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Mata-Moreno G, Bernal-Silva S, García-Sepúlveda CA, González-Ortíz AM, Ochoa-Pérez UR, Medina-Serpa AU, Pérez-González LF, Noyola DE. Population-based Influenza and Respiratory Syncytial Virus Hospitalizations and In-hospital Mortality Rates Among Mexican Children Less Than Five Years of Age. Pediatr Infect Dis J 2024; 43:493-497. [PMID: 38359346 DOI: 10.1097/inf.0000000000004269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Population-based information regarding the impact of respiratory syncytial virus (RSV) and influenza on hospital admissions and mortality is scant for many countries. METHODS Prospective testing of RSV and influenza virus was undertaken in patients <5 years old admitted to hospital with acute respiratory infection (ARI) between July, 2014 and June, 2015, and mortality rates for children living in 3 municipalities in the state of San Luis Potosí were calculated. RESULTS During the 12-month study period, 790 children living in these municipalities were admitted with ARI. RSV was detected in 245 (31%) and influenza in 47 (5.9%). History of preterm birth was recorded for 112 children on admission. For children <5 years old, ARI-, RSV- and influenza-associated admission rates were 23.2, 7.2 and 1.4 (per 1000 population), respectively. The corresponding admission rates per 1000 infants <1 year old were 78, 25.2 and 4.4. Preterm infant admission rates were 2 times higher than those of term infants. Six children died; RSV was detected in 4 (66.6%) of the deceased, while no deaths were associated with influenza. ARI and RSV in-hospital mortality rates for children <5 years were 0.18 and 0.12 per 1000 population. ARI and RSV mortality rates in preterm infants were 7 and 14 times higher than in term infants, respectively. CONCLUSIONS RSV was associated with both high admission and in-hospital mortality rates in children <5 years old. Specific interventions, such as active or passive immunization, to prevent RSV infections are required to reduce ARI-associated infant mortality.
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Affiliation(s)
- Gabriel Mata-Moreno
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Sofía Bernal-Silva
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Christian A García-Sepúlveda
- Viral and Human Genomics Laboratory, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | | | - Uciel R Ochoa-Pérez
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | | | | | - Daniel E Noyola
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
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Guo F, Zhang P, Do V, Runge J, Zhang K, Han Z, Deng S, Lin H, Ali ST, Chen R, Guo Y, Tian L. Ozone as an environmental driver of influenza. Nat Commun 2024; 15:3763. [PMID: 38704386 PMCID: PMC11069565 DOI: 10.1038/s41467-024-48199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
Under long-standing threat of seasonal influenza outbreaks, it remains imperative to understand the drivers of influenza dynamics which can guide mitigation measures. While the role of absolute humidity and temperature is extensively studied, the possibility of ambient ozone (O3) as an environmental driver of influenza has received scant attention. Here, using state-level data in the USA during 2010-2015, we examined such research hypothesis. For rigorous causal inference by evidence triangulation, we applied 3 distinct methods for data analysis: Convergent Cross Mapping from state-space reconstruction theory, Peter-Clark-momentary-conditional-independence plus as graphical modeling algorithms, and regression-based Generalised Linear Model. The negative impact of ambient O3 on influenza activity at 1-week lag is consistently demonstrated by those 3 methods. With O3 commonly known as air pollutant, the novel findings here on the inhibition effect of O3 on influenza activity warrant further investigations to inform environmental management and public health protection.
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Affiliation(s)
- Fang Guo
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
| | - Pei Zhang
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
| | - Vivian Do
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jakob Runge
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Datenwissenschaften, Jena, Germany
- Technische Universität Berlin, Berlin, Germany
| | - Kun Zhang
- Department of Philosophy, Carnegie Mellon University, Pittsburgh, PA, USA
- Machine Learning Department, Mohamed bin Zayed University of Artificial Intelligence, Abu Dhabi, UAE
| | - Zheshen Han
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
| | - Shenxi Deng
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
| | - Hongli Lin
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
| | - Sheikh Taslim Ali
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science Park, New Territories, Hong Kong SAR, PR China
| | - Ruchong Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China.
- Institute for Climate and Carbon Neutrality, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, PR China.
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Trusinska D, Zin ST, Sandoval E, Homaira N, Shi T. Risk Factors for Poor Outcomes in Children Hospitalized With Virus-associated Acute Lower Respiratory Infections: A Systematic Review and Meta-analysis. Pediatr Infect Dis J 2024; 43:467-476. [PMID: 38285519 PMCID: PMC11003409 DOI: 10.1097/inf.0000000000004258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Acute lower respiratory infection (ALRI) caused by respiratory viruses is among the most common causes of hospitalization and mortality in children. We aimed to identify risk factors for poor outcomes in children <5 years old hospitalized with ALRI caused by respiratory syncytial virus (RSV), influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS We searched Embase, Medline and Global Health databases and included observational studies reporting risk factors for poor outcomes (defined as use of supplemental oxygen, mechanical ventilation, intensive care unit admission, prolonged hospital stay and mortality) published between January 2011 and January 2023. Two authors independently extracted data on study characteristics, outcomes and risk factors. Due to limited data, meta-analyses were only conducted for RSV-ALRI poor outcome risk factors using random effects model when there were at least 3 studies. RESULTS We included 30 studies. For RSV-related ALRI, significant risk factors based on meta-analysis were: neurological disease [odds ratio (OR): 6.14; 95% confidence intervals (CIs): 2.39-15.77], Down's syndrome (5.43; 3.02-9.76), chronic lung disease (3.64; 1.31-10.09), immunocompromised status (3.41; 1.85-6.29), prematurity (2.98; 1.93-4.59), congenital heart disease (2.80; 1.84-4.24), underlying disease (2.45; 1.94-3.09), age <2 months (2.29; 1.78-2.94), age <6 months (2.08; 1.81-2.39), viral coinfection (2.01; 1.27-3.19), low birth weight (1.88; 1.19-2.95) and being underweight (1.80; 1.38-2.35). For influenza-related ALRI, chronic conditions and age 6-24 months were identified as risk factors for poor outcomes. Cardiovascular disease, immunosuppression, chronic kidney disease, diabetes and high blood pressure were reported as risk factors for mortality due to SARS-CoV-2 associated ALRI. CONCLUSIONS These findings might contribute to the development of guidelines for prophylaxis and management of ALRI caused by RSV, influenza and SARS-CoV-2.
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Affiliation(s)
- Daira Trusinska
- From the Usher Institute, Old Medical School, Teviot Place, University of Edinburgh, Edinburgh, United Kingdom
| | - Si Thu Zin
- Randwick Clinical Campus, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Emmanuel Sandoval
- From the Usher Institute, Old Medical School, Teviot Place, University of Edinburgh, Edinburgh, United Kingdom
- Department of Acute and General Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Nusrat Homaira
- Discipline of Pediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
- Respiratory Department, Sydney Children’s Hospital, Randwick, Sydney, New South Wales, Australia
- James P. Grant School of Public Health, BRAC University, Bangladesh
| | - Ting Shi
- From the Usher Institute, Old Medical School, Teviot Place, University of Edinburgh, Edinburgh, United Kingdom
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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Akano A, Sadauki AH, Adelabu AM, Malgwi A, Fagbola M, Ogunbode O, Usman A, Ameh C, Balogun MS, Ilori E, Badaru S, Adetunji A, Adebayo A, Mba N, Iniobong A, Eze E, Akerele I, Grema B, Sodipo O, Enemuo E, Ochu C, Ihekweazu C, Adetifa I. Epidemiology of influenza in Nigeria: A secondary analysis of the sentinel surveillance data in Nigeria from 2010 - 2020. J Infect Public Health 2024; 17:495-502. [PMID: 38290192 DOI: 10.1016/j.jiph.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Influenza is a leading cause of morbidity and mortality globally. Little is known of the true burden and epidemiology of influenza in Africa. Nigeria has a sentinel surveillance system for influenza virus (IFV). This study seeks to describe the epidemiological characteristics of influenza cases in Nigeria through secondary data analysis of the sentinel surveillance data from 2010 to 2020. METHODOLOGY A retrospective secondary data analysis of data collected from patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) in the four Nigeria Influenza Sentinel Surveillance sites from January 2010 to December 2020. Data was cleaned and analyzed using Microsoft Excel and Epi info 7.2 for frequencies and proportions. The results of the analysis were summarized in tables and charts. RESULTS A total of 13,828 suspected cases of influenza were recorded at the sentinel sites during the study period. About 10.3% (1421/13,828) of these tested positive for IFV of which 1243 (87.5%) were ILI patients, 175 (12.3%) SARI patients, and 3 (0.2%) novel H1N1 patients. Males accounted for 54.2% (770/1421) of the confirmed cases. The median age of confirmed cases was 3 years (range: <1month-97 years). Children 0-4 years accounted for 69.3% (985/1421) of all cases. The predominant subtypes were B lineage not determined (32.3%), A/H1N1 pdm09 (28.8%) and A/H3 (23.0%). There were periods of sustained transmission in most years with 2011 having the highest number of cases. Overall, there were more cases around January to March and August to November. Heart disease and chronic shortness of breath were the most common co-morbidities identified among confirmed cases. CONCLUSION Influenza remains a significant cause of respiratory illness, especially among children aged less than 4 years. Influenza cases occur all year round with irregular seasonality in Nigeria. Children less than 4 years and those with co-morbidities should be prioritized for vaccination. Vaccine composition in the country should take cognizance of the prevailing strains which are type B (lineage not determined), A/H1N1 pdm09 and A/H3.
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Affiliation(s)
- Adejoke Akano
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria; Nigeria Field Epidemiology and Laboratory Training Programme, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria.
| | - Aisha Habib Sadauki
- Nigeria Field Epidemiology and Laboratory Training Programme, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Adeyemi Mark Adelabu
- Nigeria Field Epidemiology and Laboratory Training Programme, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Arhyel Malgwi
- Nigeria Field Epidemiology and Laboratory Training Programme, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Motunrayo Fagbola
- Nigeria Field Epidemiology and Laboratory Training Programme, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Oladipo Ogunbode
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | | | | | - Elsie Ilori
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Sikiru Badaru
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Adewusi Adetunji
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Adedeji Adebayo
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Akanimo Iniobong
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Emmanuel Eze
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | | | | | - Emeka Enemuo
- Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria
| | - Chinwe Ochu
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Chikwe Ihekweazu
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Ifedayo Adetifa
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
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Chao S, Wang Y, Wu B, Li R, Dong J, Ji L, Li X, Li R, Yin X, Zhao X, Liang W. Characterization of viral infections in children with influenza-like-illness during December 2018-January 2019. Front Cell Infect Microbiol 2024; 13:1351814. [PMID: 38304460 PMCID: PMC10830827 DOI: 10.3389/fcimb.2023.1351814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction Respiratory viral infection (RVI) is of very concern after the outbreak of COVID-19, especially in pediatric departments. Learning pathogen spectrum of RVI in children previous the epidemic of COVID-19 could provide another perspective for understanding RVI under current situation and help to prepare for the post COVID-19 infection control. Methods A nucleic acid sequence-based amplification (NASBA) assay, with 19 pairs of primers targeting various respiratory viruses, was used for multi-pathogen screening of viral infections in children presenting influenza-like illness (ILI) symptoms. Children with ILI at the outpatient department of Beijing Tsinghua Changgung Hospital during the influenza epidemic from 12/2018 to 01/2019 were included. Throat swabs were obtained for both the influenza rapid diagnostic test (IRDT) based on the colloidal gold immunochromatographic assay and the NASBA assay, targeting various respiratory viruses with an integrated chip technology. Results and discussion Of 519 patients, 430 (82.9%) were positive in the NASBA assay. The predominant viral pathogens were influenza A H1N1 pdm1/2009 (pH1N1) (48.4%) and influenza A (H3N2) (18.1%), followed by human metapneumovirus (hMPV) (8.8%) and respiratory syncytial virus (RSV) (6.1%). Of the 320 cases identified with influenza A by NASBA, only 128 (40.0%) were positive in the IRDT. The IRDT missed pH1N1 significantly more frequently than A (H3N2) (P<0.01). Influenza A pH1N1 and A (H3N2) were the major pathogens in <6 years and 6-15 years old individuals respectively (P<0.05). In summary, influenza viruses were the major pathogens in children with ILI during the 2018-2019 winter influenza epidemic, while hMPV and RSV were non-negligible. The coexistence of multiple pathogen leading to respiratory infections is the normalcy in winter ILI cases.
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Affiliation(s)
- Shuang Chao
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yuejiao Wang
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Baolei Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Runqing Li
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jingxiao Dong
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lina Ji
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xuejun Li
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ran Li
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaomei Yin
- Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiuying Zhao
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Gao ZX, Wang Y, Yan LY, Liu T, Peng LW. Epidemiological characteristics of respiratory viruses in children during the COVID-19 epidemic in Chengdu, China. Microbiol Spectr 2024; 12:e0261423. [PMID: 38051057 PMCID: PMC10783071 DOI: 10.1128/spectrum.02614-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
IMPORTANCE During the coronavirus disease 2019 epidemic, the Chinese government launched and used a series of nonpharmaceutical interventions (NPIs), including banning social gatherings, wearing face masks, home isolation, and maintaining hand hygiene, to control the disease spread. Whether and how NPIs influence other respiratory viruses in children remain unclear. In this article, we analyzed relative data and found that the number of samples and positive proportion of respiratory viruses decreased significantly compared with that before the epidemic. Clinicians and public health policymakers should pay attention to changes in the epidemic trends and types of respiratory viruses and maintain monitoring of respiratory-related viruses to avoid possible abnormal rebounds and epidemic outbreaks of these viruses.
