoms (≥ 1 of myalgia, cough, runny nose, sore throat, or difficulty breathing) and have mid-turbinate nasal swabs collected for influenza virus testing during illness episodes. Primary outcomes include relative risk of preterm birth and mean birth weight among term singleton infants of women with and without reverse transcription polymerase chain reaction-confirmed influenza during pregnancy. Gestational age is determined by ultrasound at < 28 weeks gestation and birth weight is measured by digital scales using standardized methods. Sites are primarily urban in Bangkok, Thailand; Lima, Peru; and Nagpur, India. All sites recruit from antenatal clinics at referral hospitals and conduct surveillance using telephone calls, messaging applications, or home visits. Nasal swabs are self-collected by participants in Thailand and by study staff in Peru and India. During the first year (2017), sites enrolled participants during March–May in Peru and May–July in India and Thailand; 4779 women were enrolled. Discussion This study aims to generate evidence of the impact of influenza during pregnancy to inform decisions by Ministries of Health, healthcare providers, and pregnant women in middle-income countries about the value of influenza vaccination during pregnancy.
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Affiliation(s)
- Fatimah S Dawood
- Influenza Division, United States Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA, 30329, USA.
| | | | | | - Wanitchaya Kittikraisak
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Yeny Tinoco
- Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Kunal Kurhe
- Lata Medical Research Foundation, Nagpur, India
| | - Giselle Soto
- Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | - Shikha Garg
- Influenza Division, United States Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA, 30329, USA
| | - Tawee Chotpitayasunondh
- Queen Sirikit National Institute of Child Health, Thailand Ministry of Public Health, Bangkok, Thailand
| | | | | | - Mark G Thompson
- Influenza Division, United States Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA, 30329, USA
| | - Bajaree Chotpitayasunondh
- Queen Sirikit National Institute of Child Health, Thailand Ministry of Public Health, Bangkok, Thailand
| | | | | | - Sofia Arriola
- Influenza Division, United States Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA, 30329, USA
| | - Louis Macareo
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Prabir Das
- Lata Medical Research Foundation, Nagpur, India
| | | | | | - Eduardo Azziz-Baumgartner
- Influenza Division, United States Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA, 30329, USA
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108
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Chowdhury F, Sturm-Ramirez K, Mamun AA, Iuliano AD, Chisti MJ, Ahmed M, Bhuiyan MU, Hossain K, Haider MS, Aziz SA, Rahman M, Azziz-Baumgartner E. Effectiveness of an educational intervention to improve antibiotic dispensing practices for acute respiratory illness among drug sellers in pharmacies, a pilot study in Bangladesh. BMC Health Serv Res 2018; 18:676. [PMID: 30170573 PMCID: PMC6119333 DOI: 10.1186/s12913-018-3486-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inappropriate dispensing of antibiotics for acute respiratory illness (ARI) is common among drug sellers in Bangladesh. In this study, we evaluated the impact of an educational intervention to promote guidelines for better ARI management among drug sellers. METHODS From June 2012 to December 2013, we conducted baseline and post-intervention surveys on dispensing practices in 100 pharmacies within Dhaka city. In these surveys, drug sellers participated in 6 standardized role-playing scenarios led by study staffs acting as caregivers of ARI patients and drug sellers were blinded to these surveys. After the baseline survey, we developed ARI guidelines and facilitated a one-day educational intervention about ARI management for drug sellers. Our guidelines only recommended antibiotics for children with complicated ARI. Finally, we conducted the six month post-intervention survey using the same scenarios to record changes in drug dispensing practices. RESULTS Only 2/3 of participating pharmacies were licensed and few (11%) of drug sellers had pharmacy training. All the drug sellers were male, had a median age of 34 years (IQR 28-41). For children, dispensing of antibiotics for uncomplicated ARI decreased (30% baseline vs. 21% post-intervention; p = 0.04), but drug sellers were equally likely to dispense antibiotics for complicated ARI (15% baseline vs. 17% post-intervention; p = 0.6) and referrals to physicians for complicated ARIs decreased (70% baseline vs. 58% post-intervention; p = 0.03). For adults, antibiotic dispensing remained similar for uncomplicated ARI (48% baseline vs. 40% post-intervention; p = 0.1) but increased among those with complicated ARI (44% baseline vs. 78% post-intervention; p < 0.001). Although our evidence-based guidelines recommended against prescribing antihistamines for children, drug sellers continued to sell similar amounts for uncomplicated ARI (33% baseline vs. 32% post-intervention; p = 0.9). CONCLUSIONS Despite the intervention, drug sellers continued to frequently dispense antibiotics for ARI, except for children with uncomplicated ARI. Pairing educational interventions among drug sellers with raising awareness about proper antibiotic use among general population should be further explored. In addition, annual licensing and an reaccreditation system with comprehensive monitoring should be enforced, using penalties for non-compliant pharmacies as possible incentives for appropriate dispensing practices.
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Affiliation(s)
- Fahmida Chowdhury
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | - Katharine Sturm-Ramirez
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Abdullah Al Mamun
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | | | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | - Makhdum Ahmed
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | - Mejbah Uddin Bhuiyan
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | - Kamal Hossain
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | | | - Shaikh Abdul Aziz
- International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, (IEDCR), Dhaka, Bangladesh
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109
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Rimi NA, Sultana R, Ishtiak-Ahmed K, Haider N, Azziz-Baumgartner E, Nahar N, Luby SP. Where backyard poultry raisers seek care for sick poultry: implications for avian influenza prevention in Bangladesh. BMC Public Health 2018; 18:969. [PMID: 30075714 PMCID: PMC6090748 DOI: 10.1186/s12889-018-5819-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/10/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In Bangladesh, backyard poultry raisers lack awareness of avian influenza and infrequently follow government recommendations for its prevention. Identifying where poultry raisers seek care for their ill poultry might help the government better plan how to disseminate avian influenza prevention and control recommendations. METHODS In order to identify where backyard poultry raisers seek care for their ill poultry, we conducted in-depth and informal interviews: 70 with backyard poultry raisers and six with local poultry healthcare providers in two villages, and five with government veterinary professionals at the sub-district and union levels in two districts during June-August 2009. RESULTS Most (86% [60/70]) raisers sought care for their backyard poultry locally, 14% used home remedies only and none sought care from government veterinary professionals. The local poultry care providers provided advice and medications (n = 6). Four local care providers had shops in the village market where raisers sought healthcare for their poultry and the remaining two visited rural households to provide poultry healthcare services. Five of the six local care providers did not have formal training in veterinary medicine. Local care providers either did not know about avian influenza or considered avian influenza to be a disease common among commercial but not backyard poultry. The government professionals had degrees in veterinary medicine and experience with avian influenza and its prevention. They had their offices at the sub-district or union level and lacked staffing to reach the backyard raisers at the village level. CONCLUSIONS The local poultry care providers provided front line healthcare to backyard poultry in villages and were a potential source of information for the rural raisers. Integration of these local poultry care providers in the government's avian influenza control programs is a potentially useful approach to increase poultry raisers' and local poultry care providers' awareness about avian influenza.
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Affiliation(s)
- Nadia Ali Rimi
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Rebeca Sultana
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kazi Ishtiak-Ahmed
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- University of Copenhagen, Copenhagen, Denmark
| | - Najmul Haider
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Technical University of Denmark, Copenhagen, Denmark
| | | | - Nazmun Nahar
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Stephen P. Luby
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr, b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
- Stanford University, Stanford, California, USA
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110
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El Omeiri N, Azziz-Baumgartner E, Thompson MG, Clará W, Cerpa M, Palekar R, Mirza S, Ropero-Álvarez AM. Seasonal influenza vaccine effectiveness against laboratory-confirmed influenza hospitalizations - Latin America, 2013. Vaccine 2018; 36:3555-3566. [PMID: 28648543 PMCID: PMC5988548 DOI: 10.1016/j.vaccine.2017.06.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/12/2017] [Accepted: 06/13/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Despite widespread utilization of influenza vaccines, effectiveness (VE) has not been routinely measured in Latin America. METHODS We used a case test-negative control design to estimate trivalent inactivated influenza VE against laboratory-confirmed influenza among hospitalized children aged 6months-5years and adults aged ≥60years which are age-groups targeted for vaccination. We sought persons with severe acute respiratory infections (SARI), hospitalized at 71 sentinel hospitals in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Honduras, Panama, and Paraguay during January-December 2013. Cases had an influenza virus infection confirmed by real-time reverse transcription PCR (rRT-PCR); controls had a negative rRT-PCR result for influenza viruses. We used a two-stage random effects model to estimate pooled VE per target age-group, adjusting for the month of illness onset, age and preexisting medical conditions. RESULTS We identified 2620 SARI patients across sites: 246 influenza cases and 720 influenza-negative controls aged ≤5years and 448 cases and 1206 controls aged ≥60years. The most commonly identified subtype among participants (48%) was the influenza A(H1N1)pdm09 virus followed by influenza A(H3N2) (34%) and influenza B (18%) viruses. Among children, the adjusted VE of full vaccination (one dose for previously vaccinated or two if vaccine naïve) against any influenza virus SARI was 47% (95% confidence interval [CI]: 14-71%); VE was 58% (95% CI: 16-79%) against influenza A(H1N1)pdm09, and 65% (95% CI: -9; 89%) against influenza A(H3N2) viruses associated SARI. Crude VE of full vaccination against influenza B viruses associated SARI among children was 3% (95% CI: -150; 63). Among adults aged ≥60years, adjusted VE against any influenza SARI was 48% (95% CI: 34-60%); VE was 54% (95% CI: 37-69%) against influenza A(H1N1)pdm09, 43% (95% CI: 18-61%) against influenza A(H3N2) and 34% (95% CI: -4; 58%) against B viruses associated SARI. CONCLUSION Influenza vaccine provided moderate protection against severe influenza illness among fully vaccinated young children and older adults, supporting current vaccination strategies.
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MESH Headings
- Aged
- Case-Control Studies
- Child, Preschool
- Female
- Hospitalization/statistics & numerical data
- Humans
- Immunogenicity, Vaccine
- Infant
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza B virus/drug effects
- Influenza B virus/immunology
- Influenza Vaccines/administration & dosage
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Latin America/epidemiology
- Male
- Middle Aged
- Seasons
- Sentinel Surveillance
- Vaccination
- Vaccine Potency
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Affiliation(s)
- Nathalie El Omeiri
- Department of Family Gender and Life Course/Immunization, Pan American Health Organization/World Health Organization (PAHO/WHO), Washington D.C., USA; Université Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium.
| | | | - Mark G Thompson
- US Centers for Disease Control and Prevention (CDC), Influenza Division, Atlanta, Georgia, USA
| | | | - Mauricio Cerpa
- Department of Communicable Diseases and Health Analysis, PAHO/WHO, Washington D.C., USA
| | - Rakhee Palekar
- Department of Communicable Diseases and Health Analysis, PAHO/WHO, Washington D.C., USA
| | - Sara Mirza
- US Centers for Disease Control and Prevention (CDC), Influenza Division, Atlanta, Georgia, USA
| | - Alba María Ropero-Álvarez
- Department of Family Gender and Life Course/Immunization, Pan American Health Organization/World Health Organization (PAHO/WHO), Washington D.C., USA
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111
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Bhuiyan MU, Luby SP, Alamgir NI, Homaira N, Sturm-Ramirez K, Gurley ES, Abedin J, Zaman RU, Alamgir A, Rahman M, Ortega-Sanchez IR, Azziz-Baumgartner E. Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010. J Glob Health 2018; 7:010412. [PMID: 28702175 PMCID: PMC5502704 DOI: 10.7189/jogh.07.010412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged <5 years with laboratory–confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case–patients’ homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non–medical costs (costs for food, lodging and transportation); indirect costs (caregivers’ productivity loss), and coping strategies used by families to pay for treatment. We used WHO–Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost–per–episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43–101), indirect cost was US$ 19 (IQR = 11–29) and total cost was US$ 94 (IQR = 67–127). The median out–of–pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV–associated hospitalization in children aged <5 years in Bangladesh was US$ 10 million (IQR: US$ 7–16 million), the median indirect cost was US$ 3.0 million (IQR: 2–5 million) in 2010. Conclusion RSV–associated hospitalization among children aged <5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.
