1
|
Potdar V, Vijay N, Vipat V, Jadhav S, Gupta N, Aggarwal N. External quality assessment for laboratories in pan-India ILI/SARI surveillance for simultaneous detection of influenza virus and SARS-CoV-2. Front Public Health 2023; 11:1274508. [PMID: 38026348 PMCID: PMC10679675 DOI: 10.3389/fpubh.2023.1274508] [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: 08/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Indian Council of Medical Research has set up a nationwide network of 28 laboratories for simultaneous surveillance of influenza virus and SARS-CoV-2 in ILI/SARI patients, using an in-house developed and validated multiplex real-time RTPCR assay. The aim of this study was to ensure the quality of testing by these laboratories by implementing an external quality assessment program (EQAP). Methods For this EQAP, a proficiency test (PT) panel comprising tissue-culture or egg-grown influenza virus and SARS-CoV-2 was developed. The PT panel was distributed to all the participant laboratories, which tested the panel and submitted the qualitative results online to the EQAP provider. The performance of the laboratories was evaluated on qualitative criteria but cycle threshold (Ct) values were also gathered for each sample. Results On a qualitative basis, all the laboratories achieved the criteria of 90% concordance with the results of the PT panel provider. Ct values of different samples across the laboratories were within ≤ ±3 cycles of the corresponding mean values of the respective sample. The results of this EQAP affirmed the quality and reliability of testing being done for simultaneous surveillance of influenza virus and SARS-CoV-2 in India.
Collapse
Affiliation(s)
- Varsha Potdar
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Neetu Vijay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Veena Vipat
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Sheetal Jadhav
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neeraj Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| |
Collapse
|
2
|
Potdar V, Vijay N, Mukhopadhyay L, Aggarwal N, Bhardwaj SD, Choudhary ML, Gupta N, Kaur H, Narayan J, Kumar P, Singh H, Abdulkader RS, Murhekar M, Mishra M, Thangavel S, Nagamani K, Dhodapkar R, Fomda BA, Varshney U, Majumdar A, Dutta S, Vijayachari P, Turuk J, Majumdar T, Sahoo GC, Pandey K, Bhargava A, Negi SS, Khatri PK, Kalawat U, Biswas D, Khandelwal N, Borkakoty B, Manjushree S, Singh MP, Iravane J, Kaveri K, Shantala GB, Brijwal M, Choudhary A, Dar L, Malhotra B, Jain A. Pan-India influenza-like illness ( ILI) and Severe acute respiratory infection (SARI) surveillance: epidemiological, clinical and genomic analysis. Front Public Health 2023; 11:1218292. [PMID: 37927860 PMCID: PMC10624221 DOI: 10.3389/fpubh.2023.1218292] [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: 05/06/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
Background Over time, COVID-19 testing has significantly declined across the world. However, it is critical to monitor the virus through surveillance. In late 2020, WHO released interim guidance advising the use of the existing Global Influenza Surveillance and Response System (GISRS) for the integrated surveillance of influenza and SARS-CoV-2. Methods In July 2021, we initiated a pan-India integrated surveillance for influenza and SARS-CoV-2 through the geographically representative network of Virus Research and Diagnostic Laboratories (VRDLs) across 26 hospital and laboratory sites and 70 community sites. A total of 34,260 cases of influenza-like illness (ILI) and Severe acute respiratory infection (SARI) were enrolled from 4 July 2021 to 31 October 2022. Findings Influenza A(H3) and B/Victoria dominated during 2021 monsoon season while A(H1N1)pdm09 dominated during 2022 monsoon season. The SARS-CoV-2 "variants of concern" (VoC) Delta and Omicron predominated in 2021 and 2022, respectively. Increased proportion of SARI was seen in extremes of age: 90% cases in < 1 year; 68% in 1 to 5 years and 61% in ≥ 8 years age group. Approximately 40.7% of enrolled cases only partially fulfilled WHO ILI and SARI case definitions. Influenza- and SARS-CoV-2-infected comorbid patients had higher risks of hospitalization, ICU admission, and oxygen requirement. Interpretation The results depicted the varying strains and transmission dynamics of influenza and SARS-CoV-2 viruses over time, thus emphasizing the need to continue and expand surveillance across countries for improved decision making. The study also describes important information related to clinical outcomes of ILI and SARI patients and highlights the need to review existing WHO ILI and SARI case definitions.
Collapse
Affiliation(s)
| | - Neetu Vijay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Labanya Mukhopadhyay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neeraj Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | | | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Harmanmeet Kaur
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Jitendra Narayan
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Prabhat Kumar
- Biomedical Informatics (BMI) Division, Indian Council of Medical Research, New Delhi, India
| | - Harpreet Singh
- Biomedical Informatics (BMI) Division, Indian Council of Medical Research, New Delhi, India
| | | | | | - Meena Mishra
- VRDL, All India Institute of Medical Sciences, Nagpur, India
| | | | - K. Nagamani
- VRDL, Gandhi Medical College, Secunderabad, India
| | - Rahul Dhodapkar
- VRDL, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - Agniva Majumdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - P. Vijayachari
- ICMR-Regional Medical Research Centre, Port Blair, India
| | | | | | | | - Krishna Pandey
- ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | | | | | - Usha Kalawat
- VRDL, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Debasis Biswas
- VRDL, All India Institute of Medical Sciences, Bhopal, India
| | | | | | | | - Mini P. Singh
- VRDL, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - K. Kaveri
- VRDL, King Institute of Preventive Medicine and Research, Chennai, India
| | - G. B. Shantala
- VRDL, Bangalore Medical College and Research Institute, Bangalore, India
| | - Megha Brijwal
- VRDL, All India Institute of Medical Sciences, New Delhi, India
| | | | - Lalit Dar
- VRDL, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amita Jain
- VRDL, King George’s Medical University, Lucknow, India
| | | |
Collapse
|
3
|
Abdulkader RS, Potdar V, Mohd G, Chadwick J, Raju MK, Devika S, Bharadwaj SD, Aggarwal N, Vijay N, Sugumari C, Sundararajan T, Vasuki V, Bharathi Santhose N, Mohammed Razik CA, Madhavan V, Krupa NC, Prabakaran N, Murhekar MV, Gupta N. Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India. Front Public Health 2023; 11:1236690. [PMID: 37663861 PMCID: PMC10469860 DOI: 10.3389/fpubh.2023.1236690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.
Collapse
Affiliation(s)
| | | | - Gulam Mohd
- National Institute of Epidemiology, Chennai, India
| | | | | | - S. Devika
- National Institute of Epidemiology, Chennai, India
| | | | | | - Neetu Vijay
- Indian Council of Medical Research, New Delhi, India
| | | | - T. Sundararajan
- Government Mohan Kumaramangalam Medical College, Salem, India
| | - V. Vasuki
- Tiruvarur Medical College Hospital, Tiruvarur, India
| | | | | | | | - N. C. Krupa
- National Institute of Epidemiology, Chennai, India
| | | | | | | |
Collapse
|
4
|
Andrade A, Bang H, Reddick K, Villaseñor B, Tran NK, May L. Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing. Am J Emerg Med 2023; 66:146-151. [PMID: 36773457 PMCID: PMC10038929 DOI: 10.1016/j.ajem.2023.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Acute respiratory infections make up a sizable percentage of emergency department (ED) visits and many result in antibiotics being prescribed. Procalcitonin (PCT) has been found to reduce antibiotic use in both outpatient and critical care settings, yet remains underused in the ED. This study aimed to evaluate whether point of care molecular influenza and Respiratory Syncytial Virus (RSV) testing, PCT, and a pharmacist driven educational intervention in aggregate optimizes antibiotic and antiviral prescribing in the ED setting. METHODS A randomized trial of the Cobas Liat Flu/RSV Assay, procalcitonin, and the use of pharmacist-led education in patients 0-50 years of age being seen in the ED for Influenza Like Illness (ILI) or acute respiratory illness. The study enrolled 200 ED patients between March 2018 and April 2022. RESULTS There was little difference in antibiotic or antiviral prescribing between the intervention and control groups in this study (39%-32% = 7.0%, 95% CI: -6.2, 20.2, P = 0.30). However, a post-hoc analysis of the use of procalcitonin showed results were used as indicated in the ED (P = 0.001). CONCLUSION PCT can be used in both adult and pediatric populations to help guide the decision of whether to treat with antibiotics in the ED setting. Pharmacist guided education may not be a driving factor.
Collapse
Affiliation(s)
- Amia Andrade
- Department of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB 2100, Sacramento, CA 95817, United States of America.
| | - Heejung Bang
- Department of Public Health Sciences, School of Medicine, One Shields Ave., Med-Sci 1C, Davis, CA 95616, United States of America.
| | - Katie Reddick
- Department of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB 2100, Sacramento, CA 95817, United States of America.
| | - Bryan Villaseñor
- Department of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB 2100, Sacramento, CA 95817, United States of America.
| | - Nam K Tran
- Department of Pathology and Laboratory Medicine, University of California, Davis, 3435 Tupper Hall, Davis, CA 95616, United States of America.
| | - Larissa May
- Department of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB 2100, Sacramento, CA 95817, United States of America.
| |
Collapse
|
5
|
Fall A, Han L, Abdullah O, Norton JM, Eldesouki RE, Forman M, Morris CP, Klein E, Mostafa HH. An increase in enterovirus D68 circulation and viral evolution during a period of increased influenza like illness, The Johns Hopkins Health System, USA, 2022. J Clin Virol 2023; 160:105379. [PMID: 36652754 DOI: 10.1016/j.jcv.2023.105379] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/17/2022] [Revised: 11/30/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND An increase in influenza like illness in children and adolescents at the Johns Hopkins Health system during summer 2022 was associated with increased positivity for enterovirus/ rhinovirus. We sought to characterize the epidemiology and viral evolution of enterovirus D68 (EV-D68). METHODS A cohort of remnant respiratory samples tested at the Johns Hopkins Microbiology Laboratory was screened for EV-D68. EV-D68 positives were characterized by whole genome sequencing and viral loads were assessed by droplet digital PCR (ddPCR). Genomic changes and viral loads were analyzed along with patients' clinical presentations. RESULTS Of 566 screened samples, 126 were EV-D68 (22.3%). The median age of EV-D68 infected patients was four years, a total of 52 required supplemental oxygen (41.3%), and 35 (27.8%) were admitted. Lung disease was the most frequent comorbidity that was associated with hospitalization. A total of 75 complete and 32 partial genomes were characterized that made a new cluster within the B3 subclade that was closest to US genomes from 2018. Amino acid changes within the BC and DE loops were identified from 31 genomes (29%) which correlated with an increase in average viral load in respiratory specimens and the need for supplemental oxygen. CONCLUSIONS EV-D68 outbreaks continue to cause influenza like illness that could be overwhelming for the health system due to a significant demand for high flow oxygen. Viral evolution and an increase in the susceptible population are likely driving the trends of the increased EV-D68 infections.
Collapse
Affiliation(s)
- Amary Fall
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - Lijie Han
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - Omar Abdullah
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - Julie M Norton
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - Raghda E Eldesouki
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - Michael Forman
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States
| | - C Paul Morris
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States; National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, United States; Center for Disease Dynamics, Economics, and Policy, Washington DC, United States
| | - Heba H Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, United States.
| |
Collapse
|
6
|
Mavragani A, Li G, Yang J, Zhang T, Du J, Liu T, Zhang X, Han X, Li W, Ma L, Feng L, Yang W. Deep-Learning Model for Influenza Prediction From Multisource Heterogeneous Data in a Megacity: Model Development and Evaluation. J Med Internet Res 2023; 25:e44238. [PMID: 36780207 PMCID: PMC9972203 DOI: 10.2196/44238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/21/2022] [Accepted: 01/10/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In megacities, there is an urgent need to establish more sensitive forecasting and early warning methods for acute respiratory infectious diseases. Existing prediction and early warning models for influenza and other acute respiratory infectious diseases have limitations and therefore there is room for improvement. OBJECTIVE The aim of this study was to explore a new and better-performing deep-learning model to predict influenza trends from multisource heterogeneous data in a megacity. METHODS We collected multisource heterogeneous data from the 26th week of 2012 to the 25th week of 2019, including influenza-like illness (ILI) cases and virological surveillance, data of climate and demography, and search engines data. To avoid collinearity, we selected the best predictor according to the weight and correlation of each factor. We established a new multiattention-long short-term memory (LSTM) deep-learning model (MAL model), which was used to predict the percentage of ILI (ILI%) cases and the product of ILI% and the influenza-positive rate (ILI%×positive%), respectively. We also combined the data in different forms and added several machine-learning and deep-learning models commonly used in the past to predict influenza trends for comparison. The R2 value, explained variance scores, mean absolute error, and mean square error were used to evaluate the quality of the models. RESULTS The highest correlation coefficients were found for the Baidu search data for ILI% and for air quality for ILI%×positive%. We first used the MAL model to calculate the ILI%, and then combined ILI% with climate, demographic, and Baidu data in different forms. The ILI%+climate+demography+Baidu model had the best prediction effect, with the explained variance score reaching 0.78, R2 reaching 0.76, mean absolute error of 0.08, and mean squared error of 0.01. Similarly, we used the MAL model to calculate the ILI%×positive% and combined this prediction with different data forms. The ILI%×positive%+climate+demography+Baidu model had the best prediction effect, with an explained variance score reaching 0.74, R2 reaching 0.70, mean absolute error of 0.02, and mean squared error of 0.02. Comparisons with random forest, extreme gradient boosting, LSTM, and gated current unit models showed that the MAL model had the best prediction effect. CONCLUSIONS The newly established MAL model outperformed existing models. Natural factors and search engine query data were more helpful in forecasting ILI patterns in megacities. With more timely and effective prediction of influenza and other respiratory infectious diseases and the epidemic intensity, early and better preparedness can be achieved to reduce the health damage to the population.
