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Doran Á, Colvin CL, McLaughlin E. What can we learn from historical pandemics? A systematic review of the literature. Soc Sci Med 2024; 342:116534. [PMID: 38184966 DOI: 10.1016/j.socscimed.2023.116534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
What are the insights from historical pandemics for policymaking today? We carry out a systematic review of the literature on the impact of pandemics that occurred since the Industrial Revolution and prior to Covid-19. Our literature searches were conducted between June 2020 and September 2023, with the final review encompassing 169 research papers selected for their relevance to understanding either the demographic or economic impact of pandemics. We include literature from across disciplines to maximise our knowledge base, finding many relevant articles in journals which would not normally be on the radar of social scientists. Our review identifies two gaps in the literature: (1) the need to study pandemics and their effects more collectively rather than looking at them in isolation; and (2) the need for more study of pandemics besides 1918 Spanish Influenza, especially milder pandemic episodes. These gaps are a consequence of academics working in silos, failing to draw on the skills and knowledge offered by other disciplines. Synthesising existing knowledge on pandemics in one place provides a basis upon which to identify the lessons in preparing for future catastrophic disease events.
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Affiliation(s)
- Áine Doran
- Department of Accounting, Finance and Economics, Ulster University, 2-24 York Street, Belfast, BT15 1AP, UK.
| | - Christopher L Colvin
- Department of Economics, Queen's University Belfast, Riddel Hall, 185 Stranmillis Road, Belfast, BT9 5EE, UK.
| | - Eoin McLaughlin
- Department of Accounting, Finance and Economics, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
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Guesneau C, Boureau AS, Bourigault C, Berrut G, Lepelletier D, de Decker L, Chapelet G. Risk Factors Associated with 30-Day Mortality in Older Patients with Influenza. J Clin Med 2021; 10:jcm10163521. [PMID: 34441817 PMCID: PMC8396973 DOI: 10.3390/jcm10163521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Influenza is a common viral condition, but factors related to short-term mortality have not been fully studied in older adults. Our objective was to determine whether there is an association between geriatric factors and 30-day mortality. Methods: This was a retrospective cohort design. All patients aged 75 years and over, with a diagnosis of influenza confirmed by a positive RT-PCR, were included. The primary endpoint was death within the 30 days after diagnosis. Results: 114 patients were included; 14 (12.3%) patients died within 30 days. In multivariate analysis these patients were older (OR: 1.37 95% CI (1.05, 1.79), p = 0.021), and had a lower ADL score (OR: 0.36 95% CI (0, 17; 0.75), p = 0.006), and a higher SOFA score (OR: 2.30 95% CI (1.07, 4.94), p = 0.03). Oseltamivir treatment, initiated within the first 48 h, was independently associated with survival (OR: 0.04 95% CI (0.002, 0.78), p = 0.034). Conclusions: Identification of mortality risk factors makes it possible to consider specific secondary prevention measures such as the rapid introduction of antiviral treatment. Combined with primary prevention, these measures could help to limit the mortality associated with influenza in older patients.
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Affiliation(s)
- Charles Guesneau
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Anne Sophie Boureau
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Céline Bourigault
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
- Bacteriology and Infection Control Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Gilles Berrut
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Didier Lepelletier
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
- Bacteriology and Infection Control Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Laure de Decker
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
| | - Guillaume Chapelet
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
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Talebi M, Talebi M, Farkhondeh T, Mishra G, İlgün S, Samarghandian S. New insights into the role of the Nrf2 signaling pathway in green tea catechin applications. Phytother Res 2021; 35:3078-3112. [PMID: 33569875 DOI: 10.1002/ptr.7033] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/13/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Nuclear factor-erythroid 2-related factor 2 (Nrf2) is a transcriptional signaling pathway that plays a crucial role in numerous clinical complications. Pivotal roles of Nrf2 have been proved in cancer, autoimmune diseases, neurodegeneration, cardiovascular diseases, diabetes mellitus, renal injuries, respiratory conditions, gastrointestinal disturbances, and general disorders related to oxidative stress, inflammation, apoptosis, gelatinolysis, autophagy, and fibrogenesis processes. Green tea catechins as a rich source of phenolic compounds can deal with various clinical problems and manifestations. In this review, we attempted to focus on intervention between green tea catechins and Nrf2. Green tea catechins especially epigallocatechin gallate (EGCG) elucidated the protective role of Nrf2 and its downstream molecules in various disorders through Keap-1, HO-1, NQO-1, GPx, GCLc, GCLm, NF-kB cross-link, kinases, and apoptotic proteins. Subsequently, we compiled an updated expansions of the Nrf2 role as a gate to manage and protect different disorders and feasible indications of green tea catechins through this signaling pathway. The present review highlighted recent evidence-based data in silico, in vitro, and in vivo studies on an outline for future clinical trials.
