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Rubio IT, Wyld L, Marotti L, Athanasiou A, Regitnig P, Catanuto G, Schoones JW, Zambon M, Camps J, Santini D, Dietz J, Sardanelli F, Varga Z, Smidt M, Sharma N, Shaaban AM, Gilbert F. Corrigendum to "European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO" [Eur J Surg Oncol 50 (1) (January 2024) 107292]. Eur J Surg Oncol 2024; 50:107943. [PMID: 38246851 DOI: 10.1016/j.ejso.2023.107943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain; European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy; European Society of Surgical Oncology (ESSO), Brussels, Belgium.
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK; Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | | | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Giuseppe Catanuto
- Humanitas-Istituto Clinico Catanese Misterbianco, Italy; Fondazione G.Re.T.A., ETS, Napoli, Italy
| | - Jan W Schoones
- Research Policy & Graduate School Advisor, Leiden University Medical Center Leiden, the Netherlands
| | - Marzia Zambon
- Europa Donna - The European Breast Cancer Coalition, Milan, Italy
| | - Julia Camps
- Breast Health Units in Ribera Salud Hospitals.Valencia, Spain
| | - Donatella Santini
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Jill Dietz
- The American Society of Breast Surgeons, Columbia, MD, USA
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Marjolein Smidt
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nisha Sharma
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Beckett Street Leeds, West Yorkshire, LS9 7TF, UK
| | - Abeer M Shaaban
- Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, UK
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Rubio IT, Wyld L, Marotti L, Athanasiou A, Regitnig P, Catanuto G, Schoones JW, Zambon M, Camps J, Santini D, Dietz J, Sardanelli F, Varga Z, Smidt M, Sharma N, Shaaban AM, Gilbert F. European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO. Eur J Surg Oncol 2024; 50:107292. [PMID: 38061151 DOI: 10.1016/j.ejso.2023.107292] [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] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Breast lesions of uncertain malignant potential (B3) include atypical ductal and lobular hyperplasias, lobular carcinoma in situ, flat epithelial atypia, papillary lesions, radial scars and fibroepithelial lesions as well as other rare miscellaneous lesions. They are challenging to categorise histologically, requiring specialist training and multidisciplinary input. They may coexist with in situ or invasive breast cancer (BC) and increase the risk of subsequent BC development. Management should focus on adequate classification and management whilst avoiding overtreatment. The aim of these guidelines is to provide updated information regarding the diagnosis and management of B3 lesions, according to updated literature review evidence. METHODS These guidelines provide practical recommendations which can be applied in clinical practice which include recommendation grade and level of evidence. All sections were written according to an updated literature review and discussed at a consensus meeting. Critical appraisal by the expert writing committee adhered to the 23 items in the international Appraisal of Guidelines, Research and Evaluation (AGREE) tool. RESULTS Recommendations for further management after core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB) diagnosis of a B3 lesion reported in this guideline, vary depending on the presence of atypia, size of lesion, sampling size, and patient preferences. After CNB or VAB, the option of vacuum-assisted excision or surgical excision should be evaluated by a multidisciplinary team and shared decision-making with the patient is crucial for personalizing further treatment. De-escalation of surgical intervention for B3 breast lesions is ongoing, and the inclusion of vacuum-assisted excision (VAE) will decrease the need for surgical intervention in further approaches. Communication with patients may be different according to histological diagnosis, presence or absence of atypia, or risk of upgrade due to discordant imaging. Written information resources to help patients understand these issues alongside with verbal communication is recommended. Lifestyle interventions have a significant impact on BC incidence so lifestyle interventions need to be suggested to women at increased BC risk as a result of a diagnosis of a B3 lesion. CONCLUSIONS These guidelines provide a state-of-the-art overview of the diagnosis, management and prognosis of B3 lesions in modern multidisciplinary breast practice.
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Affiliation(s)
- Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain; European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy; European Society of Surgical Oncology (ESSO), Brussels, Belgium.
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK; Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | | | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Giuseppe Catanuto
- Humanitas-Istituto Clinico Catanese Misterbianco, Italy; Fondazione G.Re.T.A., ETS, Napoli, Italy
| | - Jan W Schoones
- Research Policy & Graduate School Advisor, Leiden University Medical Center Leiden, the Netherlands
| | - Marzia Zambon
- Europa Donna - The European Breast Cancer Coalition, Milan, Italy
| | - Julia Camps
- Breast Health Units in Ribera Salud Hospitals.Valencia, Spain
| | - Donatella Santini
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Jill Dietz
- The American Society of Breast Surgeons, Columbia, MD, USA
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Marjolein Smidt
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nisha Sharma
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Beckett Street Leeds, West Yorkshire, LS9 7TF, UK
| | - Abeer M Shaaban
- Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, UK.
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Snell LB, Vink JP, Verlander NQ, Miah S, Lackenby A, Williams D, Mitchell H, Beviz C, Kabia M, Cunningham E, Batra R, Edgeworth JD, Zambon M, Nebbia G. Nosocomial acquisition of influenza is associated with significant morbidity and mortality: Results of a prospective observational study. J Infect Public Health 2022; 15:1118-1123. [PMID: 36137361 PMCID: PMC10166711 DOI: 10.1016/j.jiph.2022.08.021] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Nosocomial acquisition of influenza is known to occur but the risk after exposure to a known case and the outcomes after acquisition are poorly defined. METHODS Prospective observational study of patients exposed to influenza from another patient in a multi-site healthcare organisation, with follow-up of 7 days or until discharge, and PCR-confirmation of symptomatic disease. Multivariable analysis was used to investigate association of influenza acquisition with high dependency unit/intensive care unit (HDU/ITU) admission and in-hospital mortality. RESULTS 23/298 (7.7%) contacts of 11 cases were subsequently symptomatic and tested influenza-positive during follow-up. HDU/ITU admission was significantly higher in these secondary cases (6/23, 26%) compared to flu-negative contacts (20/275, 7.2%; p = 0.002). In-hospital mortality was significantly higher in secondary cases (5/23, 21.7%) compared to flu-negative contacts (11/275, 4%; p < 0.001). In multivariable analysis, age (OR 1.25 95% CI: 1.01-1.54, p = 0.02) and being a secondary case (OR 4.77, 95% CI: 1.63-13.9, p = 0.008) were significantly associated with HDU/ITU admission in contacts. Age (OR 1.00, 95% CI: 0.93-1.00, p = 0.02), being a secondary case after exposure to influenza (OR 3.81, 95% CI 1.09-13.3, p = 0.049) and co-morbidity (OR 1.29 per unit increment in the Charlson score, 95% CI 1.02-1.61, p = 0.03) were significantly associated with in-hospital mortality in contacts. CONCLUSIONS Nosocomial acquisition of influenza was significantly associated with increased risk of HDU/ITU admission and in-hospital mortality.
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Affiliation(s)
- L B Snell
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas' NHS Foundation Trust, London, UK; Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK.
| | - J P Vink
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - S Miah
- UK Health Security Agency, Colindale, UK
| | - A Lackenby
- UK Health Security Agency, Colindale, UK
| | - D Williams
- UK Health Security Agency, Colindale, UK
| | - H Mitchell
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
| | - C Beviz
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
| | - M Kabia
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
| | | | - R Batra
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - J D Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas' NHS Foundation Trust, London, UK; Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
| | - M Zambon
- UK Health Security Agency, Colindale, UK
| | - G Nebbia
- Centre for Clinical Infection and Diagnostics Research, Guy's and St. Thomas' NHS Foundation Trust, London, UK; Department of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
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Atti A, Ferrari M, Castillo-Olivares J, Monk E, Gopal R, Patel M, Hoschler K, Cole M, Semper A, Hewson J, Otter A, Foulkes S, Islam J, Mirfenderesky M, Jain S, Murira J, Favager C, Nastouli E, Chand M, Brown C, Heeney J, Brooks T, Hall V, Hopkins S, Zambon M. Serological profile of first SARS-CoV-2 reinfection cases detected within the SIREN study. J Infect 2022; 84:248-288. [PMID: 34600935 PMCID: PMC8482544 DOI: 10.1016/j.jinf.2021.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022]
Affiliation(s)
- A. Atti
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK,Correspondence author
| | - M. Ferrari
- Department of Veterinary Medicine, Laboratory of Viral Zoonotics (LVZ) and HICC (Humoral Immune Correlates from COVID-19), University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - J. Castillo-Olivares
- Department of Veterinary Medicine, Laboratory of Viral Zoonotics (LVZ) and HICC (Humoral Immune Correlates from COVID-19), University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - E.J.M. Monk
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - R. Gopal
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - M. Patel
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - K. Hoschler
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - M.J. Cole
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - A. Semper
- Public Health England (PHE), Porton Down, Salisbury SP4 0JG, UK
| | - J. Hewson
- Public Health England (PHE), Porton Down, Salisbury SP4 0JG, UK
| | - A.D. Otter
- Public Health England (PHE), Porton Down, Salisbury SP4 0JG, UK
| | - S. Foulkes
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - J. Islam
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - M. Mirfenderesky
- North Middlesex University Hospital NHS Trust, Sterling Way, London N18 1QX, UK
| | - S. Jain
- North Middlesex University Hospital NHS Trust, Sterling Way, London N18 1QX, UK
| | - J. Murira
- Leeds Teaching Hospitals NHS Trust, Great George St, Leeds LS1 3EX, UK
| | - C. Favager
- Leeds Teaching Hospitals NHS Trust, Great George St, Leeds LS1 3EX, UK
| | - E. Nastouli
- Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, 250 Euston Rd, London NW1 2PG, UK,Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK
| | - M.A. Chand
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - C.S. Brown
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - J.L. Heeney
- Department of Veterinary Medicine, Laboratory of Viral Zoonotics (LVZ) and HICC (Humoral Immune Correlates from COVID-19), University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - T. Brooks
- Public Health England (PHE), Porton Down, Salisbury SP4 0JG, UK
| | - V.J. Hall
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - S. Hopkins
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - M. Zambon
- Public Health England (PHE), PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
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5
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Zambon M. EFFECTIVE ADVOCACY FOR WOMEN WITH METASTATIC BREAST CANCER: A EUROPEAN PERSPECTIVE. Breast 2021. [DOI: 10.1016/s0960-9776(21)00522-1] [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: 11/28/2022] Open
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6
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Cole ME, Kundu R, Abdulla AF, Andrews N, Hoschler K, Southern J, Jackson D, Miller E, Zambon M, Turner PJ, Tregoning JS. Pre-existing influenza-specific nasal IgA or nasal viral infection does not affect live attenuated influenza vaccine immunogenicity in children. Clin Exp Immunol 2021; 204:125-133. [PMID: 33314126 PMCID: PMC7944357 DOI: 10.1111/cei.13564] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022] Open
Abstract
The United Kingdom has a national immunization programme which includes annual influenza vaccination in school-aged children, using live attenuated influenza vaccine (LAIV). LAIV is given annually, and it is unclear whether repeat administration can affect immunogenicity. Because LAIV is delivered intranasally, pre-existing local antibody might be important. In this study, we analysed banked samples from a study performed during the 2017/18 influenza season to investigate the role of pre-existing influenza-specific nasal immunoglobulin (Ig)A in children aged 6-14 years. Nasopharyngeal swabs were collected prior to LAIV immunization to measure pre-existing IgA levels and test for concurrent upper respiratory tract viral infections (URTI). Oral fluid samples were taken at baseline and 21-28 days after LAIV to measure IgG as a surrogate of immunogenicity. Antibody levels at baseline were compared with a pre-existing data set of LAIV shedding from the same individuals, measured by reverse transcription-polymerase chain reaction. There was detectable nasal IgA specific to all four strains in the vaccine at baseline. However, baseline nasal IgA did not correlate with the fold change in IgG response to the vaccine. Baseline nasal IgA also did not have an impact upon whether vaccine virus RNA was detectable after immunization. There was no difference in fold change of antibody between individuals with and without an URTI at the time of immunization. Overall, we observed no effect of pre-existing influenza-specific nasal antibody levels on immunogenicity, supporting annual immunization with LAIV in children.