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Affiliation(s)
- Zheng-Xiang Gao
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ya Wang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ling-Yi Yan
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ting Liu
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Lei-Wen Peng
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
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8
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Chen Z, Liu Y, Yue H, Chen J, Hu X, Zhou L, Liang B, Lin G, Qin P, Feng W, Wang D, Wu D. The role of meteorological factors on influenza incidence among children in Guangzhou China, 2019-2022. Front Public Health 2024; 11:1268073. [PMID: 38259781 PMCID: PMC10800649 DOI: 10.3389/fpubh.2023.1268073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Analyzing the epidemiological characteristics of influenza cases among children aged 0-17 years in Guangzhou from 2019 to 2022. Assessing the relationships between multiple meteorological factors and influenza, improving the early warning systems for influenza, and providing a scientific basis for influenza prevention and control measures. Methods The influenza data were obtained from the Chinese Center for Disease Control and Prevention. Meteorological data were provided by Guangdong Meteorological Service. Spearman correlation analysis was conducted to examine the relevance between meteorological factors and the number of influenza cases. Distributed lag non-linear models (DLNM) were used to explore the effects of meteorological factors on influenza incidence. Results The relationship between mean temperature, rainfall, sunshine hours, and influenza cases presented a wavy pattern. The correlation between relative humidity and influenza cases was illustrated by a U-shaped curve. When the temperature dropped below 13°C, Relative risk (RR) increased sharply with decreasing temperature, peaking at 5.7°C with an RR of 83.78 (95% CI: 25.52, 275.09). The RR was increased when the relative humidity was below 66% or above 79%, and the highest RR was 7.50 (95% CI: 22.92, 19.25) at 99%. The RR was increased exponentially when the rainfall exceeded 1,625 mm, reaching a maximum value of 2566.29 (95% CI: 21.85, 3558574.07) at the highest rainfall levels. Both low and high sunshine hours were associated with reduced incidence of influenza, and the lowest RR was 0.20 (95% CI: 20.08, 0.49) at 9.4 h. No significant difference of the meteorological factors on influenza was observed between males and females. The impacts of cumulative extreme low temperature and low relative humidity on influenza among children aged 0-3 presented protective effects and the 0-3 years group had the lowest RRs of cumulative extreme high relative humidity and rainfall. The highest RRs of cumulative extreme effect of all meteorological factors (expect sunshine hours) were observed in the 7-12 years group. Conclusion Temperature, relative humidity, rainfall, and sunshine hours can be used as important predictors of influenza in children to improve the early warning system of influenza. Extreme weather reduces the risk of influenza in the age group of 0-3 years, but significantly increases the risk for those aged 7-12 years.
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Affiliation(s)
- Zhitao Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yanhui Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Haiyan Yue
- Guangzhou Meteorological Observatory, Guangzhou, China
| | - Jinbin Chen
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiangzhi Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lijuan Zhou
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Boheng Liang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Guozhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Pengzhe Qin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Dedong Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Di Wu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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9
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Gharpure R, Chard AN, Cabrera Escobar M, Zhou W, Valleau MM, Yau TS, Bresee JS, Azziz-Baumgartner E, Pallas SW, Lafond KE. Costs and cost-effectiveness of influenza illness and vaccination in low- and middle-income countries: A systematic review from 2012 to 2022. PLoS Med 2024; 21:e1004333. [PMID: 38181066 PMCID: PMC10802964 DOI: 10.1371/journal.pmed.1004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/22/2024] [Accepted: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Historically, lack of data on cost-effectiveness of influenza vaccination has been identified as a barrier to vaccine use in low- and middle-income countries. We conducted a systematic review of economic evaluations describing (1) costs of influenza illness; (2) costs of influenza vaccination programs; and (3) vaccination cost-effectiveness from low- and middle-income countries to assess if gaps persist that could hinder global implementation of influenza vaccination programs. METHODS AND FINDINGS We performed a systematic search in Medline, Embase, Cochrane Library, CINAHL, and Scopus in January 2022 and October 2023 using a combination of the following key words: "influenza" AND "cost" OR "economic." The search included studies with publication years 2012 through 2022. Studies were eligible if they (1) presented original, peer-reviewed findings on cost of illness, cost of vaccination program, or cost-effectiveness of vaccination for seasonal influenza; and (2) included data for at least 1 low- or middle-income country. We abstracted general study characteristics and data specific to each of the 3 study types. Of 54 included studies, 26 presented data on cost-effectiveness, 24 on cost-of-illness, and 5 on program costs. Represented countries were classified as upper-middle income (UMIC; n = 12), lower-middle income (LMIC; n = 7), and low-income (LIC; n = 3). The most evaluated target groups were children (n = 26 studies), older adults (n = 17), and persons with chronic medical conditions (n = 12); fewer studies evaluated pregnant persons (n = 9), healthcare workers (n = 5), and persons in congregate living settings (n = 1). Costs-of-illness were generally higher in UMICs than in LMICs/LICs; however, the highest national economic burden, as a percent of gross domestic product and national health expenditure, was reported from an LIC. Among studies that evaluated the cost-effectiveness of influenza vaccine introduction, most (88%) interpreted at least 1 scenario per target group as either cost-effective or cost-saving, based on thresholds designated in the study. Key limitations of this work included (1) heterogeneity across included studies; (2) restrictiveness of the inclusion criteria used; and (3) potential for missed influenza burden from use of sentinel surveillance systems. CONCLUSIONS The 54 studies identified in this review suggest an increased momentum to generate economic evidence about influenza illness and vaccination from low- and middle-income countries during 2012 to 2022. However, given that we observed substantial heterogeneity, continued evaluation of the economic burden of influenza illness and costs/cost-effectiveness of influenza vaccination, particularly in LICs and among underrepresented target groups (e.g., healthcare workers and pregnant persons), is needed. Use of standardized methodology could facilitate pooling across settings and knowledge sharing to strengthen global influenza vaccination programs.
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Affiliation(s)
- Radhika Gharpure
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna N. Chard
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Weigong Zhou
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Molly M. Valleau
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tat S. Yau
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Joseph S. Bresee
- Task Force for Global Health, Atlanta, Georgia, United States of America
| | | | - Sarah W. Pallas
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kathryn E. Lafond
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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10
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Wu J, Wei Z, Yang Y, Sun X, Zhan S, Jiang Q, Fu C. Gap between cognitions and behaviors among children's guardians of influenza vaccination: The role of social influence and vaccine-related knowledge. Hum Vaccin Immunother 2023; 19:2166285. [PMID: 36703498 PMCID: PMC9980667 DOI: 10.1080/21645515.2023.2166285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The seasonal influenza vaccine coverage remains suboptimal among children even though guardians expressed high willingness to vaccinate their children. This study aimed to determine the association between vaccine hesitancy and uptake to facilitate vaccination; thus, bridging the gap. A cross-sectional design, using stratified cluster random sampling, was conducted among guardians of 0-59-month-old Chinese children from July to October in 2019. A structural equation model was applied to explore the interrelationships between factors including vaccine hesitancy, vaccination, social influence, and relative knowledge among guardians. Of the 1,404 guardians, 326 were highly hesitant to vaccinate their children, 33.13% (108/326) of whom had vaccinated their children. Moreover, 517 and 561 guardians had moderate and low vaccine hesitancy, with corresponding vaccine coverage of 42.75% (221/517) and 47.95% (269/516). Guardians' gender, age, and education level were demographic variables with significant moderating effects. Social influence considered impact of communities, family members, friends, neighbors, healthcare workers, bad vaccination experience and sense on price. Actual vaccine uptake was negatively significantly associated with hesitancy (β = -0.11, p < .001) with positive association with social influence (β = 0.61, p < .001). Vaccine hesitancy was negatively significantly associated with relative knowledge (β = -2.14, p < .001) and social influence (β = -1.09, p < .001). A gap is noted between cognitions and behaviors among children's guardians regarding influenza vaccination. A comprehensive strategy including emphasizing benefits of the influenza vaccination, risk of infection, and ensuring high vaccine confidence among healthcare workers can help transform the willingness to engage in the behavior of vaccination.
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Affiliation(s)
- Jing Wu
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng Wei
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Yang
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiu Sun
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Siyi Zhan
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qijing Jiang
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuanxi Fu
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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11
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Owuor DC, de Laurent ZR, Nyawanda BO, Emukule GO, Kondor R, Barnes JR, Nokes DJ, Agoti CN, Chaves SS. Genetic and potential antigenic evolution of influenza A(H1N1)pdm09 viruses circulating in Kenya during 2009-2018 influenza seasons. Sci Rep 2023; 13:22342. [PMID: 38102198 PMCID: PMC10724140 DOI: 10.1038/s41598-023-49157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
Influenza viruses undergo rapid evolutionary changes, which requires continuous surveillance to monitor for genetic and potential antigenic changes in circulating viruses that can guide control and prevention decision making. We sequenced and phylogenetically analyzed A(H1N1)pdm09 virus genome sequences obtained from specimens collected from hospitalized patients of all ages with or without pneumonia between 2009 and 2018 from seven sentinel surveillance sites across Kenya. We compared these sequences with recommended vaccine strains during the study period to infer genetic and potential antigenic changes in circulating viruses and associations of clinical outcome. We generated and analyzed a total of 383 A(H1N1)pdm09 virus genome sequences. Phylogenetic analyses of HA protein revealed that multiple genetic groups (clades, subclades, and subgroups) of A(H1N1)pdm09 virus circulated in Kenya over the study period; these evolved away from their vaccine strain, forming clades 7 and 6, subclades 6C, 6B, and 6B.1, and subgroups 6B.1A and 6B.1A1 through acquisition of additional substitutions. Several amino acid substitutions among circulating viruses were associated with continued evolution of the viruses, especially in antigenic epitopes and receptor binding sites (RBS) of circulating viruses. Disease severity declined with an increase in age among children aged < 5 years. Our study highlights the necessity of timely genomic surveillance to monitor the evolutionary changes of influenza viruses. Routine influenza surveillance with broad geographic representation and whole genome sequencing capacity to inform on prioritization of antigenic analysis and the severity of circulating strains are critical to improved selection of influenza strains for inclusion in vaccines.
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Affiliation(s)
- D Collins Owuor
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Zaydah R de Laurent
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Gideon O Emukule
- Influenza Division, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John R Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D James Nokes
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, UK
| | - Charles N Agoti
- Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Public Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Sandra S Chaves
- Influenza Division, Centers for Disease Control and Prevention, Nairobi, Kenya
- Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, GA, USA
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12
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Zeng Q, Yang C, Li Y, Geng X, Lv X. Machine-learning-algorithms-based diagnostic model for influenza A in children. Medicine (Baltimore) 2023; 102:e36406. [PMID: 38050228 PMCID: PMC10695522 DOI: 10.1097/md.0000000000036406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND At present, nucleic acid testing is the gold standard for diagnosing influenza A, however, this method is expensive, time-consuming, and unsuitable for promotion and use in grassroots hospitals. This study aimed to establish a diagnostic model that could accurately, quickly, and simply distinguish between influenza A and influenza like diseases. METHODS Patients with influenza-like symptoms were recruited between December 2019 and August 2023 at the Children's Hospital Affiliated to Shandong University and basic information, nasopharyngeal swab and blood routine test data were included. Computer algorithms including random forest, GBDT, XGBoost and logistic regression (LR) were used to create the diagnostic model, and their performance was evaluated using the validation data sets. RESULTS A total of 4188 children with influenza-like symptoms were enrolled, of which 1992 were nucleic acid test positive and 2196 were matched negative. The diagnostic models based on the random forest, GBDT, XGBoost and logistic regression algorithms had AUC values of 0.835,0.872,0.867 and 0.784, respectively. The top 5 important features were lymphocyte (LYM) count, age, serum amyloid A (SAA), white blood cells (WBC) count and platelet-to-lymphocyte ratio (PLR). GBDT model had the best performance, the sensitivity and specificity were 77.23% and 80.29%, respectively. CONCLUSIONS A computer algorithm diagnosis model of influenza A in children based on blood routine test data was established, which could identify children with influenza A more accurately in the early stage, and was easy to popularize.
