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Owusu D, Dawood FS, Azziz-Baumgartner E, Tinoco Y, Soto G, Gonzalez O, Cabrera S, Florian R, Llajaruna E, Hunt DR, Wesley MG, Yau T, Arriola CS. Effectiveness of Maternal Influenza Vaccination in Peru PRIME Cohort. Open Forum Infect Dis 2023; 10:ofad033. [PMID: 36817741 PMCID: PMC9927556 DOI: 10.1093/ofid/ofad033] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
Background Few studies have examined influenza vaccine effectiveness (VE) among women during pregnancy in middle-income countries. We used data from a prospective cohort of women who were pregnant in Peru to estimate effectiveness of the 2018 Southern Hemisphere influenza vaccine. Methods Women at <28 weeks gestation were enrolled from 4 tertiary level hospitals in Lima, Peru at the start of the 2018 influenza season and followed until the end of their pregnancies. Participants had mid-turbinate nasal swabs collected and tested for influenza by reverse-transcription polymerase chain reaction (RT-PCR) with onset of ≥1 of myalgia, cough, runny nose or nasal congestion, sore throat, or difficulty breathing. Time-varying Cox proportional hazard regression models were used to estimate the risk of RT-PCR-confirmed influenza infection after adjusting for inverse probability treatment weight. Results We followed 1896 women for a median of 127 days (interquartile range [IQR], 86-174). Participants had a median age of 29 years (IQR, 24-34). Among the 1896 women, 49% were vaccinated with the 2018 influenza vaccine and 1039 (55%) developed influenza-like illness, 76 (7%) of whom had RT-PCR-confirmed influenza. Incidence rates of RT-PCR-confirmed influenza were 36.6 and 15.3 per 100 000 person-days among women who were unvaccinated and vaccinated, respectively. Adjusted influenza VE was 22% (95% confidence interval, -64.1% to 62.9%). Conclusions Participants vaccinated against influenza had more than 50% lower incidence of RT-PCR-confirmed influenza illness. Although the VE estimated through propensity weight-adjusted time-varying Cox regression did not reach statistical significance, our findings provide additional evidence about the value of maternal influenza vaccination in middle-income countries.
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Affiliation(s)
- Daniel Owusu
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fatimah S Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Yeny Tinoco
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Giselle Soto
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | | | | | | | | | - Meredith G Wesley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Abt Associates, Inc., Atlanta, Georgia, USA
| | - Tat Yau
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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2
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Arriola CS, Soto G, Westercamp M, Bollinger S, Espinoza A, Grogl M, Llanos-Cuentas A, Matos E, Romero C, Silva M, Smith R, Olson N, Prouty M, Azziz-Baumgartner E, Lessa FC. Effectiveness of Whole-Virus COVID-19 Vaccine among Healthcare Personnel, Lima, Peru. Emerg Infect Dis 2022; 28:S238-S243. [PMID: 36502444 DOI: 10.3201/eid2813.212477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In February 2021, Peru launched a COVID-19 vaccination campaign among healthcare personnel using an inactivated whole-virus vaccine. The manufacturer recommended 2 vaccine doses 21 days apart. We evaluated vaccine effectiveness among an existing multiyear influenza vaccine cohort at 2 hospitals in Lima. We analyzed data on 290 participants followed during February-May 2021. Participants completed a baseline questionnaire and provided weekly self-collected nasal swab samples; samples were tested by real-time reverse transcription PCR. Median participant follow-up was 2 (range 1-11) weeks. We performed multivariable logistic regression and adjusted for preselected characteristics. During the study, 25 (9%) participants tested SARS-CoV-2-positive. We estimated adjusted vaccine effectiveness at 95% (95% CI 70%-99%) among fully vaccinated participants and 100% (95% CI 88%-100%) among partially vaccinated participants. These data can inform the use and acceptance of inactivated whole-virus vaccine and support vaccination efforts in the region.
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3
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Owusu D, Rolfes MA, Arriola CS, Daily Kirley P, Alden NB, Meek J, Anderson EJ, Monroe ML, Kim S, Lynfield R, Angeles K, Spina N, Felsen CB, Billing L, Thomas A, Keipp Talbot H, Schaffner W, Chatelain R, Reed C, Garg S. Rates of Severe Influenza-Associated Outcomes Among Older Adults Living With Diabetes-Influenza Hospitalization Surveillance Network (FluSurv-NET), 2012-2017. Open Forum Infect Dis 2022; 9:ofac131. [PMID: 35450083 PMCID: PMC9017364 DOI: 10.1093/ofid/ofac131] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/14/2022] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is common among older adults hospitalized with influenza, yet data are limited on the impact of DM on risk of severe influenza-associated outcomes. METHODS We included adults aged ≥65 years hospitalized with influenza during 2012-2013 through 2016-2017 from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined counties within 13 states. We calculated population denominators using the Centers for Medicare and Medicaid Services county-specific DM prevalence estimates and National Center for Health Statistics population data. We present pooled rates and rate ratios (RRs) of intensive care unit (ICU) admission, pneumonia diagnosis, mechanical ventilation, and in-hospital death for persons with and without DM. We estimated RRs and 95% confidence intervals (CIs) using meta-analysis with site as a random effect in order to control for site differences in the estimates. RESULTS Of 31 934 hospitalized adults included in the analysis, 34% had DM. Compared to those without DM, adults with DM had higher rates of influenza-associated hospitalization (RR, 1.57 [95% CI, 1.43-1.72]), ICU admission (RR, 1.84 [95% CI, 1.67-2.04]), pneumonia (RR, 1.57 [95% CI, 1.42-1.73]), mechanical ventilation (RR, 1.95 [95% CI, 1.74-2.20]), and in-hospital death (RR, 1.48 [95% CI, 1.23-1.80]). CONCLUSIONS Older adults with DM have higher rates of severe influenza-associated outcomes compared to those without DM. These findings reinforce the importance of preventing influenza virus infections through annual vaccination, and early treatment of influenza illness with antivirals in older adults with DM.