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Affiliation(s)
- Mejbah Uddin Bhuiyan
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Stephen P Luby
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nadia Ishrat Alamgir
- James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, Dhaka, Bangladesh
| | - Nusrat Homaira
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Randwick, Australia
| | - Katharine Sturm-Ramirez
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily S Gurley
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Jaynal Abedin
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Rashid Uz Zaman
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Oxford Policy Management, Oxford, UK
| | - Asm Alamgir
- Institute of Epidemiology, Disease Control and Research, Dhanka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhanka, Bangladesh
| | | | - Eduardo Azziz-Baumgartner
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
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112
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Tinoco YO, Azziz-Baumgartner E, Uyeki TM, Rázuri HR, Kasper MR, Romero C, Silva ME, Simons MP, Soto GM, Widdowson MA, Gilman RH, Bausch DG, Montgomery JM. Burden of Influenza in 4 Ecologically Distinct Regions of Peru: Household Active Surveillance of a Community Cohort, 2009-2015. Clin Infect Dis 2017; 65:1532-1541. [PMID: 29020267 PMCID: PMC5850002 DOI: 10.1093/cid/cix565] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There are limited data on the burden of disease posed by influenza in low- and middle-income countries. Furthermore, most estimates of influenza disease burden worldwide rely on passive sentinel surveillance at health clinics and hospitals that lack accurate population denominators. METHODS We documented influenza incidence, seasonality, health-system utilization with influenza illness, and vaccination coverage through active community-based surveillance in 4 ecologically distinct regions of Peru over 6 years. Approximately 7200 people in 1500 randomly selected households were visited 3 times per week. Naso- and oropharyngeal swabs were collected from persons with influenza-like illness and tested for influenza virus by real-time reverse-transcription polymerase chain reaction. RESULTS We followed participants for 35353 person-years (PY). The overall incidence of influenza was 100 per 1000 PY (95% confidence interval [CI], 97-104) and was highest in children aged 2-4 years (256/1000 PY [95% CI, 236-277]). Seasonal incidence trends were similar across sites, with 61% of annual influenza cases occurring during the austral winter (May-September). Of all participants, 44 per 1000 PY (95% CI, 42-46) sought medical care, 0.7 per 1000 PY (95% CI, 0.4-1.0) were hospitalized, and 1 person died (2.8/100000 PY). Influenza vaccine coverage was 27% among children aged 6-23 months and 26% among persons aged ≥65 years. CONCLUSIONS Our results indicate that 1 in 10 persons develops influenza each year in Peru, with the highest incidence in young children. Active community-based surveillance allows for a better understanding of the true burden and seasonality of disease that is essential to plan the optimal target groups, timing, and cost of national influenza vaccination programs.
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Affiliation(s)
- Yeny O Tinoco
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hugo R Rázuri
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | | | - Maria E Silva
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Mark P Simons
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert H Gilman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel G Bausch
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana; and
| | - Joel M Montgomery
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
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113
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Blanton L, Wentworth DE, Alabi N, Azziz-Baumgartner E, Barnes J, Brammer L, Burns E, Davis CT, Dugan VG, Fry AM, Garten R, Grohskopf LA, Gubareva L, Kniss K, Lindstrom S, Mustaquim D, Olsen SJ, Roguski K, Taylor C, Trock S, Xu X, Katz J, Jernigan D. Update: Influenza Activity - United States and Worldwide, May 21-September 23, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1043-1051. [PMID: 28981486 PMCID: PMC5720887 DOI: 10.15585/mmwr.mm6639a3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - C Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Katherine Roguski
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Susan Trock
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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114
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Chakraborty A, Rahman M, Hossain MJ, Khan SU, Haider MS, Sultana R, Ali Rimi N, Islam MS, Haider N, Islam A, Sultana Shanta I, Sultana T, Al Mamun A, Homaira N, Goswami D, Nahar K, Alamgir ASM, Rahman M, Mahbuba Jamil K, Azziz-Baumgartner E, Simpson N, Shu B, Lindstrom S, Gerloff N, Davis CT, Katz JM, Mikolon A, Uyeki TM, Luby SP, Sturm-Ramirez K. Mild Respiratory Illness Among Young Children Caused by Highly Pathogenic Avian Influenza A (H5N1) Virus Infection in Dhaka, Bangladesh, 2011. J Infect Dis 2017; 216:S520-S528. [PMID: 28934459 DOI: 10.1093/infdis/jix019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In March 2011, a multidisciplinary team investigated 2 human cases of highly pathogenic avian influenza A(H5N1) virus infection, detected through population-based active surveillance for influenza in Bangladesh, to assess transmission and contain further spread. Methods We collected clinical and exposure history of the case patients and monitored persons coming within 1 m of a case patient during their infectious period. Nasopharyngeal wash specimens from case patients and contacts were tested with real-time reverse-transcription polymerase chain reaction, and virus culture and isolates were characterized. Serum samples were tested with microneutralization and hemagglutination inhibition assays. We tested poultry, wild bird, and environmental samples from case patient households and surrounding areas for influenza viruses. Results Two previously healthy case patients, aged 13 and 31 months, had influenzalike illness and fully recovered. They had contact with poultry 7 and 10 days before illness onset, respectively. None of their 57 contacts were subsequently ill. Clade 2.2.2.1 highly pathogenic avian influenza H5N1 viruses were isolated from the case patients and from chicken fecal samples collected at the live bird markets near the patients' dwellings. Conclusion Identification of H5N1 cases through population-based surveillance suggests possible additional undetected cases throughout Bangladesh and highlights the importance of surveillance for mild respiratory illness among populations frequently exposed to infected poultry.
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Affiliation(s)
- Apurba Chakraborty
- Institute of Epidemiology, Disease Control and Research.,International Centre for Diarrhoeal Diseases Research (icddr,b)
| | | | - M Jahangir Hossain
- International Centre for Diarrhoeal Diseases Research (icddr,b).,Medical Research Council Unit, The Gambia
| | | | | | - Rebeca Sultana
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - Nadia Ali Rimi
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - M Saiful Islam
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - Najmul Haider
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - Ausraful Islam
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | | | - Tahmina Sultana
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | | | - Nusrat Homaira
- International Centre for Diarrhoeal Diseases Research (icddr,b).,UNSW, Sydney, Australia
| | - Doli Goswami
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - Kamrun Nahar
- International Centre for Diarrhoeal Diseases Research (icddr,b)
| | - A S M Alamgir
- Institute of Epidemiology, Disease Control and Research.,World Health Organization, Dhaka, Bangladesh
| | | | | | | | - Natosha Simpson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bo Shu
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Nancy Gerloff
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - C Todd Davis
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Andrea Mikolon
- International Centre for Diarrhoeal Diseases Research (icddr,b).,Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Timothy M Uyeki
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen P Luby
- International Centre for Diarrhoeal Diseases Research (icddr,b).,Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katharine Sturm-Ramirez
- International Centre for Diarrhoeal Diseases Research (icddr,b).,Centers for Disease Control and Prevention, Atlanta, Georgia
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115
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Kile JC, Ren R, Liu L, Greene CM, Roguski K, Iuliano AD, Jang Y, Jones J, Thor S, Song Y, Zhou S, Trock SC, Dugan V, Wentworth DE, Levine MZ, Uyeki TM, Katz JM, Jernigan DB, Olsen SJ, Fry AM, Azziz-Baumgartner E, Davis CT. Update: Increase in Human Infections with Novel Asian Lineage Avian Influenza A(H7N9) Viruses During the Fifth Epidemic - China, October 1, 2016-August 7, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:928-932. [PMID: 28880856 PMCID: PMC5689040 DOI: 10.15585/mmwr.mm6635a2] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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116
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Shi T, McAllister DA, O'Brien KL, Simoes EAF, Madhi SA, Gessner BD, Polack FP, Balsells E, Acacio S, Aguayo C, Alassani I, Ali A, Antonio M, Awasthi S, Awori JO, Azziz-Baumgartner E, Baggett HC, Baillie VL, Balmaseda A, Barahona A, Basnet S, Bassat Q, Basualdo W, Bigogo G, Bont L, Breiman RF, Brooks WA, Broor S, Bruce N, Bruden D, Buchy P, Campbell S, Carosone-Link P, Chadha M, Chipeta J, Chou M, Clara W, Cohen C, de Cuellar E, Dang DA, Dash-Yandag B, Deloria-Knoll M, Dherani M, Eap T, Ebruke BE, Echavarria M, de Freitas Lázaro Emediato CC, Fasce RA, Feikin DR, Feng L, Gentile A, Gordon A, Goswami D, Goyet S, Groome M, Halasa N, Hirve S, Homaira N, Howie SRC, Jara J, Jroundi I, Kartasasmita CB, Khuri-Bulos N, Kotloff KL, Krishnan A, Libster R, Lopez O, Lucero MG, Lucion F, Lupisan SP, Marcone DN, McCracken JP, Mejia M, Moisi JC, Montgomery JM, Moore DP, Moraleda C, Moyes J, Munywoki P, Mutyara K, Nicol MP, Nokes DJ, Nymadawa P, da Costa Oliveira MT, Oshitani H, Pandey N, Paranhos-Baccalà G, Phillips LN, Picot VS, Rahman M, Rakoto-Andrianarivelo M, Rasmussen ZA, Rath BA, Robinson A, Romero C, Russomando G, Salimi V, Sawatwong P, Scheltema N, Schweiger B, Scott JAG, Seidenberg P, Shen K, Singleton R, Sotomayor V, Strand TA, Sutanto A, Sylla M, Tapia MD, Thamthitiwat S, Thomas ED, Tokarz R, Turner C, Venter M, Waicharoen S, Wang J, Watthanaworawit W, Yoshida LM, Yu H, Zar HJ, Campbell H, Nair H. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet 2017; 390:946-958. [PMID: 28689664 PMCID: PMC5592248 DOI: 10.1016/s0140-6736(17)30938-8] [Citation(s) in RCA: 1439] [Impact Index Per Article: 205.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/07/2017] [Accepted: 03/30/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015. METHODS We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity. FINDINGS We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6-50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7-3·8) hospital admissions, and 59 600 (48 000-74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2-1·7) hospital admissions, and 27 300 (UR 20 700-36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600-149 400). Incidence and mortality varied substantially from year to year in any given population. INTERPRETATION Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admissions in young children, resulting in a substantial burden on health-care services. About 45% of hospital admissions and in-hospital deaths due to RSV-ALRI occur in children younger than 6 months. An effective maternal RSV vaccine or monoclonal antibody could have a substantial effect on disease burden in this age group. FUNDING The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Ting Shi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Katherine L O'Brien
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MS, USA
| | | | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Evelyn Balsells
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Sozinho Acacio
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | | | - Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Martin Antonio
- Medical Research Council Unit The Gambia, Basse, The Gambia
| | - Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow (UP), India
| | - Juliet O Awori
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Eduardo Azziz-Baumgartner
- International Centre for Diarrhoeal Disease Research, Bangladesh; Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Henry C Baggett
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vicky L Baillie
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Alfredo Barahona
- Hospital Materno Infantil Jose Domingo de Obaldia, Ciudad De David, Chiriqui, Panama
| | - Sudha Basnet
- Center for International Health, University of Bergen, Norway; Department of Child Health, Tribhuvan University Institute of Medicine, Nepal
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; ISGlobal, Barcelona Ctr Int Health Res (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; ICREA, Pg Lluís Companys 23, 08010 Barcelona, Spain
| | - Wilma Basualdo
- Hospital General Pediátrico Niños de Acosta Ñu, Ministerio de Salud Pública y Bienestar Social, San Lorenzo, Paraguay
| | - Godfrey Bigogo
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Louis Bont
- Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands
| | | | - W Abdullah Brooks
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MS, USA; International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Shobha Broor
- All India Institute of Medical Sciences, New Delhi, India
| | - Nigel Bruce
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Dana Bruden
- Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centres for Disease Control and Prevention, Anchorage, AK, USA
| | - Philippe Buchy
- Institute Pasteur Cambodia, Children's Hospital Colorado, Aurora, CO, USA; GSK Vaccines Singapore, Children's Hospital Colorado, Aurora, CO, USA
| | - Stuart Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Phyllis Carosone-Link
- Department of Pediatric Infectious Diseases, Children's Hospital Colorado, Aurora, CO, USA
| | | | | | - Monidarin Chou
- Rodolphe Merieux Laboratory, Faculty of Pharmacy, University of Health Sciences, Phnom Penh, Cambodia
| | - Wilfrido Clara
- Centers for Disease Control and Prevention, Central American Region, Guatemala City, Guatemala
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Duc-Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Maria Deloria-Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MS, USA
| | - Mukesh Dherani
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Tekchheng Eap
- Department of Pneumology, National Pediatric Hospital, Phnom Penh, Cambodia
| | | | | | | | | | - Daniel R Feikin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Angela Gentile
- Epidemiology Department, Austral University and Ricardo Gutiérrez Children Hospital, Argentina
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Doli Goswami
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MS, USA; International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Sophie Goyet
- Institute Pasteur Cambodia, Children's Hospital Colorado, Aurora, CO, USA
| | - Michelle Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Nusrat Homaira
- International Centre for Diarrhoeal Disease Research, Bangladesh; School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, NSW, Australia
| | - Stephen R C Howie
- Medical Research Council Unit The Gambia, Basse, The Gambia; Department of Paediatrics, University of Auckland, Auckland, New Zealand; Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jorge Jara
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala
| | - Imane Jroundi
- ISGlobal, Barcelona Ctr Int Health Res (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Unit of Training and Research in Public Health, School of Medicine and Pharmacy of Rabat, University Mohamed V, Rabat, Morocco
| | | | | | - Karen L Kotloff
- Department of Pediatrics and Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
| | - Romina Libster
- Fundacion INFANT, Buenos Aires, Argentina; Vanderbilt University, Nashville, TN, USA; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Olga Lopez
- Hospital Dr Ernesto Torres Galdames, Iquique, Chile
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Florencia Lucion
- Epidemiology Department, Austral University and Ricardo Gutiérrez Children Hospital, Argentina
| | - Socorro P Lupisan
- Research Institute for Tropical Medicine-Department of Health, Philippines
| | - Debora N Marcone
- Centro de Educación Médica envestigaciones Clínicas "CEMIC", Argentina
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala
| | - Mario Mejia
- Ministry of Public Health and Social Welfare, Guatemala
| | | | - Joel M Montgomery
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - David P Moore
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Cinta Moraleda
- ISGlobal, Barcelona Ctr Int Health Res (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Patrick Munywoki
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; Pwani University, Kilifi, Kenya
| | | | - Mark P Nicol
- Division of Medical Microbiology, University of Cape Town and National Health Laboratory Services, South Africa
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | | | | | - Histoshi Oshitani
- Tohoku University Graduate School of Medicine, Department of Virology, Miyagi Prefecture, Japan
| | - Nitin Pandey
- Department of Pediatrics, King George's Medical University, Lucknow (UP), India
| | - Gláucia Paranhos-Baccalà
- Emerging Pathofens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Lia N Phillips
- Emory University, Rollins School of Public Health, AT, USA
| | - Valentina Sanchez Picot
- Emerging Pathofens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | | | | | - Zeba A Rasmussen
- Fogarty International Center Division of International Epidemiology and Population Studies, NIH, Bethesda, MD, USA
| | - Barbara A Rath
- Department of Pediatrics, Charité University Medical Center, Berlin, Germany
| | | | - Candice Romero
- United States Naval Medical Research Unit No. 6, Callao, Peru
| | - Graciela Russomando
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asuncion, Paraguay
| | - Vahid Salimi
- School of Public Health, Virology Department, Tehran University of Medical Sciences, Iran
| | - Pongpun Sawatwong
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Nienke Scheltema
- Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands
| | | | - J Anthony G Scott
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; London School of Hygiene & Tropical Medicine, London, UK
| | - Phil Seidenberg
- Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kunling Shen
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Beijing, China
| | - Rosalyn Singleton
- Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centres for Disease Control and Prevention, Anchorage, AK, USA; Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Tor A Strand
- Center for International Health, University of Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | - Milagritos D Tapia
- Department of Pediatrics and Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Somsak Thamthitiwat
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Elizabeth D Thomas
- Fogarty International Center Division of International Epidemiology and Population Studies, NIH, Bethesda, MD, USA
| | - Rafal Tokarz
- Centre for Infection and Immunity, Mailman School of Public Health, Columbia University, NY, USA
| | - Claudia Turner
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Marietjie Venter
- Centre for Viral Zoonosis, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Sunthareeya Waicharoen
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Jianwei Wang
- MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Wanitda Watthanaworawit
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Heather J Zar
- Department of Paediatrics and Child Heath, Red Cross War Memorial Children's Hospital and MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK; Public Health Foundation of India, New Delhi, India.
