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Prasert K, Praphasiri P, Lerdsamran H, Nakphook S, Ditsungnoen D, Chawalchitiporn S, Sornwong K, Poopipatpol K, Wirachwong P, Narakorn P, Surichan S, Suthepakul N, Thangsupanimitchai N, Pittayawonganon C, Puthavathana P, Davis WW, Mott JA, Olsen SJ, Patumanond J. Safety and immunogenicity of locally produced trivalent inactivated influenza vaccine (Tri Fluvac) in healthy Thai adults aged 18-64 years in Nakhon Phanom: A Phase III double blinded, three-arm, randomized, controlled trial. Vaccine 2024; 42:24-32. [PMID: 38042698 PMCID: PMC10733862 DOI: 10.1016/j.vaccine.2023.11.050] [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: 08/27/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Domestic influenza vaccine production facilitates a sustainable supply for mitigating seasonal influenza and improves national health security by providing infrastructure and experience for pandemic vaccine production, if needed. METHODS A Phase III, double blind, randomized controlled trial was conducted from Sep 2019-Oct 2020 in healthy adults 18-64 years in Nakhon Phanom, Thailand. Randomization (3:3:1) compared study vaccine (Tri Fluvac), saline placebo, and an active comparator (licensed vaccine). Primary outcomes were superior efficacy compared to placebo based on RT-PCR-confirmed influenza virus infection within 12 months and non-inferiority compared to active comparator based on immunogenicity (HAI assay) at 28 days. Safety was also assessed. RESULTS The trial enrolled 4,284 participants (Tri Fluvac = 1,836; placebo = 1,836; active comparator = 612). There were 29 RT-PCR positive influenza infections (10 Tri Fluvac, 5.5/1,000 PY; 19 placebo, 10.4/1,000PY; 0 comparator) for an absolute protective efficacy of 46.4 (95 % CI = -22.0-76.5) compared with placebo, but the power was 43.7 %. Seroconversion difference rates between Tri Fluvac and comparator at Day 28 were 1.74 (95 % CI: -2.77, 6.25), 2.22 (-2.40, 6.84), and -0.57 (-5.41, 4.27) for A(H1N1), A(H3N2), and B strains, respectively. Adverse and severe adverse events occurred in 175 (9.5 %) Tri Fluvac, 177 (10.8 %) placebo, and 66 (10.8 %) comparator arms (p-value = 0.437, Tri Fluvac vs. comparator) CONCLUSIONS: Tri Fluvac was well tolerated, and immunogenicity was non-inferior to the active comparator, meeting U.S. Food and Drug Administration (FDA) criteria for adult vaccine licensure. Few acute respiratory infections were reported during intense COVID-19 pandemic restrictions, resulting in insufficient power to evaluate clinical efficacy.
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Affiliation(s)
- Kriengkrai Prasert
- Nakhon Phanom Provincial Hospital, Nakhon Phanom, Thailand; Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand
| | - Prabda Praphasiri
- Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand; Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
| | - Hatairat Lerdsamran
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Sutthichai Nakphook
- Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand; Institute of Preventive Medicine, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Darunee Ditsungnoen
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | | | | | | | | | | | - Nava Suthepakul
- Government Pharmaceutical Organization (GPO), Bangkok, Thailand
| | | | - Chakrarat Pittayawonganon
- Institute of Preventive Medicine, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Pilaipan Puthavathana
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - William W Davis
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua A Mott
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jayanton Patumanond
- Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Thailand
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Gharpure R, Olsen SJ, Davis WW. Quantified impacts of non-pharmaceutical interventions on influenza circulation during the COVID-19 pandemic in 13 African countries, 2020-2022. Influenza Other Respir Viruses 2024; 18:e13241. [PMID: 38249442 PMCID: PMC10796249 DOI: 10.1111/irv.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/22/2023] [Accepted: 12/10/2023] [Indexed: 01/23/2024] Open
Abstract
Nonpharmaceutical interventions (NPIs) for SARS-CoV-2 disrupted circulation of influenza. We used data from 13 African countries and generalized linear models to identify associations between levels of NPIs, using the Oxford Stringency Index, and seasonal influenza activity, using parameters derived from 2020-2022 seasonal influenza surveillance. We found that for each step increase in school closings, the average percentage of respiratory specimens testing positive for influenza across the influenza season dropped by 20% (95% CI: 1-38%); no other NPI was significant. These findings may inform interventions to slow influenza circulation in pandemics and possibly during seasonal epidemics.
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Affiliation(s)
- Radhika Gharpure
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Sonja J. Olsen
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - William W. Davis
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Thailand MOPH‐U.S. CDC CollaborationNonthaburiThailand
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Montgomery MP, Morris SE, Rolfes MA, Kittikraisak W, Samuels AM, Biggerstaff M, Davis WW, Reed C, Olsen SJ. The role of asymptomatic infections in influenza transmission: what do we really know. Lancet Infect Dis 2023:S1473-3099(23)00619-9. [PMID: 38128563 DOI: 10.1016/s1473-3099(23)00619-9] [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] [Received: 07/31/2023] [Revised: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 12/23/2023]
Abstract
Before the COVID-19 pandemic, the role of asymptomatic influenza virus infections in influenza transmission was uncertain. However, the importance of asymptomatic infection with SARS-CoV-2 for onward transmission of COVID-19 has led experts to question whether the role of asymptomatic influenza virus infections in transmission had been underappreciated. We discuss the existing evidence on the frequency of asymptomatic influenza virus infections, the extent to which they contribute to infection transmission, and remaining knowledge gaps. We propose priority areas for further evaluation, study designs, and case definitions to address existing knowledge gaps.
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Affiliation(s)
- Martha P Montgomery
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
| | - Sinead E Morris
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa A Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wanitchaya Kittikraisak
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Aaron M Samuels
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William W Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Nguyen DT, Sumner KM, Nguyen TTM, Phan MQ, Hoang TM, Vo CD, Nguyen TD, Nguyen PT, Yang G, Jang Y, Jones J, Olsen SJ, Gould PL, Nguyen LV, Davis CT. Avian influenza A(H5) virus circulation in live bird markets in Vietnam, 2017-2022. Influenza Other Respir Viruses 2023; 17:e13245. [PMID: 38149927 PMCID: PMC10752245 DOI: 10.1111/irv.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A(H5) human infections are a global concern, with many A(H5) human cases detected in Vietnam, including a case in October 2022. Using avian influenza virus surveillance from March 2017-September 2022, we described the percent of pooled samples that were positive for avian influenza A, A(H5), A(H5N1), A(H5N6), and A(H5N8) viruses in live bird markets (LBMs) in Vietnam. METHODS Monthly at each LBM, 30 poultry oropharyngeal swab specimens and five environmental samples were collected. Samples were pooled in groups of five and tested for influenza A, A(H5), A(H5N1), A(H5N6), and A(H5N8) viruses by real-time reverse-transcription polymerase chain reaction. Trends in the percent of pooled samples that were positive for avian influenza were summarized by LBM characteristics and time and compared with the number of passively detected avian influenza outbreaks using Spearman's rank correlation. RESULTS A total of 25,774 pooled samples were collected through active surveillance at 167 LBMs in 24 provinces; 36.9% of pooled samples were positive for influenza A, 3.6% A(H5), 1.9% A(H5N1), 1.1% A(H5N6), and 0.2% A(H5N8). Influenza A(H5) viruses were identified January-December and at least once in 91.7% of sampled provinces. In 246 A(H5) outbreaks in poultry; 20.3% were influenza A(H5N1), 60.2% A(H5N6), and 19.5% A(H5N8); outbreaks did not correlate with active surveillance. CONCLUSIONS In Vietnam, influenza A(H5) viruses were detected by active surveillance in LBMs year-round and in most provinces sampled. In addition to outbreak reporting, active surveillance for A(H5) viruses in settings with high potential for animal-to-human spillover can provide situational awareness.
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Affiliation(s)
| | - Kelsey M. Sumner
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Epidemic Intelligence ServiceCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Thoa T. M. Nguyen
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | | | | | | | - Tho D. Nguyen
- National Center for Veterinary DiagnosisDepartment of Animal HealthHanoiVietnam
| | - Phuong T. Nguyen
- Regional Animal Health Officer Number 6Department of Animal HealthHo Chi Minh CityVietnam
| | - Genyan Yang
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Yunho Jang
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Joyce Jones
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Sonja J. Olsen
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Philip L. Gould
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | | | - Charles Todd Davis
- Influenza Division, National Center for Immunizations and Respiratory DiseaseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
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5
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Szablewski CM, Iwamoto C, Olsen SJ, Greene CM, Duca LM, Davis CT, Coggeshall KC, Davis WW, Emukule GO, Gould PL, Fry AM, Wentworth DE, Dugan VG, Kile JC, Azziz-Baumgartner E. Reported Global Avian Influenza Detections Among Humans and Animals During 2013-2022: Comprehensive Review and Analysis of Available Surveillance Data. JMIR Public Health Surveill 2023; 9:e46383. [PMID: 37651182 PMCID: PMC10502594 DOI: 10.2196/46383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/25/2023] [Accepted: 06/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Avian influenza (AI) virus detections occurred frequently in 2022 and continue to pose a health, economic, and food security risk. The most recent global analysis of official reports of animal outbreaks and human infections with all reportable AI viruses was published almost a decade ago. Increased or renewed reports of AI viruses, especially high pathogenicity H5N8 and H5N1 in birds and H5N1, H5N8, and H5N6 in humans globally, have established the need for a comprehensive review of current global AI virus surveillance data to assess the pandemic risk of AI viruses. OBJECTIVE This study aims to provide an analysis of global AI animal outbreak and human case surveillance information from the last decade by describing the circulating virus subtypes, regions and temporal trends in reporting, and country characteristics associated with AI virus outbreak reporting in animals; surveillance and reporting gaps for animals and humans are identified. METHODS We analyzed AI virus infection reports among animals and humans submitted to animal and public health authorities from January 2013 to June 2022 and compared them with reports from January 2005 to December 2012. A multivariable regression analysis was used to evaluate associations between variables of interest and reported AI virus animal outbreaks. RESULTS From 2013 to 2022, 52.2% (95/182) of World Organisation for Animal Health (WOAH) Member Countries identified 34 AI virus subtypes during 21,249 outbreaks. The most frequently reported subtypes were high pathogenicity AI H5N1 (10,079/21,249, 47.43%) and H5N8 (6722/21,249, 31.63%). A total of 10 high pathogenicity AI and 6 low pathogenicity AI virus subtypes were reported to the WOAH for the first time during 2013-2022. AI outbreaks in animals occurred in 26 more Member Countries than reported in the previous 8 years. Decreasing World Bank income classification was significantly associated with decreases in reported AI outbreaks (P<.001-.02). Between January 2013 and June 2022, 17/194 (8.8%) World Health Organization (WHO) Member States reported 2000 human AI virus infections of 10 virus subtypes. H7N9 (1568/2000, 78.40%) and H5N1 (254/2000, 12.70%) viruses accounted for the most human infections. As many as 8 of these 17 Member States did not report a human case prior to 2013. Of 1953 human cases with available information, 74.81% (n=1461) had a known animal exposure before onset of illness. The median time from illness onset to the notification posted on the WHO event information site was 15 days (IQR 9-30 days; mean 24 days). Seasonality patterns of animal outbreaks and human infections with AI viruses were very similar, occurred year-round, and peaked during November through May. CONCLUSIONS Our analysis suggests that AI outbreaks are more frequently reported and geographically widespread than in the past. Global surveillance gaps include inconsistent reporting from all regions and human infection reporting delays. Continued monitoring for AI virus outbreaks in animals and human infections with AI viruses is crucial for pandemic preparedness.