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Affiliation(s)
- Daniel Owusu
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa A Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pam Daily Kirley
- California Emerging Infections Program, Oakland, California, USA
| | - Nisha B Alden
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - James Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA
| | - Evan J Anderson
- Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA
- Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Maya L Monroe
- Maryland Department of Health, Baltimore, Maryland, USA
| | - Sue Kim
- Michigan Department of Health and Human Services, Lansing, Michigan, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St Paul, Minnesota, USA
| | - Kathy Angeles
- New Mexico Department of Health, Santa Fe, New Mexico, USA
| | - Nancy Spina
- New York State Department of Health, Albany, New York, USA
| | - Christina B Felsen
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Ann Thomas
- Oregon Public Health Authority, Portland, Oregon, USA
| | - H Keipp Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Ryan Chatelain
- Salt Lake County Health Department, Salt Lake City, Utah, USA
| | - Carrie Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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4
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Westercamp M, Soto G, Smith R, Azziz-Baumgartner E, Bollinger S, Castillo R, Cuentas AL, Grogl M, Olson N, Prouty M, Matos E, Romero C, Silva M, Lessa FC, Lessa FC, Arriola CS. 375. High Laboratory-confirmed SARS-CoV-2 Attack Rate in Lima Health Care Personnel During August 2020-March 2021 Suggests Role for Improved Infection Control. Open Forum Infect Dis 2021. [PMCID: PMC8644794 DOI: 10.1093/ofid/ofab466.576] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Peru has one of the highest per capita SARS-CoV-2 death rates in Latin America. Healthcare workers (HCW) are a critical workforce during the COVID-19 pandemic but are themselves often at increased risk of infection. We evaluated SARS-CoV-2 attack rate and risk factors among frontline HCWs. Methods We performed a prospective cohort study of HCW serving two acute care hospitals in Lima, Peru from Aug 2020 to Mar 2021. Participants had baseline SARS-CoV-2 serology using the CDC ELISA, active symptom monitoring, and weekly respiratory specimen collection with COVID-19 exposure/risk assessment for 16-weeks regardless of symptoms. Respiratory specimens were tested by real-time reverse transcriptase PCR (rRT-PCR). Results Of 783 eligible, 667 (85%) HCW were enrolled (33% nurse assistants, 29% non-clinical staff, 26% nurses, 7% physicians, and 6% other). At baseline and prior to COVID-19 vaccine introduction, 214 (32.1%; 214/667) were reactive for SARS-CoV-2 antibodies. In total, 72 (10.8%; 72/667) HCWs were found to be rRT-PCR positive during weekly follow-up. Of the rRT-PCR positive HCWs, 37.5% (27/72) did not report symptoms within 1-week of specimen collection. During follow up, HCW without detectable SARS-CoV-2 antibodies at baseline were significantly more likely to be rRT-PCR positive (65/453, 14.3%) compared to those with SARS-CoV-2 antibodies at baseline (4/214, 1.9%) (p-value: < 0.001). Three HCW were both serologically reactive and rRT-PCR positive at baseline. Looking only at HCW without SARS-CoV-2 antibodies, nurse assistants (rRT-PCR positive: 18.6%; 27/141) and non-clinical healthcare workers (16.5%; 21/127) were at greater risk of infection compared to nurses (8.5%; 10/118), physicians (7.9%; 3/38), and other staff (10.3%; 4/29) (RR 1.95;95%CI 1.2,3.3; p-value: 0.01). Conclusion Baseline SARS-CoV-2 prevalence and 16-week cumulative incidence were substantial in this pre-vaccination Peruvian HCW cohort. Almost 40% of new infections occurred in HCW without complaint of symptoms illustrating a limitation of symptom-based HCW screening for COVID-19 prevention. Nurse assistants and non-clinical healthcare workers were at greater risk of infection indicating a role for focused infection prevention and risk reduction strategies for some groups of HCW. Disclosures Fernanda C. Lessa, MD, MPH, Nothing to disclose
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Affiliation(s)
| | - Giselle Soto
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Rachel Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Susan Bollinger
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Max Grogl
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Natalie Olson
- U.S. Centers for Disease Control and Prevention – Influenza Division, Atlanta, Georgia
| | - Mike Prouty
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | | | - Marita Silva
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
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Arriola CS, Suntarattiwong P, Dawood FS, Soto G, Das P, Hunt DR, Sinthuwattanawibool C, Kurhe K, Thompson MG, Wesley MG, Saha S, Hombroek D, Brummer T, Kittikraisak W, Kaoiean S, Neyra J, Romero C, Patel A, Bhargav S, Khedikar V, Garg S, Mott JA, Gonzales O, Cabrera S, Florian R, Parvekar S, Tomyabatra K, Prakash A, Tinoco YO. What do pregnant women think about influenza disease and vaccination practices in selected countries. Hum Vaccin Immunother 2021; 17:2176-2184. [PMID: 33499708 PMCID: PMC8189050 DOI: 10.1080/21645515.2020.1851536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/11/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction: We evaluated knowledge, attitudes, and practices (KAP) related to influenza and influenza vaccination among pregnant women in three selected countries.Methods: During 2017, pregnant women seeking antenatal care at hospitals at participating sites were enrolled. We described characteristics and responses to KAP questions. We also evaluated predictors associated with influenza vaccination during pregnancy at sites with substantial influenza vaccine uptake by multivariable logistic regression.Results: Overall, 4,648 pregnant women completed the survey. There were substantial differences among the three survey populations; only 8% of the women in Nagpur had heard of influenza, compared to 90% in Lima and 96% in Bangkok (p-value<0.01). Despite significant differences in sociodemographic characteristics in the three populations, most participants across sites who were aware of influenza prior to study enrollment believe they and their infants are at risk of influenza and related complications and believe influenza vaccination is safe and effective. Half of women in Lima had verified receipt of influenza vaccine compared to <5% in Bangkok and Nagpur (p < .05). For further analysis conducted among women in Lima only, household income above the poverty line (aOR: 1.38; 95%CI: 1.01, 1.88), having 8+ antenatal visits, compared to 0-4 (aOR: 2.41; 95%CI: 1.39, 2.87, respectively), having 0 children, compared to 2+ (aOR: 1.96; 95%CIs: 1.23, 3.12), and vaccination recommended by a health-care provider (aOR: 8.25; 95%CI: 6.11, 11.14) were strongly associated with receipt of influenza vaccine during pregnancy.Conclusions: Our findings identify opportunities for targeted interventions to improve influenza vaccine uptake among pregnant women in these settings.