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Thompson MG, Hunt DR, Arbaji AK, Simaku A, Tallo VL, Biggs HM, Kulb C, Gordon A, Khader IA, Bino S, Lucero MG, Azziz-Baumgartner E, Shifflett P, Sanchez F, Marar BI, Bakalli I, Simões EAF, Levine MZ, Meece JK, Balmaseda A, Al-Sanouri TM, Dhimolea M, de Jesus JN, Thornburg NJ, Gerber SI, Gresh L. Influenza and respiratory syncytial virus in infants study (IRIS) of hospitalized and non-ill infants aged <1 year in four countries: study design and methods. BMC Infect Dis 2017; 17:222. [PMID: 28330443 PMCID: PMC5361805 DOI: 10.1186/s12879-017-2299-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/01/2017] [Indexed: 12/21/2022] Open
Abstract
Background This multi-country prospective study of infants aged <1 year aims to assess the frequency of influenza virus and respiratory syncytial virus (RSV) infections associated with hospitalizations, to describe clinical features and antibody response to infection, and to examine predictors of very severe disease requiring intensive care. Methods/Design We are enrolling a hospital-based cohort and a sample of non-ill infants in four countries (Albania, Jordan, Nicaragua, and the Philippines) using a common protocol. We are currently starting year 2 of a 2- to 3-year study and will enroll approximately 3,000 infants hospitalized for any acute illness (respiratory or non-respiratory) during periods of local influenza and/or RSV circulation. After informed consent and within 24 h of admission, we collect blood and respiratory specimens and conduct an interview to assess socio-demographic characteristics, medical history, and symptoms of acute illness (onset ≤10 days). Vital signs, interventions, and medications are documented daily through medical record abstraction. A follow-up health assessment and collection of convalescent blood occurs 3-5 weeks after enrollment. Influenza and RSV infection is confirmed by singleplex real time reverse transcriptase polymerase chain reaction (rRT-PCR) assays. Serologic conversion will be assessed comparing acute and convalescent sera using hemagglutination inhibition assay for influenza antibodies and enzyme-linked immunosorbent assay (ELISA) for RSV. Concurrent with hospital-based enrollment, respiratory specimens are also being collected (and tested by rRT-PCR) from approximately 1,400 non-ill infants aged <1 year during routine medical or preventive care. Discussion The Influenza and RSV in Infants Study (IRIS) promises to expand our knowledge of the frequency, clinical features, and antibody profiles of serious influenza and RSV disease among infants aged <1 year, quantify the proportion of infections that may be missed by traditional surveillance, and inform decisions about the potential value of existing and new vaccines and other prevention and treatment strategies.
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Affiliation(s)
- Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. .,Influenza Division, MS A-32, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA, 30333, USA.
| | | | - Ali K Arbaji
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Artan Simaku
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Veronica L Tallo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | | | | | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ilham Abu Khader
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Silvia Bino
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | | | | | - Felix Sanchez
- Hospital Infantil Manuel de Jesús Rivera, Ministry of Health, Managua, Nicaragua
| | | | | | - Eric A F Simões
- Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.,Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Min Z Levine
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Tareq M Al-Sanouri
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Majlinda Dhimolea
- Department of Epidemiology & Control of Infectious Diseases, Virology Laboratory, Institute of Public Health, Tirana, Albania
| | - Joanne N de Jesus
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | | | | | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
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Chowdhury F, Sturm-Ramirez K, Mamun AA, Iuliano AD, Bhuiyan MU, Chisti MJ, Ahmed M, Haider S, Rahman M, Azziz-Baumgartner E. Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh. Patient Prefer Adherence 2017; 11:479-486. [PMID: 28293104 PMCID: PMC5345980 DOI: 10.2147/ppa.s121800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. METHODS A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. RESULTS We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. CONCLUSION People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.
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Affiliation(s)
- Fahmida Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Correspondence: Fahmida Chowdhury, Respiratory Viruses Working Group, Programme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh, Tel +88 018 1705 4481, Email
| | - Katharine Sturm-Ramirez
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Abdullah Al Mamun
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A Danielle Iuliano
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mejbah Uddin Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Makhdum Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sabbir Haider
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
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119
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Nikolay B, Salje H, Sturm-Ramirez K, Azziz-Baumgartner E, Homaira N, Ahmed M, Iuliano AD, Paul RC, Rahman M, Hossain MJ, Luby SP, Cauchemez S, Gurley ES. Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data. PLoS Med 2017; 14:e1002218. [PMID: 28095468 PMCID: PMC5240927 DOI: 10.1371/journal.pmed.1002218] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/09/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The International Health Regulations outline core requirements to ensure the detection of public health threats of international concern. Assessing the capacity of surveillance systems to detect these threats is crucial for evaluating a country's ability to meet these requirements. METHODS AND FINDINGS We propose a framework to evaluate the sensitivity and representativeness of hospital-based surveillance and apply it to severe neurological infectious diseases and fatal respiratory infectious diseases in Bangladesh. We identified cases in selected communities within surveillance hospital catchment areas using key informant and house-to-house surveys and ascertained where cases had sought care. We estimated the probability of surveillance detecting different sized outbreaks by distance from the surveillance hospital and compared characteristics of cases identified in the community and cases attending surveillance hospitals. We estimated that surveillance detected 26% (95% CI 18%-33%) of severe neurological disease cases and 18% (95% CI 16%-21%) of fatal respiratory disease cases residing at 10 km distance from a surveillance hospital. Detection probabilities decreased markedly with distance. The probability of detecting small outbreaks (three cases) dropped below 50% at distances greater than 26 km for severe neurological disease and at distances greater than 7 km for fatal respiratory disease. Characteristics of cases attending surveillance hospitals were largely representative of all cases; however, neurological disease cases aged <5 y or from the lowest socioeconomic group and fatal respiratory disease cases aged ≥60 y were underrepresented. Our estimates of outbreak detection rely on suspected cases that attend a surveillance hospital receiving laboratory confirmation of disease and being reported to the surveillance system. The extent to which this occurs will depend on disease characteristics (e.g., severity and symptom specificity) and surveillance resources. CONCLUSION We present a new approach to evaluating the sensitivity and representativeness of hospital-based surveillance, making it possible to predict its ability to detect emerging threats.
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Affiliation(s)
- Birgit Nikolay
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique, URA3012, Paris, France
- Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
| | - Henrik Salje
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique, URA3012, Paris, France
- Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Katharine Sturm-Ramirez
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Eduardo Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nusrat Homaira
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Discipline of Paediatrics, School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Makhdum Ahmed
- School of Public Health, University of Texas Health Science Center, Houston, Texas, United States of America
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - A. Danielle Iuliano
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Repon C. Paul
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- School of Public Health and Community Medicine, University of New South Wales Australia, Sydney, New South Wales, Australia
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | | | - Stephen P. Luby
- Infectious Diseases Division, Stanford University, Stanford, California, United States of America
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique, URA3012, Paris, France
- Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
| | - Emily S. Gurley
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Xiang N, Li X, Ren R, Wang D, Zhou S, Greene CM, Song Y, Zhou L, Yang L, Davis CT, Zhang Y, Wang Y, Zhao J, Li X, Iuliano AD, Havers F, Olsen SJ, Uyeki TM, Azziz-Baumgartner E, Trock S, Liu B, Sui H, Huang X, Zhang Y, Ni D, Feng Z, Shu Y, Li Q. Assessing Change in Avian Influenza A(H7N9) Virus Infections During the Fourth Epidemic - China, September 2015-August 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1390-1394. [PMID: 27977644 DOI: 10.15585/mmwr.mm6549a2] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Since human infections with avian influenza A(H7N9) virus were first reported by the Chinese Center for Disease Control and Prevention (China CDC) in March 2013 (1), mainland China has experienced four influenza A(H7N9) virus epidemics. Prior investigations demonstrated that age and sex distribution, clinical features, and exposure history of A(H7N9) virus human infections reported during the first three epidemics were similar (2). In this report, epidemiology and virology data from the most recent, fourth epidemic (September 2015-August 2016) were compared with those from the three earlier epidemics. Whereas age and sex distribution and exposure history in the fourth epidemic were similar to those in the first three epidemics, the fourth epidemic demonstrated a greater proportion of infected persons living in rural areas, a continued spread of the virus to new areas, and a longer epidemic period. The genetic markers of mammalian adaptation and antiviral resistance remained similar across each epidemic, and viruses from the fourth epidemic remained antigenically well matched to current candidate vaccine viruses. Although there is no evidence of increased human-to-human transmissibility of A(H7N9) viruses, the continued geographic spread, identification of novel reassortant viruses, and pandemic potential of the virus underscore the importance of rigorous A(H7N9) virus surveillance and continued risk assessment in China and neighboring countries.