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MESH Headings
- Administration, Intranasal
- Adolescent
- Antibodies, Viral/immunology
- Child
- Female
- Humans
- Immunogenicity, Vaccine/immunology
- Immunoglobulin A/immunology
- Immunoglobulin G/immunology
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Male
- Nasal Cavity/immunology
- Nasal Cavity/virology
- Vaccination/methods
- Vaccines, Attenuated/administration & dosage
- Vaccines, Attenuated/immunology
- Virus Shedding/immunology
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Affiliation(s)
- M. E. Cole
- Department of Infectious DiseaseImperial College London (St Mary’s Campus)LondonUK
- Present address:
MEC – The Pirbright InstitutePirbrightUK
| | - R. Kundu
- Health Protection Research Unit in Respiratory InfectionsImperial College LondonLondonUK
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - A. F. Abdulla
- Department of Infectious DiseaseImperial College London (St Mary’s Campus)LondonUK
| | - N. Andrews
- Public Health England (Colindale)LondonUK
| | | | | | - D. Jackson
- Public Health England (Colindale)LondonUK
| | - E. Miller
- Public Health England (Colindale)LondonUK
| | - M. Zambon
- Public Health England (Colindale)LondonUK
| | - P. J. Turner
- Health Protection Research Unit in Respiratory InfectionsImperial College LondonLondonUK
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - J. S. Tregoning
- Department of Infectious DiseaseImperial College London (St Mary’s Campus)LondonUK
- Health Protection Research Unit in Respiratory InfectionsImperial College LondonLondonUK
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7
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Turner PJ, Abdulla AF, Cole ME, Javan RR, Gould V, O'Driscoll ME, Southern J, Zambon M, Miller E, Andrews NJ, Höschler K, Tregoning JS. Differences in nasal immunoglobulin A responses to influenza vaccine strains after live attenuated influenza vaccine (LAIV) immunization in children. Clin Exp Immunol 2020; 199:109-118. [PMID: 31670841 PMCID: PMC6954673 DOI: 10.1111/cei.13395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Accepted: 10/24/2019] [Indexed: 11/28/2022] Open
Abstract
Different vaccine strains included in the live attenuated influenza vaccine (LAIV) have variable efficacy. The reasons for this are not clear and may include differences in immunogenicity. We report a Phase IV open-label study on the immunogenicity of a single dose of quadrivalent LAIV (Fluenz™ Tetra) in children during the 2015/16 season, to investigate the antibody responses to different strains. Eligible children were enrolled to receive LAIV; nasal samples were collected before and approximately 4 weeks after immunization. There was a significant increase in nasal immunoglobulin (Ig)A to the H3N2, B/Victoria lineage (B/Brisbane) and B/Yamagata lineage (B/Phuket) components, but not to the H1N1 component. The fold change in nasal IgA response was inversely proportional to the baseline nasal IgA titre for H1N1, H3N2 and B/Brisbane. We investigated possible associations that may explain baseline nasal IgA, including age and prior vaccination status, but found different patterns for different antigens, suggesting that the response is multi-factorial. Overall, we observed differences in immune responses to different viral strains included in the vaccine; the reasons for this require further investigation.
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Affiliation(s)
- P. J. Turner
- National Heart and Lung InstituteImperial College LondonLondonUK
- Public Health England (Colindale)LondonUK
| | - A. F. Abdulla
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - M. E. Cole
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - R. R. Javan
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - V. Gould
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - M. E. O'Driscoll
- Infectious Diseases EpidemiologySt Mary's CampusImperial College LondonLondonUK
| | | | - M. Zambon
- Public Health England (Colindale)LondonUK
| | - E. Miller
- Public Health England (Colindale)LondonUK
| | | | | | - J. S. Tregoning
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
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8
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Pebody RG, Zhao H, Whitaker HJ, Ellis J, Donati M, Zambon M, Andrews N. Effectiveness of influenza vaccine in children in preventing influenza associated hospitalisation, 2018/19, England. Vaccine 2019; 38:158-164. [PMID: 31648914 DOI: 10.1016/j.vaccine.2019.10.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 08/09/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 01/09/2023]
Abstract
2013/14 saw the start of the introduction of a new live attenuated influenza vaccine (LAIV) programme for children in England. 2018/19 saw co-circulation of both A(H1N1)pdm09 and A(H3N2), when LAIV was offered to all healthy children 2-9 years of age. LAIV effectiveness against influenza hospitalisation is not well described. This paper presents the 2018/19 end-of-season adjusted vaccine effectiveness (aVE) against laboratory confirmed influenza related hospitalisation in children aged 2-17. The test negative case control approach was used to estimate aVE by influenza A subtype and vaccine type. Cases and controls were selected from a sentinel laboratory surveillance system which collates details of individuals tested for influenza with reverse-transcription polymerase chain reaction (RT-PCR) on respiratory samples. Vaccine and clinical history was obtained from general practitioners of study participants. There were 307 hospitalised cases and 679 hospitalised controls. End-of-season influenza aVE was 53.0% (95% CI: 33.3, 66.8) against influenza confirmed hospitalisation; 63.5% (95% CI: 34.4, 79.7) against influenza A(H1N1)pdm09 hospitalisation and 31.1% (95% CI: -53.9, 69.2) against influenza A(H3N2). LAIV aVE was 49.1% (95% CI: 25.9, 65.0) for any influenza and 70.7% (95% CI: 41.8, 85.3) for A(H1N1)pdm09, whereas for those receiving quadrivalent inactivated influenza vaccine (QIV), aVE was 64.4% (95% CI: 29.4, 82.0) and 44.4% (95% CI: -51.9, 79.6) respectively. We provide evidence of overall significant VE for both LAIV and QIV against influenza associated hospitalisation in children 2-17 years of age, most notably against influenza A(H1N1)pdm09, with non-significant protection against A(H3N2).
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Affiliation(s)
- R G Pebody
- Public Health England National Infection Service, Colindale, London, UK.
| | - H Zhao
- Public Health England National Infection Service, Colindale, London, UK
| | - H J Whitaker
- Public Health England National Infection Service, Colindale, London, UK
| | - J Ellis
- Public Health England National Infection Service, Colindale, London, UK
| | - M Donati
- Public Health England National Infection Service, Bristol, UK
| | - M Zambon
- Public Health England National Infection Service, Colindale, London, UK
| | - N Andrews
- Public Health England National Infection Service, Colindale, London, UK
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9
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Galiano M, Miah S, Akinbami O, Gonzalez Gonoggia S, Ellis J, Zambon M. A29 Genetic heterogeneity of influenza A (H3N2) viruses in the United Kingdom, 2016–8. Virus Evol 2019. [PMCID: PMC6735920 DOI: 10.1093/ve/vez002.028] [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: 11/17/2022] Open
Abstract
For the last four influenza seasons in the UK, genetic characterization of seasonal influenza viruses has shifted from single hemagglutinin (HA) and neuraminidase (NA) genes to whole genome (WG) analysis, allowing for better insight into the evolutionary dynamics of this virus. Sequences (WG or HA/NA) were obtained from >900A (H3N2) viruses sampled in the UK during influenza seasons 2016/7 and 2017/8 and the inter-seasonal period. Viral RNA was extracted from clinical samples and amplified using a multi-segment RT-PCR. Amplicons were sequenced using Nextera library preparation for Illumina MiSeq sequencing. Sequence data ????were processed using BAM-SAM tools and PHE in-house scripts. Phylogenetic analysis of the HA gene indicates that they belong to genetic group 3C.2a, which has circulated since 2014. Season 2016/7 was characterized by the emergence of cluster 3C.2a.1; further genetic heterogeneity was seen with 6 new subclusters within 3C.2a and 3C.2a.1, with predominance of those characterized by amino acid changes N121K and S144K (3C.2a) and N121K, N171K, I406K, G484E (3C.2a.1). The NA genes clustered with a similar topology to the HA. Season 2017/8 was characterized by persistence of some clades from previous season with further diversification. Three of the 3C.2a clusters continued to circulate, with predominance of clade showing T131K, R142K, and R261Q (clade 3C.2a.2). The majority of HA sequences in 3C.2a1 fall into a new subcluster which has become predominant within this subgroup, with amino acid changes E62G, K92R, and T135K (3C.2a.1b). The topology of NA and internal gene trees showed evidence of reassortment events occurring at some point between the two seasons, with group 3C.2a2 acquiring NA and some internal genes from 3C.2a1 lineage viruses. The predominance of this group during 2017–8 might be due to fitness advantage related to the new genetic constellation. Emerging viruses from group 3C.3a also have acquired genes from lineage 3C.2a1, which could be the reason for their increased frequency to 20 per cent by the end of season 2017–8. Molecular epidemiology indicates emerging genetic diversity in A(H3N2) viruses during the period of study, leading to co-circulation of variants. The frequency of circulating HA genetic groups was quite variable, with rapidly changing patterns of predominance. Evidence of reassortment events was observed which could be responsible for the rise and predominance of some clades, and might predict the emergence of other variants.