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Affiliation(s)
- Carmen S. Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Piyarat Suntarattiwong
- Queen Sirikit National Institute of Child Health, Thailand Ministry of Public Health, Bangkok, Thailand
| | - Fatimah S. Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Giselle Soto
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Prabir Das
- Lata Medical Research Foundation, Nagpur, India
| | | | | | - Kunal Kurhe
- Lata Medical Research Foundation, Nagpur, India
| | - Mark G. Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Meredith G. Wesley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Siddhartha Saha
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Wanitchaya Kittikraisak
- Thailand Ministry of Public Health - US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Surasak Kaoiean
- Rajavithi Hospital, Thailand Ministry of Public Health, Bangkok, Thailand
| | - Joan Neyra
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Candice Romero
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, India
- Datta Meghe Institute of Medical Sciences, Sawangi, India
| | | | | | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua A Mott
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Thailand Ministry of Public Health - US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | | | | | | | - Krissada Tomyabatra
- Nopparat Rajathanee Hospital, Thailand Ministry of Public Health, Bangkok, Thailand
| | | | - Yeny O. Tinoco
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
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6
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Dawood FS, Kittikraisak W, Patel A, Rentz Hunt D, Suntarattiwong P, Wesley MG, Thompson MG, Soto G, Mundhada S, Arriola CS, Azziz-Baumgartner E, Brummer T, Cabrera S, Chang HH, Deshmukh M, Ellison D, Florian R, Gonzales O, Kurhe K, Kaoiean S, Rawangban B, Lindstrom S, Llajaruna E, Mott JA, Saha S, Prakash A, Mohanty S, Sinthuwattanawibool C, Tinoco Y. Incidence of influenza during pregnancy and association with pregnancy and perinatal outcomes in three middle-income countries: a multisite prospective longitudinal cohort study. Lancet Infect Dis 2021; 21:97-106. [PMID: 33129424 PMCID: PMC10563867 DOI: 10.1016/s1473-3099(20)30592-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/22/2020] [Accepted: 07/02/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Influenza vaccination during pregnancy prevents influenza among women and their infants but remains underused among pregnant women. We aimed to quantify the risk of antenatal influenza and examine its association with perinatal outcomes. METHODS We did a prospective cohort study in pregnant women in India, Peru, and Thailand. Before the 2017 and 2018 influenza seasons, we enrolled pregnant women aged 18 years or older with expected delivery dates 8 weeks or more after the season started. We contacted women twice weekly until the end of pregnancy to identify illnesses with symptoms of myalgia, cough, runny nose or nasal congestion, sore throat, or difficulty breathing and collected mid-turbinate nasal swabs from symptomatic women for influenza real-time RT-PCR testing. We assessed the association of antenatal influenza with preterm birth, late pregnancy loss (≥13 weeks gestation), small for gestational age (SGA), and birthweight of term singleton infants using Cox proportional hazards models or generalised linear models to adjust for potential confounders. FINDINGS Between March 13, 2017, and Aug 3, 2018, we enrolled 11 277 women with a median age of 26 years (IQR 23-31) and gestational age of 19 weeks (14-24). 1474 (13%) received influenza vaccines. 310 participants (3%) had influenza (270 [87%] influenza A and 40 [13%] influenza B). Influenza incidences weighted by the population of women of childbearing age in each study country were 88·7 per 10 000 pregnant woman-months (95% CI 68·6 to 114·8) during the 2017 season and 69·6 per 10 000 pregnant woman-months (53·8 to 90·2) during the 2018 season. Antenatal influenza was not associated with preterm birth (adjusted hazard ratio [aHR] 1·4, 95% CI 0·9 to 2·0; p=0·096) or having an SGA infant (adjusted relative risk 1·0, 95% CI 0·8 to 1·3, p=0·97), but was associated with late pregnancy loss (aHR 10·7, 95% CI 4·3 to 27·0; p<0·0001) and reduction in mean birthweight of term, singleton infants (-55·3 g, 95% CI -109·3 to -1·4; p=0·0445). INTERPRETATION Women had a 0·7-0·9% risk of influenza per month of pregnancy during the influenza season, and antenatal influenza was associated with increased risk for some adverse pregnancy outcomes. These findings support the added value of antenatal influenza vaccination to improve perinatal outcomes. FUNDING US Centers for Disease Control and Prevention. TRANSLATIONS For the Thai, Hindi, Marathi and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Fatimah S Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Wanitchaya Kittikraisak
- Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, India; Datta Meghe Institute of Medical Sciences, Wardha, India
| | | | - Piyarat Suntarattiwong
- Queen Sirikit National Institute of Child Health, Thailand Ministry of Public Health, Bangkok, Thailand
| | - Meredith G Wesley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA; Abt Associates, Atlanta, GA, USA
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Giselle Soto
- US Naval Medical Research Unit No 6, Bellavista, Peru
| | | | - Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Howard H Chang
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Damon Ellison
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Kunal Kurhe
- Lata Medical Research Foundation, Nagpur, India
| | | | | | - Stephen Lindstrom
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Joshua A Mott
- Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Siddhartha Saha
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Sarita Mohanty
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yeny Tinoco
- US Naval Medical Research Unit No 6, Bellavista, Peru
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7
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Sullivan SG, Arriola CS, Bocacao J, Burgos P, Bustos P, Carville KS, Cheng AC, Chilver MB, Cohen C, Deng YM, El Omeiri N, Fasce RA, Hellferscee O, Huang QS, Gonzalez C, Jelley L, Leung VK, Lopez L, McAnerney JM, McNeill A, Olivares MF, Peck H, Sotomayor V, Tempia S, Vergara N, von Gottberg A, Walaza S, Wood T. Heterogeneity in influenza seasonality and vaccine effectiveness in Australia, Chile, New Zealand and South Africa: early estimates of the 2019 influenza season. ACTA ACUST UNITED AC 2020; 24. [PMID: 31718744 PMCID: PMC6852316 DOI: 10.2807/1560-7917.es.2019.24.45.1900645] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/21/2023]
Abstract
We compared 2019 influenza seasonality and vaccine effectiveness (VE) in four southern hemisphere countries: Australia, Chile, New Zealand and South Africa. Influenza seasons differed in timing, duration, intensity and predominant circulating viruses. VE estimates were also heterogeneous, with all-ages point estimates ranging from 7-70% (I2: 33%) for A(H1N1)pdm09, 4-57% (I2: 49%) for A(H3N2) and 29-66% (I2: 0%) for B. Caution should be applied when attempting to use southern hemisphere data to predict the northern hemisphere influenza season.
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Affiliation(s)
- Sheena G Sullivan
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - Judy Bocacao
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Pamela Burgos
- Programa Nacional de Inmunizaciones, Ministerio de Salud, Santiago, Chile
| | - Patricia Bustos
- Sección de Virus Respiratorios y Exantematicos, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Kylie S Carville
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Allen C Cheng
- Department of Infectious Diseases, Alfred Health, and Central Clinical School, Monash University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Monique Bm Chilver
- Discipline of General Practice, University of Adelaide, Adelaide, Australia
| | - Cheryl Cohen
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Reference and Research on Influenza, Melbourne, Australia
| | - Nathalie El Omeiri
- Pan American Health Organization(PAHO)/WHO Regional Office for the Americas, Washington, United States
| | - Rodrigo A Fasce
- Subdepartamento de Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | | | - Q Sue Huang
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Cecilia Gonzalez
- Programa Nacional de Inmunizaciones, Ministerio de Salud, Santiago, Chile
| | - Lauren Jelley
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Vivian Ky Leung
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Liza Lopez
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Andrea McNeill
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Maria F Olivares
- Departamento de Epidemiologia, Ministerio de Salud, Santiago, Chile
| | - Heidi Peck
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Reference and Research on Influenza, Melbourne, Australia
| | | | - Stefano Tempia
- MassGenics, Duluth, United States.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.,National Institute for Communicable Diseases, Johannesburg, South Africa.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - Natalia Vergara
- Departamento de Epidemiologia, Ministerio de Salud, Santiago, Chile
| | - Anne von Gottberg
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Sibongile Walaza
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Timothy Wood
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
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8
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Arriola CS, Kim L, Langley G, Anderson EJ, Openo K, Martin AM, Lynfield R, Bye E, Como-Sabetti K, Reingold A, Chai S, Daily P, Thomas A, Crawford C, Reed C, Garg S, Chaves SS. Estimated Burden of Community-Onset Respiratory Syncytial Virus-Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. J Pediatric Infect Dis Soc 2019; 9:587-595. [PMID: 31868913 PMCID: PMC7107566 DOI: 10.1093/jpids/piz087] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged <2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. METHODS From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged <2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. RESULTS We identified 1554 RSV-associated hospitalizations in children aged <2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0-2, 3-5, 6-11, and 12-23 months, respectively. Extrapolating to the US population, an estimated 49 509-59 867 community-onset RSV-associated hospitalizations among children aged <2 years occurred during the 2014-2015 season. CONCLUSIONS Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged <2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions.
