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Dorji K, Klungthong C, Dorji T, Wangchuk T, Yuden P, Pelki T, Ghishing TD, Gyemiry G, Gyeltshen S, Chinnawirotpisan P, Manasatienkij W, Wangchuk S, Farmer A. Epidemiology and genetic characterization of influenza viruses circulating in Bhutan in 2022. PLoS One 2024; 19:e0304849. [PMID: 39288111 DOI: 10.1371/journal.pone.0304849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/21/2024] [Indexed: 09/19/2024] Open
Abstract
INTRODUCTION Influenza (Flu) causes considerable morbidity and mortality globally, and in Bhutan, Flu viruses are a leading cause of acute respiratory infection and cause outbreaks during Flu seasons. In this study, we aim to analyze the epidemiology and the genetic characterization of Flu viruses circulated in Bhutan in 2022. METHOD Respiratory specimens were collected from patients who meet the case definition for influenza-like illness (ILI) and severe acute respiratory infection (SARI) from sentinel sites. Specimens were tested for Flu and SARS-CoV-2 viruses by RT-PCR using the Multiplex Assay. Selected positive specimens were utilized for Flu viral genome sequencing by next-generation sequencing. Descriptive analysis was performed on patient demographics to see the proportion of Flu-associated ILI and SARI. All data were analyzed using Epi Info7 and QGIS 3.16 software. RESULT A weekly average of 16.2 ILI cases per 1000 outpatient visits and 18 SARI cases per 1000 admitted cases were reported in 2022. The median age among ILI was 12 years (IQR: 5-28) and SARI was 6.2 (IQR: 2.5-15) years. Flu A(H3N2) (70.2%) subtype was the most predominant circulating strain. Flu A(H1N1)pdm09 and Flu B viruses belonged to subclades that were mismatched to the vaccine strains recommended for the 2021-2022 season but matched the vaccine strain for the 2022-2023 season with vaccine efficacy 85.14% and 88.07% respectively. Flu A(H3N2) virus belonged to two subclades which differed from the vaccine strains recommended in both the 2021-2022 and 2022-2023 seasons with vaccine efficacy 68.28%. CONCLUSION Flu virus positivity rates were substantially elevated during the Flu season in 2022 compared to 2021. Flu A(H3N2) subtype was the most predominant circulating strain in the country and globally. Genetic characterization of the Flu viruses in Bhutan showed a close relatedness of high vaccine efficacy with the vaccine strain that WHO recommended for the 2022-23 season.
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Affiliation(s)
- Kunzang Dorji
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Tshering Dorji
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Tandin Wangchuk
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Pema Yuden
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Tshering Pelki
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Tara Devi Ghishing
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Govinda Gyemiry
- ICT, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Sonam Gyeltshen
- National Influenza Centre, Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | - Wudtichai Manasatienkij
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Aaron Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Ashraf MA, Raza MA, Amjad MN. Extinction of influenza B Yamagata: Its impact on public health and vaccine implications. J Biomed Res 2024; 38:1-4. [PMID: 39164195 DOI: 10.7555/jbr.38.20240158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024] Open
Affiliation(s)
- Muhammad Awais Ashraf
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Shanghai 200031, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Muhammad Asif Raza
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Shanghai 200031, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Muhammad Nabeel Amjad
- CAS Key Laboratory of Molecular Virology & Immunology, Institutional Center for Shared Technologies and Facilities, Pathogen Discovery and Big Data Platform, Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Shanghai 200031, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
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Caini S, Meijer A, Nunes MC, Henaff L, Zounon M, Boudewijns B, Del Riccio M, Paget J. Probable extinction of influenza B/Yamagata and its public health implications: a systematic literature review and assessment of global surveillance databases. THE LANCET. MICROBE 2024; 5:100851. [PMID: 38729197 DOI: 10.1016/s2666-5247(24)00066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
Early after the start of the COVID-19 pandemic, the detection of influenza B/Yamagata cases decreased globally. Given the potential public health implications of this decline, in this Review, we systematically analysed data on influenza B/Yamagata virus circulation (for 2020-23) from multiple complementary sources of information. We identified relevant articles published in PubMed and Embase, and data from the FluNet, Global Initiative on Sharing All Influenza Data, and GenBank databases, webpages of respiratory virus surveillance systems from countries worldwide, and the Global Influenza Hospital Surveillance Network. A progressive decline of influenza B/Yamagata detections was reported across all sources, in absolute terms (total number of cases), as positivity rate, and as a proportion of influenza B detections. Sporadically reported influenza B/Yamagata cases since March, 2020 were mostly vaccine-derived, attributed to data entry errors, or have yet to be definitively confirmed. The likelihood of extinction necessitates a rapid response in terms of reassessing the composition of influenza vaccines, enhanced surveillance for B/Yamagata, and a possible change in the biosafety level when handling B/Yamagata viruses in laboratories.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands.
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Marta C Nunes
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France; South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laetitia Henaff
- Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Malaika Zounon
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Bronke Boudewijns
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Marco Del Riccio
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands; Department of Health Sciences, University of Florence, Florence, Italy
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
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4
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Mathis SM, Webber AE, León TM, Murray EL, Sun M, White LA, Brooks LC, Green A, Hu AJ, Rosenfeld R, Shemetov D, Tibshirani RJ, McDonald DJ, Kandula S, Pei S, Yaari R, Yamana TK, Shaman J, Agarwal P, Balusu S, Gururajan G, Kamarthi H, Prakash BA, Raman R, Zhao Z, Rodríguez A, Meiyappan A, Omar S, Baccam P, Gurung HL, Suchoski BT, Stage SA, Ajelli M, Kummer AG, Litvinova M, Ventura PC, Wadsworth S, Niemi J, Carcelen E, Hill AL, Loo SL, McKee CD, Sato K, Smith C, Truelove S, Jung SM, Lemaitre JC, Lessler J, McAndrew T, Ye W, Bosse N, Hlavacek WS, Lin YT, Mallela A, Gibson GC, Chen Y, Lamm SM, Lee J, Posner RG, Perofsky AC, Viboud C, Clemente L, Lu F, Meyer AG, Santillana M, Chinazzi M, Davis JT, Mu K, Pastore Y Piontti A, Vespignani A, Xiong X, Ben-Nun M, Riley P, Turtle J, Hulme-Lowe C, Jessa S, Nagraj VP, Turner SD, Williams D, Basu A, Drake JM, Fox SJ, Suez E, Cojocaru MG, Thommes EW, Cramer EY, Gerding A, Stark A, Ray EL, Reich NG, Shandross L, Wattanachit N, Wang Y, Zorn MW, Aawar MA, Srivastava A, Meyers LA, Adiga A, Hurt B, Kaur G, Lewis BL, Marathe M, Venkatramanan S, Butler P, Farabow A, Ramakrishnan N, Muralidhar N, Reed C, Biggerstaff M, Borchering RK. Title evaluation of FluSight influenza forecasting in the 2021-22 and 2022-23 seasons with a new target laboratory-confirmed influenza hospitalizations. Nat Commun 2024; 15:6289. [PMID: 39060259 PMCID: PMC11282251 DOI: 10.1038/s41467-024-50601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. For the 2021-22 and 2022-23 influenza seasons, 26 forecasting teams provided national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one-to-four weeks ahead. Forecast skill is evaluated using the Weighted Interval Score (WIS), relative WIS, and coverage. Six out of 23 models outperform the baseline model across forecast weeks and locations in 2021-22 and 12 out of 18 models in 2022-23. Averaging across all forecast targets, the FluSight ensemble is the 2nd most accurate model measured by WIS in 2021-22 and the 5th most accurate in the 2022-23 season. Forecast skill and 95% coverage for the FluSight ensemble and most component models degrade over longer forecast horizons. In this work we demonstrate that while the FluSight ensemble was a robust predictor, even ensembles face challenges during periods of rapid change.
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Affiliation(s)
| | | | - Tomás M León
- California Department of Public Health, Richmond, CA, USA
| | - Erin L Murray
- California Department of Public Health, Richmond, CA, USA
| | - Monica Sun
- California Department of Public Health, Richmond, CA, USA
| | - Lauren A White
- California Department of Public Health, Richmond, CA, USA
| | - Logan C Brooks
- Carnegie Mellon University, Pittsburgh, PA, USA
- University of California, Berkeley, Berkeley, CA, USA
| | - Alden Green
- Carnegie Mellon University, Pittsburgh, PA, USA
| | | | | | | | - Ryan J Tibshirani
- Carnegie Mellon University, Pittsburgh, PA, USA
- University of California, Berkeley, Berkeley, CA, USA
| | | | | | - Sen Pei
- Columbia University, New York, NY, USA
| | | | | | - Jeffrey Shaman
- Columbia University, New York, NY, USA
- Columbia University School of Climate, New York, NY, USA
| | | | | | | | | | | | - Rishi Raman
- Georgia Institute of Technology, Atlanta, GA, USA
| | - Zhiyuan Zhao
- Georgia Institute of Technology, Atlanta, GA, USA
| | | | | | - Shalina Omar
- Guidehouse Advisory and Consulting Services, McClean, VA, USA
| | | | | | | | | | - Marco Ajelli
- Indiana University School of Public Health, Bloomington, IN, USA
| | | | - Maria Litvinova
- Indiana University School of Public Health, Bloomington, IN, USA
| | - Paulo C Ventura
- Indiana University School of Public Health, Bloomington, IN, USA
| | | | | | | | | | - Sara L Loo
- Johns Hopkins University, Baltimore, MD, USA
| | | | - Koji Sato
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Sung-Mok Jung
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Justin Lessler
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Nikos Bosse
- London School of Health and Tropical Medicine, London, UK
| | | | - Yen Ting Lin
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | | | - Ye Chen
- Northern Arizona University, Flagstaff, AZ, USA
| | | | | | | | - Amanda C Perofsky
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Fred Lu
- Northeastern University, Boston, MA, USA
| | | | | | | | | | - Kunpeng Mu
- Northeastern University, Boston, MA, USA
| | | | | | | | | | - Pete Riley
- Predictive Science Inc, San Diego, CA, USA
| | | | | | | | - V P Nagraj
- Signature Science, LLC, Charlottesville, VA, USA
| | | | | | | | | | | | | | | | - Edward W Thommes
- University of Guelph, Guelph, ON, Canada
- Sanofi, Toronto, ON, USA
| | | | - Aaron Gerding
- University of Massachusetts Amherst, Amherst, MA, USA
| | - Ariane Stark
- University of Massachusetts Amherst, Amherst, MA, USA
| | - Evan L Ray
- University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Li Shandross
- University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Yijin Wang
- University of Massachusetts Amherst, Amherst, MA, USA
| | - Martha W Zorn
- University of Massachusetts Amherst, Amherst, MA, USA
| | - Majd Al Aawar
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Hsu VP, Pergam SA, Shenoy ES, Banach DB, Jones Batshon L, Branch-Elliman W, Dumyati G, Haessler S, Jump RLP, Malani AN, Mathew TA, Murthy RK, Weber DJ. SHEA position statement on pandemic preparedness for policymakers: emerging infectious threats. Infect Control Hosp Epidemiol 2024:1-3. [PMID: 39028203 DOI: 10.1017/ice.2024.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Affiliation(s)
- Vincent P Hsu
- AdventHealth, Altamonte Springs, FL, USA
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Steven A Pergam
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Erica S Shenoy
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Mass General Brigham, Boston, MA, USA
| | - David B Banach
- University of Connecticut School of Medicine, Farmington, CT, USA
- Yale School of Public Health, New Haven, CT, USA
| | | | - Westyn Branch-Elliman
- Harvard Medical School, Boston, MA, USA
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Ghinwa Dumyati
- University of Rochester Medical Center, Rochester, NY, USA
- Center for Community Health, Rochester, NY, USA
| | - Sarah Haessler
- Baystate Medical Center, Springfield, MA, USA
- University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA
| | - Robin L P Jump
- Geriatric Research Education and Clinical Center (GRECC) at the Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Trini A Mathew
- HealthTAMCycle3, PLLC, Troy, MI, USA
- Corewell Health, Taylor, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
- Oakland University William Beaumont, Rochester, MI, USA
| | - Rekha K Murthy
- Cedars-Sinai, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Zhang G, Zhang A, Zhang L, Zhu A, Li Z, Zhu W, Hu W, Ye C. The Characteristics of the Influenza Virus Epidemic Around the SARS-CoV-2 Epidemic Period in the Pudong New Area of Shanghai. J Epidemiol Glob Health 2024; 14:304-310. [PMID: 38381354 PMCID: PMC11176117 DOI: 10.1007/s44197-024-00194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES The concurrent impact of COVID-19 and influenza on disease burden is a topic of great concern. This discussion delves into the epidemiological characteristics of seasonal influenza activity in Shanghai within the context of the SARS-CoV-2 epidemic. METHODS From 2017 to 2023, a total of 11,081 patients having influenza-like illness (ILI) were included in this study for influenza virus detection. Reverse transcription polymerase chain reaction (RT-PCR) assays were conducted according to standardised protocols to identify the types and subtypes of influenza viruses. The positivity rate of the influenza virus among the sampled ILI cases served as a surrogate measure for estimating various influenza seasonal characteristics, such as periodicity, duration, peak occurrences, and the prevalent subtypes or lineages. Epidemiological aspects across different years and age groups were subjected to comprehensive analysis. For categorical variables, the Chi-square test or Fisher's exact test was employed, as deemed appropriate. RESULTS A total of 1553 (14.0%) tested positive for influenza virus pathogens. The highest positivity rate for influenza was observed in adults aged 25-59 years (18.8%), while the lowest rate was recorded in children under 5 years (3.8%). The influenza circulation patterns in Shanghai were characterised: (1) 2 years exhibited semiannual periodicity (2017-2018, 2022-2023); (2) 3 years displayed annual periodicity (2018-2019, 2019-2020, and 2021-2022); and (3) during 2020-2021, epidemic periodicities of seasonal influenza viruses disappeared. In terms of influenza subtypes, four subtypes were identified during 2017-2018. In 2018-2019 and 2019-2020, A/H3N2, A/H1N1, and B/Victoria were circulating. Notably, one case of B/Victoria was detected in 2020-2021. The epidemic period of 2021-2022 was attributed to B/Victoria, and during 2022-2023, the influenza A virus was the dominant circulating strain. CONCLUSIONS The seasonal epidemic period and the predominant subtype/lineage of influenza viruses around the SARS-CoV-2 epidemic period in Shanghai city are complex. This underscores the necessity for vigilant influenza control strategies amidst the backdrop of other respiratory virus pandemics.