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Affiliation(s)
- Marjan Talebi
- Department of Pharmacognosy and Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Talebi
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, Texas, USA.,Department of Research & Development, Viatris Pharmaceuticals Inc., San Antonio, Texas, USA
| | - Tahereh Farkhondeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.,Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Gaurav Mishra
- Institute of Medical Sciences, Faculty of Ayurveda, Department of Medicinal Chemistry, Banaras Hindu University, Varanasi, India
| | - Selen İlgün
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Erciyes University, Kayseri, Turkey
| | - Saeed Samarghandian
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Ortac Ersoy E, Er B, Ciftci F, Gulleroglu A, Suner K, Arpinar B, Aygencel G, Bacakoglu F, Akpinar S, Comert B, Sungurtekin H, Altıntas D, Rollas K, Turan S, Topeli A. Outcome of Patients Admitted to Intensive Care Units due to Influenza-Related Severe Acute Respiratory Illness in 2017-2018 Flu Season: A Multicenter Study from Turkey. Respiration 2020; 99:954-960. [PMID: 33271560 DOI: 10.1159/000511092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Influenza can cause severe acute respiratory illness (SARI), which occurs as local outbreaks or seasonal epidemics with high intensive care unit (ICU) admission and mortality rates. Mortality is mainly due to SARI. OBJECTIVE The aim of this study was to evaluate the outcome of patients admitted to ICU due to influenza-related SARI in 2017-2018 flu season in Turkey. METHODS A retrospective multicenter study was conducted in 13 ICUs with a total of 216 beds from 6 cities in Turkey. All adult patients (over 18 years) admitted to the ICUs in 2017-2018 flu season (between September 1, 2017, and April 30, 2018) because of SARI and with a positive nasopharyngeal swab for influenza were included in the study. RESULTS A total of 123 cases were included in the study. The mean age of patients was 64.5 ± 17.5 years, and 66 (53.7%) patients were older than 65 years. The ICU mortality was 33.9%, and hospital mortality was 35.6%. Invasive mechanical ventilation (IMV), acute kidney injury (AKI), hematologic malignancy, and >65 years of age were the factors affecting mortality in influenza. CONCLUSION SARI due to influenza carries a high mortality rate, and IMV, AKI, presence of hematologic malignancy, and older age are independent risk factors for mortality.
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Affiliation(s)
- Ebru Ortac Ersoy
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey,
| | - Berrin Er
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatma Ciftci
- Department of Chest Diseases, Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Kezban Suner
- Intensive Care Unit, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Burcu Arpinar
- Intensive Care Unit, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Gulbin Aygencel
- Medical Intensive Care Unit, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Feza Bacakoglu
- Division of Chest Diseases, Intensive Care Unit, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serdar Akpinar
- Medical Intensive Care Unit, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Bilgin Comert
- Medical Intensive Care Unit, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Hulya Sungurtekin
- Intensive Care Unit, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Defne Altıntas
- Medical Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kazim Rollas
- Intensive Care Unit, Tepecik Education Hospital, University of Health Sciences, Izmir, Turkey
| | - Sema Turan
- Intensive Care Unit, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Arzu Topeli
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Trovato M, Sartorius R, D’Apice L, Manco R, De Berardinis P. Viral Emerging Diseases: Challenges in Developing Vaccination Strategies. Front Immunol 2020; 11:2130. [PMID: 33013898 PMCID: PMC7494754 DOI: 10.3389/fimmu.2020.02130] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022] Open
Abstract
In the last decades, a number of infectious viruses have emerged from wildlife or re-emerged, generating serious threats to the global health and to the economy worldwide. Ebola and Marburg hemorrhagic fevers, Lassa fever, Dengue fever, Yellow fever, West Nile fever, Zika, and Chikungunya vector-borne diseases, Swine flu, Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the recent Coronavirus disease 2019 (COVID-19) are examples of zoonoses that have spread throughout the globe with such a significant impact on public health that the scientific community has been called for a rapid intervention in preventing and treating emerging infections. Vaccination is probably the most effective tool in helping the immune system to activate protective responses against pathogens, reducing morbidity and mortality, as proven by historical records. Under health emergency conditions, new and alternative approaches in vaccine design and development are imperative for a rapid and massive vaccination coverage, to manage a disease outbreak and curtail the epidemic spread. This review gives an update on the current vaccination strategies for some of the emerging/re-emerging viruses, and discusses challenges and hurdles to overcome for developing efficacious vaccines against future pathogens.