Collapse
Affiliation(s)
| | - Gang Li
- Beijing Centre for Disease Prevention and Control, Beijing, China
| | - Jin Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ting Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Du
- Beijing Centre for Disease Prevention and Control, Beijing, China
| | - Tian Liu
- Jingzhou Center for Disease Control and Prevention, Jingzhou, China
| | - Xingxing Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuan Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Li
- The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Libing Ma
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
7
|
Lian XY, Xi L, Zhang ZS, Yang LL, Du J, Cui Y, Li HJ, Zhang WX, Wang C, Liu B, Yang YN, Cui F, Lu QB. Impact of air pollutants on influenza-like illness outpatient visits under COVID-19 pandemic in the subcenter of Beijing, China. J Med Virol 2023; 95:e28514. [PMID: 36661040 DOI: 10.1002/jmv.28514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
This study aimed to explore the association between air pollutants and outpatient visits for influenza-like illnesses (ILI) under the coronavirus disease 2019 (COVID-19) stage in the subcenter of Beijing. The data on ILI in the subcenter of Beijing from January 1, 2018 to December 31, 2020 were obtained from the Beijing Influenza Surveillance Network. A generalized additive Poisson model was applied to examine the associations between the concentrations of air pollutants and daily outpatient visits for ILI when controlling meteorological factors and temporal trend. A total of 171 943 ILI patients were included. In the pre-coronavirus disease 2019 (COVID-19) stage, an increased risk of ILI outpatient visits was associated to a high air quality index (AQI) and the high concentrations of particulate matter less than 2.5 (PM2.5 ), particulate matter 10 (PM10 ), sulphur dioxide (SO2 ), nitrogen dioxide (NO2 ), and carbon monoxide (CO), and a low concentration of ozone (O3 ) on lag0 day and lag1 day, while a higher increased risk of ILI outpatient visits was observed by the air pollutants in the COVID-19 stage on lag0 day. Except for PM10 , the concentrations of other air pollutants on lag1 day were not significantly associated with an increased risk of ILI outpatient visits during the COVID-19 stage. The findings that air pollutants had enhanced immediate effects and diminished lag-effects on the risk of ILI outpatient visits during the COVID-19 pandemic, which is important for the development of public health and environmental governance strategies.
Collapse
Affiliation(s)
- Xin Yao Lian
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Lu Xi
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Zhong Song Zhang
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Li Li Yang
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Juan Du
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Yan Cui
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Hong Jun Li
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Wan Xue Zhang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Chao Wang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Bei Liu
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Yan Na Yang
- Center for Disease Control and Prevention of Beijing Economic and Technological Development Area, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Qing Bin Lu
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| |
Collapse
|
8
|
Faye MN, Barry MA, Jallow MM, Wade SF, Mendy MP, Sy S, Fall A, Kiori DE, Ndiaye NK, Goudiaby D, Diamanka A, Niang MN, Dia N. Epidemiology of Non-SARS-CoV2 Human Coronaviruses (HCoVs) in People Presenting with Influenza-like Illness ( ILI) or Severe Acute Respiratory Infections (SARI) in Senegal from 2012 to 2020. Viruses 2022; 15:20. [PMID: 36680061 PMCID: PMC9864203 DOI: 10.3390/v15010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/09/2022] [Revised: 12/03/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
In addition to emerging coronaviruses (SARS-CoV, MERS, SARS-CoV-2), there are seasonal human coronaviruses (HCoVs): HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1. With a wide distribution around the world, HCoVs are usually associated with mild respiratory disease. In the elderly, young children and immunocompromised patients, more severe or even fatal respiratory infections may be observed. In Africa, data on seasonal HCoV are scarce. This retrospective study investigated the epidemiology and genetic diversity of seasonal HCoVs during nine consecutive years of influenza-like illness surveillance in Senegal. Nasopharyngeal swabs were collected from ILI outpatients or from SARI hospitalized patients. HCoVs were diagnosed by qRT-PCR and the positive samples were selected for molecular characterization. Among 9337 samples tested for HCoV, 406 (4.3%) were positive: 235 (57.9%) OC43, 102 (25.1%) NL63, 58 (14.3%) 229E and 17 (4.2%) HKU1. The four types circulated during the study period and a peak was noted between November and January. Children under five were the most affected. Co-infections were observed between HCoV types (1.2%) or with other viruses (76.1%). Genetically, HCoVs types showed diversity. The results highlighted that the impact of HCoVs must be taken into account in public health; monitoring them is therefore particularly necessary both in the most sensitive populations and in animals.
Collapse
Affiliation(s)
- Modeste Name Faye
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
- Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta DIOP de Dakar, Dakar 12900, Senegal
| | - Mamadou Aliou Barry
- Epidemiology, Clinical Research and Data Science Department, Institut Pasteur de Dakar, Dakar 12900, Senegal
| | - Mamadou Malado Jallow
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
- Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta DIOP de Dakar, Dakar 12900, Senegal
| | - Serigne Fallou Wade
- Ecole Supérieure des Sciences Agricoles et de l’Alimentation (ES2A), Université Amadou Makhtar MBOW de Dakar (UAM), Dakar 12900, Senegal
| | - Marie Pedapa Mendy
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
- Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta DIOP de Dakar, Dakar 12900, Senegal
| | - Sara Sy
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
| | - Amary Fall
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
| | - Davy Evrard Kiori
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
| | | | - Deborah Goudiaby
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
| | - Arfang Diamanka
- Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta DIOP de Dakar, Dakar 12900, Senegal
| | | | - Ndongo Dia
- Département de Virologie, Institut Pasteur de Dakar, Dakar 12900, Senegal
| |
Collapse
|
9
|
Li X, Bilcke J, van der Velden AW, Bruyndonckx R, Coenen S, Bongard E, de Paor M, Chlabicz S, Godycki-Cwirko M, Francis N, Aabenhus R, Bucher HC, Colliers A, De Sutter A, Garcia-Sangenis A, Glinz D, Harbin NJ, Kosiek K, Lindbæk M, Lionis C, Llor C, Mikó-Pauer R, Radzeviciene Jurgute R, Seifert B, Sundvall PD, Touboul Lundgren P, Tsakountakis N, Verheij TJ, Goossens H, Butler CC, Beutels P. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC 4E trial in 15 European countries. Eur J Health Econ 2022:10.1007/s10198-022-01521-2. [PMID: 36131214 DOI: 10.1007/s10198-022-01521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Oseltamivir is usually not often prescribed (or reimbursed) for non-high-risk patients consulting for influenza-like-illness (ILI) in primary care in Europe. We aimed to evaluate the cost-effectiveness of adding oseltamivir to usual primary care in adults/adolescents (13 years +) and children with ILI during seasonal influenza epidemics, using data collected in an open-label, multi-season, randomised controlled trial of oseltamivir in 15 European countries. METHODS Direct and indirect cost estimates were based on patient reported resource use and official country-specific unit costs. Health-Related Quality of Life was assessed by EQ-5D questionnaires. Costs and quality adjusted life-years (QALY) were bootstrapped (N = 10,000) to estimate incremental cost-effectiveness ratios (ICER), from both the healthcare payers' and the societal perspectives, with uncertainty expressed through probabilistic sensitivity analysis and expected value for perfect information (EVPI) analysis. Additionally, scenario (self-reported spending), comorbidities subgroup and country-specific analyses were performed. RESULTS The healthcare payers' expected ICERs of oseltamivir were €22,459 per QALY gained in adults/adolescents and €13,001 in children. From the societal perspective, oseltamivir was cost-saving in adults/adolescents, but the ICER is €8,344 in children. Large uncertainties were observed in subgroups with comorbidities, especially for children. The expected ICERs and extent of decision uncertainty varied between countries (EVPI ranged €1-€35 per patient). CONCLUSION Adding oseltamivir to primary usual care in Europe is likely to be cost-effective for treating adults/adolescents and children with ILI from the healthcare payers' perspective (if willingness-to-pay per QALY gained > €22,459) and cost-saving in adults/adolescents from a societal perspective.
Collapse
Affiliation(s)
- Xiao Li
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, room D.S.221, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Joke Bilcke
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, room D.S.221, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Alike W van der Velden
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Robin Bruyndonckx
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Data Science Institute (DSI), Hasselt University, Hasselt, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Samuel Coenen
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
| | - Emily Bongard
- The Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Muirrean de Paor
- RCSI Department of General Practice, 123 St Stephens Green, Dublin 2, Ireland
| | - Slawomir Chlabicz
- Department of Family Medicine, Medical University of Bialystok, Białystok, Poland
| | | | - Nick Francis
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rune Aabenhus
- Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heiner C Bucher
- Division of Infectious Diseases and Hospital Hygiene, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Annelies Colliers
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care (Centre for Family Medicine), Gent University, Gent, Belgium
| | - Ana Garcia-Sangenis
- University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain
| | - Dominik Glinz
- Department of Clinical Research, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Nicolay J Harbin
- Department of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Morten Lindbæk
- Research Leader Antibiotic Centre for Primary Care, Department of General Practice, University of Oslo, Oslo, Norway
| | - Christos Lionis
- General Practice and Primary Health Care at the School of Medicine, University of Crete, Crete, Greece
| | - Carl Llor
- University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Bohumil Seifert
- Institute of General Practice, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Pär-Daniel Sundvall
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sandared, Sweden
| | | | | | - Theo J Verheij
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Herman Goossens
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
| | - Christopher C Butler
- The Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, room D.S.221, Universiteitsplein 1, 2610, Antwerp, Belgium
| |
Collapse
|
10
|
Li XG, Chen J, Wang W, Lin F, Li L, Liang JJ, Deng ZH, Zhang BY, Jia Y, Su YB, Kang YF, Du J, Liu YQ, Xu J, Lu QB. Oseltamivir Treatment for Influenza During the Flu Season of 2018-2019: A Longitudinal Study. Front Microbiol 2022; 13:865001. [PMID: 35620096 PMCID: PMC9127596 DOI: 10.3389/fmicb.2022.865001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Oseltamivir resistance in influenza virus (IFV) has been of widespread concern. An increase in the frequency of viruses with reduced inhibition was observed. Whether oseltamivir is effective is uncertain. We conducted this study to understand the real-world situation in northern China and the clinical efficacy for patients with IFV infection after the use of oseltamivir. Methods The longitudinal study was performed on influenza-like illness (ILI) cases in a tertiary general hospital in Beijing, China during the flu season of 2018–2019. All ILI cases (≥18 years) were recruited into the study. We analyzed the effect of the oseltamivir therapy on the number of clinic visits, hospitalization frequency, and the duration of fever and cough. Results A total of 689 ILI patients were recruited in this study with 355 in the oseltamivir therapy group and 334 in the supportive therapy group. Among the ILI patients, 388 patients were detected for IFV infection (364 IFV-A and 24 IFV-B) and divided into two groups with or without the oseltamivir therapy (302 vs. 86). There were no significant differences in the basic characteristics between the oseltamivir and supportive therapy groups in the ILI patients or in the IFV positive patients (all p < 0.05). After adjusting for the potential confounders, oseltamivir therapy reduced the times of clinic visits in the ILI and IFV positive patients (p = 0.043 and p = 0.011). No effectiveness with oseltamivir therapy was observed in the outcomes of hospitalization frequency, and the duration of fever and cough. Conclusion Oseltamivir use may reduce the times of clinic visits. However, we did not observe the differences in the duration of fever, cough, and the frequency of hospitalization between oseltamivir therapy and supportive therapy.
Collapse
Affiliation(s)
- Xiao-Guang Li
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Jing Chen
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Wei Wang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Fei Lin
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Lu Li
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Jing-Jin Liang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Zhong-Hua Deng
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Bi-Ying Zhang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Ying Jia
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Yuan-Bo Su
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Yong-Feng Kang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Ya-Qiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Jie Xu
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
11
|
Spencer JA, Shutt DP, Moser SK, Clegg H, Wearing HJ, Mukundan H, Manore CA. Distinguishing viruses responsible for influenza-like illness. J Theor Biol 2022; 545:111145. [PMID: 35490763 DOI: 10.1016/j.jtbi.2022.111145] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
The many respiratory viruses that cause influenza-like illness (ILI) are reported and tracked as one entity, defined by the CDC as a group of symptoms that include a fever of 100 degrees Fahrenheit, a cough, and/or a sore throat. In the United States alone, ILI impacts 9-49 million people every year. While tracking ILI as a single clinical syndrome is informative in many respects, the underlying viruses differ in parameters and outbreak properties. Most existing models treat either a single respiratory virus or ILI as a whole. However, there is a need for models capable of comparing several individual viruses that cause respiratory illness, including ILI. To address this need, here we present a flexible model and simulations of epidemics for influenza, RSV, rhinovirus, seasonal coronavirus, adenovirus, and SARS/MERS, parameterized by a systematic literature review and accompanied by a global sensitivity analysis. We find that for these biological causes of ILI, their parameter values, timing, prevalence, and proportional contributions differ substantially. These results demonstrate that distinguishing the viruses that cause ILI will be an important aspect of future work on diagnostics, mitigation, modeling, and preparation for future pandemics.
