1
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Caini S, Casalegno JS, Rodrigues AP, Lee V, Cohen C, Huang QS, Bruno Caicedo A, Teirlinck A, Guiomar R, Ang LW, Moyes J, Wood T, de Mora D, Bangert M, Kramer R, Staadegaard L, Heemskerk S, van Summeren J, Meijer A, Paget J. Change in Age profile of Respiratory Syncytial Virus disease over the course of annual epidemics: a multi-national study. J Infect 2024; 88:106154. [PMID: 38583722 DOI: 10.1016/j.jinf.2024.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/16/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES We aimed to study whether the percentwise age distribution of RSV cases changes over time during annual epidemics. METHODS We used surveillance data (2008-2019) from the Netherlands, Lyon (France), Portugal, Singapore, Ecuador, South Africa, and New Zealand. In each country, every season was divided into "epidemic quarters", i.e. periods corresponding to each quartile of RSV cases. Multinomial logistic regression models were fitted to evaluate whether the likelihood of RSV cases being aged <1 or ≥5 years (vs. 1 to <5) changed over time within a season. RESULTS In all countries, RSV cases were significantly more likely to be aged <1 year in the 4th vs. 1st epidemic quarter; the relative risk ratio [RRR] ranged between 1.35 and 2.56. Likewise, RSV cases were significantly more likely to be aged ≥5 years in the 4th vs. 1st epidemic quarter (except in Singapore); the RRR ranged from 1.75 to 6.70. The results did not change when stratifying by level of care or moving the lower cut-off to 6 months. CONCLUSIONS The age profile of RSV cases shifts within a season, with infants and adolescents, adults, and the elderly constituting a higher proportion of cases in the later phases of annual epidemics. These findings may have implications for RSV prevention policies with newly approved vaccines.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
| | - Jean-Sebastien Casalegno
- Virology Department, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, HCL, Lyon, France
| | | | - Vernon Lee
- Ministry of Health, Singapore, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador; Universidad Agraria del Ecuador, Guayaquil, Ecuador
| | - Anne Teirlinck
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Bilthoven, the Netherlands
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Li Wei Ang
- Ministry of Health, Singapore, Singapore
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Doménica de Mora
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | | | | | - Lisa Staadegaard
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Susanne Heemskerk
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Bilthoven, the Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
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2
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Cong B, Koç U, Bandeira T, Bassat Q, Bont L, Chakhunashvili G, Cohen C, Desnoyers C, Hammitt LL, Heikkinen T, Huang QS, Markić J, Mira-Iglesias A, Moyes J, Nokes DJ, Ploin D, Seo E, Singleton R, Wolter N, Fu Yung C, Zar HJ, Feikin DR, Sparrow EG, Nair H, Li Y. Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis. Lancet Infect Dis 2024; 24:361-374. [PMID: 38141633 DOI: 10.1016/s1473-3099(23)00630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective. METHODS We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged <5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019. FINDINGS We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0-60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4-6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6-6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7-6·1] in April, 2021, to March, 2022, vs 3·4 [1·2-9·7] in 2019; for Kenya, 2·2 cases [1·8-2·7] in 2021 vs 4·1 [3·5-4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to <3 months) and decreased with increasing age. A significantly higher proportion of children aged 12-24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07-1·59) to 2·05 (1·66-2·54). No consistent changes in disease severity were observed. INTERPRETATION The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries. FUNDING EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill & Melinda Gates Foundation, and WHO.
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Affiliation(s)
- Bingbing Cong
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Uğurcan Koç
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Teresa Bandeira
- Pediatric Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, University of Lisbon, Lisbon, Portugal
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Louis Bont
- Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; ReSViNET Foundation, Zeist, Netherlands
| | | | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Terho Heikkinen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Joško Markić
- Department of Pediatrics, University Hospital Split, Split, Croatia; University of Split School of Medicine, Split, Croatia
| | - Ainara Mira-Iglesias
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Salud Pública, Valencia, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | - Dominique Ploin
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d'Accueil des Urgences, Bron, France
| | - Euri Seo
- The Center for Viral Immunology, Korea Virus Research Institute, Institute for Basic Science, Daejeon, South Korea
| | | | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chee Fu Yung
- Infectious Diseases Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa; South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Daniel R Feikin
- Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Erin G Sparrow
- Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Harish Nair
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - You Li
- Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
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3
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Huang QS, Turner N, Wood T, Anglemyer A, McIntyre P, Aminisani N, Dowell T, Trenholme A, Byrnes C, Balm M, McIntosh C, Jefferies S, Grant CC, Nesdale A, Dobinson HC, Campbell‐Stokes P, Daniells K, Geoghegan J, de Ligt J, Jelley L, Seeds R, Jennings T, Rensburg M, Cueto J, Caballero E, John J, Penghulan E, Tan CE, Ren X, Berquist K, O'Neill M, Marull M, Yu C, McNeill A, Kiedrzynski T, Roberts S, McArthur C, Stanley A, Taylor S, Wong C, Lawrence S, Baker MG, Kvalsvig A, Van Der Werff K, McAuliffe G, Antoszewska H, Dilcher M, Fahey J, Werno A, Elvy J, Grant J, Addidle M, Zacchi N, Mansell C, Widdowson M, Thomas PG, Webby RJ. Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand. Influenza Other Respir Viruses 2024; 18:e13247. [PMID: 38350715 PMCID: PMC10864123 DOI: 10.1111/irv.13247] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years. METHODS We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions. RESULTS We observed that border closure to most people, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type-1. Partial border relaxations through quarantine-free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022. CONCLUSION Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.
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Affiliation(s)
- Q. Sue Huang
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | | | - Tim Wood
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrew Anglemyer
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | | | | | | | - Adrian Trenholme
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Cass Byrnes
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Michelle Balm
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | | | - Sarah Jefferies
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Cameron C. Grant
- University of AucklandAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Annette Nesdale
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Hazel C. Dobinson
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Priscilla Campbell‐Stokes
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Karen Daniells
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Jemma Geoghegan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Joep de Ligt
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Lauren Jelley
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Ruth Seeds
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tineke Jennings
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Megan Rensburg
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Jort Cueto
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Ernest Caballero
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Joshma John
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Emmanuel Penghulan
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Chor Ee Tan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Xiaoyun Ren
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Klarysse Berquist
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Meaghan O'Neill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Maritza Marull
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Chang Yu
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrea McNeill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tomasz Kiedrzynski
- Te Pou Hauora Tūmatanui, the Public Health AgencyManatū Hauora, Ministry of HealthWellingtonNew Zealand
| | - Sally Roberts
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Colin McArthur
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Alicia Stanley
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Susan Taylor
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Conroy Wong
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Shirley Lawrence
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | | | | | - Koen Van Der Werff
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Gary McAuliffe
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Hanna Antoszewska
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Meik Dilcher
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Jennifer Fahey
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Anja Werno
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Juliet Elvy
- Southern Community LaboratoriesDunedinNew Zealand
| | - Jenny Grant
- Southern Community LaboratoriesDunedinNew Zealand
| | - Michael Addidle
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Nicolas Zacchi
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Chris Mansell
- Te Whatu Ora, Health New Zealand WaikatoHamiltonNew Zealand
| | | | - Paul G. Thomas
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - BorderRestrictionImpactOnFluRSV Consortium
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Richard J. Webby
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
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4
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Baker MG, Kvalsvig A, Plank MJ, Geoghegan JL, Wall T, Tukuitonga C, Summers J, Bennett J, Kerr J, Turner N, Roberts S, Ward K, Betty B, Huang QS, French N, Wilson N. Continued mitigation needed to minimise the high health burden from COVID-19 in Aotearoa New Zealand. N Z Med J 2023; 136:67-91. [PMID: 37797257] [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: 10/07/2023]
Abstract
In this article we review the COVID-19 pandemic experience in Aotearoa New Zealand and consider the optimal ongoing response strategy. We note that this pandemic virus looks likely to result in future waves of infection that diminish in size over time, depending on such factors as viral evolution and population immunity. However, the burden of disease remains high with thousands of infections, hundreds of hospitalisations and tens of deaths each week, and an unknown burden of long-term illness (long COVID). Alongside this there is a considerable burden from other important respiratory illnesses, including influenza and RSV, that needs more attention. Given this impact and the associated health inequities, particularly for Māori and Pacific Peoples, we consider that an ongoing respiratory disease mitigation strategy is appropriate for New Zealand. As such, the previously described "vaccines plus" approach (involving vaccination and public health and social measures), should now be integrated with the surveillance and control of other important respiratory infections. Now is also a time for New Zealand to build on the lessons from the COVID-19 pandemic to enhance preparedness nationally and internationally. New Zealand's experience suggests elimination (or ideally exclusion) should be the default first choice for future pandemics of sufficient severity.
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Affiliation(s)
- Michael G Baker
- Epidemiologist and Public Health Physician, University of Otago Wellington
| | | | - Michael J Plank
- Mathematical Modeler, School of Mathematics and Statistics, University of Canterbury, Co-lead Covid-19 Modelling Aotearoa
| | - Jemma L Geoghegan
- Molecular biologist, Department of Microbiology and Immunology, University of Otago Dunedin
| | - Teresa Wall
- Consultant on strengthening Māori health and equity, Wellington
| | - Collin Tukuitonga
- Public Health Physician, Pacific Health Researcher, The University of Auckland
| | | | | | - John Kerr
- Senior Research Fellow, University of Otago Wellington
| | - Nikki Turner
- General Practitioner and Medical Director of the Immunisation Advisory Centre, The University of Auckland
| | - Sally Roberts
- Clinical Microbiologist, Clinical Head of Microbiology and Infection Prevention and Control, Auckland Hospital, Te Whatu Ora - Health New Zealand, Te Toka Tumai Auckland
| | | | - Bryan Betty
- General Practitioner and Chair, General Practice New Zealand, Wellington
| | - Q Sue Huang
- Virologist, Director of WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington
| | - Nigel French
- Epidemiologist, Massey University of New Zealand, Palmerston North
| | - Nick Wilson
- Epidemiologist and Public Health Physician, University of Otago Wellington
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5
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Mettelman RC, Souquette A, Van de Velde LA, Vegesana K, Allen EK, Kackos CM, Trifkovic S, DeBeauchamp J, Wilson TL, St James DG, Menon SS, Wood T, Jelley L, Webby RJ, Huang QS, Thomas PG. Baseline innate and T cell populations are correlates of protection against symptomatic influenza virus infection independent of serology. Nat Immunol 2023; 24:1511-1526. [PMID: 37592015 PMCID: PMC10566627 DOI: 10.1038/s41590-023-01590-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/13/2023] [Indexed: 08/19/2023]
Abstract
Evidence suggests that innate and adaptive cellular responses mediate resistance to the influenza virus and confer protection after vaccination. However, few studies have resolved the contribution of cellular responses within the context of preexisting antibody titers. Here, we measured the peripheral immune profiles of 206 vaccinated or unvaccinated adults to determine how baseline variations in the cellular and humoral immune compartments contribute independently or synergistically to the risk of developing symptomatic influenza. Protection correlated with diverse and polyfunctional CD4+ and CD8+ T, circulating T follicular helper, T helper type 17, myeloid dendritic and CD16+ natural killer (NK) cell subsets. Conversely, increased susceptibility was predominantly attributed to nonspecific inflammatory populations, including γδ T cells and activated CD16- NK cells, as well as TNFα+ single-cytokine-producing CD8+ T cells. Multivariate and predictive modeling indicated that cellular subsets (1) work synergistically with humoral immunity to confer protection, (2) improve model performance over demographic and serologic factors alone and (3) comprise the most important predictive covariates. Together, these results demonstrate that preinfection peripheral cell composition improves the prediction of symptomatic influenza susceptibility over vaccination, demographics or serology alone.
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Affiliation(s)
- Robert C Mettelman
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Aisha Souquette
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lee-Ann Van de Velde
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kasi Vegesana
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - E Kaitlynn Allen
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Christina M Kackos
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sanja Trifkovic
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jennifer DeBeauchamp
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Taylor L Wilson
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Microbiology, Immunology and Biochemistry, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Deryn G St James
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Microbiology, Immunology and Biochemistry, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Smrithi S Menon
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Timothy Wood
- Institute of Environmental Science and Research Limited (ESR), Wallaceville Science Centre, Upper Hutt, New Zealand
| | - Lauren Jelley
- Institute of Environmental Science and Research Limited (ESR), Wallaceville Science Centre, Upper Hutt, New Zealand
| | - Richard J Webby
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), Wallaceville Science Centre, Upper Hutt, New Zealand.