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Affiliation(s)
- Qian Zeng
- Clinical Laboratory, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Clinical Laboratory, Jinan Children’s Hospital, Jinan, China
| | - Chun Yang
- Clinical Laboratory, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Clinical Laboratory, Jinan Children’s Hospital, Jinan, China
| | - Yurong Li
- Clinical Laboratory, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Clinical Laboratory, Jinan Children’s Hospital, Jinan, China
| | - Xinran Geng
- Maternity & Child Care Center of Dezhou, China
| | - Xin Lv
- Clinical Laboratory, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Clinical Laboratory, Jinan Children’s Hospital, Jinan, China
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13
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Wolf RM, Antoon JW. Influenza in Children and Adolescents: Epidemiology, Management, and Prevention. Pediatr Rev 2023; 44:605-617. [PMID: 37907421 PMCID: PMC10676733 DOI: 10.1542/pir.2023-005962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
EDUCATION GAP Influenza is among the most common infectious causes of pediatric emergency department visits and hospitalizations. Clinicians should use evidence-based guidelines to learn how to identify, manage, prevent, and treat influenza cases. Disease caused by influenza virus can be mitigated with appropriate treatment and prevention efforts. OBJECTIVES After completing this article, readers should be able to: 1. Describe the virology and epidemiology of influenza. 2. List the clinical features and complications of influenza infections. 3. List the benefits and limitations of testing modalities for the diagnosis of influenza. 4. Appropriately apply American Academy of Pediatrics, Infectious Diseases Society of America, and Centers for Disease Control and Prevention (CDC) treatment guidelines for influenza or suspected influenza. 5. Describe the importance of influenza vaccination.
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Affiliation(s)
- Ryan M Wolf
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - James W Antoon
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
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14
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Westin J, Andersson E, Bengnér M, Berggren A, Brytting M, Ginström Ernstad E, Nilsson AC, Wahllöf M, Westman G, Furberg M. Management of influenza - updated Swedish guidelines for antiviral treatment. Infect Dis (Lond) 2023; 55:725-737. [PMID: 37459455 DOI: 10.1080/23744235.2023.2234476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 08/11/2023] Open
Abstract
Influenza causes seasonal epidemics of respiratory infection in all parts of the world. Manifestations of influenza range from mild upper to severe lower respiratory tract infection. Medical risk groups are defined by factors predisposing for development of severe disease and are recommended annual vaccination as a protective measure. The previous Swedish treatment guidelines for influenza were issued in 2011, and a review of current evidence was deemed relevant. An important reason to revisit the guidelines is the recent approval of a novel drug for influenza treatment, baloxavir. Updated Swedish evidence-based guidelines created by a group of experts from various research areas, for the management of influenza are presented here. The work has been made in collaboration with the Public Health Agency of Sweden and the Swedish Reference Group for AntiViral therapy (RAV). The updated guidelines include guidelines for diagnostics, treatment and prophylaxis in special groups, including management of pregnant women and children with influenza. A new section about infection control has been added. Pharmacological treatment is covered in detail with regards to indication and dosage. Additionally, drug resistance and environmental aspects are discussed.
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Affiliation(s)
- Johan Westin
- Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Swedish Reference Group for Antiviral Therapy (RAV), Stockholm, Sweden
| | - Emmi Andersson
- The Unit for Laboratory Virus and Vaccine Surveillance, Public Health Agency, Solna, Sweden
| | - Malin Bengnér
- Office for Control of Communicable Diseases, Region Jönköping County, Jönköping, Sweden
| | - Anna Berggren
- Department of Women and Children's Health, Division of Pediatric Hematology-Oncology, Astrid Lindgren Children's Hospital, Stockholm, Sweden
- Research and Development, Norrtälje Hospital, Norrtälje, Sweden
| | - Mia Brytting
- The Unit for Laboratory Virus and Vaccine Surveillance, Public Health Agency, Solna, Sweden
| | - Erica Ginström Ernstad
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna C Nilsson
- Department of Translational Medicine, Infectious Diseases Research Unit, Lund University, Malmö, Sweden
| | - Martina Wahllöf
- Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gabriel Westman
- Swedish Medical Products Agency, Uppsala, Sweden
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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15
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Al Nufaiei ZF, Alshenkiti A, Sallam FN, Badraig NS, Al Zhranei RM, Alshamrani KM, Sannan N, Alsulami M, Al-Thaqafy MS, Abdelrahman E. Assessment of the Knowledge and Opinions of Undergraduate Health Care Students Concerning Influenza Vaccination in Saudi Arabia: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:2681-2690. [PMID: 37720268 PMCID: PMC10503518 DOI: 10.2147/jmdh.s415745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/13/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Influenza remains a significant global public health challenge, causing substantial morbidity and mortality worldwide. Despite the availability of influenza vaccines, challenges related to vaccine hesitancy and healthcare professionals' attitudes persist. Furthermore, there is a need to understand the knowledge and opinions of undergraduate healthcare students regarding influenza vaccinations. Therefore, we aimed to assess and compare the knowledge and opinions of undergraduate healthcare students about influenza vaccinations, addressing the existing knowledge gap in this area. Methods We employed a cross-sectional study design to assess the opinions and knowledge of undergraduate healthcare students in Saudi Arabia regarding influenza vaccination. A total of 137 healthcare programs were invited to participate via filled-out the survey online. Data analysis was performed using SPSS, with descriptive statistics for the demographic profile and Chi-Square and independent t-tests for examining associations and differences in opinions and knowledge, respectively. Results A total of 429 undergraduate students completed the survey and were included. Significant associations were found between the students' major and their beliefs regarding the effectiveness of the vaccine in preventing influenza (p=0.017) and the inclusion of influenza vaccines in medical practice (p=0.016). The majority of students agreed with seven out of nine knowledge statements, with agreement percentages ranging from 42.9% to 44.8%. When comparing knowledge scores, students majoring in medicine had a significantly higher mean knowledge score (3.91) compared to students studying other medical sciences (3.72) (p=0.019). Conclusion and Recommendations Our study suggests that a comprehensive approach involving education, awareness initiatives, and policy changes is needed to enhance knowledge about influenza vaccination among Saudi Arabian undergraduate students in Medical School allied medical sciences and medical degree programs. By implementing these strategies, we can promote a positive attitude towards flu vaccination and ultimately increase its uptake.
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Affiliation(s)
- Ziyad F Al Nufaiei
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulghani Alshenkiti
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faris N Sallam
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Nizar Suhail Badraig
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Raid M Al Zhranei
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Khalid M Alshamrani
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Naif Sannan
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Maher Alsulami
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Majid S Al-Thaqafy
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Infection Prevention and Control Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Emad Abdelrahman
- General Medicine, Albayt Medical General Center, Mecca, Saudi Arabia
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16
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Thangaraj A, Anbazhagan J, Chandrasekaran V, Philomenadin FS, Dhodapkar R. Clinical profile of influenza virus-related hospitalizations in children aged 1-59 months: A five-year retrospective study from south India. Pediatr Pulmonol 2023; 58:2520-2526. [PMID: 37278543 DOI: 10.1002/ppul.26539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/04/2023] [Accepted: 05/27/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Influenza is a seasonal acute respiratory tract infection with different strains in circulation at different time periods with varying spectrum of clinical presentation. OBJECTIVES To study the clinical presentation, morbidity, and mortality patterns associated with different strains of influenza virus, to identify the predominant strains related to hospitalization, and to identify the seasonal trend in hospitalization and risk factors for mortality in children aged 1-59 months hospitalized with influenza. MATERIALS AND METHODS The records of children hospitalized with influenza were analyzed retrospectively (June 2013 to June 2018). Anonymized data from the Medical Records Department of our Institute, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), were used for the study and waiver of consent was obtained from the Institute Ethics Committee for Human Studies (JIPMER), which also approved the study. The data from the medical records were extracted as per the proforma and entered into Microsoft excel and summary statistics was obtained. Categorical data were expressed as proportion and analyzed using chi square test. Association was tested using odds ratio. RESULTS Of the 693 children tested for influenza during the study period, 91 were found to be positive for influenza infection and out of which 68 (74.7%) were hospitalized. Infection was seen during both the summer and winter months. The predominant strain being A (H1N1) pdm09 (63.2%). The other strains found were A (H3N2) and Influenza B. The predominant diagnosis was pneumonia. The need for mechanical ventilation was more common with influenza B infection (p = 0.035). No significant risk factors for mortality could be found in our study. CONCLUSION An absence of seasonal predilection for the disease was noted with influenza A (H1N1) pdm09 being the predominant strain with influenza B seen as an emerging strain and an important contributor towards morbidity.
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Affiliation(s)
- Abarna Thangaraj
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jagadeesh Anbazhagan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Venkatesh Chandrasekaran
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | | | - Rahul Dhodapkar
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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17
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Chan PSF, Fang Y, Kawuki J, Chen S, Liang X, Mo PKH, Wang Z. Parental Acceptance, Parental Hesitancy, and Uptake of Seasonal Influenza Vaccination among Children Aged 6-59 Months: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1360. [PMID: 37631928 PMCID: PMC10459009 DOI: 10.3390/vaccines11081360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
This systematic review and meta-analysis summarises the literature on parental acceptance, parental hesitancy, uptake, and the associated factors of seasonal influenza vaccination (SIV) among children aged 6-59 months. Studies were sourced from the following platforms: PubMed, Web of Science, MEDLINE, and EMBASE databases. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of parental acceptance, parental hesitancy, and SIV uptake in the last flu season and lifetime among children. A total of 36 studies were included for analysis. The overall prevalence was 64% for parental acceptance (95% CI: 51-75%), 34% for parental hesitancy (95% CI: 22-48%), 41% for SIV uptake in the last flu season (95% CI: 33-50%), and 46% for SIV uptake in a lifetime (95% CI: 20-74%). Associated factors of parental acceptance/hesitancy and uptake included the age of the children or parents, parental education level, household income level, ethnicity, and other modifiable factors, including perceived benefits, perceived barriers, perceived severity, perceived susceptibility, and cues to action related to SIV. Meta-regression analyses revealed regional differences in parental acceptance (Americas: 79% vs. Asia: 60%). The results provided implications informing us of the development of intervention programs targeting parents to improve SIV coverage among young children.
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Affiliation(s)
- Paul Shing-fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China;
| | - Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Xue Liang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Phoenix Kit-han Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
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18
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Orrico-Sánchez A, Valls-Arévalo Á, Garcés-Sánchez M, Álvarez Aldeán J, Ortiz de Lejarazu Leonardo R. Efficacy and effectiveness of influenza vaccination in healthy children. A review of current evidence. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:396-406. [PMID: 36681572 DOI: 10.1016/j.eimce.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/08/2022] [Indexed: 01/21/2023]
Abstract
Influenza is common in healthy children and adolescents and is associated with a high rate of hospitalization in this group, especially for those <5 years. Although the WHO has recommended vaccination in children under 5 years of age since 2012, it is really implemented in few countries today. The aim of this paper was to review the available evidence on the efficacy/effectiveness of influenza vaccination in healthy children <18 years of age through a non-systematic search of studies conducted between 2010 and 2020. Despite the high variability in results due to differences in design, vaccine type and season included in the 41 selected studies, statistically significant studies show efficacy values for the influenza vaccine of between 25.6% and 74.2%, and effectiveness from 26% to 78.8%. Although a systematic review would be necessary to corroborate the evidence, this review suggests that paediatric vaccination is generally an effective measure for preventing influenza in healthy children in line with international organisms' recommendations.
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Affiliation(s)
- Alejandro Orrico-Sánchez
- Área de Investigación en vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO) - Salud Pública, Valencia, Spain
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19
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Gao Z, Yu L, Cao L, Yang M, Li Y, Lan Y, Tang R, Huang Y, Luan G, Liu Y, Yu H, Jian L, Zha Y, Fan Z, Bai Y, Luo M, He M, Deng S. Analysis of coexisting pathogens in nasopharyngeal swabs from COVID-19. Front Cell Infect Microbiol 2023; 13:1140548. [PMID: 37424777 PMCID: PMC10325643 DOI: 10.3389/fcimb.2023.1140548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background The impact of COVID-19 on the world is still ongoing, and it is currently under regular management. Although most infected people have flu-like symptoms and can cure themselves, coexisting pathogens in COVID-19 patients should not be taken lightly. The present study sought to investigate the coexisting pathogens in SARS-CoV-2 infected patients and identify the variety and abundance of dangerous microbes to guide treatment strategies with a better understanding of the untested factors. Methods We extracted total DNA and RNA in COVID-19 patient specimens from nasopharyngeal swabs to construct a metagenomic library and utilize Next Generation Sequencing (NGS) to discover chief bacteria, fungi, and viruses in the body of patients. High-throughput sequencing data from Illumina Hiseq 4000 were analyzed using Krona taxonomic methodology for species diversity. Results We studied 56 samples to detect SARS-CoV-2 and other pathogens and analyzed the species diversity and community composition of these samples after sequencing. Our results showed some threatening pathogens such as Mycoplasma pneumoniae, Klebsiella pneumoniae, Streptococcus pneumoniae, and some previously reported pathogens. SARS-CoV-2 combined with bacterial infection is more common. The results of heat map analysis showed that the abundance of bacteria was mostly more than 1000 and that of viruses was generally less than 500. The pathogens most likely to cause SARS-CoV-2 coinfection or superinfection include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Klebsiella pneumoniae, and Human gammaherpesvirus 4. Conclusions The current coinfection and superinfection status is not optimistic. Bacteria are the major threat group that increases the risk of complications and death in COVID-19 patients and attention should be paid to the use and control of antibiotics. Our study investigated the main types of respiratory pathogens prone to coexisting or superinfection in COVID-19 patients, which is valuable for identifying and treating SARS-CoV-2.