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Affiliation(s)
- Christine M Szablewski
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Chelsea Iwamoto
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Carolyn M Greene
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lindsey M Duca
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - C Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kira C Coggeshall
- Division of Global Health Protection, Global Health Center, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - William W Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gideon O Emukule
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Philip L Gould
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James C Kile
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
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Igboh LS, Roguski K, Marcenac P, Emukule GO, Charles MD, Tempia S, Herring B, Vandemaele K, Moen A, Olsen SJ, Wentworth DE, Kondor R, Mott JA, Hirve S, Bresee JS, Mangtani P, Nguipdop-Djomo P, Azziz-Baumgartner E. Timing of seasonal influenza epidemics for 25 countries in Africa during 2010-19: a retrospective analysis. Lancet Glob Health 2023; 11:e729-e739. [PMID: 37061311 PMCID: PMC10126228 DOI: 10.1016/s2214-109x(23)00109-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Using country-specific surveillance data to describe influenza epidemic activity could inform decisions on the timing of influenza vaccination. We analysed surveillance data from African countries to characterise the timing of seasonal influenza epidemics to inform national vaccination strategies. METHODS We used publicly available sentinel data from African countries reporting to the WHO Global Influenza Surveillance and Response FluNet platform that had 3-10 years of data collected during 2010-19. We calculated a 3-week moving proportion of samples positive for influenza virus and assessed epidemic timing using an aggregate average method. The start and end of each epidemic were defined as the first week when the proportion of positive samples exceeded or went below the annual mean, respectively, for at least 3 consecutive weeks. We categorised countries into five epidemic patterns: northern hemisphere-dominant, with epidemics occurring in October-March; southern hemisphere-dominant, with epidemics occurring in April-September; primarily northern hemisphere with some epidemic activity in southern hemisphere months; primarily southern hemisphere with some epidemic activity in northern hemisphere months; and year-round influenza transmission without a discernible northern hemisphere or southern hemisphere predominance (no clear pattern). FINDINGS Of the 34 countries reporting data to FluNet, 25 had at least 3 years of data, representing 46% of the countries in Africa and 89% of Africa's population. Study countries reported RT-PCR respiratory virus results for a total of 503 609 specimens (median 12 971 [IQR 9607-20 960] per country-year), of which 74 001 (15%; median 2078 [IQR 1087-3008] per country-year) were positive for influenza viruses. 248 epidemics occurred across 236 country-years of data (median 10 [range 7-10] per country). Six (24%) countries had a northern hemisphere pattern (Algeria, Burkina Faso, Egypt, Morocco, Niger, and Tunisia). Eight (32%) had a primarily northern hemisphere pattern with some southern hemisphere epidemics (Cameroon, Ethiopia, Mali, Mozambique, Nigeria, Senegal, Tanzania, and Togo). Three (12%) had a primarily southern hemisphere pattern with some northern hemisphere epidemics (Ghana, Kenya, and Uganda). Three (12%) had a southern hemisphere pattern (Central African Republic, South Africa, and Zambia). Five (20%) had no clear pattern (Côte d'Ivoire, DR Congo, Madagascar, Mauritius, and Rwanda). INTERPRETATION Most countries had identifiable influenza epidemic periods that could be used to inform authorities of non-seasonal and seasonal influenza activity, guide vaccine timing, and promote timely interventions. FUNDING None. TRANSLATIONS For the Berber, Luganda, Xhosa, Chewa, Yoruba, Igbo, Hausa and Afan Oromo translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Ledor S Igboh
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Immunization Systems Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Katherine Roguski
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Perrine Marcenac
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Myrna D Charles
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stefano Tempia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Belinda Herring
- World Health Organization-Regional Office for Africa, Brazzaville, Congo
| | - Katelijn Vandemaele
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Ann Moen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Josh A Mott
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | - Siddhivinayak Hirve
- Department of Infectious Hazard Management, World Health Organization, Geneva, Switzerland
| | | | - Punam Mangtani
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Nguipdop-Djomo
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Adlhoch C, Delgado-Sanz C, Carnahan A, Larrauri A, Popovici O, Bossuyt N, Thomas I, Kynčl J, Slezak P, Brytting M, Guiomar R, Redlberger-Fritz M, Maistre Melillo J, Melillo T, van Gageldonk-Lafeber AB, Marbus SD, O’Donnell J, Domegan L, Gomes Dias J, Olsen SJ. Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. Euro Surveill 2023; 28:2200340. [PMID: 36700868 PMCID: PMC9881178 DOI: 10.2807/1560-7917.es.2023.28.4.2200340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Odette Popovici
- National Institute of Public Health Romania-National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | | | | | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | | | - Tanya Melillo
- Infectious Disease prevention and Control unit, Malta
| | | | - Sierk D. Marbus
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Marcenac P, McCarron M, Davis W, Igboh LS, Mott JA, Lafond KE, Zhou W, Sorrells M, Charles MD, Gould P, Arriola CS, Veguilla V, Guthrie E, Dugan VG, Kondor R, Gogstad E, Uyeki TM, Olsen SJ, Emukule GO, Saha S, Greene C, Bresee JS, Barnes J, Wentworth DE, Fry AM, Jernigan DB, Azziz-Baumgartner E. Leveraging International Influenza Surveillance Systems and Programs during the COVID-19 Pandemic. Emerg Infect Dis 2022; 28:S26-S33. [PMID: 36502434 DOI: 10.3201/eid2813.212248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A network of global respiratory disease surveillance systems and partnerships has been built over decades as a direct response to the persistent threat of seasonal, zoonotic, and pandemic influenza. These efforts have been spearheaded by the World Health Organization, country ministries of health, the US Centers for Disease Control and Prevention, nongovernmental organizations, academic groups, and others. During the COVID-19 pandemic, the US Centers for Disease Control and Prevention worked closely with ministries of health in partner countries and the World Health Organization to leverage influenza surveillance systems and programs to respond to SARS-CoV-2 transmission. Countries used existing surveillance systems for severe acute respiratory infection and influenza-like illness, respiratory virus laboratory resources, pandemic influenza preparedness plans, and ongoing population-based influenza studies to track, study, and respond to SARS-CoV-2 infections. The incorporation of COVID-19 surveillance into existing influenza sentinel surveillance systems can support continued global surveillance for respiratory viruses with pandemic potential.
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9
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Schmidt SSS, Iuliano AD, Vestergaard LS, Mazagatos-Ateca C, Larrauri A, Brauner JM, Olsen SJ, Nielsen J, Salomon JA, Krause TG. All-cause versus cause-specific excess deaths for estimating influenza-associated mortality in Denmark, Spain, and the United States. Influenza Other Respir Viruses 2022; 16:707-716. [PMID: 35194940 PMCID: PMC9178070 DOI: 10.1111/irv.12966] [Citation(s) in RCA: 7] [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] [Received: 10/06/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Seasonal influenza-associated excess mortality estimates can be timely and provide useful information on the severity of an epidemic. This methodology can be leveraged during an emergency response or pandemic. METHOD For Denmark, Spain, and the United States, we estimated age-stratified excess mortality for (i) all-cause, (ii) respiratory and circulatory, (iii) circulatory, (iv) respiratory, and (v) pneumonia, and influenza causes of death for the 2015/2016 and 2016/2017 influenza seasons. We quantified differences between the countries and seasonal excess mortality estimates and the death categories. We used a time-series linear regression model accounting for time and seasonal trends using mortality data from 2010 through 2017. RESULTS The respective periods of weekly excess mortality for all-cause and cause-specific deaths were similar in their chronological patterns. Seasonal all-cause excess mortality rates for the 2015/2016 and 2016/2017 influenza seasons were 4.7 (3.3-6.1) and 14.3 (13.0-15.6) per 100,000 population, for the United States; 20.3 (15.8-25.0) and 24.0 (19.3-28.7) per 100,000 population for Denmark; and 22.9 (18.9-26.9) and 52.9 (49.1-56.8) per 100,000 population for Spain. Seasonal respiratory and circulatory excess mortality estimates were two to three times lower than the all-cause estimates. DISCUSSION We observed fewer influenza-associated deaths when we examined cause-specific death categories compared with all-cause deaths and observed the same trends in peaks in deaths with all death causes. Because all-cause deaths are more available, these models can be used to monitor virus activity in near real time. This approach may contribute to the development of timely mortality monitoring systems during public health emergencies.
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Affiliation(s)
- Sebastian S S Schmidt
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | | | - Lasse S Vestergaard
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Clara Mazagatos-Ateca
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Jan M Brauner
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Sonja J Olsen
- Health Emergencies Program, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | | | - Tyra G Krause
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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10
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Davis WW, Mott JA, Olsen SJ. The role of non-pharmaceutical interventions on influenza circulation during the COVID-19 pandemic in nine tropical Asian countries. Influenza Other Respir Viruses 2022; 16:568-576. [PMID: 34997697 PMCID: PMC8983905 DOI: 10.1111/irv.12953] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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] [Received: 11/24/2021] [Accepted: 12/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background Low global influenza circulation was reported during the coronavirus‐19 pandemic. We explored relationships between non‐pharmaceutical interventions (NPIs) and influenza in tropical Asian countries. Methods Using World Health Organization (WHO) surveillance data from 2015 to 2019 and the WHO shiny app, we constructed expected seasonal influenza epidemic curves from March 2020 to June 2021 and compared the timing, and average percent positivity with observed data. We used multivariate regression to test associations between ordinal NPI data (from the Oxford Stringency Index) 4 weeks before the expected 2020/21 epidemics and present adjusted incidence rate ratio (IRR) or relative proportion ratio (RPR) and 95% confidence intervals (CI). Results Data from nine countries predicted 18 seasonal epidemics; seven were observed. Five started 6–24 weeks later, and all were 4–21 weeks shorter than expected. Five epidemics had lower maximum peak values (percent positivity), and all but one had lower average percent positivity than expected. All countries implemented NPIs. Each increased level of school closure reduced risk of an epidemic by 43% (IRR = 0.57, CI: 0.34, 0.95). Each increased level of canceling public events reduced the average percent positivity across the season by 44% (RPR = 0.56, CI: 0.39, 0.82) and each increased level in restricting internal movements reduced it by 41% (RPR = 0.59, CI: 0.36, 0.96). Other NPIs were not associated with changes. Conclusions Among nine countries, the 2020/21 seasonal epidemics were delayed, shorter, and less intense than expected. Although layered NPIs were difficult to tease apart, school closings, canceling public events, and restricting internal movements before influenza circulation seemed to reduce transmission.