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
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6
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O’Neill GK, Taylor J, Kok J, Dwyer DE, Dilcher M, Hua H, Levy A, Smith D, Minney-Smith CA, Wood T, Jelley L, Huang QS, Trenholme A, McAuliffe G, Barr I, Sullivan SG. Circulation of influenza and other respiratory viruses during the COVID-19 pandemic in Australia and New Zealand, 2020-2021. Western Pac Surveill Response J 2023; 14:1-9. [PMID: 37946717 PMCID: PMC10630701 DOI: 10.5365/wpsar.2023,14.3.948] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Objective Circulation patterns of influenza and other respiratory viruses have been globally disrupted since the emergence of coronavirus disease (COVID-19) and the introduction of public health and social measures (PHSMs) aimed at reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Methods We reviewed respiratory virus laboratory data, Google mobility data and PHSMs in five geographically diverse regions in Australia and New Zealand. We also described respiratory virus activity from January 2017 to August 2021. Results We observed a change in the prevalence of circulating respiratory viruses following the emergence of SARS-CoV-2 in early 2020. Influenza activity levels were very low in all regions, lower than those recorded in 2017-2019, with less than 1% of laboratory samples testing positive for influenza virus. In contrast, rates of human rhinovirus infection were increased. Respiratory syncytial virus (RSV) activity was delayed; however, once it returned, most regions experienced activity levels well above those seen in 2017-2019. The timing of the resurgence in the circulation of both rhinovirus and RSV differed within and between the two countries. Discussion The findings of this study suggest that as domestic and international borders are opened up and other COVID-19 PHSMs are lifted, clinicians and public health professionals should be prepared for resurgences in influenza and other respiratory viruses. Recent patterns in RSV activity suggest that these resurgences in non-COVID-19 viruses have the potential to occur out of season and with increased impact.
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Affiliation(s)
- Genevieve K O’Neill
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Janette Taylor
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Meik Dilcher
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Harry Hua
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Avram Levy
- PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - David Smith
- PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
| | | | - Timothy Wood
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Lauren Jelley
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q Sue Huang
- Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Gary McAuliffe
- Virology and Immunology Department, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases and Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
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7
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Li Y, Wang X, Blau DM, Caballero MT, Feikin DR, Gill CJ, Madhi SA, Omer SB, Simões EAF, Campbell H, Pariente AB, Bardach D, Bassat Q, Casalegno JS, Chakhunashvili G, Crawford N, Danilenko D, Do LAH, Echavarria M, Gentile A, Gordon A, Heikkinen T, Huang QS, Jullien S, Krishnan A, Lopez EL, Markić J, Mira-Iglesias A, Moore HC, Moyes J, Mwananyanda L, Nokes DJ, Noordeen F, Obodai E, Palani N, Romero C, Salimi V, Satav A, Seo E, Shchomak Z, Singleton R, Stolyarov K, Stoszek SK, von Gottberg A, Wurzel D, Yoshida LM, Yung CF, Zar HJ, Nair H. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022; 399:2047-2064. [PMID: 35598608 PMCID: PMC7613574 DOI: 10.1016/s0140-6736(22)00478-0] [Citation(s) in RCA: 398] [Impact Index Per Article: 199.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. METHODS In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). FINDINGS In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4-44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9-4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6-9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0-2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2·0% of deaths in children aged 0-60 months (UR 1·6-2·4) and 3·6% of deaths in children aged 28 days to 6 months (3·0-4·4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). INTERPRETATION RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. FUNDING EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).
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Affiliation(s)
- You Li
- School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Xin Wang
- School of Public Health, Nanjing Medical University, Nanjing, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mauricio T Caballero
- Fundacion INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel R Feikin
- Department of Immunizations, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - Christopher J Gill
- Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa; African Leadership Initiative in Vaccinology Expertise, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, CT, USA
| | - Eric A F Simões
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado, School of Medicine, Aurora, CO, USA; Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ana Bermejo Pariente
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Darmaa Bardach
- National Center for Communicable Diseases (Mongolia), Ulaanbaatar, Mongolia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Jean-Sebastien Casalegno
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France
| | | | - Nigel Crawford
- The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russia
| | - Lien Anh Ha Do
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Marcela Echavarria
- Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | - Angela Gentile
- Ricardo Gutierrez Children Hospital, Buenos Aires, Argentina
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Terho Heikkinen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Sophie Jullien
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Jigme Dorji Wangchuck National Referral Hospital, Gongphel Lam, Thimphu, Bhutan
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Eduardo Luis Lopez
- Hospital de Niños Dr. Ricardo Gutiérrez, Department of Medicine, Pediatric Infectious Diseases Program, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Joško Markić
- Department of Pediatrics, University Hospital Split, Split, Croatia; University of Split, School of Medicine, Split, Croatia
| | - Ainara Mira-Iglesias
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Salud Pública, Valencia, Spain
| | - Hannah C Moore
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Jocelyn Moyes
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Lawrence Mwananyanda
- Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | - Faseeha Noordeen
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Evangeline Obodai
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Nandhini Palani
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | | | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashish Satav
- MAHAN Trust Mahatma Gandhi Tribal Hospital, Karmgram, Utavali, Tahsil, Dharni, India
| | - Euri Seo
- Department of Pediatrics, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
| | - Zakhar Shchomak
- Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | | | - Kirill Stolyarov
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russia
| | | | - Anne von Gottberg
- School of Pathology, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa; National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Danielle Wurzel
- Murdoch Children's Research Institute, Melbourne, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chee Fu Yung
- Infectious Diseases Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Imperial College, Nanyang Technological University, Singapore
| | - Heather J Zar
- Department of Paediatrics and Child Health, and South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Respiratory Syncytial Virus Network Foundation, Zeist, Netherlands, on behalf of the Respiratory Virus Global Epidemiology Network, and the RESCEU investigators.
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8
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Davis W, Duque J, Huang QS, Olson N, Grant CC, Newbern EC, Thompson M, Waite B, Prasad N, Trenholme A, Azziz-Baumgartner E. Sensitivity and specificity of surveillance case definitions in detection of influenza and respiratory syncytial virus among hospitalized patients, New Zealand, 2012-2016. J Infect 2022; 84:216-226. [PMID: 34953903 DOI: 10.1016/j.jinf.2021.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 11/30/2021] [Accepted: 12/15/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The WHO is exploring the value of adding RSV testing to existing influenza surveillance systems to inform RSV control programs. We evaluate the usefulness of four commonly used influenza surveillance case-definitions for influenza and RSV surveillance. METHODS SHIVERS, a multi-institutional collaboration, conducted surveillance for influenza and RSV in four New Zealand hospitals. Nurses reviewed admission logs, enrolled patients with suspected acute respiratory infections (ARI), and obtained nasopharyngeal swabs for RT-PCR. We compared the performance characteristics for identifying laboratory-confirmed influenza and RSV severe acute respiratory infection (SARI), defined as persons admitted with measured or reported fever and cough within 10 days of illness, to three other case definitions: 1. reported fever and cough or shortness of breath, 2. cough and shortness of breath, or 3. cough. RESULTS During April-September 2012-2016, SHIVERS identified 16,055 admissions with ARI; of 6374 cases consented and tested for influenza or RSV, 5437 (85%) had SARI and 937 (15%) did not. SARI had the highest specificity in detecting influenza (40.6%) and RSV (40.8%) but the lowest sensitivity (influenza 78.8%, RSV 60.3%) among patients of all ages. Cough or shortness of breath had the highest sensitivity (influenza 99.3%, RSV 99.9%) but the lowest specificity (influenza 1.6%, RSV 1.9%). SARI sensitivity among children aged <3 months was 60.8% for influenza and 43.6% for RSV-both lower than in other age groups. CONCLUSIONS While SARI had the highest specificity, its sensitivity was limited, especially among children aged <3 months. Cough or shortness of breath was the most sensitive.
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Affiliation(s)
- William Davis
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Jazmin Duque
- US Centers for Disease Control and Prevention, Atlanta, USA; Battelle Atlanta, Atlanta, USA; The University of Auckland, Auckland, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Natalie Olson
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Cameron C Grant
- The University of Auckland, Auckland, New Zealand; Starship Children's Hospital, Auckland, New Zealand
| | - E Claire Newbern
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Mark Thompson
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Ben Waite
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Namrata Prasad
- The University of Auckland, Auckland, New Zealand; Institute of Environmental Science and Research, Wellington, New Zealand
| | - Adrian Trenholme
- The University of Auckland, Auckland, New Zealand; Middlemore Hospital, Auckland, New Zealand
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9
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Vieira MC, Donato CM, Arevalo P, Rimmelzwaan GF, Wood T, Lopez L, Huang QS, Dhanasekaran V, Koelle K, Cobey S. Lineage-specific protection and immune imprinting shape the age distributions of influenza B cases. Nat Commun 2021; 12:4313. [PMID: 34262041 PMCID: PMC8280188 DOI: 10.1038/s41467-021-24566-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 10/12/2020] [Accepted: 06/22/2021] [Indexed: 02/06/2023] Open
Abstract
How a history of influenza virus infections contributes to protection is not fully understood, but such protection might explain the contrasting age distributions of cases of the two lineages of influenza B, B/Victoria and B/Yamagata. Fitting a statistical model to those distributions using surveillance data from New Zealand, we found they could be explained by historical changes in lineage frequencies combined with cross-protection between strains of the same lineage. We found additional protection against B/Yamagata in people for whom it was their first influenza B infection, similar to the immune imprinting observed in influenza A. While the data were not informative about B/Victoria imprinting, B/Yamagata imprinting could explain the fewer B/Yamagata than B/Victoria cases in cohorts born in the 1990s and the bimodal age distribution of B/Yamagata cases. Longitudinal studies can test if these forms of protection inferred from historical data extend to more recent strains and other populations.
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Affiliation(s)
- Marcos C Vieira
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA.
| | - Celeste M Donato
- Enteric Diseases Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Philip Arevalo
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Guus F Rimmelzwaan
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Timothy Wood
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Liza Lopez
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Vijaykrishna Dhanasekaran
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Katia Koelle
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Sarah Cobey
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA.
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10
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang QS, Wood T, Guiomar R, Rodrigues AP, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Demont C, Bangert M, Dückers M, van Summeren J, Paget J. Defining the seasonality of respiratory syncytial virus around the world: National and subnational surveillance data from 12 countries. Influenza Other Respir Viruses 2021; 15:732-741. [PMID: 34255934 PMCID: PMC8542954 DOI: 10.1111/irv.12885] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract infections and have a major burden on society. For prevention and control to be deployed effectively, an improved understanding of the seasonality of RSV is necessary. Objectives The main objective of this study was to contribute to a better understanding of RSV seasonality by examining the GERi multi‐country surveillance dataset. Methods RSV seasons were included in the analysis if they contained ≥100 cases. Seasonality was determined using the “average annual percentage” method. Analyses were performed at a subnational level for the United States and Brazil. Results We included 601 425 RSV cases from 12 countries. Most temperate countries experienced RSV epidemics in the winter, with a median duration of 10–21 weeks. Not all epidemics fit this pattern in a consistent manner, with some occurring later or in an irregular manner. More variation in timing was observed in (sub)tropical countries, and we found substantial differences in seasonality at a subnational level. No association was found between the timing of the epidemic and the dominant RSV subtype. Conclusions Our findings suggest that geographical location or climatic characteristics cannot be used as a definitive predictor for the timing of RSV epidemics and highlight the need for (sub)national data collection and analysis.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Universidad Agraria del Ecuador, Guayaquil, Ecuador.,Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
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11
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Prasad N, Walker TA, Waite B, Wood T, Trenholme AA, Baker MG, McArthur C, Wong CA, Grant CC, Huang QS, Newbern EC. Respiratory Syncytial Virus-Associated Hospitalizations Among Adults With Chronic Medical Conditions. Clin Infect Dis 2021; 73:e158-e163. [PMID: 32531019 DOI: 10.1093/cid/ciaa730] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/04/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In contrast with respiratory disease caused by influenza, information on the risk of respiratory syncytial virus (RSV) disease among adults with chronic medical conditions (CMCs) is limited. METHODS We linked population-based surveillance of acute respiratory illness hospitalizations to national administrative data to estimate seasonal RSV hospitalization rates among adults aged 18-80 years with the following preexisting CMCs: chronic obstructive pulmonary disease (COPD), asthma, congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), diabetes mellitus (DM), and end-stage renal disease (ESRD). Age- and ethnicity-adjusted rates stratified by age group were estimated. RESULTS Among 883 999 adult residents aged 18-80 years, 281 RSV-positive hospitalizations were detected during 2012-2015 winter seasons. Across all ages, RSV hospitalization rates were significantly higher among adults with COPD, asthma, CHF, and CAD compared with those without each corresponding condition. RSV hospitalization rates were significantly higher among adults with ESRD aged 50-64 years and adults with DM aged 18-49 years and 65-80 years compared with adults in each age group without these conditions. No increased risk was seen for adults with CVA. The CMC with the highest risk of RSV hospitalization was CHF (incidence rate ratio [IRR] range, 4.6-36.5 across age strata) and COPD (IRR range, 9.6-9.7). Among RSV-positive adults, CHF and COPD were independently associated with increased length of hospital stay. CONCLUSIONS Adults with specific CMCs are at increased risk of RSV hospitalizations. Age affects this relationship for some CMCs. Such populations maybe relevant for future RSV prevention strategies.