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MESH Headings
- Animals
- Antibody-Dependent Enhancement/immunology
- Betacoronavirus/immunology
- COVID-19
- COVID-19 Vaccines
- Communicable Diseases, Emerging/prevention & control
- Communicable Diseases, Emerging/virology
- Coronavirus Infections/immunology
- Coronavirus Infections/prevention & control
- Coronavirus Infections/therapy
- Coronavirus Infections/virology
- Cross Reactions/immunology
- Humans
- Immunization, Passive
- Pandemics/prevention & control
- Pneumonia, Viral/prevention & control
- Pneumonia, Viral/therapy
- Pneumonia, Viral/virology
- SARS-CoV-2
- Vaccination
- Vaccines, Attenuated/immunology
- Vaccines, DNA/immunology
- Vaccines, Inactivated/immunology
- Vaccines, Subunit/immunology
- Viral Vaccines/immunology
- COVID-19 Serotherapy
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Affiliation(s)
- Maria Trovato
- Institute of Biochemistry and Cell Biology, National Research Council, Naples, Italy
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Papadimitriou-Olivgeris M, Gkikopoulos N, Wüst M, Ballif A, Simonin V, Maulini M, Nusbaumer C, Bertaiola Monnerat L, Tschopp J, Kampouri EE, Wilson P, Duplain H. Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment. Eur J Intern Med 2020; 74:86-91. [PMID: 31899057 DOI: 10.1016/j.ejim.2019.12.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/18/2019] [Accepted: 12/24/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Influenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes. METHODS All adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season. RESULTS Among 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus (P 0.035; OR 7.1; 95% CI 1.1-43.8), malnutrition (P < 0.001; OR 25.0; 95% CI 4.5-138.8), hospital-acquired infection (P 0.003; OR 12.2; 95% CI 2.3-65.1), respiratory insufficiency (PaO2/FiO2 < 300) (P < 0.001; OR 125.8; 95% CI 9.6-1648.7) and pulmonary infiltrate on X-ray (P 0.020; OR 6.0; 95% CI 1.3-27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI). CONCLUSION qSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis.
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Affiliation(s)
- Matthaios Papadimitriou-Olivgeris
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland; Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland.