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Affiliation(s)
- Ge Zhang
- School of Public Health, Dali University, Yunnan, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Anran Zhang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Aiqin Zhu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhongjie Li
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weiping Zhu
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Chuchu Ye
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
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Kwaah B, Gruner WE, DeMarcus LS, Thervil JW, Jenkins WN, Castillo FM, Hartless TR, Heh VK, Muehleman D, Fries AC, Sjoberg PA, Evengue FE, Robbins AS. Surveillance outcomes of respiratory pathogen infections during the 2021-2022 season among U.S. Military Health System beneficiaries, October 3, 2021-October 1, 2022. MSMR 2024; 31:16-23. [PMID: 38857490 PMCID: PMC11208036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
The Department of Defense Global Respiratory Pathogen Surveillance Program conducts continuous surveillance for influenza, severe acute respiratory syndrome 2 (SARS-CoV-2), and other respiratory pathogens at 104 sentinel sites across the globe. These sites submitted 65,475 respiratory specimens for clinical diagnostic testing during the 2021-2022 surveillance season. The predominant influenza strain was influenza A(H3N2) (n=777), of which 99.9% of strains were in clade 3C.2a1b.2a2. A total of 21,466 SARSCoV-2-positive specimens were identified, and 12,225 of the associated viruses were successfully sequenced. The Delta variant predominated at the start of the season, until December 2021, when Omicron became dominant. Most circulating SARS-CoV-2 viruses were subsequently held by Omicron sublineages BA.1, BA.2, and BA.5 during the season. Clinical manifestation, obtained through a self-reported questionnaire, found that cough, sinus congestion, and runny nose complaints were the most common symptoms presenting among all pathogens. Sentinel surveillance can provide useful epidemiological data to supplement other disease monitoring activities, and has become increasingly useful with increasing numbers of individuals utilizing COVID-19 rapid self-test kits and reductions in outpatient visits for routine respiratory testing.
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Affiliation(s)
- Bismark Kwaah
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - William E Gruner
- JYG Innovations, LLC, Dayton, OH
- U.S. Air Force School of Aerospace Medicine Epidemiology Laboratory, Wright-Patterson Air Force Base
| | - Laurie S DeMarcus
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Jeffrey W Thervil
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Whitney N Jenkins
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Fritz M Castillo
- Department of Pathology and Area Laboratory Services, Landstuhl Regional Medical Center, Germany
| | - Tamara R Hartless
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Victor K Heh
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Deanna Muehleman
- JYG Innovations, LLC, Dayton, OH
- U.S. Air Force School of Aerospace Medicine Epidemiology Laboratory, Wright-Patterson Air Force Base
| | - Anthony C Fries
- U.S. Air Force School of Aerospace Medicine Epidemiology Laboratory, Wright-Patterson Air Force Base
| | - Paul A Sjoberg
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
- Innovative Element, LLC, Beavercreek, OH
| | - Fabrice E Evengue
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
| | - Anthony S Robbins
- U.S. Defense Health Agency Armed Forces Health Surveillance Division Air Force Satellite-U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, OH
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8
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Nham E, Noh JY, Park O, Choi WS, Song JY, Cheong HJ, Kim WJ. COVID-19 Vaccination Strategies in the Endemic Period: Lessons from Influenza. Vaccines (Basel) 2024; 12:514. [PMID: 38793765 PMCID: PMC11125835 DOI: 10.3390/vaccines12050514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly contagious zoonotic respiratory disease with many similarities to influenza. Effective vaccines are available for both; however, rapid viral evolution and waning immunity make them virtually impossible to eradicate with vaccines. Thus, the practical goal of vaccination is to reduce the incidence of serious illnesses and death. Three years after the introduction of COVID-19 vaccines, the optimal vaccination strategy in the endemic period remains elusive, and health authorities worldwide have begun to adopt various approaches. Herein, we propose a COVID-19 vaccination strategy based on the data available until early 2024 and discuss aspects that require further clarification for better decision making. Drawing from comparisons between COVID-19 and influenza vaccination strategies, our proposed COVID-19 vaccination strategy prioritizes high-risk groups, emphasizes seasonal administration aligned with influenza vaccination campaigns, and advocates the co-administration with influenza vaccines to increase coverage.
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Affiliation(s)
- Eliel Nham
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Ok Park
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (E.N.); (J.Y.N.); (O.P.); (W.S.C.); (J.Y.S.); (H.J.C.)
- Vaccine Innovation Center, Korea University, Seoul 02841, Republic of Korea
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9
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Lewis NM, Zhu Y, Peltan ID, Gaglani M, McNeal T, Ghamande S, Steingrub JS, Shapiro NI, Duggal A, Bender WS, Taghizadeh L, Brown SM, Hager DN, Gong MN, Mohamed A, Exline MC, Khan A, Wilson JG, Qadir N, Chang SY, Ginde AA, Mohr NM, Mallow C, Lauring AS, Johnson NJ, Gibbs KW, Kwon JH, Columbus C, Gottlieb RL, Raver C, Vaughn IA, Ramesh M, Johnson C, Lamerato L, Safdar B, Casey JD, Rice TW, Halasa N, Chappell JD, Grijalva CG, Talbot HK, Baughman A, Womack KN, Swan SA, Harker E, Price A, DeCuir J, Surie D, Ellington S, Self WH. Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, and Death: United States, 2022-2023. Clin Infect Dis 2024; 78:1056-1064. [PMID: 38051664 DOI: 10.1093/cid/ciad677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain. METHODS To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative control-patients. RESULTS A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%-46%) and varied by age (18-64 years: 47% [30%-60%]; ≥65 years: 28% [10%-43%]), and virus (A[H3N2]: 29% [6%-46%], A[H1N1]: 47% [23%-64%]). VE against more severe influenza-associated outcomes included: 41% (29%-50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%-72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%-81%) against influenza with respiratory failure treated with invasive mechanical ventilation. CONCLUSIONS During an early 2022-2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure.
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Affiliation(s)
- Nathaniel M Lewis
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Temple and Dallas, Texas, and Texas A&M University College of Medicine, Temple, Texas, USA
| | - Tresa McNeal
- Baylor Scott and White Health, and Baylor College of Medicine, Temple, Texas, USA
| | - Shekhar Ghamande
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Leyla Taghizadeh
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Samuel M Brown
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle N Gong
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Amira Mohamed
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Akram Khan
- Department of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Jennifer G Wilson
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Nida Qadir
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Steven Y Chang
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas M Mohr
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicholas J Johnson
- Department of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennie H Kwon
- Department of Medicine, Washington University, St.Louis, Missouri, USA
| | | | - Robert L Gottlieb
- Baylor University Medical Center Dallas, Baylor, Scott & White Heart and Vascular Hospital, Baylor, Scott and White Research Institute, Dallas, Texas, USA
| | | | - Ivana A Vaughn
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Mayur Ramesh
- Division of Infectious Diseases, Henry Ford Health, Detroit, Michigan, USA
| | - Cassandra Johnson
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lois Lamerato
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Basmah Safdar
- Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan D Casey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Todd W Rice
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - H Keipp Talbot
- Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Harker
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Ashley Price
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer DeCuir
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Diya Surie
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Sascha Ellington
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt Institute for Clinical and Translational Research, and Vanderbilt University Medical Center, Nashville, Tennessee, USA
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10
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Borchering RK, Biggerstaff M, Brammer L, Budd A, Garg S, Fry AM, Iuliano AD, Reed C. Responding to the Return of Influenza in the United States by Applying Centers for Disease Control and Prevention Surveillance, Analysis, and Modeling to Inform Understanding of Seasonal Influenza. JMIR Public Health Surveill 2024; 10:e54340. [PMID: 38587882 PMCID: PMC11036179 DOI: 10.2196/54340] [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: 11/06/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 04/09/2024] Open
Abstract
We reviewed the tools that have been developed to characterize and communicate seasonal influenza activity in the United States. Here we focus on systematic surveillance and applied analytics, including seasonal burden and disease severity estimation, short-term forecasting, and longer-term modeling efforts. For each set of activities, we describe the challenges and opportunities that have arisen because of the COVID-19 pandemic. In conclusion, we highlight how collaboration and communication have been and will continue to be key components of reliable and actionable influenza monitoring, forecasting, and modeling activities.
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Affiliation(s)
- Rebecca K Borchering
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Matthew Biggerstaff
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lynnette Brammer
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alicia Budd
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Shikha Garg
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alicia M Fry
- Fulton County Board of Health, Atlanta, GA, United States
| | - A Danielle Iuliano
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Carrie Reed
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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11
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Mao J, Eom GD, Yoon KW, Kim MJ, Chu KB, Kang HJ, Quan FS. Crossprotection induced by virus-like particles containing influenza dual-hemagglutinin and M2 ectodomain. Nanomedicine (Lond) 2024; 19:741-754. [PMID: 38390688 DOI: 10.2217/nnm-2023-0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Aims: To develop an effective universal vaccine against antigenically different influenza viruses. Materials & methods: We generated influenza virus-like particles (VLPs) expressing the H1 and H3 antigens with or without M2e5x. VLP-induced immune responses and crossprotection against H1N1, H3N2 or H5N1 viruses were assessed to evaluate their protective efficacy. Results: H1H3M2e5x immunization elicited higher crossreactive IgG antibodies than H1H3 VLPs. Upon challenge, both VLPs enhanced lung IgG, IgA and germinal center B-cell responses compared with control. While these VLPs conferred protection, H1H3M2e5x showed greater lung viral load reduction than H1H3 VLPs with minimal body weight loss. Conclusion: Utilizing VLPs containing dual-hemagglutinin, along with M2e5x, can be a vaccination strategy for inducing crossprotection against influenza A viruses.
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Affiliation(s)
- Jie Mao
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Gi-Deok Eom
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Keon-Woong Yoon
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Min-Ju Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Ki-Back Chu
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, Core Research Institute (CRI), Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Hae-Ji Kang
- Center for Translational Antiviral Research, Georgia State University Institute for Biomedical Sciences, Atlanta, GA 30303, USA
| | - Fu-Shi Quan
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, Core Research Institute (CRI), Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Medical Zoology, School of Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
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12
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Barouch SE, Chicz TM, Blanc R, Barbati DR, Parker LJ, Tong X, Li W, McNamara RP. Concurrent Administration of COVID-19 and Influenza Vaccines Enhances Spike-Specific Antibody Responses. Open Forum Infect Dis 2024; 11:ofae144. [PMID: 38567194 PMCID: PMC10986856 DOI: 10.1093/ofid/ofae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background The bivalent COVID-19 mRNA boosters became available in fall 2022 and were recommended alongside the seasonal influenza vaccine. However, the immunogenicity of concurrent vs separate administration of these vaccines remains unclear. Methods Here, we analyzed antibody responses in health care workers who received the bivalent COVID-19 booster and the influenza vaccine on the same day or on different days through systems serology. Antibody-binding and functional responses were characterized at peak responses and after 6 months following vaccination. Results IgG1 and neutralization responses to SARS-CoV-2 XBB.1.5 were higher at peak and after 6 months following concurrent administration as compared with separate administration of the COVID-19 and influenza vaccines. While similar results were not observed for influenza responses, no interference was noted with concurrent administration. Conclusions These data suggest that concurrent administration of these vaccines may yield higher and more durable SARS-CoV-2 neutralizing antibody responses while maintaining responses against influenza.
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Affiliation(s)
- Susanna E Barouch
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Taras M Chicz
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Ross Blanc
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Domenic R Barbati
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Lily J Parker
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Xin Tong
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Wenjun Li
- Department of Public Health, Center for Health Statistics and Biostatistics, University of Massachusetts at Lowell. Lowell, Massachusetts, USA
| | - Ryan P McNamara
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
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13
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Wang Y, Fekadu G, You JH. Web-based intervention for improving influenza vaccination in pregnant women: a cost-effectiveness analysis. Pathog Glob Health 2024; 118:99-108. [PMID: 37846153 PMCID: PMC11141307 DOI: 10.1080/20477724.2023.2272109] [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] [Indexed: 10/18/2023] Open
Abstract
A website with vaccine information and interactive social media was reported to improve maternal influenza vaccine uptake. This study aimed to evaluate cost-effectiveness of a web-based intervention on influenza vaccine uptake among pregnant women from the perspective of US healthcare providers. A one-year decision-analytic model estimated outcomes in a hypothetical cohort of pregnant women with: (1) website with vaccine information and interactive social media (intervention group), and (2) usual care (usual care group). Primary measures included influenza infection, influenza-related hospitalization, mortality, direct medical cost, and quality-adjusted life-year (QALY) loss. In base-case analysis, intervention group reduced cost (by USD28), infection (by 28 per 1,000 pregnant women), hospitalization (by 1.226 per 1,000 pregnant women), mortality (by 0.0036 per 1,000 pregnant women), and saved 0.000305 QALYs versus usual care group. Relative improvement of vaccine uptake by the intervention and number of pregnant women in the healthcare system were two influential factors identified in deterministic sensitivity analysis. The intervention was cost-effective in 99.5% of 10,000 Monte Carlo simulations (at willingness-to-pay threshold 50,000 USD/QALY). A website with vaccine information and interactive social media to promote influenza vaccination for pregnant women appears to reduce direct medical costs and gain QALYs from the perspective of US healthcare providers.