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Affiliation(s)
- M Galiano
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - S Miah
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - O Akinbami
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - S Gonzalez Gonoggia
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - J Ellis
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - M Zambon
- Respiratory Virus Unit (National Influenza Centre), Virus Reference Department, National Infection Service, Public Health England, London, UK
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Scriven JE, Scobie A, Verlander NQ, Houston A, Collyns T, Cajic V, Kon OM, Mitchell T, Rahama O, Robinson A, Withama S, Wilson P, Maxwell D, Agranoff D, Davies E, Llewelyn M, Soo SS, Sahota A, Cooper MA, Hunter M, Tomlins J, Tiberi S, Kendall S, Dedicoat M, Alexander E, Fenech T, Zambon M, Lamagni T, Smith EG, Chand M. Mycobacterium chimaera infection following cardiac surgery in the United Kingdom: clinical features and outcome of the first 30 cases. Clin Microbiol Infect 2018; 24:1164-1170. [PMID: 29803845 DOI: 10.1016/j.cmi.2018.04.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Mycobacterium chimaera infection following cardiac surgery, due to contaminated cardiopulmonary bypass heater-cooler units, has been reported worldwide. However, the spectrum of clinical disease remains poorly understood. To address this, we report the clinical and laboratory features, treatment and outcome of the first 30 UK cases. METHODS Case note review was performed for cases identified retrospectively through outbreak investigations and prospectively through ongoing surveillance. Case definition was Mycobacterium chimaera detected in any clinical specimen, history of cardiothoracic surgery with cardiopulmonary bypass, and compatible clinical presentation. RESULTS Thirty patients were identified (28 with prosthetic material) exhibiting a spectrum of disease including prosthetic valve endocarditis (14/30), sternal wound infection (2/30), aortic graft infection (4/30) and disseminated (non-cardiac) disease (10/30). Patients presented a median of 14 months post surgery (maximum 5 years) most commonly complaining of fever and weight loss. Investigations frequently revealed lymphopenia, thrombocytopenia, liver cholestasis and non-necrotizing granulomatous inflammation. Diagnostic sensitivity for a single mycobacterial blood culture was 68% but increased if multiple samples were sent. In all, 27 patients started macrolide-based combination treatment and 14 had further surgery. To date, 18 patients have died (60%) a median of 30 months (interquartile range 20-39 months) after initial surgery. Survival analysis identified younger age, mitral valve surgery, mechanical valve replacement, higher serum sodium concentration and lower C-reactive protein as factors associated with better survival. CONCLUSIONS Mycobacterium chimaera infection following cardiac surgery is associated with a wide spectrum of disease. The diagnosis should be considered in all patients who develop an unexplained illness following cardiac surgery.
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Affiliation(s)
- J E Scriven
- Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK; National Infection Service, Public Health England, Colindale, London, UK.
| | - A Scobie
- National Infection Service, Public Health England, Colindale, London, UK
| | - N Q Verlander
- Statistics Unit, National Infection Service, Public Health England, Colindale, London, UK
| | - A Houston
- Department of Infection, St Georges Universities NHS Foundation Trust, London, UK
| | - T Collyns
- Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - V Cajic
- Department of Infection, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - O M Kon
- Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - T Mitchell
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - O Rahama
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - A Robinson
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - S Withama
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - P Wilson
- University College London Hospitals NHS Foundation Trust, London, UK
| | - D Maxwell
- Department of Respiratory Medicine, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - D Agranoff
- Department of Microbiology and Infection, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - E Davies
- Public Health Wales Microbiology, Cardiff, UK
| | - M Llewelyn
- Department of Infectious Diseases, Royal Gwent Hospital, Newport, UK
| | - S-S Soo
- Department of Microbiology, Nottingham University Hospitals NHS Trust, QMC Campus, Nottingham, UK
| | - A Sahota
- Department of Infection and Tropical Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - M A Cooper
- Department of Microbiology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - M Hunter
- Department of Infectious Diseases, Royal Victoria Hospital, Belfast, UK
| | - J Tomlins
- Department of Infection, St Georges Universities NHS Foundation Trust, London, UK
| | - S Tiberi
- Division of Infection, Barts Health NHS Trust, Royal London Hospital, London, UK; Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK
| | - S Kendall
- Society for Cardiothoracic Surgery in Great Britain and Ireland, London, UK; South Tees Hospitals Foundation NHS Trust, Middlesbrough, UK
| | - M Dedicoat
- Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK
| | - E Alexander
- National Infection Service, Public Health England, Colindale, London, UK
| | | | - M Zambon
- National Infection Service, Public Health England, Colindale, London, UK
| | - T Lamagni
- National Infection Service, Public Health England, Colindale, London, UK
| | - E G Smith
- National Infection Service, Public Health England, Colindale, London, UK
| | - M Chand
- National Infection Service, Public Health England, Colindale, London, UK; National Institute for Health Research Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK
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11
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Zago V, Zambon M, Civettini M, Zaltum O, Manfrin A. Virulence-associated factors in Vibrio cholerae non-O1/non-O139 and V. mimicus strains isolated in ornamental fish species. J Fish Dis 2017; 40:1857-1868. [PMID: 28677232 DOI: 10.1111/jfd.12659] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/28/2017] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 06/07/2023]
Abstract
During recent decades, ornamental fish have proven to be one of the fastest growing categories of pets in Europe. In this framework, we evaluated both the potential pathogenic and zoonotic risks caused by 53 Vibrio cholerae non-O1/non-O139 and a Vibrio mimicus strain isolated from ornamental fish species mostly originating from South-East Asia countries between 2000 and 2015 in Italy. All the strains were firstly identified at species level by biochemical, phylogenetic and mass spectrometry (matrix-assisted laser desorption ionization time of flight) methods, and then studied to reveal the presence of the main virulence and colonization-associated factors, as ctxA, ace, zot, stn/sto, toxR, rtxA, hlyA and tcpA by multiplex and single endpoint PCR assays. Findings showed that 21 of 54 strains harboured at least one virulence factor with a predominance for the toxR+ , rtxA+ and hlyAET+ genotype. Interestingly, the V. mimicus strain harboured the colonization factor and the CTX prophage receptor, tcpA, indicating the ability to capture and integrate it in its genome increasing its pathogenicity. Although these enterotoxins can sporadically cause gastroenteritis, the results highlight their probable involvement in causing severe implications for public health, suggesting the need for an European microbiological monitoring.
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Affiliation(s)
- V Zago
- National Reference Laboratory for Fish, Mollusc and Crustacean Diseases, Istituto Zooprofilattico Sperimentale delle Venezie, Adria, RO, Italy
| | - M Zambon
- National Reference Laboratory for Fish, Mollusc and Crustacean Diseases, Istituto Zooprofilattico Sperimentale delle Venezie, Adria, RO, Italy
| | - M Civettini
- National Reference Laboratory for Fish, Mollusc and Crustacean Diseases, Istituto Zooprofilattico Sperimentale delle Venezie, Adria, RO, Italy
| | - O Zaltum
- National Reference Laboratory for Fish, Mollusc and Crustacean Diseases, Istituto Zooprofilattico Sperimentale delle Venezie, Adria, RO, Italy
| | - A Manfrin
- National Reference Laboratory for Fish, Mollusc and Crustacean Diseases, Istituto Zooprofilattico Sperimentale delle Venezie, Adria, RO, Italy
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Woods K, Nic-Fhogartaigh C, Arnold C, Boutthasavong L, Phuklia W, Lim C, Chanthongthip A, Tulsiani SM, Craig SB, Burns MA, Weier SL, Davong V, Sihalath S, Limmathurotsakul D, Dance DAB, Shetty N, Zambon M, Newton PN, Dittrich S. A comparison of two molecular methods for diagnosing leptospirosis from three different sample types in patients presenting with fever in Laos. Clin Microbiol Infect 2017; 24:1017.e1-1017.e7. [PMID: 29092789 PMCID: PMC6125144 DOI: 10.1016/j.cmi.2017.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 06/16/2017] [Revised: 10/16/2017] [Accepted: 10/18/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To compare two molecular assays (rrs quantitative PCR (qPCR) versus a combined 16SrRNA and LipL32 qPCR) on different sample types for diagnosing leptospirosis in febrile patients presenting to Mahosot Hospital, Vientiane, Laos. METHODS Serum, buffy coat and urine samples were collected on admission, and follow-up serum ∼10 days later. Leptospira spp. culture and microscopic agglutination tests (MAT) were performed as reference standards. Bayesian latent class modelling was performed to estimate sensitivity and specificity of each diagnostic test. RESULTS In all, 787 patients were included in the analysis: 4/787 (0.5%) were Leptospira culture positive, 30/787 (3.8%) were MAT positive, 76/787 (9.7%) were rrs qPCR positive and 20/787 (2.5%) were 16SrRNA/LipL32 qPCR positive for pathogenic Leptospira spp. in at least one sample. Estimated sensitivity and specificity (with 95% CI) of 16SrRNA/LipL32 qPCR on serum (53.9% (33.3%-81.8%); 99.6% (99.2%-100%)), buffy coat (58.8% (34.4%-90.9%); 99.9% (99.6%-100%)) and urine samples (45.0% (27.0%-66.7%); 99.6% (99.3%-100%)) were comparable with those of rrs qPCR, except specificity of 16SrRNA/LipL32 qPCR on urine samples was significantly higher (99.6% (99.3%-100%) vs. 92.5% (92.3%-92.8%), p <0.001). Sensitivities of MAT (16% (95% CI 6.3%-29.4%)) and culture (25% (95% CI 13.3%-44.4%)) were low. Mean positive Cq values showed that buffy coat samples were more frequently inhibitory to qPCR than either serum or urine (p <0.001). CONCLUSIONS Serum and urine are better samples for qPCR than buffy coat, and 16SrRNA/LipL32 qPCR performs better than rrs qPCR on urine. Quantitative PCR on admission is a reliable rapid diagnostic tool, performing better than MAT or culture, with significant implications for clinical and epidemiological investigations of this global neglected disease.
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Affiliation(s)
- K Woods
- National Infection Service, Public Health England, London, UK; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos.
| | - C Nic-Fhogartaigh
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Bart's Health Division of Infection, Pathology and Pharmacy Department, Royal London Hospital, London, UK
| | - C Arnold
- National Infection Service, Public Health England, London, UK
| | - L Boutthasavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - W Phuklia
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - C Lim
- Mahidol-Oxford-Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - A Chanthongthip
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - S M Tulsiani
- Queensland Health Forensic and Scientific Service, WHO Collaborating Centre for Reference and Research on Leptospirosis, Brisbane, Qld, Australia
| | - S B Craig
- Queensland Health Forensic and Scientific Service, WHO Collaborating Centre for Reference and Research on Leptospirosis, Brisbane, Qld, Australia; University of the Sunshine Coast, Faculty of Science Health, Education and Engineering, Sippy Downs, Qld, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia
| | - M-A Burns
- Queensland Health Forensic and Scientific Service, WHO Collaborating Centre for Reference and Research on Leptospirosis, Brisbane, Qld, Australia
| | - S L Weier
- Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia
| | - V Davong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - S Sihalath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - D Limmathurotsakul
- Mahidol-Oxford-Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK
| | - D A B Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - N Shetty
- National Infection Service, Public Health England, London, UK
| | - M Zambon
- National Infection Service, Public Health England, London, UK
| | - P N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK
| | - S Dittrich
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK; Foundation for Innovative New Diagnostics, Geneva, Switzerland
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13
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Vidaña A, Garcon F, Nuñez A, Major D, Brown I, Zambon M, Brookes S. Different Efficacy of Inactivated Pandemic 2009 H1N1 Influenza A Virus Vaccines after Homologous Infection in Ferrets. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.088] [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: 11/28/2022]
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Caini S, Andrade W, Badur S, Balmaseda A, Barakat A, Bella A, Bimohuen A, Brammer L, Bresee J, Bruno A, Castillo L, Ciblak MA, Clara AW, Cohen C, Daouda C, de Lozano C, De Mora D, Dorji K, Emukule GO, Fasce RA, Feng L, Ferreira de Almeida WA, Guiomar R, Heraud JM, Holubka O, Huang QS, Kadjo HA, Kiyanbekova L, Kosasih H, Kusznierz G, Lee V, Lara J, Li M, Lopez L, Mai HP, Pessanha HC, Matute ML, Mironenko A, Moreno B, Mott JA, Njouom R, Ospanova A, Owen R, Pebody R, Pennington K, Puzelli S, Quynh Le MT, Razanajatovo NH, Rodrigues A, Rudi JM, Venter M, Vernet MA, Wei AL, Wangchuk S, Yang J, Yu H, Zambon M, Schellevis F, Paget J. Correction: Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination? PLoS One 2016; 11:e0155089. [PMID: 27135748 PMCID: PMC4852893 DOI: 10.1371/journal.pone.0155089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0152310.].