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Affiliation(s)
- William W Davis
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
| | - Joshua A Mott
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
| | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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11
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Sengkeopraseuth B, Co KC, Leuangvilay P, Mott JA, Khomgsamphanh B, Somoulay V, Tsuyuoka R, Chiew M, Ketmayoon P, Jones J, Pusch E, Jang Y, Barnes J, Davis CT, Phommachanh P, Khamphaphongphane B, Olsen SJ, Xangsayyarath P. First human infection of avian influenza A(H5N6) virus reported in Lao People's Democratic Republic, February-March 2021. Influenza Other Respir Viruses 2021; 16:181-185. [PMID: 34761535 PMCID: PMC8818831 DOI: 10.1111/irv.12934] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/24/2021] [Indexed: 12/03/2022] Open
Abstract
In March 2021, Lao People's Democratic Republic (Laos) reported an avian influenza A(H5N6) virus infection in a 5‐year‐old child identified through sentinel surveillance. This was the first human A(H5N6) infection reported outside of China. A multidisciplinary investigation undertook contact tracing and enhanced human and animal surveillance in surrounding villages and live bird markets. Seven Muscovy ducks tested positive for highly pathogenic avian influenza A(H5N6) viruses. Sequenced viruses belonged to clade 2.3.4.4h and were closely related to viruses detected in poultry in Vietnam and to previous viruses detected in Laos. Surveillance and coordinated outbreak response remain essential to global health security.
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Affiliation(s)
- Bounthanom Sengkeopraseuth
- National Center for Laboratory and Epidemiology, Department of Communicable Disease Control, Ministry of Health, Vientiane, Lao PDR
| | | | | | - Joshua A Mott
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Virasack Somoulay
- National Center for Laboratory and Epidemiology, Department of Communicable Disease Control, Ministry of Health, Vientiane, Lao PDR
| | | | - May Chiew
- World Health Organization, Vientiane, Lao PDR
| | | | - Joyce Jones
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Pusch
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yunho Jang
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John Barnes
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Phouvong Phommachanh
- National Animal Health Laboratory, Department of Livestock and Fisheries, Ministry of Agriculture and Forestry, Vientiane, Lao PDR
| | - Bouaphanh Khamphaphongphane
- National Center for Laboratory and Epidemiology, Department of Communicable Disease Control, Ministry of Health, Vientiane, Lao PDR
| | - Sonja J Olsen
- U. S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Phonepadith Xangsayyarath
- National Center for Laboratory and Epidemiology, Department of Communicable Disease Control, Ministry of Health, Vientiane, Lao PDR
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12
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Adlhoch C, Sneiderman M, Martinuka O, Melidou A, Bundle N, Fielding J, Olsen SJ, Penttinen P, Pastore L, Pebody R. Spotlight influenza: The 2019/20 influenza season and the impact of COVID-19 on influenza surveillance in the WHO European Region. ACTA ACUST UNITED AC 2021; 26. [PMID: 34622760 PMCID: PMC8511754 DOI: 10.2807/1560-7917.es.2021.26.40.2100077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BackgroundAnnual seasonal influenza activity in the northern hemisphere causes a high burden of disease during the winter months, peaking in the first weeks of the year.AimWe describe the 2019/20 influenza season and the impact of the COVID-19 pandemic on sentinel surveillance in the World Health Organization (WHO) European Region.MethodsWe analysed weekly epidemiological and virological influenza data from sentinel primary care and hospital sources reported by countries, territories and areas (hereafter countries) in the European Region.ResultsWe observed co-circulation of influenza B/Victoria-lineage, A(H1)pdm09 and A(H3) viruses during the 2019/20 season, with different dominance patterns observed across the Region. A higher proportion of patients with influenza A virus infection than type B were observed. The influenza activity started in week 47/2019, and influenza positivity rate was ≥ 50% for 2 weeks (05-06/2020) rather than 5-8 weeks in the previous five seasons. In many countries a rapid reduction in sentinel reports and the highest influenza activity was observed in weeks 09-13/2020. Reporting was reduced from week 14/2020 across the Region coincident with the onset of widespread circulation of SARS-CoV-2.ConclusionsOverall, influenza type A viruses dominated; however, there were varying patterns across the Region, with dominance of B/Victoria-lineage viruses in a few countries. The COVID-19 pandemic contributed to an earlier end of the influenza season and reduced influenza virus circulation probably owing to restricted healthcare access and public health measures.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Miriam Sneiderman
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Oksana Martinuka
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - James Fielding
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Sonja J Olsen
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lucia Pastore
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Richard Pebody
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | -
- The members of the European Influenza Surveillance Network are listed under Investigators
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13
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Belazi S, Olsen SJ, Brown C, Green HK, Mook P, Nguyen-Van-Tam J, Penttinen P, Lansbury L. Spotlight influenza: Laboratory-confirmed seasonal influenza in people with acute respiratory illness: a literature review and meta-analysis, WHO European Region, 2004 to 2017. ACTA ACUST UNITED AC 2021; 26. [PMID: 34596019 PMCID: PMC8485580 DOI: 10.2807/1560-7917.es.2021.26.39.2000343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Indexed: 12/31/2022]
Abstract
Background Across the World Health Organization European Region, there are few estimates of the proportion of people seeking medical care for influenza-like illness or acute respiratory infections and who have laboratory-confirmed seasonal influenza infection. Methods We conducted a meta-analysis of data extracted from studies published between 2004 and 2017 and from sentinel data from the European surveillance system (TESSy) between 2004 and 2018. We pooled within-season estimates by influenza type/subtype, setting (outpatient (OP)/inpatient (IP)) and age group to estimate the proportion of people tested who have laboratory-confirmed and medically-attended seasonal influenza in Europe. Results In the literature review, the pooled proportion for all influenza types was 33% (95% confidence interval (CI): 30–36), higher among OP 36% (95% CI: 33–40) than IP 24% (95% CI: 20–29). Pooled estimates for all influenza types by age group were: 0–17 years, 26% (22–31); 18–64 years, 41% (32–50); ≥ 65 years, 33% (27–40). From TESSy data, 33% (31–34) of OP and 24% (21–27) of IP were positive. The highest proportion of influenza A was in people aged 18–64 years (22%, 16–29). By subtype, A(H1N1)pdm09 was highest in 18–64 year-olds (16%, 11–21%) whereas A(H3N2) was highest in those ≥ 65 years (10%, 2–22). For influenza B, the highest proportion of infections was in those aged 18–64 years (15%, 9–24). Conclusions Laboratory-confirmed influenza accounted for approximately one third of all acute respiratory infections for which medical care was sought during the influenza season.
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Affiliation(s)
- Sara Belazi
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | | | | | | | - Piers Mook
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Jonathan Nguyen-Van-Tam
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Louise Lansbury
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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14
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Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, Kniss K, Burns E, Rowe T, Foust A, Jasso G, Merced-Morales A, Davis CT, Jang Y, Jones J, Daly P, Gubareva L, Barnes J, Kondor R, Sessions W, Smith C, Wentworth DE, Garg S, Havers FP, Fry AM, Hall AJ, Brammer L, Silk BJ. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic-United States, 2020-2021. Am J Transplant 2021; 21:3481-3486. [PMID: 34624182 PMCID: PMC8653380 DOI: 10.1111/ajt.16049] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Sonja J. Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Correspondence Sonja J. Olsen, Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Amber K. Winn
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Amber K. Winn, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Alicia P. Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Mila M. Prill
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Steel
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Thomas Rowe
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angela Foust
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Gabriela Jasso
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angiezel Merced-Morales
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - C. Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Joyce Jones
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Peter Daly
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Catherine Smith
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - David E. Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Fiona P. Havers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Aron J. Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Benjamin J. Silk
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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15
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Um S, Siegers JY, Sar B, Chin S, Patel S, Bunnary S, Hak M, Sor S, Sokhen O, Heng S, Chau D, Sothyra T, Khalakdina A, Mott JA, Olsen SJ, Claes F, Sovann L, Karlsson EA. Human Infection with Avian Influenza A(H9N2) Virus, Cambodia, February 2021. Emerg Infect Dis 2021; 27:2742-2745. [PMID: 34546164 PMCID: PMC8462329 DOI: 10.3201/eid2710.211039] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In February 2021, routine sentinel surveillance for influenza-like illness in Cambodia detected a human avian influenza A(H9N2) virus infection. Investigations identified no recent H9N2 virus infections in 43 close contacts. One chicken sample from the infected child’s house was positive for H9N2 virus and genetically similar to the human virus.
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16
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Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, Kniss K, Burns E, Rowe T, Foust A, Jasso G, Merced-Morales A, Davis CT, Jang Y, Jones J, Daly P, Gubareva L, Barnes J, Kondor R, Sessions W, Smith C, Wentworth DE, Garg S, Havers FP, Fry AM, Hall AJ, Brammer L, Silk BJ. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic - United States, 2020-2021. MMWR Morb Mortal Wkly Rep 2021; 70:1013-1019. [PMID: 34292924 PMCID: PMC8297694 DOI: 10.15585/mmwr.mm7029a1] [Citation(s) in RCA: 255] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Rolfes MA, Olsen SJ, Kittikraisak W, Suntarattiwong P, Klungthong C, Ellison D, Mott JA, Chotpitayasunondh T. Influenza-Associated Medical Visits Prevented by Influenza Vaccination in Young Children in Thailand, 2012-2014. J Pediatric Infect Dis Soc 2021; 10:349-351. [PMID: 32706366 PMCID: PMC10776449 DOI: 10.1093/jpids/piaa076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/24/2020] [Indexed: 11/12/2022]
Abstract
Despite recommendations, few children aged 6-35 months in Thailand receive seasonal influenza vaccination. Using previously estimated incidence and vaccine effectiveness data from the period 2012-2014, we estimate that up to 121 000 medical visits could be prevented each year with 50% coverage and expanded recommendations to children aged <5 years.