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Affiliation(s)
- Yingcheng Wang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ginenus Fekadu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joyce H.S. You
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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14
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Kohlbrand A, Stokes RW, Sankaran B, Cohen SM. Structural Studies of Inhibitors with Clinically Relevant Influenza Endonuclease Variants. Biochemistry 2024; 63:264-272. [PMID: 38190441 PMCID: PMC10851415 DOI: 10.1021/acs.biochem.3c00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
Vital to the treatment of influenza is the use of antivirals such as Oseltamivir (Tamiflu) and Zanamivir (Relenza); however, antiviral resistance is becoming an increasing problem for these therapeutics. The RNA-dependent RNA polymerase acidic N-terminal (PAN) endonuclease, a critical component of influenza viral replication machinery, is an antiviral target that was recently validated with the approval of Baloxavir Marboxil (BXM). Despite its clinical success, BXM has demonstrated susceptibility to resistance mutations, specifically the I38T, E23K, and A36 V mutants of PAN. To better understand the effects of these mutations on BXM resistance and improve the design of more robust therapeutics, this study examines key differences in protein-inhibitor interactions with two inhibitors and the I38T, E23K, and A36 V mutants. Differences in inhibitor binding were evaluated by measuring changes in binding to PAN using two biophysical methods. The binding mode of two distinct inhibitors was determined crystallographically with both wild-type and mutant forms of PAN. Collectively, these studies give some insight into the mechanism of antiviral resistance of these mutants.
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Affiliation(s)
- Alysia
J. Kohlbrand
- Department
of Chemistry and Biochemistry, University
of California, La Jolla, California 92093, United States
| | - Ryjul W. Stokes
- Department
of Chemistry and Biochemistry, University
of California, La Jolla, California 92093, United States
| | - Banumathi Sankaran
- The
Berkeley Center for Structural Biology, Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Seth M. Cohen
- Department
of Chemistry and Biochemistry, University
of California, La Jolla, California 92093, United States
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15
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Uno N, Ross TM. Multivalent next generation influenza virus vaccines protect against seasonal and pre-pandemic viruses. Sci Rep 2024; 14:1440. [PMID: 38228649 PMCID: PMC10792005 DOI: 10.1038/s41598-023-51024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024] Open
Abstract
Each year, new influenza virus vaccine formulations are generated to keep up with continuously circulating and mutating viral variants. A next-generation influenza virus vaccine would provide long-lasting, broadly-reactive immune protection against current and future influenza virus strains for both seasonal and pre-pandemic viruses. Next generation immunogens were designed using computationally optimized broadly reactive antigen (COBRA) methodology to protect against a broad range of strains over numerous seasons. Novel HA and NA amino acid sequences were derived from multilayered consensus sequence alignment for multiple subtypes of influenza. This multivalent formulation was hypothesized to elicit broadly protective immune responses against both seasonal and pre-pandemic influenza viruses. Mice were vaccinated with multivalent mixtures of HA and NA (H1, H2, H3, H5, H7, N1, N2) proteins. Multivalent COBRA vaccinations elicited antibodies that recognized a broad panel of strains and vaccinated mice were protected against viruses representing multiple subtypes. This is a promising candidate for a universal influenza vaccine that elicits protective immune responses against seasonal and pre-pandemic strains over multiple seasons.
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Affiliation(s)
- Naoko Uno
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ted M Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA.
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
- Florida Research and Innovation Center, Cleveland Clinic Florida, 9801 SW Discovery Way, Port Saint Lucie, FL, 34986, USA.
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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16
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Zhang Y, Huang X, Zhang J, Tao Z. Risk factors for hospitalization and pneumonia development of pediatric patients with seasonal influenza during February-April 2023. Front Public Health 2024; 11:1300228. [PMID: 38249383 PMCID: PMC10797015 DOI: 10.3389/fpubh.2023.1300228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives In China influenza remains a low activity for continuous 3 years due to COVID-19 controls. We here sought to study the clinical characteristics and risk factors of the influenza infection among children after the mandatory COVID-19 restrictions were lifted. Methods We included 1,006 pediatric patients with influenza A virus (IAV) infection, enrolled in one tertiary hospital in Zhenjiang, Jiangsu Province, China, during February to April 2023. Patients were divided into the outpatient (n = 798) and inpatient (n = 208) groups, and their baseline characteristics were compared between two groups to conclude the risk factors for pediatric hospitalization. Separately, pediatric inpatients (n = 208) were further divided into the pneumonia and non-pneumonia groups with comparison of their clinical characteristics, including their laboratory test results and representative radiological features, to derive the key determinants for pneumonia development after hospitalization. Results Compared to outpatients, IAV-infected pediatric inpatients exhibited younger age, higher female: male ratio, more co-infection of influenza B virus (IBV) and hematological abnormality. Multivariate regression analysis determined the independent risk factors of hospitalization to be the clinical symptom of abdominal pain (OR = 2.63, [95% CI, 1.05-6.57], p = 0.039), co-infection of IBV (OR = 44.33, [95% CI, 25.10-78.30], p = 0.001), elevated levels of lymphocytes (OR = 2.24, [95% CI,1.65-3.05], p = 0.001) and c-reactive proteins (CRPs) (OR = 1.06, [95% CI, 1.03-1.08], p = 0.001) upon hospital admission. Furthermore, the cough symptom (OR = 17.39, [95% CI, 3.51-86.13], p = 0.001) and hospitalization length (OR = 1.36, [95% CI, 1.12-1.67], p = 0.002) were determined to be risk factors of pneumonia acquirement for pediatric inpatients. Conclusion While the abdominal pain, viral co-infection and some hematological abnormality mainly contribute to hospitalization of pediatric patients with IAV infection, the length of hospital stay and clinical sign of coughing upon hospital admission constitute the key determinants for nosocomial pneumonia development.
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Affiliation(s)
- Yuqian Zhang
- Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Xing Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jianguo Zhang
- Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Zhimin Tao
- Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China
- Jiangsu Province Key Laboratory of Medical Science and Laboratory Medicine, Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
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17
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Shu B, Wilson MM, Keller MW, Tran H, Sokol T, Lee G, Rambo‐Martin BL, Kirby MK, Hassell N, Haydel D, Hand J, Wentworth DE, Barnes JR. In-field detection and characterization of B/Victoria lineage deletion variant viruses causing early influenza activity and an outbreak in Louisiana, 2019. Influenza Other Respir Viruses 2024; 18:e13246. [PMID: 38188372 PMCID: PMC10767671 DOI: 10.1111/irv.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 01/09/2024] Open
Abstract
Background In 2019, the Louisiana Department of Health reported an early influenza B/Victoria (B/VIC) virus outbreak. Method As it was an atypically large outbreak, we deployed to Louisiana to investigate it using genomics and a triplex real-time RT-PCR assay to detect three antigenically distinct B/VIC lineage variant viruses. Results The investigation indicated that B/VIC V1A.3 subclade, containing a three amino acid deletion in the hemagglutinin and known to be antigenically distinct to the B/Colorado/06/2017 vaccine virus, was the most prevalent circulating virus within the specimens evaluated (86/88 in real-time RT-PCR). Conclusion This work underscores the value of portable platforms for rapid, onsite pathogen characterization.
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Affiliation(s)
- Bo Shu
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Malania M. Wilson
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Matthew W. Keller
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Ha Tran
- Louisiana Department of HealthOffice of Public Health LaboratoryBaton RougeLouisianaUSA
| | - Theresa Sokol
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - Grace Lee
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - Benjamin L. Rambo‐Martin
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Marie K. Kirby
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Norman Hassell
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Danielle Haydel
- Louisiana Department of HealthOffice of Public Health LaboratoryBaton RougeLouisianaUSA
| | - Julie Hand
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - David E. Wentworth
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - John R. Barnes
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
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18
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Lee Y, Jang TS, Kim JK. Effects of Coronavirus Disease 2019 on Prevalence of Acute Respiratory Viruses: Changes during the Pandemic. J Glob Infect Dis 2024; 16:27-32. [PMID: 38680753 PMCID: PMC11045149 DOI: 10.4103/jgid.jgid_155_23] [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: 09/10/2023] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic may have influenced the prevalence and seasonality of acute respiratory viral infections. The aim of the study was to investigate the prevalence of all viruses causing acute viral respiratory infections before and after social distancing measures were lifted. Methods Cross-sectional study where outpatients and inpatients at Kyunghee University Hospital were examined. From January 2021 to December 2022, respiratory samples were analyzed using multiplex reverse transcriptase real-time polymerase chain reaction. Results Of 3953 samples obtained, 412 (10.42%) were positive for acute respiratory viral infection, and 502 viruses were detected. The number of viral infections increased from 184 in 2021 to 318 in 2022. Human metapneumovirus was detected from August to November 2022. Human bocavirus (HBoV) was frequently detected from April to June 2021; however, in 2022, HBoV was frequently detected from July to October. Human parainfluenza virus 3 was rarely detected after its initial frequent detection from October to December 2021 but was continuously observed after frequent detection in September 2022. Co-infection occurred in 78 (18.9%) cases. The most common combination of simultaneous infections was human rhinovirus-HBoV (n = 30, 38.5%). Conclusions During the COVID-19 pandemic, the incidence of acute respiratory viral infection decreased significantly but increased in 2022 when measures were lifted. The prevalence and seasonality of respiratory viral infections have changed since the pandemic. Our findings contribute to the prediction of an effective response to changes in the prevalence of respiratory viruses.
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Affiliation(s)
- Yonghee Lee
- Department of Biomedical Laboratory Science, Dankook University College of Health and Welfare, Cheonan-si, Chungnam, Republic of Korea
| | - Tae Su Jang
- Department of Health Administration, Dankook University College of Health and Welfare, Cheonan-si, Chungnam, Republic of Korea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, Dankook University College of Health and Welfare, Cheonan-si, Chungnam, Republic of Korea
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19
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Mathis SM, Webber AE, León TM, Murray EL, Sun M, White LA, Brooks LC, Green A, Hu AJ, McDonald DJ, Rosenfeld R, Shemetov D, Tibshirani RJ, Kandula S, Pei S, Shaman J, Yaari R, Yamana TK, Agarwal P, Balusu S, Gururajan G, Kamarthi H, Prakash BA, Raman R, Rodríguez A, Zhao Z, Meiyappan A, Omar S, Baccam P, Gurung HL, Stage SA, Suchoski BT, Ajelli M, Kummer AG, Litvinova M, Ventura PC, Wadsworth S, Niemi J, Carcelen E, Hill AL, Jung SM, Lemaitre JC, Lessler J, Loo SL, McKee CD, Sato K, Smith C, Truelove S, McAndrew T, Ye W, Bosse N, Hlavacek WS, Lin YT, Mallela A, Chen Y, Lamm SM, Lee J, Posner RG, Perofsky AC, Viboud C, Clemente L, Lu F, Meyer AG, Santillana M, Chinazzi M, Davis JT, Mu K, Piontti APY, Vespignani A, Xiong X, Ben-Nun M, Riley P, Turtle J, Hulme-Lowe C, Jessa S, Nagraj VP, Turner SD, Williams D, Basu A, Drake JM, Fox SJ, Gibson GC, Suez E, Thommes EW, Cojocaru MG, Cramer EY, Gerding A, Stark A, Ray EL, Reich NG, Shandross L, Wattanachit N, Wang Y, Zorn MW, Al Aawar M, Srivastava A, Meyers LA, Adiga A, Hurt B, Kaur G, Lewis BL, Marathe M, Venkatramanan S, Butler P, Farabow A, Muralidhar N, Ramakrishnan N, Reed C, Biggerstaff M, Borchering RK. Evaluation of FluSight influenza forecasting in the 2021-22 and 2022-23 seasons with a new target laboratory-confirmed influenza hospitalizations. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.08.23299726. [PMID: 38168429 PMCID: PMC10760285 DOI: 10.1101/2023.12.08.23299726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. Forecasting teams were asked to provide national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one through four weeks ahead for the 2021-22 and 2022-23 influenza seasons. Across both seasons, 26 teams submitted forecasts, with the submitting teams varying between seasons. Forecast skill was evaluated using the Weighted Interval Score (WIS), relative WIS, and coverage. Six out of 23 models outperformed the baseline model across forecast weeks and locations in 2021-22 and 12 out of 18 models in 2022-23. Averaging across all forecast targets, the FluSight ensemble was the 2nd most accurate model measured by WIS in 2021-22 and the 5th most accurate in the 2022-23 season. Forecast skill and 95% coverage for the FluSight ensemble and most component models degraded over longer forecast horizons and during periods of rapid change. Current influenza forecasting efforts help inform situational awareness, but research is needed to address limitations, including decreased performance during periods of changing epidemic dynamics.