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Affiliation(s)
- Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay Kim
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gayle Langley
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Evan J Anderson
- Departments of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Kyle Openo
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Andrew M Martin
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Erica Bye
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | | | - Arthur Reingold
- California Emerging Infections Program, Oakland, California, USA
| | - Shua Chai
- California Emerging Infections Program, Oakland, California, USA
| | - Pam Daily
- California Emerging Infections Program, Oakland, California, USA
| | - Ann Thomas
- Oregon Public Health Division, Portland, Oregon
| | | | - C Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sandra S Chaves
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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9
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Wesley MG, Tinoco Y, Patel A, Suntarattiwong P, Hunt DR, Soto G, Sinthuwattanawibool C, Kittikraisak W, Arriola CS, Hombroek D, Mott J, Kurhe K, Bhargav S, Prakash AA, Florian R, Gonzales O, Cabrera S, Llajaruna Zumaeta E, Brummer T, Malek P, Saha S, Garg S, Azziz-Baumgartner E, Thompson MG, Dawood FS. 1644. Performance of Symptom-Based Case Definitions to Identify Influenza Virus Infection among Pregnant Women in Middle-Income Countries: Findings from the Pregnancy and Influenza Multinational Epidemiologic (PRIME) Study. Open Forum Infect Dis 2019. [PMCID: PMC6809908 DOI: 10.1093/ofid/ofz360.1508] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The World Health Organization (WHO) recommends case definitions for influenza surveillance that are also used in public health research, though their performance has not been assessed in many risk groups, including pregnant women in whom influenza may manifest differently. Â We evaluated the performance of symptom-based case definitions to detect influenza in a cohort of pregnant women in India, Peru, and Thailand.
Methods
In 2017, we contacted 4774 pregnant women twice a week during the influenza season to identify illnesses with new or worsened cough, runny nose, sore throat, difficulty breathing or myalgia, and collected data on other symptoms and nasal swabs for influenza rRT–PCR testing. To identify symptom predictors of influenza, we used multivariable logistic regression with forward selection of symptoms significant in univariate analysis after controlling for country, chronic conditions, influenza vaccination, and time from symptom onset to swab collection. We calculated sensitivity and specificity of each symptom, WHO respiratory illness case definitions and a case definition based on significant predictors from the multivariable model.
Results
Of 2431 eligible illness episodes among 1,716 participants, 142 (5.8%) were positive for influenza. Among individual symptoms, runny nose was most sensitive and measured fever ≥ 38° Celsius was most specific (Figure 1). In a multivariable model, measured fever ≥ 38° Celsius [adjusted odds ratio = 3.8, 95% confidence interval [CI] = 2.0–7.2], cough [2.7, CI 1.6–4.7], chills [2.2, CI 1.2–3.8], and myalgia [1.2, CI 2.2, 5.3] were independently associated with influenza illness. A case definition based on these four (measured fever, cough, chills or myalgia), was 91%-sensitive and 37% specific. Sensitivity and specificity of case definitions varied (Figure 2).
Conclusion
While a case definition based on one or more of fever, chills, cough or myalgia is highly-sensitive and moderately specific among pregnant women, case definitions requiring measured or subjective fever may miss many influenza cases making them sub-optimal for studies of burden or vaccine efficacy. The intended use of case definitions should be considered when evaluating the tradeoff between sensitivity and specificity.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
| | - Yeny Tinoco
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, Madhya Pradesh, India
| | - Piyarat Suntarattiwong
- Queen Sirikit National Institute of Child Health, Bangkok, Thailand
- Thailand Ministry of Public Health, Bangkok, Krung Thep, Thailand
| | | | - Giselle Soto
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Chalinthorn Sinthuwattanawibool
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Bangkok, Krung Thep, Thailand
| | - Wanitchaya Kittikraisak
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Bangkok, Krung Thep, Thailand
| | | | | | - Joshua Mott
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Bangkok, Krung Thep, Thailand
| | - Kunal Kurhe
- Lata Medical Research Foundation, Nagpur, Madhya Pradesh, India
| | - Savita Bhargav
- Lata Medical Research Foundation, Nagpur, Madhya Pradesh, India
| | - Amber A Prakash
- Lata Medical Research Foundation, Nagpur, Madhya Pradesh, India
| | | | | | | | | | | | | | - Siddhartha Saha
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shikha Garg
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mark G Thompson
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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10
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Garg S, Beacham L, Arriola CS, O’Halloran A, Cummings CN, Reingold A, Alden NB, Yousey-Hindes K, Anderson EJ, Monroe M, Kim S, Lynfield R, Irizarry L, Muse A, Bennett NM, Billing LM, Thomas A, Talbot K, McCaffrey K, Fry AM, Reed C. 898. Influenza Vaccination Reduces Risk of Severe Outcomes among Adults Hospitalized with Influenza A(H1N1)pdm09, FluSurv-NET, 2013–2018. Open Forum Infect Dis 2019. [PMCID: PMC6808964 DOI: 10.1093/ofid/ofz359.057] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Influenza vaccination may reduce illness severity among those with influenza; however, data are limited. We determined whether outcomes were less severe among vaccinated compared with unvaccinated adults hospitalized with influenza over 5 seasons. Methods We included adults (≥18 years) hospitalized with laboratory-confirmed influenza during seasons 2013–2014 through 2017–2018 and identified through the US Influenza Hospitalization Surveillance Network (FluSurv-NET). Vaccination status was obtained through medical records, vaccine registries, and interviews. We excluded patients who were institutionalized, did not receive antivirals, or had unknown vaccine status or vaccine receipt <14 days before positive influenza test. We used inverse propensity score weighting to balance differences between vaccinated and unvaccinated groups and multivariable logistic and competing risk regression to evaluate the association between vaccination and outcomes including pneumonia, intensive care unit (ICU) admission, mechanical ventilation (MV), death, and ICU and hospital length of stay (LOS) in days. Models were adjusted for season and admission timing in relation to timing of antiviral treatment, symptom onset and season peak. Results Among 67,452 adults hospitalized with influenza, 43,608 were included; 47% were 18–64 years (38% vaccinated) and 53% were ≥65 years (65% vaccinated). Among patients with influenza A(H1N1)pdm09, vaccination was associated with decreased odds of ICU admission (odds ratio (OR) 0.81; OR 0.72) and MV (OR 0.66; OR 0.54) in adults 18–64 and ≥65 years, respectively; decreased odds of pneumonia (OR 0.83), death (OR 0.64) and shortened ICU LOS (relative hazard (RH) 0.82) in adults 18–64 years; and shortened hospital LOS (RH 0.91) in adults ≥65 years (figure). Vaccination was not associated with attenuation of severe outcomes in patients with influenza A(H3N2) and B. Conclusion Vaccination was associated with reduced odds of severe outcomes, including death, by up to 36% in adults hospitalized with influenza A(H1N1)pdm09. All adults without contraindications should receive annual influenza vaccination as there is evidence that it can improve outcomes among those who develop influenza despite vaccination. ![]()
Disclosures All Authors: No reported Disclosures.