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Affiliation(s)
- Melissa A. Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sonja J. Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wanitchaya Kittikraisak
- Influenza Program, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Piyarat Suntarattiwong
- Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand
| | | | - Damon Ellison
- US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Joshua A. Mott
- Influenza Program, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Tawee Chotpitayasunondh
- Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand
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18
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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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19
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Mott JA, Fry AM, Kondor R, Wentworth DE, Olsen SJ. Re-emergence of influenza virus circulation during 2020 in parts of tropical Asia: Implications for other countries. Influenza Other Respir Viruses 2021; 15:415-418. [PMID: 33566441 PMCID: PMC8051733 DOI: 10.1111/irv.12844] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Joshua A Mott
- Influenza Division, Centers for Disease Control and Prevention Regional Influenza Program, Bangkok, Thailand
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca Kondor
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David E Wentworth
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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20
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Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, Cohen C, Fry AM. Decreased influenza activity during the COVID-19 pandemic-United States, Australia, Chile, and South Africa, 2020. Am J Transplant 2020; 20:3681-3685. [PMID: 33264506 PMCID: PMC7753605 DOI: 10.1111/ajt.16381] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [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: 01/25/2023]
Abstract
Transplant recipients are among the groups for whom the updated recommendations for 2020–2021 influenza vaccination should generally be considered essential, notably in the face of the COVID-19 pandemic.
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Affiliation(s)
- Sonja J. Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Correspondence Sonja J. Olsen, Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA.
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Alicia P. Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Sheena Sullivan
- Doherty Department, World Health Organization Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Rodrigo F. Pineda
- Virology Department, Public Health Institute of Chile, Santiago, Chile
| | - Cheryl Cohen
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa,Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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21
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Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, Cohen C, Fry AM. Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1305-1309. [PMID: 32941415 PMCID: PMC7498167 DOI: 10.15585/mmwr.mm6937a6] [Citation(s) in RCA: 345] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
After recognition of widespread community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by mid- to late February 2020, indicators of influenza activity began to decline in the Northern Hemisphere. These changes were attributed to both artifactual changes related to declines in routine health seeking for respiratory illness as well as real changes in influenza virus circulation because of widespread implementation of measures to mitigate transmission of SARS-CoV-2. Data from clinical laboratories in the United States indicated a 61% decrease in the number of specimens submitted (from a median of 49,696 per week during September 29, 2019-February 29, 2020, to 19,537 during March 1-May 16, 2020) and a 98% decrease in influenza activity as measured by percentage of submitted specimens testing positive (from a median of 19.34% to 0.33%). Interseasonal (i.e., summer) circulation of influenza in the United States (May 17-August 8, 2020) is currently at historical lows (median = 0.20% tests positive in 2020 versus 2.35% in 2019, 1.04% in 2018, and 2.36% in 2017). Influenza data reported to the World Health Organization's (WHO's) FluNet platform from three Southern Hemisphere countries that serve as robust sentinel sites for influenza from Oceania (Australia), South America (Chile), and Southern Africa (South Africa) showed very low influenza activity during June-August 2020, the months that constitute the typical Southern Hemisphere influenza season. In countries or jurisdictions where extensive community mitigation measures are maintained (e.g., face masks, social distancing, school closures, and teleworking), those locations might have little influenza circulation during the upcoming 2020-21 Northern Hemisphere influenza season. The use of community mitigation measures for the COVID-19 pandemic, plus influenza vaccination, are likely to be effective in reducing the incidence and impact of influenza, and some of these mitigation measures could have a role in preventing influenza in future seasons. However, given the novelty of the COVID-19 pandemic and the uncertainty of continued community mitigation measures, it is important to plan for seasonal influenza circulation in the United States this fall and winter. Influenza vaccination of all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might cocirculate (1).
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22
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Paz–Bailey G, Quandelacy TM, Adams LE, Olsen SJ, Blanton L, Munoz-Jordan JL, Lozier M, Alvarado LI, Johansson MA. Recent influenza activity in tropical Puerto Rico has become synchronized with mainland US. Influenza Other Respir Viruses 2020; 14:515-523. [PMID: 32614504 PMCID: PMC7431640 DOI: 10.1111/irv.12744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We used data from the Sentinel Enhanced Dengue Surveillance System (SEDSS) to describe influenza trends in southern Puerto Rico during 2012-2018 and compare them to trends in the United States. METHODS Patients with fever onset ≤ 7 days presenting were enrolled. Nasal/oropharyngeal swabs were tested for influenza A and B viruses by PCR. Virologic data were obtained from the US World Health Organization (WHO) Collaborating Laboratories System and the National Respiratory and Enteric Virus Surveillance System (NREVSS). We compared influenza A and B infections identified from SEDSS and WHO/NREVSS laboratories reported by US Department of Health and Human Services (HHS) region using time series decomposition methods, and analysed coherence of climate and influenza trends by region. RESULTS Among 23,124 participants, 9% were positive for influenza A and 5% for influenza B. Influenza A and B viruses were identified year-round, with no clear seasonal patterns from 2012 to 2015 and peaks in December-January in 2016-2017 and 2017-2018 seasons. Influenza seasons in HHS regions were relatively synchronized in recent years with the seasons in Puerto Rico. We observed high coherence between absolute humidity and influenza A and B virus in HHS regions. In Puerto Rico, coherence was much lower in the early years but increased to similar levels to HHS regions by 2017-2018. CONCLUSIONS Influenza seasons in Puerto Rico have recently become synchronized with seasons in US HHS regions. Current US recommendations are for everyone 6 months and older to receive influenza vaccination by the end of October seem appropriate for Puerto Rico.
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Affiliation(s)
| | | | - Laura E. Adams
- Centers for Disease Control and PreventionSan JuanPuerto Rico
| | - Sonja J. Olsen
- Centers for Disease Control and PreventionAtlantaGeorgia
| | - Lenee Blanton
- Centers for Disease Control and PreventionAtlantaGeorgia
| | | | - Matthew Lozier
- Centers for Disease Control and PreventionSan JuanPuerto Rico
| | - Luisa I. Alvarado
- Saint Luke’s Episcopal Hospital and Ponce Health Sciences UniversityPoncePuerto Rico
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23
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Melidou A, Hungnes O, Pereyaslov D, Adlhoch C, Segaloff H, Robesyn E, Penttinen P, Olsen SJ. Predominance of influenza virus A(H3N2) 3C.2a1b and A(H1N1)pdm09 6B.1A5A genetic subclades in the WHO European Region, 2018-2019. Vaccine 2020; 38:5707-5717. [PMID: 32624252 DOI: 10.1016/j.vaccine.2020.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The 2018/2019 influenza season in the WHO European Region was dominated by influenza A (H1N1)pdm09 and (H3N2) viruses, with very few influenza B viruses detected. METHODS Countries in the European Region reported virus characterization data to The European Surveillance System for weeks 40/2018 to 20/2019. These virus antigenic and genetic characterization and haemagglutinin (HA) sequence data were analysed to describe and assess circulating viruses relative to the 2018/2019 vaccine virus components for the northern hemisphere. RESULTS Thirty countries reported 4776 viruses characterized genetically and 3311 viruses antigenically. All genetically characterized A(H1N1)pdm09 viruses fell in subclade 6B.1A, of which 90% carried the amino acid substitution S183P in the HA gene. Antigenic data indicated that circulating A(H1N1)pdm09 viruses were similar to the 2018/2019 vaccine virus. Genetic data showed that A(H3N2) viruses mostly fell in clade 3C.2a (75%) and 90% of which were subclade 3C.2a1b. A lower proportion fell in clade 3C.3a (23%) and were antigenically distinct from the vaccine virus. All B/Victoria viruses belonged to clade 1A; 30% carried a double amino acid deletion in HA and were genetically and antigenically similar to the vaccine virus component, while 55% carried a triple amino acid deletion or no deletion in HA; these were antigenically distinct from each other and from the vaccine component. All B/Yamagata viruses belonged to clade 3 and were antigenically similar to the virus component in the quadrivalent vaccine for 2018/2019. CONCLUSIONS A simultaneous circulation of genetically and antigenically diverse A(H3N2) and B/Victoria viruses was observed and represented a challenge to vaccine strain selection.
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Affiliation(s)
- Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Olav Hungnes
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Emmanuel Robesyn
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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24
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Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braeye T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Lytras T, Gkolfinopoulou K, Paldy A, Domegan L, O'Donnell J, De' Donato F, Noccioli F, Hoffmann P, Velez T, England K, van Asten L, White RA, Tønnessen R, da Silva SP, Rodrigues AP, Larrauri A, Delgado-Sanz C, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty M, Marquess DF, Kennedy S, Olsen SJ, Pebody R, Krause TG, Mølbak K. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32643601 PMCID: PMC7346364 DOI: 10.2807/1560-7917.es.2020.25.26.2001214] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [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] [Indexed: 12/02/2022]
Abstract
A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March–April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45–64 (8%) and 15–44 year olds (1%). No excess mortality was observed in 0–14 year olds.
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Affiliation(s)
| | | | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Public Health Institute, Budapest, Hungary
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Kathleen England
- Directorate for Health Information and Research, Ministry for Health, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | | | - Nick Andrews
- Public Health England, Colindale, United Kingdom
| | | | | | | | - Sonja J Olsen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | -
- The members of the ECDC Public Health Emergency Team for COVID-19 are listed below
| | | | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
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25
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Olsen SJ, Chen MY, Liu YL, Witschi M, Ardoin A, Calba C, Mathieu P, Masserey V, Maraglino F, Marro S, Penttinen P, Robesyn E, Pukkila J. Early Introduction of Severe Acute Respiratory Syndrome Coronavirus 2 into Europe. Emerg Infect Dis 2020; 26:1567-1570. [PMID: 32197059 PMCID: PMC7323534 DOI: 10.3201/eid2607.200359] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Early infections with severe acute respiratory syndrome coronavirus 2 in Europe were detected in travelers from Wuhan, China, in January 2020. In 1 tour group, 5 of 30 members were ill; 3 cases were laboratory confirmed. In addition, a healthcare worker was infected. This event documents early importation and subsequent spread of the virus in Europe.