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Thompson CI, Ellis J, Galiano M, Ramsay M, Brown KE, Zambon M. Detection of influenza A(H3N2) virus in children with suspected mumps during winter 2014/15 in England. ACTA ACUST UNITED AC 2015; 20. [PMID: 26290428 DOI: 10.2807/1560-7917.es2015.20.31.21203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Influenza A(H3N2) virus was detected in oral fluid from 16/107 children (aged 2 to 12 years) with a clinical diagnosis of mumps, who were sampled between December 2014 and February 2015 in England, during the peak of the 2014/15 influenza season. Sequence analysis of an A(H3N2) virus from a child with suspected mumps showed the virus was similar to other circulating A(H3N2) viruses detected in winter 2014/15, which were antigenically drifted from the A(H3N2) vaccine strain.
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Affiliation(s)
- C I Thompson
- Public Health England, Virus Reference Department, Colindale, London, United Kingdom
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16
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Goddard N, Rebelo-de-Andrade H, Meijer A, McCauley J, Daniels R, Zambon M. Future directions for the European influenza reference laboratory network in influenza surveillance. ACTA ACUST UNITED AC 2015; 20. [PMID: 26250071 DOI: 10.2807/1560-7917.es2015.20.30.21195] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
By defining strategic objectives for the network of influenza laboratories that have national influenza centre status or national function within European Union Member States, Iceland and Norway, it is possible to align their priorities in undertaking virological surveillance of influenza. This will help maintain and develop the network to meet and adapt to new challenges over the next 3-5 years and underpin a longer-term strategy over 5-10 years. We analysed the key activities undertaken by influenza reference laboratories in Europe and categorised them into a framework of four key strategic objectives areas: enhancing laboratory capability, ensuring laboratory capacity, providing emergency response and translating laboratory data into information for public health action. We make recommendations on the priority areas for future development.
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Affiliation(s)
- N Goddard
- Public Health England (PHE), London, United Kingdom
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Bell A, Lewandowski K, Myers R, Wooldridge D, Aarons E, Simpson A, Vipond R, Jacobs M, Gharbia S, Zambon M. Genome sequence analysis of Ebola virus in clinical samples from three British healthcare workers, August 2014 to March 2015. ACTA ACUST UNITED AC 2015; 20. [PMID: 26027482 DOI: 10.2807/1560-7917.es2015.20.20.21131] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We determined complete viral genome sequences from three British healthcare workers infected with Ebola virus (EBOV) in Sierra Leone, directly from clinical samples. These sequences closely resemble those previously observed in the current Ebola virus disease outbreak in West Africa, with glycoprotein and polymerase genes showing the most sequence variation. Our data indicate that current PCR diagnostic assays remain suitable for detection of EBOV in this epidemic and provide confidence for their continued use in diagnosis.
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Affiliation(s)
- A Bell
- Public Health England, Porton Down, Salisbury, United Kingdom
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Elliot AJ, Bermingham A, Charlett A, Lackenby A, Ellis J, Sadler C, Sebastianpillai P, Powers C, Foord D, Povey E, Evans B, Durnall H, Fleming DM, Brown D, Smith GE, Zambon M. Self-sampling for community respiratory illness: a new tool for national virological surveillance. ACTA ACUST UNITED AC 2015; 20:21058. [PMID: 25788252 DOI: 10.2807/1560-7917.es2015.20.10.21058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This report aims to evaluate the usefulness of self-sampling as an approach for future national surveillance of emerging respiratory infections by comparing virological data from two parallel surveillance schemes in England. Nasal swabs were obtained via self-administered sampling from consenting adults (≥ 16 years-old) with influenza symptoms who had contacted the National Pandemic Flu Service (NPFS) health line during the 2009 influenza pandemic. Equivalent samples submitted by sentinel general practitioners participating in the national influenza surveillance scheme run jointly by the Royal College of General Practitioners (RCGP) and Health Protection Agency were also obtained. When comparable samples were analysed there was no significant difference in results obtained from self-sampling and clinician-led sampling schemes. These results demonstrate that self-sampling can be applied in a responsive and flexible manner, to supplement sentinel clinician-based sampling, to achieve a wide spread and geographically representative way of assessing community transmission of a known organism.
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Affiliation(s)
- A J Elliot
- Public Health England, Birmingham, United Kingdom
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Pebody RG, Warburton F, Ellis J, Andrews N, Thompson C, von Wissmann B, Green HK, Cottrell S, Johnston J, de Lusignan S, Moore C, Gunson R, Robertson C, McMenamin J, Zambon M. Low effectiveness of seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2014/15 mid–season results. Euro Surveill 2015. [DOI: 10.2807/1560-7917.es2015.20.5.21025] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2014/15 the United Kingdom experienced circulation of influenza A(H3N2) with impact in the elderly. Mid-season vaccine effectiveness (VE) shows an adjusted VE of 3.4% (95% CI: ?44.8 to 35.5) against primary care consultation with laboratory-confirmed influenza and ?2.3% (95% CI: ?56.2 to 33.0) for A(H3N2). The low VE reflects mismatch between circulating viruses and the 2014/15 northern hemisphere A(H3N2) vaccine strain. Early use of antivirals for prophylaxis and treatment of vulnerable populations remains important.
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Affiliation(s)
- R G Pebody
- Public Health England Centre of Infectious Disease Surveillance and Control, London, United Kingdom
| | - F Warburton
- Public Health England Centre of Infectious Disease Surveillance and Control, London, United Kingdom
| | - J Ellis
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
| | - N Andrews
- Public Health England Centre of Infectious Disease Surveillance and Control, London, United Kingdom
| | - C Thompson
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
| | | | - H K Green
- Public Health England Centre of Infectious Disease Surveillance and Control, London, United Kingdom
| | - S Cottrell
- Public Health Wales, Cardiff, United Kingdom
| | - J Johnston
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | - S de Lusignan
- Royal College of General Practitioners Research and Surveillance Centre, United Kingdom
| | - C Moore
- Public Health Wales Molecular Diagnostics Unit, Cardiff, United Kingdom
| | - R Gunson
- West of Scotland Specialist Virology Centre, Glasgow, United Kingdom
| | - C Robertson
- University of Strathclyde, Glasgow, United Kingdom
- International Prevention Research Institute, Lyon, France
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - M Zambon
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
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Pebody RG, Warburton F, Ellis J, Andrews N, Thompson C, von Wissmann B, Green HK, Cottrell S, Johnston J, de Lusignan S, Moore C, Gunson R, Robertson C, McMenamin J, Zambon M. Low effectiveness of seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2014/15 mid-season results. Euro Surveill 2015; 20:21025. [PMID: 25677050] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
MESH Headings
- Adolescent
- Adult
- Age Distribution
- Aged
- Aged, 80 and over
- Case-Control Studies
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Infant, Newborn
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/immunology
- Influenza B virus/isolation & purification
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Influenza, Human/diagnosis
- Influenza, Human/epidemiology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Logistic Models
- Male
- Middle Aged
- Primary Health Care
- Real-Time Polymerase Chain Reaction
- Seasons
- Sentinel Surveillance
- Surveys and Questionnaires
- Treatment Outcome
- United Kingdom/epidemiology
- Vaccination/statistics & numerical data
- Young Adult
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Affiliation(s)
- R G Pebody
- Public Health England Centre of Infectious Disease Surveillance and Control, London, United Kingdom
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21
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Dabrera G, Zhao H, Andrews N, Begum F, Green H, Ellis J, Elias K, Donati M, Zambon M, Pebody R. Effectiveness of seasonal influenza vaccination during pregnancy in preventing influenza infection in infants, England, 2013/14. ACTA ACUST UNITED AC 2014; 19:20959. [PMID: 25411687 DOI: 10.2807/1560-7917.es2014.19.45.20959] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this study we used the screening method to estimate the effectiveness of seasonal influenza vaccination during pregnancy in preventing influenza virus infection and influenza-related hospitalisation in infants under six months, in England in the 2013/14 season. Seasonal influenza vaccination in pregnancy was 71% (95% CI: 24–89%) effective in preventing infant influenza virus infection and 64% (95% CI: 6–86%) effective in preventing infant influenza hospitalisation, and should be recommended in pregnancy.
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Affiliation(s)
- G Dabrera
- Field Epidemiology Training Programme, Public Health England, London, United Kingdom
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22
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Green HK, Zhao H, Boddington NL, Andrews N, Durnall H, Elliot AJ, Smith G, Gorton R, Donati M, Ellis J, Zambon M, Pebody R. Detection of varying influenza circulation within England in 2012/13: informing antiviral prescription and public health response. J Public Health (Oxf) 2014; 37:295-304. [PMID: 25096307 DOI: 10.1093/pubmed/fdu046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Subnational variation of 2009 pandemic influenza activity in England has been reported; however, little work has been published on this topic for seasonal influenza. If variation is present, this knowledge may assist with both identifying the onset of influenza epidemics, informing community antiviral prescription and local health planning. METHODS An end-of-season analysis of influenza surveillance systems (acute respiratory outbreaks, primary care consultations, virological testing, influenza-confirmed secondary care admissions and excess all-cause mortality) was undertaken at national and subnational levels for 2012/13 when influenza B and A(H3N2) dominated. RESULTS National community antiviral prescription was recommended in Week 51 following national threshold exceedance. However, this was preceded up to 2 weeks by subnational influenza activity in 2/9 regions in England. Regional variation in circulation of influenza subtypes was observed and severe influenza surveillance data sources were able to monitor the subnational impact. CONCLUSIONS Evidence of virological activity in two or more regions above a threshold indicated the onset of the 2012/13 season. Subnational thresholds should be determined and evaluated in order to improve timeliness of the national antiviral alert. During the season, outputs should be reported at levels that can inform local public health responses and variation considered when retrospectively evaluating the impact of interventions.