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Affiliation(s)
- Zhan Gao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Lisong Yu
- Information Institute, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- Department of Information Technology, Assumption University, Bangkok, Thailand
| | - Ling Cao
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Meng Yang
- Non-Coding RNA and Drug Discovery KeyLaboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Yuhui Li
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Human Leukocyte Antigen (HLA) Typing Laboratory, Blood Center of Shaanxi Province, Institute of Xi’an Blood Bank, Xi’an, China
| | - Yue Lan
- College of Life Sciences, Sichuan University, Chengdu, China
| | - Ruixiang Tang
- College of Life Sciences, Sichuan University, Chengdu, China
| | - Yang Huang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Guangxin Luan
- Non-Coding RNA and Drug Discovery KeyLaboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Yingfen Liu
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Hailin Yu
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Ling Jian
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Yi Zha
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Zhenxin Fan
- College of Life Sciences, Sichuan University, Chengdu, China
| | - Yujiao Bai
- Non-Coding RNA and Drug Discovery KeyLaboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Mei Luo
- Department of Laboratory Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Shanshan Deng
- Non-Coding RNA and Drug Discovery KeyLaboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
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20
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Okubo Y, Uda K, Miyairi I. Trends in Influenza and Related Health Resource Use During 2005-2021 Among Children in Japan. Pediatr Infect Dis J 2023; Publish Ahead of Print:00006454-990000000-00474. [PMID: 37310897 DOI: 10.1097/inf.0000000000003966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND To determine the epidemiological trends in pediatric influenza and changes in healthcare resource use from 2005 to 2021 using nationally representative outpatient database in Japan. METHODS We conducted a retrospective cohort study consisting of 3.5 million children with 177 million person-months during 2005-2021 using Japan Medical Data Center claims database in Japan. We investigated trends in incidence rates of influenza and changes in healthcare resource use (eg, use of antivirals) over 17 years. Generalized estimation equations were used to investigate the impact of the 2009 influenza pandemic and the coronaviral disease 2019 (COVID-19) pandemic on incidence rates of influenza and related healthcare utilization. RESULTS Annual incidence rates of influenza were estimated at 55 cases per 1000 person-years with a 93% relative increase [95% confidence interval (CI): 80%-107%] during the 2009 influenza pandemic and a 99.4% relative reduction (95% CI: 99.3%-99.4%) during the COVID-19 pandemic. Similar patterns were observed for health resource use, total healthcare costs, admission rates and antiviral agent use. Approximately 80% of children with influenza received prescriptions for antivirals. The most prescribed antivirals were oseltamivir, but we observed a temporal increase in zanamivir use during 2007-2009, an increasing trend in laminamivir use during 2010-2017, a temporal increase in baloxavir use in 2018. Symptomatic medications with serious side effects (codeine, salicylate, sedative antihistamine) showed decreasing trends over the study period. CONCLUSIONS Influenza incidence and healthcare resource use were largely affected by the 2009 influenza pandemic and the COVID-19 pandemic. Our study indicates improvement of quality in healthcare delivered to children.
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Affiliation(s)
- Yusuke Okubo
- From the Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuhiro Uda
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
- Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, TN
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
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21
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Igboh LS, Roguski K, Marcenac P, Emukule GO, Charles MD, Tempia S, Herring B, Vandemaele K, Moen A, Olsen SJ, Wentworth DE, Kondor R, Mott JA, Hirve S, Bresee JS, Mangtani P, Nguipdop-Djomo P, Azziz-Baumgartner E. Timing of seasonal influenza epidemics for 25 countries in Africa during 2010-19: a retrospective analysis. Lancet Glob Health 2023; 11:e729-e739. [PMID: 37061311 PMCID: PMC10126228 DOI: 10.1016/s2214-109x(23)00109-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Using country-specific surveillance data to describe influenza epidemic activity could inform decisions on the timing of influenza vaccination. We analysed surveillance data from African countries to characterise the timing of seasonal influenza epidemics to inform national vaccination strategies. METHODS We used publicly available sentinel data from African countries reporting to the WHO Global Influenza Surveillance and Response FluNet platform that had 3-10 years of data collected during 2010-19. We calculated a 3-week moving proportion of samples positive for influenza virus and assessed epidemic timing using an aggregate average method. The start and end of each epidemic were defined as the first week when the proportion of positive samples exceeded or went below the annual mean, respectively, for at least 3 consecutive weeks. We categorised countries into five epidemic patterns: northern hemisphere-dominant, with epidemics occurring in October-March; southern hemisphere-dominant, with epidemics occurring in April-September; primarily northern hemisphere with some epidemic activity in southern hemisphere months; primarily southern hemisphere with some epidemic activity in northern hemisphere months; and year-round influenza transmission without a discernible northern hemisphere or southern hemisphere predominance (no clear pattern). FINDINGS Of the 34 countries reporting data to FluNet, 25 had at least 3 years of data, representing 46% of the countries in Africa and 89% of Africa's population. Study countries reported RT-PCR respiratory virus results for a total of 503 609 specimens (median 12 971 [IQR 9607-20 960] per country-year), of which 74 001 (15%; median 2078 [IQR 1087-3008] per country-year) were positive for influenza viruses. 248 epidemics occurred across 236 country-years of data (median 10 [range 7-10] per country). Six (24%) countries had a northern hemisphere pattern (Algeria, Burkina Faso, Egypt, Morocco, Niger, and Tunisia). Eight (32%) had a primarily northern hemisphere pattern with some southern hemisphere epidemics (Cameroon, Ethiopia, Mali, Mozambique, Nigeria, Senegal, Tanzania, and Togo). Three (12%) had a primarily southern hemisphere pattern with some northern hemisphere epidemics (Ghana, Kenya, and Uganda). Three (12%) had a southern hemisphere pattern (Central African Republic, South Africa, and Zambia). Five (20%) had no clear pattern (Côte d'Ivoire, DR Congo, Madagascar, Mauritius, and Rwanda). INTERPRETATION Most countries had identifiable influenza epidemic periods that could be used to inform authorities of non-seasonal and seasonal influenza activity, guide vaccine timing, and promote timely interventions. FUNDING None. TRANSLATIONS For the Berber, Luganda, Xhosa, Chewa, Yoruba, Igbo, Hausa and Afan Oromo translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Ledor S Igboh
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Immunization Systems Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Katherine Roguski
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Perrine Marcenac
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Myrna D Charles
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stefano Tempia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Belinda Herring
- World Health Organization-Regional Office for Africa, Brazzaville, Congo
| | - Katelijn Vandemaele
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Ann Moen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Josh A Mott
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Siddhivinayak Hirve
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | | | - Punam Mangtani
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Nguipdop-Djomo
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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22
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Korsun N, Trifonova I, Dobrinov V, Madzharova I, Grigorova I, Christova I. Low prevalence of influenza viruses and predominance of A(H3N2) virus with respect to SARS-CoV-2 during the 2021-2022 season in Bulgaria. J Med Virol 2023; 95:e28489. [PMID: 36832544 PMCID: PMC10107854 DOI: 10.1002/jmv.28489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/24/2023]
Abstract
Social distancing, mask-wearing, and travel restrictions during the COVID-19 pandemic have significantly impacted the spread of influenza viruses. The objectives of this study were to analyze the pattern of influenza virus circulation with respect to that of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Bulgaria during the 2021-2022 season and to perform a phylogenetic/molecular analysis of the hemagglutinin (HA) and neuraminidase (NA) sequences of representative influenza strains. Influenza infection was confirmed using real-time reverse transcription polymerase chain reaction in 93 (4.2%) of the 2193 patients with acute respiratory illness tested wherein all detected viruses were subtyped as A(H3N2). SARS-CoV-2 was identified in 377 (24.3%) of the 1552 patients tested. Significant differences in the incidence of influenza viruses and SARS-CoV-2 were found between individual age groups, outpatients/inpatients, and in the seasonal distribution of cases. Two cases of coinfections were identified. In hospitalized patients, the Ct values of influenza viruses at admission were lower in adults aged ≥65 years (indicating higher viral load) than in children aged 0-14 years (p < 0.05). In SARS-CoV-2-positive inpatients, this association was not statistically significant. HA genes of all A(H3N2) viruses analyzed belonged to subclade 3C.2a1b.2a. The sequenced viruses carried 11 substitutions in HA and 5 in NA, in comparison to the vaccine virus A/Cambodia/e0826360/2020, including several substitutions in the HA antigenic sites B and C. This study revealed extensive changes in the typical epidemiology of influenza infection, including a dramatic reduction in the number of cases, diminished genetic diversity of circulating viruses, changes in age, and seasonal distribution of cases.
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Affiliation(s)
- Neli Korsun
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Veselin Dobrinov
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iliyana Grigorova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iva Christova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Paget J, Staadegaard L, Wang X, Li Y, van Pomeren T, van Summeren J, Dückers M, Chaves SS, Johnson EK, Mahé C, Nair H, Viboud C, Spreeuwenberg P. Global and national influenza-associated hospitalisation rates: Estimates for 40 countries and administrative regions. J Glob Health 2023; 13:04003. [PMID: 36701368 PMCID: PMC9879557 DOI: 10.7189/jogh.13.04003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to improve the understanding of influenza-associated hospitalisation estimates at a national and global level. Methods We performed a systematic literature review of English- and Chinese-language studies published between 1995 and 2020 estimating influenza-associated hospitalisation. We included a total of 127 studies (seven in Chinese) in the meta-analysis and analyzed their data using a logit-logistic regression model to understand the influence of five study factors and produce national and global estimates by age groups. The five study factors assessed were: 1) the method used to calculate the influenza-associated hospitalisation estimates (rate- or time series regression-based), 2) the outcome measure (divided into three envelopes: narrow, medium, or wide), 3) whether every case was laboratory-confirmed or not, 4) whether the estimates were national or sub-national, 5) whether the rates were based on a single year or multiple years. Results The overall pooled influenza-associated hospitalisation rate was 40.5 (95% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates varying substantially by age: 224.0 (95% CI = 118.8-420.0) in children aged 0-4 years and 96.8 (95% CI = 57.0-164.3) in the elderly aged >65 years. The overall pooled hospitalisation rates varied by calculation method; for all ages, the rates were significantly higher when they were based on rate-based methods or calculated on a single season and significantly lower when cases were laboratory-confirmed. The national hospitalisation rates (all ages) varied considerably, ranging from 11.7 (95% CI = 3.8-36.3) per 100 000 in New Zealand to 122.1 (95% CI = 41.5-358.4) per 100 000 in India (all age estimates). Conclusions Using the pooled global influenza-associated hospitalisation rate, we estimate that seasonal influenza epidemics result in 3.2 million cases of severe illness (hospitalisations) per annum. More extensive analyses are required to assess the influence of other factors on the estimates (e.g. vaccination and dominant virus (sub)types) and efforts to harmonize the methods should be encouraged. Our study highlights the high rates of influenza-associated hospitalisations in children aged 0-4 years and the elderly aged 65+ years.
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Affiliation(s)
- John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Lisa Staadegaard
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Xin Wang
- School of Public Health, Nanjing Medical University, Nanjing, China,Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - You Li
- School of Public Health, Nanjing Medical University, Nanjing, China,Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Tayma van Pomeren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | | | - Michel Dückers
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - Emily K Johnson
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Cédric Mahé
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
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Smith KA, Hudson SM, Betz CL, Chwa JS, Cellura R, Van Speybroeck A. Risk factors for unanticipated hospitalizations in children and youth with spina bifida at an urban children's hospital: A cross-sectional study. Disabil Health J 2023; 16:101373. [PMID: 36156271 DOI: 10.1016/j.dhjo.2022.101373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Spina bifida (SB) is a condition resulting from the improper closure of the neural tube and vertebral column during fetal development. While patients' life expectancy and quality of life have improved dramatically due to medical advances, children continue to experience health-related issues that often require hospitalizations. OBJECTIVE The association among sociodemographic and clinical characteristics with potentially preventable hospitalizations (PPH) in children and youth with myelomeningocele type SB was investigated in this cross-sectional study. METHODS Chart reviews and data extraction were conducted on 108 children and youth, ages 1 month to 21 years, admitted for PPH in a regional children's academic medical center between May 2017 and July 2019. Sociodemographic variables included sex, age, type of insurance and ethnicity. Clinical variables included level of lesion, ambulation status, shunt dependency and selected diagnostic categories. Univariate, bivariate, and multivariate analyses were conducted to identify factors associated with PPH. RESULTS Factors associated with PPH included being male, ages 5-18 years, low lumbar level lesions, non-ambulatory, with public insurance, Hispanic and shunt dependent. Most hospitalizations (73%) were for neurologic or urologic conditions. Factors independently associated with PPH were ethnicity for urologic conditions, being ambulatory for metabolic conditions, and age for gastroenterology conditions. CONCLUSION Selected demographic and clinical variables were found to be associated with PPH of children and youth with myelomeningocele-type SB. The most common reasons for PPH were shunt malfunctions and urinary tract infections, consistent with other studies.