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Weaver AM, Khatun-E-Jannat K, Cercone E, Krytus K, Sohel BM, Ahmed M, Rahman M, Azziz-Baumgartner E, Yu J, Fry AM, Luby SP, Ram PK. Household-level risk factors for secondary influenza-like illness in a rural area of Bangladesh. Trop Med Int Health 2016; 22:187-195. [PMID: 27889937 PMCID: PMC7169715 DOI: 10.1111/tmi.12820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective To describe household‐level risk factors for secondary influenza‐like illness (ILI), an important public health concern in the low‐income population of Bangladesh. Methods Secondary analysis of control participants in a randomised controlled trial evaluating the effect of handwashing to prevent household ILI transmission. We recruited index‐case patients with ILI – fever (<5 years); fever, cough or sore throat (≥5 years) – from health facilities, collected information on household factors and conducted syndromic surveillance among household contacts for 10 days after resolution of index‐case patients’ symptoms. We evaluated the associations between household factors at baseline and secondary ILI among household contacts using negative binomial regression, accounting for clustering by household. Results Our sample was 1491 household contacts of 184 index‐case patients. Seventy‐one percentage reported that smoking occurred in their home, 27% shared a latrine with one other household and 36% shared a latrine with >1 other household. A total of 114 household contacts (7.6%) had symptoms of ILI during follow‐up. Smoking in the home (RRadj 1.9, 95% CI: 1.2, 3.0) and sharing a latrine with one household (RRadj 2.1, 95% CI: 1.2, 3.6) or >1 household (RRadj 3.1, 95% CI: 1.8–5.2) were independently associated with increased risk of secondary ILI. Conclusion Tobacco use in homes could increase respiratory illness in Bangladesh. The mechanism between use of shared latrines and household ILI transmission is not clear. It is possible that respiratory pathogens could be transmitted through faecal contact or contaminated fomites in shared latrines.
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Affiliation(s)
- Anne M Weaver
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.,Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | | | - Emily Cercone
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Kimberly Krytus
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Badrul Munir Sohel
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Makhdum Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Jihnhee Yu
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Alicia M Fry
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen P Luby
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Stanford University, Stanford, CA, USA
| | - Pavani K Ram
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
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122
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Refaey S, Amin MM, Roguski K, Azziz-Baumgartner E, Uyeki TM, Labib M, Kandeel A. Cross-sectional survey and surveillance for influenza viruses and MERS-CoV among Egyptian pilgrims returning from Hajj during 2012-2015. Influenza Other Respir Viruses 2016; 11:57-60. [PMID: 27603034 PMCID: PMC5155725 DOI: 10.1111/irv.12429] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Approximately 80 000 Egyptians participate in Hajj pilgrimage annually. The purpose of this study was to estimate influenza virus and MERS-CoV prevalence among Egyptian pilgrims returning from Hajj. STUDY A cross-sectional survey among 3 364 returning Egyptian pilgrims from 2012 to 2015 was conducted. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from all participants. Sputum specimens were collected from participants with respiratory symptoms and productive cough at the time of their interview. Specimens were tested for influenza viruses, and a convenience sample of NP/OP specimens was tested for MERS-CoV. Thirty percent of participants met the case definition for influenza-like illness (ILI), 14% tested positive for influenza viruses, and none tested positive for MERS-CoV. Self-reported influenza vaccination was 20%. CONCLUSIONS High prevalence of reported ILI during pilgrimage and confirmed influenza virus on return from pilgrimage suggest a continued need for influenza prevention strategies for Egyptian Hajj pilgrims. An evaluation of the Ministry of Health and Population's current risk communication campaigns to increase influenza vaccine use among pilgrims may help identify strategies to improve vaccine coverage.
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Affiliation(s)
- Samir Refaey
- Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt
| | | | - Katherine Roguski
- Influenza Division, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Timothy M Uyeki
- Influenza Division, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Manal Labib
- Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt
| | - Amr Kandeel
- Egyptian Ministry of Health and Population (MOHP), Cairo, Egypt
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123
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Pollett S, Boscardin WJ, Azziz-Baumgartner E, Tinoco YO, Soto G, Romero C, Kok J, Biggerstaff M, Viboud C, Rutherford GW. Evaluating Google Flu Trends in Latin America: Important Lessons for the Next Phase of Digital Disease Detection. Clin Infect Dis 2016; 64:34-41. [PMID: 27678084 DOI: 10.1093/cid/ciw657] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 08/25/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Latin America has a substantial burden of influenza and rising Internet access and could benefit from real-time influenza epidemic prediction web tools such as Google Flu Trends (GFT) to assist in risk communication and resource allocation during epidemics. However, there has never been a published assessment of GFT's accuracy in most Latin American countries or in any low- to middle-income country. Our aim was to evaluate GFT in Argentina, Bolivia, Brazil, Chile, Mexico, Paraguay, Peru, and Uruguay. METHODS Weekly influenza-test positive proportions for the eight countries were obtained from FluNet for the period January 2011-December 2014. Concurrent weekly Google-predicted influenza activity in the same countries was abstracted from GFT. Pearson correlation coefficients between observed and Google-predicted influenza activity trends were determined for each country. Permutation tests were used to examine background seasonal correlation between FluNet and GFT by country. RESULTS There were frequent GFT prediction errors, with correlation ranging from r = -0.53 to 0.91. GFT-predicted influenza activity best correlated with FluNet data in Mexico follow by Uruguay, Argentina, Chile, Brazil, Peru, Bolivia and Paraguay. Correlation was generally highest in the more temperate countries with more regular influenza seasonality and lowest in tropical regions. A substantial amount of autocorrelation was noted, suggestive that GFT is not fully specific for influenza virus activity. CONCLUSIONS We note substantial inaccuracies with GFT-predicted influenza activity compared with FluNet throughout Latin America, particularly among tropical countries with irregular influenza seasonality. Our findings offer valuable lessons for future Internet-based biosurveillance tools.
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Affiliation(s)
- Simon Pollett
- Department of Epidemiology & Biostatistics, University of California at San Francisco.,Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney
| | - W John Boscardin
- Department of Epidemiology & Biostatistics, University of California at San Francisco
| | | | - Yeny O Tinoco
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Giselle Soto
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Candice Romero
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Level 3 Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, New South Wales, Australia
| | - Matthew Biggerstaff
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - George W Rutherford
- Department of Epidemiology & Biostatistics, University of California at San Francisco
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124
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Dawood FS, Jara J, Gonzalez R, Castillo JM, De León T, Estripeaut D, Luciani K, Sujey Brizuela Y, Barahona A, Cazares RA, Lawson AM, Rodriguez M, de Viana D, Franco D, Castillo M, Fry AM, Gubareva L, Tamura D, Hughes M, Gargiullo P, Clara W, Azziz-Baumgartner E, Widdowson MA. A randomized, double-blind, placebo-controlled trial evaluating the safety of early oseltamivir treatment among children 0–9 years of age hospitalized with influenza in El Salvador and Panama. Antiviral Res 2016; 133:85-94. [DOI: 10.1016/j.antiviral.2016.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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125
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Rimi NA, Sultana R, Ishtiak-Ahmed K, Rahman MZ, Hasin M, Islam MS, Azziz-Baumgartner E, Nahar N, Gurley ES, Luby SP. Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography. BMC Public Health 2016; 16:858. [PMID: 27552983 PMCID: PMC4995615 DOI: 10.1186/s12889-016-3543-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The spread of the highly pathogenic avian influenza (HPAI) H5N1 virus among poultry and humans has raised global concerns and has motivated government and public health organizations to initiate interventions to prevent the transmission of HPAI. In Bangladesh, H5N1 became endemic in poultry and seven human H5N1 cases have been reported since 2007, including one fatality. This study piloted messages to increase awareness about avian influenza and its prevention in two rural communities, and explored change in villagers' awareness and behaviors attributable to the intervention. METHODS During 2009-10, a research team implemented the study in two rural villages in two districts of Bangladesh. The team used a focused ethnographic approach for data collection, including informal interviews and observations to provide detailed contextual information about community response to a newly emerging disease. They collected pre-intervention qualitative data for one month. Then another team disseminated preventive messages focused on safe slaughtering methods, through courtyard meetings and affixed posters in every household. After dissemination, the research team collected post-intervention data for one month. RESULTS More villagers reported hearing about 'bird flu' after the intervention compared to before the intervention. After the intervention, villagers commonly recalled changes in the color of combs and shanks of poultry as signs of avian influenza, and perceived zoonotic transmission of avian influenza through direct contact and through inhalation. Consequently the villagers valued covering the nose and mouth while handling sick and dead poultry as a preventive measure. Nevertheless, the team did not observe noticeable change in villagers' behavior after the intervention. Villagers reported not following the recommended behaviors because of the perceived absence of avian influenza in their flocks, low risk of avian influenza, cost, inconvenience, personal discomfort, fear of being rebuked or ridiculed, and doubt about the necessity of the intervention. CONCLUSIONS The villagers' awareness about avian influenza improved after the intervention, however, the intervention did not result in any measurable improvement in preventive behaviors. Low cost approaches that promote financial benefits and minimize personal discomfort should be developed and piloted.
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Affiliation(s)
- Nadia Ali Rimi
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Rebeca Sultana
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Kazi Ishtiak-Ahmed
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Md Zahidur Rahman
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Marufa Hasin
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - M. Saiful Islam
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Eduardo Azziz-Baumgartner
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
| | - Nazmun Nahar
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Emily S. Gurley
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Stephen P. Luby
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
- Stanford University, Stanford, CA USA
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126
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Tinoco YO, Montgomery JM, Kasper MR, Nelson MI, Razuri H, Guezala MC, Azziz-Baumgartner E, Widdowson MA, Barnes J, Gilman RH, Bausch DG, Gonzalez AE. Transmission dynamics of pandemic influenza A(H1N1)pdm09 virus in humans and swine in backyard farms in Tumbes, Peru. Influenza Other Respir Viruses 2016; 10:47-56. [PMID: 26011186 PMCID: PMC4687498 DOI: 10.1111/irv.12329] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/31/2022] Open
Abstract
Objectives We aimed to determine the frequency of pH1N1 transmission between humans and swine on backyard farms in Tumbes, Peru. Design Two‐year serial cross‐sectional study comprising four sampling periods: March 2009 (pre‐pandemic), October 2009 (peak of the pandemic in Peru), April 2010 (1st post‐pandemic period), and October 2011 (2nd post‐pandemic period). Sample Backyard swine serum, tracheal swabs, and lung sample were collected during each sampling period. Main outcome measures We assessed current and past pH1N1 infection in swine through serological testing, virus culture, and RT‐PCR and compared the results with human incidence data from a population‐based active surveillance cohort study in Peru. Results Among 1303 swine sampled, the antibody prevalence to pH1N1 was 0% pre‐pandemic, 8% at the peak of the human pandemic (October 2009), and 24% in April 2010 and 1% in October 2011 (post‐pandemic sampling periods). Trends in swine seropositivity paralleled those seen in humans in Tumbes. The pH1N1 virus was isolated from three pigs during the peak of the pandemic. Phylogenetic analysis revealed that these viruses likely represent two separate human‐to‐swine transmission events in backyard farm settings. Conclusions Our findings suggest that human‐to‐swine pH1N1 transmission occurred during the pandemic among backyard farms in Peru, emphasizing the importance of interspecies transmission in backyard pig populations. Continued surveillance for influenza viruses in backyard farms is warranted.
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Affiliation(s)
- Yeny O Tinoco
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Joel M Montgomery
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,U.S. Centers for Disease Control and Prevention, Division of Global Health Protection, Nairobi, Kenya
| | | | - Martha I Nelson
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Hugo Razuri
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | | | | | - John Barnes
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
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127
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Refaey S, Azziz-Baumgartner E, Amin MM, Fahim M, Roguski K, Elaziz HAEA, Iuliano AD, Salah N, Uyeki TM, Lindstrom S, Davis CT, Eid A, Genedy M, Kandeel A. Increased Number of Human Cases of Influenza Virus A(H5N1) Infection, Egypt, 2014-15. Emerg Infect Dis 2016; 21:2171-3. [PMID: 26584397 PMCID: PMC4672432 DOI: 10.3201/eid2112.150885] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
During November 2014–April 2015, a total of 165 case-patients with influenza virus A(H5N1) infection, including 6 clusters and 51 deaths, were identified in Egypt. Among infected persons, 99% reported poultry exposure: 19% to ill poultry and 35% to dead poultry. Only 1 person reported wearing personal protective equipment while working with poultry.
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128
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Shanta IS, Hasnat MA, Zeidner N, Gurley ES, Azziz-Baumgartner E, Sharker MAY, Hossain K, Khan SU, Haider N, Bhuyan AA, Hossain MA, Luby SP. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices. Transbound Emerg Dis 2016; 64:1454-1464. [PMID: 27311406 DOI: 10.1111/tbed.12536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Indexed: 11/27/2022]
Abstract
Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while <1% covered their nose and mouth with a cloth when handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of backyard poultry.