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Affiliation(s)
- H K Green
- Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5EQ, UK
| | - H Zhao
- Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5EQ, UK
| | - N L Boddington
- Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5EQ, UK
| | - N Andrews
- Statistics Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5EQ, UK
| | - H Durnall
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham B17 9DB, UK
| | - A J Elliot
- Real Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - G Smith
- Real Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK
| | - R Gorton
- Field Epidemiology Services North East, Public Health England, Newcastle upon Tyne NE1 4WH, UK
| | - M Donati
- Bristol Public Health Laboratory, Public Health England, Bristol BS2 8EL, UK
| | - J Ellis
- Public Health England Respiratory Virus Unit, Virus Reference Department, Reference Microbiology Services, PHE Colindale, London NW9 5EQ, UK
| | - M Zambon
- Public Health England Respiratory Virus Unit, Virus Reference Department, Reference Microbiology Services, PHE Colindale, London NW9 5EQ, UK
| | - R Pebody
- Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London NW9 5EQ, UK
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23
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Andrews N, McMenamin J, Durnall H, Ellis J, Lackenby A, Robertson C, von Wissmann B, Cottrell S, Smyth B, Moore C, Gunson R, Zambon M, Fleming D, Pebody R. Effectiveness of trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2012/13 end of season results. Euro Surveill 2014; 19:5-13. [PMID: 25033051] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
The effectiveness of the 2012/13 trivalent seasonal influenza vaccine (TIV) was assessed using a test-negative case-control study of patients consulting primary care with influenza-like illness in the United Kingdom. Strain characterisation was undertaken on selected isolates. Vaccine effectiveness (VE) against confirmed influenza A(H3N2), A(H1N1) and B virus infection, adjusted for age, sex, surveillance scheme (i.e. setting) and month of sample collection was 26% (95% confidence interval (CI): -4 to 48), 73% (95% CI: 37 to 89) and 51% (95% CI: 34 to 63) respectively. There was an indication, although not significant, that VE declined by time since vaccination for influenza A(H3N2) (VE 50% within three months, 2% after three months, p=0.25). For influenza A(H3N2) this is the second season of low VE, contributing to the World Health Organization (WHO) recommendation that the 2013/14 influenza vaccine strain composition be changed to an A(H3N2) virus antigenically like cell-propagated prototype 2012/13 vaccine strain (A/Victoria/361/2011). The lower VE seen for type B is consistent with antigenic drift away from the 2012/13 vaccine strain. The majority of influenza B viruses analysed belong to the genetic clade 2 and were antigenically distinguishable from the 2012/13 vaccine virus B/Wisconsin/1/2010 clade 3. These findings supported the change to the WHO recommended influenza B vaccine component for 2013/14.
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MESH Headings
- Adolescent
- Adult
- Aged
- Case-Control Studies
- Child
- Female
- Hemagglutination Inhibition Tests
- Humans
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/immunology
- Influenza B virus/isolation & purification
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Influenza Vaccines/therapeutic use
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Male
- Middle Aged
- Primary Health Care
- Reverse Transcriptase Polymerase Chain Reaction
- Seasons
- Sentinel Surveillance
- Sequence Analysis, DNA
- Time Factors
- Treatment Outcome
- United Kingdom/epidemiology
- Vaccination/statistics & numerical data
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Affiliation(s)
- N Andrews
- Public Health England Health Protection Directorate, Colindale, London, United Kingdom
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24
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Andrews N, McMenamin J, Durnall H, Ellis J, Lackenby A, Robertson C, von Wissmann B, Cottrell S, Smyth B, Moore C, Gunson R, Zambon M, Fleming D, Pebody R. Effectiveness of trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2012/13 end of season results. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.27.20851] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- N Andrews
- Public Health England Health Protection Directorate, Colindale, London, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - H Durnall
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - J Ellis
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
| | - A Lackenby
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
| | - C Robertson
- Health Protection Scotland, Glasgow, United Kingdom
- International Prevention Research Institute, Lyon, France
- University of Strathclyde, Glasgow, United Kingdom
| | | | - S Cottrell
- Public Health Wales, Cardiff, United Kingdom
| | - B Smyth
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | - C Moore
- Public Health Wales, Cardiff, United Kingdom
| | - R Gunson
- West of Scotland Specialist Virology Centre, Glasgow, United Kingdom
| | - M Zambon
- Public Health England Operations Directorate, Microbiology Services, Colindale, London, United Kingdom
| | - D Fleming
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - R Pebody
- Public Health England Health Protection Directorate, Colindale, London, United Kingdom
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25
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Pebody RG, Green HK, Andrews N, Zhao H, Boddington N, Bawa Z, Durnall H, Singh N, Sunderland A, Letley L, Ellis J, Elliot AJ, Donati M, Smith GE, de Lusignan S, Zambon M. Uptake and impact of a new live attenuated influenza vaccine programme in England: early results of a pilot in primary school-age children, 2013/14 influenza season. Euro Surveill 2014. [DOI: 10.2807/ese.19.22.20823-en] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
| | - H K Green
- Public Health England, United Kingdom
| | - N Andrews
- Public Health England, United Kingdom
| | - H Zhao
- Public Health England, United Kingdom
| | | | - Z Bawa
- Public Health England, United Kingdom
| | - H Durnall
- Royal College of General Practitioners Research and Surveillance Unit, Birmingham, United Kingdom
| | - N Singh
- Public Health England, United Kingdom
| | | | - L Letley
- Public Health England, United Kingdom
| | - J Ellis
- Public Health England, United Kingdom
| | | | - M Donati
- Public Health England, United Kingdom
| | - G E Smith
- Public Health England, United Kingdom
| | - S de Lusignan
- Royal College of General Practitioners Research and Surveillance Unit, Birmingham, United Kingdom
- University of Surrey, Guildford, United Kingdom
| | - M Zambon
- Public Health England, United Kingdom
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26
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Pebody RG, Green HK, Andrews N, Zhao H, Boddington N, Bawa Z, Durnall H, Singh N, Sunderland A, Letley L, Ellis J, Elliot AJ, Donati M, Smith GE, de Lusignan S, Zambon M. Uptake and impact of a new live attenuated influenza vaccine programme in England: early results of a pilot in primary school-age children, 2013/14 influenza season. ACTA ACUST UNITED AC 2014; 19. [PMID: 24925457 DOI: 10.2807/1560-7917.es2014.19.22.20823] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As part of the introduction and roll-out of a universal childhood live-attenuated influenza vaccination programme, 4–11 year-olds were vaccinated in seven pilot areas in England in the 2013/14 influenza season. This paper presents the uptake and impact of the programme for a range of disease indicators. End-of-season uptake was defined as the number of children in the target population who received at least one dose of influenza vaccine. Between week 40 2013 and week 15 2014, cumulative disease incidence per 100,000 population (general practitioner consultations for influenza-like illness and laboratory-confirmed influenza hospitalisations), cumulative influenza swab positivity in primary and secondary care and cumulative proportion of emergency department respiratory attendances were calculated. Indicators were compared overall and by age group between pilot and non-pilot areas. Direct impact was defined as reduction in cumulative incidence based on residence in pilot relative to non-pilot areas in 4–11 year-olds. Indirect impact was reduction between pilot and non-pilot areas in <4 year-olds and >11 year-olds. Overall vaccine uptake of 52.5% (104,792/199,475) was achieved. Although influenza activity was low, a consistent, though not statistically significant, decrease in cumulative disease incidence and influenza positivity across different indicators was seen in pilot relative to non-pilot areas in both targeted and non-targeted age groups, except in older age groups, where no difference was observed for secondary care indicators.
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27
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Broberg E, Pereyaslov D, Struelens M, Palm D, Meijer A, Ellis J, Zambon M, McCauley J, Daniels R. Laboratory preparedness in EU/EEA countries for detection of novel avian influenza A(H7N9) virus, May 2013. ACTA ACUST UNITED AC 2014; 19. [PMID: 24507469 DOI: 10.2807/1560-7917.es2014.19.4.20682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Following human infections with novel avian influenza A(H7N9) viruses in China, the European Centre for Disease Prevention and Control, the World Health Organization (WHO) Regional Office for Europe and the European Reference Laboratory Network for Human Influenza (ERLI-Net) rapidly posted relevant information, including real-time RT-PCR protocols. An influenza RNA sequence-based computational assessment of detection capabilities for this virus was conducted in 32 national influenza reference laboratories in 29 countries, mostly WHO National Influenza Centres participating in the WHO Global Influenza Surveillance and Response System (GISRS). Twenty-seven countries considered their generic influenza A virus detection assay to be appropriate for the novel A(H7N9) viruses. Twenty-two countries reported having containment facilities suitable for its isolation and propagation. Laboratories in 27 countries had applied specific H7 real-time RT-PCR assays and 20 countries had N9 assays in place. Positive control virus RNA was provided by the WHO Collaborating Centre in London to 34 laboratories in 22 countries to allow evaluation of their assays. Performance of the generic influenza A virus detection and H7 and N9 subtyping assays was good in 24 laboratories in 19 countries. The survey showed that ERLI-Net laboratories had rapidly developed and verified good capability to detect the novel A(H7N9) influenza viruses.
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Affiliation(s)
- E Broberg
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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28
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Zhao H, Green H, Lackenby A, Donati M, Ellis J, Thompson C, Bermingham A, Field J, Sebastianpillai P, Zambon M, Watson JM, Pebody R. A new laboratory-based surveillance system (Respiratory DataMart System) for influenza and other respiratory viruses in England: results and experience from 2009 to 2012. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.3.20680] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- H Zhao
- Respiratory Diseases Department, Public Health England (PHE), Colindale, London, United Kingdom
| | - H Green
- Respiratory Diseases Department, Public Health England (PHE), Colindale, London, United Kingdom
| | - A Lackenby
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - M Donati
- Bristol Public Health Laboratory, Public Health England (PHE), Bristol, United Kingdom
| | - J Ellis
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - C Thompson
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - A Bermingham
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - J Field
- Respiratory Diseases Department, Public Health England (PHE), Colindale, London, United Kingdom
| | - P Sebastianpillai
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - M Zambon
- Respiratory Virus Unit, Virus Reference Department, Public Health England( PHE) Microbiology Services, London, United Kingdom
| | - J M Watson
- Respiratory Diseases Department, Public Health England (PHE), Colindale, London, United Kingdom
| | - R Pebody
- Respiratory Diseases Department, Public Health England (PHE), Colindale, London, United Kingdom
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29
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Landoni G, Pieri M, Testa V, Silvetti S, Zambon M, Borghi G, Azzolini M, Di Prima AL, Nobile L, Lembo R, Zangrillo A. Intrathecal lactate to predict spinal cord ischemia in major abdominal surgery. Crit Care 2014. [PMCID: PMC4069986 DOI: 10.1186/cc13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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30
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Nobile L, Beccaria P, Zambon M, Cabrini L, Landoni G, Zangrillo A. Lung ultrasound reaeration score: a useful tool to predict non-invasive ventilation effectiveness. Crit Care 2014. [PMCID: PMC4069489 DOI: 10.1186/cc13445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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31
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Pebody R, Nicoll A, Buchholz U, Zambon M, Mounts A. Enhanced surveillance and investigation of coronavirus: what is required? East Mediterr Health J 2013. [DOI: 10.26719/2013.19.supp1.s55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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32
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Hoschler K, Thompson C, Casas I, Ellis J, Galiano M, Andrews N, Zambon M. Population susceptibility to North American and Eurasian swine influenza viruses in England, at three time points between 2004 and 2011. ACTA ACUST UNITED AC 2013; 18:pii=20578. [PMID: 24079379 DOI: 10.2807/1560-7917.es2013.18.36.20578] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Age-stratified sera collected in 2004, 2008 and 2010 in England were evaluated for antibody to swine influenza A(H3N2) and A(H1N1) viruses from the United States or Europe as a measure of population susceptibility to the emergence of novel viruses. Children under 11 years of age had little or no measurable antibody to recent swine H3N2 viruses despite their high levels of antibody to recent H3N2 seasonal human strains. Adolescents and young adults (born 1968–1999) had higher antibody levels to swine H3N2 viruses. Antibody levels to swine H3N2 influenza show little correlation with exposure to recent seasonal H3N2 (A/Perth/16/2009) strains, but with antibody to older H3N2 strains represented by A/Wuhan/359/1995. Children had the highest seropositivity to influenza A(H1N1)pdm09 virus, and young adults had the lowest antibody levels to A/Perth/16/2009. No age group showed substantial antibody levels to A/Aragon/RR3218/2008, a European swine H1N1 virus belonging to the Eurasian lineage. After vaccination with contemporary trivalent vaccine we observed evidence of boosted reactivity to swine H3N2 viruses in children and adults, while only a limited boosting effect on antibody levels to A/Aragon/RR3218/2008 was observed in both groups. Overall, our results suggest that different vaccination strategies may be necessary according to age if swine viruses emerge as a significant pandemic threat.