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26
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Amoah S, Mishina M, Praphasiri P, Cao W, Kim JH, Liepkalns JS, Guo Z, Carney PJ, Chang JC, Fernandez S, Garg S, Beacham L, Holtz TH, Curlin ME, Dawood F, Olsen SJ, Gangappa S, Stevens J, Sambhara S. Standard-Dose Intradermal Influenza Vaccine Elicits Cellular Immune Responses Similar to Those of Intramuscular Vaccine in Men With and Those Without HIV Infection. J Infect Dis 2020; 220:743-751. [PMID: 31045222 DOI: 10.1093/infdis/jiz205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/24/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-infected persons are at a higher risk of severe influenza. Although we have shown that a standard-dose intradermal influenza vaccine versus a standard-dose intramuscular influenza vaccine does not result in differences in hemagglutination-inhibition titers in this population, a comprehensive examination of cell-mediated immune responses remains lacking. METHODS Serological, antigen-specific B-cell, and interleukin 2-, interferon γ-, and tumor necrosis factor α-secreting T-cell responses were assessed in 79 HIV-infected men and 79 HIV-uninfected men. RESULTS The route of vaccination did not affect the immunoglobulin A and immunoglobulin G (IgG) plasmablast or memory B-cell response, although these were severely impaired in the group with a CD4+ T-cell count of <200 cells/μL. The frequencies of IgG memory B cells measured on day 28 after vaccination were highest in the HIV-uninfected group, followed by the group with a CD4+ T-cell count of ≥200 cells/μL and the group with a CD4+ T-cell count of <200 cells/μL. The route of vaccination did not affect the CD4+ or CD8+ T-cell responses measured at various times after vaccination. CONCLUSIONS The route of vaccination had no effect on antibody responses, antibody avidity, T-cell responses, or B-cell responses in HIV-infected or HIV-uninfected subjects. With the serological and cellular immune responses to influenza vaccination being impaired in HIV-infected individuals with a CD4+ T-cell count of <200 cells/μL, passive immunization strategies need to be explored to protect this population. CLINICAL TRIALS REGISTRATION NCT01538940.
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Affiliation(s)
- Samuel Amoah
- Battelle Memorial Institute, Atlanta, Georgia.,Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Margarita Mishina
- Battelle Memorial Institute, Atlanta, Georgia.,Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | | | - Weiping Cao
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Jin Hyang Kim
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Justine S Liepkalns
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Zhu Guo
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Paul J Carney
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Jessie C Chang
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Lauren Beacham
- Battelle Memorial Institute, Atlanta, Georgia.,Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Timothy H Holtz
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.,HIV/STD Research Program, Thailand Ministry of Public Health-CDC Collaboration, Nonthaburi, Bangkok, Thailand
| | - Marcel E Curlin
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Fatimah Dawood
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Shivaprakash Gangappa
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - James Stevens
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Suryaprakash Sambhara
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
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27
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Mook P, Meerhoff T, Olsen SJ, Snacken R, Adlhoch C, Pereyaslov D, Broberg EK, Melidou A, Brown C, Penttinen P. Alternating patterns of seasonal influenza activity in the WHO European Region following the 2009 pandemic, 2010-2018. Influenza Other Respir Viruses 2020; 14:150-161. [PMID: 31944604 PMCID: PMC7040975 DOI: 10.1111/irv.12703] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/05/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Influenza virus infections are common and lead to substantial morbidity and mortality worldwide. We characterized the first eight influenza epidemics since the 2009 influenza pandemic by describing the distribution of viruses and epidemics temporally and geographically across the WHO European Region. METHODS We retrospectively analyzed laboratory-confirmed influenza detections in ambulatory patients from sentinel sites. Data were aggregated by reporting entity and season (weeks 40-20) for 2010-2011 to 2017-2018. We explored geographical spread using correlation coefficients. RESULTS There was variation in the regional influenza epidemics during the study period. Influenza A virus subtypes alternated in dominance, except for 2013-2014 during which both cocirculated, and only one season (2017-2018) was B virus dominant. The median start week for epidemics in the Region was week 50, the time to the peak ranged between four and 13 weeks, and the duration of the epidemic ranged between 19 and 25 weeks. There was evidence of a west-to-east spread across the Region during epidemics in 2010-2011 (r = .365; P = .019), 2012-2013 (r = .484; P = .001), 2014-2015 (r = .423; P = .006), and 2017-2018 (r = .566; P < .001) seasons. Variation in virus distribution and timing existed within reporting entities across seasons and across reporting entities for a given season. CONCLUSIONS Aggregated influenza detection data from sentinel surveillance sites by season between 2010 and 2018 have been presented for the European Region for the first time. Substantial diversity exists between influenza epidemics. These data can inform prevention and control efforts at national, sub-national, and international levels. Aggregated, regional surveillance data from early affected reporting entities may provide an early warning function and be helpful for early season forecasting efforts.
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Affiliation(s)
- Piers Mook
- Division of Health Emergencies and Communicable DiseasesHigh Threat PathogensWHO Regional Office for EuropeCopenhagenDenmark
| | - Tamara Meerhoff
- Radboud University Medical CenterRadboud Institute for Health SciencesDepartment of Primary and Community CareNijmegenThe Netherlands
| | - Sonja J. Olsen
- Division of Health Emergencies and Communicable DiseasesHigh Threat PathogensWHO Regional Office for EuropeCopenhagenDenmark
| | - René Snacken
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
| | - Dmitriy Pereyaslov
- Division of Health Emergencies and Communicable DiseasesHigh Threat PathogensWHO Regional Office for EuropeCopenhagenDenmark
| | - Eeva K. Broberg
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
| | - Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
| | - Caroline Brown
- Division of Health Emergencies and Communicable DiseasesHigh Threat PathogensWHO Regional Office for EuropeCopenhagenDenmark
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
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Tokars JI, Olsen SJ, Reed C. Seasonal Incidence of Symptomatic Influenza in the United States. Clin Infect Dis 2019; 66:1511-1518. [PMID: 29206909 DOI: 10.1093/cid/cix1060] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/29/2017] [Indexed: 02/02/2023] Open
Abstract
Background The seasonal incidence of influenza is often approximated as 5%-20%. Methods We used 2 methods to estimate the seasonal incidence of symptomatic influenza in the United States. First, we made a statistical estimate extrapolated from influenza-associated hospitalization rates for 2010-2011 to 2015-2016, collected as part of national surveillance, covering approximately 9% of the United States, and including the existing mix of vaccinated and unvaccinated persons. Second, we performed a literature search and meta-analysis of published manuscripts that followed cohorts of subjects during 1996-2016 to detect laboratory-confirmed symptomatic influenza among unvaccinated persons; we adjusted this result to the US median vaccination coverage and effectiveness during 2010-2016. Results The statistical estimate of influenza incidence among all ages ranged from 3.0%-11.3% among seasons, with median values of 8.3% (95% confidence interval [CI], 7.3%-9.7%) for all ages, 9.3% (95% CI, 8.2%-11.1%) for children <18 years, and 8.9% (95% CI, 8.2%-9.9%) for adults 18-64 years. Corresponding values for the meta-analysis were 7.1% (95% CI, 6.1%-8.1%) for all ages, 8.7% (95% CI, 6.6%-10.5%) for children, and 5.1% (95% CI, 3.6%-6.6%) for adults. Conclusions The 2 approaches produced comparable results for children and persons of all ages. The statistical estimates are more versatile and permit estimation of season-to-season variation. During 2010-2016, the incidence of symptomatic influenza among vaccinated and unvaccinated US residents, including both medically attended and nonattended infections, was approximately 8% and varied from 3% to 11% among seasons.
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Affiliation(s)
- Jerome I Tokars
- Influenza Division, National Centers for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sonja J Olsen
- Influenza Division, National Centers for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carrie Reed
- Influenza Division, National Centers for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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29
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Rungrojcharoenkit K, Kittikraisak W, Ditsungnoen D, Olsen SJ, Suntarattiwong P, Chotpitayasunondh T, Klungthong C, Yoon IK, Dawood FS, Fernandez S, Macareo L, Lindblade KA. Influenza virus seroincidence in a cohort of healthy and high-risk children enrolled in infancy, Bangkok, Thailand. Int J Infect Dis 2019; 89:21-26. [PMID: 31470089 DOI: 10.1016/j.ijid.2019.08.022] [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: 07/15/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We measured seroconversion to influenza viruses and incidence of symptomatic influenza virus infection in a cohort of children in Bangkok, Thailand. METHODS Children aged ≤6 months were followed for two years for acute respiratory illness (ARI) and had serum specimens taken at 6-month intervals and tested by hemagglutination inhibition (HI) assay. Seroconversion was defined as a >4-fold rise in the HI titers between time points with a titer of >40 in the second specimen. Respiratory swabs were tested by rRT-PCR for influenza. Data were analyzed using generalized linear models. RESULTS Of 350 children, 266 (76%, 147 were healthy and 119 were high-risk) had ≥2 serum specimens collected before influenza vaccination. During the 2-year follow-up, 266 children contributed 370 person-years of observation, excluding post-vaccination periods. We identified 32 ARI cases with rRT-PCR-confirmed influenza virus infection (7 infections/100 person-years, 95% confidence interval [CI], 4-11). There were 126 episodes of influenza virus infection, resulting in a seroconversion rate of 35 infections/100 person-years (95% CI, 30-42). Rates in healthy and high-risk children did not differ. CONCLUSIONS Influenza virus infection is common during the first two years of life among Thai children. A large proportion of infections may not be detected using the ARI case definition.
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Affiliation(s)
| | - Wanitchaya Kittikraisak
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
| | - Darunee Ditsungnoen
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Sonja J Olsen
- Influenza Division, U.S. Centers for Disease Control and Prevention, Georgia, USA
| | | | | | - Chonticha Klungthong
- Virolgy Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - In-Kyu Yoon
- Virolgy Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Fatimah S Dawood
- Influenza Division, U.S. Centers for Disease Control and Prevention, Georgia, USA
| | - Stefan Fernandez
- Virolgy Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Louis Macareo
- Virolgy Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Kim A Lindblade
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Influenza Division, U.S. Centers for Disease Control and Prevention, Georgia, USA
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30
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Rolfes MA, Vonglokham P, Khanthamaly V, Chitry B, Pholsena V, Chitranondh V, Mirza SA, Moen A, Bresee JS, Xeuatvongsa A, Olsen SJ. Measurement of birth outcomes in analyses of the impact of maternal influenza vaccination. Influenza Other Respir Viruses 2019; 13:547-555. [PMID: 31424627 PMCID: PMC6800304 DOI: 10.1111/irv.12673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 11/29/2022] Open
Abstract
Background The estimated association of maternal influenza vaccination and birth outcomes may be sensitive to methods used to define preterm birth or small‐for‐gestational age (SGA). Methods In a cohort of pregnant women in Lao People's Democratic Republic, we estimated gestational age from: (a) date of last menstrual period (LMP), (b) any prenatal ultrasound, (c) first trimester ultrasound, (d) Ballard Score at delivery, and (e) an algorithm combining LMP and ultrasound. Infants were classified as SGA at birth using a Canadian, global, and equation‐based growth reference. We estimated the association of maternal influenza vaccination and birth outcomes, by influenza activity, using multivariable log‐binomial regression and Cox proportional hazards regression with vaccination as a time‐varying exposure. Results The frequency of preterm birth in the cohort varied by method to estimate gestational age, from 5% using Ballard Score to 15% using any ultrasound. Using LMP, any ultrasound, or the algorithm, we found statistically significant reductions in preterm birth among vaccinated women during periods of high influenza activity and statistically significant increases in SGA, using a Canadian growth reference. We did not find statistically significant associations with SGA when using global or equation‐based growth references. Conclusions The association of maternal influenza vaccination and birth outcomes was most affected by the choice of a growth reference used to define SGA at birth. The association with pre‐term birth was present and consistent across multiple statistical approaches. Future studies of birth outcomes, specifically SGA, should carefully consider the potential for bias introduced by measurement choice.