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Affiliation(s)
- Namrata Prasad
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand.,Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
| | - Tiffany A Walker
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand
| | - Ben Waite
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand
| | - Tim Wood
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand
| | - Adrian A Trenholme
- Kidz First Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Michael G Baker
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Colin McArthur
- School of Medicine, University of Otago, Wellington, New Zealand
| | - Conroy A Wong
- Kidz First Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand.,Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - Q Sue Huang
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand
| | - E Claire Newbern
- National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand
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12
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Prasad N, Read JM, Jewell C, Waite B, Trenholme AA, Huang QS, Grant CC, Newbern EC, Hogan AB. Modelling the impact of respiratory syncytial virus (RSV) vaccine and immunoprophylaxis strategies in New Zealand. Vaccine 2021; 39:4383-4390. [PMID: 34147296 DOI: 10.1016/j.vaccine.2021.05.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/09/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mathematical models of respiratory syncytial virus (RSV) transmission can help describe seasonal epidemics and assess the impact of potential vaccines and immunoprophylaxis with monoclonal antibodies (mAb). METHODS We developed a deterministic, compartmental model for RSV transmission, which was fitted to population-based RSV hospital surveillance data from Auckland, New Zealand. The model simulated the introduction of either a maternal vaccine or a seasonal mAb among infants aged less than 6 months and estimated the reduction in RSV hospitalizations for a range of effectiveness and coverage values. RESULTS The model accurately reproduced the annual seasonality of RSV epidemics in Auckland. We found that a maternal vaccine with effectiveness of 30-40% in the first 90 days and 15-20% for the next 90 days could reduce RSV hospitalizations by 18-24% in children younger than 3 months, by 11-14% in children aged 3-5 months, and by 2-3% in children aged 6-23 months. A seasonal infant mAb with 40-60% effectiveness for 150 days could reduce RSV hospitalizations by 30-43%, 34-48% and by 14-21% in children aged 0-2 months, 3-5 months and 6-23 months, respectively. CONCLUSIONS Our results suggest that either a maternal RSV vaccine or mAb would effectively reduce RSV hospitalization disease burden in New Zealand. Overall, a seasonal mAb resulted in a larger disease prevention impact than a maternal vaccine.
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Affiliation(s)
- Namrata Prasad
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand; Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand.
| | - Jonathan M Read
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Christopher Jewell
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Ben Waite
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Adrian A Trenholme
- Kidz First Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Q Sue Huang
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand; General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - E Claire Newbern
- National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand
| | - Alexandra B Hogan
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
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13
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Mettelman RC, Souquette A, Van de Velde LA, Allen EK, Wood T, Krammer F, Petrie JG, Martin ET, Monto AS, Huang QS, Thomas PG. Defining cellular correlates of protection and vaccine failure to influenza across two human cohorts. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.103.37] [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] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
Influenza viruses are endemic viral pathogens causing mild to severe respiratory illness in humans. Immunologic protection against influenza is determined by immune correlates of protection– factors associated with reduced infection or severe disease. While antibodies specific to viral surface proteins are known correlates, waning seasonal vaccine efficacy and reported infection of patients despite elevated antibody titers suggest that humoral responses alone do not provide complete protective immunity. Indeed, evidence points to a larger role for cell-mediated immunity (CMI; innate cells and antigen-specific T cells) in conferring protection. CMI correlates, which act independently from humoral responses, have yet to be identified. Here, we analyzed samples from adult human subjects across two influenza infection and vaccination cohorts to identify distinct CMI correlates of protection to influenza. We profiled CMI responses using high-dimension flow cytometry from PBMCs collected pre- and post-exposure to influenza infection or vaccination. Statistical comparison of cell frequency and infection status identified candidate CMI correlates, which were validated using logistic regression accounting for vaccination, demographic (age, sex, BMI), and serologic (antibody) covariates. We identified 9 individual and 6 cell clusters across myeloid and lymphoid compartments associated with protection. The strongest correlations were observed in Th17, cTfh, and subsets of NK and dendritic cells. Further, AUROC models identified 3 baseline CMI infection classifiers. Lastly, our study identified correlates of vaccine failure– pre-exposure CMI profiles correlated with positive infection status despite vaccination.
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Affiliation(s)
- Robert C Mettelman
- 1Department of Immunology, St Jude Children’s Research Hospital, Memphis
| | - Aisha Souquette
- 1Department of Immunology, St Jude Children’s Research Hospital, Memphis
| | | | - E. Kaitlynn Allen
- 1Department of Immunology, St Jude Children’s Research Hospital, Memphis
| | - Timothy Wood
- 2Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wallaceville, Upper Hutt, New Zealand
| | - Florian Krammer
- 3Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Joshua G Petrie
- 4Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Emily T Martin
- 4Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Arnold S Monto
- 4Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Q. Sue Huang
- 2Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wallaceville, Upper Hutt, New Zealand
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14
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Wong SS, Oshansky CM, Guo XZJ, Ralston J, Wood T, Reynolds GE, Seeds R, Jelley L, Waite B, Jeevan T, Zanin M, Widdowson MA, Huang QS, Thomas PG, Webby RJ. Activated CD4 + T cells and CD14 hiCD16 + monocytes correlate with antibody response following influenza virus infection in humans. Cell Rep Med 2021; 2:100237. [PMID: 33948570 PMCID: PMC8080109 DOI: 10.1016/j.xcrm.2021.100237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/25/2021] [Accepted: 03/10/2021] [Indexed: 12/19/2022]
Abstract
The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts. Post-infection seroconversion is associated with severity of influenza virus infection Seroconverters have early proliferation and activation of CD4+ T cells CD8+ T cells are unaffected CD14hiCD16+ monocytes in the blood and nasal mucosa is associated with antibody response
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Affiliation(s)
- Sook-San Wong
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, 151 Dongfengxi Road, Yuexiu District, Guangzhou 510000, China.,Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.,School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Christine M Oshansky
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.,Biomedical Advanced Research and Development Authority (BARDA), Office of the Assistant Secretary for Preparedness and Response (ASPR), US Department of Health and Human Services (DHHS), 200 C Street, SW, Washington, DC 20201, USA
| | - Xi-Zhi J Guo
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.,Integrated Biomedical Sciences Program, University of Tennessee Health Science Center, Memphis, TN 38163, USA.,Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Jacqui Ralston
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand
| | - Timothy Wood
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand
| | - Gary E Reynolds
- Immunisation Advisory Centre, University of Auckland, Auckland, New Zealand
| | - Ruth Seeds
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand.,Minsitry for Primary Industries, 66 Ward Street, Upper Hutt 5140, New Zealand
| | - Lauren Jelley
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand
| | - Ben Waite
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand
| | - Trushar Jeevan
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Mark Zanin
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, 151 Dongfengxi Road, Yuexiu District, Guangzhou 510000, China.,Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.,School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.,Institute of Tropical Medicine (ITM), Nationalestraat 155, 2000 Antwerp, Belgium
| | - Q Sue Huang
- Institute for Environmental Science and Research, NCBID Wallaceville, 66 Ward Street, Upper Hutt 5018, New Zealand
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.,Integrated Biomedical Sciences Program, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
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15
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Lafond KE, Porter RM, Whaley MJ, Suizan Z, Ran Z, Aleem MA, Thapa B, Sar B, Proschle VS, Peng Z, Feng L, Coulibaly D, Nkwembe E, Olmedo A, Ampofo W, Saha S, Chadha M, Mangiri A, Setiawaty V, Ali SS, Chaves SS, Otorbaeva D, Keosavanh O, Saleh M, Ho A, Alexander B, Oumzil H, Baral KP, Huang QS, Adebayo AA, Al-Abaidani I, von Horoch M, Cohen C, Tempia S, Mmbaga V, Chittaganpitch M, Casal M, Dang DA, Couto P, Nair H, Bresee JS, Olsen SJ, Azziz-Baumgartner E, Nuorti JP, Widdowson MA. Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis. PLoS Med 2021; 18:e1003550. [PMID: 33647033 PMCID: PMC7959367 DOI: 10.1371/journal.pmed.1003550] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/15/2021] [Accepted: 01/27/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Influenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings. METHODS AND FINDINGS We aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996-31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle-Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20-64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%-16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000-46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000-9,432,000) LRI hospitalizations occur each year among adults. While adults <65 years contribute most influenza-associated LRI hospitalizations and episodes (3,464,000 [95% CI 1,885,000-5,978,000] LRI hospitalizations and 31,087,000 [95% CI 19,987,000-44,444,000] LRI episodes), hospitalization rates were highest in those ≥65 years (437/100,000 person-years [95% CI 265-612/100,000 person-years]). For this analysis, published articles were limited in their inclusion of stratified testing data by year and age group. Lack of information regarding influenza vaccination of the study population was also a limitation across both types of data sources. CONCLUSIONS In this meta-analysis, we estimated that influenza viruses are associated with over 5 million hospitalizations worldwide per year. Inclusion of both published and unpublished findings allowed for increased power to generate stratified estimates, and improved representation from lower-income countries. Together, the available data demonstrate the importance of influenza viruses as a cause of severe disease and hospitalizations in younger and older adults worldwide.
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Affiliation(s)
- Kathryn E. Lafond
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- * E-mail: (KEL); (MAW)
| | - Rachael M. Porter
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Melissa J. Whaley
- US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Zhou Suizan
- Influenza Division, US Centers for Disease Control and Prevention, Beijing, China
| | - Zhang Ran
- Influenza Division, US Centers for Disease Control and Prevention, Beijing, China
| | - Mohammad Abdul Aleem
- Program for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Binay Thapa
- Royal Centre for Disease Control, Thimphu, Bhutan
| | - Borann Sar
- Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | | | - Zhibin Peng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- School of Population Medicine & Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | | | - Edith Nkwembe
- Institut National de Recherches Biomédicales, Kinshasa, République Démocratique du Congo
| | | | - William Ampofo
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Siddhartha Saha
- Influenza Division, US Centers for Disease Control and Prevention, New Delhi, India
| | | | - Amalya Mangiri
- US Centers for Disease Control and Prevention, Jakarta, Indonesia
| | - Vivi Setiawaty
- National Institute of Health Research and Development, Jakarta, Indonesia
| | | | - Sandra S. Chaves
- Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Dinagul Otorbaeva
- Department of State Sanitary Epidemiological Surveillance, Bishkek, Kyrgyzstan
| | - Onechanh Keosavanh
- National Center for Laboratory and Epidemiology, Vientiane, Lao People’s Democratic Republic
| | - Majd Saleh
- Epidemiological Surveillance Program, Lebanese Ministry of Public Health, Beirut, Lebanon
| | - Antonia Ho
- MRC–University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
- Malawi–Liverpool–Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | | | - Hicham Oumzil
- Virology Department, Institut National d’Hygiène, Rabat, Morocco
- Faculty of Medicine, Microbiology RPU, Mohammed V University, Rabat, Morocco
| | | | - Q. Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Adedeji A. Adebayo
- Nigeria Centre for Disease Control, Federal Ministry of Health, Abuja, Nigeria
| | - Idris Al-Abaidani
- Directorate General of Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Marta von Horoch
- Ministerio de Salud Publica y Bienestar Social, Asunción, Paraguay
| | - Cheryl Cohen
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Stefano Tempia
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- MassGenics, Duluth, Georgia, United States of America
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Malinee Chittaganpitch
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Mariana Casal
- Arizona Department of Health Services, Phoenix, Arizona, United States of America
| | - Duc Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Paula Couto
- Pan American Health Organization, Washington, District of Columbia, United States of America
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Joseph S. Bresee
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sonja J. Olsen
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eduardo Azziz-Baumgartner
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - J. Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marc-Alain Widdowson
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, Kenya
- Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail: (KEL); (MAW)
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16
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Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K, Nesdale A, Dowell T, Turner N, Campbell-Stokes P, Balm M, Dobinson HC, Grant CC, James S, Aminisani N, Ralston J, Gunn W, Bocacao J, Danielewicz J, Moncrieff T, McNeill A, Lopez L, Waite B, Kiedrzynski T, Schrader H, Gray R, Cook K, Currin D, Engelbrecht C, Tapurau W, Emmerton L, Martin M, Baker MG, Taylor S, Trenholme A, Wong C, Lawrence S, McArthur C, Stanley A, Roberts S, Ranama F, Bennett J, Mansell C, Dilcher M, Werno A, Grant J, van der Linden A, Youngblood B, Thomas PG, Webby RJ. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. medRxiv 2020:2020.11.11.20228692. [PMID: 33200149 PMCID: PMC7668762 DOI: 10.1101/2020.11.11.20228692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Stringent nonpharmaceutical interventions (NPIs) such as lockdowns and border closures are not currently recommended for pandemic influenza control. New Zealand used these NPIs to eliminate coronavirus disease 2019 during its first wave. Using multiple surveillance systems, we observed a parallel and unprecedented reduction of influenza and other respiratory viral infections in 2020. This finding supports the use of these NPIs for controlling pandemic influenza and other severe respiratory viral threats.