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Affiliation(s)
- Shikha Garg
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lauren Beacham
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Nisha B Alden
- Colorado Dept of Public Health and Environment, Denver, Colorado
| | | | | | - Maya Monroe
- Maryland Department of Health, Baltimore, Maryland
| | - Sue Kim
- Michigan Department of Health and Human Services, Lansing, Michigan
| | - Ruth Lynfield
- Minnesota Department of Health, Saint Paul, Minnesota
| | | | - Alison Muse
- New York State Department of Health, Albany, New York
| | | | | | - Ann Thomas
- Oregon Health Authority, Portland, Oregon
| | - Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Alicia M Fry
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Baumeister E, Duque J, Varela T, Palekar R, Couto P, Savy V, Giovacchini C, Haynes AK, Rha B, Arriola CS, Gerber SI, Azziz-Baumgartner E. Timing of respiratory syncytial virus and influenza epidemic activity in five regions of Argentina, 2007-2016. Influenza Other Respir Viruses 2018; 13:10-17. [PMID: 30051595 PMCID: PMC6304310 DOI: 10.1111/irv.12596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022] Open
Abstract
Background Within‐country differences in the timing of RSV and influenza epidemics have not been assessed in Argentina, the eighth largest country in the world by area. Objective We aimed to compare seasonality for RSV and influenza both nationally and in each of the five regions to inform Argentina’s prevention and treatment guidelines. Method The Argentine National Laboratories and Health Institutes Administration collected respiratory specimens from clinical practices, outbreak investigations, and respiratory virus surveillance in 2007‐2016; these were tested using immunofluorescence or RT‐PCR techniques. We calculated weekly percent positive (PP) and defined season onset as >2 consecutive weeks when PP exceeded the annual mean for the respective year and region. Median season measures (onset, offset and peak) and the established mean method were calculated for each virus. Results An annual median 59 396 specimens were tested for RSV and 60 931 for influenza; 21–29% tested positive for RSV and 2–7% for influenza. National RSV activity began in April; region‐specific start weeks varied by 7 weeks. Duration of RSV activity did not vary widely by region (16–18 weeks in duration). National influenza activity started in June; region‐specific start weeks varied by 3 weeks. Duration of influenza epidemic activity varied more by region than that of RSV (7–13 weeks in duration). Conclusion In Argentina, RSV and influenza activity overlapped during the winter months. RSV season tended to begin prior to the influenza season, and showed more variation in start week by region. Influenza seasons tended to vary more in duration than RSV seasons.
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Affiliation(s)
- Elsa Baumeister
- Servicio Virosis Respiratorias, Instituto Nacional de Enfermedades Infecciosas, INEI-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Jazmin Duque
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,Battelle Atlanta, Atlanta, Georgia
| | - Teresa Varela
- Sistema Nacional de Vigilancia por Laboratorio, Sistema Nacional de Vigilancia de la Salud, Ministerio de Salud de la Nación, Buenos Aires, Argentina
| | - Rakhee Palekar
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,Pan American Health Organization, Washington, District of Columbia
| | - Paula Couto
- Pan American Health Organization, Washington, District of Columbia
| | - Vilma Savy
- Servicio Virosis Respiratorias, Instituto Nacional de Enfermedades Infecciosas, INEI-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | | | - Amber K Haynes
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carmen S Arriola
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.,U.S. Public Health Service, Rockville, Maryland
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12
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Arriola CS, Vasconez N, Bresee J, Ropero AM. Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua. Vaccine 2018; 36:3686-3693. [PMID: 29748029 DOI: 10.1016/j.vaccine.2018.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 02/05/2018] [Revised: 04/20/2018] [Accepted: 05/02/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Nicaragua implemented an influenza vaccination program for pregnant women with high-risk obstetric conditions in 2007. In 2014, the recommendation of influenza vaccination expanded to include all pregnant women. Given the expansion in the recommendation of vaccination, we evaluated knowledge, attitudes and practices of pregnant women and their healthcare providers towards influenza vaccination and its recommendation. METHODS We conducted surveys among pregnant women and their healthcare providers from June to August 2016 at two hospitals and 140 health facilities in Managua. The questions were adapted from the U.S. national CDC influenza survey and related to knowledge, attitudes and practices about influenza vaccination and barriers to vaccination. We analyzed reasons for not receiving vaccination among pregnant women as well as receipt of vaccination recommendation and offer by their healthcare providers. RESULTS Of 1,303 pregnant women enrolled, 42% (5 4 5) reported receiving influenza vaccination in the 2016 season. Of those who reported not receiving vaccination, 46% indicated barriers to vaccination. Pregnant women who were vaccinated were more likely to be aware of the recommendation for vaccination and the risks of influenza illness during pregnancy and to perceive the vaccine as safe and effective, compared to unvaccinated pregnant women (p-values < 0.001). Of the 619 health workers enrolled, over 89% recalled recommending influenza vaccination to all pregnant women, regardless of obstetric risk. Of the 1,223 women who had a prenatal visit between the start date of the influenza vaccination and the time of interview, 44% recalled receiving a recommendation for influenza vaccination and 43% were offered vaccination. Vaccination rates were higher for those receiving a recommendation and offer of vaccination compared with those who received neither (95% vs 5%, p-value < 0.001). CONCLUSION Pregnant women in Managua had positive perceptions of influenza vaccine and were receptive to receiving influenza vaccination, especially after the offer and recommendation by their healthcare providers.