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Affiliation(s)
- K Hoschler
- Public Health England, Microbiology Services Colindale, London, United Kingdom
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33
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Pebody RG, Andrews N, McMenamin J, Durnall H, Ellis J, Thompson CI, Robertson C, Cottrell S, Smyth B, Zambon M, Moore C, Fleming DM, Watson JM. Vaccine effectiveness of 2011/12 trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: evidence of waning intra-seasonal protection. Euro Surveill 2013; 18. [DOI: 10.2807/ese.18.05.20389-en] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- R G Pebody
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - N Andrews
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - H Durnall
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - J Ellis
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - C I Thompson
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - C Robertson
- International Prevention Research Institute, Lyon, France
- University of Strathclyde, Glasgow, United Kingdom
| | - S Cottrell
- Public Health Wales, Cardiff, United Kingdom
| | - B Smyth
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | - M Zambon
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - C Moore
- Public Health Wales, Cardiff, United Kingdom
| | - D M Fleming
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - J M Watson
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
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34
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McMenamin J, Andrews N, Robertson C, Fleming DM, Durnall H, von Wissmann B, Ellis J, Lackenby A, Cottrell S, Smyth B, Zambon M, Moore C, Watson JM, Pebody RG. Effectiveness of seasonal 2012/13 vaccine in preventing laboratory-confirmed
influenza infection in primary care in the United Kingdom: mid-season analysis 2012/13. Euro Surveill 2013; 18. [DOI: 10.2807/ese.18.05.20393-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The early experience of the United Kingdom (UK) is that influenza B has dominated the influenza 2012/13 season. Overall trivalent influenza vaccine (TIV) adjusted vaccine effectiveness (VE) against all laboratory-confirmed influenza in primary care was 51% (95% confidence interval (CI): 27% to 68%); TIV adjusted VE against influenza A alone or influenza B alone was 49% (95% CI: -2% to 75%) and 52% (95% CI: 23% to 70%) respectively. Vaccination remains the best protection against influenza.
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Affiliation(s)
- J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - N Andrews
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - C Robertson
- International Prevention Research Institute, Lyon, France
- University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - D M Fleming
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - H Durnall
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | | | - J Ellis
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - A Lackenby
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - S Cottrell
- Public Health Wales, Cardiff, United Kingdom
| | - B Smyth
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | - M Zambon
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - C Moore
- Public Health Wales, Cardiff, United Kingdom
| | - J M Watson
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - R G Pebody
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
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35
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Pebody RG, Nicoll A, Buchholz U, Zambon M, Mounts A. Enhanced surveillance and investigation of coronavirus: what is required? East Mediterr Health J 2013; 19 Suppl 1:S55-S60. [PMID: 23888796] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Following the discovery in September 2012 of 2 patients, both with links to the Eastern Mediterranean Region, with serious respiratory illness due to novel coronavirus, all countries have instigated surveillance and laboratory activities to detect further cases, with intensive case-contact investigations undertaken on laboratory confirmation of cases. A total of 30 cases, of whom 18 have died, and at least 3 clusters have been detected to date (1 cluster among health-care workers and another 2 clusters among family members). To date, transmission studies have shown a low risk of onward human transmission, with clinical presentation remaining severe for the majority. Many questions remain including the zoonotic source and geographical extent of infection. Surveillance has been extended to include clusters of cases or health-care workers with severe, undiagnosed respiratory illness regardless of travel history. Environmental studies, on-going surveillance and linked case-contact investigations will provide a critical role in answering some of these issues.
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Affiliation(s)
- R G Pebody
- Public Health England, London, United Kingdom.
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Bermingham A, Chand MA, Brown CS, Aarons E, Tong C, Langrish C, Hoschler K, Brown K, Galiano M, Myers R, Pebody RG, Green HK, Boddington NL, Gopal R, Price N, Newsholme W, Drosten C, Fouchier RA, Zambon M. Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.40.20290-en] [Citation(s) in RCA: 268] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East.
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Affiliation(s)
- A Bermingham
- Health Protection Agency (HPA), London, United Kingdom
| | - M A Chand
- Health Protection Agency (HPA), London, United Kingdom
| | - C S Brown
- Centre for Clinical Infection and Diagnostics Research, King’s College London, London, England
- Health Protection Agency (HPA), London, United Kingdom
| | - E Aarons
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Tong
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Langrish
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - K Hoschler
- Health Protection Agency (HPA), London, United Kingdom
| | - K Brown
- Health Protection Agency (HPA), London, United Kingdom
| | - M Galiano
- Health Protection Agency (HPA), London, United Kingdom
| | - R Myers
- Health Protection Agency (HPA), London, United Kingdom
| | - R G Pebody
- Health Protection Agency (HPA), London, United Kingdom
| | - H K Green
- Health Protection Agency (HPA), London, United Kingdom
| | | | - R Gopal
- Health Protection Agency (HPA), London, United Kingdom
| | - N Price
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - W Newsholme
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Drosten
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
| | - R A Fouchier
- Department of Virology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M Zambon
- Health Protection Agency (HPA), London, United Kingdom
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Bermingham A, Chand MA, Brown CS, Aarons E, Tong C, Langrish C, Hoschler K, Brown K, Galiano M, Myers R, Pebody RG, Green HK, Boddington NL, Gopal R, Price N, Newsholme W, Drosten C, Fouchier RA, Zambon M. Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012. Euro Surveill 2012; 17:20290. [PMID: 23078800] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East.
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Corman VM, Eckerle I, Bleicker T, Zaki A, Landt O, Eschbach-Bludau M, van Boheemen S, Gopal R, Ballhause M, Bestebroer TM, Muth D, Müller MA, Drexler JF, Zambon M, Osterhaus AD, Fouchier RM, Drosten C. Detection of a novel human coronavirus by real-time reverse-transcription polymerase chain reaction. ACTA ACUST UNITED AC 2012; 17. [PMID: 23041020 DOI: 10.2807/ese.17.39.20285-en] [Citation(s) in RCA: 397] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present two real-time reverse-transcription polymerase chain reaction assays for a novel human coronavirus (CoV), targeting regions upstream of the E gene (upE) or within open reading frame (ORF)1b, respectively. Sensitivity for upE is 3.4 copies per reaction (95% confidence interval (CI): 2.5–6.9 copies) or 291 copies/mL of sample. No cross-reactivity was observed with coronaviruses OC43, NL63, 229E, SARS-CoV, nor with 92 clinical specimens containing common human respiratory viruses. We recommend using upE for screening and ORF1b for confirmation.
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Affiliation(s)
- V M Corman
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
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Brown CS, Chand MA, Hoffman P, Woodford N, Livermore DM, Brailsford S, Gharbia S, Small N, Billingham E, Zambon M, Grant K. Possible contamination of organ preservation fluid with Bacillus cereus: the United Kingdom response. ACTA ACUST UNITED AC 2012; 17. [PMID: 22587955 DOI: 10.2807/ese.17.18.20165-en] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe here the United Kingdom (UK) response following the recent international recall of an organ preservation fluid owing to potential Bacillus cereus contamination. This fluid is used for the transport of solid organs and pancreatic islet cells for transplant. We detail the response mechanisms, including the initial risk stratification, investigatory approaches, isolate analysis and communications to professional bodies. This report further lays out the potential need for enhanced surveillance in UK transplant patients.
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Affiliation(s)
- C S Brown
- Microbiology Services Division, Health Protection Agency, London, United Kingdom.