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Affiliation(s)
- Q Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Lauren Jelley
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Tineke Jennings
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Sarah Jefferies
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Karen Daniells
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Annette Nesdale
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Tony Dowell
- University of Otago, School of Medicine in Wellington, Wellington, New Zealand
| | | | | | - Michelle Balm
- Capital Coast District Health Board, Wellington, New Zealand
| | | | | | - Shelley James
- Capital Coast District Health Board, Wellington, New Zealand
| | - Nayyereh Aminisani
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Jacqui Ralston
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Wendy Gunn
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Judy Bocacao
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Tessa Moncrieff
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Andrea McNeill
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Liza Lopez
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Ben Waite
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Hannah Schrader
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Rebekah Gray
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Kayla Cook
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Danielle Currin
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Chaune Engelbrecht
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Whitney Tapurau
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Leigh Emmerton
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Maxine Martin
- Regional Public Health, Hutt Valley District Health Board, Wellington, New Zealand
| | - Michael G Baker
- University of Otago, School of Medicine in Wellington, Wellington, New Zealand
| | - Susan Taylor
- Counties Manukau District Health Board, Auckland, New Zealand
| | | | - Conroy Wong
- Counties Manukau District Health Board, Auckland, New Zealand
| | | | | | | | - Sally Roberts
- Auckland District Health Board, Auckland, New Zealand
| | | | - Jenny Bennett
- Waikato District Health Board, Hamilton, New Zealand
| | - Chris Mansell
- Waikato District Health Board, Hamilton, New Zealand
| | - Meik Dilcher
- Canterbury District Health Board, Christchurch, New Zealand
| | - Anja Werno
- Canterbury District Health Board, Christchurch, New Zealand
| | | | | | - Ben Youngblood
- WHO Collaborating Centre, St Jude Children's Research Hospital, Memphis, USA
| | - Paul G Thomas
- WHO Collaborating Centre, St Jude Children's Research Hospital, Memphis, USA
| | - Richard J Webby
- WHO Collaborating Centre, St Jude Children's Research Hospital, Memphis, USA
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17
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Walker TA, Waite B, Thompson MG, McArthur C, Wong C, Baker MG, Wood T, Haubrock J, Roberts S, Gross DK, Huang QS, Newbern EC. Risk of Severe Influenza Among Adults With Chronic Medical Conditions. J Infect Dis 2020; 221:183-190. [PMID: 31678990 DOI: 10.1093/infdis/jiz570] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/01/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Severe influenza illness is presumed more common in adults with chronic medical conditions (CMCs), but evidence is sparse and often combined into broad CMC categories. METHODS Residents (aged 18-80 years) of Central and South Auckland hospitalized for World Health Organization-defined severe acute respiratory illness (SARI) (2012-2015) underwent influenza virus polymerase chain reaction testing. The CMC statuses for Auckland residents were modeled using hospitalization International Classification of Diseases, Tenth Revision codes, pharmaceutical claims, and laboratory results. Population-level influenza rates in adults with congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus (DM), and end-stage renal disease (ESRD) were calculated by Poisson regression stratified by age and adjusted for ethnicity. RESULTS Among 891 276 adults, 2435 influenza-associated SARI hospitalizations occurred. Rates were significantly higher in those with CMCs compared with those without the respective CMC, except for older adults with DM or those aged <65 years with CVA. The largest effects occurred with CHF (incidence rate ratio [IRR] range, 4.84-13.4 across age strata), ESRD (IRR range, 3.30-9.02), CAD (IRR range, 2.77-10.7), and COPD (IRR range, 5.89-8.78) and tapered with age. CONCLUSIONS Our findings support the increased risk of severe, laboratory-confirmed influenza disease among adults with specific CMCs compared with those without these conditions.
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Affiliation(s)
- Tiffany A Walker
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ben Waite
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Colin McArthur
- Department of Critical Care Medicine, Auckland District Health Board, Greenlane, Auckland, New Zealand
| | - Conroy Wong
- Department of Respiratory Medicine, Counties Manukau District Health Board, Papatoetoe, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, School of Medicine, Newtown, Wellington, New Zealand
| | - Tim Wood
- Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Jennifer Haubrock
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Sally Roberts
- Department of Microbiology, Auckland District Health Board, Greenlane, Auckland, New Zealand
| | - Diane K Gross
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - E Claire Newbern
- Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand
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18
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Sullivan SG, Arriola CS, Bocacao J, Burgos P, Bustos P, Carville KS, Cheng AC, Chilver MB, Cohen C, Deng YM, El Omeiri N, Fasce RA, Hellferscee O, Huang QS, Gonzalez C, Jelley L, Leung VK, Lopez L, McAnerney JM, McNeill A, Olivares MF, Peck H, Sotomayor V, Tempia S, Vergara N, von Gottberg A, Walaza S, Wood T. Heterogeneity in influenza seasonality and vaccine effectiveness in Australia, Chile, New Zealand and South Africa: early estimates of the 2019 influenza season. ACTA ACUST UNITED AC 2020; 24. [PMID: 31718744 PMCID: PMC6852316 DOI: 10.2807/1560-7917.es.2019.24.45.1900645] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We compared 2019 influenza seasonality and vaccine effectiveness (VE) in four southern hemisphere countries: Australia, Chile, New Zealand and South Africa. Influenza seasons differed in timing, duration, intensity and predominant circulating viruses. VE estimates were also heterogeneous, with all-ages point estimates ranging from 7-70% (I2: 33%) for A(H1N1)pdm09, 4-57% (I2: 49%) for A(H3N2) and 29-66% (I2: 0%) for B. Caution should be applied when attempting to use southern hemisphere data to predict the northern hemisphere influenza season.
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Affiliation(s)
- Sheena G Sullivan
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - Judy Bocacao
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Pamela Burgos
- Programa Nacional de Inmunizaciones, Ministerio de Salud, Santiago, Chile
| | - Patricia Bustos
- Sección de Virus Respiratorios y Exantematicos, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Kylie S Carville
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Allen C Cheng
- Department of Infectious Diseases, Alfred Health, and Central Clinical School, Monash University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Monique Bm Chilver
- Discipline of General Practice, University of Adelaide, Adelaide, Australia
| | - Cheryl Cohen
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Reference and Research on Influenza, Melbourne, Australia
| | - Nathalie El Omeiri
- Pan American Health Organization(PAHO)/WHO Regional Office for the Americas, Washington, United States
| | - Rodrigo A Fasce
- Subdepartamento de Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | | | - Q Sue Huang
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Cecilia Gonzalez
- Programa Nacional de Inmunizaciones, Ministerio de Salud, Santiago, Chile
| | - Lauren Jelley
- National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Vivian Ky Leung
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Liza Lopez
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Andrea McNeill
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
| | - Maria F Olivares
- Departamento de Epidemiologia, Ministerio de Salud, Santiago, Chile
| | - Heidi Peck
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Reference and Research on Influenza, Melbourne, Australia
| | | | - Stefano Tempia
- MassGenics, Duluth, United States.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.,National Institute for Communicable Diseases, Johannesburg, South Africa.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - Natalia Vergara
- Departamento de Epidemiologia, Ministerio de Salud, Santiago, Chile
| | - Anne von Gottberg
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Sibongile Walaza
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Timothy Wood
- Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand
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19
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Prasad N, Newbern EC, Trenholme AA, Thompson MG, McArthur C, Wong CA, Jelley L, Aminisani N, Huang QS, Grant CC. The health and economic burden of respiratory syncytial virus associated hospitalizations in adults. PLoS One 2020; 15:e0234235. [PMID: 32525898 PMCID: PMC7289360 DOI: 10.1371/journal.pone.0234235] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of illness in adults; however, data on RSV disease and economic burden in this age group remain limited. We aimed to provide comprehensive estimates of RSV disease burden among adults aged ≥18 years. Methods During 2012–2015, population-based, active surveillance of acute respiratory infection (ARI) hospitalizations enabled estimation of the seasonal incidence of RSV hospitalizations and direct health costs in adults aged ≥18 years in Auckland, New Zealand. Results Of 4,600 ARI hospitalizations tested for RSV, 348 (7.6%) were RSV positive. The median (interquartile range) length of hospital stay for RSV positive patients was 4 (2–6) days. The seasonal incidence rate (IR) of RSV hospitalizations, corrected for non-testing, was 23.6 (95% confidence intervals [CI] 21.0–26.1) per 100,000 adults aged ≥18 years. Hospitalization risk increased with age with the highest incidence among adults aged ≥80 years (IR 190.8 per 100,000, 95% CI 137.6–244.0). Being of Māori or Pacific ethnicity or living in a neighborhood with low socioeconomic status (SES) were independently associated with increased RSV hospitalization rates. We estimate RSV-associated hospitalizations among adults aged ≥18 years to cost on average NZD $4,758 per event. Conclusions RSV infection is associated with considerable disease and economic cost in adults. RSV disproportionally affects adult sub-groups defined by age, ethnicity, and neighborhood SES. An effective RSV vaccine or RSV treatment may offer benefits for older adults.
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Affiliation(s)
- Namrata Prasad
- Institute of Environmental Science and Research, Wellington, New Zealand
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
- * E-mail: (NP); (CN)
| | - E. Claire Newbern
- Institute of Environmental Science and Research, Wellington, New Zealand
- * E-mail: (NP); (CN)
| | | | - Mark G. Thompson
- United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Colin McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Conroy A. Wong
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Lauren Jelley
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Nayyereh Aminisani
- Institute of Environmental Science and Research, Wellington, New Zealand
- Non-Communicable Disease Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Q. Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Cameron C. Grant
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
- General Paediatrics, Starship Children’s Hospital, Auckland, New Zealand
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20
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Prasad N, Huang QS, Wood T, Aminisani N, McArthur C, Baker MG, Seeds R, Thompson MG, Widdowson MA, Newbern EC. Influenza-Associated Outcomes Among Pregnant, Postpartum, and Nonpregnant Women of Reproductive Age. J Infect Dis 2020; 219:1893-1903. [PMID: 30690449 DOI: 10.1093/infdis/jiz035] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/16/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pregnant women are prioritized for seasonal influenza vaccination, but the evidence on the risk of influenza during pregnancy that is used to inform these policies is limited. METHODS Individual-level administrative data sets and active surveillance data were joined to estimate influenza-associated hospitalization and outpatient visit rates by pregnancy, postpartum, and trimester status. RESULTS During 2012-2015, 46 of 260 (17.7%) influenza-confirmed hospitalizations for acute respiratory infection and 13 of 294 (4.4%) influenza-confirmed outpatient visits were among pregnant and postpartum women. Pregnant and postpartum women experienced higher rates of influenza-associated hospitalization than nonpregnant women overall (rate ratio [RR], 3.4; 95% confidence interval [CI], 2.5-4.7) and by trimester (first, 2.5 [95% CI, 1.2-5.4]; second, 3.9 [95% CI, 2.4-6.3]; and third, 4.8 [95% CI, 3.0-7.7]); the RR for the postpartum period was 0.7 (95% CI, 3.0-7.7). Influenza A viruses were associated with an increased risk (RR for 2009 pandemic influenza A[H1N1] virus, 5.3 [95% CI, 3.2-8.7]; RR for influenza A(H3N2) virus, 3.0 [95% CI, 1.8-5.0]), but influenza B virus was not (RR, 1.8; 95% CI, .7-4.6). Influenza-associated hospitalization rates in pregnancy were significantly higher for Māori women (RR, 3.2; 95% CI, 1.3-8.4), compared with women of European or other ethnicity. Similar risks for influenza-confirmed outpatient visits were not observed. CONCLUSION Seasonal influenza poses higher risks of hospitalization among pregnant women in all trimesters, compared with nonpregnant women. Hospitalization rates vary by influenza virus type and ethnicity among pregnant women.
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Affiliation(s)
- Namrata Prasad
- Institute of Environmental Science and Research, Upper Hutt, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research, Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research, Upper Hutt, New Zealand
| | - Nayyereh Aminisani
- Institute of Environmental Science and Research, Upper Hutt, New Zealand.,Noncommunicable Disease Research Center, Neyshabur University of Medical Sciences, Iran
| | - Colin McArthur
- Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ruth Seeds
- Institute of Environmental Science and Research, Upper Hutt, New Zealand
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - E Claire Newbern
- Institute of Environmental Science and Research, Upper Hutt, New Zealand
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21
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Walker TA, Waite B, Thompson MG, McArthur C, Wong C, Baker MG, Wood T, Haubrock J, Roberts S, Gross DK, Huang QS, Newbern EC. Risk of Severe Influenza Among Adults With Chronic Medical Conditions. J Infect Dis 2020. [PMID: 31678990 DOI: 10.1093/infdis/jiz570[publishedonlinefirst:2019/11/05]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Severe influenza illness is presumed more common in adults with chronic medical conditions (CMCs), but evidence is sparse and often combined into broad CMC categories. METHODS Residents (aged 18-80 years) of Central and South Auckland hospitalized for World Health Organization-defined severe acute respiratory illness (SARI) (2012-2015) underwent influenza virus polymerase chain reaction testing. The CMC statuses for Auckland residents were modeled using hospitalization International Classification of Diseases, Tenth Revision codes, pharmaceutical claims, and laboratory results. Population-level influenza rates in adults with congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus (DM), and end-stage renal disease (ESRD) were calculated by Poisson regression stratified by age and adjusted for ethnicity. RESULTS Among 891 276 adults, 2435 influenza-associated SARI hospitalizations occurred. Rates were significantly higher in those with CMCs compared with those without the respective CMC, except for older adults with DM or those aged <65 years with CVA. The largest effects occurred with CHF (incidence rate ratio [IRR] range, 4.84-13.4 across age strata), ESRD (IRR range, 3.30-9.02), CAD (IRR range, 2.77-10.7), and COPD (IRR range, 5.89-8.78) and tapered with age. CONCLUSIONS Our findings support the increased risk of severe, laboratory-confirmed influenza disease among adults with specific CMCs compared with those without these conditions.