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Affiliation(s)
- Sarabeth M Mathis
- Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, USA
| | - Alexander E Webber
- Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, USA
| | - Tomás M León
- California Department of Public Health, Richmond, CA, 95899
| | - Erin L Murray
- California Department of Public Health, Richmond, CA, 95899
| | - Monica Sun
- California Department of Public Health, Richmond, CA, 95899
| | - Lauren A White
- California Department of Public Health, Richmond, CA, 95899
| | - Logan C Brooks
- Carnegie Mellon University, Pittsburgh, PA, 15213
- University of California, Berkeley, Berkeley, CA 94720
| | - Alden Green
- Carnegie Mellon University, Pittsburgh, PA, 15213
| | - Addison J Hu
- Carnegie Mellon University, Pittsburgh, PA, 15213
| | | | | | | | - Ryan J Tibshirani
- Carnegie Mellon University, Pittsburgh, PA, 15213
- University of California, Berkeley, Berkeley, CA 94720
| | | | - Sen Pei
- Columbia University, New York, NY, 10032
| | - Jeffrey Shaman
- Columbia University, New York, NY, 10032
- Columbia University School of Climate, New York, NY 10025
| | - Rami Yaari
- Columbia University, New York, NY, 10032
| | | | | | | | | | | | | | - Rishi Raman
- Georgia Institute of Technology, Atlanta, GA, 30318
| | | | - Zhiyuan Zhao
- Georgia Institute of Technology, Atlanta, GA, 30318
| | | | - Shalina Omar
- Guidehouse Advisory and Consulting Services, McClean VA, 22102
| | | | | | | | | | - Marco Ajelli
- Indiana University School of Public Health, Bloomington, IN, 47405
| | | | - Maria Litvinova
- Indiana University School of Public Health, Bloomington, IN, 47405
| | - Paulo C Ventura
- Indiana University School of Public Health, Bloomington, IN, 47405
| | | | | | | | | | - Sung-Mok Jung
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Justin Lessler
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sara L Loo
- Johns Hopkins University, Baltimore, MD, 21205
| | | | - Koji Sato
- Johns Hopkins University, Baltimore, MD, 21205
| | | | | | | | | | - Nikos Bosse
- London School of Health and Tropical Medicine, London, UK, WC1E 7HT
| | | | - Yen Ting Lin
- Los Alamos National Laboratory, Los Alamos, NM, 87545
| | | | - Ye Chen
- Northern Arizona University, Flagstaff, AZ, 86011
| | | | - Jaechoul Lee
- Northern Arizona University, Flagstaff, AZ, 86011
| | | | - Amanda C Perofsky
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892
| | | | - Fred Lu
- Northeastern University, Boston, MA, 02115
| | | | | | | | | | - Kunpeng Mu
- Northeastern University, Boston, MA, 02115
| | | | | | | | | | - Pete Riley
- Predictive Science Inc, San Diego, CA 92121
| | | | | | | | - V P Nagraj
- Signature Science, LLC, Charlottesville, VA, 22911
| | | | | | | | | | | | | | - Ehsan Suez
- University of Georgia, Athens, GA, 30609
| | - Edward W Thommes
- University of Guelph, Guelph, ON N1G 2W1, Canada
- Sanofi, Toronto, ON, M2R 3T4
| | | | | | - Aaron Gerding
- University of Massachusetts Amherst, Amherst, MA, 01003
| | - Ariane Stark
- University of Massachusetts Amherst, Amherst, MA, 01003
| | - Evan L Ray
- University of Massachusetts Amherst, Amherst, MA, 01003
| | | | - Li Shandross
- University of Massachusetts Amherst, Amherst, MA, 01003
| | | | - Yijin Wang
- University of Massachusetts Amherst, Amherst, MA, 01003
| | - Martha W Zorn
- University of Massachusetts Amherst, Amherst, MA, 01003
| | - Majd Al Aawar
- University of Southern California, Los Angeles, CA, 90089
| | | | | | | | | | | | | | | | | | | | | | | | | | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, USA
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20
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Jeong S, Son SU, Kim J, Cho SI, Kang T, Kim S, Lim EK, Ko Park SH. Rapid and simultaneous multiple detection of a tripledemic using a dual-gate oxide semiconductor thin-film transistor-based immunosensor. Biosens Bioelectron 2023; 241:115700. [PMID: 37757509 DOI: 10.1016/j.bios.2023.115700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/22/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
The simultaneous infection with a tripledemic-simultaneous infection with influenza A pH1N1 virus (Flu), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV)-necessitates the development of accurate and fast multiplex diagnostic tests. The coronavirus disease 2019 (COVID-19) pandemic has emphasized the importance of virus detection. Field-effect transistor (FET)-based immuno-biosensors have a short detection time and do not require labeling or polymerase chain reaction. This study demonstrates the rapid, sensitive detection of influenza A pH1N1, SARS-CoV-2, and RSV using a multiplex immunosensor based on a dual-gate oxide semiconductor thin-film transistor (TFT), a type of FET. The dual-gate oxide TFT was modified by adjusting both top and bottom gate insulators to improve capacitive coupling to approximately 120-fold amplification, exhibiting a high pH sensitivity of about 10 V/pH. The dual-gate oxide TFT-based immunosensor detected the target proteins (hemagglutinin (HA) protein of Flu, spike 1 (S1) protein of SARS-CoV-2, and fusion protein of RSV) of each virus, with a limit of detection of approximately 1 fg/mL. Cultured viruses in phosphate-buffered saline or artificial saliva and clinical nasopharynx samples were detected in 1-μL sample volumes within 60 s. This promising diagnosis could be potentially as point-of-care tests to facilitate a prompt response to future pandemics with high sensitivity and multiplexed detection without pretreatment.
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Affiliation(s)
- Sehun Jeong
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Seong Uk Son
- BioNanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; Department of Nanobiotechnology, Korea Research Institute of Bioscience and Biotechnology, School of Biotechnology, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea
| | - Jingyu Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Seong-In Cho
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Taejoon Kang
- BioNanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon, 51472, Republic of Korea; Gyeongnam Center for Infectious Disease Control and Prevention, Changwon, 51154, Republic of Korea; Gyeongsang National University College of Medicine, Gyeongsang Institute of Health Sciences, Jinju, 52727, Republic of Korea
| | - Eun-Kyung Lim
- BioNanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; Department of Nanobiotechnology, Korea Research Institute of Bioscience and Biotechnology, School of Biotechnology, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea; School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Sang-Hee Ko Park
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea.
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21
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Fall A, Han L, Yunker M, Gong YN, Li TJ, Norton JM, Abdullah O, Rothman RE, Fenstermacher KZJ, Morris CP, Pekosz A, Klein E, Mostafa HH. Evolution of Influenza A(H3N2) Viruses in 2 Consecutive Seasons of Genomic Surveillance, 2021-2023. Open Forum Infect Dis 2023; 10:ofad577. [PMID: 38088981 PMCID: PMC10715682 DOI: 10.1093/ofid/ofad577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023] Open
Abstract
Background The circulation and the genomic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons were studied and associated with infection outcomes. Methods Remnant influenza A-positive samples following standard-of-care testing from patients across the Johns Hopkins Health System (JHHS) were used for the study. Samples were randomly selected for whole viral genome sequencing. The sequence-based pEpitope model was used to estimate the predicted vaccine efficacy (pVE) for circulating H3N2 viruses. Clinical data were collected and associated with viral genomic data. Results A total of 121 683 respiratory specimens were tested for influenza at JHHS between 1 September 2021 and 31 December 2022. Among them, 6071 (4.99%) tested positive for influenza A. Of these, 805 samples were randomly selected for sequencing, with hemagglutinin (HA) segments characterized for 610 samples. Among the characterized samples, 581 were H3N2 (95.2%). Phylogenetic analysis of HA segments revealed the exclusive circulation of H3N2 viruses with HA segments of the 3C.2a1b.2a.2 clade. Analysis of a total of 445 complete H3N2 genomes revealed reassortments; 200 of 227 of the 2022/2023 season genomes (88.1%) were found to have reassorted with clade 3C.2a1b.1a. The pVE was estimated to be -42.53% for the 2021/2022 season and 30.27% for the 2022/2023 season. No differences in clinical presentations or admissions were observed between the 2 seasons. Conclusions The increased numbers of cases and genomic diversity of influenza A(H3N2) during the 2022/2023 season were not associated with a change in disease severity compared to the previous influenza season.
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Affiliation(s)
- Amary Fall
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lijie Han
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Madeline Yunker
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Tai-Jung Li
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Julie M Norton
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Omar Abdullah
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - C Paul Morris
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, Maryland, USA
| | - Andrew Pekosz
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- W.Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics, and Policy, Washington, District of Columbia, USA
| | - Heba H Mostafa
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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22
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Lei R, Kim W, Lv H, Mou Z, Scherm MJ, Schmitz AJ, Turner JS, Tan TJC, Wang Y, Ouyang WO, Liang W, Rivera-Cardona J, Teo C, Graham CS, Brooke CB, Presti RM, Mok CKP, Krammer F, Dai X, Ellebedy AH, Wu NC. Leveraging vaccination-induced protective antibodies to define conserved epitopes on influenza N2 neuraminidase. Immunity 2023; 56:2621-2634.e6. [PMID: 37967533 PMCID: PMC10655865 DOI: 10.1016/j.immuni.2023.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 07/19/2023] [Accepted: 10/10/2023] [Indexed: 11/17/2023]
Abstract
There is growing appreciation for neuraminidase (NA) as an influenza vaccine target; however, its antigenicity remains poorly characterized. In this study, we isolated three broadly reactive N2 antibodies from the plasmablasts of a single vaccinee, including one that cross-reacts with NAs from seasonal H3N2 strains spanning five decades. Although these three antibodies have diverse germline usages, they recognize similar epitopes that are distant from the NA active site and instead involve the highly conserved underside of NA head domain. We also showed that all three antibodies confer prophylactic and therapeutic protection in vivo, due to both Fc effector functions and NA inhibition through steric hindrance. Additionally, the contribution of Fc effector functions to protection in vivo inversely correlates with viral growth inhibition activity in vitro. Overall, our findings advance the understanding of NA antibody response and provide important insights into the development of a broadly protective influenza vaccine.
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Affiliation(s)
- Ruipeng Lei
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Wooseob Kim
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA; Department of Microbiology, Korea University College of Medicine, Seoul 02841, Korea
| | - Huibin Lv
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Zongjun Mou
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Michael J Scherm
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Aaron J Schmitz
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Jackson S Turner
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Timothy J C Tan
- Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Yiquan Wang
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Wenhao O Ouyang
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Weiwen Liang
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Joel Rivera-Cardona
- Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Chuyun Teo
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Claire S Graham
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Christopher B Brooke
- Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Rachel M Presti
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA; Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO 63110, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Chris K P Mok
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; S.H. Ho Research Centre for Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Center for Vaccine Research and Pandemic Preparedness (C-VARPP), Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Xinghong Dai
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Ali H Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA; Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO 63110, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Nicholas C Wu
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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23
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Kikuchi C, Antonopoulos A, Wang S, Maemura T, Karamanska R, Lee C, Thompson AJ, Dell A, Kawaoka Y, Haslam SM, Paulson JC. Glyco-engineered MDCK cells display preferred receptors of H3N2 influenza absent in eggs used for vaccines. Nat Commun 2023; 14:6178. [PMID: 37794004 PMCID: PMC10551000 DOI: 10.1038/s41467-023-41908-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023] Open
Abstract
Evolution of human H3N2 influenza viruses driven by immune selection has narrowed the receptor specificity of the hemagglutinin (HA) to a restricted subset of human-type (Neu5Acα2-6 Gal) glycan receptors that have extended poly-LacNAc (Galβ1-4GlcNAc) repeats. This altered specificity has presented challenges for hemagglutination assays, growth in laboratory hosts, and vaccine production in eggs. To assess the impact of extended glycan receptors on virus binding, infection, and growth, we have engineered N-glycan extended (NExt) cell lines by overexpressing β3-Ν-acetylglucosaminyltransferase 2 in MDCK, SIAT, and hCK cell lines. Of these, SIAT-NExt cells exhibit markedly increased binding of H3 HAs and susceptibility to infection by recent H3N2 virus strains, but without impacting final virus titers. Glycome analysis of these cell lines and allantoic and amniotic egg membranes provide insights into the importance of extended glycan receptors for growth of recent H3N2 viruses and relevance to their production for cell- and egg-based vaccines.
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Affiliation(s)
- Chika Kikuchi
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Shengyang Wang
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Tadashi Maemura
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Rositsa Karamanska
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Chiara Lee
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Andrew J Thompson
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Anne Dell
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Yoshihiro Kawaoka
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- The Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
- Pandemic Preparedness, Infection and Advanced Research Center, The University of Tokyo, Tokyo, Japan
| | - Stuart M Haslam
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK.
| | - James C Paulson
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA.
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA.
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24
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Mahmud AS, Martinez PP, Baker RE. The impact of current and future climates on spatiotemporal dynamics of influenza in a tropical setting. PNAS NEXUS 2023; 2:pgad307. [PMID: 38741656 PMCID: PMC11089418 DOI: 10.1093/pnasnexus/pgad307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 05/16/2024]
Abstract
Although the drivers of influenza have been well studied in high-income settings in temperate regions, many open questions remain about the burden, seasonality, and drivers of influenza dynamics in the tropics. In temperate climates, the inverse relationship between specific humidity and transmission can explain much of the observed temporal and spatial patterns of influenza outbreaks. Yet, this relationship fails to explain seasonality, or lack there-of, in tropical and subtropical countries. Here, we analyzed eight years of influenza surveillance data from 12 locations in Bangladesh to quantify the role of climate in driving disease dynamics in a tropical setting with a distinct rainy season. We find strong evidence for a nonlinear bimodal relationship between specific humidity and influenza transmission in Bangladesh, with highest transmission occurring for relatively low and high specific humidity values. We simulated influenza burden under current and future climate in Bangladesh using a mathematical model with a bimodal relationship between humidity and transmission, and decreased transmission at very high temperatures, while accounting for changes in population immunity. The climate-driven mechanistic model can accurately capture both the temporal and spatial variation in influenza activity observed across Bangladesh, highlighting the usefulness of mechanistic models for low-income countries with inadequate surveillance. By using climate model projections, we also highlight the potential impact of climate change on influenza dynamics in the tropics and the public health consequences.