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Nicholson KG, Abrams KR, Batham S, Clark TW, Hoschler K, Lim WS, Medina M, Nguyen-Van-Tam JS, Read RC, Warren FC, Zambon M. A randomised, partially observer blind, multicentre, head-to-head comparison of a two-dose regimen of Baxter and GlaxoSmithKline H1N1 pandemic vaccines, administered 21 days apart. Health Technol Assess 2011; 14:193-334. [PMID: 21208550 DOI: 10.3310/hta14550-04] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the immunogenicity of a two-dose schedule of Baxter cell-cultured, non-adjuvanted, whole-virion H1N1 vaccine, and GlaxoSmithKline AS03(A)-adjuvanted split-virion H1N1 vaccine with respect to the EU Committee for Medicinal Products for Human Use (CHMP) and the US Food and Drug Administration (FDA) licensing criteria. DESIGN An age-stratified, randomised, observer-blind, parallel-group, multicentre controlled trial was carried out in volunteers aged ≥ 18-44, ≥ 45-64 and ≥ 65 years. SETTING Three teaching hospitals in the UK (Leicester Royal Infirmary, Leicester; Nottingham City Hospital, Nottingham; and Royal Hallamshire Hospital, Sheffield). PARTICIPANTS Three hundred and forty-seven subjects were identified and randomised to AS03(A)-adjuvanted split-virion H1N1 vaccine or whole-virion (WV) vaccine in age groups [≥ 18-44 years (n = 140), ≥ 45-64 years (n = 136) and ≥ 65 years (n = 71)]. INTERVENTIONS Vaccine was administered by intramuscular injection into the deltoid muscle of the non-dominant arm. One hundred and seventy-five randomised subjects were allocated AS03(A)-adjuvanted split H1N1 vaccine; one hundred and sixty-nine subjects had a second dose of the same vaccine 21 days later. One hundred and seventy-two subjects were allocated WV vaccine; one hundred and seventy-one subjects had a second dose of the same vaccine 21 days later. Serum samples for antibody measurements were collected on days 0 (before the first vaccination), 7, 14, 21 (before the second vaccination), 28, 35, 42 and 180. Subjects were observed for local and systemic reactions for 30 minutes after each injection, and for the next 7 days they recorded, in self-completed diaries, the severity of solicited local (pain, bruising, erythema and swelling) and systemic symptoms (chills, malaise, muscle aches, nausea and headache), oral temperature and use of analgesic medications. MAIN OUTCOME MEASURES Vaccine immunogenicity using the CHMP and the FDA licensing criteria. Antibody titres were measured using haemagglutination inhibition (HI) and microneutralisation (MN) assays at baseline and 7, 14 and 21 days after each vaccination and at day 180. The three immunogenicity criteria end points were the seroprotection rate, the seroconversion rate and the mean-fold titre elevation. RESULTS Both vaccine doses were given in 340 subjects (98%). Data from 680 (99%) of 687 issued diary cards were returned. Sera were obtained from 340 (98.0%), 333 (96.0%), 341 (98.3%), 331 (95.4%), 329 (94.8%) and 332 (95.7%) subjects on days 7, 14, 21, 28, 35 and 42, respectively. Three hundred and forty-six and 345 subjects were included in the safety and immunogenicity analyses, respectively. Prevaccination antibody was detected by HI (titre ≥ 1 : 8) and MN (titre ≥ 1 : 10) in 14% and 31% of subjects, respectively. Among the 298 (85.9%) subjects without baseline antibody on HI assay, a titre of ≥ 1 : 40 (seroprotection) was achieved after a single dose of AS03(A)-adjuvanted vaccine and WV vaccine by day 21 in 93.0% and 65.5%, respectively, of subjects between 18 and 44 years, 76.4% and 36.1% of subjects between 45 and 64 years, and 53.1% and 30.0% of subjects ≥ 65 years. Among all 347 subjects, a titre of ≥ 1 : 40 was achieved after a single dose of AS03(A)-adjuvanted vaccine and WV vaccine by day 21 in 94.0% and 71.4%, respectively, of subjects between 18 and 44 years, 77.3% and 38.8% of subjects between 45 and 64 years, and 51.4% and 32.4% of subjects ≥ 65 years. The age-adjusted odds ratio (OR) for adjuvanted compared with WV vaccine, in terms of seroprotection, was 4.42 [95% confidence interval (CI) 2.63 to 7.44, p < 0.001]. On day 42, among subjects without baseline antibody on HI assay, a titre of ≥ 1 : 40 was achieved after the second dose of AS03(A)-adjuvanted vaccine and WV vaccine by 100% and 67.9%, respectively, of subjects between 18 and 44 years, 89.3% and 41% of subjects between 45 and 64 years, and 76.5% and 34.5% of subjects ≥ 65 years. Among all 347 subjects, a titre of ≥ 1 : 40 was achieved on day 42 after the second dose of AS03(A)-adjuvanted vaccine and WV vaccine in 100% and 73.1%, respectively, of subjects between 18 and 44 years, 90.8% and 43.9% of subjects between 45 and 64 years, and 75.7% and 36.4% of subjects ≥ 65 years. The age-adjusted OR for adjuvanted vaccine compared with WV vaccine, in terms of seroprotection, was 11.21 (95% CI 5.80 to 21.64, p < 0.001). Age-related decline in antibody response occurred after both doses of both vaccines. WV vaccine was associated with fewer local and systemic reactions and lower immune responses than was AS03(A)-adjuvanted vaccine. The most frequent solicited local event was pain, reported by 28% and 76% of subjects after either dose of WV or adjuvanted vaccine, respectively (OR 7.71, 95% CI 4.48 to 13.24, p < 0.0001). The most common systemic event was myalgia, reported by 24% and 49% of subjects after either dose of WV or adjuvanted vaccine (OR 2.99, 95% CI 1.86 to 4.80, p < 0.0001). CONCLUSIONS AS03(A)-adjuvanted 2009 H1N1 vaccine is more immunogenic and provides greater antigen-sparing capacity than WV 2009 H1N1 vaccine. TRIAL REGISTRATION Current Controlled Trials ISRCTN92328241. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 14, No. 55. See the HTA programme website for further project information.
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Affiliation(s)
- K G Nicholson
- Vaccine Evaluation Centre, University Hospitals of Leicester NHS Trust, Department of Inflammation, Infection and Immunity, University of Leicester, UK.
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Puleston RL, Bugg G, Hoschler K, Konje J, Thornton J, Stephenson I, Myles P, Enstone J, Augustine G, Davis Y, Zambon M, Nicholson KG, Nguyen-Van-Tam JS. Observational study to investigate vertically acquired passive immunity in babies of mothers vaccinated against H1N1v during pregnancy. Health Technol Assess 2011; 14:1-82. [PMID: 21208547 DOI: 10.3310/hta14550-01] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The primary objective was to determine the proportion of babies who acquired passive immunity to A/H1N1v, born to mothers who accepted vaccination as part of the national vaccination programme while pregnant (during the second and/or third trimesters) against the novel A/H1N1v influenza virus (exposed group) compared with unvaccinated (unexposed) mothers. DESIGN An observational study at three sites in the UK. The purpose was to determine if mothers immunised against A/H1N1v during the pandemic vaccination period transferred that immunity to their child in utero. SETTING Three sites in the UK [Queen's Medical Centre, Nottingham; City Hospital, Nottingham (both forming University Hospitals Nottingham), and Leicester Royal Infirmary (part of University Hospitals Leicester)]. PARTICIPANTS All pregnant women in the second and third trimester presenting at the NHS hospitals above to deliver were eligible to participate in the study. Women were included regardless of age, social class, ethnicity, gravida and parity status, past and current medical history (including current medications), ethnicity, mode of delivery and pregnancy outcome (live/stillbirth). INTERVENTIONS At enrolment, participants provided written consent and completed a questionnaire. At parturition, venous cord blood was obtained for serological antibody analysis. Serological analysis was undertaken by the Respiratory Virus Unit (RVU), Health Protection Agency (HPA) Centre for Infections, London. MAIN OUTCOME MEASURES The primary end point in the study was the serological results of the cord blood samples for immunity to A/H1N1v. Regarding a suitable threshold for the determination of a serological response consistent with clinical protection, this issue is somewhat complex for pandemic influenza. The European Medicines Agency (EMEA) Committee for Human Medicinal Products (CHMP) judges that a haemagglutination inhibition (HI) titre of 1 : 40 is an acceptable threshold. However, this level was set in the context of licensing plain trivalent seasonal vaccine, where a titre of 1 : 40 is but one of several related immunogenicity criteria, and supported by paired sera capable of demonstrating a fourfold rise in antibody titre in response to vaccination. The current study mainly investigated the effects of an AS03-adjuvanted monovalent vaccine, and it was not possible to obtain paired sera where the initial sample was taken before vaccination (in vaccinated subjects). Of possibly greater relevance is the fact that it has been established from the study of early outbreaks of pandemic influenza in secondary schools in the UK (HPA, unpublished observations) that an HI antibody titre of 1 : 32 seems to be the threshold for a humoral response to 'wild-type' A/H1N1v infection. On that basis, a threshold of 1 : 32 is at least as appropriate as one of 1 : 40, especially in unvaccinated individuals. Given the difficulties that would accrue by applying thresholds of 1 : 32 in unvaccinated patients and 1 : 40 in vaccinated patients, we have therefore applied a threshold of 1 : 32 and 1 : 40, to increase the robustness of our findings. Differences arising are described. A microneutralisation (MN) titre of 1 : 40 may be also used, although it is not part of the CHMP criteria for vaccine licensure. Nonetheless, we utilised this analysis as a secondary end point, based on a conservative threshold of 1 : 60. RESULTS Reverse cumulative distribution percentage curves for haemagglutinin dilution and MN titres demonstrate background immunity in babies of unvaccinated mothers of 25%-30%. Humoral immunity in babies of vaccinated mothers was present in 80% of the group. The difference in positive immunity between the babies of unvaccinated and vaccinated mothers was statistically significant (chi-squared test, p < 0.001). CONCLUSIONS Our findings reveal a highly significant difference in HI titres between babies born to mothers vaccinated with pandemic-specific vaccine against A/H1N1v during the 2009-10 pandemic period. The subjects recruited were comparable from a baseline perspective and thus do not represent different groups that otherwise could have introduced bias into the study. Continued circulation of 2009 A/H1N1-like viruses is uncertain, but is possible as seasonal influenza in years to come. It is possible that future seasonal waves may display increased virulence. Given the adverse outcomes experienced for a small proportion of pregnant women during the influenza pandemic of 2009-10, this study provides useful evidence to support vaccination in pregnancy to protect both the mother and baby. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Hardelid P, Andrews NJ, Hoschler K, Stanford E, Baguelin M, Waight PA, Zambon M, Miller E. Assessment of baseline age-specific antibody prevalence and incidence of infection to novel influenza A/H1N1 2009. Health Technol Assess 2011; 14:115-92. [PMID: 21208549 DOI: 10.3310/hta14550-03] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The objectives of the H1N1 2009 serological surveillance project were twofold: to document (1) the prevalence of cross-reactive antibodies to H1N1 2009 by age group in the population of England prior to arrival of the pandemic strain virus in the UK and (2) the age-specific incidence of infection by month as the pandemic progressed by measuring increases in the proportion of individuals with antibodies to H1N1 2009 by age. METHODS Residual aliquots of samples submitted to 16 microbiology laboratories in eight regions in England in defined age groups in 2008 and stored by the Health Protection Agency serological surveillance programme were used to document age-stratified prevalence of antibodies to H1N1 2009 prior to the arrival of the pandemic in the UK. Functional antibodies to the H1N1 2009 virus were measured by haemagglutination inhibition (HI) and microneutralisation (MN) assays. For timely measurement of monthly incidence of infection with H1N1 2009 between August 2009 and April 2010, the microbiology serum collections were supplemented by collection of residual sera from chemical pathology laboratories in England. Monthly seroincidence samples were tested by HI only, apart from the final sera collected post pandemic in 2010, which were also tested by MN. Incidence during the pandemic was estimated from changes in prevalence between time points and also by a likelihood-based method. SETTING Eight regions of England. PARTICIPANTS Serum samples from patients accessing health care in England from whom blood samples were taken for unrelated microbiological or chemical pathology testing. INTERVENTIONS None. MAIN OUTCOME MEASURES Baseline age-specific prevalence of functional antibodies to the H1NI 2009 virus prior to the arrival of the pandemic; changes in antibody prevalence during the period August 2009 to April 2010. RESULTS Pre-existing cross-reactive antibodies to H1N1 2009 were detected in the baseline sera and increased with age, particularly in those born before 1950. The prediction of immunological protection derived from the baseline serological analysis was consistent with the lower clinical attack rates in older age groups. The high levels of susceptibility in children < 15 years, together with their mixing within school, resulted in the highest attack rates in this age group. Serological analysis by region confirms that there were geographical differences in timing of major pandemic waves. London had a big first wave among the 5- to 14-year age group, with the rest of the country reducing the gap after the second wave. Cumulative incidence in London remained higher throughout the pandemic in each age group. By the end of the second wave it is estimated that as many as 70% of school-aged children in London had been infected. Taken together, these observations are consistent with observations from previous pandemics in 1918, 1957 and 1968 - that the major impact of influenza pandemics is on younger age groups, with a pattern of morbidity and mortality distinct from seasonal influenza epidemics. CONCLUSIONS Serological analysis of appropriately structured, age-stratified and geographically representative samples can provide an immense amount of information to set in context other measures of pandemic impact in a population, and provide the most accurate measures of population exposure. National scale seroepidemiology studies require cross-agency coordination, multidisciplinary working, and considerable scientific resource. FUNDING The National Institute for Health Research Health Technology Assessment programme and the Health Protection Agency.