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Affiliation(s)
- Tiffany A Walker
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ben Waite
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Colin McArthur
- Department of Critical Care Medicine, Auckland District Health Board, Greenlane, Auckland, New Zealand
| | - Conroy Wong
- Department of Respiratory Medicine, Counties Manukau District Health Board, Papatoetoe, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, School of Medicine, Newtown, Wellington, New Zealand
| | - Tim Wood
- Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Jennifer Haubrock
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Sally Roberts
- Department of Microbiology, Auckland District Health Board, Greenlane, Auckland, New Zealand
| | - Diane K Gross
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - E Claire Newbern
- Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand
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22
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Huang QS, Bandaranayake D, Wood T, Newbern EC, Seeds R, Ralston J, Waite B, Bissielo A, Prasad N, Todd A, Jelley L, Gunn W, McNicholas A, Metz T, Lawrence S, Collis E, Retter A, Wong SS, Webby R, Bocacao J, Haubrock J, Mackereth G, Turner N, McArdle B, Cameron J, Reynolds EG, Baker MG, Grant CC, McArthur C, Roberts S, Trenholme A, Wong C, Taylor S, Thomas P, Duque J, Gross D, Thompson MG, Widdowson MA. Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study. J Infect Dis 2019; 219:347-357. [PMID: 30016464 DOI: 10.1093/infdis/jiy443] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background Understanding the attack rate of influenza infection and the proportion who become ill by risk group is key to implementing prevention measures. While population-based studies of antihemagglutinin antibody responses have been described previously, studies examining both antihemagglutinin and antineuraminidase antibodies are lacking. Methods In 2015, we conducted a seroepidemiologic cohort study of individuals randomly selected from a population in New Zealand. We tested paired sera for hemagglutination inhibition (HAI) or neuraminidase inhibition (NAI) titers for seroconversion. We followed participants weekly and performed influenza polymerase chain reaction (PCR) for those reporting influenza-like illness (ILI). Results Influenza infection (either HAI or NAI seroconversion) was found in 321 (35% [95% confidence interval, 32%-38%]) of 911 unvaccinated participants, of whom 100 (31%) seroconverted to NAI alone. Young children and Pacific peoples experienced the highest influenza infection attack rates, but overall only a quarter of all infected reported influenza PCR-confirmed ILI, and one-quarter of these sought medical attention. Seroconversion to NAI alone was higher among children aged <5 years vs those aged ≥5 years (14% vs 4%; P < .001) and among those with influenza B vs A(H3N2) virus infections (7% vs 0.3%; P < .001). Conclusions Measurement of antineuraminidase antibodies in addition to antihemagglutinin antibodies may be important in capturing the true influenza infection rates.
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Affiliation(s)
- Q Sue Huang
- Institute of Environmental Science and Research, Wellington
| | | | - Tim Wood
- Institute of Environmental Science and Research, Wellington
| | | | - Ruth Seeds
- Institute of Environmental Science and Research, Wellington
| | - Jacqui Ralston
- Institute of Environmental Science and Research, Wellington
| | - Ben Waite
- Institute of Environmental Science and Research, Wellington
| | - Ange Bissielo
- Institute of Environmental Science and Research, Wellington
| | - Namrata Prasad
- Institute of Environmental Science and Research, Wellington
| | - Angela Todd
- Institute of Environmental Science and Research, Wellington
| | - Lauren Jelley
- Institute of Environmental Science and Research, Wellington
| | - Wendy Gunn
- Institute of Environmental Science and Research, Wellington
| | | | - Thomas Metz
- Institute of Environmental Science and Research, Wellington
| | | | - Emma Collis
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Amanda Retter
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Sook-San Wong
- World Health Organization Collaborating Centre, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Richard Webby
- World Health Organization Collaborating Centre, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Judy Bocacao
- Institute of Environmental Science and Research, Wellington
| | | | | | | | | | | | | | | | | | | | | | | | - Conroy Wong
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Susan Taylor
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Paul Thomas
- World Health Organization Collaborating Centre, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Jazmin Duque
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diane Gross
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, Georgia
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23
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Caini S, Kusznierz G, Garate VV, Wangchuk S, Thapa B, de Paula Júnior FJ, Ferreira de Almeida WA, Njouom R, Fasce RA, Bustos P, Feng L, Peng Z, Araya JL, Bruno A, de Mora D, Barahona de Gámez MJ, Pebody R, Zambon M, Higueros R, Rivera R, Kosasih H, Castrucci MR, Bella A, Kadjo HA, Daouda C, Makusheva A, Bessonova O, Chaves SS, Emukule GO, Heraud JM, Razanajatovo NH, Barakat A, El Falaki F, Meijer A, Donker GA, Huang QS, Wood T, Balmaseda A, Palekar R, Arévalo BM, Rodrigues AP, Guiomar R, Lee VJM, Ang LW, Cohen C, Treurnicht F, Mironenko A, Holubka O, Bresee J, Brammer L, Le MTQ, Hoang PVM, El Guerche-Séblain C, Paget J. The epidemiological signature of influenza B virus and its B/Victoria and B/Yamagata lineages in the 21st century. PLoS One 2019; 14:e0222381. [PMID: 31513690 PMCID: PMC6742362 DOI: 10.1371/journal.pone.0222381] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/29/2019] [Indexed: 12/15/2022] Open
Abstract
We describe the epidemiological characteristics, pattern of circulation, and geographical distribution of influenza B viruses and its lineages using data from the Global Influenza B Study. We included over 1.8 million influenza cases occurred in thirty-one countries during 2000–2018. We calculated the proportion of cases caused by influenza B and its lineages; determined the timing of influenza A and B epidemics; compared the age distribution of B/Victoria and B/Yamagata cases; and evaluated the frequency of lineage-level mismatch for the trivalent vaccine. The median proportion of influenza cases caused by influenza B virus was 23.4%, with a tendency (borderline statistical significance, p = 0.060) to be higher in tropical vs. temperate countries. Influenza B was the dominant virus type in about one every seven seasons. In temperate countries, influenza B epidemics occurred on average three weeks later than influenza A epidemics; no consistent pattern emerged in the tropics. The two B lineages caused a comparable proportion of influenza B cases globally, however the B/Yamagata was more frequent in temperate countries, and the B/Victoria in the tropics (p = 0.048). B/Yamagata patients were significantly older than B/Victoria patients in almost all countries. A lineage-level vaccine mismatch was observed in over 40% of seasons in temperate countries and in 30% of seasons in the tropics. The type B virus caused a substantial proportion of influenza infections globally in the 21st century, and its two virus lineages differed in terms of age and geographical distribution of patients. These findings will help inform health policy decisions aiming to reduce disease burden associated with seasonal influenza.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
- * E-mail:
| | - Gabriela Kusznierz
- National Institute of Respiratory Diseases "Emilio Coni", Santa Fe, Argentina
| | | | - Sonam Wangchuk
- Royal Centre for Disease Control, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | | | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Rodrigo A. Fasce
- Sub-Department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sub-Department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Luzhao Feng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Zhibin Peng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Jenny Lara Araya
- National Influenza Center, Ministry of Health, San José, Costa Rica
| | - Alfredo Bruno
- National Institute of Public Health Research (INSPI), National Reference Centre for Influenza and Other Respiratory Viruses, Guayaquil, Ecuador
- Agricultural University of Ecuador, Guayaquil, Ecuador
| | - Doménica de Mora
- National Institute of Public Health Research (INSPI), National Reference Centre for Influenza and Other Respiratory Viruses, Guayaquil, Ecuador
| | | | | | - Maria Zambon
- Public Health England, London, England, United Kingdom
| | - Rocio Higueros
- National Influenza Center, Ministry of Health, Guatemala City, Guatemala
| | | | | | - Maria Rita Castrucci
- National Influenza Center, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Hervé A. Kadjo
- Department of Epidemic Virus, Institut Pasteur, Abidjan, Côte d'Ivoire
| | - Coulibaly Daouda
- Service of Epidemiological Diseases Surveillance, National Institute of Public Hygiene, Abidjan, Côte d'Ivoire
| | - Ainash Makusheva
- National Center of Expertise, Committee of Public Health Protection, Ministry of Health, Astana, Kazakhstan
| | - Olga Bessonova
- National Center of Expertise, Committee of Public Health Protection, Ministry of Health, Uralsk City, Kazakhstan
| | - Sandra S. Chaves
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Influenza Program, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Gideon O. Emukule
- Influenza Program, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Norosoa H. Razanajatovo
- National Influenza Center, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Amal Barakat
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Fatima El Falaki
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Adam Meijer
- National Institute for Public Health and the Environment, Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, Bilthoven, The Netherlands
| | - Gé A. Donker
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Q. Sue Huang
- Institute of Environmental Science and Research, Weillngton, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research, Weillngton, New Zealand
| | - Angel Balmaseda
- National Influenza Center, Ministry of Health, Managua, Nicaragua
| | - Rakhee Palekar
- Pan American Health Organization, Washington, District of Columbia, United States of America
| | | | - Ana Paula Rodrigues
- Department of epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Li Wei Ang
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Florette Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Alla Mironenko
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases, National Academy of Medical Science of Ukraine, Department of Respiratory and other Viral Infections, Kyiv, Ukraine
| | - Olha Holubka
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases, National Academy of Medical Science of Ukraine, Department of Respiratory and other Viral Infections, Kyiv, Ukraine
| | - Joseph Bresee
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lynnette Brammer
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mai T. Q. Le
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Clotilde El Guerche-Séblain
- Global Vaccine Epidemiology and Modeling Department (VEM), Franchise Epidemiologist, Sanofi Pasteur, Lyon, France
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
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24
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Cohen L, Fiore-Gartland A, Randolph AG, Panoskaltsis-Mortari A, Wong SS, Ralston J, Wood T, Seeds R, Huang QS, Webby RJ, Thomas PG, Hertz T. A Modular Cytokine Analysis Method Reveals Novel Associations With Clinical Phenotypes and Identifies Sets of Co-signaling Cytokines Across Influenza Natural Infection Cohorts and Healthy Controls. Front Immunol 2019; 10:1338. [PMID: 31275311 PMCID: PMC6594355 DOI: 10.3389/fimmu.2019.01338] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 02/13/2019] [Accepted: 05/28/2019] [Indexed: 12/11/2022] Open
Abstract
Cytokines and chemokines are key signaling molecules of the immune system. Recent technological advances enable measurement of multiplexed cytokine profiles in biological samples. These profiles can then be used to identify potential biomarkers of a variety of clinical phenotypes. However, testing for such associations for each cytokine separately ignores the highly context-dependent covariation in cytokine secretion and decreases statistical power to detect associations due to multiple hypothesis testing. Here we present CytoMod—a novel data-driven approach for analysis of cytokine profiles that uses unsupervised clustering and regression to identify putative functional modules of co-signaling cytokines. Each module represents a biosignature of co-signaling cytokines. We applied this approach to three independent clinical cohorts of subjects naturally infected with influenza in which cytokine profiles and clinical phenotypes were collected. We found that in two out of three cohorts, cytokine modules were significantly associated with clinical phenotypes, and in many cases these associations were stronger than the associations of the individual cytokines within them. By comparing cytokine modules across datasets, we identified cytokine “cores”—specific subsets of co-expressed cytokines that clustered together across the three cohorts. Cytokine cores were also associated with clinical phenotypes. Interestingly, most of these cores were also co-expressed in a cohort of healthy controls, suggesting that in part, patterns of cytokine co-signaling may be generalizable. CytoMod can be readily applied to any cytokine profile dataset regardless of measurement technology, increases the statistical power to detect associations with clinical phenotypes and may help shed light on the complex co-signaling networks of cytokines in both health and infection.
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Affiliation(s)
- Liel Cohen
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.,National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Andrew Fiore-Gartland
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.,Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Angela Panoskaltsis-Mortari
- Department of Pediatrics, Bone Marrow Transplantation, Pulmonary and Critical Care Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Sook-San Wong
- State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou, China
| | - Jacqui Ralston
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Upper Hutt, New Zealand
| | - Timothy Wood
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Upper Hutt, New Zealand
| | - Ruth Seeds
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Upper Hutt, New Zealand
| | - Q Sue Huang
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Upper Hutt, New Zealand
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Tomer Hertz
- National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
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25
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Wong SS, Oshansky CM, Guo XZJ, Ralston J, Wood T, Seeds R, Newbern C, Waite B, Reynolds G, Widdowson MA, Huang QS, Webby RJ, Thomas PG. Severe Influenza Is Characterized by Prolonged Immune Activation: Results From the SHIVERS Cohort Study. J Infect Dis 2019; 217:245-256. [PMID: 29112724 DOI: 10.1093/infdis/jix571] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022] Open
Abstract
Background The immunologic factors underlying severe influenza are poorly understood. To address this, we compared the immune responses of influenza-confirmed hospitalized individuals with severe acute respiratory illness (SARI) to those of nonhospitalized individuals with influenza-like illness (ILI). Methods Peripheral blood lymphocytes were collected from 27 patients with ILI and 27 with SARI, at time of enrollment and then 2 weeks later. Innate and adaptive cellular immune responses were assessed by flow cytometry, and serum cytokine levels were assessed by a bead-based assay. Results During the acute phase, SARI was associated with significantly reduced numbers of circulating myeloid dendritic cells, CD192+ monocytes, and influenza virus-specific CD8+ and CD4+ T cells as compared to ILI. By the convalescent phase, however, most SARI cases displayed continued immune activation characterized by increased numbers of CD16+ monocytes and proliferating, and influenza virus-specific, CD8+ T cells as compared to ILI cases. SARI was also associated with reduced amounts of cytokines that regulate T-cell responses (ie, interleukin 4, interleukin 13, interleukin 12, interleukin 10, and tumor necrosis factor β) and hematopoiesis (interleukin 3 and granulocyte-macrophage colony-stimulating factor) but increased amounts of a proinflammatory cytokine (tumor necrosis factor α), chemotactic cytokines (MDC, MCP-1, GRO, and fractalkine), and growth-promoting cytokines (PDGFBB/AA, VEGF, and EGF) as compared to ILI. Conclusions Severe influenza cases showed a delay in the peripheral immune activation that likely led prolonged inflammation, compared with mild influenza cases.