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Affiliation(s)
- Ayesha S Mahmud
- Department of Demography, University of California, Berkeley, Berkeley, CA, USA
| | - Pamela P Martinez
- Department of Microbiology, University of Illinois Urbana-Champaign, Champaign, IL, USA
- Department of Statistics, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Rachel E Baker
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
- Institute at Brown for Environment and Society, Brown University, Providence, RI, USA
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Numata M, Kandasamy P, Voelker DR. The anti-inflammatory and antiviral properties of anionic pulmonary surfactant phospholipids. Immunol Rev 2023; 317:166-186. [PMID: 37144896 PMCID: PMC10524216 DOI: 10.1111/imr.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
The pulmonary surfactant system of the lung is a lipid and protein complex, which regulates the biophysical properties of the alveoli to prevent lung collapse and the innate immune system in the lung. Pulmonary surfactant is a lipoprotein complex consisting of 90% phospholipids and 10% protein, by weight. Two minor components of pulmonary surfactant phospholipids, phosphatidylglycerol (PG) and phosphatidylinositol (PI), exist at very high concentrations in the extracellular alveolar compartments. We have reported that one of the most dominant molecular species of PG, palmitoyl-oleoyl-phosphatidylglycerol (POPG) and PI inhibit inflammatory responses induced by multiple toll-like receptors (TLR2/1, TLR3, TLR4, and TLR2/6) by interacting with subsets of multiprotein receptor components. These lipids also exert potent antiviral effects against RSV and influenza A, in vitro, by inhibiting virus binding to host cells. POPG and PI inhibit these viral infections in vivo, in multiple animal models. Especially noteworthy, these lipids markedly attenuate SARS-CoV-2 infection including its variants. These lipids are natural compounds that already exist in the lung and, thus, are less likely to cause adverse immune responses by hosts. Collectively, these data demonstrate that POPG and PI have strong potential as novel therapeutics for applications as anti-inflammatory compounds and preventatives, as treatments for broad ranges of RNA respiratory viruses.
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Affiliation(s)
- Mari Numata
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
| | - Pitchaimani Kandasamy
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
| | - Dennis R. Voelker
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
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26
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Tenforde MW, Weber ZA, DeSilva MB, Stenehjem E, Yang DH, Fireman B, Gaglani M, Kojima N, Irving SA, Rao S, Grannis SJ, Naleway AL, Kirshner L, Kharbanda AB, Dascomb K, Lewis N, Dalton AF, Ball SW, Natarajan K, Ong TC, Hartmann E, Embi PJ, McEvoy CE, Grisel N, Zerbo O, Dunne MM, Arndorfer J, Goddard K, Dickerson M, Patel P, Timbol J, Griggs EP, Hansen J, Thompson MG, Flannery B, Klein NP. Vaccine Effectiveness Against Influenza-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2021-2022 Season, VISION Network. J Infect Dis 2023; 228:185-195. [PMID: 36683410 PMCID: PMC11306092 DOI: 10.1093/infdis/jiad015] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Following historically low influenza activity during the 2020-2021 season, the United States saw an increase in influenza circulating during the 2021-2022 season. Most viruses belonged to the influenza A(H3N2) 3C.2a1b 2a.2 subclade. METHODS We conducted a test-negative case-control analysis among adults ≥18 years of age at 3 sites within the VISION Network. Encounters included emergency department/urgent care (ED/UC) visits or hospitalizations with ≥1 acute respiratory illness (ARI) discharge diagnosis codes and molecular testing for influenza. Vaccine effectiveness (VE) was calculated by comparing the odds of influenza vaccination ≥14 days before the encounter date between influenza-positive cases (type A) and influenza-negative and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls, applying inverse probability-to-be-vaccinated weights, and adjusting for confounders. RESULTS In total, 86 732 ED/UC ARI-associated encounters (7696 [9%] cases) and 16 805 hospitalized ARI-associated encounters (649 [4%] cases) were included. VE against influenza-associated ED/UC encounters was 25% (95% confidence interval (CI), 20%-29%) and 25% (95% CI, 11%-37%) against influenza-associated hospitalizations. VE against ED/UC encounters was lower in adults ≥65 years of age (7%; 95% CI, -5% to 17%) or with immunocompromising conditions (4%; 95% CI, -45% to 36%). CONCLUSIONS During an influenza A(H3N2)-predominant influenza season, modest VE was observed. These findings highlight the need for improved vaccines, particularly for A(H3N2) viruses that are historically associated with lower VE.
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Affiliation(s)
- Mark W. Tenforde
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Edward Stenehjem
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | | | - Bruce Fireman
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Manjusha Gaglani
- Department of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott and White Health, Temple, Texas, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Noah Kojima
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Suchitra Rao
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shaun J. Grannis
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | | | | | | | - Kristin Dascomb
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Ned Lewis
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Alexandra F. Dalton
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Toan C. Ong
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Emily Hartmann
- Paso del Norte Health Information Exchange, El Paso, Texas, USA
| | - Peter J. Embi
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Nancy Grisel
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Ousseny Zerbo
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | | | - Julie Arndorfer
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Kristin Goddard
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Monica Dickerson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Palak Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julius Timbol
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Eric P. Griggs
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John Hansen
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Mark G. Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicola P. Klein
- Kaiser Permanente Northern California Division of Research, Kaiser Permanente Vaccine Study Center, Oakland, California, USA
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Khalil AM, Piepenbrink MS, Markham I, Basu M, Martinez-Sobrido L, Kobie JJ. Fc-Effector-Independent in vivo Activity of a Potent Influenza B Neuraminidase Broadly Neutralizing Antibody. Viruses 2023; 15:1540. [PMID: 37515226 PMCID: PMC10383564 DOI: 10.3390/v15071540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Influenza B virus (IBV) contributes to substantial influenza-mediated morbidity and mortality, particularly among children. Similar to influenza A viruses (IAV), the hemagglutinin (HA) and neuraminidase (NA) of IBV undergo antigenic drift, necessitating regular reformulation of seasonal influenza vaccines. NA inhibitors, such as oseltamivir, have reduced activity and clinical efficacy against IBV, while M2 channel inhibitors are only effective against IAV, highlighting the need for improved vaccine and therapeutics for the treatment of seasonal IBV infections. We have previously described a potent human monoclonal antibody (hMAb), 1092D4, that is specific for IBV NA and neutralizes a broad range of IBVs. The anti-viral activity of MAbs can include direct mechanisms such as through neutralization and/or Fc-mediated effector functions that are dependent on accessory cells expressing Fc receptors and that could be impacted by potential host-dependent variability. To discern if the in vivo efficacy of 1092D4 was dependent on Fc-effector function, 1092D4 hMAb with reduced ability to bind to Fc receptors (1092D4-LALAPG) was generated and tested. 1092D4-LALAPG had comparable in vitro binding, neutralization, and inhibition of NA activity to 1092D4. 1092D4-LALAPG was effective at protecting against a lethal challenge of IBV in mice. These results suggest that hMAb 1092D4 in vivo activity is minimally dependent on Fc-effector functions, a characteristic that may extend to other hMAbs that have potent NA inhibition activity.
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Affiliation(s)
- Ahmed M Khalil
- Texas Biomedical Research Institute, San Antonio, TX 78245, USA
- Department of Zoonotic Diseases, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
| | - Michael S Piepenbrink
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ian Markham
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Madhubanti Basu
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | - James J Kobie
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Abd Alhadi M, Friedman LM, Karlsson EA, Cohen-Lavi L, Burkovitz A, Schultz-Cherry S, Noah TL, Weir SS, Shulman LM, Beck MA, Hertz T. Obesity Is Associated with an Impaired Baseline Repertoire of Anti-Influenza Virus Antibodies. Microbiol Spectr 2023; 11:e0001023. [PMID: 37098954 PMCID: PMC10269616 DOI: 10.1128/spectrum.00010-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/27/2023] [Indexed: 04/27/2023] Open
Abstract
Obesity is a risk factor for severe disease and mortality for both influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. While previous studies show that individuals with obesity generate antibody responses following influenza vaccination, infection rates within the obese group were twice as high as those in the healthy-weight group. The repertoire of antibodies raised against influenza viruses following previous vaccinations and/or natural exposures is referred to here as baseline immune history (BIH). To investigate the hypothesis that obesity impacts immune memory to infections and vaccines, we profiled the BIH of obese and healthy-weight adults vaccinated with the 2010-2011 seasonal influenza vaccine in response to conformational and linear antigens. Despite the extensive heterogeneity of the BIH profiles in both groups, there were striking differences between obese and healthy subjects, especially with regard to A/H1N1 strains and the 2009 pandemic virus (Cal09). Individuals with obesity had lower IgG and IgA magnitude and breadth for a panel of A/H1N1 whole viruses and hemagglutinin proteins from 1933 to 2009 but increased IgG magnitude and breadth for linear peptides from the Cal09 H1 and N1 proteins. Age was also associated with A/H1N1 BIH, with young individuals with obesity being more likely to have reduced A/H1N1 BIH. We found that individuals with low IgG BIH had significantly lower neutralizing antibody titers than individuals with high IgG BIH. Taken together, our findings suggest that increased susceptibility of obese participants to influenza infection may be mediated in part by obesity-associated differences in the memory B-cell repertoire, which cannot be ameliorated by current seasonal vaccination regimens. Overall, these data have vital implications for the next generation of influenza virus and SARS-CoV-2 vaccines. IMPORTANCE Obesity is associated with increased morbidity and mortality from influenza and SARS-CoV-2 infection. While vaccination is the most effective strategy for preventing influenza virus infection, our previous studies showed that influenza vaccines fail to provide optimal protection in obese individuals despite reaching canonical correlates of protection. Here, we show that obesity may impair immune history in humans and cannot be overcome by seasonal vaccination, especially in younger individuals with decreased lifetime exposure to infections and seasonal vaccines. Low baseline immune history is associated with decreased protective antibody responses. Obesity potentially handicaps overall responses to vaccination, biasing it toward responses to linear epitopes, which may reduce protective capacity. Taken together, our data suggest that young obese individuals are at an increased risk of reduced protection by vaccination, likely due to altered immune history biased toward nonprotective antibody responses. Given the worldwide obesity epidemic coupled with seasonal respiratory virus infections and the inevitable next pandemic, it is imperative that we understand and improve vaccine efficacy in this high-risk population. The design, development, and usage of vaccines for and in obese individuals may need critical evaluation, and immune history should be considered an alternate correlate of protection in future vaccine clinical trials.
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Affiliation(s)
- Marwa Abd Alhadi
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lilach M. Friedman
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Erik A. Karlsson
- Virology Unit, Institute Pasteur du Cambodge, Phnom Penh, Cambodia
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Liel Cohen-Lavi
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Burkovitz
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Stacey Schultz-Cherry
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Terry L. Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Samuel S. Weir
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lester M. Shulman
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Melinda A. Beck
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tomer Hertz
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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Kim DeLuca E, Gebremariam A, Rose A, Biggerstaff M, Meltzer MI, Prosser LA. Cost-effectiveness of routine annual influenza vaccination by age and risk status. Vaccine 2023:S0264-410X(23)00495-4. [PMID: 37291022 DOI: 10.1016/j.vaccine.2023.04.069] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND The epidemiology of circulating seasonal influenza strains changed following the 2009 pandemic influenza A(H1N1). A universal influenza vaccination recommendation has been implemented and new vaccine types have become available post-2009. The objective of this study was to evaluate the cost-effectiveness of routine annual influenza vaccination in the context of this new evidence. METHODS A state transition simulation model was constructed to estimate the health and economic outcomes of influenza vaccination compared to no vaccination for hypothetical US cohorts stratified by age and risk status. Model input parameters were derived from multiple sources, including post-2009 vaccine effectiveness data from the US Flu Vaccine Effectiveness Network. The analysis used societal and healthcare sector perspectives and a one-year time horizon, except permanent outcomes were also included. The primary outcome was the incremental cost-effectiveness ratio (ICER) in dollars per quality-adjusted life years (QALYs) gained. RESULTS Compared to no vaccination, vaccination yielded ICERs lower than $95,000/QALY for all age and risk groups, except for non-high-risk adults 18-49 years ($194,000/QALY). Vaccination was cost-saving for adults ≥50 years at higher risk for influenza-related complications. Results were most sensitive to changes in the probability of influenza illness. Performing the analysis from the healthcare sector perspective, excluding vaccination time costs, delivering vaccinations in lower-cost settings, and including productivity losses improved the cost-effectiveness of vaccination. Sensitivity analysis revealed that vaccination remains below $100,000/QALY for older persons ≥65 years at vaccine effectiveness estimates as low as 4 %. CONCLUSIONS Cost-effectiveness of influenza vaccination varied by age and risk status and was less than $95,000/QALY for all subgroups, except for non-high-risk working-age adults. Results were sensitive to the probability of influenza illness and vaccination was more favorable under certain scenarios. Vaccination for higher risk subgroups resulted in ICERs below $100,000/QALY even at low levels of vaccine effectiveness or circulating virus.
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Affiliation(s)
- Ellen Kim DeLuca
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States; Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Acham Gebremariam
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Angela Rose
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Matthew Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Martin I Meltzer
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lisa A Prosser
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States; Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States.
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30
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Kandeel A, Fahim M, Deghedy O, Roshdy WH, Khalifa MK, Shesheny RE, Kandeil A, Naguib A, Afifi S, Mohsen A, Abdelghaffar K. Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022. BMC Public Health 2023; 23:1067. [PMID: 37277781 DOI: 10.1186/s12889-023-15880-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Two years after unprecedented low rates of circulation of most common respiratory viruses (SARS-CoV-2), the Egyptian ARI surveillance system detected an increase in acute respiratory infections (ARIs) with a reduced circulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially among school children. A national survey was conducted to estimate the burden and identify the viral causes of ARIs among children < 16 years of age. METHODS A one-day survey was carried out in 98 governmental outpatient clinics distributed all over Egypt 26 governorates. The four largest referral hospitals in each governorate where most influenza-like illness (ILI) patients seek care were selected. Using the WHO case definition, the first five patients < 16 years of age with ILI symptoms visiting the selected outpatient clinics on the survey day were enrolled. Basic demographic and clinical data of patients were collected using a linelist. Patients were swabbed and tested for SARS-CoV-2, influenza, and Respiratory Syncytial virus (RSV) by RT-PCR at the Central Laboratory in Cairo. RESULTS Overall, 530 patients enrolled, their mean age was 5.8 ± 4.2, 57.1% were males, and 70.2% reside in rural or semi-rural areas. Of all patients, 134 (25.3%) had influenza, 111 (20.9%) RSV, and 14 (2.8%) coinfections. Influenza-positive children were older compared to RSV, (7.2 ± 4.1, 4.3 ± 4.1, p < 0.001), with more than half of them (53.0%) being school students. Dyspnea was reported in RSV more than in influenza (62.2% vs. 49.3%, p < 0.05). Among RSV patients, children < 2 years had a higher rate of dyspnea than others (86.7% vs. 53.1%, < 0.001). CONCLUSIONS A resurgence of influenza and RSV was detected in Egypt in the 2022-2023 winter season. Influenza caused a higher rate of infection than RSV, while RSV caused more severe symptoms than influenza. Monitoring a broader range of respiratory pathogens is recommended to estimate the ARI burden and risky groups for severe disease in Egypt.