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Affiliation(s)
| | | | | | | | - E Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M A Y Sharker
- icddr,b, Dhaka, Bangladesh.,College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - S U Khan
- icddr,b, Dhaka, Bangladesh.,College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - N Haider
- icddr,b, Dhaka, Bangladesh.,Section for Epidemiology, DTU vet, Technical University of Denmark, Copenhagen, Denmark
| | - A A Bhuyan
- icddr,b, Dhaka, Bangladesh.,Department of Animal Husbandry and Veterinary Science, University of Rajshahi, Rajshahi, Bangladesh
| | - Md A Hossain
- Department of Livestock Service, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | - S P Luby
- icddr,b, Dhaka, Bangladesh.,Division of Infectious Disease and Geographic Medicine, Stanford University, Stanford, CA, USA
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129
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Cheng PY, Palekar R, Azziz-Baumgartner E, Iuliano D, Alencar AP, Bresee J, Oliva O, de Souza MDFM, Widdowson MA. Burden of influenza-associated deaths in the Americas, 2002-2008. Influenza Other Respir Viruses 2016; 9 Suppl 1:13-21. [PMID: 26256291 PMCID: PMC4549098 DOI: 10.1111/irv.12317] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza disease is a vaccine-preventable cause of morbidity and mortality. The Pan American Health Organization (PAHO) region has invested in influenza vaccines, but few estimates of influenza burden exist to justify these investments. We estimated influenza-associated deaths for 35 PAHO countries during 2002-2008. METHODS Annually, PAHO countries report registered deaths. We used respiratory and circulatory (R&C) codes from seven countries with distinct influenza seasonality and high-quality mortality data to estimate influenza-associated mortality rates by age group (0-64, 65-74, and ≥ 75 years) with a Serfling regression model or a negative binomial model. We calculated the percent of all R&C deaths attributable to influenza by age group in these countries (etiologic fraction) and applied it to the age-specific mortality in 13 countries with good mortality data but poorly defined seasonality. Lastly, we grouped the remaining 15 countries into WHO mortality strata and applied the age and mortality stratum-specific rate of influenza mortality calculated from the 20 countries. We summed each country's estimate to arrive at an average total annual number and rate of influenza deaths in the Americas. RESULTS For the 35 PAHO countries, we estimated an annual mean influenza-associated mortality rate of 2·1/100,000 among <65-year olds, 31·9/100 000 among those 65-74 years, and 161·8/100,000 among those ≥ 75 years. We estimated that annually between 40,880 and 160,270 persons (mean, 85,100) die of influenza illness in the PAHO region. CONCLUSION Influenza remains an important cause of mortality in the Americas.
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Affiliation(s)
- Po-Yung Cheng
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rakhee Palekar
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA.,Pan American Health Organization, Washington, DC, USA
| | | | - Danielle Iuliano
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Airlane P Alencar
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Joseph Bresee
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Otavio Oliva
- Pan American Health Organization, Washington, DC, USA
| | | | - Marc-Alain Widdowson
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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130
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Hirve S, Newman LP, Paget J, Azziz-Baumgartner E, Fitzner J, Bhat N, Vandemaele K, Zhang W. Influenza Seasonality in the Tropics and Subtropics - When to Vaccinate? PLoS One 2016; 11:e0153003. [PMID: 27119988 PMCID: PMC4847850 DOI: 10.1371/journal.pone.0153003] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/22/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The timing of the biannual WHO influenza vaccine composition selection and production cycle has been historically directed to the influenza seasonality patterns in the temperate regions of the northern and southern hemispheres. Influenza activity, however, is poorly understood in the tropics with multiple peaks and identifiable year-round activity. The evidence-base needed to take informed decisions on vaccination timing and vaccine formulation is often lacking for the tropics and subtropics. This paper aims to assess influenza seasonality in the tropics and subtropics. It explores geographical grouping of countries into vaccination zones based on optimal timing of influenza vaccination. METHODS Influenza seasonality was assessed by different analytic approaches (weekly proportion of positive cases, time series analysis, etc.) using FluNet and national surveillance data. In case of discordance in the seasonality assessment, consensus was built through discussions with in-country experts. Countries with similar onset periods of their primary influenza season were grouped into geographical zones. RESULTS The number and period of peak activity was ascertained for 70 of the 138 countries in the tropics and subtropics. Thirty-seven countries had one and seventeen countries had two distinct peaks. Countries near the equator had secondary peaks or even identifiable year-round activity. The main influenza season in most of South America and Asia started between April and June. The start of the main season varied widely in Africa (October and December in northern Africa, April and June in Southern Africa and a mixed pattern in tropical Africa). Eight "influenza vaccination zones" (two each in America and Asia, and four in Africa and Middle East) were defined with recommendations for vaccination timing and vaccine formulation. The main limitation of our study is that FluNet and national surveillance data may lack the granularity to detect sub-national variability in seasonality patterns. CONCLUSION Distinct influenza seasonality patterns, though complex, could be ascertained for most countries in the tropics and subtropics using national surveillance data. It may be possible to group countries into zones based on similar recommendations for vaccine timing and formulation.
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Affiliation(s)
| | - Laura P. Newman
- University of Washington, Seattle, Washington, United States of America
| | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | | | - Julia Fitzner
- Global Influenza Program, World Health Organization, Geneva, Switzerland
| | - Niranjan Bhat
- Program for Appropriate Technology, Seattle, Washington, United States of America
| | | | - Wenqing Zhang
- Global Influenza Program, World Health Organization, Geneva, Switzerland
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131
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Descalzo MA, Clara W, Guzmán G, Mena R, Armero J, Lara B, Saenz C, Aragón A, Chacón R, El-Omeiri N, Méndez-Rico J, Cerpa M, Palekar R, Jara J, Azziz-Baumgartner E. Estimating the burden of influenza-associated hospitalizations and deaths in Central America. Influenza Other Respir Viruses 2016; 10:340-5. [PMID: 26946216 PMCID: PMC4910178 DOI: 10.1111/irv.12385] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives Our objective was to estimate the incidence of influenza‐associated hospitalizations and in‐hospital deaths in Central American Region. Design and setting We used hospital discharge records, influenza surveillance virology data, and population projections collected from Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua to estimate influenza‐associated hospitalizations and in‐hospital deaths. We performed a meta‐analysis of influenza‐associated hospitalizations and in‐hospital deaths. Main outcome measures The highest annual incidence was observed among children aged <5 years (136 influenza‐associated hospitalizations per 100 000 persons). Results Annually, 7 625–11 289 influenza‐associated hospitalizations and 352–594 deaths occurred in the subregion. Conclusions Our results suggest that a substantive number of persons are annually hospitalized because of influenza. Health officials should estimate how many illnesses could be averted through increased influenza vaccination.
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Affiliation(s)
- Miguel A Descalzo
- Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala
| | - Wilfrido Clara
- U.S. CDC Regional Office for Central America Region (CDC-CAR), Guatemala Ciudad, Guatemala
| | - Guiselle Guzmán
- Caja Costarricense del Seguro Social (CCSS), San José, Costa Rica
| | - Ricardo Mena
- Ministerio de Salud Pública y Asistencia Social de Guatemala (MSPAS), Guatemala Ciudad, Guatemala
| | - Julio Armero
- Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador
| | - Bredy Lara
- Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - Carlos Saenz
- Ministerio de Salud de Nicaragua (MINSA), Managua, Nicaragua
| | - Anabela Aragón
- Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala
| | - Rafael Chacón
- Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala
| | | | | | | | - Rakhee Palekar
- Pan American Health Organization, Washington, DC, USA.,U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Jorge Jara
- Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala
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Azziz-Baumgartner E, Garten RJ, Palekar R, Cerpa M, Mirza S, Ropero AM, Palomeque FS, Moen A, Bresee J, Shaw M, Widdowson MA. Determination of Predominance of Influenza Virus Strains in the Americas. Emerg Infect Dis 2016; 21:1209-12. [PMID: 26079140 PMCID: PMC4816329 DOI: 10.3201/eid2107.140788] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
During 2001–2014, predominant influenza A(H1N1) and A(H3N2) strains in South America predominated in all or most subsequent influenza seasons in Central and North America. Predominant A(H1N1) and A(H3N2) strains in North America predominated in most subsequent seasons in Central and South America. Sharing data between these subregions may improve influenza season preparedness.
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133
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Lafond KE, Nair H, Rasooly MH, Valente F, Booy R, Rahman M, Kitsutani P, Yu H, Guzman G, Coulibaly D, Armero J, Jima D, Howie SRC, Ampofo W, Mena R, Chadha M, Sampurno OD, Emukule GO, Nurmatov Z, Corwin A, Heraud JM, Noyola DE, Cojocaru R, Nymadawa P, Barakat A, Adedeji A, von Horoch M, Olveda R, Nyatanyi T, Venter M, Mmbaga V, Chittaganpitch M, Nguyen TH, Theo A, Whaley M, Azziz-Baumgartner E, Bresee J, Campbell H, Widdowson MA. Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012: A Systematic Analysis. PLoS Med 2016; 13:e1001977. [PMID: 27011229 PMCID: PMC4807087 DOI: 10.1371/journal.pmed.1001977] [Citation(s) in RCA: 249] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 02/05/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. METHODS AND FINDINGS We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. CONCLUSIONS Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo.
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Affiliation(s)
- Kathryn E. Lafond
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- School of Health Sciences, University of Tampere, Tampere, Finland
- * E-mail: (KEL); (MAW)
| | - Harish Nair
- Centre for Global Health Research, University of Edinburgh, Edinburgh, United Kingdom
- Public Health Foundation of India, New Delhi, India
| | - Mohammad Hafiz Rasooly
- Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan
| | - Fátima Valente
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | - Paul Kitsutani
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China
| | | | | | - Julio Armero
- Ministerio de Salud de El Salvador, San Salvador, El Salvador
| | - Daddi Jima
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Stephen R. C. Howie
- Medical Research Council Unit, Fajara, The Gambia
- Department of Paediatrics, University of Auckland, Auckland, New Zealand
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - William Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ricardo Mena
- Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala
| | | | - Ondri Dwi Sampurno
- National Institute of Health Research and Development, Jakarta, Indonesia
| | | | | | - Andrew Corwin
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jean Michel Heraud
- National Influenza Centre, Virology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar
| | - Daniel E. Noyola
- Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Radu Cojocaru
- National Centre for Public Health, Chisinau, Republic of Moldova
| | | | - Amal Barakat
- Institut National d’Hygiène, Ministère de la Santé, Rabat, Morocco
| | | | - Marta von Horoch
- Ministerio de Salud Publica y Bienestar Social, Asunción, Paraguay
| | - Remigio Olveda
- Research Institute for Tropical Medicine, Manila, Philippines
| | | | - Marietjie Venter
- National Institute for Communicable Diseases, Johannesburg, South Africa
- Zoonoses Research Unit, Department Medical Virology, University of Pretoria, Pretoria, South Africa
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | | | | | - Andros Theo
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Melissa Whaley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eduardo Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Joseph Bresee
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Harry Campbell
- Centre for Global Health Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail: (KEL); (MAW)
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134
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Durand LO, Cheng PY, Palekar R, Clara W, Jara J, Cerpa M, El Omeiri N, Ropero-Alvarez AM, Ramirez JB, Araya JL, Acosta B, Bruno A, Calderon de Lozano C, Castillo Signor LDC, Matute ML, Jackson-Betty S, Mung KS, Díaz-Quiñonez JA, López-Martinez I, Balmaseda A, Arévalo BM, Vazquez C, Gutierrez V, Garten R, Widdowson MA, Azziz-Baumgartner E. Timing of influenza epidemics and vaccines in the American tropics, 2002-2008, 2011-2014. Influenza Other Respir Viruses 2016; 10:170-5. [PMID: 26701079 PMCID: PMC4814866 DOI: 10.1111/irv.12371] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2015] [Indexed: 01/09/2023] Open
Abstract
Background Influenza‐associated illness results in increased morbidity and mortality in the Americas. These effects can be mitigated with an appropriately chosen and timed influenza vaccination campaign. To provide guidance in choosing the most suitable vaccine formulation and timing of administration, it is necessary to understand the timing of influenza seasonal epidemics. Objectives Our main objective was to determine whether influenza occurs in seasonal patterns in the American tropics and when these patterns occurred. Methods Publicly available, monthly seasonal influenza data from the Pan American Health Organization and WHO, from countries in the American tropics, were obtained during 2002–2008 and 2011–2014 (excluding unseasonal pandemic activity during 2009–2010). For each country, we calculated the monthly proportion of samples that tested positive for influenza. We applied the monthly proportion data to a logistic regression model for each country. Results We analyzed 2002–2008 and 2011–2014 influenza surveillance data from the American tropics and identified 13 (81%) of 16 countries with influenza epidemics that, on average, started during May and lasted 4 months. Conclusions The majority of countries in the American tropics have seasonal epidemics that start in May. Officials in these countries should consider the impact of vaccinating persons during April with the Southern Hemisphere formulation.