Collapse
Affiliation(s)
- Julie A Spencer
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA.
| | - Deborah P Shutt
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA
| | - S Kane Moser
- B-10 Biosecurity and Public Health, Los Alamos National Laboratory, NM87545, USA
| | - Hannah Clegg
- A-1 Information Systems and Modeling, Los Alamos National Laboratory, NM87545, USA
| | - Helen J Wearing
- Department of Biology, University of New Mexico, NM87131, USA; Department of Mathematics and Statistics, University of New Mexico, NM87102, USA
| | - Harshini Mukundan
- C-PCS Physical Chemistry and Applied Spectroscopy, Los Alamos National Laboratory, NM87545, USA
| | - Carrie A Manore
- T-6 Theoretical Biology and Biophysics, Los Alamos National Laboratory, NM87545, USA
| |
Collapse
|
12
|
Zhang H, Ren X, Tian K, Yu J, Zhu A, Zhang L, Gao GF, Li Z. The Impact and Vaccination Coverage of Seasonal Influenza among Children Aged 6-59 Months in China in 2017-2018: An Internet Panel Survey. Vaccines (Basel) 2022; 10:vaccines10040630. [PMID: 35455379 PMCID: PMC9031834 DOI: 10.3390/vaccines10040630] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/02/2022] [Accepted: 04/12/2022] [Indexed: 02/05/2023] Open
Abstract
Seasonal influenza vaccination is highly recommended for 6-59-month-old children. To determine the impact of seasonal influenza and the factors affecting influenza vaccine uptake among children, we conducted an opt-in Internet panel survey of parents from 21 March 2018 to 1 April 2018. Overall, 40.5% (1913/4719) of children experienced influenza-like illness (ILI), 92.4% of parents sought medical care for children with ILI (outpatients: 61.2%, inpatients: 12.8%), 39.6% of parents preferred to take their sick child to a tertiary hospital, and 57.3% of family members requested leave to care for children with ILI. There was a median of three days of absenteeism (2, 5) per sick child, and 39.4% of children received the influenza vaccine during the 2017-2018 influenza season. Vaccine coverage among children aged 6-11 months and 48-59 months was lower than that among 12-47-month-old children. The top three reasons for not vaccinating were: the influenza vaccine was not recommended by healthcare workers (21.1%), no knowledge about the influenza vaccine (19.2%), and lack of confidence in the vaccine's effectiveness (14.3%). Our findings highlight the need for awareness about the severity of influenza, hygiene behavior, and effectiveness of the influenza vaccine among children and their family members in China.
Collapse
Affiliation(s)
- Hangjie Zhang
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100101, China;
- The Center for Disease Control and Prevention of Zhejiang Province, Hangzhou 310051, China
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (K.T.); (L.Z.)
| | - Xiang Ren
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (X.R.); (J.Y.); (A.Z.)
| | - Keqing Tian
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (K.T.); (L.Z.)
| | - Jianxing Yu
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (X.R.); (J.Y.); (A.Z.)
| | - Aiqing Zhu
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (X.R.); (J.Y.); (A.Z.)
| | - Lijie Zhang
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (K.T.); (L.Z.)
| | - George Fu Gao
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100101, China;
- Correspondence: (G.F.G.); (Z.L.); Tel.: +86-10-5890-0211 (G.F.G.); +86-10-5890-0547 (Z.L.)
| | - Zhongjie Li
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 100101, China; (X.R.); (J.Y.); (A.Z.)
- Correspondence: (G.F.G.); (Z.L.); Tel.: +86-10-5890-0211 (G.F.G.); +86-10-5890-0547 (Z.L.)
| |
Collapse
|
13
|
Sapra M, Kirubanandhan S, Kanta P, Ghosh A, Goyal K, Singh MP, Ratho RK. Respiratory viral infections other than SARS CoV-2 among the North Indian patients presenting with acute respiratory illness during the first COVID-19 wave. Virusdisease 2022;:1-8. [PMID: 35411310 DOI: 10.1007/s13337-022-00761-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Abstract
Acute respiratory infections due to viral or bacterial etiology can cause 60 deaths per one lakh population. Viral etiology is more common as compared to bacterial, but lack of definite diagnosis leads to increased usage of empirical antibiotics. During the first wave of the COVID-19 pandemic, there was a need to identify co-infections especially in severe acute respiratory illness (SARI) patients to identify it as one of the cofactors for increased severity of illness and to identify the causative agents in COVID-19 negative individuals. The SARS CoV-2 real time PCR was carried out using ICMR approved kits and the other respiratory viruses were detected using the multiplex commercially available real time kit. A total of 186 patients presenting with either SARI (89.8%) or influenza like illness (10.2%) were included in the study. Out of these, 43 (23.1%) were positive for SARS CoV-2 RNA and 2 (4.6%) patients with SARI showed concomitant infection with either human rhinovirus or human respiratory syncytial virus . Out of 143 patients negative for SARS CoV-2, 35 (24.5%) were positive for one or more microbial infections and 28 (19.6%) infected with other respiratory viral infection most common being human rhinovirus. The results suggest that viral coinfections are significantly higher among COVID-19 negative individuals (24.5% vs 4.6%) presenting with respiratory illness as compared to COVID-19 positive individuals possibly due to viral interference and competitive advantage of SARS-CoV-2 in modulating the host immunity. Further detailed research is required for the understanding of mechanisms of viral co-infection.
Collapse
|
14
|
Tsan YT, Chen DY, Liu PY, Kristiani E, Nguyen KLP, Yang CT. The Prediction of Influenza-like Illness and Respiratory Disease Using LSTM and ARIMA. Int J Environ Res Public Health 2022; 19:1858. [PMID: 35162879 DOI: 10.3390/ijerph19031858] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023]
Abstract
This paper proposed the forecasting model of Influenza-like Illness (ILI) and respiratory disease. The dataset was extracted from the Taiwan Environmental Protection Administration (EPA) for air pollutants data and the Centers for Disease Control (CDC) for disease cases from 2009 to 2018. First, this paper applied the ARIMA method, which trained based on the weekly number of disease cases in time series. Second, we implemented the Long short-term memory (LSTM) method, which trained based on the correlation between the weekly number of diseases and air pollutants. The models were also trained and evaluated based on five and ten years of historical data. Autoregressive integrated moving average (ARIMA) has an excellent model in the five-year dataset of ILI at 2564.9 compared to ten years at 8173.6 of RMSE value. This accuracy is similar to the Respiratory dataset, which gets 15,656.7 in the five-year dataset and 22,680.4 of RMSE value in the ten-year dataset. On the contrary, LSTM has better accuracy in the ten-year dataset than the five-year dataset. For example, on average of RMSE in the ILI dataset, LSTM has 720.2 RMSE value in five years and 517.0 in ten years dataset. Also, in the Respiratory disease dataset, LSTM gets 4768.6 of five years of data and 3254.3 of the ten-year dataset. These experiments revealed that the LSTM model generally outperforms ARIMA by three to seven times higher model performance.
Collapse
|
15
|
Sycińska-Dziarnowska M, Woźniak K, Paradowska-Stankiewicz I. Intrest in influenza and influenza like illnesses in Poland 2016-2021 based on Google Trend's data analysis. Przegl Epidemiol 2022; 76:11-18. [PMID: 35860920 DOI: 10.32394/pe.76.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Influenza and Influenza Like Illness (ILI) are viral diseases that show seasonality in incidence. Influenza can be effectively prevented with immunization. Vaccination is recommended for risk groups, especially for the elderly, immunocompromised population, with chronic diseases and pregnant women. AIM OF THE STUDY The purpose of the study was to assess interest in influenza and influenza vaccine in Poland by users of the Google search engine over the last five years using the Google Trends (GT) tool. MATERIAL AND METHODS Data collected from Google Trends (GT) over a five-year period beginning on 11/9/2016 was analyzed. The time trend analysis focused at four phrases in Polish "grypa", "grypa objawy", "szczepionka przeciw grypie" and "szczepionka na grypę", which can be translated into English, as; "flu", "flu symptoms", "flu vaccine", and a colloquial phrase meaning "against the flu vaccine". RESULTS Before the outbreak of the COVID-19 pandemic, a seasonal increase in inquiries is evident, mimicking the increase in influenza and ILI cases or an increase in interest in the topic during the season in which prophylaxis is carried out using available vaccines. During the COVID-19 pandemic, the seasonal interest in the above topic was disrupted. CONCLUSIONS During the COVID-19 pandemic, there were changes in the search terms in Polish. This included the timing and amount of queries related to influenza-themed expressions. During the COVID-19 pandemic, there was an increase in influenza and ILI queries during the period of increased incidence of COVID-19.
Collapse
Affiliation(s)
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University in Szczecin
| | - Iwona Paradowska-Stankiewicz
- National Institute of Public Health NIH - National Research Institute, Departament of Epidemiology of Infectious Diseases and Surveillance
| |
Collapse
|
16
|
Korsten K, Adriaenssens N, Coenen S, Butler CC, Verheij TJM, Bont LJ, Wildenbeest JG. World Health Organization Influenza-Like Illness Underestimates the Burden of Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults. J Infect Dis 2021; 226:S71-S78. [PMID: 34904176 PMCID: PMC9374507 DOI: 10.1093/infdis/jiab452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) surveillance is heavily dependent on the influenza-like illness (ILI) case definition from the World Health Organization (WHO). Because ILI includes fever in its syndromic case definition, its ability to accurately identify acute respiratory tract infections (ARTI) caused by RSV in older adults is uncertain. Methods The accuracy of the WHO ILI and a modified ILI (requiring only self-reported fever) case definitions in identifying patients with PCR-confirmed RSV-ARTI was evaluated in community-dwelling older adults (≥60 years) from the prospective European RESCEU cohort study. Results Among 1040 participants, 750 ARTI episodes were analyzed including 36 confirmed RSV-ARTI. Due to a general lack of fever, sensitivity for RSV-ARTI was 33% for modified ILI and 11% for ILI. The area under the curve for both ILI definitions was 0.52 indicating poor discrimination for RSV. RSV-ARTI could not be distinguished from all other ARTI based on clinical symptoms. Conclusions The use of ILI underestimated the occurrence of RSV-ARTI in community-dwelling older adults up to 9-fold (11% sensitivity). Because worldwide RSV surveillance depends largely on ILI, there is an urgent need for a better approach to measure the occurrence of RSV disease and the impact of future RSV vaccine introduction. Clinical Trials Registration. NCT03621930.
Collapse
Affiliation(s)
- Koos Korsten
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Niels Adriaenssens
- Vaccine and Infectious Disease Institute, Laboratory of Medical Microbiology, University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium.,Department of Family Medicine and Population Medicine, Primary and Interdisciplinary Care, Centre for General Practice, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Samuel Coenen
- Vaccine and Infectious Disease Institute, Laboratory of Medical Microbiology, University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium.,Department of Family Medicine and Population Medicine, Primary and Interdisciplinary Care, Centre for General Practice, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Chris C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Theo J M Verheij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Louis J Bont
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joanne G Wildenbeest
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | | |
Collapse
|
17
|
Goossens ME, Neven KY, Pannus P, Barbezange C, Thomas I, Gucht SV, Dierick K, Schmickler MN, Verbrugghe M, Loon NV, Ariën KK, Marchant A, Goriely S, Desombere I. The prior infection with SARS-CoV-2 study (PICOV) in nursing home residents and staff - study protocol description and presentation of preliminary findings on symptoms. Arch Public Health 2021; 79:195. [PMID: 34763723 PMCID: PMC8581120 DOI: 10.1186/s13690-021-00715-z] [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: 03/19/2021] [Accepted: 10/17/2021] [Indexed: 01/06/2023] Open
Abstract
Background The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented itself as one of the most important health concerns of the 2020’s, and hit the geriatric population the hardest. The presence of co-morbidities and immune ageing in the elderly lead to an increased susceptibility to COVID-19, as is the case for other influenza-like illnesses (ILI) or acute respiratory tract infections (ARI). However, little is known, about the impact of a previous or current infection on the other in terms of susceptibility, immune response, and clinical course. The aim of the “Prior Infection with SARS-COV-2” (PICOV) study is to compare the time to occurrence of an ILI or ARI between participants with a confirmed past SARS-CoV-2 infection (previously infected) and those without a confirmed past infection (naïve) in residents and staff members of nursing homes. This paper describes the study design and population characteristics at baseline. Methods In 26 Belgian nursing homes, all eligible residents and staff members were invited to participate, resulting in 1,226 participants. They were classified as naïve or previously infected based on the presence of detectable SARS-CoV-2 antibodies and/or a positive RT-qPCR result before participation in the study. Symptoms from a prior SARS-CoV-2 infection between March and August 2020 were compared between previously infected residents and staff members. Results Infection naïve nursing home residents reported fewer symptoms than previously infected residents: on average 1.9 and 3.1 symptoms, respectively (p = 0.016). The same effect was observed for infection naïve staff members and previously infected staff members (3.1 and 6.1 symptoms, respectively; p <0.0001). Moreover, the antibody development after a SARS-CoV-2 infection differs between residents and staff members, as previously infected residents tend to have a higher rate of asymptomatic cases compared to previously infected staff members (20.5% compared to 12.4%; p <0.0001). Conclusions We can postulate that COVID-19 disease development and symptomatology are different between a geriatric and younger population. Therefore, the occurrence and severity of a future ILI and/or ARI might vary from resident to staff.