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Affiliation(s)
- Sook-San Wong
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis
| | | | - Xi-Zhi J Guo
- Department of Immunology, St. Jude Children's Research Hospital, Memphis.,Integrated Biomedical Sciences Program, University of Tennessee Health Science Center, Memphis
| | - Jacqui Ralston
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Timothy Wood
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Ruth Seeds
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Claire Newbern
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Ben Waite
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Gary Reynolds
- Immunisation Advisory Service, Department of Population Health, University of Auckland, New Zealand
| | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Q Sue Huang
- Institute for Environmental Science and Research, National Centre for Biosecurity and Infectious Disease-Wallaceville, Upper Hutt
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis.,Integrated Biomedical Sciences Program, University of Tennessee Health Science Center, Memphis
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26
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Thompson MG, Pierse N, Sue Huang Q, Prasad N, Duque J, Claire Newbern E, Baker MG, Turner N, McArthur C. Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012–2015. Vaccine 2018; 36:5916-5925. [DOI: 10.1016/j.vaccine.2018.07.028] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/08/2018] [Accepted: 07/15/2018] [Indexed: 12/26/2022]
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27
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Wu MY, Huang QS, Le Guen K, Ilakovac V, Li BX, Wang ZS, Giglia A, Rueff JP, Jonnard P. Characterization of Pd/Y multilayers with B 4C barrier layers using GIXR and X-ray standing wave enhanced HAXPES. J Synchrotron Radiat 2018; 25:1417-1424. [PMID: 30179181 DOI: 10.1107/s1600577518009402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
Pd/Y multilayers are high-reflectance mirrors designed to work in the 7.5-11 nm wavelength range. Samples, prepared by magnetron sputtering, are deposited with or without B4C barrier layers located at the interfaces of the Pd and Y layers to reduce interdiffusion, which is expected from calculating the mixing enthalpy of Pd and Y. Grazing-incident X-ray reflectometry is used to characterize these multilayers. B4C barrier layers are found to be effective in reducing Pd-Y interdiffusion. Details of the composition of the multilayers are revealed by hard X-ray photoemission spectroscopy with X-ray standing wave effects. This consists of measuring the photoemission intensity from the samples by performing an angular scan in the region corresponding to the multilayer period and an incident photon energy according to Bragg's law. The experimental results indicate that Pd does not chemically react with B nor C at the Pd-B4C interface while Y does react at the Y-B4C interface. The formation of Y-B or Y-C chemical compounds could be the reason why the interfaces are stabilized. By comparing the experimentally obtained angular variation of the characteristic photoemission with theoretical calculations, the depth distribution of each component element can be interpreted.
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Affiliation(s)
- M Y Wu
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
| | - Q S Huang
- Key Laboratory of Advanced Micro-Structured Materials MOE, Institute of Precision Optical Engineering, School of Physics Science and Engineering, Tongji University, Shanghai 200092, People's Republic of China
| | - K Le Guen
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
| | - V Ilakovac
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
| | - B X Li
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
| | - Z S Wang
- Key Laboratory of Advanced Micro-Structured Materials MOE, Institute of Precision Optical Engineering, School of Physics Science and Engineering, Tongji University, Shanghai 200092, People's Republic of China
| | - A Giglia
- CNR, Istituto Officina Materiali, 34149 Trieste, Italy
| | - J P Rueff
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
| | - P Jonnard
- Laboratoire de Chimie Physique - Matière et Rayonnement, Sorbonne University, UMR CNRS 7614, 4 Place Jussieu, 75005 Paris, France
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28
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Khieu TQT, Pierse N, Telfar-Barnard LF, Zhang J, Huang QS, Baker MG. Modelled seasonal influenza mortality shows marked differences in risk by age, sex, ethnicity and socioeconomic position in New Zealand. J Infect 2017; 75:225-233. [PMID: 28579304 DOI: 10.1016/j.jinf.2017.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/06/2017] [Accepted: 05/24/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Influenza is responsible for a large number of deaths which can only be estimated using modelling methods. Such methods have rarely been applied to describe the major socio-demographic characteristics of this disease burden. METHODS We used quasi Poisson regression models with weekly counts of deaths and isolates of influenza A, B and respiratory syncytial virus for the period 1994 to 2008. RESULTS The estimated average mortality rate was 13.5 per 100,000 people which was 1.8% of all deaths in New Zealand. Influenza mortality differed markedly by age, sex, ethnicity and socioeconomic position. Relatively vulnerable groups were males aged 65-79 years (Rate ratio (RR) = 1.9, 95% CI: 1.9, 1.9 compared with females), Māori (RR = 3.6, 95% CI: 3.6, 3.7 compared with European/Others aged 65-79 years), Pacific (RR = 2.4, 95% CI: 2.4, 2.4 compared with European/Others aged 65-79 years) and those living in the most deprived areas (RR = 1.8, 95% CI: 1.3, 2.4) for New Zealand Deprivation (NZDep) 9&10 (the most deprived) compared with NZDep 1&2 (the least deprived). CONCLUSIONS These results support targeting influenza vaccination and other interventions to the most vulnerable groups, in particular Māori and Pacific people and men aged 65-79 years and those living in the most deprived areas.
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Affiliation(s)
- Trang Q T Khieu
- Department of Public Health, University of Otago, Wellington, New Zealand; Health Environment Management Agency, Ministry of Health of Viet Nam, Ha Noi, Viet Nam.
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | - Jane Zhang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Q Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science & Research, Wellington, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
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29
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Cowling BJ, Caini S, Chotpitayasunondh T, Djauzi S, Gatchalian SR, Huang QS, Koul PA, Lee PI, Muttalif AR, Plotkin S. Influenza in the Asia-Pacific region: Findings and recommendations from the Global Influenza Initiative. Vaccine 2017; 35:856-864. [PMID: 28081970 DOI: 10.1016/j.vaccine.2016.12.064] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/15/2016] [Accepted: 12/28/2016] [Indexed: 11/28/2022]
Abstract
The fourth roundtable meeting of the Global Influenza Initiative (GII) was held in Hong Kong, China, in July 2015. An objective of this meeting was to gain a broader understanding of the epidemiology, surveillance, vaccination policies and programs, and obstacles to vaccination of influenza in the Asia-Pacific region through presentations of data from Australia, Hong Kong, India, Indonesia, Malaysia, New Zealand, the Philippines, Taiwan, Thailand, and Vietnam. As well as a need for improved levels of surveillance in some areas, a range of factors were identified that act as barriers to vaccination in some countries, including differences in climate and geography, logistical challenges, funding, lack of vaccine awareness and education, safety concerns, perceived lack of vaccine effectiveness, and lack of inclusion in national guidelines. From the presentations at the meeting, the GII discussed a number of recommendations for easing the burden of influenza and overcoming the current challenges in the Asia-Pacific region. These recommendations encompass the need to improve surveillance and availability of epidemiological data; the development and publication of national guidelines, where not currently available and/or that are in line with those proposed by the World Health Organization; the requirement for optimal timing of vaccination programs according to local or country-specific epidemiology; and calls for advocacy and government support of vaccination programs in order to improve availability and uptake and coverage. In conclusion, in addition to the varied epidemiology of seasonal influenza across this diverse region, there are a number of logistical and resourcing issues that present a challenge to the development of optimally effective vaccination strategies and that need to be overcome to improve access to and uptake of seasonal influenza vaccines. The GII has developed a number of recommendations to address these challenges and improve the control of influenza.
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Affiliation(s)
- Benjamin J Cowling
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Saverio Caini
- NIVEL, Dutch Institute for Health Services Research, Utrecht, The Netherlands
| | - Tawee Chotpitayasunondh
- Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand
| | | | - Salvacion R Gatchalian
- University of the Philippines Manila, College of Medicine, Philippine General Hospital, Manila City, Philippines
| | - Q Sue Huang
- Institute of Environmental Science and Research (ESR), Wallaceville, Upper Hutt, New Zealand
| | - Parvaiz A Koul
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Ping-Ing Lee
- National Taiwan University Children's Hospital, Taipei, Taiwan
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30
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Harrower J, Kiedrzynski T, Baker S, Upton A, Rahnama F, Sherwood J, Huang QS, Todd A, Pulford D. Sexual Transmission of Zika Virus and Persistence in Semen, New Zealand, 2016. Emerg Infect Dis 2016; 22:1855-7. [PMID: 27454745 PMCID: PMC5038405 DOI: 10.3201/eid2210.160951] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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31
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Caini S, Huang QS, Ciblak MA, Kusznierz G, Owen R, Wangchuk S, Henriques CMP, Njouom R, Fasce RA, Yu H, Feng L, Zambon M, Clara AW, Kosasih H, Puzelli S, Kadjo HA, Emukule G, Heraud JM, Ang LW, Venter M, Mironenko A, Brammer L, Mai LTQ, Schellevis F, Plotkin S, Paget J. Epidemiological and virological characteristics of influenza B: results of the Global Influenza B Study. Influenza Other Respir Viruses 2016; 9 Suppl 1:3-12. [PMID: 26256290 PMCID: PMC4549097 DOI: 10.1111/irv.12319] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Literature on influenza focuses on influenza A, despite influenza B having a large public health impact. The Global Influenza B Study aims to collect information on global epidemiology and burden of disease of influenza B since 2000. METHODS Twenty-six countries in the Southern (n = 5) and Northern (n = 7) hemispheres and intertropical belt (n = 14) provided virological and epidemiological data. We calculated the proportion of influenza cases due to type B and Victoria and Yamagata lineages in each country and season; tested the correlation between proportion of influenza B and maximum weekly influenza-like illness (ILI) rate during the same season; determined the frequency of vaccine mismatches; and described the age distribution of cases by virus type. RESULTS The database included 935 673 influenza cases (2000-2013). Overall median proportion of influenza B was 22·6%, with no statistically significant differences across seasons. During seasons where influenza B was dominant or co-circulated (>20% of total detections), Victoria and Yamagata lineages predominated during 64% and 36% of seasons, respectively, and a vaccine mismatch was observed in ≈25% of seasons. Proportion of influenza B was inversely correlated with maximum ILI rate in the same season in the Northern and (with borderline significance) Southern hemispheres. Patients infected with influenza B were usually younger (5-17 years) than patients infected with influenza A. CONCLUSION Influenza B is a common disease with some epidemiological differences from influenza A. This should be considered when optimizing control/prevention strategies in different regions and reducing the global burden of disease due to influenza.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Gabriela Kusznierz
- Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni, Santa Fe, Argentina
| | - Rhonda Owen
- Department of Health and Ageing, Influenza Surveillance Section, Surveillance Branch, Office of Health Protection, Woden, ACT, Australia
| | - Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | | | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Rodrigo A Fasce
- Sección de Virus Respiratorios y Exantemáticos, Instituto de Salud Pública de Chile, Santiago de Chile, Chile
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maria Zambon
- Respiratory Virus Unit, Public Health England, Colindale, UK
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Herman Kosasih
- US Naval Medical Research Unit No. 2, Jakarta, Indonesia
| | - Simona Puzelli
- National Influenza Center, Istituto Superiore Sanità, Rome, Italy
| | - Herve A Kadjo
- Respiratory Viruses Unit, Pasteur Institute of Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Gideon Emukule
- US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore
| | - Marietjie Venter
- Global Disease Detection, US-CDC, Pretoria, South Africa.,Zoonoses Research Unit, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Alla Mironenko
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Kiev, Ukraine
| | - Lynnette Brammer
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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32
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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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33
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Bissielo A, Pierse N, Huang QS, Thompson MG, Kelly H, Mishin VP, Turner N. Effectiveness of seasonal influenza vaccine in preventing influenza primary care visits and hospitalisation in Auckland, New Zealand in 2015: interim estimates. Euro Surveill 2016; 21:30101. [DOI: 10.2807/1560-7917.es.2016.21.1.30101] [Citation(s) in RCA: 10] [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] [Received: 12/01/2015] [Accepted: 12/22/2015] [Indexed: 11/20/2022] Open
Abstract
Preliminary results for influenza vaccine effectiveness (VE) against acute respiratory illness with circulating laboratory-confirmed influenza viruses in New Zealand from 27 April to 26 September 2015, using a case test-negative design were 36% (95% confidence interval (CI): 11–54) for general practice encounters and 50% (95% CI: 20–68) for hospitalisations. VE against hospitalised influenza A(H3N2) illnesses was moderate at 53% (95% CI: 6–76) but improved compared with previous seasons.