| | | | - Melissa Wüst
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland
| | - Aurelie Ballif
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland
| | - Valentin Simonin
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland
| | - Marie Maulini
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland
| | | | | | - Jonathan Tschopp
- Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Patrick Wilson
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland
| | - Hervé Duplain
- Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland; Faculty of biology and medicine, University of Lausanne, Lausanne, Switzerland
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Tekin S, Keske S, Alan S, Batirel A, Karakoc C, Tasdelen-Fisgin N, Simsek-Yavuz S, Isler B, Aydin M, Kapmaz M, Yilmaz-Karadag F, Ergonul O. Predictors of fatality in influenza A virus subtype infections among inpatients in the 2015-2016 season. Int J Infect Dis 2019; 81:6-9. [PMID: 30641199 DOI: 10.1016/j.ijid.2019.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/02/2019] [Accepted: 01/05/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Infection with the influenza A virus can cause severe disease and mortality. The effect of the different subtypes of influenza on morbidity and mortality is not yet known in Turkey. The aim of this study was to describe the predictors of fatality related to influenza A infection among hospitalized patients in Istanbul during the 2015-2016 influenza season, and to detail the differences between infections caused by H3N2 and H1N1. METHODS This was a multicenter study performed by the Istanbul Respiratory Infections Study Group of The Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK), among patients hospitalized for influenza in Istanbul during the 2015-2016 influenza season. RESULTS A total of 222 patients hospitalized with laboratory-confirmed influenza during the 2015-2016 season were included in the study, of whom 25 (11.2%) died. The fatality rate was significantly higher among patients older than 65 years of age and those with chronic heart and kidney diseases (p<0.001), chronic neurological diseases (p=0.009), and malignancies (p=0.021). Thrombocyte counts were lower in those who died than in those who survived (p<0.004). The median alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein levels were higher among fatal cases. In the multivariate analysis for the prediction of fatality, being >65years old (odds ratio (OR) 6.9, 95% confidence interval (CI) 2.07-23.08, p=0.002), being infected with influenza A(H3N2) (OR 4.2, 95% CI 1.27-14.38, p=0.019), and a 1-day delay in antiviral use (OR 1.28, 95% CI 1.01-1.63, p=0.036) were found to be associated with an increased likelihood of fatality. CONCLUSIONS The case fatality rate of influenza A(H3N2) was significantly higher than that of influenza A(H1N1). Detection of the infection, allowing the opportunity for the early use of antiviral agents, was found to be important for the prevention of fatality. The vaccination should be prioritized for at-risk groups.
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Affiliation(s)
- S Tekin
- Department of Infectious Diseases and Clinical Microbiology, Koç University Hospital, Istanbul, Turkey
| | - S Keske
- Department of Infectious Diseases and Clinical Microbiology, American Hospital, Istanbul, Turkey
| | - S Alan
- Department of Infectious Diseases and Clinical Microbiology, Memorial Hospital, Istanbul, Turkey
| | - A Batirel
- Department of Infectious Diseases and Clinical Microbiology, Kartal Training and Research Hospital, Ministry of Health, Istanbul, Turkey
| | - C Karakoc
- Department of Infectious Diseases and Clinical Microbiology, Liv Hospital, Istanbul, Turkey
| | - N Tasdelen-Fisgin
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Ministry of Health, Istanbul, Turkey
| | - S Simsek-Yavuz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - B Isler
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Training and Research Hospital, Ministry of Health, Istanbul, Turkey
| | - M Aydin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Hospital, Baskent University, Istanbul, Turkey
| | - M Kapmaz
- Department of Infectious Diseases and Clinical Microbiology, Safa Hospital, Istanbul, Turkey
| | - F Yilmaz-Karadag
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Medeniyet University, Ministry of Health, Istanbul, Turkey
| | - O Ergonul
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey.
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Taymaz T, Ergönül Ö, Kebapcı A, Okyay R. Significance of the detection of influenza and other respiratory viruses for antibiotic stewardship: Lessons from the post-pandemic period. Int J Infect Dis 2018; 77:53-56. [PMID: 30315991 DOI: 10.1016/j.ijid.2018.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The aim was to describe the factors associated with antibiotic use in upper respiratory tract infections (URTI) in the post-pandemic influenza period. METHODS All consecutive patients who attended the emergency and outpatient departments of a private 265-bed hospital in Istanbul, Turkey with symptoms of an influenza-like illness (ILI) between January and June 2011 were included. RESULTS Out of 1270 patients, 100 were tested for Streptococcus A infection and 16 (16%) were found to be positive; 36 patients were tested for respiratory syncytial virus and five were found to be positive. A rapid influenza test (chromatographic) was performed for 325 patients and 45% were found to be positive for influenza A or B. In total, 500 patients (40%) were prescribed antibiotics; these were fluoroquinolones (12%), macrolides (10%), amoxicillin-clavulanate (10%), cefuroxime (7%), and third-generation cephalosporins (3%). On multivariate analysis, antibiotic prescription was found to be decreased by the diagnosis of influenza, whereas antibiotic prescription increased with age >65years, C-reactive protein (CRP) >20mg/L, polymorphonuclear leukocytes >80%, the detection of rales on auscultation, the presence of cough, comorbidities, and having infiltrations on a X-ray. CONCLUSIONS The diagnosis of influenza is important for the implementation of antimicrobial stewardship programs. Each institution should implement an algorithm for the diagnosis and management of upper respiratory tract infections. Biomarkers such as CRP and procalcitonin should be used more effectively.