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Affiliation(s)
- Kathryn A Smith
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.
| | - Sharon M Hudson
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Cecily L Betz
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Jason S Chwa
- University of Southern California, Dornsife College of Letters, Arts and Sciences, 3551 Trousdale Pkwy, Los Angeles, CA 90089, USA
| | - Rhonda Cellura
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA
| | - Alexander Van Speybroeck
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
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25
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Sobierajski T, Rykowska D, Wanke-Rytt M, Kuchar E. Vaccine or Garlic-Is It a Choice? Awareness of Medical Personnel on Prevention of Influenza Infections. Vaccines (Basel) 2022; 11:vaccines11010066. [PMID: 36679911 PMCID: PMC9865668 DOI: 10.3390/vaccines11010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Preventing the spread of the influenza virus is one of the primary health policy challenges of many countries worldwide. One of the more effective ways to prevent infection is influenza vaccination, and the people who enjoy the most public confidence in preventive health care are health workers (HWs). For this reason, it is crucial to study the attitudes of HWs toward influenza vaccination. METHODS The survey was conducted among 950 medical (physicians and nurses) and administrative staff in three academic hospitals. Respondents to the survey were selected on a random-target basis to represent hospital employees in the study best. The survey was conducted using the PAPI method between August and September 2020. RESULTS Respondents considered hand washing (52.8%) and avoiding contact with sick people (49.3%) the most effective ways to prevent influenza infection. Three in ten respondents considered wearing a protective mask (30.1%) and getting vaccinated against influenza (29.9%) is fully effective in preventing influenza. Influenza vaccination as effective in preventing influenza virus infection was chosen more often by those who worked in a pediatric hospital. Nurses were twice less likely than physicians to declare that influenza vaccination prevents infection (42.4% for nurses vs. 84.0% for physicians). At the same time, 20.4% of nurses believed that eating garlic effectively prevented influenza infection, and 28.1% declared daily vitamin C helpful. CONCLUSIONS The study pointed to significant educational gaps regarding the role and effectiveness of influenza vaccination in the process of influenza virus infection and indicated a firm belief in medical myths, especially in the nursing community, related to protection against influenza virus infection.
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Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
- Correspondence: ; Tel.: +48-503-456-234
| | - Dominika Rykowska
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
| | - Monika Wanke-Rytt
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki & Wigury Str., 02-091 Warsaw, Poland
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26
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Bhoite R, Satyavrat V, Premasudha Sadananda M. Clinical benefits of β-glucan supplementation in children: a review. Discov Food 2022. [PMCID: PMC9793387 DOI: 10.1007/s44187-022-00038-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractMalnutrition is a global concern since it affects 130 million children under the age of 5 worldwide. The child’s immunity is brutally compromised, making them susceptible to various diseases and infections, leading to a high mortality rate. Multiple strategies have been implemented to strengthen immunity in children with compromised immunity, such as rendering a balanced diet, fortifying food, dietary supplements, and introducing potential natural dietary fibers to maintain good nutrition status, such as β-glucan. A class of biologically active polysaccharides, sourced from yeast, mushroom, bacteria, and cereals with versatile immunomodulatory benefits that potentially primes the host immune system, drives several metabolic health effects, increases infection resistance, shields against the damaging effects of stress, and maintains healthy energy levels. This review focuses on the capabilities, underlying mechanisms, immune-stimulating potency, and clinically meaningful shreds of evidence to substantiate the multiple health benefits of β-glucan in children. Although, more clinical studies are required, current findings confirms the various biological response modifying abilities of β-glucan that may notably aid in the development of a strong immune system in children for their overall health and wellbeing.
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Affiliation(s)
- Rachana Bhoite
- Dr Reddy’s Laboratories Pvt Ltd, Ameerpet, Hyderabad, India
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Fisher WA, Gilca V, Murti M, Orth A, Garfield H, Roumeliotis P, Rampakakis E, Brown V, Yaremko J, Van Buynder P, Boikos C, Mansi JA. Continuing Medical Education Improves Physician Communication Skills and Increases Likelihood of Pediatric Vaccination: Findings from the Pediatric Influenza Vaccination Optimization Trial (PIVOT)-II. Vaccines (Basel) 2022; 11:17. [PMID: 36679861 DOI: 10.3390/vaccines11010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
This study evaluated the impact of a continuing medical education (CME) program that emphasized actionable information, motivation to act, and skills to strengthen physician recommendations for seasonal influenza vaccination in children 6 through 23 months of age for whom influenza immunization rates are suboptimal. Physicians were randomly assigned to an accredited CME program or to no CME. Participants completed pre- and post-study questionnaires. Influenza immunization rates were compared between groups. A total of 33 physicians in the CME group and 35 in the control group documented 292 and 322 healthy baby visits, respectively. Significantly more parents immunized their children against influenza after interacting with CME-trained physicians than those with no CME training (52.9% vs. 40.7%; p = 0.007). The odds ratio for vaccination after visits with CME-trained physicians was 1.52 (95% confidence interval 1.09 to 2.12; p = 0.014), which was unaffected by the socioeconomic status of parents. Parents who discussed influenza vaccination with CME-trained physicians were 20% more likely to choose an approved but publicly unfunded adjuvanted pediatric influenza vaccine. The percentages of physicians reporting the highest levels of knowledge, ability, and confidence doubled or tripled after the CME intervention. Significantly more parents immunized very young children after interacting with physicians who had undergone CME training.
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Li W, Li T, Zhao C, Song T, Mi Y, Chuangfeng Z, Hou Y, Jia Z. XiaoEr LianHuaQinqGan alleviates viral pneumonia in mice infected by influenza A and respiratory syncytial viruses. Pharm Biol 2022; 60:2355-2366. [PMID: 36444944 PMCID: PMC9809968 DOI: 10.1080/13880209.2022.2147961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/10/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Xiaoer lianhuaqinqgan (XELH), developed based on Lianhua Qingwen (LHQW) prescription, contains 13 traditional Chinese medicines. It has completed the investigational new drug application to treat respiratory viral infections in children in China. OBJECTIVE This study demonstrates the pharmacological effects of XELH against viral pneumonia. MATERIALS AND METHODS The antiviral and anti-inflammatory effects of XELH were investigated in vitro using H3N2-infected A549 and LPS-stimulated RAW264.7 cells and in vivo using BALB/c mice models of influenza A virus (H3N2) and respiratory syncytial virus (RSV)-infection. Mice were divided into 7 groups (n = 20): Control, Model, LHQW (0.5 g/kg), XELH-low (2 g/kg), XELH-medium (4 g/kg), XELH-high (8 g/kg), and positive drug (20 mg/kg oseltamivir or 60 mg/kg ribavirin) groups. The anti-inflammatory effects of XELH were tested in a rat model of LPS-induced fever and a mouse model of xylene-induced ear edoema. RESULTS In vitro, XELH inhibited the pro-inflammatory cytokines and replication of H1N1, H3N2, H1N1, FluB, H9N2, H6N2, H7N3, RSV, and HCoV-229E viruses, with (IC50 47.4, 114, 79, 250, 99.2, 170, 79, 62.5, and 93 μg/mL, respectively). In vivo, XELH reduced weight loss and lung index, inhibited viral replication and macrophage M1 polarization, ameliorated lung damage, decreased inflammatory cell infiltration and pro-inflammatory cytokines expression in lung tissues, and increased the CD4+/CD8+ ratio. XELH inhibited LPS-induced fever in rats and xylene-induced ear edoema in mice. CONCLUSION XELH efficacy partially depends on integrated immunoregulatory effects. XELH is a promising therapeutic option against childhood respiratory viral infections.
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Affiliation(s)
- Wenyan Li
- Hebei Yiling Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Shijiazhuang Yiling Pharmaceutical Co., Ltd, Shijiazhuang, Hebei, China
| | - Tongtong Li
- College of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Chi Zhao
- Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tao Song
- Shijiazhuang Yiling Pharmaceutical Co., Ltd, Shijiazhuang, Hebei, China
| | - Yao Mi
- Shijiazhuang Yiling Pharmaceutical Co., Ltd, Shijiazhuang, Hebei, China
| | - Zhang Chuangfeng
- Shijiazhuang Yiling Pharmaceutical Co., Ltd, Shijiazhuang, Hebei, China
| | - Yunlong Hou
- College of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, Hebei, China
- Shijiazhuang Compound Traditional Chinese Medicine Technology Innovation Center, Shijiazhuang, Hebei, China
| | - Zhenhua Jia
- College of Integrated Traditional Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Shijiazhuang Compound Traditional Chinese Medicine Technology Innovation Center, Shijiazhuang, Hebei, China
- Hebei Yiling Hospital, Shijiazhuang, Hebei, China
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Frimpong JA, Ampofo WK, Nyarko KM, Duque J, Aboagye J, Koram K, Widdowson M. Effect of antipyretics on performance of influenza surveillance in Ghana. Influenza Other Respir Viruses 2022; 17:e13068. [PMID: 36370028 PMCID: PMC9835404 DOI: 10.1111/irv.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The World Health Organization's case definition for influenza-like illness (ILI) includes a measured temperature of ≥38°C. We conducted this study to assess the effect of antipyretics on performance of ILI surveillance in Ghana. METHODS A cross-sectional study was conducted in two districts of Ghana from September 2013 to May 2014. We collected epidemiological data and respiratory specimens from an expanded ILI case definition, which included patients presenting to health facilities with measured temperature ≥38°C or reported fever (but afebrile at the time of evaluation), and cough, with onset in the last 10 days. Specimens were tested for influenza viruses by real time reverse-transcription polymerase chain reaction. RESULTS Of 321 participants who met our expanded ILI case definition, 236 presented with temperature of <38°C but reported subjective fever. Of these, 17% (39/236) were positive for influenza virus; Of those with fever ≤38°C who took antipyretics, 21%(16/77) were positive for influenza, compared with 14%(23/159) of those who did not take antipyretics. The addition of subjective fever to the standard ILI case definition captured approximately an additional 57% influenza cases but also required testing of approximately four times as many patients. However, including those without fever on presentation that had taken antipyretics found an additional 23% of Influenza cases and only two times as much testing. CONCLUSION Depending on the goals of surveillance (monitoring virus circulation or determining disease burden) and available resources, a more sensitive case definition including subjective fever and history of use of antipyretics may be warranted.
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Affiliation(s)
| | | | - Kofi Mensah Nyarko
- Department of Environmental and Public HealthUniversity of Environmental and Sustainable DevelopmentSomanyaGhana
| | | | - James Aboagye
- Noguchi Memorial Institute for Medical ResearchUniversity of GhanaAccraGhana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical ResearchUniversity of GhanaAccraGhana
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CALABRÒ GIOVANNAELISA, ICARDI GIANCARLO, BONANNI PAOLO, GABUTTI GIOVANNI, VITALE FRANCESCO, RIZZO CATERINA, CICCHETTI AMERICO, STAIANO ANNAMARIA, ANSALDI FILIPPO, ORSI ANDREA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, BERT FABRIZIO, VILLANI ALBERTO, IERACI ROBERTO, CONVERSANO MICHELE, RUSSO CARMELA, RUMI FILIPPO, SCOTTI SILVESTRO, MAIO TOMMASA, RUSSO ROCCO, VACCARO CONCETTAMARIA, SILIQUINI ROBERTA, RICCIARDI WALTER. [Flu vaccination and value-based health care: operational solutions to safeguard public health]. J Prev Med Hyg 2022; 63:E1-E85. [PMID: 36310765 PMCID: PMC9586154 DOI: 10.15167/2421-4248/jpmh2022.63.2s2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma
- VIHTALI - Value In Health Technology and Academy for Leadership & Innovation, Spin-Off dell'Università Cattolica del Sacro Cuore, Roma
- Autore corrispondente: Giovanna Elisa Calabrò, Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia - E-mail:
| | - GIANCARLO ICARDI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- U.O. Igiene, IRCCS Ospedale Policlinico San Martino, Genova
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute (DSS), Università di Firenze
| | - GIOVANNI GABUTTI
- Coordinatore Nazionale GdL Vaccini e Politiche Vaccinali della SItI
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, Università degli Studi di Palermo
| | - CATERINA RIZZO
- Dipartimento di ricerca traslazionale e nuove tecnologie in medicina e chirurgia, Università degli Studi di Pisa
| | - AMERICO CICCHETTI
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma
| | - ANNAMARIA STAIANO
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi “Federico II”, Napoli
- Presidente Società Italiana di Pediatria (SIP)
| | - FILIPPO ANSALDI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- A.Li.Sa. Azienda Ligure Sanitaria Regione Liguria
| | - ANDREA ORSI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- U.O. Igiene, IRCCS Ospedale Policlinico San Martino, Genova
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- A.Li.Sa. Azienda Ligure Sanitaria Regione Liguria
| | - FABRIZIO BERT
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino
- SSDU Igiene Ospedaliera e Governo delle Infezioni Correlate all’Assistenza, ASL TO3
| | - ALBERTO VILLANI
- Dipartimento Emergenza Accettazione Ospedale Pediatrico Bambino Gesù, IRCCS, Roma
- Dipartimento di Medicina dei Sistemi, Università di Roma Tor Vergata
| | - ROBERTO IERACI
- Strategie vaccinali, Regione Lazio
- Ricercatore associato CID Ethics-CNR
| | | | - CARMELA RUSSO
- U.O.S.V.D. Epidemiologia - Comunicazione e Formazione Coordinamento delle Attività di Promozione della Salute e di Educazione Sanitaria, ASL Taranto
| | - FILIPPO RUMI
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma
| | | | - TOMMASA MAIO
- Federazione Italiana Medici di Medicina Generale (FIMMG)
| | - ROCCO RUSSO
- Coordinatore tavolo tecnico vaccinazioni, Società Italiana di Pediatria (SIP)
| | | | - ROBERTA SILIQUINI
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino
- AOU Città della Salute e della Scienza di Torino
| | - WALTER RICCIARDI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma
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Nasiri MJ, Danaei B, Deravi N, Chirani AS, Bonjar AHS, Khoshgoftar Z, Karimi F. Impact of educational interventions on the prevention of influenza: A systematic review. Front Public Health 2022; 10:978456. [PMID: 36203669 PMCID: PMC9530567 DOI: 10.3389/fpubh.2022.978456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Seasonal influenza, a contagious viral disease affecting the upper respiratory tract, circulates annually, causing considerable morbidity and mortality. The present study investigates the effectiveness of educational interventions to prevent influenza. Methods We searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) for relevant clinical studies up to March 1 2022. The following terms were used: "influenza," "flu," "respiratory infection," "prevent," "intervention," and "education." Results Out of 255 studies, 21 articles satisfied the inclusion criteria and were included in our study: 13 parallel randomized controlled trials (RCT) studies, two cross-over RCT studies, two cohort studies, and four quasi-experimental studies. A total of approximately 12,500 adults (18 years old or above) and 11,000 children were evaluated. Educational sessions and reminders were the most common interventions. The measured outcomes were vaccination rates, the incidence of respiratory tract infection (RTI), and preventive behaviors among participants. Eighteen out of 21 articles showed a significant association between educational interventions and the outcomes. Conclusions The included studies in the current systematic review reported the efficacy of health promotion educational interventions in improving knowledge about influenza, influenza prevention behaviors, vaccination rates, and decreased RTI incidence regardless of the type of intervention and the age of cases.