Collapse
Affiliation(s)
- Maria E Goossens
- SD Epidemiology and Public Health, Sciensano, Brussels, Belgium.
| | - Kristof Y Neven
- SD Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Pieter Pannus
- SD Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Isabelle Thomas
- SD Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | | | | | | | | | - Nele Van Loon
- Mensura Occupational Health Service, Antwerp, Belgium
| | - Kevin K Ariën
- Virology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Arnaud Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Stanislas Goriely
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | | |
Collapse
|
18
|
Cawley C, Bergey F, Mehl A, Finckh A, Gilsdorf A. Novel Methods in the Surveillance of Influenza-Like Illness in Germany Using Data From a Symptom Assessment App (Ada): Observational Case Study. JMIR Public Health Surveill 2021; 7:e26523. [PMID: 34734836 PMCID: PMC8722671 DOI: 10.2196/26523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/04/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Participatory epidemiology is an emerging field harnessing consumer data entries of symptoms. The free app Ada allows users to enter the symptoms they are experiencing and applies a probabilistic reasoning model to provide a list of possible causes for these symptoms. Objective The objective of our study is to explore the potential contribution of Ada data to syndromic surveillance by comparing symptoms of influenza-like illness (ILI) entered by Ada users in Germany with data from a national population-based reporting system called GrippeWeb. Methods We extracted data for all assessments performed by Ada users in Germany over 3 seasons (2017/18, 2018/19, and 2019/20) and identified those with ILI (report of fever with cough or sore throat). The weekly proportion of assessments in which ILI was reported was calculated (overall and stratified by age group), standardized for the German population, and compared with trends in ILI rates reported by GrippeWeb using time series graphs, scatterplots, and Pearson correlation coefficient. Results In total, 2.1 million Ada assessments (for any symptoms) were included. Within seasons and across age groups, the Ada data broadly replicated trends in estimated weekly ILI rates when compared with GrippeWeb data (Pearson correlation—2017-18: r=0.86, 95% CI 0.76-0.92; P<.001; 2018-19: r=0.90, 95% CI 0.84-0.94; P<.001; 2019-20: r=0.64, 95% CI 0.44-0.78; P<.001). However, there were differences in the exact timing and nature of the epidemic curves between years. Conclusions With careful interpretation, Ada data could contribute to identifying broad ILI trends in countries without existing population-based monitoring systems or to the syndromic surveillance of symptoms not covered by existing systems.
Collapse
|
19
|
Li X, Xu J, Wang W, Liang JJ, Deng ZH, Du J, Xie MZ, Wang XR, Liu Y, Cui F, Lu QB. Air pollutants and outpatient visits for influenza-like illness in Beijing, China. PeerJ 2021; 9:e11397. [PMID: 34141466 PMCID: PMC8179240 DOI: 10.7717/peerj.11397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background Air pollution leads to many adverse health conditions, mainly manifested by respiratory or cardiac symptoms. Previous studies are limited as to whether air pollutants were associated to influenza-like illness (ILI). This study aimed to explore the association between air pollutants and outpatient visits for ILI, especially during an outbreak of influenza. Methods Daily counts of hospital visits for ILI were obtained from Peking University Third Hospital between January 1, 2015, and March 31, 2018. A generalized additive Poisson model was applied to examine the associations between air pollutants concentrations and daily outpatient visits for ILI when adjusted for the meteorological parameters. Results There were 35862 outpatient visits at the fever clinic for ILI cases. Air quality index (AQI), PM2.5, PM10, CO and O3 on lag0 days, as well as nitrogen dioxide (NO2) and sulfur dioxide (SO2) on lag1 days, were significantly associated with an increased risk of outpatient visits for ILI from January 2015 to November 2017. From December 2017 to March 2018, on lag0 days, air pollutants PM2.5 [risk ratio (RR) = 0.971, 95% CI: 0.963-0.979], SO2 (RR = 0.892, 95% CI: 0.840–0.948) and CO (RR = 0.306, 95% CI: 0.153–0.612) were significantly associated with a decreased risk of outpatient visits for ILI. Interestingly, on the lag2 days, all the pollutants were significantly associated with a reduced risk of outpatient visits for ILI except for O3. We did not observe the linear correlations between the outpatient visits for ILI and any of air pollutants, which were instead associated via a curvilinear relationship. Conclusions We found that the air pollutants may be associated with an increased risk of outpatient visits for ILI during the non-outbreak period and with a decreased risk during the outbreak period, which may be linked with the use of disposable face masks and the change of outdoor activities. These findings expand the current knowledge of ILI outpatient visits correlated with air pollutants during an influenza pandemic.
Collapse
Affiliation(s)
- Xiaoguang Li
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Jie Xu
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Wei Wang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Jing-Jin Liang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Zhong-Hua Deng
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Juan Du
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Ming-Zhu Xie
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xin-Rui Wang
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Yaqiong Liu
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Fuqiang Cui
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial of Science and Technology, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
20
|
Mirza FN, Malik AA, Couzens C, Omer SB. Influenza-negative influenza-like illness (fn ILI) Z-score as a proxy for incidence and mortality of COVID-19. J Infect 2020; 81:793-796. [PMID: 32888977 PMCID: PMC7462572 DOI: 10.1016/j.jinf.2020.08.046] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 01/08/2023]
Abstract
Although direct detection of SARS-CoV2 in symptomatic or asymptomatic individuals is the ideal epidemiological tool for determining the burden of disease, the lack of availability of testing can preclude its wider implementation as a robust surveillance system. We correlated the use of the derivative influenza-negative influenza-like illness (fnILI) z-score from the US Centers for Disease Control and Prevention as a proxy for incident cases and disease-specific deaths. For every unit increase of fnILI z-score, the number of cases increased by 376.5 (95% CI [202.5, 550.5]) and number of deaths increased by 10.2 (95% CI [5.4, 15.0]). FnILI data may serve as an accurate outcome measurement to track the spread of COVID-19 infection and disease, and allow for informed and timely decision-making on public health interventions.
Collapse
Affiliation(s)
- Fatima N Mirza
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Yale School of Medicine, Yale University, New Haven, CT 06510, United States.
| | - Amyn A Malik
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, United States
| | - Chandra Couzens
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States
| | - Saad B Omer
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, United States; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT 06510, United States; Yale School of Nursing, Yale University, Orange, CT 06477, United States
| |
Collapse
|
21
|
Skowronski DM, Leir S, Sabaiduc S, Murti M, Dickinson JA, Olsha R, Gubbay JB, Croxen MA, Charest H, Chan T, Bastien N, Li Y, Krajden M, De Serres G. Interim estimates of 2018/19 vaccine effectiveness against influenza A(H1N1)pdm09, Canada, January 2019. ACTA ACUST UNITED AC 2020; 24. [PMID: 30696523 PMCID: PMC6351998 DOI: 10.2807/1560-7917.es.2019.24.4.1900055] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 11/20/2022]
Abstract
Using a test-negative design, the Canadian Sentinel Practitioner Surveillance Network assessed interim 2018/19 vaccine effectiveness (VE) against predominant influenza A(H1N1)pdm09 viruses. Adjusted VE was 72% (95% confidence interval: 60 to 81) against medically attended, laboratory-confirmed influenza A(H1N1)pdm09 illness. This substantial vaccine protection was observed in all age groups, notably young children who appeared to be disproportionately affected. Sequence analysis identified heterogeneity in emerging clade 6B.1 viruses but no dominant drift variant.
Collapse
Affiliation(s)
- Danuta M Skowronski
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Siobhan Leir
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Michelle Murti
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | | | | | - Jonathan B Gubbay
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | - Matthew A Croxen
- University of Alberta, Edmonton, Canada.,Provincial Laboratory for Public Health, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Quebec City, Canada
| | - Tracy Chan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Yan Li
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Mel Krajden
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec, Quebec City, Canada.,Laval University, Quebec City, Canada.,Institut National de Santé Publique du Québec, Quebec City, Canada
| |
Collapse
|
22
|
van Asten L, Luna Pinzon A, van de Kassteele J, Donker G, de Lange DW, Dongelmans DA, de Keizer NF, van der Hoek W. The association between influenza infections in primary care and intensive care admissions for severe acute respiratory infection (SARI): A modelling approach. Influenza Other Respir Viruses 2020; 14:575-586. [PMID: 32530142 PMCID: PMC7431650 DOI: 10.1111/irv.12759] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/05/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 01/25/2023] Open
Abstract
Background The burden of severe influenza virus infections is poorly known, for which surveillance of severe acute respiratory infection (SARI) is encouraged. Hospitalized SARI patients are however not always tested for influenza virus infection. Thus, to estimate the impact of influenza circulation we studied how influenza in primary care relates to intensive care unit (ICU) admissions using a modelling approach. Methods We used time‐series regression modelling to estimate a) the number of SARI admissions to ICU associated with medically attended influenza infections in primary care; b) how this varies by season; and c) the time lag between SARI and influenza time series. We analysed weekly adult ICU admissions (registry data) and adult influenza incidence (primary care surveillance data) from July 2007 through June 2016. Results Depending on the year, 0% to 12% of annual SARI admissions were associated with influenza (0‐554 in absolute numbers; population rate: 0/10 000‐0.39/10 000 inhabitants), up to 27% during influenza epidemics. The average optimal fitting lag was +1 week (SARI trend preceding influenza by 1 week), varying between seasons (−1 to +4) with most seasons showing positive lags. Conclusion Up to 12% of yearly SARI admissions to adult ICU are associated with influenza, but with large year‐to‐year variation and higher during influenza epidemics. In most years, SARI increases earlier than medically attended influenza infections in the general population. SARI surveillance could thus complement influenza‐like illness surveillance by providing an indication of the season‐specific burden of severe influenza infections and potential early warning of influenza activity and severity.
Collapse
Affiliation(s)
- Liselotte van Asten
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Angie Luna Pinzon
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan van de Kassteele
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gé Donker
- Nivel Primary Care Database - sentinel practices, Utrecht, the Netherlands
| | - Dylan W de Lange
- National Intensive Care Evaluation, Amsterdam, the Netherlands.,Department of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, the Netherlands
| | - Dave A Dongelmans
- National Intensive Care Evaluation, Amsterdam, the Netherlands.,Department of Intensive Care Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Nicolette F de Keizer
- National Intensive Care Evaluation, Amsterdam, the Netherlands.,Department of Medical Informatics, Amsterdam UMC, Location AMC, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| |
Collapse
|
23
|
Skowronski DM, Leir S, De Serres G, Murti M, Dickinson JA, Winter AL, Olsha R, Croxen MA, Drews SJ, Charest H, Martineau C, Sabaiduc S, Bastien N, Li Y, Petric M, Jassem A, Krajden M, Gubbay JB. Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: possible cohort effect following the 2009 influenza pandemic. ACTA ACUST UNITED AC 2020; 24. [PMID: 30994107 PMCID: PMC6470369 DOI: 10.2807/1560-7917.es.2019.24.15.1900104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/05/2023]
Abstract
Introduction Findings from the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) suggest children were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic. Aim To compare the age distribution of A(H1N1)pdm09 cases in 2018/19 to prior seasonal influenza epidemics in Canada. Methods The age distribution of unvaccinated influenza A(H1N1)pdm09 cases and test-negative controls were compared across A(H1N1)pdm09-dominant epidemics in 2018/19, 2015/16 and 2013/14 and with the general population of SPSN provinces. Similar comparisons were undertaken for influenza A(H3N2)-dominant epidemics. Results In 2018/19, more influenza A(H1N1)pdm09 cases were under 10 years old than controls (29% vs 16%; p < 0.001). In particular, children aged 5–9 years comprised 14% of cases, greater than their contribution to controls (4%) or the general population (5%) and at least twice their contribution in 2015/16 (7%; p < 0.001) or 2013/14 (5%; p < 0.001). Conversely, children aged 10–19 years (11% of the population) were under-represented among A(H1N1)pdm09 cases versus controls in 2018/19 (7% vs 12%; p < 0.001), 2015/16 (7% vs 13%; p < 0.001) and 2013/14 (9% vs 12%; p = 0.12). Conclusion Children under 10 years old contributed more to outpatient A(H1N1)pdm09 medical visits in 2018/19 than prior seasonal epidemics in Canada. In 2018/19, all children under 10 years old were born after the 2009 A(H1N1)pdm09 pandemic and therefore lacked pandemic-induced immunity. In addition, more than half those born after 2009 now attend school (i.e. 5–9-year-olds), a socio-behavioural context that may enhance transmission and did not apply during prior A(H1N1)pdm09 epidemics.