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Affiliation(s)
- Tolga Taymaz
- Emergency Department, American Hospital, Istanbul, Turkey
| | - Önder Ergönül
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey.
| | - Ayda Kebapcı
- School of Nursing, Koç University, Istanbul, Turkey
| | - Rıfat Okyay
- Emergency Department, American Hospital, Istanbul, Turkey
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9
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An Overview of the 2009 A(H1N1) Pandemic in Europe: Efficiency of the Vaccination and Healthcare Strategies. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2016:5965836. [PMID: 27195658 PMCID: PMC5058565 DOI: 10.1155/2016/5965836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022]
Abstract
2009 A(H1N1) data for 13 European countries obtained from the weekly influenza surveillance overview (WISO) reports of European Centre for Disease Prevention and Control (ECDC) in the form of weekly cumulative fatalities are analyzed. The variability of relative fatalities is explained by the health index of analyzed countries. Vaccination and healthcare practices as reported in the literature are used to explain the departures from this model. The timing of the vaccination with respect to the peak of the epidemic and its role in the efficiency of the vaccination is discussed. Simulations are used to show that on-time vaccination reduces considerably the final value of R(t), Rf, but it has little effect on the shape of normalized curve R(t)/Rf.
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10
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Zhou F, Li H, Gu L, Liu M, Xue CX, Cao B, Wang C. Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients. Respir Med 2017; 134:86-91. [PMID: 29413513 DOI: 10.1016/j.rmed.2017.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/22/2017] [Accepted: 11/26/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Nosocomial infections following influenza are important causes of death, requiring early implementation of preventive measures, but predictors for nosocomial infection in the early stage remained undetermined. We aimed to determine risk factors that can help clinicians identify patients with high risk of nosocomial infection following influenza on admission. METHOD Using a database prospectively collected through a Chinese national network for hospitalised severe influenza A(H1N1)pdm09 patients, we compared the characteristics on admission between patients with and without nosocomial infection. RESULT A total of 2146 patients were enrolled in the final analysis with a median age of 36.0 years, male patients comprising 50.2% of the sample and 232 (10.8%) patients complicated with nosocomial infection. Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Staphylococcus aureus were the leading pathogens, and invasive fungal infection was found in 30 cases (12.9%). The in-hospital mortality was much higher in patients with nosocomial infection than those without (45.7% vs 11.8%, P < 0.001). Need for mechanical ventilation (OR: 3.336; 95% CI 2.362-4.712), sepsis (OR: 2.125; 95% CI 1.236-3.651), ICU admission on first day (OR: 2.074; 95% CI 1.425-3.019), lymphocytopenia (OR: 1.906; 95% CI 1.361-2.671), age > 65 years (OR: 1.83; 95% CI 1.04-3.21) and anaemia (OR: 1.39; 95% CI 1.39-2.79) were independently associated with nosocomial infection. CONCLUSION Need for mechanical ventilation, sepsis, ICU admission on first day, lymphocytopenia, older age and anaemia were independent risk factors that can help clinicians identify severe influenza A(H1N1)pdm09 patients at high risk of nosocomial infection.