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Affiliation(s)
- A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - QS Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - MG Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
| | - VP Mishin
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States
| | - N Turner
- University of Auckland, Auckland, New Zealand
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34
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Taylor E, Haven K, Reed P, Bissielo A, Harvey D, McArthur C, Bringans C, Freundlich S, Ingram RJH, Perry D, Wilson F, Milne D, Modahl L, Huang QS, Gross D, Widdowson MA, Grant CC. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study. BMC Med Imaging 2015; 15:61. [PMID: 26714630 PMCID: PMC4696329 DOI: 10.1186/s12880-015-0103-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 12/16/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity scoring system. METHODS We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes. Initially, four radiologists scored CXRs independently. Subsequently, a pediatrician, physician, two residents, two medical students, and a research nurse independently scored CXR reports. Inter-observer reliability was determined using a weighted Kappa (κ) for comparisons between radiologists; radiologists and clinicians; and clinicians. Agreement was defined as moderate (κ > 0.4-0.6), good (κ > 0.6-0.8) and very good (κ > 0.8-1.0). RESULTS Agreement between the two pediatric radiologists was very good (κ = 0.83, 95% CI 0.65-1.00) and between the two adult radiologists was good (κ = 0.75, 95% CI 0.57-0. 93). Agreement of the clinicians with the radiologists was moderate-to-good (pediatrician:κ = 0.65; pediatric resident:κ = 0.69; physician:κ = 0.68; resident:κ = 0.67; research nurse:κ = 0.49, medical students: κ = 0.53 and κ = 0.56). Agreement between clinicians was good-to-very good (pediatrician vs. physician:κ = 0.85; vs. pediatric resident:κ = 0.81; vs. medicine resident:κ = 0.76; vs. research nurse:κ = 0.75; vs. medical students:κ = 0.63 and 0.66). Following review of discrepant CXR report scores by clinician pairs, κ values for radiologist-clinician agreement ranged from 0.59 to 0.70 and for clinician-clinician agreement from 0.97 to 0.99. CONCLUSIONS This five-point CXR scoring tool, suitable for use in poorly- and well-resourced settings and by clinicians of varying experience levels, reliably describes SARI severity. The resulting numerical data enables epidemiological comparisons of SARI severity between different countries and settings.
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Affiliation(s)
- Emma Taylor
- Starship Children's Hospital, Auckland, New Zealand
| | - Kathryn Haven
- The SHIVERS study, Auckland and Wellington, New Zealand
| | - Peter Reed
- Children's Research Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Ange Bissielo
- The SHIVERS study, Auckland and Wellington, New Zealand.,Institute of Environmental Science and Research, Wellington, New Zealand
| | - Dave Harvey
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Colin McArthur
- The SHIVERS study, Auckland and Wellington, New Zealand.,Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | | | | | - R Joan H Ingram
- Infectious Diseases, Auckland City Hospital, Auckland, New Zealand
| | - David Perry
- Radiology, Starship Children's Hospital, Auckland, New Zealand
| | | | - David Milne
- Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Lucy Modahl
- Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Q Sue Huang
- The SHIVERS study, Auckland and Wellington, New Zealand.,Infectious Diseases, Auckland City Hospital, Auckland, New Zealand
| | - Diane Gross
- Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | | | - Cameron C Grant
- Starship Children's Hospital, Auckland, New Zealand. .,The SHIVERS study, Auckland and Wellington, New Zealand. .,University of Auckland, Auckland, New Zealand. .,Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Wellesley Street, Auckland, 1142, New Zealand.
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35
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Pierse N, Kelly H, Thompson MG, Bissielo A, Radke S, Huang QS, Baker MG, Turner N. Influenza vaccine effectiveness for hospital and community patients using control groups with and without non-influenza respiratory viruses detected, Auckland, New Zealand 2014. Vaccine 2015; 34:503-509. [PMID: 26685091 DOI: 10.1016/j.vaccine.2015.11.073] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 08/12/2015] [Revised: 11/26/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND We aimed to estimate the protection afforded by inactivated influenza vaccine, in both community and hospital settings, in a well characterised urban population in Auckland during 2014. METHODS We used two different comparison groups, all patients who tested negative for influenza and only those patients who tested negative for influenza and had a non-influenza respiratory virus detected, to calculate the vaccine effectiveness in a test negative study design. Estimates were made separately for general practice outpatient consultations and hospitalised patients, stratified by age group and by influenza type and subtype. Vaccine status was confirmed by electronic record for general practice patients and all respiratory viruses were detected by real time polymerase chain reaction. RESULTS 1039 hospitalised and 1154 general practice outpatient consultations met all the study inclusion criteria and had a respiratory sample tested for influenza and other respiratory viruses. Compared to general practice patients, hospitalised patients were more likely to be very young or very old, to be Māori or Pacific Islander, to have a low income and to suffer from chronic disease. Vaccine effectiveness (VE) adjusted for age and other participant characteristics using all influenza negative controls was 42% (95% CI: 16 to 60%) for hospitalised and 56% (95% CI: 35 to 70%) for general practice patients. The vaccine appeared to be most effective against the influenza A(H1N1)pdm09 strain with an adjusted VE of 62% (95% CI:38 to 77%) for hospitalised and 59% (95% CI:36 to 74%) for general practice patients, using influenza virus negative controls. Similar results found when patients testing positive for a non-influenza respiratory virus were used as the control group. CONCLUSION This study contributes to validation of the test negative design and confirms that inactivated influenza vaccines continue to provide modest but significant protection against laboratory-confirmed influenza.
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Affiliation(s)
- Nevil Pierse
- The University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
| | - Heath Kelly
- The Australian National University, Canberra 0200, ACT Australia; Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia.
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Ange Bissielo
- Institute of Environmental Science and Research, Upper Hutt Wellington, New Zealand.
| | - Sarah Radke
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand.
| | - Q Sue Huang
- Institute of Environmental Science and Research, Upper Hutt Wellington, New Zealand.
| | - Michael G Baker
- The University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
| | - Nikki Turner
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand.
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36
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Khieu TQ, Pierse N, Telfar-Barnard LF, Huang QS, Baker MG. Estimating the contribution of influenza to hospitalisations in New Zealand from 1994 to 2008. Vaccine 2015; 33:4087-92. [DOI: 10.1016/j.vaccine.2015.06.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/08/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
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Affiliation(s)
- Angela Todd
- Institute of Environmental Science and Research Limited, National Centre for Biosecurity and Infectious Disease, Wallaceville, Upper Hutt, New Zealand
| | - Susan Taylor
- Middlemore Hospital, Otahuhu, Auckland, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited, National Centre for Biosecurity and Infectious Disease, Wallaceville, Upper Hutt, New Zealand
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38
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Vijaykrishna D, Holmes EC, Joseph U, Fourment M, Su YCF, Halpin R, Lee RTC, Deng YM, Gunalan V, Lin X, Stockwell TB, Fedorova NB, Zhou B, Spirason N, Kühnert D, Bošková V, Stadler T, Costa AM, Dwyer DE, Huang QS, Jennings LC, Rawlinson W, Sullivan SG, Hurt AC, Maurer-Stroh S, Wentworth DE, Smith GJD, Barr IG. The contrasting phylodynamics of human influenza B viruses. eLife 2015; 4:e05055. [PMID: 25594904 PMCID: PMC4383373 DOI: 10.7554/elife.05055] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [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: 10/06/2014] [Accepted: 01/15/2015] [Indexed: 11/13/2022] Open
Abstract
A complex interplay of viral, host, and ecological factors shapes the spatio-temporal incidence and evolution of human influenza viruses. Although considerable attention has been paid to influenza A viruses, a lack of equivalent data means that an integrated evolutionary and epidemiological framework has until now not been available for influenza B viruses, despite their significant disease burden. Through the analysis of over 900 full genomes from an epidemiological collection of more than 26,000 strains from Australia and New Zealand, we reveal fundamental differences in the phylodynamics of the two co-circulating lineages of influenza B virus (Victoria and Yamagata), showing that their individual dynamics are determined by a complex relationship between virus transmission, age of infection, and receptor binding preference. In sum, this work identifies new factors that are important determinants of influenza B evolution and epidemiology.
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Affiliation(s)
| | - Edward C Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Udayan Joseph
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Mathieu Fourment
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Yvonne C F Su
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | | | - Raphael T C Lee
- Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | - Yi-Mo Deng
- World Health Organisation Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Vithiagaran Gunalan
- Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | - Xudong Lin
- J Craig Venter Institute, Rockville, United States
| | | | | | - Bin Zhou
- J Craig Venter Institute, Rockville, United States
| | - Natalie Spirason
- World Health Organisation Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Denise Kühnert
- Department of Environmental Systems Science, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
| | - Veronika Bošková
- Department of Biosystems Science and Engineering, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | | | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital and University of Sydney, Westmead, Australia
| | - Q Sue Huang
- Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Upper Hutt, New Zealand
| | - Lance C Jennings
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand
| | - William Rawlinson
- Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia
| | - Sheena G Sullivan
- World Health Organisation Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Aeron C Hurt
- World Health Organisation Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Sebastian Maurer-Stroh
- Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | | | | | - Ian G Barr
- World Health Organisation Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014; 19:20934. [PMID: 25358042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
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Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
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40
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Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H, on behalf of the SHIVERS investigation team C. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.42.20934] [Citation(s) in RCA: 13] [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: 11/20/2022] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
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Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Thompson
- Influenza Division, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
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41
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Turner N, Pierse N, Bissielo A, Huang QS, Radke S, Baker M, Widdowson MA, Kelly H. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill 2014; 19:20884. [PMID: 25188614 PMCID: PMC4627593] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
This study reports the first vaccine effectiveness (VE) estimates for the prevention of general practice visits and hospitalisations for laboratory-confirmed influenza from an urban population in Auckland, New Zealand, in the same influenza season (2013). A case test-negative design was used to estimate propensity-adjusted VE in both hospital and community settings. Patients with a severe acute respiratory infection (SARI) or influenza-like illness (ILI) were defined as requiring hospitalisation (SARI) or attending a general practice (ILI) with a history of fever or measured temperature ≥38 °C, cough and onset within the past 10 days. Those who tested positive for influenza virus were cases while those who tested negative were controls. Results were analysed to 7 days post symptom onset and adjusted for the propensity to be vaccinated and the timing during the influenza season. Influenza vaccination provided 52% (95% CI: 32 to 66) protection against laboratory-confirmed influenza hospitalisation and 56% (95% CI: 34 to 70) against presenting to general practice with influenza. VE estimates were similar for all types and subtypes. This study found moderate effectiveness of influenza vaccine against medically attended and hospitalised influenza in New Zealand, a temperate, southern hemisphere country during the 2013 winter season.
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Affiliation(s)
- Nikki Turner
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand
| | - Nevil Pierse
- The University of Otago, Wellington, PO Box 7343 Wellington South 6242, New Zealand
| | - Ange Bissielo
- Institute of Environmental Science and Research, PO Box Box 40-158 Upper Hutt 5140 Wellington, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research, PO Box Box 40-158 Upper Hutt 5140 Wellington, New Zealand
| | - Sarah Radke
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand
| | - Michael Baker
- The University of Otago, Wellington, PO Box 7343 Wellington South 6242, New Zealand
| | | | - Heath Kelly
- The Australian National University, Canberra, ACT 0200 Australia and the Victorian Infectious Diseases Reference Laboratory, 10 Wrecklyn St, North Menbourne VIC 3051 Melbourne, Australia
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42
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Turner N, Pierse N, Bissielo A, Huang QS, Radke S, Baker MG, Widdowson MA, Kelly H, on behalf of the SHIVERS investigation team C. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.34.20884] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Baker
- University of Otago, Wellington, New Zealand
| | - M A Widdowson
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
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43
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Turner N, Pierse N, Bissielo A, Huang QS, Baker MG, Widdowson MA, Kelly H. The effectiveness of seasonal trivalent inactivated influenza vaccine in preventing laboratory confirmed influenza hospitalisations in Auckland, New Zealand in 2012. Vaccine 2014; 32:3687-93. [PMID: 24768730 DOI: 10.1016/j.vaccine.2014.04.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 11/05/2013] [Revised: 03/24/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Few studies report the effectiveness of trivalent inactivated influenza vaccine (TIV) in preventing hospitalisation for influenza-confirmed respiratory infections. Using a prospective surveillance platform, this study reports the first such estimate from a well-defined ethnically diverse population in New Zealand (NZ). METHODS A case test-negative design was used to estimate propensity adjusted vaccine effectiveness. Patients with a severe acute respiratory infection (SARI), defined as a patient of any age requiring hospitalisation with a history of a fever or a measured temperature ≥38°C and cough and onset within the past 7 days, admitted to public hospitals in South and Central Auckland were eligible for inclusion in the study. Cases were SARI patients who tested positive for influenza, while non-cases (controls) were SARI patients who tested negative. Results were adjusted for the propensity to be vaccinated and the timing of the influenza season. RESULTS The propensity and season adjusted vaccine effectiveness (VE) was estimated as 39% (95% CI 16;56). The VE point estimate against influenza A (H1N1) was lower than for influenza B or influenza A (H3N2) but confidence intervals were wide and overlapping. Estimated VE was 59% (95% CI 26;77) in patients aged 45-64 years but only 8% (-78;53) in those aged 65 years and above. CONCLUSION Prospective surveillance for SARI has been successfully established in NZ. This study for the first year, the 2012 influenza season, has shown low to moderate protection by TIV against influenza positive hospitalisation.