Collapse
Affiliation(s)
- Danuta M Skowronski
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Siobhan Leir
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec, Quebec, Canada.,Laval University, Quebec, Canada.,Institut National de Santé Publique du Québec, Quebec, Canada
| | - Michelle Murti
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | | | | | | | - Matthew A Croxen
- University of Alberta, Edmonton, Canada.,Provincial Laboratory for Public Health, Edmonton, Canada
| | - Steven J Drews
- University of Alberta, Edmonton, Canada.,Provincial Laboratory for Public Health, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Quebec, Canada
| | | | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Yan Li
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | | | - Agatha Jassem
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Mel Krajden
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Jonathan B Gubbay
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| |
Collapse
|
24
|
Galanti M, Comito D, Ligon C, Lane B, Matienzo N, Ibrahim S, Shittu A, Tagne E, Birger R, Ud-Dean M, Filip I, Morita H, Rabadan R, Anthony S, Freyer GA, Dayan P, Shopsin B, Shaman J. Active surveillance documents rates of clinical care seeking due to respiratory illness. Influenza Other Respir Viruses 2020; 14:499-506. [PMID: 32415751 PMCID: PMC7276732 DOI: 10.1111/irv.12753] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/04/2020] [Accepted: 04/12/2020] [Indexed: 12/17/2022] Open
Abstract
Background Respiratory viral infections are a leading cause of disease worldwide. However, the overall community prevalence of infections has not been properly assessed, as standard surveillance is typically acquired passively among individuals seeking clinical care. Methods We conducted a prospective cohort study in which participants provided daily diaries and weekly nasopharyngeal specimens that were tested for respiratory viruses. These data were used to analyze healthcare seeking behavior, compared with cross‐sectional ED data and NYC surveillance reports, and used to evaluate biases of medically attended ILI as signal for population respiratory disease and infection. Results The likelihood of seeking medical attention was virus‐dependent: higher for influenza and metapneumovirus (19%‐20%), lower for coronavirus and RSV (4%), and 71% of individuals with self‐reported ILI did not seek care and half of medically attended symptomatic manifestations did not meet the criteria for ILI. Only 5% of cohort respiratory virus infections and 21% of influenza infections were medically attended and classifiable as ILI. We estimated 1 ILI event per person/year but multiple respiratory infections per year. Conclusion Standard, healthcare‐based respiratory surveillance has multiple limitations. Specifically, ILI is an incomplete metric for quantifying respiratory disease, viral respiratory infection, and influenza infection. The prevalence of respiratory viruses, as reported by standard, healthcare‐based surveillance, is skewed toward viruses producing more severe symptoms. Active, longitudinal studies are a helpful supplement to standard surveillance, can improve understanding of the overall circulation and burden of respiratory viruses, and can aid development of more robust measures for controlling the spread of these pathogens.
Collapse
Affiliation(s)
- Marta Galanti
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Devon Comito
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Integrative Biology, University of California, Berkeley, CA, USA
| | - Chanel Ligon
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Benjamin Lane
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nelsa Matienzo
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sadiat Ibrahim
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Atinuke Shittu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eudosie Tagne
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ruthie Birger
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.,The Earth Institute, Columbia University, New York, NY, USA
| | - Minhaz Ud-Dean
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ioan Filip
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Haruka Morita
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Raul Rabadan
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Simon Anthony
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Greg A Freyer
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Peter Dayan
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Bo Shopsin
- Departments of Medicine and Microbiology, New York University School of Medicine, New York, NY, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
25
|
Tadesse M, Mengesha M, Tayachew A, Belay D, Hassen A, Woyessa AB, Zemelak E, Beyene B, Kassa W, Ayele W, Teshome B, Mekonen M, Assefa Z, Moges B. Burden and seasonality of medically attended influenza like illness ( ILI) in Ethiopia, 2012 to 2017. BMC Infect Dis 2020; 20:148. [PMID: 32070275 PMCID: PMC7029599 DOI: 10.1186/s12879-020-4827-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/28/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The influenza virus spreads rapidly around the world in seasonal epidemics, resulting in significant morbidity and mortality. Influenza-related incidence data are limited in many countries in Africa despite established sentinel surveillance. This study aimed to address the information gap by estimating the burden and seasonality of medically attended influenza like illness in Ethiopia. METHOD Influenza sentinel surveillance data collected from 3 influenza like illness (ILI) and 5 Severe Acute Respiratory Illness (SARI) sites from 2012 to 2017 was used for analysis. Descriptive statistics were applied for simple analysis. The proportion of medically attended influenza positive cases and incidence rate of ILI was determined using total admitted patients and catchment area population. Seasonality was estimated based on weekly trend of ILI and predicted threshold was done by applying the "Moving Epidemic Method (MEM)". RESULT A total of 5715 medically attended influenza suspected patients who fulfills ILI and SARI case definition (77% ILI and 23% SARI) was enrolled. Laboratory confirmed influenza virus (influenza positive case) among ILI and SARI suspected case was 25% (1130/4426) and 3% (36/1289). Of which, 65% were influenza type A. The predominantly circulating influenza subtype were seasonal influenza A(H3N2) (n = 455, 60%) and Influenza A(H1N1)pdm09 (n = 293, 38.81%). The estimated mean annual influenza positive case proportion and ILI incidence rate was 160.04 and 52.48 per 100,000 population. The Incidence rate of ILI was higher in the age group of 15-44 years of age ['Incidence rate (R) = 254.6 per 100,000 population', 95% CI; 173.65, 335.55] and 5-14 years of age [R = 49.5, CI 95%; 31.47, 130.43]. The seasonality of influenza has two peak seasons; in a period from October-December and from April-June. CONCLUSION Significant morbidity of influenza like illness was observed with two peak seasons of the year and seasonal influenza A (H3N2) remains the predominantly circulating influenza subtype. Further study need to be considered to identify potential risks and improving the surveillance system to continue early detection and monitoring of circulating influenza virus in the country has paramount importance.
Collapse
Affiliation(s)
- Musse Tadesse
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia.
| | - Mesfin Mengesha
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Desalegn Belay
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Abdulhafiz Hassen
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Etsehiwot Zemelak
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Berhan Beyene
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Wubayehu Kassa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Workenesh Ayele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Bethel Teshome
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Mikias Mekonen
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Zewdu Assefa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Beyene Moges
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| |
Collapse
|
26
|
Fall A, Jallow MM, Kebe O, Kiori DE, Sy S, Goudiaby D, Boye CSB, Niang MN, Dia N. Low Circulation of Subclade A1 Enterovirus D68 Strains in Senegal during 2014 North America Outbreak. Emerg Infect Dis 2019; 25:1404-1407. [PMID: 31211670 PMCID: PMC6590772 DOI: 10.3201/eid2507.181441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/17/2022] Open
Abstract
To retrospectively investigate enterovirus D68 circulation in Senegal during the 2014 US outbreak, we retrieved specimens from 708 persons, mostly children, who had acute respiratory symptoms during September-December 2014. Enterovirus D68 was detected in 14 children (2.1%); most cases occurred in October. Phylogenetic analysis revealed that all strains clustered within subclade A1.
Collapse
|
27
|
Cowman K, Mittal J, Weston G, Harris E, Shapiro L, Schlair S, Park S, Nori P. Understanding drivers of influenza-like illness presenteeism within training programs: A survey of trainees and their program directors. Am J Infect Control 2019; 47:895-901. [PMID: 30898375 DOI: 10.1016/j.ajic.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Working with influenza-like illness (ILI) is pervasive throughout health care. We assessed knowledge, attitudes, and practices regarding ILI presenteeism of both postgraduate trainees and program leaders. METHODS This survey study was conducted at the Montefiore Medical Center, Albert Einstein College of Medicine, a large academic center in the Bronx, New York. Internal medicine and subspecialty house staff and program directors completed an anonymous electronic survey between April 23 and June 15, 2018. RESULTS A total of 197 of 400 (49%) house staff and 23 of 39 (59%) program leaders participated; 107 (54%) trainees and 6 (26%) program leaders self-reported ILI presenteeism in the past 12 months. More than 90% of trainees and program leaders reported that ILI presenteeism places others at risk. Only 9% of program leaders accurately estimated trainee ILI presenteeism prevalence. Both cited "not wanting to burden colleagues" as the top reason for ILI presenteeism. Twenty-six (24%) trainees practiced ILI presenteeism on critical care units. The majority reported that they would provide patient care with upper respiratory symptoms without fever. Most trainees incorrectly answered influenza knowledge questions. CONCLUSIONS ILI presenteeism prevalence is high within training programs at our medical center. Program leaders can model best practices, enforce nonpunitive sick-leave policies, and ensure infection prevention competencies are met annually.
Collapse
Affiliation(s)
- Kelsie Cowman
- Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
| | - Jaimie Mittal
- St. Luke's Physician Group-Infectious Disease Associates, St. Luke's University Health Network, Bethlehem, PA
| | - Gregory Weston
- Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Emily Harris
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Lauren Shapiro
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Sheira Schlair
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Sun Park
- Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Priya Nori
- Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| |
Collapse
|
28
|
Yazidi R, Aissi W, Bouguerra H, Nouira M, Kharroubi G, Maazaoui L, Zorraga M, Abdeddaiem N, Chlif S, El Moussi A, Ben Hadj Kacem MA, Snoussi MA, Ghawar W, Koubaa M, Polansky L, McCarron M, Boussarsar M, Menif K, Amine S, Ben Khelil J, Ben Jemaa M, Bettaieb J, Bouafif Ben Alaya N, Ben Salah A. Evaluation of the influenza-like illness surveillance system in Tunisia, 2012-2015. BMC Public Health 2019; 19:694. [PMID: 31170955 PMCID: PMC6555026 DOI: 10.1186/s12889-019-7035-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/22/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study was initiated to evaluate, for the first time, the performance and quality of the influenza-like illness (ILI) surveillance system in Tunisia. METHODS The evaluation covered the period of 2012-2015 and used different data sources to measure indicators related to data quality and completeness, representativeness, timeliness, simplicity, acceptability, flexibility, stability and utility. RESULTS During the evaluation period, 485.221 ILI cases were reported among 6.386.621 outpatients at 268 ILI sentinel sites. To conserve resources, cases were only enrolled and tested for influenza during times when the number of patients meeting the ILI case definition exceeded 7% (10% after 2014) of the total number of outpatients for the week. When this benchmark was met, five to 10 patients were enrolled and sampled by nasopharyngeal swabs the following week. In total, The National Influenza Center (NIC) received 2476 samples, of which 683 (27.6%) were positive for influenza. The greatest strength of the system was its representativeness and flexibility. The timeliness of the data and the acceptability of the surveillance system performed moderately well; however, the utility of the data and the stability and simplicity of the surveillance system need improvement. Overall, the performance of the Tunisian influenza surveillance system was evaluated as performing moderately well for situational awareness in the country and for collecting representative influenza virologic samples. CONCLUSIONS The influenza surveillance system in Tunisia provided pertinent evidence for public health interventions related to influenza situational awareness. To better monitor influenza, we propose that ILI surveillance should be limited to sites that are currently performing well and the quality of data collected should be closely monitored and improved.
Collapse
Affiliation(s)
- Rihab Yazidi
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia. .,University of Carthage, Faculty of Sciences of Bizerte, Jarzouna, 7021, Bizerte, Tunisia.
| | - Wafa Aissi
- National Institute of Public Health, 5-7 rue El-Khartoum, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Hind Bouguerra
- Observatoire National des Maladies Nouvelles et Emergentes de Tunis, Tunis, Tunisia
| | - Mariem Nouira
- Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | - Ghassen Kharroubi
- Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | | | | | | | - Sadok Chlif
- Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | - Awatef El Moussi
- National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle's Hospital, Tunis, Tunisia
| | - Mohamed Ali Ben Hadj Kacem
- National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle's Hospital, Tunis, Tunisia
| | - Mohamed Ali Snoussi
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia.,Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | - Wissem Ghawar
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia.,Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | - Makram Koubaa
- Department of Infectious Diseases, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Lauren Polansky
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A20, Atlanta, GA, 30329-4027, USA
| | - Margaret McCarron
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A20, Atlanta, GA, 30329-4027, USA
| | - Mohamed Boussarsar
- Medical Intensive Care Unit Farhat Hached University Hospital, 4000, Sousse, Tunisia.,Research Laboratory, Heart Failure, N LR12SP09 Ibn Al Jazzar Faculty of Medicine, 4000, Sousse, Tunisia.,Non Invasive Ventilation Specialized Master Coordinator Ibn Al Jazzar, Faculty of Medicine, 4000, Sousse, Tunisia
| | - Khaled Menif
- Pediatric Intensive Care Unit, Children's Hospital Bechir Hamza of Tunis, Place Bab Saadoun, 1007, Tunis, Tunisia
| | - Slim Amine
- National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle's Hospital, Tunis, Tunisia
| | - Jalila Ben Khelil
- Intensive care department Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Mounir Ben Jemaa
- Department of Infectious Diseases, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Jihene Bettaieb
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia.,Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia
| | - Nissaf Bouafif Ben Alaya
- Observatoire National des Maladies Nouvelles et Emergentes de Tunis, Tunis, Tunisia.,Primary Health Care Directorate, Tunis, Tunisia
| | - Afif Ben Salah
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia. .,Service of Medical Epidemiology, Institut Pasteur de Tunis, 13, Place Pasteur, BP 74, 1002, Tunis-Belvédère, Tunisia. .,Department of Family and Community Medicine, College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Manama, Bahrain.
| |
Collapse
|
29
|
Rath B, Maltezou HC, Papaevangelou V, Papagrigoriou-Theodoridou MA, Alchikh M, Myles P, Schweiger B. Partnering for enhanced digital surveillance of influenza-like disease and the effect of antivirals and vaccines (PEDSIDEA). Influenza Other Respir Viruses 2019; 13:309-318. [PMID: 31169347 PMCID: PMC6586183 DOI: 10.1111/irv.12645] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Standardised clinical outcome measures are urgently needed for the surveillance of influenza and influenza-like illness (ILI) based on individual patient data (IPD). OBJECTIVES We report a multicentre prospective cohort using a predefined disease severity score in routine care. PATIENTS/METHODS The Vienna Vaccine Safety initiative (ViVI) Disease Severity Score ("ViVI Score") was made available as an android-based mobile application to three paediatric hospitals in Berlin and Athens between 2013 and 2016. Healthcare professionals assessed ILI patients at the point of care including severity, risk factors and use of antibiotics/antivirals/vaccines. RT-PCR for influenza A/B viruses was performed at the Hellenic Pasteur Institute and the Robert Koch Institute. PCR testing was blinded to severity scoring and vice versa. RESULTS A total of 1615 children aged 0-5 years (54.4% males) were assessed at the three sites. The mean age was 1.7 years (SD 1.5; range 0-5.9). The success rate (completion of the scoring without disruption to the ER workflow) was 100%. ViVI Disease Severity Scores ranged from 0 to 35 (mean 13.72). Disease severity in the Berlin Cohort was slightly higher (mean 15.26) compared to the Athens Cohorts (mean 10.86 and 11.13). The administration of antibiotics was most prevalent in the Berlin Cohort, with 41.2% on antibiotics (predominantly cefuroxime) as opposed to only 0.5% on neuraminidase inhibitors. Overall, Risk-adjusted ViVI Scores were significantly linked to the prescription of both, antibiotics and antivirals. CONCLUSIONS The Risk-adjusted ViVI Score enables a precision medicine approach to managing ILI in multicentre settings. Using mobile applications, severity data will be obtained in real time with important implications for the evaluation of antiviral/vaccine use.