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Affiliation(s)
| | - Po-Yung Cheng
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Wilfrido Clara
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jorge Jara
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | | | | | - Juliana Barbosa Ramirez
- Centro Nacional de Influenza, Laboratorio de Virología, Instituto Nacional De Salud, Bogotá, Colombia
| | - Jenny Lara Araya
- Centro Nacional de Influenza, Centro Nacional de Referencia de Virología, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, San Jose, Costa Rica
| | - Belsy Acosta
- Centro Nacional de Influenza, Departamento de Virología, Instituto de Medicina Tropical ‟Pedro Kouríˮ, Havana, Cuba
| | - Alfredo Bruno
- El Centro de Referencia Nacional de Influenza y Otros Virus Respiratorios Insituto Nacional de Investigacion en Salud Publica (INSPI), Quito, Ecuador
| | - Celina Calderon de Lozano
- Unidad de Vigilancia Laboratorial Dr. Max Bloch, Centro Nacional de Influenza, San Salvador, El Salvador
| | | | - Maria Luisa Matute
- Departamento de Laboratorio Nacional de Vigilancia de la Salud, Tegucigalpa, Honduras
| | - Sandra Jackson-Betty
- National Influenza Centre-Jamaica, Department of Microbiology, University of West Indies, Kingston, Jamaica
| | - Kam Suan Mung
- PAHO/WHO Jamaica, National Influenza Centre-Jamaica, Department of Microbiology, University of West Indies, Kingston, Jamaica
| | - José Alberto Díaz-Quiñonez
- National Influenza Centre, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ministry of Health, Mexico City, Mexico
| | - Irma López-Martinez
- National Influenza Centre, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ministry of Health, Mexico City, Mexico
| | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Brechla Morneo Arévalo
- Depto. de Investigación en Virología Instituto Conmemorativo Gorgas, Panamá City, Panamá
| | | | | | - Rebecca Garten
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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135
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Homaira N, Luby SP, Hossain K, Islam K, Ahmed M, Rahman M, Rahman Z, Paul RC, Bhuiyan MU, Brooks WA, Sohel BM, Banik KC, Widdowson MA, Willby M, Rahman M, Bresee J, Ramirez KS, Azziz-Baumgartner E. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014. PLoS One 2016; 11:e0147982. [PMID: 26840782 PMCID: PMC4739641 DOI: 10.1371/journal.pone.0147982] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 01/11/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. METHODS Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. RESULTS We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10-12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2-3), 0.5(0.4-0.8), 0.4 (0.3-0.6), 0.4 (0.3-0.6), and 0.4 (0.3-0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3-7), 2 (1-3), 1 (0.6-2), and 3 (2-4) in 2010, 2011, 2012 and 2013, respectively. CONCLUSION Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh.
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Affiliation(s)
- Nusrat Homaira
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Stephen P. Luby
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Kamal Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kariul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Makhdum Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ziaur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Repon C. Paul
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mejbah Uddin Bhuiyan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - W. Abdullah Brooks
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Bloomberg School of Public, Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Badrul Munir Sohel
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kajal Chandra Banik
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Marc-Alain Widdowson
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Melisa Willby
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Mahmudur Rahman
- Institute of Epidemiology Disease Control and Research, (IEDCR), Dhaka, Bangladesh
| | - Joseph Bresee
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Katharine-Sturm Ramirez
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Eduardo Azziz-Baumgartner
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
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136
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Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Lim WS, Al Mamun A, Anovadiya AP, Araújo WN, Azziz-Baumgartner E, Báez C, Bantar C, Barhoush MM, Bassetti M, Beovic B, Bingisser R, Bonmarin I, Borja-Aburto VH, Cao B, Carratala J, Cuezzo MR, Denholm JT, Dominguez SR, Duarte PAD, Dubnov-Raz G, Echavarria M, Fanella S, Fraser J, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Higuera Iglesias AL, Hoeger PH, Hoffmann M, Hu X, Islam QT, Jiménez MF, Kandeel A, Keijzers G, Khalili H, Khandaker G, Knight M, Kusznierz G, Kuzman I, Kwan AMC, Lahlou Amine I, Langenegger E, Lankarani KB, Leo YS, Linko R, Liu P, Madanat F, Manabe T, Mayo-Montero E, McGeer A, Memish ZA, Metan G, Mikić D, Mohn KGI, Moradi A, Nymadawa P, Ozbay B, Ozkan M, Parekh D, Paul M, Poeppl W, Polack FP, Rath BA, Rodríguez AH, Siqueira MM, Skręt-Magierło J, Talarek E, Tang JW, Torres A, Törün SH, Tran D, Uyeki TM, van Zwol A, Vaudry W, Velyvyte D, Vidmar T, Zarogoulidis P, Nguyen-Van-Tam JS. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis. Influenza Other Respir Viruses 2016; 10:192-204. [PMID: 26602067 PMCID: PMC4814862 DOI: 10.1111/irv.12363] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 02/05/2023] Open
Abstract
Background The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.
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Affiliation(s)
- Stella G Muthuri
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Sudhir Venkatesan
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Puja R Myles
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Wei Shen Lim
- Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Abdullah Al Mamun
- International Centre for Diarrhoeal Diseases, Research Bangladesh (ICDDRB), Dhaka, Bangladesh
| | - Ashish P Anovadiya
- Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
| | | | | | - Clarisa Báez
- Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Bantar
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Mazen M Barhoush
- Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Bojana Beovic
- Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia
| | - Roland Bingisser
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | | | | | - Bin Cao
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jordi Carratala
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Institute for Biomedical Research, L'Hospitalet de Llobregat, Red Española de Investigación en Patología Infecciosa, University of Barcelona, Barcelona, Spain
| | | | - Justin T Denholm
- Victorian Infectious Diseases Service and Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Parkville, Vic., Australia
| | - Samuel R Dominguez
- Department of Pediatric Infectious Diseases, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Gal Dubnov-Raz
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Marcela Echavarria
- Clinical Virology Laboratory, CEMIC University Hospital, Buenos Aires, Argentina
| | - Sergio Fanella
- Section of Pediatric Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - James Fraser
- Paediatric Intensive Care Unit, Bristol Children's Hospital, Bristol, UK
| | - Zhancheng Gao
- Department of Respiratory & Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Patrick Gérardin
- NICU/PICU, PFME, CHU Saint Pierre, Saint Pierre, La Réunion, France.,CIC 1410 (CHU/Inserm/University of La Réunion/URML-OI), CHU Saint Pierre, Saint Pierre, La Réunion, France.,UMR PIMIT (CHU/Inserm/University of La Réunion/IRD/CNRS), CYROI, Saint Denis - Reunion Island, Saint Denis, France.,NICU/PICU CHU of La Réunion, Groupe Hospitalier Sud Réunion, Saint Pierre, La Réunion, France
| | - Maddalena Giannella
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Sophie Gubbels
- Department of Infectious Disease Epidemiology, Sector for National Health Documentation and Research, Statens Serum Institut, Copenhagen, Denmark
| | - Jethro Herberg
- Section of Paediatrics, Division of Infectious Disease, Imperial College, London, UK
| | - Anjarath L Higuera Iglesias
- Epidemiology Research Unit, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Mexico City, Mexico
| | - Peter H Hoeger
- Cath. Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Matthias Hoffmann
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Xiaoyun Hu
- Peking Union Medical College Hospital, Beijing, China
| | | | - Mirela F Jiménez
- Departamento de Ginecologia e Obstetrícia - UFCSPA, Preceptora da Residência Médica do Hospital Fêmina, Porto Alegre, Brazil
| | | | | | - Hossein Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Gulam Khandaker
- National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gabriela Kusznierz
- National Institute of Respiratory Diseases 'Emilio Coni' ANLIS "C. Malbran", Santa Fe, Argentina
| | - Ilija Kuzman
- School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Zagreb, Croatia
| | - Arthur M C Kwan
- Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Idriss Lahlou Amine
- Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, University Mohammed V-Souissi, Rabat, Morocco
| | - Eduard Langenegger
- Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg, Stellenbosch, South Africa
| | - Kamran B Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yee-Sin Leo
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - Rita Linko
- Helsinki University Hospital, Helsinki, Finland
| | - Pei Liu
- Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Faris Madanat
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
| | - Toshie Manabe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Elga Mayo-Montero
- Instituto de Medicina Preventiva de la Defensa, Capitan Medico Ramon y Cajal (IMPDEF), Ministerio de Defensa, Madrid, Spain
| | - Allison McGeer
- Toronto Invasive Bacterial Diseases Network, University of Toronto, Toronto, ON, Canada
| | - Ziad A Memish
- Ministry of Health, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Gokhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Dragan Mikić
- Military Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
| | - Kristin G I Mohn
- Section for Infectious Diseases, Medical Department, and Department of Research and Development, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, The Influenza Centre, University of Bergen, Bergen, Norway
| | - Ahmadreza Moradi
- The Division of Ocular Immunology, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,National Research Institute for Tuberculosis and Lung Disease, Massih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pagbajabyn Nymadawa
- National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Bulent Ozbay
- Department of Pulmonary and Critical Care, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Mehpare Ozkan
- Clinic of Pediatric Neurology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
| | - Dhruv Parekh
- Critical Care and Pain Perioperative, Critical Care and Trauma Trials Group, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Mical Paul
- Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel
| | | | - Fernando P Polack
- Department of Pediatrics, Vanderbilt Vaccine Center, Vanderbilt University, Nashville, TN, USA.,Fundacion INFANT, Buenos Aires, Argentina
| | - Barbara A Rath
- Division of Pneumonology-Immunology, Department of Pediatrics, Charité University Medical Center, Berlin, Germany
| | - Alejandro H Rodríguez
- Critical Care Department, Hospital Joan XXIII, IISPV, URV, CIBERES, Tarragona, Spain
| | - Marilda M Siqueira
- Laboratory of Respiratory Viruses, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | | | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Julian W Tang
- Division of Microbiology/Molecular Diagnostic Centre, Department of Laboratory Medicine, National University Hospital, Singapore, Singapore.,Alberta Provincial Laboratory for Public Health, University of Alberta Hospital, Edmonton, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Antoni Torres
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
| | - Selda H Törün
- Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul, Turkey
| | - Dat Tran
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Annelies van Zwol
- Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands
| | - Wendy Vaudry
- Division of Infectious Diseases, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Daiva Velyvyte
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Paul Zarogoulidis
- Unit of Infectious Diseases, University General Hospital of Alexandroupolis, Democritus University Thrace, Dragana, Greece
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137
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Tinoco YO, Azziz-Baumgartner E, Rázuri H, Kasper MR, Romero C, Ortiz E, Gomez J, Widdowson MA, Uyeki TM, Gilman RH, Bausch DG, Montgomery JM. A population-based estimate of the economic burden of influenza in Peru, 2009-2010. Influenza Other Respir Viruses 2016; 10:301-9. [PMID: 26547629 PMCID: PMC4910177 DOI: 10.1111/irv.12357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 12/05/2022] Open
Abstract
Introduction Influenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource‐limited settings. We therefore studied the cost of influenza in Peru. Methods We used data collected during June 2009–December 2010 from laboratory‐confirmed influenza cases identified through a household cohort in Peru. We determined the self‐reported direct and indirect costs of self‐treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15‐day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health‐related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household. Results There were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5–26] for self‐treatment, $19 (IQR 9–34) for ambulatory non‐medical attended illness, $29 (IQR 14–51) for ambulatory medical attended illness, and $171 (IQR 113–258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83–$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile). Conclusion Influenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza.
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Affiliation(s)
- Yeny O Tinoco
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Hugo Rázuri
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | | | | | - Ernesto Ortiz
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - Jorge Gomez
- General Directorate of Epidemiology, Ministry of Health, Lima, Peru
| | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert H Gilman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Joel M Montgomery
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Division of Global Disease Detection International Emerging Infections Program, Centers for Disease Control and Prevention, Nairobi, Kenya
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138
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Nasreen S, Khan SU, Luby SP, Gurley ES, Abedin J, Zaman RU, Sohel BM, Rahman M, Hancock K, Levine MZ, Veguilla V, Wang D, Holiday C, Gillis E, Sturm-Ramirez K, Bresee JS, Rahman M, Uyeki TM, Katz JM, Azziz-Baumgartner E. Highly pathogenic Avian Influenza A(H5N1) virus infection among workers at live bird markets, Bangladesh, 2009-2010. Emerg Infect Dis 2015; 21:629-37. [PMID: 25811942 PMCID: PMC4378465 DOI: 10.3201/eid2104.141281] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Evidence of infection was low despite frequent exposure to infected poultry and low use of personal protective equipment. The risk for influenza A(H5N1) virus infection is unclear among poultry workers in countries where the virus is endemic. To assess H5N1 seroprevalence and seroconversion among workers at live bird markets (LBMs) in Bangladesh, we followed a cohort of workers from 12 LBMs with existing avian influenza surveillance. Serum samples from workers were tested for H5N1 antibodies at the end of the study or when LBM samples first had H5N1 virus–positive test results. Of 404 workers, 9 (2%) were seropositive at baseline. Of 284 workers who completed the study and were seronegative at baseline, 6 (2%) seroconverted (7 cases/100 poultry worker–years). Workers who frequently fed poultry, cleaned feces from pens, cleaned food/water containers, and did not wash hands after touching sick poultry had a 7.6 times higher risk for infection compared with workers who infrequently performed these behaviors. Despite frequent exposure to H5N1 virus, LBM workers showed evidence of only sporadic infection.