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Affiliation(s)
- Amr Kandeel
- Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Ministry of Health and Population, Cairo, Egypt
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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Principi N, Autore G, Ramundo G, Esposito S. Epidemiology of Respiratory Infections during the COVID-19 Pandemic. Viruses 2023; 15:v15051160. [PMID: 37243246 DOI: 10.3390/v15051160] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
To face the COVID-19 outbreak, a wide range of non-pharmaceutical interventions (NPIs) aimed at limiting the spread of the virus in communities, such as mask-wearing, hand hygiene, social distancing, travel restrictions, and school closures, were introduced in most countries. Thereafter, a significant reduction of new asymptomatic and symptomatic COVID-19 cases occurred, although there were differences between countries according to the type and duration of the NPIs. In addition, the COVID-19 pandemic has been accompanied by significant variations in the global incidence of diseases due to the most common non-SARS-CoV-2 respiratory viruses and some bacteria. In this narrative review, the epidemiology of the most common non-SARS-CoV-2 respiratory infections during the COVID-19 pandemic is detailed. Moreover, factors that could have had a role in modifying the traditional circulation of respiratory pathogens are discussed. A literature analysis shows that NPIs were the most important cause of the general reduction in the incidence of influenza and respiratory syncytial virus infection in the first year of the pandemic, although the different sensitivity of each virus to NPIs, the type and duration of measures used, as well as the interference among viruses may have played a role in modulating viral circulation. Reasons for the increase in the incidences of Streptococcus pneumoniae and group A Streptococcus infections seem strictly linked to immunity debt and the role played by NPIs in reducing viral infections and limiting bacterial superimposed infections. These results highlight the importance of NPIs during pandemics, the need to monitor the circulation of infectious agents that cause diseases similar to those caused by pandemic agents, and the need to make efforts to improve coverage with available vaccines.
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Affiliation(s)
| | - Giovanni Autore
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Greta Ramundo
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
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32
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Lewis NM, Delahoy MJ, Sumner KM, Lauring AS, Bendall EE, Mortenson L, Edwards E, Stamper A, Flannery B, Martin ET. Risk factors for infection with influenza A(H3N2) virus on a US university campus, October-November 2021. Influenza Other Respir Viruses 2023; 17:e13151. [PMID: 37246148 PMCID: PMC10209643 DOI: 10.1111/irv.13151] [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: 03/07/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Knowledge of the specific dynamics of influenza introduction and spread in university settings is limited. METHODS Persons with acute respiratory illness symptoms received influenza testing by molecular assay during October 6-November 23, 2022. Viral sequencing and phylogenetic analysis were conducted on nasal swab samples from case-patients. Case-control analysis of a voluntary survey of persons tested was used to identify factors associated with influenza; logistic regression was conducted to calculate odds ratios and 95% CIs. A subset of case-patients tested during the first month of the outbreak was interviewed to identify sources of introduction and early spread. RESULTS Among 3268 persons tested, 788 (24.1%) tested positive for influenza; 744 (22.8%) were included in the survey analysis. All 380 sequenced specimens were influenza A (H3N2) virus clade 3C.2a1b.2a.2, suggesting rapid transmission. Influenza (OR [95% CI]) was associated with indoor congregate dining (1.43 [1.002-2.03]), attending large gatherings indoors (1.83 [1.26-2.66]) or outdoors (2.33 [1.64-3.31]), and varied by residence type (apartment with ≥1 roommate: 2.93 [1.21-7.11], residence hall room alone: 4.18 [1.31-13.31], or with roommate: 6.09 [2.46-15.06], or fraternity/sorority house: 15.13 [4.30-53.21], all compared with single-dwelling apartment). Odds of influenza were lower among persons who left campus for ≥1 day during the week before their influenza test (0.49 [0.32-0.75]). Almost all early cases reported attending large events. CONCLUSIONS Congregate living and activity settings on university campuses can lead to rapid spread of influenza following introduction. Isolating following a positive influenza test or administering antiviral medications to exposed persons may help mitigate outbreaks.
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Affiliation(s)
- Nathaniel M. Lewis
- Influenza Division, National Center for Immunization and Respiratory DiseasesCDCAtlantaGeorgiaUSA
| | - Miranda J. Delahoy
- Influenza Division, National Center for Immunization and Respiratory DiseasesCDCAtlantaGeorgiaUSA
- Epidemic Intelligence ServiceCDCAtlantaGeorgiaUSA
| | - Kelsey M. Sumner
- Influenza Division, National Center for Immunization and Respiratory DiseasesCDCAtlantaGeorgiaUSA
- Epidemic Intelligence ServiceCDCAtlantaGeorgiaUSA
| | - Adam S. Lauring
- University of Michigan School of MedicineAnn ArborMichiganUSA
| | | | - Lindsey Mortenson
- University of Michigan University Health ServiceAnn ArborMichiganUSA
| | - Elizabeth Edwards
- University of Michigan University Health ServiceAnn ArborMichiganUSA
| | | | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory DiseasesCDCAtlantaGeorgiaUSA
| | - Emily T. Martin
- University of Michigan School of Public HealthAnn ArborMichiganUSA
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Price AM, Flannery B, Talbot HK, Grijalva CG, Wernli KJ, Phillips CH, Monto AS, Martin ET, Belongia EA, McLean HQ, Gaglani M, Mutnal M, Geffel KM, Nowalk MP, Tartof SY, Florea A, McLean C, Kim SS, Patel MM, Chung JR. Influenza Vaccine Effectiveness Against Influenza A(H3N2)-Related Illness in the United States During the 2021-2022 Influenza Season. Clin Infect Dis 2023; 76:1358-1363. [PMID: 36504336 PMCID: PMC10893961 DOI: 10.1093/cid/ciac941] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In the United States, influenza activity during the 2021-2022 season was modest and sufficient enough to estimate influenza vaccine effectiveness (VE) for the first time since the beginning of the coronavirus disease 2019 pandemic. We estimated influenza VE against laboratory-confirmed outpatient acute illness caused by predominant A(H3N2) viruses. METHODS Between October 2021 and April 2022, research staff across 7 sites enrolled patients aged ≥6 months seeking outpatient care for acute respiratory illness with cough. Using a test-negative design, we assessed VE against influenza A(H3N2). Due to strong correlation between influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, participants who tested positive for SARS-CoV-2 were excluded from VE estimations. Estimates were adjusted for site, age, month of illness, race/ethnicity, and general health status. RESULTS Among 6260 participants, 468 (7%) tested positive for influenza only, including 440 (94%) for A(H3N2). All 206 sequenced A(H3N2) viruses were characterized as belonging to genetic group 3C.2a1b subclade 2a.2, which has antigenic differences from the 2021-2022 season A(H3N2) vaccine component that belongs to clade 3C.2a1b subclade 2a.1. After excluding 1948 SARS-CoV-2-positive patients, 4312 patients were included in analyses of influenza VE; 2463 (57%) were vaccinated against influenza. Effectiveness against A(H3N2) for all ages was 36% (95% confidence interval, 20%-49%) overall. CONCLUSIONS Influenza vaccination in 2021-2022 provided protection against influenza A(H3N2)-related outpatient visits among young persons.
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Affiliation(s)
- Ashley M Price
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - H Keipp Talbot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - C Hallie Phillips
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Emily T Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | | | - Manjusha Gaglani
- Department of Pediatrics, Baylor Scott & White Health, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Manohar Mutnal
- Department of Pediatrics, Baylor Scott & White Health, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Krissy Moehling Geffel
- Department of Family Medicine, University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pannsylvania, USA
| | - Mary Patricia Nowalk
- Department of Family Medicine, University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pannsylvania, USA
| | - Sara Y Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Ana Florea
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Callie McLean
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara S Kim
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish M Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessie R Chung
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Tenforde MW, Patel MM, Lewis NM, Adams K, Gaglani M, Steingrub JS, Shapiro NI, Duggal A, Prekker ME, Peltan ID, Hager DN, Gong MN, Exline MC, Ginde AA, Mohr NM, Mallow C, Martin ET, Talbot HK, Gibbs KW, Kwon JH, Chappell JD, Halasa N, Lauring AS, Lindsell CJ, Swan SA, Hart KW, Womack KN, Baughman A, Grijalva CG, Self WH. Vaccine Effectiveness Against Influenza A(H3N2)-Associated Hospitalized Illness: United States, 2022. Clin Infect Dis 2023; 76:1030-1037. [PMID: 36327388 PMCID: PMC10226741 DOI: 10.1093/cid/ciac869] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic was associated with historically low influenza circulation during the 2020-2021 season, followed by an increase in influenza circulation during the 2021-2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b subclade that predominated was antigenically different from the vaccine strain. METHODS To understand the effectiveness of the 2021-2022 vaccine against hospitalized influenza illness, a multistate sentinel surveillance network enrolled adults aged ≥18 years hospitalized with acute respiratory illness and tested for influenza by a molecular assay. Using the test-negative design, vaccine effectiveness (VE) was measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative controls, adjusting for confounders. A separate analysis was performed to illustrate bias introduced by including SARS-CoV-2-positive controls. RESULTS A total of 2334 patients, including 295 influenza cases (47% vaccinated), 1175 influenza- and SARS-CoV-2-negative controls (53% vaccinated), and 864 influenza-negative and SARS-CoV-2-positive controls (49% vaccinated), were analyzed. Influenza VE was 26% (95% CI: -14% to 52%) among adults aged 18-64 years, -3% (-54% to 31%) among adults aged ≥65 years, and 50% (15-71%) among adults aged 18-64 years without immunocompromising conditions. Estimated VE decreased with inclusion of SARS-CoV-2-positive controls. CONCLUSIONS During a season where influenza A(H3N2) was antigenically different from the vaccine virus, vaccination was associated with a reduced risk of influenza hospitalization in younger immunocompetent adults. However, vaccination did not provide protection in adults ≥65 years of age. Improvements in vaccines, antivirals, and prevention strategies are warranted.
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Affiliation(s)
- Mark W Tenforde
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish M Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nathaniel M Lewis
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Adams
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Matthew E Prekker
- Departments of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle N Gong
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - H Keipp Talbot
- Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennie H Kwon
- Department of Medicine, Washington University, St Louis, Missouri, USA
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher J Lindsell
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kimberly W Hart
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wesley H Self
- Vanderbilt Institute for Clinical and Translational Research and Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Abuladze LR, Blokhin IA, Gonchar AP, Suchilova MM, Vladzymyrskyy AV, Gombolevskiy VA, Balanyuk EA, Ni OG, Troshchansky DV, Reshetnikov RV. CT imaging of HIV-associated pulmonary disorders in COVID-19 pandemic. Clin Imaging 2023; 95:97-106. [PMID: 36706642 PMCID: PMC9846904 DOI: 10.1016/j.clinimag.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/30/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Affiliation(s)
- Liya R. Abuladze
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation,The Vishnevsky Nаtionаl Mediсаl Reseаrсh Сenter of Surgery, 117997 Mosсow, Bol. Serpukhovskаyа str., 27, Russian Federation,Corresponding author at: Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation
| | - Ivan A. Blokhin
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation
| | - Anna P. Gonchar
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation
| | - Maria M. Suchilova
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation
| | - Anton V. Vladzymyrskyy
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation,I.M. Sechenov First Moscow State Medical University (Sechenov University), 8, Trubetskaya str. 2, 119991 Moscow, Russian Federation
| | - Victor A. Gombolevskiy
- Artificial Intelligence Research Institute (AIRI), 121170, Kutuzovsky pr. 32, 1, Moscow, Russian Federation
| | - Eleonora A. Balanyuk
- Clinic of Aesthetic Medicine “Olymp Clinic”, 129090, 7, Sadovaya-Sukharevskaya str.1, Moscow, Russian Federation
| | - Oksana G. Ni
- City Clinical Hospital №40, Moscow Health Care Department, 8 Sosensky stan, Kommunarka settlement, 129301 Moscow, Russian Federation
| | - Dmitry V. Troshchansky
- City Clinical Hospital №40, Moscow Health Care Department, 8 Sosensky stan, Kommunarka settlement, 129301 Moscow, Russian Federation
| | - Roman V. Reshetnikov
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, 127051 Moscow, 24, Petrovka str. 1, Russian Federation
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Nandi A, Pecetta S, Bloom DE. Global antibiotic use during the COVID-19 pandemic: analysis of pharmaceutical sales data from 71 countries, 2020-2022. EClinicalMedicine 2023; 57:101848. [PMID: 36776504 PMCID: PMC9900305 DOI: 10.1016/j.eclinm.2023.101848] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite bacterial coinfection rates of less than 10%, antibiotics are prescribed to an estimated 75% of patients with COVID-19, potentially exacerbating antimicrobial resistance. We estimated the associations of COVID-19 cases and vaccinations with global antibiotic sales during the first two years of the COVID-19 pandemic. METHODS We obtained monthly data on broad-spectrum antibiotic sales volumes (cephalosporins, penicillins, macrolides, and tetracyclines) in 71 countries during March 2020-May 2022 from the IQVIA MIDAS® database. These data were combined with country-month-level COVID-19 case and vaccination data from Our World in Data. We used least squares (pooled) and fixed-effects panel data regression models, accounting for country characteristics, to estimate the associations between antibiotic sales volumes and COVID-19 cases and vaccinations per 1000 people. FINDINGS Sales of all four antibiotics fell sharply during April and May 2020, followed by a gradual rise to near pre-pandemic levels through May 2022. In fixed-effects regression models, a 10% increase in monthly COVID-19 cases was associated with 0.2%-0.3% higher sales of cephalosporins, 0.2%-0.3% higher sales of penicillins, 0.4%-0.6% higher sales of macrolides, and 0.3% higher sales of all four antibiotics combined per 1000 people. Across continents, a 10% increase in monthly COVID-19 cases was associated with 0.8%, 1.3%, and 1.5% higher macrolides sales in Europe, North America, and Africa respectively. Sales of other antibiotics across continent were also positively associated with COVID-19 cases, although the estimated associations were smaller in magnitude. No consistent associations were observed between antibiotic sales and COVID-19 vaccinations. Results from pooled regression analysis were similar to those from the fixed-effects models. INTERPRETATION Antibiotic sales were positively associated with COVID-19 cases globally during 2020-2022. Our findings underline that antibiotic stewardship in the context of COVID-19 remains essential. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York, USA
- One Health Trust, Washington DC, USA
- Corresponding author. Dag Hammarskjold Plaza, New York, NY, 10017, USA.