Collapse
Affiliation(s)
- Barbara Rath
- Vienna Vaccine Safety Initiative, Berlin, Germany.,Department of Epidemiology and Public Health, The University of Nottingham School of Medicine, Nottingham, UK
| | - Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, University General Hospital 'Attikon', National Kapodistrian University of Athens, Athens, Greece
| | | | - Maren Alchikh
- Vienna Vaccine Safety Initiative, Berlin, Germany.,Department of Paediatrics, Charité University Medical Centre, Berlin, Germany
| | - Puja Myles
- Department of Epidemiology and Public Health, The University of Nottingham School of Medicine, Nottingham, UK
| | - Brunhilde Schweiger
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | | |
Collapse
|
30
|
Yaron-Yakoby H, Sefty H, Pando R, Dichtiar R, Katz MA, Stein Y, Mandelboim M, Mendelson E, Shohat T, Glatman-Freedman A. Effectiveness of influenza vaccine in preventing medically-attended influenza virus infection in primary care, Israel, influenza seasons 2014/15 and 2015/16. ACTA ACUST UNITED AC 2019; 23. [PMID: 29471622 PMCID: PMC5824129 DOI: 10.2807/1560-7917.es.2018.23.7.17-00026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 11/20/2022]
Abstract
Influenza vaccine is recommended for the entire population in Israel. We assessed influenza vaccine effectiveness (VE) for the 2014/15 and 2015/16 seasons in Israel, for the first time. Methods: Combined nose and throat swab specimens were collected from patients with influenza-like illness (ILI) presenting to sentinel primary care clinics and tested for influenza virus by RT-PCR. VE of the trivalent inactivated vaccine (TIV) was assessed using test-negative case–control design. Results: During the 2014/15 season 1,142 samples were collected; 327 (28.6%) were positive for influenza, 83.8% A(H3N2), 5.8% A(H1N1)pdm09, 9.2% B and 1.2% A un-subtyped. Adjusted VE against all influenza viruses for this influenza season was −4.8% (95% confidence interval (CI): −54.8 to 29.0) and against influenza A(H3N2), it was −15.8% (95% CI: −72.8 to 22.4). For the 2015/16 season, 1,919 samples were collected; 853 (44.4%) were positive for influenza, 43.5% A(H1N1)pdm09, 57% B, 0.7% A(H3N2) and 11 samples positive for both A(H1N1)pdm09 and B. Adjusted VE against all influenza viruses for this influenza season was 8.8% (95% CI: −25.1 to 33.5), against influenza A(H1N1)pdm09, it was 32.3% (95% CI: (−4.3 to 56.1) and against influenza B, it was −2.2% (95% CI: (−47.0 to 29.0). Conclusions: Using samples from patients with ILI visiting sentinel clinics in Israel, we demonstrated the feasibility of influenza VE estimation in Israel.
Collapse
Affiliation(s)
- Hamutal Yaron-Yakoby
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Hanna Sefty
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rakefet Pando
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Mark A Katz
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States.,Ben Gurion University, Beer Sheva, Israel
| | - Yaniv Stein
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Aharona Glatman-Freedman
- Departments of Pediatrics and Family and Community Medicine, New York Medical College, Valhalla, New York, United States.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | -
- The members of the group are listed at the end of the paper
| |
Collapse
|
31
|
Dermont M, Elmer T. Influenza vaccination of UK Armed Forces personnel, a waste of resources or an essential public health measure? J ROY ARMY MED CORPS 2019; 165:390. [PMID: 30842222 DOI: 10.1136/jramc-2019-001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Mark Dermont
- Defence Public Health Unit, Defence Medical Services, Lichfield, UK
| | - T Elmer
- Defence Public Health Unit, Defence Medical Services, Lichfield, UK
| |
Collapse
|
32
|
Adisasmito W, Budayanti S, Aisyah DN, Coker R, Andayani AR, Smith GJD, Rudge JW. Surveillance and characterisation of influenza viruses among patients with influenza-like illness in Bali, Indonesia, July 2010-June 2014. BMC Infect Dis 2019; 19:231. [PMID: 30845930 PMCID: PMC6407202 DOI: 10.1186/s12879-019-3842-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/21/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although Indonesia has high fatality rate of human A/H5N1 cases, epidemiological and clinical data on influenza virus circulation among humans has been limited. Within Indonesia, Bali province is of interest due to high population densities of humans, pigs and poultry. This study aims to characterize and compare the epidemiological and clinical patterns of influenza viruses in humans through surveillance among patients with influenza-like illness (ILI) in Bali, Indonesia. METHODS ILI patients were recruited at 21 sentinel health facilities across all nine regencies in Bali, from July 2010 to June 2014. PCR-based assays were used for detection and subtyping of influenza viruses. Demographic, behavioural and clinical data were tested for associations with influenza using chi-squared tests and logistic regression. RESULTS Of 2077 ILI patients, 291 (14.0%) tested positive for influenza A, 152 (7.3%) for influenza B, and 16 (0.77%) for both influenza A and B. Of the influenza A isolates, the majority 61.2% were A/H3N2, followed by A/H1N1-pdm09 (80; 26.1%). Two A/H5N1 were identified. Influenza positive rates were significantly higher during wet season months (28.3%), compared with the dry season (13.8%; χ2 = 61.1; df = 1; p < 0.0001). Clinical predictors for infection varied by virus type, with measured fever (≥38 °C) more strongly associated with influenza B (AOR: 1.62; 95% CI: 1.10, 2.39). CONCLUSION Influenza circulates year-round among humans in Bali with higher activity during the wet season. High contact rates with poultry and pigs, along with influenza virus detection that could not be subtyped through conventional assays, highlight the need for molecular studies to characterize epidemiological and evolutionary dynamics of influenza in this setting.
Collapse
Affiliation(s)
- Wiku Adisasmito
- Faculty of Public Health, Universitas Indonesia, Depok, West Java 16424 Indonesia
| | | | - Dewi Nur Aisyah
- Faculty of Public Health, Universitas Indonesia, Depok, West Java 16424 Indonesia
| | - Richard Coker
- Communicable Diseases Policy Research Group, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | | | - James W. Rudge
- Communicable Diseases Policy Research Group, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| |
Collapse
|
33
|
Kajon AE, Lamson DM, Bair CR, Lu X, Landry ML, Menegus M, Erdman DD, St George K. Adenovirus Type 4 Respiratory Infections among Civ ilian Adults, Northeastern United States, 2011-2015 1. Emerg Infect Dis 2019; 24:201-209. [PMID: 29350143 PMCID: PMC5782899 DOI: 10.3201/eid2402.171407] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011–2015. Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities. HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases. Two novel a-like variants were recovered from students enrolled at a college in Tompkins County, New York, USA, and a prototype-like variant distinguishable from the vaccine strain was isolated from an 18-year-old woman visiting a physician’s office in Ulster County, New York, USA, with symptoms of influenza-like illness. Our data suggest that HAdV-4 might be an underestimated causative agent of ARD among civilian adults.
Collapse
|
34
|
Drăgănescu A, Săndulescu O, Florea D, Vlaicu O, Streinu-Cercel A, Oţelea D, Aramă V, Luminos ML, Streinu-Cercel A, Niţescu M, Ivanciuc A, Bacruban R, Piţigoi D. The influenza season 2016/17 in Bucharest, Romania - surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital. Braz J Infect Dis 2018; 22:377-386. [PMID: 30391275 PMCID: PMC9427989 DOI: 10.1016/j.bjid.2018.10.275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/18/2018] [Accepted: 10/18/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Influenza continues to drive seasonal morbidity, particularly in settings with low vaccine coverage. OBJECTIVES To describe the influenza cases and viral circulation among hospitalized patients. METHODS A prospective study based on active surveillance of inpatients with influenza-like illness from a tertiary hospital in Bucharest, Romania, in the season 2016/17. RESULTS A total of 446 patients were tested, with a balanced gender distribution. Overall, 192 (43%) patients tested positive for influenza, with the highest positivity rate in the age groups 3-13 years and >65 years. Peak activity occurred between weeks 1 and 16/2017, with biphasic distribution: A viruses were replaced by B viruses from week 9/2017; B viruses predominated (66.1%). Among the 133 (69.3%) subtyped samples, all influenza A were subtype H3 (n=57) and all influenza B were B/Victoria (n=76). Patients who tested positive for influenza presented fewer comorbidities (p=0.012), except for the elderly, in whom influenza was more common in patients with comorbidities (p=0.050). Disease evolution was generally favorable under antiviral treatment. The length of hospital stay was slightly longer in patients with influenza-like illness who tested patients negative for influenza (p=0.031). CONCLUSIONS Distinctive co-circulation of A/H3 and B/Victoria in Bucharest, Romania in the 2016/17 influenza season was found. While the A/H3 subtype was predominant throughout Europe that season, B/Victoria appears to have circulated specifically in Romania and the Eastern European region, predominantly affecting preschoolers and school children.
Collapse
Affiliation(s)
- Anca Drăgănescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Oana Săndulescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Dragoş Florea
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ovidiu Vlaicu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Anca Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dan Oţelea
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Victoria Aramă
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Monica Luminiţa Luminos
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adrian Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Maria Niţescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alina Ivanciuc
- Cantacuzino Military-Medical Research-Development National Institute, Bucharest, Romania; Bucharest University, Faculty of Biology, Bucharest, Romania
| | - Rodica Bacruban
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Daniela Piţigoi
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
35
|
Girit S, Karaaslan A, Gençer S, Yılmaz E, Ayhan Y, Vayvada ER, Akçay Ciblak M, Badur S, Akın Y. Active Surveillance of Influenza A and Other Respiratory Viruses in Children with Influenza-like-illness in Two Seasons. J Infect Dev Ctries 2018; 11:944-949. [PMID: 31626600 DOI: 10.3855/jidc.8867] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/31/2016] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The aim of this study was to asses the surveillance of influenza A/other respiratory viruses and risk factors in hospitalized children with the symptoms of influenza-like illness during two consecutive influenza seasons. METHODOLOGY All children hospitalized with adiagnosis of influenza-like illness had been investigated for Influenza A and other respiratory antigens in pharengeal/nasopharyngeal secretions. RESULTS A total of 132 hospitalized children between December 2013-May 2014 and December 2014-May 2015 were enrolled in this study. At least one respiratory virus was found to be positive by RT-PCR in 78 (59%) patients, influenza A (H3N2) was detected in only 8 (6%) patients. In 54 (41%) patients samples no respiratory viral pathogen was detected and in 70 (53%) patients, one non- influenza A virus was detected. The respiratory viral pathogens detected in decreasing rates were:RSV (n = 46, 35%), HCoV (n = 10, 7.5%), adenovirüs (n = 7, 5%), rhinovirüs (n = 6, 4.5%), HMPV (n = 5, 4%), Influenza B (n = 4, 3%) ve human Bocavirus (n = 2, 1.5%). In 10 patients, coinfection was detected, however none was with H3N2. In the H3N2 (+) group, the following risk factors were identified: age older than three years (p < 0.05), asthma history (p < 0.05) and chronic lung diseases (p < 0.05). CONCLUSION Influenza A virus was detected in 6% of hospitalized patients with influenza-like illness. Viruses other then Influenza, especially RSV, can cause similar symptoms compatible with Influenza-like-illness.