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Affiliation(s)
- Nikki Turner
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand.
| | - Nevil Pierse
- The University of Otago, PO Box 7343 Wellington South 6242, Wellington, New Zealand.
| | - Ange Bissielo
- Institute of Environmental Science and Research, PO Box 40-158 Upper Hutt 5140, Wellington, New Zealand.
| | - Q Sue Huang
- Institute of Environmental Science and Research, PO Box 40-158 Upper Hutt 5140, Wellington, New Zealand.
| | - Michael G Baker
- The University of Otago, PO Box 7343 Wellington South 6242, Wellington, New Zealand.
| | | | - Heath Kelly
- The Australian National University, Canberra 0200, ACT, Australia; Victorian Infectious Diseases Reference Laboratory, 10 Wrecklyn St., North Melbourne, 3051 Melbourne, VIC, Australia.
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Peacey M, Hall RJ, Wang J, Todd AK, Yen S, Chan-Hyams J, Rand CJ, Stanton JA, Huang QS. Enterovirus 74 infection in children. PLoS One 2013; 8:e76492. [PMID: 24098514 PMCID: PMC3788726 DOI: 10.1371/journal.pone.0076492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022] Open
Abstract
Enterovirus 74 (EV74) is a rarely detected viral infection of children. In 2010, EV74 was identified in New Zealand in a 2 year old child with acute flaccid paralysis (AFP) through routine polio AFP surveillance. A further three cases of EV74 were identified in children within six months. These cases are the first report of EV74 in New Zealand. In this study we describe the near complete genome sequence of four EV74 isolates from New Zealand, which shows only limited sequence identity in the non-structural proteins when compared to the other two known EV74 sequences. As is typical of enteroviruses multiple recombination events were evident, particularly in the P2 region and P3 regions. This is the first complete EV74 genome sequenced from a patient with acute flaccid paralysis.
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Affiliation(s)
- Matthew Peacey
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
- * E-mail:
| | - Richard J. Hall
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
| | - Jing Wang
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
| | - Angela K. Todd
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
| | - Seiha Yen
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
| | - Jasmine Chan-Hyams
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
| | - Christy J. Rand
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Jo-Ann Stanton
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Q. Sue Huang
- Clinical Virology, The Institute of Environmental Science and Research, National Centre for Biosecurity and Infectious Disease, Wellington, New Zealand
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Hall RJ, Wang J, Todd AK, Bissielo AB, Yen S, Strydom H, Moore NE, Ren X, Huang QS, Carter PE, Peacey M. Evaluation of rapid and simple techniques for the enrichment of viruses prior to metagenomic virus discovery. J Virol Methods 2013; 195:194-204. [PMID: 24036074 PMCID: PMC7113663 DOI: 10.1016/j.jviromet.2013.08.035] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/26/2013] [Accepted: 08/29/2013] [Indexed: 02/06/2023]
Abstract
The effect of simple virus enrichment methods were tested on a metagenomics dataset. Centrifugation, filtration or nuclease-treatment was evaluated. A multi-step enrichment method increased the proportion of virus sequences. This evaluation guides researchers in their choice of enrichment methodology.
The discovery of new or divergent viruses using metagenomics and high-throughput sequencing has become more commonplace. The preparation of a sample is known to have an effect on the representation of virus sequences within the metagenomic dataset yet comparatively little attention has been given to this. Physical enrichment techniques are often applied to samples to increase the number of viral sequences and therefore enhance the probability of detection. With the exception of virus ecology studies, there is a paucity of information available to researchers on the type of sample preparation required for a viral metagenomic study that seeks to identify an aetiological virus in an animal or human diagnostic sample. A review of published virus discovery studies revealed the most commonly used enrichment methods, that were usually quick and simple to implement, namely low-speed centrifugation, filtration, nuclease-treatment (or combinations of these) which have been routinely used but often without justification. These were applied to a simple and well-characterised artificial sample composed of bacterial and human cells, as well as DNA (adenovirus) and RNA viruses (influenza A and human enterovirus), being either non-enveloped capsid or enveloped viruses. The effect of the enrichment method was assessed by both quantitative real-time PCR and metagenomic analysis that incorporated an amplification step. Reductions in the absolute quantities of bacteria and human cells were observed for each method as determined by qPCR, but the relative abundance of viral sequences in the metagenomic dataset remained largely unchanged. A 3-step method of centrifugation, filtration and nuclease-treatment showed the greatest increase in the proportion of viral sequences. This study provides a starting point for the selection of a purification method in future virus discovery studies, and highlights the need for more data to validate the effect of enrichment methods on different sample types, amplification, bioinformatics approaches and sequencing platforms. This study also highlights the potential risks that may attend selection of a virus enrichment method without any consideration for the sample type being investigated.
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Affiliation(s)
- Richard J Hall
- Institute of Environmental Science and Research, at the National Centre for Biosecurity & Infectious Disease, 66 Ward Street, Wallaceville, Upper Hutt 5018, New Zealand.
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Trauer JM, Bandaranayake D, Booy R, Chen MI, Cretikos M, Dowse GK, Dwyer DE, Greenberg ME, Huang QS, Khandaker G, Kok J, Laurie KL, Lee VJ, McVernon J, Walter S, Markey PG. Seroepidemiologic effects of influenza A(H1N1)pdm09 in Australia, New Zealand, and Singapore. Emerg Infect Dis 2013; 19:92-101. [PMID: 23260059 PMCID: PMC3557971 DOI: 10.3201/eid1901.111643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To estimate population attack rates of influenza A(H1N1)pdm2009 in the Southern Hemisphere during June-August 2009, we conducted several serologic studies. We pooled individual-level data from studies using hemagglutination inhibition assays performed in Australia, New Zealand, and Singapore. We determined seropositive proportions (titer ≥40) for each study region by age-group and sex in pre- and postpandemic phases, as defined by jurisdictional notification data. After exclusions, the pooled database consisted of, 4,414 prepandemic assays and 7,715 postpandemic assays. In the prepandemic phase, older age groups showed greater seropositive proportions, with age-standardized, community-based proportions ranging from 3.5% in Singapore to 11.9% in New Zealand. In the postpandemic phase, seropositive proportions ranged from 17.5% in Singapore to 30.8% in New Zealand, with highest proportions seen in school-aged children. Pregnancy and residential care were associated with lower postpandemic seropositivity, whereas Aboriginal and Torres Strait Islander Australians and Pacific Peoples of New Zealand had greater postpandemic seropositivity.
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Affiliation(s)
- James M Trauer
- Melbourne Sleep Disorders Centre, East Melbourne, Victoria, Australia.
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Todd AK, Hall RJ, Wang J, Peacey M, McTavish S, Rand CJ, Stanton JA, Taylor S, Huang QS. Detection and whole genome sequence analysis of an enterovirus 68 cluster. Virol J 2013; 10:103. [PMID: 23548106 PMCID: PMC3621541 DOI: 10.1186/1743-422x-10-103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
Background Enteroviruses are a common cause of human disease and are associated with a wide range of clinical manifestations. Enterovirus 68 is rarely detected yet was reported in many countries in 2010. Here enterovirus 68 was identified for the first time in New Zealand in 2010 and was detected in a further fourteen specimens over a six month period. Objectives To genetically characterise enterovirus 68 specimens identified in New Zealand in 2010. Study design The genome sequence of a New Zealand representative enterovirus 68 isolate was obtained. Ten clinical specimens were analysed by sequencing the VP1 region of the enterovirus 68 genome. Results Based on sequence analysis of the VP1 region and the full genome of one representative isolate, the New Zealand enterovirus 68 isolates clustered with contemporary enterovirus 68 viruses and do not show any clear distinguishing genetic diversity when compared to other strains. All fifteen specimens showed high similarity with enterovirus 68 by VP1 sequencing. The majority of New Zealand patients suffered from bronchiolitis, were less than two years of age and were of Pacific Island or Maori descent. Conclusions We document the rare occurrence of an enterovirus 68 cluster in New Zealand in 2010. These viruses shared similarity with other clusters of enterovirus 68 that occurred globally in 2010. A greater awareness in enterovirus 68 infection may help detect this virus with increased frequency and enable us to better understand the role this strain plays in disease and the reasons behind this global emergence in 2010.
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Affiliation(s)
- Angela K Todd
- Institute of Environmental Science and Research Limited, National Centre for Biosecurity and Infectious Disease, 66 Ward Street, Wallaceville, Upper Hutt 5018, New Zealand.
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Williamson DA, Huang QS, Roberts SA, Grant CC, McArthur C, Baker MG. Surveillance for influenza using hospital discharge data may underestimate the burden of influenza-related hospitalization. Infect Control Hosp Epidemiol 2013; 33:1064-6. [PMID: 22961034 DOI: 10.1086/667742] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Leang SK, Deng YM, Shaw R, Caldwell N, Iannello P, Komadina N, Buchy P, Chittaganpitch M, Dwyer DE, Fagan P, Gourinat AC, Hammill F, Horwood PF, Huang QS, Ip PK, Jennings L, Kesson A, Kok T, Kool JL, Levy A, Lin C, Lindsay K, Osman O, Papadakis G, Rahnamal F, Rawlinson W, Redden C, Ridgway J, Sam IC, Svobodova S, Tandoc A, Wickramasinghe G, Williamson J, Wilson N, Yusof MA, Kelso A, Barr IG, Hurt AC. Influenza antiviral resistance in the Asia-Pacific region during 2011. Antiviral Res 2012; 97:206-10. [PMID: 23274624 DOI: 10.1016/j.antiviral.2012.12.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/05/2012] [Accepted: 12/12/2012] [Indexed: 11/30/2022]
Abstract
Despite greater than 99% of influenza A viruses circulating in the Asia-Pacific region being resistant to the adamantane antiviral drugs in 2011, the large majority of influenza A (>97%) and B strains (∼99%) remained susceptible to the neuraminidase inhibitors oseltamivir and zanamivir. However, compared to the first year of the 2009 pandemic, cases of oseltamivir-resistant A(H1N1)pdm09 viruses with the H275Y neuraminidase mutation increased in 2011, primarily due to an outbreak of oseltamivir-resistant viruses that occurred in Newcastle, as reported in Hurt et al. (2011c, 2012a), where the majority of the resistant viruses were from community patients not being treated with oseltamivir. A small number of influenza B viruses with reduced oseltamivir or zanamivir susceptibility were also detected. The increased detection of neuraminidase inhibitor resistant strains circulating in the community and the detection of novel variants with reduced susceptibility are reminders that monitoring of influenza viruses is important to ensure that antiviral treatment guidelines remain appropriate.
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Affiliation(s)
- Sook-Kwan Leang
- WHO Collaborating Centre for Reference and Research on Influenza, North Melbourne, Victoria, Australia
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Wu AM, Wang XY, Chi YL, Xu HZ, Weng W, Huang QS, Ni WF. Management of acute combination atlas-axis fractures with percutaneous triple anterior screw fixation in elderly patients. Orthop Traumatol Surg Res 2012; 98:894-9. [PMID: 23158783 DOI: 10.1016/j.otsr.2012.09.006] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/22/2012] [Accepted: 09/07/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Patients with combined C1-2 fractures were often treated by posterior arthrodesis. However, elderly patients with multiple injuries (such as brain injury), the large surgical trauma of posterior arthrodesis will increase the risk of perioperative mortality. A minimally invasive technique may be better for them, and decrease the risk of perioperative mortality. MATERIALS AND METHODS Seven patients with combined C1-2 fractures underwent percutaneous anterior odontoid screw and anterior C1-2 transarticular screws (percutaneous triple anterior screws fixation). The surgical technique of percutaneous triple anterior screws fixation is described. RESULTS The operation performed on all patients successfully without technical difficulties, and no intra-operative surgery-related complications such as vertebral artery, nerve injury and soft tissue complications occurred. No pullout, loosening, or breakage of internal screws was observed. C1/2 stable was found in all cases and radiographic union achieved in all odontoid fractures. CONCLUSION Using the appropriate instruments allied to intra-operative image-intensification, we suggest that percutaneous triple anterior screw fixation is reliable, effective and minimally invasive procedure for elderly and brain injured patients suffering of combined atlas-axis fractures. LEVEL OF EVIDENCE Level IV. Retrospective study.
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Affiliation(s)
- A M Wu
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, #109 XueYuan Western Road, WenZhou, ZheJiang, China.
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