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Affiliation(s)
- Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Mohammad Javad Nasiri
| | - Bardia Danaei
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Hashem Shahidi Bonjar
- Clinician Scientist of Dental Materials and Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Khoshgoftar
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Zohreh Khoshgoftar
| | - Forouzan Karimi
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Forouzan Karimi
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Azziz-Baumgartner E, Duca LM, González R, Calvo A, Kaydos-Daniels SC, Olson N, MacNeil A, Veguilla V, Domínguez R, Vicari A, Rauda R, Vuong N, Ropero AM, Armero J, Porter R, Franco D, Pascale JM. Incidence of respiratory virus illness and hospitalizations in a Panama and El Salvador birth cohort, 2014-2018. Lancet Reg Health Am 2022; 13:None. [PMID: 36189114 PMCID: PMC9485193 DOI: 10.1016/j.lana.2022.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Respiratory viruses remain a key cause of early childhood illness, hospitalization, and death globally.The recent pandemic has rekindled interest in the control of respiratory viruses among paediatric populations. We estimate the burden of such viruses among children <2 years. Methods Enrolled neonates were followed until two years of age. Weekly active symptom monitoring for the development of acute respiratory illnesses (ARI) defined as cough, rhinorrhoea, difficulty breathing, asthenia, anorexia, irritability, or vomiting was conducted. When the child had ARI and fever, nasopharyngeal swabbing was performed, and samples were tested through singleplex RT-PCR. Incidence of respiratory viruses was calculated by dividing the number of laboratory-confirmed detections by the person-time accrued during weeks when that virus was detectable through national surveillance then corrected for under-ascertainment among untested children. Findings During December 2014-November 2017, 1567 enrolled neonates contributed 2,186.9 person-years (py). Six in ten (64·4%) children developed ARI (total 2493 episodes). Among children <2 years, incidence of respiratory syncytial virus (RSV)-associated ARI episodes (21·0, 95%CI 19·3-22·8, per 100py) and rhinovirus-associated (20·5, 95%CI 20·4-20·7) were similar and higher than parainfluenza 1-3-associated (14·2, 95%CI 12·2-16·1), human metapneumovirus-associated (9·2, 95%CI 7·7-10·8), influenza-associated (5·9, 95%CI 4·4-7·5), and adenovirus-associated ARI episodes (5·1, 95%CI 5·0-5·2). Children aged <3 months had the highest rates of RSV ARI (49·1, 95%CI 44·0-54·1 per 100py) followed by children aged 3-5 (25·1, 95%CI 20·1-30·0), 6-11 (17·6, 95%CI 13·2-21·9), and 12-23 months (11·9, 95%CI 10·8-12·9). One in ten children with RSV was referred to the hospital (2·5, 95%CI 2·1-2·8, per 100py). Interpretation Children frequently developed viral ARI and a substantive proportion required hospital care. Such findings suggest the importance of exploring the value of new interventions and increasing uptake of existing prevention measures to mitigate burden of epidemic-prone respiratory viruses. Funding The study was supported by the Centers for Disease Control and Prevention.
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Affiliation(s)
| | - Lindsey M Duca
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Arlene Calvo
- Gorgas Institute, Panama City, Panama
- University of South Florida, Panama
| | | | - Natalie Olson
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adam MacNeil
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vic Veguilla
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Rafael Rauda
- National Institute of Health of El Salvador, El Salvador
| | - Nga Vuong
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Julio Armero
- National Institute of Health of El Salvador, El Salvador
| | - Rachael Porter
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sona S, Sharma A, Chamuah K, Henbi LN, Rajbongshi G. Influenza virus and its subtypes circulating during 2018-2019: A hospital-based study from Assam. Indian J Med Microbiol 2022:S0255-0857(22)00142-6. [PMID: 36002356 DOI: 10.1016/j.ijmmb.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/23/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Influenza virus can cause serious respiratory illness sometimes resulting in epidemics and pandemics associated with significant morbidity and mortality across the globe. Hence, continuous surveillance of the activity of the influenza virus and its subtypes is necessary to help the policy makers to take effective and appropriate decisions regarding its control. The study aimed to determine distribution of influenza viruses in Assam of north-east India having subtropical climate that may lead to viral subtype divergence. METHODS Clinically suspected ninety cases with Influenza like illness (ILI) were included, irrespective of age and sex during the period 1st July 2018 to 30th June 2019. Aseptically collected Nasopharyngeal swabs in viral transport media (VTM) were tested by conventional Reverse Transcriptase Polymerase Chain Reaction (RT PCR) for detection of Influenza A and Influenza B viruses which were further processed for detection of subtypes such as H1N1 pdm09, H3N2 and Influenza B (Yamagata and Victoria lineage). Normally distributed continuous variables were summarised by mean and standard deviation. All categorical variables were summarised as percentages. RESULTS Influenza activity was seen in 42.2% of ILI cases with male predominance (57.9%). Influenza A was the predominant type (84.2%). Among the subtypes, A(H1N1) pdm09 was predominant (76.3%) followed by Influenza B (Victoria lineages) (15.8%) and AH3N2 (7.9%). Significant difference was observed between different subtypes with regard to age distribution only. Influenza activity in Assam showed two seasonal peaks; the primary one from May to July and the secondary from November to February. CONCLUSION The study described the distribution of different Influenza viruses and its subtypes in Assam along with their seasonal activities. These findings will help to formulate the policy for its prevention and control in Assam as well as to monitor the efficacy of the current influenza vaccine.
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Omer SB, O'Leary ST, Bednarczyk RA, Ellingson MK, Spina CI, Dudley MZ, Chamberlain AT, Limaye RJ, Brewer SE, Frew PM, Malik FA, Orenstein W, Halsey N, Ault K, Salmon DA. Multi-tiered intervention to increase maternal immunization coverage: A randomized, controlled trial. Vaccine 2022; 40:4955-4963. [PMID: 35817646 DOI: 10.1016/j.vaccine.2022.06.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/13/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the impact of a multi-component intervention package of maternal immunization uptake in obstetric care clinics. METHODS In a multi-level, cluster- and individually-randomized controlled trial we implemented an evidence-based intervention that targeted practice-, provider- and patient-level barriers to vaccine uptake. Obstetric practices were randomized to receive the practice and provider-level interventions or continue their normal standard of care. We enrolled pregnant women at practices in Georgia and Colorado and randomized women into patient-level intervention and control groups, resulting in four study arms. The primary outcomes were receipt of the influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccines during pregnancy. A sample size of 550 women per arm (2200 total) was planned and enrolled to compare the intervention between the four study arms. RESULTS Between June 2017 and July 2018, 4907 women were screened and 2200 women were randomized, 550 to each of the four study arms. We were unable to follow-up with 108 women, for a final sample size of 2092. Sample characteristics and sample size were similar among study arms. There was no significant increase in Tdap or influenza vaccine uptake overall. Among women who had no intention of or were unsure about receiving the influenza vaccine during pregnancy, those who received just the patient-level intervention were 61% more likely to receive the influenza vaccine than those in the control arm (Relative risk: 1.61; 95% Confidence Interval: 1.18-2.21). There was no significant difference in vaccine uptake for either influenza or tetanus, diphtheria and acellular pertussis between the four arms of the study. CONCLUSIONS This trial highlights the need for more targeted interventions to improve vaccine uptake. Future work should focus on clinics with low baseline vaccine uptake and the patient-level intervention should be expanded and targeted towards women with low vaccine confidence.
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Affiliation(s)
- Saad B Omer
- Yale Institute for Global Health, Yale University, New Haven, CT, United States; Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, United States; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States; Yale School of Nursing, Yale University, New Haven, CT, United States
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, United States; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Emory Vaccine Center, Emory University, Atlanta, GA, United States
| | - Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States.
| | - Christine I Spina
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, United States
| | - Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sarah E Brewer
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, United States; Department of Family Medicine, University of Colorado Anschutz Medical Campus, United States
| | - Paula M Frew
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Fauzia A Malik
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, United States; Dean's Office, Yale School of Public Health, New Haven, CT, United States
| | - Walter Orenstein
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Emory Vaccine Center, Emory University, Atlanta, GA, United States; Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Neal Halsey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kevin Ault
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, United States
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Peng Y, Chen Z, Li H, Han Y, Sun D, Li Y, Wu X, Chen H, Li X. Traditional Chinese Medicine Injections Combined With Oseltamivir for Influenza: Systematic Review and Network Meta-Analysis. Front Pharmacol 2022; 13:848770. [PMID: 35935865 PMCID: PMC9355026 DOI: 10.3389/fphar.2022.848770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background: As a cause of respiratory tract infections in humans, influenza remains with high morbidity and mortality, with associated significant healthcare burden and increased financial burden. Traditional Chinese medicine injections (TCMIs) combined with oseltamivir (TCMIs + oseltamivir) are the representative therapeutic strategies for influenza, which is a compliant with clinical applications in China. The aim of this study was to describe the comparative efficacy and safety of TCMIs + oseltamivir in patients with influenza, based on the current evidence. Methods: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP information resource integration service platform databases, and the Chinese biomedical literature service system were searched to find randomized controlled trials where TCMIs + oseltamivir are the representative therapeutic strategies for influenza, from inception until October 2021, without language restriction. Two investigators independently screened eligibility criteria, extracted data, and appraised the risk of bias with the same criteria. We conducted a network meta-analysis using the Bayesian random method for each outcome and performed the sensitivity analysis, meta-regression, and Egger’s and Begg’s tests for the reliability and robustness of our results. Results: Thirty-one trials including 2,893 participants proved eligible and reported on four TCMIs + oseltamivir versus oseltamivir. Network meta-analysis showed Yanhuning (YHN) +oseltamivir (MD = −1.7, 95% CrI: −2.5 to −0.88; SUCRA = 0.89; low certainty of evidence) in fever disappearance time, Tanreqing (TRQ) +oseltamivir (MD = −1.9, 95% CrI: −2.8 to −1; SUCRA = 0.97; low certainty of evidence) in cough disappearance time, and Xiyanping (XYP) +oseltamivir (OR = 5.9, 95% CrI: 3.1 to 11; SUCRA = 0.82; very low certainty of evidence) in the response rate to be more efficacious than oseltamivir alone with the best SUCRA. Based on the combined SUCRA value for primary outcomes, TRQ + oseltamivir is probably better in cough disappearance time, and XYP + oseltamivir and YHN + oseltamivir may be better in fever disappearance time than others. No significant difference in safety between the treatments. Conclusion: In patients with influenza, TCMIs + oseltamivir only partially improve flu symptoms. Overall therapeutic efficacy and safety are inconclusive, based on low to very low certainty of evidence. However, the safety remains uncertain, and TCMI treatments for influenza should be considered with caution. More high-quality studies examining the efficacy and safety of TCMIs are needed. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021286994
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Affiliation(s)
- Yingying Peng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhe Chen
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huanmin Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yaowei Han
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Dan Sun
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yanjiao Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaoxia Wu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hongxiang Chen
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xinmin Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- *Correspondence: Xinmin Li,
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Ji Y, Hu C, Chen Z, Li Y, Dai J, Zhang J, Shu Q. Clinical trials of stem cell-based therapies for pediatric diseases: a comprehensive analysis of trials registered on ClinicalTrials.gov and the ICTRP portal site. Stem Cell Res Ther 2022; 13:307. [PMID: 35841064 PMCID: PMC9284479 DOI: 10.1186/s13287-022-02973-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research on clinical trials that employ stem cells to treat children's diseases is limited. The clinical trial registry database provides a unique window to us to get known about clinical trial researches with different statuses. However, few studies aimed to perform a comprehensive and thorough analysis of those registered trials in the aforementioned field based on ClinicalTrials.gov and the ICTRP portal site. METHODS Our study covered the clinical researches about stem cell therapy enrolling subjects aged under 18 years old registered on ClinicalTrials.gov and WHO ICTRP before May 18, 2021. A cross-sectional study was implemented to comprehensively describe and analyze the included trials that met the criteria. Results were available on ClinicalTrials.gov, and publications related to the included trials were identified. All analyses were performed utilizing the SPSS 25.0 software. RESULTS Eventually, 202 clinical trials were included and evaluated. The participant number of trials tended to be small; 71.3% were enrolled < 50. And 93.5% of the subjects were without gender restrictions. Till May 2020, 112 trials had been preliminary completed, of which only 39 trials had published papers or uploaded results. Most (73.6%) of 186 interventional trials were in phase 1 and phase 2, where 131 (70.4%) trials were conducted without masking, and 26.3% trials were randomized; 55.4% trials were performed single group assignment. Of 16 observational trials, case-only/series took up 37.5%. Hematopoietic stem cells (37.1%) and mesenchymal stem cells (36.1%) were mostly employed, while umbilical cord blood (UCB)-derived cells (24.3%) and bone marrow (BM)-derived cells (20.8%) were the major sources. CONCLUSIONS This study provided an overall picture of utilizing stem cells for treatment and management of childhood diseases. Since clinical trials in this area are insufficient in quantity and quality, there is an urgent need of larger, better-designed trials. Increased investment in clinical research of stem cell treatment products should be carried out to achieve the transformation of results as soon as possible. Moreover, it is important to optimize the management of the registration platform and shorten the time it takes for research results to be published.