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Affiliation(s)
- Fei Zhou
- Beijing Chao-Yang Hospital, Capital Medical University, No 8, Gongti Road, Chaoyang District, Beijing, 100020, China
| | - Hui Li
- Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Clinical Research Centre for Respiratory Disease, Capital Medical University, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Li Gu
- Beijing Chao-Yang Hospital, Capital Medical University, No 8, Gongti Road, Chaoyang District, Beijing, 100020, China
| | - Meng Liu
- Respiratory Department, Beijing Hospital of Traditional Chinese Medicine (TCM), Capital Medical University, No 23, Art Museum Backstreet, Dongcheng District, Beijing, 100010, China
| | - Chun-Xue Xue
- Department of Respiratory and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, No 82, Xinhua Shouth Road, Tongzhou District, Beijing, 101149, China
| | - Bin Cao
- Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Clinical Research Centre for Respiratory Disease, Capital Medical University, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.
| | - Chen Wang
- Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Clinical Research Centre for Respiratory Disease, Capital Medical University, No. 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China
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11
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Boikos C, Caya C, Doll MK, Kraicer-Melamed H, Dolph M, Delisle G, Winters N, Gore G, Quach C. Safety and effectiveness of neuraminidase inhibitors in situations of pandemic and/or novel/variant influenza: a systematic review of the literature, 2009-15. J Antimicrob Chemother 2017; 72:1556-1573. [PMID: 28204554 DOI: 10.1093/jac/dkx013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/05/2017] [Indexed: 01/02/2023] Open
Abstract
Objectives To review systematically the published literature evaluating neuraminidase inhibitor (NI) safety and effectiveness in situations of pandemic and novel/variant influenza. Methods We searched six online databases using comprehensive search criteria for observational studies and randomized controlled trials investigating the effects of NI treatment, prophylaxis or outbreak control in patients of all ages. Results Overall, 165 studies were included (95% observational), which were generally of low methodological quality due to lack of adjustment for confounding variables. In studies reporting adjusted estimates in general populations, NI treatment appeared likely to be effective against mortality (primarily if administered within 48 h of symptom onset) and potentially effective in reducing pneumonia. NIs appeared effective in reducing secondary transmission when indicated for prophylaxis. Limited, low-quality data suggest NIs are likely safe in general populations and may be safe in pregnant women and children. Data are scarce regarding safety of NIs in adults and high-risk individuals. Conclusions Most included studies were observational, statistically underpowered and at high risk of reporting biased and/or confounded effect estimates. NI treatment appeared likely effective in reducing mortality (cause unspecified) and pneumonia in general populations, with increasing benefit when administered with 48 h of symptom onset. NI pre- or post-exposure prophylaxis is likely effective in reducing secondary transmission of influenza in a general population. Our evidence suggests NIs are likely safe to use in the general population; however, data for children and pregnant women are limited. Knowledge gaps persist in specific populations such as Aboriginals, high-risk individuals and the elderly.
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Affiliation(s)
- C Boikos
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - C Caya
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - M K Doll
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - H Kraicer-Melamed
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - M Dolph
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | | | - N Winters
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - G Gore
- Life Sciences Library, McGill University, Montreal, QC, Canada
| | - C Quach
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.,Department of Pediatrics, Division of Infectious Diseases, The Montreal Children's Hospital, Montreal, QC, Canada.,Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, QC, Canada
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12
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Morales KF, Paget J, Spreeuwenberg P. Possible explanations for why some countries were harder hit by the pandemic influenza virus in 2009 - a global mortality impact modeling study. BMC Infect Dis 2017; 17:642. [PMID: 28946870 PMCID: PMC5613504 DOI: 10.1186/s12879-017-2730-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 09/12/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A global pandemic mortality study found prominent regional mortality variations in 2009 for Influenza A(H1N1)pdm09. Our study attempts to identify factors that explain why the pandemic mortality burden was high in some countries and low in others. METHODS As a starting point, we identified possible risk factors worth investigating for Influenza A(H1N1)pdm09 mortality through a targeted literature search. We then used a modeling procedure (data simulations and regression models) to identify factors that could explain differences in respiratory mortality due to Influenza A(H1N1)pdm09. We ran sixteen models to produce robust results and draw conclusions. In order to assess the role of each factor in explaining differences in excess pandemic mortality, we calculated the reduction in between country variance, which can be viewed as an effect-size for each factor. RESULTS The literature search identified 124 publications and 48 possible risk factors, of which we were able to identify 27 factors with appropriate global datasets. The modelling procedure indicated that age structure (explaining 40% of the mean between country variance), latitude (8%), influenza A and B viruses circulating during the pandemic (3-8%), influenza A and B viruses circulating during the preceding influenza season (2-6%), air pollution (pm10; 4%) and the prevalence of other infections (HIV and TB) (4-6%) were factors that explained differences in mortality around the world. Healthcare expenditure, levels of obesity, the distribution of antivirals, and air travel did not explain global pandemic mortality differences. CONCLUSIONS Our study found that countries with a large proportion of young persons had higher pandemic mortality rates in 2009. The co-circulation of influenza viruses during the pandemic and the circulation of influenza viruses during the preceding season were also associated with pandemic mortality rates. We found that real time assessments of 2009 pandemic mortality risk factors (e.g. obesity) probably led to a number of false positive findings.