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Affiliation(s)
- Carmen S Arriola
- Influenza Division, Centers for Disease Prevention and Control, Atlanta, GA, USA.
| | | | - Joseph Bresee
- Influenza Division, Centers for Disease Prevention and Control, Atlanta, GA, USA
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13
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Arriola CS, Nelson DI, Deliberto TJ, Blanton L, Kniss K, Levine MZ, Trock SC, Finelli L, Jhung MA. Infection Risk for Persons Exposed to Highly Pathogenic Avian Influenza A H5 Virus-Infected Birds, United States, December 2014-March 2015. Emerg Infect Dis 2016; 21:2135-40. [PMID: 26583382 PMCID: PMC4672413 DOI: 10.3201/eid2112.150904] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Newly emerged highly pathogenic avian influenza (HPAI) A H5 viruses have caused outbreaks among birds in the United States. These viruses differ genetically from HPAI H5 viruses that previously caused human illness, most notably in Asia and Africa. To assess the risk for animal-to-human HPAI H5 virus transmission in the United States, we determined the number of persons with self-reported exposure to infected birds, the number with an acute respiratory infection (ARI) during a 10-day postexposure period, and the number with ARI who tested positive for influenza by real-time reverse transcription PCR or serologic testing for each outbreak during December 15, 2014-March 31, 2015. During 60 outbreaks in 13 states, a total of 164 persons were exposed to infected birds. ARI developed in 5 of these persons within 10 days of exposure. H5 influenza virus infection was not identified in any persons with ARI, suggesting a low risk for animal-to-human HPAI H5 virus transmission.
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14
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Tomczyk S, Arriola CS, Beall B, Benitez A, Benoit SR, Berman L, Bresee J, da Gloria Carvalho M, Cohn A, Cross K, Diaz MH, Francois Watkins LK, Gierke R, Hagan JE, Harris AM, Jain S, Kim L, Kobayashi M, Lindstrom S, McGee L, McMorrow M, Metcalf BL, Moore MR, Moura I, Nix WA, Nyangoma E, Oberste MS, Olsen SJ, Pimenta F, Socias C, Thurman K, Waller J, Waterman SH, Westercamp M, Wharton M, Whitney CG, Winchell JM, Wolff B, Kim C. Multistate Outbreak of Respiratory Infections Among Unaccompanied Children, June 2014-July 2014. Clin Infect Dis 2016; 63:48-56. [PMID: 27001799 DOI: 10.1093/cid/ciw147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/07/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND From January 2014-July 2014, more than 46 000 unaccompanied children (UC) from Central America crossed the US-Mexico border. In June-July, UC aged 9-17 years in 4 shelters and 1 processing center in 4 states were hospitalized with acute respiratory illness. We conducted a multistate investigation to interrupt disease transmission. METHODS Medical charts were abstracted for hospitalized UC. Nonhospitalized UC with influenza-like illness were interviewed, and nasopharyngeal and oropharyngeal swabs were collected to detect respiratory pathogens. Nasopharyngeal swabs were used to assess pneumococcal colonization in symptomatic and asymptomatic UC. Pneumococcal blood isolates from hospitalized UC and nasopharyngeal isolates were characterized by serotyping and whole-genome sequencing. RESULTS Among 15 hospitalized UC, 4 (44%) of 9 tested positive for influenza viruses, and 6 (43%) of 14 with blood cultures grew pneumococcus, all serotype 5. Among 48 nonhospitalized children with influenza-like illness, 1 or more respiratory pathogens were identified in 46 (96%). Among 774 nonhospitalized UC, 185 (24%) yielded pneumococcus, and 70 (38%) were serotype 5. UC transferring through the processing center were more likely to be colonized with serotype 5 (odds ratio, 3.8; 95% confidence interval, 2.1-6.9). Analysis of core pneumococcal genomes detected 2 related, yet independent, clusters. No pneumococcus cases were reported after pneumococcal and influenza immunization campaigns. CONCLUSIONS This respiratory disease outbreak was due to multiple pathogens, including Streptococcus pneumoniae serotype 5 and influenza viruses. Pneumococcal and influenza vaccinations prevented further transmission. Future efforts to prevent similar outbreaks will benefit from use of both vaccines.
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Affiliation(s)
- Sara Tomczyk
- Epidemic Intelligence Service Respiratory Diseases Branch
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jose E Hagan
- Epidemic Intelligence Service Global Immunizations Division, Centers for Disease Control and Prevention, Atlanta, Georgia US Public Health Service, Rockville, Maryland
| | - Aaron M Harris
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | - Lindsay Kim
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | | | | | | | | | - Matthew R Moore
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | - W Allan Nix
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edith Nyangoma
- Epidemic Intelligence Service Division of Global Migration and Quarantine
| | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Christina Socias
- Epidemic Intelligence Service National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | | | | | | | | | | | - Cynthia G Whitney
- Respiratory Diseases Branch US Public Health Service, Rockville, Maryland
| | | | | | - Curi Kim
- US Public Health Service, Rockville, Maryland Office of Refugee Resettlement, Administration for Children and Families, Washington D.C
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15
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Arriola CS, Vasconez N, Thompson M, Mirza S, Moen AC, Bresee J, Talavera I, Ropero AM. Factors associated with a successful expansion of influenza vaccination among pregnant women in Nicaragua. Vaccine 2016; 34:1086-90. [PMID: 26782740 DOI: 10.1016/j.vaccine.2015.12.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Pregnant women are at risk of severe influenza disease and are a priority group for influenza vaccination programs. Nicaragua expanded recommendations to include influenza vaccination to all pregnant women in the municipality of Managua in 2013. METHODS We carried out a survey among 1,807 pregnant women who delivered at public hospitals in the municipality of Managua to evaluate the uptake of influenza vaccination and factors associated with vaccination. RESULTS We observed a high (71%) uptake of influenza vaccination among this population, with no differences observed by age, education or parity of the women. Having four antenatal visits and five or more visits were associated with receipt of influenza vaccination (AORs: 2.58; 95% CI: 1.15, 5.81, and 2.37; 95% CI: 1.12, 5.0, respectively). Also, receipt of influenza vaccination recommendation from a health care provider was positively associated with receipt of influenza vaccination (AOR: 14.22; 95% CI: 10.45, 19.33). CONCLUSIONS The successful expansion of influenza vaccination among pregnant women in the municipality of Managua may be due to ready access to free medical care and health care providers' recommendation for vaccination at health care clinics that received influenza vaccine.