| | - Simone Pecetta
- Research and Development Center, GlaxoSmithKline, Siena, Italy
| | - David E. Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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McLean HQ, Petrie JG, Hanson KE, Meece JK, Rolfes MA, Sylvester GC, Neumann G, Kawaoka Y, Belongia EA. Interim Estimates of 2022-23 Seasonal Influenza Vaccine Effectiveness - Wisconsin, October 2022-February 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:201-205. [PMID: 36821715 PMCID: PMC9949852 DOI: 10.15585/mmwr.mm7208a1] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
In the United States, 2022-23 influenza activity began earlier than usual, increasing in October 2022, and has been associated with high rates of hospitalizations among children* (1). Influenza A(H3N2) represented most influenza viruses detected and subtyped during this period, but A(H1N1)pdm09 viruses cocirculated as well. Most viruses characterized were in the same genetic subclade as and antigenically similar to the viruses included in the 2022-23 Northern Hemisphere influenza vaccine (1,2). Effectiveness of influenza vaccine varies by season, influenza virus subtype, and antigenic match with circulating viruses. This interim report used data from two concurrent studies conducted at Marshfield Clinic Health System (MCHS) in Wisconsin during October 23, 2022-February 10, 2023, to estimate influenza vaccine effectiveness (VE). Overall, VE was 54% against medically attended outpatient acute respiratory illness (ARI) associated with laboratory-confirmed influenza A among patients aged 6 months-64 years. In a community cohort of children and adolescents aged <18 years, VE was 71% against symptomatic laboratory-confirmed influenza A virus infection. These interim analyses indicate that influenza vaccination substantially reduced the risk for medically attended influenza among persons aged <65 years and for symptomatic influenza in children and adolescents. Annual influenza vaccination is the best strategy for preventing influenza and its complications. CDC recommends that health care providers continue to administer annual influenza vaccine to persons aged ≥6 months as long as influenza viruses are circulating (2).
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Rolfes MA, Talbot HK, McLean HQ, Stockwell MS, Ellingson KD, Lutrick K, Bowman NM, Bendall EE, Bullock A, Chappell JD, Deyoe JE, Gilbert J, Halasa NB, Hart KE, Johnson S, Kim A, Lauring AS, Lin JT, Lindsell CJ, McLaren SH, Meece JK, Mellis AM, Moreno Zivanovich M, Ogokeh CE, Rodriguez M, Sano E, Silverio Francisco RA, Schmitz JE, Vargas CY, Yang A, Zhu Y, Belongia EA, Reed C, Grijalva CG. Household Transmission of Influenza A Viruses in 2021-2022. JAMA 2023; 329:482-489. [PMID: 36701144 PMCID: PMC9880862 DOI: 10.1001/jama.2023.0064] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
IMPORTANCE Influenza virus infections declined globally during the COVID-19 pandemic. Loss of natural immunity from lower rates of influenza infection and documented antigenic changes in circulating viruses may have resulted in increased susceptibility to influenza virus infection during the 2021-2022 influenza season. OBJECTIVE To compare the risk of influenza virus infection among household contacts of patients with influenza during the 2021-2022 influenza season with risk of influenza virus infection among household contacts during influenza seasons before the COVID-19 pandemic in the US. DESIGN, SETTING, AND PARTICIPANTS This prospective study of influenza transmission enrolled households in 2 states before the COVID-19 pandemic (2017-2020) and in 4 US states during the 2021-2022 influenza season. Primary cases were individuals with the earliest laboratory-confirmed influenza A(H3N2) virus infection in a household. Household contacts were people living with the primary cases who self-collected nasal swabs daily for influenza molecular testing and completed symptom diaries daily for 5 to 10 days after enrollment. EXPOSURES Household contacts living with a primary case. MAIN OUTCOMES AND MEASURES Relative risk of laboratory-confirmed influenza A(H3N2) virus infection in household contacts during the 2021-2022 season compared with prepandemic seasons. Risk estimates were adjusted for age, vaccination status, frequency of interaction with the primary case, and household density. Subgroup analyses by age, vaccination status, and frequency of interaction with the primary case were also conducted. RESULTS During the prepandemic seasons, 152 primary cases (median age, 13 years; 3.9% Black; 52.0% female) and 353 household contacts (median age, 33 years; 2.8% Black; 54.1% female) were included and during the 2021-2022 influenza season, 84 primary cases (median age, 10 years; 13.1% Black; 52.4% female) and 186 household contacts (median age, 28.5 years; 14.0% Black; 63.4% female) were included in the analysis. During the prepandemic influenza seasons, 20.1% (71/353) of household contacts were infected with influenza A(H3N2) viruses compared with 50.0% (93/186) of household contacts in 2021-2022. The adjusted relative risk of A(H3N2) virus infection in 2021-2022 was 2.31 (95% CI, 1.86-2.86) compared with prepandemic seasons. CONCLUSIONS AND RELEVANCE Among cohorts in 5 US states, there was a significantly increased risk of household transmission of influenza A(H3N2) in 2021-2022 compared with prepandemic seasons. Additional research is needed to understand reasons for this association.
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Affiliation(s)
- Melissa A. Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | | | | | | | | | | | - Jessica E. Deyoe
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Sheroi Johnson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ahra Kim
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | | | | | | | - Alexandra M. Mellis
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Constance E. Ogokeh
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ellen Sano
- Columbia University, New York City, New York
| | | | | | | | - Amy Yang
- University of North Carolina at Chapel Hill
| | - Yuwei Zhu
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Carrie Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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Chen B, Zhu Z, Li Q, He D. Resurgence of different influenza types in China and the US in 2021. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:6327-6333. [PMID: 37161109 DOI: 10.3934/mbe.2023273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Various nonpharmaceutical interventions (NPIs) were implemented to alleviate the COVID-19 pandemic since its outbreak. The transmission dynamics of other respiratory infectious diseases, such as seasonal influenza, were also affected by these interventions. The drastic decline of seasonal influenza caused by such interventions would result in waning of population immunity and may trigger the seasonal influenza epidemic with the lift of restrictions during the post-pandemic era. We obtained weekly influenza laboratory confirmations from FluNet to analyse the resurgence patterns of seasonal influenza in China and the US. Our analysis showed that due to the impact of NPIs including travel restrictions between countries, the influenza resurgence was caused by influenza virus A in the US while by influenza virus B in China.
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Affiliation(s)
- Boqiang Chen
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Zhizhou Zhu
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Qiong Li
- BNU-HKBU United International College, Zhuhai, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
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40
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Haupt R, Baracco L, Harberts EM, Loganathan M, Kerstetter LJ, Krammer F, Coughlan L, Ernst RK, Frieman MB. Enhancing the protection of influenza virus vaccines with BECC TLR4 adjuvant in aged mice. Sci Rep 2023; 13:715. [PMID: 36639569 PMCID: PMC9838488 DOI: 10.1038/s41598-023-27965-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Influenza A virus (IAV) is a leading cause of respiratory disease worldwide often resulting in severe morbidity and mortality. We have previously shown that the Bacterial Enzymatic Combinatorial Chemistry (BECC) adjuvants, BECC438 and BECC470, formulated with an influenza virus hemagglutinin (HA) protein vaccine, offer greater protection from influenza virus challenge in mouse respiratory models using adult mice than standard HA:adjuvant combinations. In this study, we determined that immunization with HA + BECC adjuvants also significantly broadened the epitopes targeted on HA as compared with other adjuvants, resulting in increased titers of antibodies directed against the highly conserved HA stalk domain. Importantly, we demonstrate that BECC470 combined with an influenza virus HA protein antigen in a prime-only immunization regimen was able to achieve complete protection from challenge in a ~ 12-month-old mouse aged model. Together, this demonstrates the heightened protection provided by the BECC470 adjuvant in an influenza virus vaccine model and shows the enhanced immune response, as compared to other adjuvants elicited by the formulation of HA with BECC470.
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Affiliation(s)
- Robert Haupt
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA
- Center for Pathogen Research, School of Medicine, University of Maryland, Baltimore, MD, USA
- Therapeutic Discovery Branch, Molecular Biology Division, USAMRIID, Fort Detrick, MD, USA
| | - Lauren Baracco
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA
- Center for Pathogen Research, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Erin M Harberts
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | | | - Lucas J Kerstetter
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine, New York, NY, USA
- Center for Vaccine Research and Pandemic Preparedness (C-VARPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lynda Coughlan
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA
- Center for Vaccine Development and Global Health (CVD), University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Robert K Ernst
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Matthew B Frieman
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA.
- Center for Pathogen Research, School of Medicine, University of Maryland, Baltimore, MD, USA.
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Adams K, Tastad KJ, Huang S, Ujamaa D, Kniss K, Cummings C, Reingold A, Roland J, Austin E, Kawasaki B, Meek J, Yousey-Hindes K, Anderson EJ, Openo KP, Reeg L, Leegwater L, McMahon M, Bye E, Poblete M, Landis Z, Spina NL, Engesser K, Bennett NM, Gaitan MA, Shiltz E, Moran N, Sutton M, Abdullah N, Schaffner W, Talbot HK, Olsen K, Staten H, Taylor CA, Havers FP, Reed C, Budd A, Garg S, O’Halloran A, Brammer L. Prevalence of SARS-CoV-2 and Influenza Coinfection and Clinical Characteristics Among Children and Adolescents Aged <18 Years Who Were Hospitalized or Died with Influenza - United States, 2021-22 Influenza Season. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1589-1596. [PMID: 36520656 PMCID: PMC9762905 DOI: 10.15585/mmwr.mm7150a4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The 2022-23 influenza season shows an early rise in pediatric influenza-associated hospitalizations (1). SARS-CoV-2 viruses also continue to circulate (2). The current influenza season is the first with substantial co-circulation of influenza viruses and SARS-CoV-2 (3). Although both seasonal influenza viruses and SARS-CoV-2 can contribute to substantial pediatric morbidity (3-5), whether coinfection increases disease severity compared with that associated with infection with one virus alone is unknown. This report describes characteristics and prevalence of laboratory-confirmed influenza virus and SARS-CoV-2 coinfections among patients aged <18 years who had been hospitalized or died with influenza as reported to three CDC surveillance platforms during the 2021-22 influenza season. Data from two Respiratory Virus Hospitalizations Surveillance Network (RESP-NET) platforms (October 1, 2021-April 30, 2022),§ and notifiable pediatric deaths associated¶ with influenza virus and SARS-CoV-2 coinfection (October 3, 2021-October 1, 2022)** were analyzed. SARS-CoV-2 coinfections occurred in 6% (32 of 575) of pediatric influenza-associated hospitalizations and in 16% (seven of 44) of pediatric influenza-associated deaths. Compared with patients without coinfection, a higher proportion of those hospitalized with coinfection received invasive mechanical ventilation (4% versus 13%; p = 0.03) and bilevel positive airway pressure or continuous positive airway pressure (BiPAP/CPAP) (6% versus 16%; p = 0.05). Among seven coinfected patients who died, none had completed influenza vaccination, and only one received influenza antivirals.†† To help prevent severe outcomes, clinicians should follow recommended respiratory virus testing algorithms to guide treatment decisions and consider early antiviral treatment initiation for pediatric patients with suspected or confirmed influenza, including those with SARS-CoV-2 coinfection who are hospitalized or at increased risk for severe illness. The public and parents should adopt prevention strategies including considering wearing well-fitted, high-quality masks when respiratory virus circulation is high and staying up-to-date with recommended influenza and COVID-19 vaccinations for persons aged ≥6 months.