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Affiliation(s)
- Melissa A Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Viengphone Khanthamaly
- Influenza Program, U.S. CDC-Lao PDR, American Embassy, Vientiane, Lao People's Democratic Republic
| | - Bounlap Chitry
- Mother and Child Hospital, Vientiane, Lao People's Democratic Republic
| | | | - Visith Chitranondh
- Luang Prabang Provincial Hospital, Luang Prabang, Lao People's Democratic Republic
| | - Sara A Mirza
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ann Moen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph S Bresee
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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31
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Olsen SJ, Rooney JA, Blanton L, Rolfes MA, Nelson DI, Gomez TM, Karli SA, Trock SC, Fry AM. Estimating Risk to Responders Exposed to Avian Influenza A H5 and H7 Viruses in Poultry, United States, 2014-2017. Emerg Infect Dis 2019; 25:1011-1014. [PMID: 30741630 PMCID: PMC6478193 DOI: 10.3201/eid2505.181253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In the United States, outbreaks of avian influenza H5 and H7 virus infections in poultry have raised concern about the risk for infections in humans. We reviewed the data collected during 2014-2017 and found no human infections among 4,555 exposed responders who were wearing protection.
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32
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Stewart RJ, Rossow J, Eckel S, Bidol S, Ballew G, Signs K, Conover JT, Burns E, Bresee JS, Fry AM, Olsen SJ, Biggerstaff M. Text-Based Illness Monitoring for Detection of Novel Influenza A Virus Infections During an Influenza A (H3N2)v Virus Outbreak in Michigan, 2016: Surveillance and Survey. JMIR Public Health Surveill 2019; 5:e10842. [PMID: 31025948 PMCID: PMC6658270 DOI: 10.2196/10842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/13/2018] [Accepted: 12/20/2018] [Indexed: 01/23/2023] Open
Abstract
Background Rapid reporting of human infections with novel influenza A viruses accelerates detection of viruses with pandemic potential and implementation of an effective public health response. After detection of human infections with influenza A (H3N2) variant (H3N2v) viruses associated with agricultural fairs during August 2016, the Michigan Department of Health and Human Services worked with the US Centers for Disease Control and Prevention (CDC) to identify infections with variant influenza viruses using a text-based illness monitoring system. Objective To enhance detection of influenza infections using text-based monitoring and evaluate the feasibility and acceptability of the system for use in future outbreaks of novel influenza viruses. Methods During an outbreak of H3N2v virus infections among agricultural fair attendees, we deployed a text-illness monitoring (TIM) system to conduct active illness surveillance among households of youth who exhibited swine at fairs. We selected all fairs with suspected H3N2v virus infections. For fairs without suspected infections, we selected only those fairs that met predefined criteria. Eligible respondents were identified and recruited through email outreach and/or on-site meetings at fairs. During the fairs and for 10 days after selected fairs, enrolled households received daily, automated text-messages inquiring about illness; reports of illness were investigated by local health departments. To understand the feasibility and acceptability of the system, we monitored enrollment and trends in participation and distributed a Web-based survey to households of exhibitors from five fairs. Results Among an estimated 500 households with a member who exhibited swine at one of nine selected fairs, representatives of 87 (17.4%) households were enrolled, representing 392 household members. Among fairs that were ongoing when the TIM system was deployed, the number of respondents peaked at 54 on the third day of the fair and then steadily declined throughout the rest of the monitoring period; 19 out of 87 household representatives (22%) responded through the end of the 10-day monitoring period. We detected 2 H3N2v virus infections using the TIM system, which represents 17% (2/12) of all H3N2v virus infections detected during this outbreak in Michigan. Of the 70 survey respondents, 16 (23%) had participated in the TIM system. A total of 73% (11/15) participated because it was recommended by fair coordinators and 80% (12/15) said they would participate again. Conclusions Using a text-message system, we monitored for illness among a large number of individuals and households and detected H3N2v virus infections through active surveillance. Text-based illness monitoring systems are useful for detecting novel influenza virus infections when active monitoring is necessary. Participant retention and testing of persons reporting illness are critical elements for system improvement.
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Affiliation(s)
- Rebekah J Stewart
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - John Rossow
- Epidemiology Elective Program, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, United States.,College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Seth Eckel
- Michigan Department of Health and Human Services, Lansing, MI, United States
| | - Sally Bidol
- Michigan Department of Health and Human Services, Lansing, MI, United States
| | - Grant Ballew
- Compliant Campaign, Scottsdale, AZ, United States
| | - Kimberly Signs
- Michigan Department of Health and Human Services, Lansing, MI, United States
| | | | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Joseph S Bresee
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Matthew Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Xeuatvongsa A, Mott JA, Khanthamaly V, Patthammavong C, Phounphenghak K, McKinlay M, Mirza S, Lafond KE, McCarron M, Corwin A, Moen A, Olsen SJ, Bresee JS. Progress toward sustainable influenza vaccination in the Lao Peoples' Democratic Republic, 2012-2018. Vaccine 2019; 37:3002-3005. [PMID: 31027926 DOI: 10.1016/j.vaccine.2019.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 11/24/2022]
Abstract
Despite global recommendations for influenza vaccination of high-risk, target populations, few low and middle-income countries have national influenza vaccination programs. Between 2012 and 2017, Lao PDR planned and conducted a series of activities to develop its national influenza vaccine program as a part of its overall national immunization program. In this paper, we review the underlying strategic planning for this process, and outline the sequence of activities, research studies, partnerships, and policy decisions that were required to build Laos' influenza vaccine program. The successful development and sustainability of the program in Laos offers lessons for other low and middle-income countries interested in initiating or expanding influenza immunization.
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Affiliation(s)
| | - J A Mott
- Centers for Disease Control and Prevention, Bangkok, Thailand
| | - V Khanthamaly
- Centers for Disease Control and Prevention, Vientiane, Laos
| | | | | | - M McKinlay
- Task Force for Global Health, Atlanta, GA, USA
| | - S Mirza
- Centers for Disease Control and Prevention, Atlanta GA, USA
| | - K E Lafond
- Centers for Disease Control and Prevention, Atlanta GA, USA
| | - M McCarron
- Centers for Disease Control and Prevention, Atlanta GA, USA
| | - A Corwin
- Thammasat University, Faculty of Public Health, Bangkok, Thailand
| | - A Moen
- Centers for Disease Control and Prevention, Atlanta GA, USA
| | - S J Olsen
- Centers for Disease Control and Prevention, Atlanta GA, USA
| | - J S Bresee
- Centers for Disease Control and Prevention, Atlanta GA, USA.
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34
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Segaloff H, Melidou A, Adlhoch C, Pereyaslov D, Robesyn E, Penttinen P, Olsen SJ. Co-circulation of influenza A(H1N1)pdm09 and influenza A(H3N2) viruses, World Health Organization (WHO) European Region, October 2018 to February 2019. Euro Surveill 2019; 24:1900125. [PMID: 30862331 PMCID: PMC6402174 DOI: 10.2807/1560-7917.es.2019.24.9.1900125] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In the World Health Organization European Region, the 2018/19 influenza season started in week 49 2018, crossing 10% virus-positivity in sentinel surveillance specimens. At week 5 2019, activity remained elevated with positivity rates at 55%. Both A(H1N1)pdm09 and A(H3N2) viruses circulated widely and detection levels in primary care and hospital settings were similar to past seasons. Hospitalisation data may suggest an increased susceptibility to A(H1N1)pdm09 virus in older age groups.
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Affiliation(s)
- Hannah Segaloff
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Dmitriy Pereyaslov
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Emmanuel Robesyn
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sonja J Olsen
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
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35
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Chittaganpitch M, Waicharoen S, Yingyong T, Praphasiri P, Sangkitporn S, Olsen SJ, Lindblade KA. Viral etiologies of influenza-like illness and severe acute respiratory infections in Thailand. Influenza Other Respir Viruses 2018. [PMID: 29518269 PMCID: PMC6005612 DOI: 10.1111/irv.12554] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Indexed: 11/28/2022] Open
Abstract
Background Information on the burden, characteristics and seasonality of non‐influenza respiratory viruses is limited in tropical countries. Objectives Describe the epidemiology of selected non‐influenza respiratory viruses in Thailand between June 2010 and May 2014 using a sentinel surveillance platform established for influenza. Methods Patients with influenza‐like illness (ILI; history of fever or documented temperature ≥38°C, cough, not requiring hospitalization) or severe acute respiratory infection (SARI; history of fever or documented temperature ≥38°C, cough, onset <10 days, requiring hospitalization) were enrolled from 10 sites. Throat swabs were tested for influenza viruses, respiratory syncytial virus (RSV), metapneumovirus (MPV), parainfluenza viruses (PIV) 1‐3, and adenoviruses by polymerase chain reaction (PCR) or real‐time reverse transcriptase‐PCR. Results We screened 15 369 persons with acute respiratory infections and enrolled 8106 cases of ILI (5069 cases <15 years old) and 1754 cases of SARI (1404 cases <15 years old). Among ILI cases <15 years old, influenza viruses (1173, 23%), RSV (447, 9%), and adenoviruses (430, 8%) were the most frequently identified respiratory viruses tested, while for SARI cases <15 years old, RSV (196, 14%) influenza (157, 11%) and adenoviruses (90, 6%) were the most common. The RSV season significantly overlapped the larger influenza season from July to November in Thailand. Conclusions The global expansion of influenza sentinel surveillance provides an opportunity to gather information on the characteristics of cases positive for non‐influenza respiratory viruses, particularly seasonality, although adjustments to case definitions may be required.