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Affiliation(s)
- Carmen S Arriola
- Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, GA, USA; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Mark Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Mirza
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ann C Moen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph Bresee
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ivy Talavera
- Pan American Health Organization, Managua, Nicaragua
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16
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Affiliation(s)
- Carmen S Arriola
- Epidemic Intelligence Service Program Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra S Chaves
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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17
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Arriola CS, Mercado-Crespo MC, Rivera B, Serrano-Rodriguez R, Macklin N, Rivera A, Graitcer S, Lacen M, Bridges CB, Kennedy ED. Reasons for low influenza vaccination coverage among adults in Puerto Rico, influenza season 2013-2014. Vaccine 2015; 33:3829-35. [PMID: 26144896 DOI: 10.1016/j.vaccine.2015.06.093] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/19/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Influenza vaccination is recommended annually for all persons 6 months and older. Reports of increased influenza-related morbidity and mortality during the 2013-2014 influenza season raised concerns about low adult influenza immunization rates in Puerto Rico. In order to inform public health actions to increase vaccination rates, we surveyed adults in Puerto Rico regarding influenza vaccination-related attitudes and barriers. METHODS A random-digit-dialing telephone survey (50% landline: 50% cellphone) regarding influenza vaccination, attitudes, practices and barriers was conducted November 19-25, 2013 among adults in Puerto Rico. Survey results were weighted to reflect sampling design and adjustments for non-response. RESULTS Among 439 surveyed, 229 completed the survey with a 52% response rate. Respondents' median age was 55 years; 18% reported receiving 2013-2014 influenza vaccination. Among 180 unvaccinated respondents, 38% reported barriers associated with limited access to vaccination, 24% reported they did not want or need influenza vaccination, and 20% reported safety concerns. Vaccinated respondents were more likely to know if they were recommended for influenza vaccination, to report greater perceived risk of influenza illness, and to report being less concerned about influenza vaccine safety (p-value<0.05). Of the 175 respondents who saw a healthcare provider (HCP) since July 1, 2013, 38% reported their HCP recommended influenza vaccination and 17% were offered vaccination. Vaccination rates were higher among adults who received a recommendation and/or offer of influenza vaccination (43% vs. 14%; p-value<0.01). CONCLUSIONS Failure of HCP to recommend and/or offer influenza vaccination and patient attitudes (low perceived risk of influenza virus infection) may have contributed to low vaccination rates during the 2013-2014 season. HCP and public health practitioners should strongly recommend influenza vaccination and provide vaccinations during clinical encounters or refer patients for vaccination.
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Affiliation(s)
- Carmen S Arriola
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Melissa C Mercado-Crespo
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brenda Rivera
- Puerto Rico Department of Health, San Juan, Puerto Rico, USA
| | | | - Nora Macklin
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angel Rivera
- Puerto Rico Department of Health, San Juan, Puerto Rico, USA
| | - Samuel Graitcer
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mayra Lacen
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn B Bridges
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin D Kennedy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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18
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Arriola CS, Anderson EJ, Baumbach J, Bennett N, Bohm S, Hill M, Lindegren ML, Lung K, Meek J, Mermel E, Miller L, Monroe ML, Morin C, Oni O, Reingold A, Schaffner W, Thomas A, Zansky SM, Finelli L, Chaves SS. Does Influenza Vaccination Modify Influenza Severity? Data on Older Adults Hospitalized With Influenza During the 2012-2013 Season in the United States. J Infect Dis 2015; 212:1200-8. [PMID: 25821227 DOI: 10.1093/infdis/jiv200] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/19/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Some studies suggest that influenza vaccination might be protective against severe influenza outcomes in vaccinated persons who become infected. We used data from a large surveillance network to further investigate the effect of influenza vaccination on influenza severity in adults aged ≥50 years who were hospitalized with laboratory-confirmed influenza. METHODS We analyzed influenza vaccination and influenza severity using Influenza Hospitalization Surveillance Network (FluSurv-NET) data for the 2012-2013 influenza season. Intensive care unit (ICU) admission, death, diagnosis of pneumonia, and hospital and ICU lengths of stay served as measures of disease severity. Data were analyzed by multivariable logistic regression, parametric survival models, and propensity score matching (PSM). RESULTS Overall, no differences in severity were observed in the multivariable logistic regression model. Using PSM, adults aged 50-64 years (but not other age groups) who were vaccinated against influenza had a shorter length of ICU stay than those who were unvaccinated (hazard ratio for discharge, 1.84; 95% confidence interval, 1.12-3.01). CONCLUSIONS Our findings show a modest effect of influenza vaccination on disease severity. Analysis of data from seasons with different predominant strains and higher estimates of vaccine effectiveness are needed.
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Affiliation(s)
- Carmen S Arriola
- Epidemic Intelligence Service Program Influenza Division, Centers for Disease Control and Prevention
| | - Evan J Anderson
- Department of Medicine, Emory University School of Medicine Atlanta Veterans Affairs Medical Center, Georgia
| | | | - Nancy Bennett
- Department of Medicine, University of Rochester School of Medicine and Dentistry
| | - Susan Bohm
- Michigan Department of Community Health, Lansing
| | - Mary Hill
- Salt Lake County Health Department, Utah
| | | | | | - James Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven
| | | | - Lisa Miller
- Colorado Department of Public Health and Environment, Denver
| | - Maya L Monroe
- Maryland Department of Health and Mental Hygiene, Baltimore
| | | | | | | | | | | | - Shelley M Zansky
- Emerging Infections Program, New York State Department of Health, Albany, New York
| | - Lyn Finelli
- Influenza Division, Centers for Disease Control and Prevention
| | - Sandra S Chaves
- Influenza Division, Centers for Disease Control and Prevention
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19
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Sharp TM, Roth NM, Torres J, Ryff KR, Pérez Rodríguez NM, Mercado C, del Pilar Diaz Padró M, Ramos M, Phillips R, Lozier M, Arriola CS, Johansson M, Hunsperger E, Muñoz-Jordán JL, Margolis HS, García BR. Chikungunya cases identified through passive surveillance and household investigations--Puerto Rico, May 5-August 12, 2014. MMWR Morb Mortal Wkly Rep 2014; 63:1121-8. [PMID: 25474032 PMCID: PMC4584601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Chikungunya and dengue are mosquito-borne, viral, acute febrile illnesses that can be difficult to distinguish clinically. Whereas dengue is endemic in many countries in the Caribbean and the Americas, the first locally acquired chikungunya case in the Western Hemisphere was reported from the Caribbean island of St. Martin in December 2013 and was soon followed by cases in many parts of the region. In January 2014, the Puerto Rico Department of Health (PRDH) and CDC initiated chikungunya surveillance by building on an existing passive dengue surveillance system. To assess the extent of chikungunya in Puerto Rico, the severity of illnesses, and the health care-seeking behaviors of residents, PRDH and CDC analyzed data from passive surveillance and investigations conducted around the households of laboratory-positive chikungunya patients. Passive surveillance indicated that the first locally acquired, laboratory-positive chikungunya case in Puerto Rico was in a patient with illness onset on May 5, 2014. By August 12, a total of 10,201 suspected chikungunya cases (282 per 100,000 residents) had been reported. Specimens from 2,910 suspected cases were tested, and 1,975 (68%) were positive for chikungunya virus (CHIKV) infection. Four deaths were reported. The household investigations found that, of 250 participants, 70 (28%) tested positive for current or recent CHIKV infection, including 59 (84%) who reported illness within the preceding 3 months. Of 25 laboratory-positive participants that sought medical care, five (20%) were diagnosed with chikungunya and two (8%) were reported to PRDH. These investigative efforts indicated that chikungunya cases were underrecognized and underreported, prompting PRDH to conduct information campaigns to increase knowledge of the disease among health care professionals and the public. PRDH and CDC recommended that health care providers manage suspected chikungunya cases as they do dengue because of the similarities in symptoms and increased risk for complications in dengue patients that are not appropriately managed. Residents of and travelers to the tropics can minimize their risk for both chikungunya and dengue by taking standard measures to avoid mosquito bites.