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139
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Soebiyanto RP, Clara WA, Jara J, Balmaseda A, Lara J, Lopez Moya M, Palekar R, Widdowson MA, Azziz-Baumgartner E, Kiang RK. Associations between seasonal influenza and meteorological parameters in Costa Rica, Honduras and Nicaragua. Geospat Health 2015; 10:372. [PMID: 26618318 DOI: 10.4081/gh.2015.372] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/08/2015] [Accepted: 08/19/2015] [Indexed: 05/23/2023]
Abstract
Seasonal influenza affects a considerable proportion of the global population each year. We assessed the association between subnational influenza activity and temperature, specific humidity and rainfall in three Central America countries, i.e. Costa Rica, Honduras and Nicaragua. Using virologic data from each country's national influenza centre, rainfall from the Tropical Rainfall Measuring Mission and air temperature and specific humidity data from the Global Land Data Assimilation System, we applied logistic regression methods for each of the five sub-national locations studied. Influenza activity was represented by the weekly proportion of respiratory specimens that tested positive for influenza. The models were adjusted for the potentially confounding co-circulating respiratory viruses, seasonality and previous weeks' influenza activity. We found that influenza activity was proportionally associated (P<0.05) with specific humidity in all locations [odds ratio (OR) 1.21-1.56 per g/kg], while associations with temperature (OR 0.69-0.81 per °C) and rainfall (OR 1.01-1.06 per mm/day) were location-dependent. Among the meteorological parameters, specific humidity had the highest contribution (~3-15%) to the model in all but one location. As model validation, we estimated influenza activity for periods, in which the data was not used in training the models. The correlation coefficients between the estimates and the observed were ≤0.1 in 2 locations and between 0.6-0.86 in three others. In conclusion, our study revealed a proportional association between influenza activity and specific humidity in selected areas from the three Central America countries.
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Affiliation(s)
- Radina P Soebiyanto
- Goddard Earth Sciences Technology and Research, Universities Space Research Association, Columbia, MD; Global Change Data Center, NASA Goddard Space Flight Center, Greenbelt, MD.
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140
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Chacon R, Clara AW, Jara J, Armero J, Lozano C, El Omeiri N, Widdowson MA, Azziz-Baumgartner E. Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012. PLoS One 2015; 10:e0140890. [PMID: 26485296 PMCID: PMC4618691 DOI: 10.1371/journal.pone.0140890] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022] Open
Abstract
We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded) patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.
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Affiliation(s)
- Rafael Chacon
- Influenza Unit, University of the Valley of Guatemala, Guatemala City, Guatemala
- * E-mail:
| | - Alexey Wilfrido Clara
- Influenza Program, Centers for Disease Control and Prevention for Central American Region, Guatemala City, Guatemala
| | - Jorge Jara
- Influenza Unit, University of the Valley of Guatemala, Guatemala City, Guatemala
| | - Julio Armero
- Health Surveillance Directorate, Ministry of Health of El Salvador, San Salvador, El Salvador
| | - Celina Lozano
- National Influenza Center, Ministry of Health of El Salvador, San Salvador, El Salvador
| | - Nathalie El Omeiri
- Influenza Unit, Training Programs in Epidemiology and Public Health Interventions Network, Guatemala City, Guatemala
| | - Marc-Alain Widdowson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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141
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Durand LO, Glew P, Gross D, Kasper M, Trock S, Kim IK, Bresee JS, Donis R, Uyeki TM, Widdowson MA, Azziz-Baumgartner E. Timing of influenza A(H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004-2013. Emerg Infect Dis 2015; 21:202-8. [PMID: 25625302 PMCID: PMC4313643 DOI: 10.3201/eid2102.140877] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Co-circulation of H5N1 in poultry and humans during seasonal influenza epidemic periods signals the need for enhanced surveillance and biosafety measures. Co-circulation of influenza A(H5N1) and seasonal influenza viruses among humans and animals could lead to co-infections, reassortment, and emergence of novel viruses with pandemic potential. We assessed the timing of subtype H5N1 outbreaks among poultry, human H5N1 cases, and human seasonal influenza in 8 countries that reported 97% of all human H5N1 cases and 90% of all poultry H5N1 outbreaks. In these countries, most outbreaks among poultry (7,001/11,331, 62%) and half of human cases (313/625, 50%) occurred during January–March. Human H5N1 cases occurred in 167 (45%) of 372 months during which outbreaks among poultry occurred, compared with 59 (10%) of 574 months that had no outbreaks among poultry. Human H5N1 cases also occurred in 59 (22%) of 267 months during seasonal influenza periods. To reduce risk for co-infection, surveillance and control of H5N1 should be enhanced during January–March, when H5N1 outbreaks typically occur and overlap with seasonal influenza virus circulation.
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142
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Razuri H, Malecki M, Tinoco Y, Ortiz E, Guezala MC, Romero C, Estela A, Breña P, Morales ML, Reaves EJ, Gomez J, Uyeki TM, Widdowson MA, Azziz-Baumgartner E, Bausch DG, Schildgen V, Schildgen O, Montgomery JM. Human Coronavirus-Associated Influenza-Like Illness in the Community Setting in Peru. Am J Trop Med Hyg 2015; 93:1038-40. [PMID: 26324726 DOI: 10.4269/ajtmh.15-0271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/29/2015] [Indexed: 12/28/2022] Open
Abstract
We present findings describing the epidemiology of non-severe acute respiratory syndrome human coronavirus-associated influenza-like illness from a population-based active follow-up study in four different regions of Peru. In 2010, the prevalence of infections by human coronaviruses 229E, OC43, NL63, or HKU1 was 6.4% in participants with influenza-like illness who tested negative for influenza viruses. Ten of 11 human coronavirus infections were identified in the fall-winter season. Human coronaviruses are present in different regions of Peru and are relatively frequently associated with influenza-like illness in Peru.
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Affiliation(s)
- Hugo Razuri
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Monika Malecki
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Yeny Tinoco
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Ernesto Ortiz
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - M Claudia Guezala
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Candice Romero
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Abel Estela
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Patricia Breña
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Maria-Luisa Morales
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Erik J Reaves
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Jorge Gomez
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Timothy M Uyeki
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Marc-Alain Widdowson
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Eduardo Azziz-Baumgartner
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Daniel G Bausch
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Verena Schildgen
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Oliver Schildgen
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Joel M Montgomery
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
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143
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Chacon R, Mirza S, Rodriguez D, Paredes A, Guzman G, Moreno L, Then CJ, Jara J, Blanco N, Bonilla L, Clara WA, Minaya P, Palekar R, Azziz-Baumgartner E. Demographic and clinical characteristics of deaths associated with influenza A(H1N1) pdm09 in Central America and Dominican Republic 2009-2010. BMC Public Health 2015; 15:734. [PMID: 26227404 PMCID: PMC4521479 DOI: 10.1186/s12889-015-2064-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 07/16/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The demographic characteristics of pandemic influenza decedents among middle and low-income tropical countries are poorly understood. We explored the demographics of persons who died with influenza A (H1N1)pdm09 infection during 2009-2010, in seven countries in the American tropics. METHODS We used hospital-based surveillance to identify laboratory-confirmed influenza deaths in Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and Dominican Republic. An influenza death was defined as a person who died within two weeks of a severe acute respiratory infection (SARI) defined as sudden onset of fever >38 °C, cough or sore-throat, and shortness of breath, or difficulty breathing requiring hospitalization, and who tested positive for influenza A (H1N1)pdm09 virus by real time polymerase chain reaction. We abstracted the demographic and clinical characteristics of the deceased from their medical records. RESULTS During May 2009-June 2010, we identified 183 influenza deaths. Their median age was 32 years (IQR 18-46 years). One-hundred and one (55 %) were female of which 20 (20 %) were pregnant and 7 (7 %) were in postpartum. One-hundred and twelve decedents (61 %) had pre-existing medical conditions, (15 % had obesity, 13 % diabetes, 11 % asthma, 8 % metabolic disorders, 5 % chronic obstructive pulmonary disease, and 10 % neurological disorders). 65 % received oseltamivir but only 5 % received it within 48 h of symptoms onset. CONCLUSIONS The pandemic killed young adults, pregnant women and those with pre-existing medical conditions. Most sought care too late to fully benefit from oseltamivir. We recommend countries review antiviral treatment policies for people at high risk of developing complications.
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Affiliation(s)
- Rafael Chacon
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95, zona 15, Vista Hermosa III, Guatemala, Guatemala.
| | - Sara Mirza
- Centers for Disease Control and Prevention, Influenza Division, Atlanta, Georgia, USA.
| | | | | | | | | | - Cecilia J Then
- Ministry of Health, Dominican Republic, Dominican Republic.
| | - Jorge Jara
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95, zona 15, Vista Hermosa III, Guatemala, Guatemala.
| | - Natalia Blanco
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95, zona 15, Vista Hermosa III, Guatemala, Guatemala.
| | - Luis Bonilla
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95, zona 15, Vista Hermosa III, Guatemala, Guatemala.
| | - Wilfrido A Clara
- Centers for Disease Control and Prevention, Influenza Division, Atlanta, Georgia, USA.
| | - Percy Minaya
- Training of Epidemiology and Public Health Intervention Network, Guatemala, Guatemala.
| | - Rakhee Palekar
- Influenza Group. Pan-American Health Organization, Washington DC, USA.
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144
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El Omeiri N, Azziz-Baumgartner E, Clará W, Guzmán-Saborío G, Elas M, Mejía H, Molina IB, De Molto Y, Mirza S, Widdowson MA, Ropero-Álvarez AM. Pilot to evaluate the feasibility of measuring seasonal influenza vaccine effectiveness using surveillance platforms in Central-America, 2012. BMC Public Health 2015; 15:673. [PMID: 26184659 PMCID: PMC4504410 DOI: 10.1186/s12889-015-2001-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/30/2015] [Indexed: 11/30/2022] Open
Abstract
Background Since 2004, the uptake of seasonal influenza vaccines in Latin America and the Caribbean has markedly increased. However, vaccine effectiveness (VE) is not routinely measured in the region. We assessed the feasibility of using routine surveillance data collected by sentinel hospitals to estimate influenza VE during 2012 against laboratory-confirmed influenza hospitalizations in Costa-Rica, El Salvador, Honduras and Panama. We explored the completeness of variables needed for VE estimation. Methods We conducted the pilot case–control study at 23 severe acute respiratory infections (SARI) surveillance hospitals. Participant inclusion criteria included children 6 months–11 years and adults ≥60 years targeted for vaccination and hospitalized for SARI during January–December 2012. We abstracted information needed to estimate target group specific VE (i.e., date of illness onset and specimen collection, preexisting medical conditions, 2012 and 2011 vaccination status and date, and pneumococcal vaccination status for children and adults) from SARI case-reports and for children ≤9 years, inquired about the number of annual vaccine doses given. A case was defined as an influenza virus positive by RT-PCR in a person with SARI, while controls were RT-PCR negative. We recruited 3 controls per case from the same age group and month of onset of symptoms. Results We identified 1,186 SARI case-patients (342 influenza cases; 849 influenza-negative controls), of which 994 (84 %) had all the information on key variables sought. In 893 (75 %) SARI case-patients, the vaccination status field was missing in the SARI case-report forms and had to be completed using national vaccination registers (36 %), vaccination cards (30 %), or other sources (34 %). After applying exclusion criteria for VE analyses, 541 (46 %) SARI case-patients with variables necessary for the group-specific VE analyses were selected (87 cases, 236 controls among children; 64 cases, 154 controls among older adults) and were insufficient to provide precise regional estimates (39 % for children and 25 % for adults of minimum sample size needed). Conclusions Sentinel surveillance networks in middle income countries, such as some Latin American and Caribbean countries, could provide a simple and timely platform to estimate regional influenza VE annually provided SARI forms collect all necessary information. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2001-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nathalie El Omeiri
- Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET)/The Taskforce for Global Health, Inc., ᅟ, ᅟ. .,Pan American Health Organization, Ancón, Avenida Gorgas, Edificio 261, Panama City, Panama.
| | | | - Wilfrido Clará
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
| | - Guiselle Guzmán-Saborío
- Costa-Rican Social Security Fund (Caja Costarricense de Seguro Social), San José, Costa-Rica.