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Affiliation(s)
| | | | | | - Prabda Praphasiri
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Somchai Sangkitporn
- National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim A Lindblade
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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36
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Shang M, Blanton L, Brammer L, Olsen SJ, Fry AM. Influenza-Associated Pediatric Deaths in the United States, 2010-2016. Pediatrics 2018; 141:peds.2017-2918. [PMID: 29440502 DOI: 10.1542/peds.2017-2918] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [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] [Accepted: 12/18/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Influenza-associated pediatric deaths became a notifiable condition in the United States in 2004. METHODS We analyzed deaths in children aged <18 years with laboratory-confirmed influenza virus infection reported to the Centers for Disease Control and Prevention during the 2010-2011 to 2015-2016 influenza seasons. Data were collected with a standard case report form that included demographics, medical conditions, and clinical diagnoses. RESULTS Overall, 675 deaths were reported. The median age was 6 years (interquartile range: 2-12). The average annual incidence was 0.15 per 100 000 children (95% confidence interval: 0.14-0.16) and was highest among children aged <6 months (incidence: 0.66; 95% confidence interval: 0.53-0.82), followed by children aged 6-23 months (incidence: 0.33; 95% confidence interval: 0.27-0.39). Only 31% (n = 149 of 477) of children aged ≥6 months had received any influenza vaccination. Overall, 65% (n = 410 of 628) of children died within 7 days after symptom onset. Half of the children (n = 327 of 654) had no preexisting medical conditions. Compared with children with preexisting medical conditions, children with none were younger (median: 5 vs 8 years old), less vaccinated (27% vs 36%), more likely to die before hospital admission (77% vs 48%), and had a shorter illness duration (4 vs 7 days; P < .05 for all). CONCLUSIONS Each year, influenza-associated pediatric deaths are reported. Young children have the highest death rates, especially infants aged <6 months. Increasing vaccination among children, pregnant women, and caregivers of infants may reduce influenza-associated pediatric deaths.
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Affiliation(s)
- Mei Shang
- Epidemic Intelligence Service and.,Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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37
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Budd AP, Wentworth DE, Blanton L, Elal AIA, Alabi N, Barnes J, Brammer L, Burns E, Cummings CN, Davis T, Flannery B, Fry AM, Garg S, Garten R, Gubareva L, Jang Y, Kniss K, Kramer N, Lindstrom S, Mustaquim D, O'Halloran A, Olsen SJ, Sessions W, Taylor C, Xu X, Dugan VG, Katz J, Jernigan D. Update: Influenza Activity - United States, October 1, 2017-February 3, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:169-179. [PMID: 29447145 PMCID: PMC5815487 DOI: 10.15585/mmwr.mm6706a1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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38
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Rolfes MA, Foppa IM, Garg S, Flannery B, Brammer L, Singleton JA, Burns E, Jernigan D, Olsen SJ, Bresee J, Reed C. Annual estimates of the burden of seasonal influenza in the United States: A tool for strengthening influenza surveillance and preparedness. Influenza Other Respir Viruses 2018; 12:132-137. [PMID: 29446233 PMCID: PMC5818346 DOI: 10.1111/irv.12486] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 01/05/2023] Open
Abstract
Background Estimates of influenza disease burden are broadly useful for public health, helping national and local authorities monitor epidemiologic trends, plan and allocate resources, and promote influenza vaccination. Historically, estimates of the burden of seasonal influenza in the United States, focused mainly on influenza‐related mortality and hospitalization, were generated every few years. Since the 2010‐2011 influenza season, annual US influenza burden estimates have been generated and expanded to include estimates of influenza‐related outpatient medical visits and symptomatic illness in the community. Methods We used routinely collected surveillance data, outbreak field investigations, and proportions of people seeking health care from survey results to estimate the number of illnesses, medical visits, hospitalizations, and deaths due to influenza during six influenza seasons (2010‐2011 through 2015‐2016). Results We estimate that the number of influenza‐related illnesses that have occurred during influenza season has ranged from 9.2 million to 35.6 million, including 140 000 to 710 000 influenza‐related hospitalizations. Discussion These annual efforts have strengthened public health communications products and supported timely assessment of the impact of vaccination through estimates of illness and hospitalizations averted. Additionally, annual estimates of influenza burden have highlighted areas where disease surveillance needs improvement to better support public health decision making for seasonal influenza epidemics as well as future pandemics.
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Affiliation(s)
- Melissa A Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ivo M Foppa
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Battelle Memorial Institute, Atlanta, GA, USA
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph Bresee
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Barnes SR, Wansaula Z, Herrick K, Oren E, Ernst K, Olsen SJ, Casal MG. Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010-2014. BMC Infect Dis 2018; 18:78. [PMID: 29433471 PMCID: PMC5809880 DOI: 10.1186/s12879-018-2984-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 01/31/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND From October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults ≥ 65 years old. The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality. METHODS Patients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled. Demographic data were used to link SARI patients to Arizona death certificates. Mortality within 30 days after the date of admission was calculated and risk factors were identified using logistic regression models. RESULTS Among 258 SARI patients, 47% were females, 51% were white, non-Hispanic and 39% were Hispanic. The median age was 63 years (range, 19 to 97 years) and 80% had one or more pre-existing health condition; 9% died in hospital. Mortality increased to 12% (30/258, 30% increase) when electronic vital records and a 30-day post-hospitalization time frame were used. Being age ≥ 65 years (OR = 4.0; 95% CI: 1.6-9.9) and having an intensive care unit admission (OR = 7.4; 95% CI: 3.0-17.9) were independently associated with mortality. CONCLUSION The use of electronic vital records increased SARI-associated mortality estimates by 30%. These findings may help guide prevention and treatment measures, particularly in high-risk persons in this highly fluid border population.
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Affiliation(s)
- Steve R. Barnes
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Zimy Wansaula
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
| | - Kristen Herrick
- Arizona Department of Health Services, Office of Infectious Disease Services, 150 N 18th Ave Phoenix, Phoenix, AZ 85007 USA
| | - Eyal Oren
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Sonja J. Olsen
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027 USA
| | - Mariana G. Casal
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
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40
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Dugan VG, Blanton L, Elal AIA, Alabi N, Barnes J, Brammer L, Burns E, Cummings CN, Davis T, Flannery B, Fry AM, Garg S, Garten R, Gubareva L, Jang Y, Kniss K, Kramer N, Lindstrom S, Mustaquim D, O'Halloran A, Olsen SJ, Sessions W, Taylor C, Trock S, Xu X, Wentworth DE, Katz J, Jernigan D. Update: Influenza Activity - United States, October 1-November 25, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1318-1326. [PMID: 29216030 PMCID: PMC5757637 DOI: 10.15585/mmwr.mm6648a2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Susan Trock
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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Stewart RJ, Rossow J, Conover JT, Lobelo EE, Eckel S, Signs K, Stobierski MG, Trock SC, Fry AM, Olsen SJ, Biggerstaff M. Do animal exhibitors support and follow recommendations to prevent transmission of variant influenza at agricultural fairs? A survey of animal exhibitor households after a variant influenza virus outbreak in Michigan. Zoonoses Public Health 2017; 65:195-201. [PMID: 29143461 PMCID: PMC6631301 DOI: 10.1111/zph.12425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Indexed: 11/30/2022]
Abstract
Influenza A viruses circulate in swine and can spread rapidly among swine when housed in close proximity, such as at agricultural fairs. Youth who have close and prolonged contact with influenza-infected swine at agricultural fairs may be at increased risk of acquiring influenza virus infection from swine. Animal and human health officials have issued written measures to minimize influenza transmission at agricultural exhibitions; however, there is little information on the knowledge, attitudes, and practice (KAP) of these measures among animal exhibitors. After an August 2016 outbreak of influenza A(H3N2) variant (“H3N2v”) virus infections (i.e., humans infected with swine influenza viruses) in Michigan, we surveyed households of animal exhibitors at eight fairs (including one with known H3N2v infections) to assess their KAP related to variant virus infections and their support for prevention measures. Among 170 households interviewed, most (90%, 151/167) perceived their risk of acquiring influenza from swine to be low or very low. Animal exhibitor households reported high levels of behaviours that put them at increased risk of variant influenza virus infections, including eating or drinking in swine barns (43%, 66/154) and hugging, kissing or snuggling with swine at agricultural fairs (31%, 48/157). Among several recommendations, including limiting the duration of swine exhibits and restricting eating and drinking in the animal barns, the only recommendation supported by a majority of households was the presence of prominent hand-washing stations with a person to monitor hand-washing behaviour (76%, 129/170). This is a unique study of KAP among animal exhibitors and highlights that animal exhibitor households engage in behaviours that could increase their risk of variant virus infections and have low support for currently recommended measures to minimize infection transmission. Further efforts are needed to understand the lack of support for recommended measures and to encourage healthy behaviours at fairs.