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Affiliation(s)
- Yinwen Ji
- National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People's Republic of China
| | - Chuan Hu
- Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, 310016, People's Republic of China
| | - Zuxing Chen
- Department of Orthopedics Surgery Shengli Clinical Medical, College of Fujian Medical University, 134 Dongjie Road, Fuzhou, 350001, People's Republic of China
| | - Ying Li
- National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People's Republic of China
| | - Jiayong Dai
- Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, 310016, People's Republic of China
| | - Jin Zhang
- College of Chemical Engineering, Fuzhou University, 2 Xueyuan Road, Fuzhou, 350108, People's Republic of China.
| | - Qiang Shu
- National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People's Republic of China.
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Zhao L, Zhao Y, Liu Q, Huang J, Lu Y, Ping J. DDX5/METTL3-METTL14/YTHDF2 Axis Regulates Replication of Influenza A Virus. Microbiol Spectr 2022; 10:e0109822. [PMID: 35583334 PMCID: PMC9241928 DOI: 10.1128/spectrum.01098-22] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/28/2022] [Indexed: 12/14/2022] Open
Abstract
DEAD-box helicase 5 (DDX5), a member of the DEAD/H-box helicases, is known to participate in all aspects of RNA metabolism. However, its regulatory effect in antiviral innate immunity during replication of influenza virus remains unclear. Herein, we found that human DDX5 promotes replication of influenza virus in A549 cells. Moreover, our results further revealed that DDX5 relies on its N terminus to interact with the nucleoprotein (NP) of influenza virus, which is independent of RNA. Of course, we also observed colocalization of DDX5 with NP in the context of transfection or infection. However, influenza virus infection had no significant effect on the protein expression and nucleocytoplasmic distribution of DDX5. Importantly, we found that DDX5 suppresses antiviral innate immunity induced by influenza virus infection. Mechanistically, DDX5 downregulated the mRNA levels of interferon beta (IFN-β), interleukin 6 (IL-6), and DHX58 via the METTL3-METTL14/YTHDF2 axis. We revealed that DDX5 bound antiviral transcripts and regulated immune responses through YTHDF2-dependent mRNA decay. Taken together, our data demonstrate that the DDX5/METTL3-METTL14/YTHDF2 axis regulates the replication of influenza A virus. IMPORTANCE The replication and transcription of influenza virus depends on the participation of many host factors in cells. Exploring the relationship between viruses and host factors will help us fully understand the characteristics and pathogenic mechanisms of influenza viruses. In this study, we showed that DDX5 interacted with the NP of influenza virus. We demonstrated that DDX5 downregulated the expression of IFN-β and IL-6 and the transcription of antiviral genes downstream from IFN-β in influenza virus-infected A549 cells. Additionally, DDX5 downregulated the mRNA levels of antiviral transcripts via the METTL3-METTL14/YTHDF2 axis. Our findings provide a novel perspective to understand the mechanism by which DDX5 regulates antiviral immunity.
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Affiliation(s)
- Lingcai Zhao
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Yongzhen Zhao
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Qingzheng Liu
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Jingjin Huang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Yuanlu Lu
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Jihui Ping
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Engineering Laboratory of Animal Immunity of Jiangsu Province, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
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Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen HA, Myint-Yoshida L, Eggo RM, Flasche S. Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 2022; 18:e1010234. [PMID: 35749561 PMCID: PMC9262224 DOI: 10.1371/journal.pcbi.1010234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/07/2022] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95%CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other. Influenza and Respiratory Syncytial Virus (RSV) cause large burdens of disease. Instead of acting independently, there may be short term cross-protection between them. The evidence of this to date comes from ecological studies which are unable to test the mechanism, or biological studies that are unable to determine the population level impacts of such cross-protection. We create a mathematical model that simulates the circulation of these two viruses, and allows for cross-protection between them. We then fit this model to hospital reported cases of confirmed infection from Nha Trang, Vietnam in order to estimate whether any cross-protection exists in this setting. We show that there are two possibilities—either no interaction or moderate interaction that can result in the observed circulation patterns. However, we further show that co-infection results in an increased reporting rate, presumably due to increased severity.
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Affiliation(s)
- Naomi R. Waterlow
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Edwin van Leeuwen
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Statistics, Modelling and Economics Department, UKHSA, London, United Kingdom
| | | | - Lay Myint-Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Rosalind M. Eggo
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Bullard BL, DeBeauchamp J, Pekarek MJ, Petro-Turnquist E, Vogel P, Webby RJ, Weaver EA. An epitope-optimized human H3N2 influenza vaccine induces broadly protective immunity in mice and ferrets. NPJ Vaccines 2022; 7:65. [PMID: 35739199 DOI: 10.1038/s41541-022-00492-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/16/2022] [Indexed: 12/03/2022] Open
Abstract
There is a crucial need for an improved H3N2 influenza virus vaccine due to low vaccine efficacy rates and increased morbidity and mortality associated with H3N2-dominated influenza seasons. Here, we utilize a computational design strategy to produce epitope-optimized, broadly cross-reactive H3 hemagglutinins in order to create a universal H3N2 influenza vaccine. The Epigraph immunogens are designed to maximize the viral population frequency of epitopes incorporated into the immunogen. We compared our Epigraph H3 vaccine to the traditional egg-based inactivated influenza vaccine from 2018-19, FluZone. Epigraph vaccination-induced stronger cross-reactive antibody responses than FluZone against 18 H3N2 viruses isolated from 1968 to 2019 in both mice and ferrets, with protective hemagglutination inhibition titers against 93-100% of the contemporary H3N2 strains compared to only 27% protection measured from FluZone. In addition, Epigraph vaccination-induced strong cross-reactive T-cell immunity which significantly contributes to protection against lethal influenza virus infection. Finally, Epigraph vaccination protected ferrets from influenza disease after challenge with two H3N2 viruses. The superior cross-reactive immunity induced by these Epigraph immunogens supports their development as a universal H3N2 influenza vaccine.
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Kanecki K, Lewtak K, Goryński P, Tyszko P, Bogdan M, Rząd M, Nitsch-Osuch A. Hospitalization of Children Aged <5 Years Due to Influenza: Study Based on the National Hospitalization Registry. Children (Basel) 2022; 9. [PMID: 35883914 DOI: 10.3390/children9070930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022]
Abstract
Background: Influenza constitutes a significant health care burden that can be related to an increased morbidity and mortality. The aim of the study is to show up-to-date information on influenza hospitalization cases in Poland in children aged <5 years. Methods: The data used in the study were hospitalization records from 2015−2019, which had been gathered in a Nationwide General Hospital Morbidity Study and made available by the National Institute of Public Health. Results: 8565 records of patients with influenza were subject to analysis. The mean and median age of the patients were 2.2 and 2.1 years, respectively. Influenza hospitalization incidence was estimated at 90 per 100,000 person-years (PY) in children aged <5 years. The number of hospitalization cases was significantly higher in patients living in urban regions than in those living in rural regions (97 vs. 77 per 100,000 PY; p < 0.001). The age of patients living in urban regions was significantly lower than the age of patients living in rural regions (2.2 vs. 2.3 years; p < 0.001). A statistically significant increase in hospitalization was observed. Conclusions: The reported increasing trend in hospitalizations indicates the need to take focused measures. Presented data may be useful in comparative analyses in a European context.
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Tran C, Pham T, Chichirelo-Konstantynovych KD, Konstantynovych TV, Alif SM. Efficacy of maternal vaccination during pregnancy against infant respiratory viruses. Breathe (Sheff) 2022; 18:220017. [DOI: 10.1183/20734735.0017-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
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Minter A, Hoschler K, Jagne YJ, Sallah H, Armitage E, Lindsey B, Hay JA, Riley S, de Silva TI, Kucharski AJ. Estimation of Seasonal Influenza Attack Rates and Antibody Dynamics in Children Using Cross-Sectional Serological Data. J Infect Dis 2022; 225:1750-1754. [PMID: 32556290 PMCID: PMC9113438 DOI: 10.1093/infdis/jiaa338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/13/2020] [Indexed: 11/14/2022] Open
Abstract
Directly measuring evidence of influenza infections is difficult, especially in low-surveillance settings such as sub-Saharan Africa. Using a Bayesian model, we estimated unobserved infection times and underlying antibody responses to influenza A/H3N2, using cross-sectional serum antibody responses to 4 strains in children aged 24-60 months. Among the 242 individuals, we estimated a variable seasonal attack rate and found that most children had ≥1 infection before 2 years of age. Our results are consistent with previously published high attack rates in children. The modeling approach highlights how cross-sectional serological data can be used to estimate epidemiological dynamics.
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Affiliation(s)
- Amanda Minter
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katja Hoschler
- Respiratory Virus Reference Department, Public Health England, London, United Kingdom
| | - Ya Jankey Jagne
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Hadijatou Sallah
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Edwin Armitage
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Benjamin Lindsey
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - James A Hay
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Steven Riley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Thushan I de Silva
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- The Florey Institute, Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, United Kingdom
| | - Adam J Kucharski
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Correspondence: Adam Kucharski, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London WC1E 7HT, United Kingdom ()
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McRae JE, Blyth CC, Cheng AC, Quinn HE, Wood NJ, Macartney KK. Risk factors and disease severity in Australian infants aged under 6 months hospitalised with influenza 2011-2019. J Paediatr Child Health 2022; 58:848-855. [PMID: 34927770 DOI: 10.1111/jpc.15857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/14/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022]
Abstract
AIM Infants aged <6 months are vulnerable to severe influenza disease and no vaccine is approved for use in this age group. We aimed to describe the epidemiology, risk factors associated with severe outcomes and management of influenza in Australian infants aged <6 months. METHODS Incident cases aged <6 months of laboratory-confirmed influenza were captured through two national active prospective sentinel hospital-based surveillance systems in Australia from 2011 to 2019, inclusive. Demographic and clinical features, disease risk factors and outcomes (intensive care unit (ICU) admission and length of stay) and oseltamivir use were analysed. The proportion of infant influenza hospitalisations and nosocomial cases among all hospitalisations were also reported. RESULTS Of 680 hospitalised infants aged <6 months, 57.9% were male and 14.5% were Indigenous Australian. Median age was 2.6 months, 19.2% were born premature and 19.0% had a comorbidity, excluding prematurity. Overall, 77.9% had influenza A. Nosocomial cases accounted for 7.8%. ICU admission occurred in 14.7% and oseltamivir was prescribed for 18.8%. Factors associated with ICU admission included age <1 month (adjusted odds ratio (aOR) 3.95, 95% confidence interval (CI): 1.47-10.60), comorbidity (aOR 7.69, 95% CI: 4.04-14.64) and prematurity (aOR 2.60, 95% CI: 1.40-4.81). The proportion of infants with influenza among all infant hospitalisations ranged 1.0-2.6% in the 2019 influenza season. CONCLUSION Infants aged <6 months, and particularly neonates, experience serious disease from influenza. This data underpins the need for preventative strategies such as maternal immunisation and continued investigation into the possibility of safe and efficacious vaccination prior to 6 months of age.