Collapse
Affiliation(s)
- Saniye Girit
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | - Ayşe Karaaslan
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | - Serap Gençer
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | - Emel Yılmaz
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | - Yetkin Ayhan
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | - Elif Ruşen Vayvada
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | | | | | - Yasemin Akın
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
| |
Collapse
|
36
|
Moolasart V, Chottanapund S, Ausavapipit J, Likanonsakul S, Uttayamakul S, Changsom D, Lerdsamran H, Puthavathana P. The Effect of Detectable HIV Viral Load among HIV-Infected Children during Antiretroviral Treatment: A Cross-Sectional Study. Children (Basel) 2018; 5:children5010006. [PMID: 29301267 PMCID: PMC5789288 DOI: 10.3390/children5010006] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/20/2017] [Accepted: 12/27/2017] [Indexed: 11/24/2022]
Abstract
The RNA viral load of human immunodeficiency virus (HIV) is initially used to determine the status of the HIV infection. The goal of therapy following treatment failure is to achieve and maintain virologic suppression. A detectable viral load may relate to the progression of HIV infection. A cross-sectional survey was conducted from January 2013 to December 2014 at the Bamrasnaradura Infectious Diseases Institute, Thailand. The aim was to determine the prevalence of detectable HIV viral load (dVL) and analyze the factors associated with post-dVL conditions that occur independently of a switch to a new antiretroviral agent. The prevalence of dVL was 27% (27 of 101). The mean ages of dVL and non-dVL children were 12.0 and 12.3 years, respectively. Age, sex, body mass index for age z-scores, previous tuberculosis disease history and parental tuberculosis history of both groups were not significantly different (p > 0.05). The prevalence of poor adherence (<95%), influenza-like illness (ILI) and opportunistic infections were higher in dVL than non-dVL children (p < 0.05). The mean nadir CD4 cell count during the study was lower in dVL than non-dVL children (646 compared to 867, respectively; p < 0.05). Other factors were not significant (all p > 0.05). In multivariable analysis, dVL was significantly associated with ILI (odds ratio (OR) = 9.6, 95% confidence interval (CI) = 1.3–69.4), adherence (OR = 0.195, 95% CI = 0.047–0.811) and nadir CD4 during the study (OR = 1.102, 95% CI = 1.100–1.305). The prevalence of dVL was 27% with this dVL among HIV-infected children found to be associated with ILI, poor adherence and lower nadir CD4 during the study.
Collapse
Affiliation(s)
- Visal Moolasart
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 11000 Nonthaburi, Thailand.
| | - Suthat Chottanapund
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 11000 Nonthaburi, Thailand.
| | - Jarurnsook Ausavapipit
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 11000 Nonthaburi, Thailand.
| | - Sirirat Likanonsakul
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 11000 Nonthaburi, Thailand.
| | - Sumonmal Uttayamakul
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 11000 Nonthaburi, Thailand.
| | - Don Changsom
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand.
| | - Hatairat Lerdsamran
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand.
| | - Pilaipan Puthavathana
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand.
| |
Collapse
|
37
|
Pelat C, Bonmarin I, Ruello M, Fouillet A, Caserio-Schönemann C, Levy-Bruhl D, Le Strat Y. Improving regional influenza surveillance through a combination of automated outbreak detection methods: the 2015/16 season in France. ACTA ACUST UNITED AC 2017; 22:30593. [PMID: 28816649 PMCID: PMC6373610 DOI: 10.2807/1560-7917.es.2017.22.32.30593] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/19/2017] [Indexed: 11/20/2022]
Abstract
The 2014/15 influenza epidemic caused a work overload for healthcare facilities in France. The French national public health agency announced the start of the epidemic – based on indicators aggregated at the national level – too late for many hospitals to prepare. It was therefore decided to improve the influenza alert procedure through (i) the introduction of a pre-epidemic alert level to better anticipate future outbreaks, (ii) the regionalisation of surveillance so that healthcare structures can be informed of the arrival of epidemics in their region, (iii) the standardised use of data sources and statistical methods across regions. A web application was developed to deliver statistical results of three outbreak detection methods applied to three surveillance data sources: emergency departments, emergency general practitioners and sentinel general practitioners. This application was used throughout the 2015/16 influenza season by the epidemiologists of the headquarters and regional units of the French national public health agency. It allowed them to signal the first influenza epidemic alert in week 2016-W03, in Brittany, with 11 other regions in pre-epidemic alert. This application received positive feedback from users and was pivotal for coordinating surveillance across the agency’s regional units.
Collapse
Affiliation(s)
- Camille Pelat
- Santé publique France, French national public health agency. Saint-Maurice, France
| | - Isabelle Bonmarin
- Santé publique France, French national public health agency. Saint-Maurice, France
| | - Marc Ruello
- Santé publique France, French national public health agency. Saint-Maurice, France
| | - Anne Fouillet
- Santé publique France, French national public health agency. Saint-Maurice, France
| | | | - Daniel Levy-Bruhl
- Santé publique France, French national public health agency. Saint-Maurice, France
| | - Yann Le Strat
- Santé publique France, French national public health agency. Saint-Maurice, France
| | -
- Members of the regional influenza study group are mentioned at the end of the article
| |
Collapse
|
38
|
Kissling E, Rondy M. Early 2016/17 vaccine effectiveness estimates against influenza A(H3N2): I-MOVE multicentre case control studies at primary care and hospital levels in Europe. ACTA ACUST UNITED AC 2017; 22:30464. [PMID: 28230524 PMCID: PMC5322188 DOI: 10.2807/1560-7917.es.2017.22.7.30464] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 02/16/2017] [Indexed: 12/17/2022]
Abstract
We measured early 2016/17 season influenza vaccine effectiveness (IVE) against influenza A(H3N2) in Europe using multicentre case control studies at primary care and hospital levels. IVE at primary care level was 44.1%, 46.9% and 23.4% among 0–14, 15–64 and ≥ 65 year-olds, and 25.7% in the influenza vaccination target group. At hospital level, IVE was 2.5%, 7.9% and 2.4% among ≥ 65, 65–79 and ≥ 80 year-olds. As in previous seasons, we observed suboptimal IVE against influenza A(H3N2).
Collapse
Affiliation(s)
- Esther Kissling
- EpiConcept, Paris, France.,Both authors have contributed equally to the study and manuscript writing
| | - Marc Rondy
- EpiConcept, Paris, France.,Both authors have contributed equally to the study and manuscript writing
| | -
- The members of I-MOVE/I-MOVE+ study team are listed at the end of the article
| |
Collapse
|
39
|
Huaman JL, Carrion G, Ampuero JS, Ocaña V, Laguna-Torres VA, Hontz RD. Enterovirus-71 genotype C isolated in Peru between 2006 and 2009. J Clin Virol 2016; 85:40-43. [PMID: 27833060 DOI: 10.1016/j.jcv.2016.10.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/11/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
Enterovirus-71 (EV71) was first isolated in California, United States in 1969, belongs to the genus Enterovirus, family Picornaviridae. Although infection normally causes mild, often undiagnosed illness, it can cause central nervous system infections that could turn fatal. Based on VP1 gene analysis, EV71 has been classified into six separate genotypes. Although the molecular epidemiology of EV71 has been well described via studies originating from Asia and Europe, it is mostly unknown in South America. From our study, four EV71 isolates from Peru were characterized using phylogenetic methods to determine their relationship with known reference strains. These four Peruvian EV71 isolates from between 2006 and 2009 were analyzed by RT-PCR using primers capable of amplifying the entire VP1 gene. Reference strains representing all six known genotypes were used to determine any recognizable phylogenetic relationships. In fact, all of our isolates clustered together within the genotype C1 lineage- separate from Asian, European, North American, and Australian strains. We present evidence that EV71 genotype C1 exists in Peru, and this is the first such report documenting EV71 genotype C1 circulating in South America. Gathering additional isolates will help elucidate a more complete global epidemiological picture of EV71 infections.
Collapse
Affiliation(s)
| | | | | | - Victor Ocaña
- Centro de Salud Pachitea, Dirección Regional de Salud de Piura, Ministerio de Salud, Piura, Peru.
| | | | | |
Collapse
|
40
|
Biswas D, Buragohain M, Yadav K, Dutta M, Sarmah K, Baruah PJ, Borkakoty B. Outbreak of influenza-like illness investigated during August 2013 near Indo-China border of Arunachal Pradesh, Northeast India. J Med Virol 2016; 88:1999-2003. [PMID: 27035572 DOI: 10.1002/jmv.24539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2016] [Indexed: 11/11/2022]
Abstract
During August 2013, an outbreak of influenza-like illnesses (ILI) was investigated in Monigong area, near Indo-China border of Arunachal Pradesh, Northeast India. Influenza type A/H3N2 was detected by RT-PCR in 33.3% (8/24) of ILI cases. Sequence analysis of HA and NA genes revealed eight and five amino acid substitutions, respectively in Monigong H3N2 (Mo/H3N2) strains as compared to vaccine strain A/Victoria/361/2011. Four non-synonymous substitutions, three localizing at antigenic sites T144A, A; R158G, B; L173S, D, and one H9Y in close proximity to a potential glycosylation site aa8 in HA1 domain along with the substitution T329N in NA are likely to influence the antigenicity/virulence of Mo/H3N2 viruses. J. Med. Virol. 88:1999-2003, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Dipankar Biswas
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Manika Buragohain
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Kaushal Yadav
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Mousumi Dutta
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Kimmi Sarmah
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Pranjal Jyoti Baruah
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| | - Biswajyoti Borkakoty
- Regional Medical Research Centre, North East Region, Indian Council of Medical Research, Dibrugarh, Assam, India
| |
Collapse
|
41
|
Wong JM, Cosmas L, Nyachieo D, Williamson JM, Olack B, Okoth G, Njuguna H, Feikin DR, Burke H, Montgomery JM, Breiman RF. Increased Rates of Respiratory and Diarrheal Illnesses in HIV-Negative Persons Living With HIV-Infected Individuals in a Densely Populated Urban Slum in Kenya. J Infect Dis 2015; 212:745-53. [PMID: 25722292 DOI: 10.1093/infdis/jiv107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/13/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prolonged pathogen shedding and increased duration of illness associated with infections in immunosuppressed individuals put close human immunodeficiency virus (HIV)-negative contacts of HIV-infected persons at increased risk of exposure to infectious pathogens. METHODS We calculated incidence and longitudinal prevalence (number of days per year) of influenzalike illness (ILI), diarrhea, and nonspecific febrile illness during 2008 from a population-based surveillance program in the urban slum of Kibera (Kenya) that included 1830 HIV-negative household contacts of HIV-infected individuals and 13 677 individuals living in exclusively HIV-negative households. RESULTS For individuals ≥5 years old, incidence was significantly increased for ILI (risk ratio [RR], 1.47; P < .05) and diarrhea (RR, 1.41; P < .05) in HIV-negative household contacts of HIV-infected individuals compared with exclusively HIV-negative households. The risk of illness among HIV-negative persons was directly proportional to the number of HIV-infected persons living in the home for ILI (RR, 1.39; P < .05) and diarrhea (RR, 1.36; P < .01). We found no increased rates of illness in children <5 years old who lived with HIV-infected individuals. CONCLUSIONS Living with HIV-infected individuals is associated with modestly increased rates of respiratory and diarrheal infections in HIV-negative individuals >5 years old. Targeted interventions are needed, including ensuring that HIV-infected persons are receiving appropriate care and treatment.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| |
Collapse
|
42
|
Nolan T, Borja-Tabora C, Lopez P, Weckx L, Ulloa-Gutierrez R, Lazcano-Ponce E, Kerdpanich A, Weber MAR, Mascareñas de Los Santos A, Tinoco JC, Safadi MAP, Seng LF, Hernandez-de Mezerville M, Faingezicht I, Cruz-Valdez A, Feng Y, Li P, Durviaux S, Haars G, Roy-Ghanta S, Vaughn DW, Taylor S. Prevalence and Incidence of Respiratory Syncytial Virus and Other Respiratory Viral Infections in Children Aged 6 Months to 10 Years With Influenza-like Illness Enrolled in a Randomized Trial. Clin Infect Dis 2015; 60:e80-9. [PMID: 25673560 PMCID: PMC4429758 DOI: 10.1093/cid/civ065] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/24/2015] [Indexed: 02/06/2023] Open
Abstract
Background. The high burden of respiratory syncytial virus (RSV)-associated morbidity and
mortality makes vaccine development a priority. Methods. As part of an efficacy trial of pandemic influenza vaccines (NCT01051661), RSV
epidemiology in healthy children aged 6 months to <10 years at first vaccination with
influenza-like illness (ILI) was evaluated in Australia, Brazil, Colombia, Costa Rica,
Mexico, the Philippines, Singapore, and Thailand between February 2010 and August 2011.
Active surveillance for ILI was conducted for approximately 1 year, with nasal and throat
swabs analyzed by polymerase chain reaction. The prevalence and incidence of RSV among ILI
episodes were calculated. Results. A total of 6266 children were included, of whom 2421 experienced 3717 ILI episodes
with a respiratory sample available. RSV was detected for 359 ILI episodes, a prevalence
of 9.7% (95% confidence interval: 8.7–10.7). The highest prevalence was in children aged
12–23 or 24–35 months in all countries except the Philippines, where it was in children
aged 6–11 months. The incidence of RSV-associated ILI was 7.0 (6.3–7.7) per 100
person-years (PY). Eighty-eight ILI episodes resulted in hospitalization, of which 8 were
associated with RSV (prevalence 9.1% [4.0–17.1]; incidence 0.2 [0.1–0.3] per 100 PY). The
incidence of RSV-associated ILI resulting in medical attendance was 6.0 (5.4–6.7) per 100
PY. RSV B subtypes were observed more frequently than A subtypes. Conclusions. Active surveillance demonstrated the considerable burden of RSV-associated illness
that would not be identified through hospital-based surveillance, with a substantial part
of the burden occurring in older infants and children.