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Barraza MFO, Fasce RA, Nogareda F, Marcenac P, Mallegas NV, Alister PB, Loayza S, Chard AN, Arriola CS, Couto P, Calavaro CG, Rodriguez A, Wentworth DE, Cuadrado C, Azziz-Baumgartner E. Influenza incidence and vaccine effectiveness during the Southern Hemisphere Influenza season-Chile, 2022. Am J Transplant 2022; 22:3170-3174. [PMID: 36458704 PMCID: PMC9834235 DOI: 10.1111/ajt.16685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
| | - Rodrigo A. Fasce
- Virology Department, Public Health Institute of Chile, Santiago, Chile,Correspondence Rodrigo A. Fasce, Virology Department, Public Health Institute of Chile, Santiago, Chile.
| | | | - Perrine Marcenac
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | | | | | - Sergio Loayza
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Anna N. Chard
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Carmen Sofia Arriola
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Paula Couto
- Pan American Health Organization, Washington, District of Columbia, USA
| | | | - Angel Rodriguez
- Pan American Health Organization, Washington, District of Columbia, USA
| | - David E. Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | | | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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43
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Kolosova NP, Ilyicheva TN, Unguryan VV, Danilenko AV, Svyatchenko SV, Onhonova GS, Goncharova NI, Kosenko MN, Gudymo AS, Marchenko VY, Shvalov AN, Susloparov IM, Tregubchak TV, Gavrilova EV, Maksyutov RA, Ryzhikov AB. Re-Emergence of Circulation of Seasonal Influenza during COVID-19 Pandemic in Russia and Receptor Specificity of New and Dominant Clade 3C.2a1b.2a.2 A(H3N2) Viruses in 2021-2022. Pathogens 2022; 11:1388. [PMID: 36422639 PMCID: PMC9698969 DOI: 10.3390/pathogens11111388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2023] Open
Abstract
The circulation of seasonal influenza in 2020-2021 around the world was drastically reduced after the start of the COVID-19 pandemic and the implementation of mitigation strategies. The influenza virus circulation reemerged in 2021-2022 with the global spread of the new genetic clade 3C.2a1b.2a.2 of A(H3N2) viruses. The purpose of this study was to characterize influenza viruses in the 2021-2022 season in Russia and to analyze the receptor specificity properties of the 3C.2a1b.2a.2 A(H3N2) viruses. Clinical influenza samples were collected at the local Sanitary-and-Epidemiological Centers of Rospotrebnadzor. Whole genome sequencing was performed using NGS. The receptor specificity of hemagglutinin was evaluated using molecular modeling and bio-layer interferometry. Clinical samples from 854 cases of influenza A and B were studied; A(H3N2) viruses were in the majority of the samples. All genetically studied A(H3N2) viruses belonged to the new genetic clade 3C.2a1b.2a.2. Molecular modeling analysis suggested a higher affinity of hemagglutinin of 3C.2a1b.2a.2. A(H3N2) viruses to the α2,6 human receptor. In vitro analysis using a trisaccharide 6'-Sialyl-N-acetyllactosamine receptor analog did not resolve the differences in the receptor specificity of 3C.2a1b.2a.2 clade viruses from viruses belonging to the 3C.2a1b.2a.1 clade. Further investigation of the A(H3N2) viruses is required for the evaluation of their possible adaptive advantages. Constant monitoring and characterization of influenza are critical for epidemiological analysis.
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Affiliation(s)
- Natalia P. Kolosova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Tatiana N. Ilyicheva
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Vasily V. Unguryan
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
- Department of Physics, Novosibirsk State University, Novosibirsk 630090, Russia
| | - Alexey V. Danilenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Svetlana V. Svyatchenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Galina S. Onhonova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Natalia I. Goncharova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Maksim N. Kosenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Andrey S. Gudymo
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Vasiliy Y. Marchenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Alexander N. Shvalov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Ivan M. Susloparov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Tatiana V. Tregubchak
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Elena V. Gavrilova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Rinat A. Maksyutov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Alexander B. Ryzhikov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
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Kim DB, Lee SM, Geem KR, Kim J, Kim EH, Lee DW. In planta Production and Validation of Neuraminidase Derived from Genotype 4 Reassortant Eurasian Avian-like H1N1 Virus as a Vaccine Candidate. PLANTS (BASEL, SWITZERLAND) 2022; 11:2984. [PMID: 36365437 PMCID: PMC9655071 DOI: 10.3390/plants11212984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Influenza viruses are a major public health threat that causes repetitive outbreaks. In recent years, genotype 4 (G4) reassortant Eurasian avian-like (EA) H1N1 (G4 EA H1N1) has garnered attention as a potential novel pandemic strain. The necessity of developing vaccines against G4 EA H1N1 is growing because of the increasing cases of human infection and the low cross-reactivity of the strain with current immunity. In this study, we produced a G4 EA H1N1-derived neuraminidase (G4NA) as a vaccine candidate in Nicotiana benthamiana. The expressed G4NA was designed to be accumulated in the endoplasmic reticulum (ER). The M-domain of the human receptor-type tyrosine-protein phosphatase C was incorporated into the expression cassette to enhance the translation of G4NA. In addition, the family 3 cellulose-binding module and Brachypodium distachyon small ubiquitin-like modifier sequences were used to enable the cost-effective purification and removal of unnecessary domains after purification, respectively. The G4NA produced in plants displayed high solubility and assembled as a tetramer, which is required for the efficacy of an NA-based vaccine. In a mouse immunization model, the G4NA produced in plants could induce significant humoral immune responses. The plant-produced G4NA also stimulated antigen-specific CD4 T cell activation. These G4NA vaccine-induced immune responses were intensified by the administration of the antigen with a vaccine adjuvant. These results suggest that G4NA produced in plants has great potential as a vaccine candidate against G4 EA H1N1.
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Affiliation(s)
- Da Been Kim
- Department of Integrative Food, Bioscience and Biotechnology, Chonnam National University, Gwangju 61186, Korea
| | - Sun Min Lee
- Viral Immunology Laboratory, Institut Pasteur Korea, Seongnam 13488, Korea
| | - Kyoung Rok Geem
- Department of Bioenergy Science and Technology, Chonnam National University, Gwangju 61186, Korea
| | - Jitae Kim
- Bio-Energy Research Center, Chonnam National University, Gwangju 61186, Korea
| | - Eui Ho Kim
- Viral Immunology Laboratory, Institut Pasteur Korea, Seongnam 13488, Korea
| | - Dong Wook Lee
- Department of Integrative Food, Bioscience and Biotechnology, Chonnam National University, Gwangju 61186, Korea
- Department of Bioenergy Science and Technology, Chonnam National University, Gwangju 61186, Korea
- Bio-Energy Research Center, Chonnam National University, Gwangju 61186, Korea
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45
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Wang HB, Lin JC, Huang HN, Xu JT, Tu CN. Comprehensive evaluation of an one pot quadruplex RT-qPCR assay for the simultaneously subtyping influenza A virus into H1, H3, N1 and N2. JOURNAL OF CLINICAL VIROLOGY PLUS 2022. [DOI: 10.1016/j.jcvp.2022.100119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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46
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Guo Z, Zhang L, Liu J, Liu M. Impact of COVID-19 Prevention and Control on the Influenza Epidemic in China: A Time Series Study. HEALTH DATA SCIENCE 2022; 2022:9830159. [PMID: 38487480 PMCID: PMC10880177 DOI: 10.34133/2022/9830159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/06/2022] [Indexed: 03/17/2024]
Abstract
Background. COVID-19 prevention and control measures might affect influenza epidemic in China since the nonpharmaceutical interventions (NPIs) and behavioral changes contain transmission of both SARS-CoV-2 and influenza virus. We aimed to explore the impact of COVID-19 prevention and control measures on influenza using data from the National Influenza Surveillance Network.Methods. The percentage of influenza-like illness (ILI%) in southern and northern China from 2010 to 2022 was collected from the National Influenza Surveillance Network. Weekly ILI% observed value from 2010 to 2019 was used to calculate estimated annual percentage change (EAPC) of ILI% with 95% confidence intervals (CIs). Time series analysis was applied to estimate weekly ILI% predicted values in 2020/2021 and 2021/2022 season. Impact index was used to explore the impact of COVID-19 prevention and control on influenza during nonpharmaceutical intervention and vaccination stages.Results. China influenza activity was affected by the COVID-19 pandemic and different prevention and control measures during 2020-2022. In 2020/2021 season, weekly ILI% observed value in both southern and northern China was at a low epidemic level, and there was no obvious epidemic peak in winter and spring. In 2021/2022 season, weekly ILI% observed value in southern and northern China showed a small peak in summer and epidemic peak in winter and spring. The weekly ILI% observed value was generally lower than the predicted value in southern and northern China during 2020-2022. The median of impact index of weekly ILI% was 15.11% in north and 22.37% in south in 2020/2021 season and decreased significantly to 2.20% in north and 3.89% in south in 2021/2022 season.Conclusion. In summary, there was a significant decrease in reported ILI in China during the 2020-2022 COVID-19 pandemic, particularly in winter and spring. Reduction of influenza virus infection might relate to everyday Chinese public health COVID-19 interventions. The confirmation of this relationship depends on future studies.
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Affiliation(s)
- Zirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Li Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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47
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Olivares Barraza MF, Fasce RA, Nogareda F, Marcenac P, Vergara Mallegas N, Bustos Alister P, Loayza S, Chard AN, Arriola CS, Couto P, García Calavaro C, Rodriguez A, Wentworth DE, Cuadrado C, Azziz-Baumgartner E. Influenza Incidence and Vaccine Effectiveness During the Southern Hemisphere Influenza Season - Chile, 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1353-1358. [PMID: 36301733 PMCID: PMC9620570 DOI: 10.15585/mmwr.mm7143a1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has affected influenza virus transmission, with historically low activity, atypical timing, or altered duration of influenza seasons during 2020-22 (1,2). Community mitigation measures implemented since 2020, including physical distancing and face mask use, have, in part, been credited for low influenza detections globally during the pandemic, compared with those during prepandemic seasons (1). Reduced population exposure to natural influenza infections during 2020-21 and relaxed community mitigation measures after introduction of COVID-19 vaccines could increase the possibility of severe influenza epidemics. Partners in Chile and the United States assessed Southern Hemisphere influenza activity and estimated age-group-specific rates of influenza-attributable hospitalizations and vaccine effectiveness (VE) in Chile in 2022. Chile's most recent influenza season began in January 2022, which was earlier than during prepandemic seasons and was associated predominantly with influenza A(H3N2) virus, clade 3C.2a1b.2a.2. The cumulative incidence of influenza-attributable pneumonia and influenza (P&I) hospitalizations was 5.1 per 100,000 person-years during 2022, which was higher than that during 2020-21 but lower than incidence during the 2017-19 influenza seasons. Adjusted VE against influenza A(H3N2)-associated hospitalization was 49%. These findings indicate that influenza activity continues to be disrupted after emergence of SARS-CoV-2 in 2020. Northern Hemisphere countries might benefit from preparing for an atypical influenza season, which could include early influenza activity with potentially severe disease during the 2022-23 season, especially in the absence of prevention measures, including vaccination. Health authorities should encourage all eligible persons to seek influenza vaccination and take precautions to reduce transmission of influenza (e.g., avoiding close contact with persons who are ill).
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48
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Ríos-Silva M, Trujillo X, Huerta M, Benites-Godínez V, Guzmán-Esquivel J, Bricio-Barrios JA, Mendoza-Cano O, Lugo-Radillo A, Murillo-Zamora E. Reemerging Influenza Virus Infections during the Dominance of the Omicron SARS-CoV-2 Variant in Mexico. Pathogens 2022; 11:1181. [PMID: 36297238 PMCID: PMC9607464 DOI: 10.3390/pathogens11101181] [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: 09/13/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
The burden of influenza in Mexico has been high. We aimed to characterize its epidemiological patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. A retrospective cohort study was conducted and 5652 PCR-confirmed cases of influenza (October 2019-April 2022) were analyzed. The highest incidence (144 per million) was observed in December 2019 and rapidly decreased right before the start of the pandemic (February 2020). No cases were documented in the 2020-2021 season, and infections reemerged at a low level (8 per million) in December 2021. The case-fatality rates were around 5% in both seasons (p = 0.591). The dominant strains were AH1N1 and AH3N2 in the 2019-2020 and 2021-2022 seasons, respectively. In multiple analysis, males and older patients were at increased risk of a fatal outcome. Flu vaccination and infection by B lineages (vs. AH1N1) showed a protective effect. Our results suggest that the spread of the influenza virus reemerged in the 2021-2022 season when the SARS-CoV-2 Omicron variant (B.1.1.529) was dominant. Efforts focusing on the prevention of transmission of respiratory viral pathogens, together with flu vaccination, may be useful to reduce the risk of an influenza outbreak.
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Affiliation(s)
- Mónica Ríos-Silva
- University Center for Biomedical Research, CONACyT—University of Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Xóchitl Trujillo
- University Center for Biomedical Research, University of Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Miguel Huerta
- University Center for Biomedical Research, University of Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Verónica Benites-Godínez
- Health Education Coordination, Mexican Institute of Social Security, Calzada del Ejercito Nacional 14, Col. Fray Junípero Serra, Tepic 63160, Mexico
- Academic Unit of Medicine, Autonomous University of Nayarit, Ciudad de la Cultura Amado Nervo, Tepic 63155, Mexico
| | - José Guzmán-Esquivel
- Faculty of Medicine, University of Colima, Av. Universidad 333, Col. Las Víboras, Colima 28040, Mexico
- Clinical Epidemiology Research Unit, Mexican Institute of Social Security Institute, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | | | - Oliver Mendoza-Cano
- Faculty of Civil Engineering, University of Colima, km. 9 carr. Colima-Coquimatlán, Coquimatlán 28400, Mexico
| | - Agustín Lugo-Radillo
- Faculty of Medicine and Surgery, CONACyT—Autonomous University Benito Juarez of Oaxaca, Ex Hacienda Aguilera S/N Sur, camino a San Felupe del Agua, Oaxaca 68020, Mexico
| | - Efrén Murillo-Zamora
- Faculty of Medicine, University of Colima, Av. Universidad 333, Col. Las Víboras, Colima 28040, Mexico
- Family Medicine Unit No. 19, Department of Epidemiology, Mexican Institute of Social Security, Av. Javier Mina 301, Col. Centro, Colima 28000, Mexico
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49
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Paget J, Caini S, Del Riccio M, van Waarden W, Meijer A. Has influenza B/Yamagata become extinct and what implications might this have for quadrivalent influenza vaccines? EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 36177871 PMCID: PMC9524051 DOI: 10.2807/1560-7917.es.2022.27.39.2200753] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
While two influenza B virus lineages have co-circulated, B/Yamagata-lineage circulation has not been confirmed since March 2020. The WHO FluNet database indicates that B/Yamagata-lineage detections were reported in 2021 and 2022. However, detections can result from use of quadrivalent live-attenuated vaccines. Of the type B viruses detected post-March 2020, all ascribed to a lineage have been B/Victoria-lineage. There is need for a global effort to detect and lineage-ascribe type B influenza viruses, to assess if B/Yamagata-lineage viruses have become extinct.
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Affiliation(s)
- John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Saverio Caini
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Marco Del Riccio
- University of Florence, Florence, Italy.,Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Willemijn van Waarden
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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