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Affiliation(s)
- Jocelynne E McRae
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher C Blyth
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,Pathwest Laboratory Medicine, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Allen C Cheng
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas J Wood
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Kristine K Macartney
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
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Wang C, Yang YN, Xi L, Yang LL, Du J, Zhang ZS, Lian XY, Cui Y, Li HJ, Zhang WX, Liu B, Cui F, Lu QB. Dynamics of influenza-like illness under urbanization procedure and COVID-19 pandemic in the sub-center of Beijing during 2013-2021. J Med Virol 2022; 94:3801-3810. [PMID: 35451054 PMCID: PMC9088387 DOI: 10.1002/jmv.27803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 12/02/2022]
Abstract
Influenza‐like illness (ILI) varies in intensity year by year, generally keeping a stable pattern except for great changes of its epidemic pattern. Of the most impacting factors, urbanization has been suggested as shaping the intensity of influenza epidemics. Besides, growing evidence indicates the nonpharmaceutical interventions (NPIs) to severe acute respiratory syndrome coronavirus 2 offer great advantages in controlling infectious diseases. The present study aimed to evaluate the impact of urbanization and NPIs on the dynamic of ILI in Tongzhou, Beijing, during January 2013 to March 2021. ILI epidemiological surveillance data in Tongzhou district were obtained from Beijing Influenza Surveillance Network and separated into three periods of urbanization and four intervals of coronavirus disease 2019 pandemic. Standardized average incidence rates of ILI in each separate stages were calculated and compared by using Wilson method and time series model of seasonal ARIMA. Influenza seasonal outbreaks showed similar epidemic size and intensity before urbanization during 2013–2016. Increased ILI activity was found during the process of Tongzhou's urbanization during 2017–2019, with the rate difference of 2.48 (95% confidence interva [CI]: 2.44, 2.52) and the rate ratio of 1.75 (95% CI: 1.74, 1.76) of ILI incidence between preurbanization and urbanization periods. ILI activity abruptly decreased from the beginning of 2020 and kept at the bottom level almost in every epidemic interval. The top decrease in ILI activity by NPIs was shown in 5–14 years group in 2020–2021 influenza season, as 92.2% (95% CI: 78.3%, 95.2%). The results indicated that both urbanization and NPIs interrupted the epidemic pattern of ILI. We should pay more attention to public health when facing increasing population density, human contact, population mobility, and migration in the process of urbanization. NPIs and influenza vaccination should be implemented as necessary measures to protect people from common infectious diseases like ILI.
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Affiliation(s)
- Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yan-Na Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Lu Xi
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Li-Li Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zhong-Song Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xin-Yao Lian
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Hong-Jun Li
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Wan-Xue Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
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Alhatim N, Al-Bashaireh AM, Alqudah O. Knowledge, attitude, and practice of seasonal influenza and influenza vaccine immunization among people visiting primary healthcare centers in Riyadh, Saudi Arabia. PLoS One 2022; 17:e0266440. [PMID: 35377923 PMCID: PMC8979468 DOI: 10.1371/journal.pone.0266440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022] Open
Abstract
Influenza infection continues to be a hazard to the Saudi population, resulting in high death rates and illness prevalence; it also places a substantial financial burden on the government. The government takes several strategies and approaches through the Ministry of Health has shown great success in curbing the disease. Vaccination is considered the most appropriate control measure; unfortunately, most Saudi residents, particularly in the city of Riyadh, do not consider vaccination a safe health practice. As a result, many have not participated in the influenza vaccine immunisation programme. Therefore, this study aimed to assess the knowledge, attitudes, and practices (KAPs) of seasonal influenza and influenza vaccine immunisation among clients visiting primary healthcare centers in Riyadh, Saudi Arabia. Furthermore, the study investigated the relationship between participants’ demographics and their KAPs regarding influenza vaccination. A cross-sectional, descriptive, correlational study was conducted among 611 individuals who visited four of Riyadh’s primary healthcare centers: Alsylimania, Alwady, Alyasmin, and Alsahafah. A self-reported questionnaire was used to assess the KAPs of participants, with questions regarding seasonal influenza and influenza vaccine immunisation. The scores of participants’ knowledge showed that the majority had good knowledge regarding seasonal flu (64.5%) and the flu vaccine (73.3%). Furthermore, only 52% of participants had a positive attitude score towards the seasonal influenza vaccination. Despite that, significant knowledge gaps and mistaken beliefs regarding certain aspects of influenza were noted in participants, resulting in negative attitudes and perceptions as well as a reduced likelihood of being vaccinated. In this study, 43.7% of participants (267 out of 611) had ever received a flu vaccine. Participants with a history of previous vaccination had a significantly higher level of knowledge and more positive attitudes, which resulted in increased vaccination coverage. Therefore, educational strategies to improve knowledge regarding influenza in Riyadh are recommended.
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Affiliation(s)
- Norah Alhatim
- King Fahad Medical City Academy for Postgraduate Studies in Family Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Ahmad M. Al-Bashaireh
- Department of Primary Care Nursing, Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | - Ola Alqudah
- Department of Community Health, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
- * E-mail:
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Orrico-sánchez A, Valls-arévalo Á, Garcés-sánchez M, Álvarez Aldeán J, Ortiz de Lejarazu Leonardo R. Efficacy and effectiveness of influenza vaccination in healthy children. A review of current evidence. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Cason C, Zamagni G, Cozzi G, Tonegutto D, Ronfani L, Oretti C, De Manzini A, Barbi E, Comar M, Amaddeo A. Spread of Respiratory Pathogens During the COVID-19 Pandemic Among Children in the Northeast of Italy. Front Microbiol 2022; 13:804700. [PMID: 35401434 PMCID: PMC8988150 DOI: 10.3389/fmicb.2022.804700] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022] Open
Abstract
The social distancing measures adopted during the coronavirus disease 2019 (COVID-19) pandemic led to a profound change in the behavioral habits of the population. This study analyzes the impact of restriction measures on the shaping of the epidemiology of common winter respiratory pathogens in the pediatric population of northeast of Italy. From August 2020 to March 2021, a total of 1,227 nasopharyngeal swabs from symptomatic pediatric patients were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B, adenovirus, other coronaviruses, parainfluenza virus 1–4, enterovirus, bocavirus, metapneumovirus, respiratory syncytial virus, rhinovirus, Bordetella pertussis, Bordetella parapertussis, and Mycoplasma pneumoniae. To relate virus positivity with the clinic characteristics of the subjects enrolled, multinomial logistic models were estimated. SARS-CoV-2 was detected in 5.2% of the children; fever resulted as risk factor for infection [relative risk ratio (RRR) = 2.88, p = 0.034]. Rhinovirus was detected in the 40.7% of the subjects, with cough and rhinitis as risk factors (respectively, RRR = 1.79, p = 0.001 and RRR = 1.53, p = 0.018). Other coronaviruses were found in 10.8% of children and were associated to pharyngodynia (RRR = 4.94, p < 0.001). Adenovirus, observed in 11.6% of subjects, showed to have fever as risk factor (RRR = 6.44, p < 0.001). Bocavirus was detected in 3.2% of children. In conclusion, our results showed that social isolation measures had an impact on the circulation of RSV and influenza, although children under the age of 2 were most affected by the other respiratory infections. Therefore, this study highlights the need for continuing surveillance for a delayed spread of RSV and other respiratory pathogens.
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Affiliation(s)
- Carolina Cason
- Department of Advanced Translational Microbiology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Giulia Zamagni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Giorgio Cozzi
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Davide Tonegutto
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Chiara Oretti
- Department of Services, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), Trieste, Italy
| | - Andrea De Manzini
- Department of Services, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), Trieste, Italy
| | - Egidio Barbi
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Manola Comar
- Department of Advanced Translational Microbiology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- *Correspondence: Manola Comar,
| | - Alessandro Amaddeo
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
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48
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Groves HE, Papenburg J, Mehta K, Bettinger JA, Sadarangani M, Halperin SA, Morris SK. The effect of the COVID-19 pandemic on influenza-related hospitalization, intensive care admission and mortality in children in Canada: A population-based study. Lancet Reg Health Am 2022; 7:100132. [PMID: 35291567 PMCID: PMC8913102 DOI: 10.1016/j.lana.2021.100132] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The COVID-19 pandemic resulted in unprecedented implementation of wide-ranging public health measures globally. During the pandemic, dramatic decreases in seasonal influenza virus detection have been reported worldwide. Information on the impact on paediatric influenza-related hospitalisations is limited. We describe influenza-related hospitalisation in children in Canada following the onset of the COVID-19 pandemic. Methods Data on influenza-related hospitalisations, intensive care unit (ICU) admissions and in-hospital deaths in children across Canada were obtained from the Canadian Immunisation Monitoring Program, ACTive (IMPACT). This national active surveillance initiative comprises 90% of all tertiary care paediatric beds in Canada. The study period included eleven influenza seasons, from the 2010/2011 season until the 2020/2021 season inclusive. Time series modelling was used to compare the observed to predicted influenza-related hospitalisations following the COVID-19 pandemic. Results Following the COVID-19 pandemic there was a significant decrease in paediatric influenza-related hospitalisations compared to predicted influenza-related hospitalisations for this time period (p < 0•0001). No paediatric influenza-related hospitalisations, ICU admission or deaths were reported for the 2020/2021 influenza season. Conclusions We show complete absence of paediatric influenza infection-related hospitalisation in a Canadian National Surveillance Network during the 2020/2021 influenza season. This significant decrease is likely related in large part to non-pharmacological public health interventions implemented during the COVID-19 pandemic, although the potential role of viral interference is unknown. Funding The Canadian Immunisation Monitoring Program, Active (IMPACT) influenza surveillance is a national surveillance initiative managed by the Canadian Paediatric Society and conducted by the IMPACT network of paediatric investigators on behalf of the Public Health Agency of Canada's Centre for Immunisation and Respiratory Infectious Diseases.
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Affiliation(s)
- Helen E Groves
- Division of Infectious Diseases, The Hospital for Sick Children, Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jesse Papenburg
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Divisions of Infectious Diseases and Medical Microbiology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Kayur Mehta
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Centre, BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Centre, BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Scott A Halperin
- Canadian Centre for Vaccinology, Halifax, NS, Canada.,Dalhousie University and the IWK Health Centre Dalhousie University, Halifax, NS, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, The Hospital for Sick Children, Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Nesselroth D, Yakub Hana H, Gleyzer A, Simoes EAF, Abu Atta M, Ben Yehuda Y, Bibi H, Somekh I, Somekh E. Comparison of the medical burden of COVID-19 with seasonal influenza and measles outbreaks. Acta Paediatr 2022; 111:595-601. [PMID: 34874581 DOI: 10.1111/apa.16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/02/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine and compare the medical burden of measles, influenza and COVID-19 outbreaks in the city of Bnei Brak, Israel. METHODS The study was conducted during 2018-2021. The numbers of hospitalisations for these infections and their complications were recorded. Hospitalisation rates were determined by using the number of children residing in Bnei Brak and hospitalised with these infections during the study period as the numerators. The denominators were the estimated paediatric cases of measles, influenza and COVID-19 in Bnei Brak and were calculated under both pragmatic and conservative assumptions. RESULTS A total of 247, 65 and 32 children were hospitalised with influenza, COVID-19 and measles respectively. Complication rates were higher following measles than after influenza and SARS-CoV-2 infections. Hospitalisation rates were 10% for measles, 0.6%-1.2% for influenza and 0.15% - 0.25% for COVID-19 infections. Relative risks (RR) with 95% confidence intervals (CI) for hospitalisation following measles compared with COVID-19 ranged from 42 (26.3-67.3) to 70.1 (43.8-112.1), while the relative risks for influenza hospitalisation ranged from 2.5 (1.83-3.41) to 8.2 (6.0-11.2), compared with COVID-19 infection. CONCLUSION Hospitalisation rates and direct medical burdens of measles and influenza were significantly higher than those of COVID-19 infection in children.
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Affiliation(s)
- Dafna Nesselroth
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Hussam Yakub Hana
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Alexandra Gleyzer
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | | | - Mahdi Abu Atta
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Yoram Ben Yehuda
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Haim Bibi
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Ido Somekh
- Department of Pediatric Hematology Oncology Schneider Children's Medical Center Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Eli Somekh
- Department of Pediatrics Mayanei Hayeshuah Medical Center Bnei Brak Israel
- Affiliated with Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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50
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Mcrae J, Blyth C, Cheng A, Quinn H, Wood N, Macartney K. Preventing severe influenza in Australian infants: Maternal influenza vaccine effectiveness in the PAEDS-FluCAN networks using the test-negative design. Vaccine 2022. [DOI: 10.1016/j.vaccine.2022.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
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