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Affiliation(s)
- P Hardelid
- Centre for Infections, Health Protection Agency, London, UK
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Landoni G, Augoustides JG, Guarracino F, Santini F, Ponschab M, Pasero D, Rodseth RN, Biondi-Zoccai G, Silvay G, Salvi L, Camporesi E, Comis M, Conte M, Bevilacqua S, Cabrini L, Cariello C, Caramelli F, De Santis V, Del Sarto P, Dini D, Forti A, Galdieri N, Giordano G, Gottin L, Greco M, Maglioni E, Mantovani L, Manzato A, Meli M, Paternoster G, Pittarello D, Rana KN, Ruggeri L, Salandin V, Sangalli F, Zambon M, Zucchetti M, Bignami E, Alfieri O, Zangrillo A. Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference. Acta Anaesthesiol Scand 2011; 55:259-66. [PMID: 21288207 DOI: 10.1111/j.1399-6576.2010.02381.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
There is no consensus on which drugs/techniques/strategies can affect mortality in the perioperative period of cardiac surgery. With the aim of identifying these measures, and suggesting measures for prioritized future investigation we performed the first International Consensus Conference on this topic. The consensus was a continuous international internet-based process with a final meeting on 28 June 2010 in Milan at the Vita-Salute University. Participants included 340 cardiac anesthesiologists, cardiac surgeons, and cardiologists from 65 countries all over the world. A comprehensive literature review was performed to identify topics that subsequently generated position statements for discussion, voting, and ranking. Of the 17 major topics with a documented mortality effect, seven were subsequently excluded after further evaluation due to concerns about clinical applicability and/or study methodology. The following topics are documented as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic β-blockade, early aspirin therapy, the use of pre-operative intra-aortic balloon counterpulsation, and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence and effect on mortality and a position statement was generated. This International Consensus Conference has identified the non-surgical interventions that merit urgent study to achieve further reductions in mortality after cardiac surgery: insulin, intra-aortic balloon counterpulsation, levosimendan, volatile anesthetics, statins, chronic β-blockade, early aspirin therapy, and referral to high-volume centers. The use of aprotinin and aged red blood cells may result in increased mortality.
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Affiliation(s)
- G Landoni
- Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
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Pebody R, Hardelid P, Fleming D, McMenamin J, Andrews N, Robertson C, Thomas D, Sebastianpillai P, Ellis J, Carman W, Wreghitt T, Zambon M, Watson J. Effectiveness of seasonal 2010/11 and pandemic influenza A(H1N1)2009 vaccines in preventing influenza infection in the United Kingdom: mid-season analysis 2010/11. Euro Surveill 2011; 16:19791. [PMID: 21329644] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 - 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 - 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 - 78%) if vaccinated in both seasons.
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Affiliation(s)
- R Pebody
- Health Protection Agency Health Protection Services - Colindale, London, UK.
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45
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Pebody R, Hardelid P, Fleming DM, McMenamin J, Andrews N, Robertson C, Thomas DR, Sebastianpillai P, Ellis J, Carman W, Wreghitt T, Zambon M, Watson JM. Effectiveness of seasonal 2010/11 and pandemic influenza A(H1N1)2009 vaccines in preventing influenza infection in the United Kingdom: mid-season analysis 2010/11. Euro Surveill 2011. [DOI: 10.2807/ese.16.06.19791-en] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 - 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 - 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 - 78%) if vaccinated in both seasons.
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Affiliation(s)
- R Pebody
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - P Hardelid
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - D M Fleming
- Royal College of General Practitioners Research and Surveillance Centre, Birmingham, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - N Andrews
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
| | - C Robertson
- University of Strathclyde, Glasgow, United Kingdom
- Health Protection Scotland, Glasgow, United Kingdom
| | - D R Thomas
- Public Health Wales, Cardiff, United Kingdom
| | - P Sebastianpillai
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - J Ellis
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - W Carman
- West of Scotland Specialist Virology Centre, Glasgow, United Kingdom
| | - T Wreghitt
- Health Protection Agency Microbiology Services, Cambridge, United Kingdom
| | - M Zambon
- Health Protection Agency Microbiology Services – Colindale, London, United Kingdom
| | - J M Watson
- Health Protection Agency Health Protection Services – Colindale, London, United Kingdom
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Lackenby A, Moran Gilad J, Pebody R, Miah S, Calatayud L, Bolotin S, Vipond I, Muir P, Guiver M, McMenamin J, Reynolds A, Moore C, Gunson R, Thompson C, Galiano M, Bermingham A, Ellis J, Zambon M. Continued emergence and changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus, United Kingdom, winter 2010/11. Euro Surveill 2011; 16:19784. [PMID: 21315056] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
During the winter period 2010/11 27 epidemiologically unlinked, confirmed cases of oseltamivir-resistant influenza A(H1N1)2009 virus infection have been detected in multiple, geographically dispersed settings. Three of these cases were in community settings, with no known exposure to oseltamivir. This suggests possible onward transmission of resistant strains and could be an indication of a possibility of changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus.
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MESH Headings
- Adolescent
- Adult
- Aged
- Antiviral Agents/therapeutic use
- Child
- Child, Preschool
- Drug Resistance, Viral
- Female
- Humans
- Infant
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza, Human/drug therapy
- Influenza, Human/epidemiology
- Influenza, Human/transmission
- Influenza, Human/virology
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Neuraminidase/genetics
- Oseltamivir/therapeutic use
- Pandemics
- Polymorphism, Single Nucleotide
- Population Surveillance
- Seasons
- United Kingdom/epidemiology
- Young Adult
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Affiliation(s)
- A Lackenby
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom.
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47
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Lackenby A, Moran Gilad J, Pebody R, Miah S, Calatayud L, Bolotin S, Vipond I, Muir P, Guiver M, McMenamin J, Reynolds A, Moore C, Gunson R, Thompson CI, Galiano M, Bermingham A, Ellis J, Zambon M. Continued emergence and changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus, United Kingdom, winter 2010/11. Euro Surveill 2011. [DOI: 10.2807/ese.16.05.19784-en] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During the winter period 2010/11 27 epidemiologically unlinked, confirmed cases of oseltamivir-resistant influenza A(H1N1)2009 virus infection have been detected in multiple, geographically dispersed settings. Three of these cases were in community settings, with no known exposure to oseltamivir. This suggests possible onward transmission of resistant strains and could be an indication of a possibility of changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus.
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Affiliation(s)
- A Lackenby
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom
| | - J Moran Gilad
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom
| | - R Pebody
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - S Miah
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom
| | - L Calatayud
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - S Bolotin
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - I Vipond
- Health Protection Agency, Microbiology Services Bristol, United Kingdom
| | - P Muir
- Health Protection Agency, Microbiology Services Bristol, United Kingdom
| | - M Guiver
- Health Protection Agency, Microbiology Services Manchester, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Reynolds
- Health Protection Scotland, Glasgow, United Kingdom
| | - C Moore
- Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, United Kingdom
| | - R Gunson
- West of Scotland Specialist Virology Centre, Glasgow, United Kingdom
| | - CI Thompson
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - M Galiano
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - A Bermingham
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - J Ellis
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - M Zambon
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
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48
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Ellis J, Galiano M, Pebody R, Lackenby A, Thompson CI, Bermingham A, McLean E, Zhao H, Bolotin S, Dar O, Watson JM, Zambon M. Authors’ reply. Virological analysis of fatal influenza cases in the United Kingdom during the early wave of influenza in winter 2010/11. Euro Surveill 2011. [DOI: 10.2807/ese.16.04.19773-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J Ellis
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - M Galiano
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - R Pebody
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - A Lackenby
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - CI Thompson
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - A Bermingham
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - E McLean
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - H Zhao
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - S Bolotin
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - O Dar
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - J M Watson
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - M Zambon
- Health Protection Agency, Centre for Infections, London, United Kingdom
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Ellis J, Galiano M, Pebody R, Lackenby A, Thompson CI, Bermingham A, McLean E, Zhao H, Bolotin S, Dar O, Watson JM, Zambon M. Virological analysis of fatal influenza cases in the United Kingdom during the early wave of influenza in winter 2010/11. Euro Surveill 2011. [DOI: 10.2807/ese.16.01.19760-en] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 2010/11 winter influenza season is underway in the United Kingdom, with co-circulation of influenza A(H1N1)2009 (antigenically similar to the current 2010/11 vaccine strain), influenza B (mainly B/Victoria/2/87 lineage, similar to the 2010/11 vaccine strain) and a few sporadic influenza A(H3N2) viruses. Clinical influenza activity has been increasing. Severe illness, resulting in hospitalisation and deaths, has occurred in children and young adults and has predominantly been associated with influenza A(H1N1)2009, but also influenza B viruses.
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Affiliation(s)
- J Ellis
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - M Galiano
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - R Pebody
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - A Lackenby
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - CI Thompson
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - A Bermingham
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - E McLean
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - H Zhao
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - S Bolotin
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - O Dar
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - J M Watson
- Health Protection Agency, Centre for Infections, London, United Kingdom
| | - M Zambon
- Health Protection Agency, Centre for Infections, London, United Kingdom
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Ellis J, Galiano M, Pebody R, Lackenby A, Thompson C, Bermingham A, McLean E, Zhao H, Bolotin S, Dar O, Watson JM, Zambon M. Virological analysis of fatal influenza cases in the United Kingdom during the early wave of influenza in winter 2010/11. Euro Surveill 2011; 16:19760. [PMID: 21223836] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The 2010/11 winter influenza season is underway in the United Kingdom, with co-circulation of influenza A(H1N1)2009 (antigenically similar to the current 2010/11 vaccine strain), influenza B (mainly B/Victoria/2/87 lineage, similar to the 2010/11 vaccine strain) and a few sporadic influenza A(H3N2) viruses. Clinical influenza activity has been increasing. Severe illness, resulting in hospitalisation and deaths, has occurred in children and young adults and has predominantly been associated with influenza A(H1N1)2009, but also influenza B viruses.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, Viral/genetics
- Child
- Disease Outbreaks
- Female
- Genotype
- Hospitalization
- Humans
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/immunology
- Influenza B virus/isolation & purification
- Influenza Vaccines/immunology
- Influenza, Human/diagnosis
- Influenza, Human/mortality
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Male
- Middle Aged
- Phenotype
- Phylogeny
- Seasons
- Sentinel Surveillance
- Sequence Analysis, DNA
- Severity of Illness Index
- United Kingdom/epidemiology
- Young Adult
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Affiliation(s)
- J Ellis
- Health Protection Agency, Centre for Infections, London, United Kingdom
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