| | - Miguel Elas
- Ministry of Health, San Salvador, El Salvador.
| | | | | | | | - Sara Mirza
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
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145
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Ampofo WK, Azziz-Baumgartner E, Bashir U, Cox NJ, Fasce R, Giovanni M, Grohmann G, Huang S, Katz J, Mironenko A, Mokhtari-Azad T, Sasono PM, Rahman M, Sawanpanyalert P, Siqueira M, Waddell AL, Waiboci L, Wood J, Zhang W, Ziegler T. Strengthening the influenza vaccine virus selection and development process: Report of the 3rd WHO Informal Consultation for Improving Influenza Vaccine Virus Selection held at WHO headquarters, Geneva, Switzerland, 1-3 April 2014. Vaccine 2015; 33:4368-82. [PMID: 26148877 DOI: 10.1016/j.vaccine.2015.06.090] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
Despite long-recognized challenges and constraints associated with their updating and manufacture, influenza vaccines remain at the heart of public health preparedness and response efforts against both seasonal and potentially pandemic influenza viruses. Globally coordinated virological and epidemiological surveillance is the foundation of the influenza vaccine virus selection and development process. Although national influenza surveillance and reporting capabilities are being strengthened and expanded, sustaining and building upon recent gains has become a major challenge. Strengthening the vaccine virus selection process additionally requires the continuation of initiatives to improve the timeliness and representativeness of influenza viruses shared by countries for detailed analysis by the WHO Global Influenza Surveillance and Response System (GISRS). Efforts are also continuing at the national, regional, and global levels to better understand the dynamics of influenza transmission in both temperate and tropical regions. Improved understanding of the degree of influenza seasonality in tropical countries of the world should allow for the strengthening of national vaccination policies and use of the most appropriate available vaccines. There remain a number of limitations and difficulties associated with the use of HAI assays for the antigenic characterization and selection of influenza vaccine viruses by WHOCCs. Current approaches to improving the situation include the more-optimal use of HAI and other assays; improved understanding of the data produced by neutralization assays; and increased standardization of serological testing methods. A number of new technologies and associated tools have the potential to revolutionize influenza surveillance and response activities. These include the increasingly routine use of whole genome next-generation sequencing and other high-throughput approaches. Such approaches could not only become key elements in outbreak investigations but could drive a new surveillance paradigm. However, despite the advances made, significant challenges will need to be addressed before next-generation technologies become routine, particularly in low-resource settings. Emerging approaches and techniques such as synthetic genomics, systems genetics, systems biology and mathematical modelling are capable of generating potentially huge volumes of highly complex and diverse datasets. Harnessing the currently theoretical benefits of such bioinformatics ("big data") concepts for the influenza vaccine virus selection and development process will depend upon further advances in data generation, integration, analysis and dissemination. Over the last decade, growing awareness of influenza as an important global public health issue has been coupled to ever-increasing demands from the global community for more-equitable access to effective and affordable influenza vaccines. The current influenza vaccine landscape continues to be dominated by egg-based inactivated and live attenuated vaccines, with a small number of cell-based and recombinant vaccines. Successfully completing each step in the annual influenza vaccine manufacturing cycle will continue to rely upon timely and regular communication between the WHO GISRS, manufacturers and regulatory authorities. While the pipeline of influenza vaccines appears to be moving towards a variety of niche products in the near term, it is apparent that the ultimate aim remains the development of effective "universal" influenza vaccines that offer longer-lasting immunity against a broad range of influenza A subtypes.
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Affiliation(s)
| | | | - Uzma Bashir
- National Institute of Health, Islamabad, Pakistan
| | - Nancy J Cox
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Rodrigo Fasce
- Public Health Institute of Chile, National Influenza Center, Chile
| | | | - Gary Grohmann
- Therapeutics Goods Administration, Symonston, Australia
| | - Sue Huang
- National Influenza Center, Upper Hutt, New Zealand
| | - Jackie Katz
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | | | | | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | | | | | | | | | - John Wood
- Formerly National Institute for Biological Standards and Control (NIBSC), Potters Bar, UK
| | - Wenqing Zhang
- World Health Organization (WHO), Geneva, Switzerland.
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146
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Ram PK, DiVita MA, Khatun-e-Jannat K, Islam M, Krytus K, Cercone E, Sohel BM, Ahmed M, Rahman AMQ, Rahman M, Yu J, Brooks WA, Azziz-Baumgartner E, Fry AM, Luby SP. Impact of Intensive Handwashing Promotion on Secondary Household Influenza-Like Illness in Rural Bangladesh: Findings from a Randomized Controlled Trial. PLoS One 2015; 10:e0125200. [PMID: 26066651 PMCID: PMC4465839 DOI: 10.1371/journal.pone.0125200] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 03/15/2015] [Indexed: 12/04/2022] Open
Abstract
Rationale There is little evidence for the efficacy of handwashing for prevention of influenza transmission in resource-poor settings. We tested the impact of intensive handwashing promotion on household transmission of influenza-like illness and influenza in rural Bangladesh. Methods In 2009–10, we identified index case-patients with influenza-like illness (fever with cough or sore throat) who were the only symptomatic person in their household. Household compounds of index case-patients were randomized to control or intervention (soap and daily handwashing promotion). We conducted daily surveillance and collected oropharyngeal specimens. Secondary attack ratios (SAR) were calculated for influenza and ILI in each arm. Among controls, we investigated individual risk factors for ILI among household contacts of index case-patients. Results Among 377 index case-patients, the mean number of days between fever onset and study enrollment was 2.1 (SD 1.7) among the 184 controls and 2.6 (SD 2.9) among 193 intervention case-patients. Influenza infection was confirmed in 20% of controls and 12% of intervention index case-patients. The SAR for influenza-like illness among household contacts was 9.5% among intervention (158/1661) and 7.7% among control households (115/1498) (SAR ratio 1.24, 95% CI 0.92–1.65). The SAR ratio for influenza was 2.40 (95% CI 0.68–8.47). In the control arm, susceptible contacts <2 years old (RRadj 5.51, 95% CI 3.43–8.85), those living with an index case-patient enrolled ≤24 hours after symptom onset (RRadj 1.91, 95% CI 1.18–3.10), and those who reported multiple daily interactions with the index case-patient (RRadj 1.94, 95% CI 1.71–3.26) were at increased risk of influenza-like illness. Discussion Handwashing promotion initiated after illness onset in a household member did not protect against influenza-like illness or influenza. Behavior may not have changed rapidly enough to curb transmission between household members. A reactive approach to reduce household influenza transmission through handwashing promotion may be ineffective in the context of rural Bangladesh. Trial Registration ClinicalTrials.gov NCT00880659
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Affiliation(s)
- Pavani K. Ram
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, United States of America
- * E-mail:
| | - Margaret A. DiVita
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - Kaniz Khatun-e-Jannat
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Manoshi Islam
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Kimberly Krytus
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - Emily Cercone
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - Badrul Munir Sohel
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Makhdum Ahmed
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Abid Mahmud Quaiyum Rahman
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Mustafizur Rahman
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Jihnhee Yu
- Department of Biostatistics, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - W. Abdullah Brooks
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Eduardo Azziz-Baumgartner
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Alicia M. Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Stephen P. Luby
- Centre for Communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
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147
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Dawood FS, Jara J, Estripeaut D, Vergara O, Luciani K, Corro M, de León T, Saldaña R, Castillo Baires JM, Rauda Flores R, Cazares RA, Brizuela de Fuentes YS, Franco D, Gaitan M, Schneider E, Berman L, Azziz-Baumgartner E, Widdowson MA. What Is the Added Benefit of Oropharyngeal Swabs Compared to Nasal Swabs Alone for Respiratory Virus Detection in Hospitalized Children Aged <10 Years? J Infect Dis 2015; 212:1600-3. [PMID: 25943205 DOI: 10.1093/infdis/jiv265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/24/2015] [Indexed: 11/13/2022] Open
Abstract
We evaluated the added value of collecting both nasal and oropharyngeal swabs, compared with collection of nasal swabs alone, for detection of common respiratory viruses by reverse transcription-polymerase chain reaction in hospitalized children aged <10 years. Nasal swabs had equal or greater sensitivity than oropharyngeal swabs for detection of respiratory syncytial virus, adenovirus, human metapneumovirus, rhinovirus, and influenza virus but not parainfluenza virus. The addition of an oropharyngeal swab, compared with use of a nasal swab alone, increased the frequency of detection of each respiratory virus by no more than 10% in children aged <10 years.
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Affiliation(s)
| | - Jorge Jara
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City
| | | | | | | | - Mary Corro
- Hospital De Especialidades Pediátricas Omar Torrijos
| | - Tirza de León
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | - Ricardo Saldaña
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | | | | | | | | | - Danilo Franco
- Gorgas Memorial Institute for Health Studies, Panama City
| | - Melissa Gaitan
- Gorgas Memorial Institute for Health Studies, Panama City
| | - Eileen Schneider
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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148
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Callejas L, Darce ACM, Amador JJ, Conklin L, Gaffga N, Schurz Rogers H, DeGrasse S, Hall S, Earley M, Mei J, Rubin C, Aldighieri S, Backer LC, Azziz-Baumgartner E. Paralytic shellfish poisonings resulting from an algal bloom in Nicaragua. BMC Res Notes 2015; 8:74. [PMID: 25890043 PMCID: PMC4359551 DOI: 10.1186/s13104-015-1012-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/12/2015] [Indexed: 11/23/2022] Open
Abstract
Background During an October 2005 algal bloom (i.e., a rapid increase or accumulation in the population of algae) off the coast of Nicaragua, 45 people developed symptoms of paralytic shellfish poisoning (PSP) and one person died. PSP in humans is caused by ingestion of saxitoxin, which is a neurotoxin often associated with shellfish contaminated by algal blooms. To explore the relationship between the algal bloom and human illnesses, we performed a case-control study of residents living in a coastal island. We administered a standardized clinical questionnaire, sampled locally harvested seafood and algae, and obtained urine samples for saxitoxin testing from symptomatic and asymptomatic persons. PSP case-patients were defined as island residents who developed at least one neurological symptom during the November 4–16 intoxication period. Seafood and algal samples were analyzed for saxitoxins using the receptor-binding assay and high-performance liquid chromatography. Two urine samples were analyzed for saxitoxins using a newly developed immunoassay. Findings Three shellfish and two algal samples tested positive for saxitoxins. Ten (9%) of 107 participants developed neurological symptoms during the specified time period and five required hospitalization. While 6 (67%) of 9 possible case-patients and 21 (21%) of 98 controls had eaten fish (p=0.008), all case-patients and 17 (17%) of controls had eaten clams (P<0.0001). The saxitoxin concentration in the urine of a hospitalized case-patient was 21 ng saxitoxin/g creatinine compared to 0.16 ng saxitoxin/g creatinine in the single control patient’s urine. Conclusions These findings suggest that a bloom of saxitoxin-producing algae resulted in saxitoxin accumulation in local clams and was responsible for the PSP intoxication.
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Affiliation(s)
- Luis Callejas
- Field Epidemiology Training Program, Managua, Nicaragua, USA.
| | | | | | - Laura Conklin
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Nicholas Gaffga
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Helen Schurz Rogers
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Stacey DeGrasse
- U.S. Food and Drug Administration, College Park, Maryland, USA.
| | - Sherwood Hall
- U.S. Food and Drug Administration, College Park, Maryland, USA.
| | - Marie Earley
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Joanne Mei
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Carol Rubin
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | | | - Lorraine C Backer
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
| | - Eduardo Azziz-Baumgartner
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA, 30333, USA.
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Durand LO, Glew P, Gross D, Kasper M, Trock S, Kim IK, Bresee JS, Donis R, Uyeki TM, Widdowson MA, Azziz-Baumgartner E. Timing of Influenza A(H5N1) in Poultry and Humans and Seasonal Influenza Activity Worldwide, 2004–2013. Emerg Infect Dis 2015. [DOI: 10.3201/eid2102.140087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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150
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Saborío GG, Clara A, Garcia A, Quesada F, Palekar R, Minaya P, Cervantes M, Lopez M, Lara J, Jara J, Blanco N, Bresee J, Widdowson MA, Azziz-Baumgartner E. Influenza-associated Hospitalizations and Deaths, Costa Rica, 2009-2012. Emerg Infect Dis 2014; 20:878-81. [PMID: 24750897 PMCID: PMC4012819 DOI: 10.3201/eid2005.131775] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Data needed to guide influenza vaccine policies are lacking in tropical countries. We multiplied the number of severe acute respiratory infections by the proportion testing positive for influenza. There were ≈6,699 influenza hospitalizations and 803 deaths in Costa Rica during 2009-2012, supporting continuation of a national influenza vaccine program.
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