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Affiliation(s)
- R J Stewart
- Epidemic Intelligence Service, CDC, Atlanta, GA, USA.,Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Rossow
- Epidemiology Elective Program, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Atlanta, GA, USA.,University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - J T Conover
- Michigan State University Extension, East Lansing, MI, USA
| | - E E Lobelo
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Eckel
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - K Signs
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - M G Stobierski
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - S C Trock
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Blanton L, Wentworth DE, Alabi N, Azziz-Baumgartner E, Barnes J, Brammer L, Burns E, Davis CT, Dugan VG, Fry AM, Garten R, Grohskopf LA, Gubareva L, Kniss K, Lindstrom S, Mustaquim D, Olsen SJ, Roguski K, Taylor C, Trock S, Xu X, Katz J, Jernigan D. Update: Influenza Activity - United States and Worldwide, May 21-September 23, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1043-1051. [PMID: 28981486 PMCID: PMC5720887 DOI: 10.15585/mmwr.mm6639a3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - C Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Katherine Roguski
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Susan Trock
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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Kile JC, Ren R, Liu L, Greene CM, Roguski K, Iuliano AD, Jang Y, Jones J, Thor S, Song Y, Zhou S, Trock SC, Dugan V, Wentworth DE, Levine MZ, Uyeki TM, Katz JM, Jernigan DB, Olsen SJ, Fry AM, Azziz-Baumgartner E, Davis CT. Update: Increase in Human Infections with Novel Asian Lineage Avian Influenza A(H7N9) Viruses During the Fifth Epidemic - China, October 1, 2016-August 7, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:928-932. [PMID: 28880856 PMCID: PMC5689040 DOI: 10.15585/mmwr.mm6635a2] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Praphasiri P, Ditsungneon D, Greenbaum A, Dawood FS, Yoocharoen P, Stone DM, Olsen SJ, Lindblade KA, Muangchana C. Do Thai Physicians Recommend Seasonal Influenza Vaccines to Pregnant Women? A Cross-Sectional Survey of Physicians' Perspectives and Practices in Thailand. PLoS One 2017; 12:e0169221. [PMID: 28099486 PMCID: PMC5242501 DOI: 10.1371/journal.pone.0169221] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/25/2016] [Accepted: 12/13/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Physicians play a major role in influencing acceptance and uptake of vaccines. However, little is known about physicians' perspectives on influenza vaccination of pregnant women in Thailand, for whom vaccine coverage is estimated at <1%. METHOD In 2013, a self-administered questionnaire on physicians' perceptions, attitudes and practices related to influenza vaccination for pregnant women was distributed to 1,134 hospitals with an antenatal care clinic (ANC) in Thailand. At each hospital, one physician working at the ANC completed the survey. Predictors of routine recommendation of influenza vaccine were analyzed utilizing log-binomial regression. RESULTS A total of 580 (51%) complete responses were received from physicians practicing at ANCs. A favorable attitude towards vaccination was expressed by 436 (75%) physicians, however only 142 (25%) reported routinely recommending influenza vaccine to pregnant women in their current practice. Physicians were more likely to recommend influenza vaccine routinely when they had more than three years of practice (prevalence ratio [PR] 1.9, 95% CI 1.2-2.3), had treated pregnant women for influenza (PR 1.8, 95% CI 1.3-2.7), perceived the influenza vaccine to be effective (moderate level: PR 1.6, 95% CI 1.1-2.4; high level: PR 1.9, 95% CI 1.3-2.9) and were aware of the Ministry of Public Health's (MOPH) recommendation of influenza vaccination in pregnancy (PR 1.3, 95% CI 1.1-1.7). Vaccine not being available, perception that policy was ambiguous and lack of awareness of MOPH recommendations were the most commonly cited barriers to routine recommendation of influenza vaccine. CONCLUSION Despite a national policy to vaccinate pregnant women for influenza, only 25% of Thai physicians working in ANCs routinely recommend vaccination. Strategies are needed to increase vaccine availability and free vaccine services, address clinician concerns over vaccine effectiveness and expand healthcare provider awareness of MOPH recommendations.
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Affiliation(s)
- Prabda Praphasiri
- Influenza Program, Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- * E-mail:
| | - Darunee Ditsungneon
- Influenza Program, Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Adena Greenbaum
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Fatimah S. Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pornsak Yoocharoen
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Deborah M. Stone
- Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Sonja J. Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kim A. Lindblade
- Influenza Program, Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Shang M, Blanton L, Kniss K, Mustaquim D, Alabi N, Barnes S, Budd A, Davlin SL, Kramer N, Garg S, Cummings CN, Flannery B, Fry AM, Grohskopf LA, Olsen SJ, Bresee J, Sessions W, Garten R, Xu X, Elal AIA, Gubareva L, Barnes J, Wentworth DE, Burns E, Katz J, Jernigan D, Brammer L. Update: Influenza Activity - United States, October 2-December 17, 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1439-1444. [PMID: 28033315 DOI: 10.15585/mmwr.mm655051a5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This report summarizes U.S. influenza activity* during October 2-December 17, 2016.† Influenza activity in the United States remained low in October and has been slowly increasing since November. Influenza A viruses were identified most frequently, with influenza A (H3N2) viruses predominating. Most influenza viruses characterized during this period were genetically or antigenically similar to the reference viruses representing vaccine components recommended for production in the 2016-17 Northern Hemisphere influenza vaccines.
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MESH Headings
- Adolescent
- Adult
- Aged
- Ambulatory Care/statistics & numerical data
- Antiviral Agents/pharmacology
- Child
- Child Mortality
- Child, Preschool
- Drug Resistance, Viral
- Hospitalization/statistics & numerical data
- Humans
- Infant
- Infant, Newborn
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H1N2 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/drug effects
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Influenza, Human/epidemiology
- Influenza, Human/mortality
- Influenza, Human/virology
- Middle Aged
- Pneumonia/mortality
- Population Surveillance
- Seasons
- United States/epidemiology
- Young Adult
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Xiang N, Li X, Ren R, Wang D, Zhou S, Greene CM, Song Y, Zhou L, Yang L, Davis CT, Zhang Y, Wang Y, Zhao J, Li X, Iuliano AD, Havers F, Olsen SJ, Uyeki TM, Azziz-Baumgartner E, Trock S, Liu B, Sui H, Huang X, Zhang Y, Ni D, Feng Z, Shu Y, Li Q. Assessing Change in Avian Influenza A(H7N9) Virus Infections During the Fourth Epidemic - China, September 2015-August 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1390-1394. [PMID: 27977644 DOI: 10.15585/mmwr.mm6549a2] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Since human infections with avian influenza A(H7N9) virus were first reported by the Chinese Center for Disease Control and Prevention (China CDC) in March 2013 (1), mainland China has experienced four influenza A(H7N9) virus epidemics. Prior investigations demonstrated that age and sex distribution, clinical features, and exposure history of A(H7N9) virus human infections reported during the first three epidemics were similar (2). In this report, epidemiology and virology data from the most recent, fourth epidemic (September 2015-August 2016) were compared with those from the three earlier epidemics. Whereas age and sex distribution and exposure history in the fourth epidemic were similar to those in the first three epidemics, the fourth epidemic demonstrated a greater proportion of infected persons living in rural areas, a continued spread of the virus to new areas, and a longer epidemic period. The genetic markers of mammalian adaptation and antiviral resistance remained similar across each epidemic, and viruses from the fourth epidemic remained antigenically well matched to current candidate vaccine viruses. Although there is no evidence of increased human-to-human transmissibility of A(H7N9) viruses, the continued geographic spread, identification of novel reassortant viruses, and pandemic potential of the virus underscore the importance of rigorous A(H7N9) virus surveillance and continued risk assessment in China and neighboring countries.
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Olsen SJ, Vetsaphong P, Vonglokham P, Mirza S, Khanthamaly V, Chanthalangsy T, Chittanavanh S, Syhavong B, Moen A, Bresee J, Corwin A, Xeuatvongsa A. A retrospective review of birth outcomes at the Mother and Child Health Hospital in Lao People's Democratic Republic, 2004-2013. BMC Pregnancy Childbirth 2016; 16:379. [PMID: 27894346 PMCID: PMC5126820 DOI: 10.1186/s12884-016-1168-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background The Lao People’s Democratic Republic (Lao PDR) is a lower-middle income country making steady progress improving maternal and child health outcomes. We sought to ascertain if there have been improvements in three specific birth outcomes (low birth weight, preterm birth and small for gestational age) over the last decade. Methods We retrospectively reviewed birth records between 2004 and 2013 at the Mother and Child Health (MCH) hospital in Vientiane. We defined preterm birth as gestation <37 weeks and low birth weight as <2,500 g. We calculated small for gestational age (SGA). We describe birth outcomes over time and compare proportions using Chi square. Results Between 2004 and 2013, the annual average number of newborns delivered each year was 4,322 and the frequency of low birth weight ranged from 9.5 to 12%, preterm births from 6.3 to 10%, and infants born SGA from 25 to 35%. There were no improvements in these frequencies over time. Women <18 years at delivery had a statistically significantly higher frequency of babies born with a low birth weight (15.3 vs. 10.8%, p < 0.02) or preterm (16.4 vs. 7.8%, p < 0.01) than those aged >18. There was no difference in the frequency of babies born SGA by age (26.8% in women <18 years vs. 29.7% in women >18 years, p = 0.30). Conclusions At the largest maternal and child hospital in Lao PDR, we found a high frequency of poor birth outcomes with no improvements over the last decade.
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Affiliation(s)
- Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
| | | | | | - Sara Mirza
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | | | | | | | | | - Ann Moen
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Joseph Bresee
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Andrew Corwin
- Influenza Program, CDC, Vientiane, Lao PDR.,The QED Group, American Embassy, Vientiane, Lao PDR
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Schicker RS, Rossow J, Eckel S, Fisher N, Bidol S, Tatham L, Matthews-Greer J, Sohner K, Bowman AS, Avrill J, Forshey T, Blanton L, Davis CT, Schiltz J, Skorupski S, Berman L, Jang Y, Bresee JS, Lindstrom S, Trock SC, Wentworth D, Fry AM, de Fijter S, Signs K, DiOrio M, Olsen SJ, Biggerstaff M. Outbreak of Influenza A(H3N2) Variant Virus Infections Among Persons Attending Agricultural Fairs Housing Infected Swine — Michigan and Ohio, July–August 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1157-1160. [DOI: 10.15585/mmwr.mm6542a1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Fry AM, Flannery B, Olsen SJ, Grohskopf L, Bresee J. Letter to the editor: Regarding the editorial by Penttinen and Friede. Euro Surveill 2016; 21:30366. [PMID: 27748252 PMCID: PMC5071613 DOI: 10.2807/1560-7917.es.2016.21.40.30366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/05/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
- Alicia M Fry
- Influenza Division, National Centers for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States
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Budd A, Blanton L, Kniss K, Smith S, Mustaquim D, Davlin SL, Kramer N, Flannery B, Fry AM, Grohskopf LA, Olsen SJ, Bresee J, Sessions W, Garten R, Xu X, Elal AIA, Gubareva L, Barnes J, Wentworth DE, Burns E, Katz J, Jernigan D, Brammer L. Update: Influenza Activity - United States and Worldwide, May 22-September 10, 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1008-1014. [PMID: 27657671 DOI: 10.15585/mmwr.mm6537a5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
During May 22-September 10, 2016,* the United States experienced typical low levels of seasonal influenza activity overall; beginning in late August, clinical laboratories reported a slight increase in influenza positive test results and CDC received reports of a small number of localized influenza outbreaks caused by influenza A (H3N2) viruses. Influenza A (H1N1)pdm09, influenza A (H3N2), and influenza B viruses were detected during May-September in the United States and worldwide. The majority of the influenza viruses collected from the United States and other countries during that time have been characterized antigenically or genetically or both as being similar to the reference viruses representing vaccine components recommended for the 2016-17 Northern Hemisphere vaccine. During May 22-September 10, 2016, 20 influenza variant virus† infections were reported; two were influenza A (H1N2) variant (H1N2v) viruses (Minnesota and Wisconsin) and 18 were influenza A (H3N2) variant (H3N2v) viruses (12 from Michigan and six from Ohio).
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Affiliation(s)
- Alicia Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sophie Smith
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stacy L Davlin
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Joseph Bresee
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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