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Affiliation(s)
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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13
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14
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van Riel D, Mittrücker HW, Engels G, Klingel K, Markert UR, Gabriel G. Influenza pathogenicity during pregnancy in women and animal models. Semin Immunopathol 2016; 38:719-726. [PMID: 27387428 PMCID: PMC7101682 DOI: 10.1007/s00281-016-0580-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/01/2016] [Indexed: 11/30/2022]
Abstract
Pregnant women are at the highest risk to develop severe and even fatal influenza. The high vulnerability of women against influenza A virus infections during pregnancy was repeatedly highlighted during influenza pandemics including the pandemic of this century. In 2009, mortality rates were particularly high among otherwise healthy pregnant women. However, our current understanding of the molecular mechanisms involved in severe disease development during pregnancy is still very limited. In this review, we summarize the knowledge on the clinical observations in influenza A virus-infected pregnant women. In addition, knowledge obtained from few existing experimental infections in pregnant animal models is discussed. Since clinical data do not provide in-depth information on the pathogenesis of severe influenza during pregnancy, adequate animal models are urgently required that mimic clinical findings. Studies in pregnant animal models will allow the dissection of involved molecular disease pathways that are key to improve patient management and care.
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Affiliation(s)
- Debby van Riel
- Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
- Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Geraldine Engels
- Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
- Department of Obstetrics and Fetal Medicine, Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Karin Klingel
- Department of Molecular Pathology, University Hospital Tübingen, Tübingen, Germany
| | - Udo R Markert
- Department of Obstetrics and Gynecology, University Hospital Jena, Jena, Germany
| | - Gülsah Gabriel
- Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany.
- University of Lübeck, Lübeck, Germany.
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15
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On the uniqueness of epidemic models fitting a normalized curve of removed individuals. J Math Biol 2014; 71:767-94. [PMID: 25312413 DOI: 10.1007/s00285-014-0838-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 08/26/2014] [Indexed: 10/24/2022]
Abstract
The susceptible-infected-removed (SIR) and the susceptible-exposed-infected-removed (SEIR) epidemic models with constant parameters are adequate for describing the time evolution of seasonal diseases for which available data usually consist of fatality reports. The problems associated with the determination of system parameters starts with the inference of the number of removed individuals from fatality data, because the infection to death period may depend on health care factors. Then, one encounters numerical sensitivity problems for the determination of the system parameters from a correct but noisy representative of the number of removed individuals. Finally as the available data is necessarily a normalized one, the models fitting this data may not be unique. We prove that the parameters of the (SEIR) model cannot be determined from the knowledge of a normalized curve of "Removed" individuals and we show that the proportion of removed individuals, [Formula: see text], is invariant under the interchange of the incubation and infection periods and corresponding scalings of the contact rate. On the other hand we prove that the SIR model fitting a normalized curve of removed individuals is unique and we give an implicit relation for the system parameters in terms of the values of [Formula: see text] and [Formula: see text], where [Formula: see text] is the steady state value of [Formula: see text] and [Formula: see text] and [Formula: see text] are the values of [Formula: see text] and its derivative at the inflection point [Formula: see text] of [Formula: see text]. We use these implicit relations to provide a robust method for the estimation of the system parameters and we apply this procedure to the fatality data for the H1N1 epidemic in the Czech Republic during 2009. We finally discuss the inference of the number of removed individuals from observational data, using a clinical survey conducted at major hospitals in Istanbul, Turkey, during 2009 H1N1 epidemic.
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