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Affiliation(s)
- Tyler M. Sharp
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC,Corresponding author: Tyler M. Sharp, , 787-706-2399
| | - Nicole M. Roth
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Jomil Torres
- Office of Epidemiology, Puerto Rico Department of Health
| | - Kyle R. Ryff
- Office of Epidemiology, Puerto Rico Department of Health
| | - Nicole M. Pérez Rodríguez
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Chanis Mercado
- Office of Epidemiology, Puerto Rico Department of Health
| | | | - Maria Ramos
- Office of Epidemiology, Puerto Rico Department of Health
| | - Raina Phillips
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC,Epidemic Intelligence Service, CDC
| | - Matthew Lozier
- Epidemic Intelligence Service, CDC,Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Carmen S. Arriola
- Epidemic Intelligence Service, CDC,Division of Global Health Protection, Center for Global Health, CDC
| | - Michael Johansson
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Elizabeth Hunsperger
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Jorge L. Muñoz-Jordán
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Harold S. Margolis
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC
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20
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Arriola CS, Gonzalez AE, Gomez-Puerta LA, Lopez-Urbina MT, Garcia HH, Gilman RH. New insights in cysticercosis transmission. PLoS Negl Trop Dis 2014; 8:e3247. [PMID: 25329903 PMCID: PMC4199528 DOI: 10.1371/journal.pntd.0003247] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
Taenia solium infection causes severe neurological disease in humans. Even though infection and exposure to swine cysticercosis is scattered throughout endemic villages, location of the tapeworm only explains some of the nearby infections and is not related to location of seropositive pigs. Other players might be involved in cysticercosis transmission. In this study we hypothesize that pigs that carry nematodes specific to dung beetles are associated with cysticercosis infection and/or exposure. We carried out a cross-sectional study of six villages in an endemic region in northern Peru. We euthanized all pigs (326) in the villages and performed necropsies to diagnose cysticercosis. For each pig, we counted cysticerci; measured anti-cysticercus antibodies; identified intestinal nematodes; tabulated distance to nearest human tapeworm infection; and recorded age, sex, productive stage, and geographic reference. For the purpose of this paper, we defined cysticercosis infection as the presence of at least one cysticercus in pig muscles, and cysticercosis exposure as seropositivity to anti-cysticercus antibodies with the presence of 0–5 cysticerci. Compared to pigs without nematode infections, those pigs infected with the nematode Ascarops strongylina were significantly associated with the presence of cysticerci (OR: 4.30, 95%CI: 1.83–10.09). Similarly, pigs infected with the nematode Physocephalus sexalatus were more likely to have cysticercosis exposure (OR: 2.21, 95%CI: 1.50–3.28). In conclusion, our results suggest that there appears to be a strong positive association between the presence of nematodes and both cysticercosis infection and exposure in pigs. The role of dung beetles in cysticercosis dynamics should be further investigated. In endemic areas, pigs acquire cysticercosis when ingesting Taenia solium eggs that have been released into the environment in the feces of a person infected with T. solium. The present study has found evidence that players, such as dung beetles, might be involved in further dissemination of the parasite into the environment. Specifically, we found an association between helminths, for whom dung beetles act as an intermediate host, and porcine cysticercosis infection and exposure after adjusting for other porcine cysticercosis predictors such as distance to tapeworm carrier and age. Although the study does not evaluate dung beetles directly, parasites specific to dung beetles serve as a novel proxy to evidence the potential role of dung beetles in the epidemiology of cysticercosis. Therefore, it is important that further studies elucidate the role of other players in cysticercosis transmission in order to better explain the reemergence and persistence of cysticercosis after elimination and control efforts. In addition, vector populations could potentially be used as markers for cysticercosis in the communities.
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Affiliation(s)
- Carmen S. Arriola
- San Marcos Veterinary School, San Marcos Major National University, Lima, Peru
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, United States of America
- * E-mail:
| | - Armando E. Gonzalez
- San Marcos Veterinary School, San Marcos Major National University, Lima, Peru
| | | | | | | | - Robert H. Gilman
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, United States of America
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21
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Arriola CS, Brammer L, Epperson S, Blanton L, Kniss K, Mustaquim D, Steffens C, Dhara R, Leon M, Perez A, Chaves SS, Katz J, Wallis T, Villanueva J, Xu X, Abd Elal AI, Gubareva L, Cox N, Finelli L, Bresee J, Jhung M. Update: influenza activity - United States, September 29, 2013-February 8, 2014. MMWR Morb Mortal Wkly Rep 2014; 63:148-54. [PMID: 24553198 PMCID: PMC4584759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Influenza activity in the United States began to increase in mid-November and remained elevated through February 8, 2014. During that time, influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, while few B and A (H3N2) viruses were detected. This report summarizes U.S. influenza activity* during September 29, 2013-February 8, 2014, and updates the previous summary.
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Affiliation(s)
- Carmen S. Arriola
- EIS officer, CDC,Influenza Division, National Center for Immunization and Respiratory Diseases, CDC,Corresponding author: Carmen S. Arriola, , 404-639-3747
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Scott Epperson
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Craig Steffens
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rosaline Dhara
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Michelle Leon
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alejandro Perez
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sandra S. Chaves
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jackie Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Teresa Wallis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Julie Villanueva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Nancy Cox
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lyn Finelli
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Joseph Bresee
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Michael Jhung
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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22
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Arriola CS, Güere ME, Larsen J, Skov RL, Gilman RH, Gonzalez AE, Silbergeld EK. Presence of methicillin-resistant Staphylococcus aureus in pigs in Peru. PLoS One 2011; 6:e28529. [PMID: 22174831 PMCID: PMC3234269 DOI: 10.1371/journal.pone.0028529] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022] Open
Abstract
We report the first detection of methicillin-resistant Staphylococcus aureus isolates in pigs in Peru. The isolates belong to a livestock-associated lineage previously reported in North America and Europe, CC398, and a highly virulent USA300-like ST8-IV variant, which is the predominant community-associated lineage in Latin America.
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Affiliation(s)
- Carmen S. Arriola
- School of Veterinary Medicine, San Marcos Major National University, Lima, Peru
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Mariella E. Güere
- School of Veterinary Medicine, San Marcos Major National University, Lima, Peru
| | - Jesper Larsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - Robert L. Skov
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - Robert H. Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Armando E. Gonzalez
- School of Veterinary Medicine, San Marcos Major National University, Lima, Peru
| | - Ellen K. Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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