Collapse
Affiliation(s)
- Terry Nolan
- Murdoch Children's Research Institute and Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Charissa Borja-Tabora
- Department of Health, Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | - Pio Lopez
- Centro de Estudios en Infectologia Pediatrica, Cali, Colombia
| | - Lily Weckx
- Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, Brazil
| | | | | | - Angkool Kerdpanich
- Infectious Diseases Unit, Department of Pediatrics, Phramongkutklao Hospital, Thailand
| | | | | | | | - Marco Aurelio P Safadi
- Department of Pediatrics, Faculdade de Ciências Médicas da Santa Casa de São Paulo and Associação Fundo de Incentivo à Pesquisa, Brazil
| | | | | | - Idis Faingezicht
- Instituto Costarricense de Investigaciones Clínicas, San José, Costa Rica
| | | | | | - Ping Li
- GSK Vaccines, King of Prussia, Pennsylvania
| | | | | | | | | | | |
Collapse
|
43
|
Minh An DT, Ngoc NTB, Nilsson M. Influenza-like illness in a Vietnamese province: epidemiology in correlation with weather factors and determinants from the surveillance system. Glob Health Action 2014; 7:23073. [PMID: 25511881 PMCID: PMC4265650 DOI: 10.3402/gha.v7.23073] [Citation(s) in RCA: 7] [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: 10/14/2013] [Revised: 03/10/2014] [Accepted: 04/03/2014] [Indexed: 11/14/2022] Open
Abstract
Background Seasonal influenza affects from 5 to 15% of the world's population annually and causes an estimated 250,000–500,000 deaths worldwide. The World Health Organization (WHO) recommends ‘sentinel surveillance’ for influenza-like illness (ILI) because it is simple and calls for standardized methods at a relatively low cost that can be implemented throughout the world. In Vietnam, ILI is a key priority for public health also because of its annually recurring temporal pattern. Two major factors, on which the spread of influenza depends, are the strain of the virus and its rate of mutation, since flu strains constantly mutate as they compete with host immune systems. In the context of global climate change, the role of climatic factors has been discussed, as they may significantly contribute to the cause of large outbreaks of ILI. Objectives 1) To describe the epidemiology of ILI in Ha Nam province, Vietnam; 2) to seek scientific evidence on the association of ILI occurrence with weather factors in Ha Nam province; and 3) to analyze factors from the Ha Nam ILI surveillance system that contribute to explaining the correlation between the ILI and the weather factors. Design A data set of 89,270 monthly reported ILI cases from 2008 to 2012 in Ha Nam was used to describe ILI epidemiological characteristics. Spearman correlation analyses between ILI cases and weather factors were conducted to identify which preceding period of months and weather patterns influenced the occurrence of ILI cases. Ten in-depth interviews with health workers in charge of recording and reporting ILI cases at different levels of the ILI surveillance system were conducted to gain a deeper understanding of factors contributing to explaining the relation between the ILI and the weather factors. Results The results indicated that the ILI occurred annually in all districts of the Ha Nam province in the five studied years. An epidemic occurred in 2009 with the number of cases three times higher than the average threshold. There was a relation between the ILI cases in the previous 1 month with ILI cases of the following month. A seasonal cycle of ILI and correlation between weather elements were not clearly detected. A qualitative study showed that the number of ILI cases reported by the Provincial Preventive Medicine Centre (PPMC) in Ha Nam might not have reflected the accurate number of seasonal ILI occurring in this area. This was due to three gaps in the ILI surveillance system that initially were detected through key in-depth interviews in the Duy Tien and Binh Luc districts. They reported inconsistent ways of recording and reporting ILI cases among communes, lack of ILI survey forms, and irregular and delayed feedback from the PPMC. Conclusions There were no clear patterns of association between weather factors and ILI cases detected from the five studied years. The number of ILI cases reported by the PPMC in Ha Nam may not reflect adequately the actual number of seasonal ILI occurring in this area due to three weak points in the ILI surveillance system initially detected through the case of the Duy Tien and Binh Luc districts. These three weak points of the system should be examined by a study conducted in the remaining districts in Ha Nam.
Collapse
Affiliation(s)
- Dao Thi Minh An
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam;
| | - Nguyen Thi Bich Ngoc
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maria Nilsson
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
44
|
de Perio MA, Wiegand DM, Brueck SE. Influenza-like illness and presenteeism among school employees. Am J Infect Control 2014; 42:450-2. [PMID: 24679576 DOI: 10.1016/j.ajic.2013.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/04/2013] [Accepted: 11/11/2013] [Indexed: 11/24/2022]
Abstract
We determined the prevalence of influenza-like illness (ILI) among employees of a suburban Ohio school district. In a survey of 412 of 841 employees (49%), 120 (29%) reported ILI symptoms during the school year, and 92 (77%) reported working while ill. Age ≥50 years and asthma were significantly associated with reporting of ILI symptoms. Encouraging school employees to receive the seasonal influenza vaccine and to stay home when ill should be part of a comprehensive influenza prevention strategy.
Collapse
|
45
|
Lee SS, Wong NS. Respiratory symptoms in households as an effective marker for influenza-like illness surveillance in the community. Int J Infect Dis 2014; 23:44-6. [PMID: 24680819 DOI: 10.1016/j.ijid.2014.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 11/22/2022] Open
Abstract
To effectively track the growth of influenza, we piloted an online system to monitor influenza-like illness (ILI) in the community in one district of Hong Kong. Four syndromic markers, namely fever, respiratory symptoms, fever with respiratory symptoms, fever and/or respiratory symptoms, either of the individual or of the household, were collected during the study period from June 2012 to October 2013. A total of 132 residents of Tuen Mun District reported syndromic markers at the individual and household levels on a weekly basis. Temporal patterns of these markers were compared with data derived from laboratory surveillance by dynamic linear regression. Household respiratory symptoms were found to be an effective syndromic marker, pre-dating overall laboratory virus surveillance results on influenza diseases in two influenza seasons by 3-4 weeks. To conclude, respiratory symptoms can be a good marker predicting the onset of the influenza season in the community, and is particularly useful with regard to data from households, even if the sample size may not be a large one.
Collapse
|
46
|
Werker GR, Sharif B, Sun H, Cooper C, Bansback N, Anis AH. Optimal timing of influenza vaccination in patients with human immunodeficiency virus: a Markov cohort model based on serial study participant hemoagglutination inhibition titers. Vaccine 2013; 32:677-84. [PMID: 24355089 DOI: 10.1016/j.vaccine.2013.11.103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/18/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Seasonal influenza vaccination offers one of the best population-level protections against influenza-like illness (ILI). For most people, a single dose prior to the flu season offers adequate immunogenicity. HIV+ patients, however, tend to exhibit a shorter period of clinical protection, and therefore may not retain immunogenicity for the entire season. Building on the work of Nosyk et al. (2011) that determined a single dose is the optimal dosing strategy for HIV+ patients, we investigate the optimal time to administer this vaccination. METHODS Using data from the "single dose" treatment arm of an RCT conducted at 12 CIHR Canadian HIV Trials Network sites we estimated semimonthly clinical seroprotection levels for a cohort (N=93) based on HAI titer levels. These estimates were combined with CDC attack rate data for the three main strains of seasonal influenza to estimate instances of ILI over different vaccination timing strategies. Using bootstrap resampling of the cohort, nine years of CDC data, and parameter distributions, we developed a Markov cohort model that included probabilistic sensitivity analysis. Cost, quality adjusted life-years (QALYs), and net monetary benefits are presented for each timing strategy. RESULTS The beginning of December is the optimal time for HIV+ patients to receive the seasonal influenza vaccine. Assuming a willingness-to-pay threshold of $50,000, the net monetary benefit associated with a Dec 1 vaccination date is $19,501.49 and the annual QALY was 0.833744. INTERPRETATION Our results support a policy of administering the seasonal influenza vaccination for this population in the middle of November or beginning of December, assuming nothing is know about the upcoming flu season. But because the difference in between this strategy and the CDC guideline is small-12 deaths averted per year and a savings of $60 million across the HIV+ population in the US-more research is needed concerning strategies for subpopulations.
Collapse
Affiliation(s)
- Gregory R Werker
- Centre for Health Evaluation and Outcome Sciences, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3 Canada.
| | - Behnam Sharif
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3 Canada
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada; CIHR Canadian HIV Trials Network, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada
| | - Curtis Cooper
- CIHR Canadian HIV Trials Network, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada; Division of Infectious Diseases, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5 Canada
| | - Nick Bansback
- Centre for Health Evaluation and Outcome Sciences, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3 Canada
| | - Aslam H Anis
- Centre for Health Evaluation and Outcome Sciences, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3 Canada; CIHR Canadian HIV Trials Network, 588 - 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6 Canada.
| |
Collapse
|
47
|
Nguyen YT, Graitcer SB, Nguyen TH, Tran DN, Pham TD, Le MT, Tran HN, Bui CT, Dang DT, Nguyen LT, Uyeki TM, Dennis D, Kile JC, Kapella BK, Iuliano A, Widdowson MA, Nguyen HT. National surveillance for influenza and influenza-like illness in Vietnam, 2006-2010. Vaccine 2013; 31:4368-74. [PMID: 23911781 PMCID: PMC5820022 DOI: 10.1016/j.vaccine.2013.07.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [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: 05/20/2013] [Revised: 07/08/2013] [Accepted: 07/08/2013] [Indexed: 11/20/2022]
Abstract
Influenza virus infections result in considerable morbidity and mortality both in the temperate and tropical world. Influenza surveillance over multiple years is important to determine the impact and epidemiology of influenza and to develop a national vaccine policy, especially in countries developing influenza vaccine manufacturing capacity, such as Vietnam. We conducted surveillance of influenza and influenza-like illness in Vietnam through the National Influenza Surveillance System during 2006-2010. At 15 sentinel sites, the first two patients presenting each weekday with influenza-like illness (ILI), defined as fever and cough and/or sore throat with illness onset within 3 days, were enrolled and throat specimens were collected and tested for influenza virus type and influenza A subtype by RT-PCR. De-identified demographic and provider reported subsequent hospitalization information was collected on each patient. Each site also collected information on the total number of patients with influenza-like illness evaluated per week. Of 29,804 enrolled patients presenting with influenza-like illness, 6516 (22%) were influenza positive. Of enrolled patients, 2737 (9.3%) were reported as subsequently hospitalized; of the 2737, 527 (19%) were influenza positive. Across all age groups with ILI, school-aged children had the highest percent of influenza infection (29%) and the highest percent of subsequent hospitalizations associated with influenza infection (28%). Influenza viruses co-circulated throughout most years in Vietnam during 2006-2010 and often reached peak levels multiple times during a year, when >20% of tests were influenza positive. Influenza is an important cause of all influenza-like illness and provider reported subsequent hospitalization among outpatients in Vietnam, especially among school-aged children. These findings may have important implications for influenza vaccine policy in Vietnam.
Collapse
Affiliation(s)
- Yen T. Nguyen
- National Institute of Hygiene and Epidemiology, Viet Nam
| | - Samuel B. Graitcer
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, USA
- Influenza Division, Centers for Disease Control and Prevention, USA
| | - Tuan H. Nguyen
- National Institute of Hygiene and Epidemiology, Viet Nam
| | - Duong N. Tran
- National Institute of Hygiene and Epidemiology, Viet Nam
| | - Tho D. Pham
- National Institute of Hygiene and Epidemiology, Viet Nam
| | - Mai T.Q. Le
- National Institute of Hygiene and Epidemiology, Viet Nam
| | - Huu N. Tran
- Pasteur Institute, Ho Chi Minh City, Viet Nam
| | | | | | | | - Timothy M. Uyeki
- Influenza Division, Centers for Disease Control and Prevention, USA
| | - David Dennis
- Influenza Division, Centers for Disease Control and Prevention, USA
| | - James C. Kile
- Influenza Division, Centers for Disease Control and Prevention, USA
| | - Bryan K. Kapella
- Influenza Division, Centers for Disease Control and Prevention, USA
| | - A.D. Iuliano
- Influenza Division, Centers for Disease Control and Prevention, USA
| | | | - Hien T. Nguyen
- National Institute of Hygiene and Epidemiology, Viet Nam
| |
Collapse
|
48
|
Schoub BD, Gessner BD, Ampofo W, Cohen AL, Steffen CA. Afriflu2--second international workshop on influenza vaccination in the African continent--8 November 2012, Cape Town (South Africa). Vaccine 2013; 31:3461-6. [PMID: 23602535 DOI: 10.1016/j.vaccine.2013.04.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/22/2013] [Accepted: 04/05/2013] [Indexed: 11/23/2022]
Abstract
The second meeting of the Afriflu conferences took place in Cape Town, South Africa, with over 60 participants from 15 countries in Africa and also outside the continent. Significant progress in surveillance has been made in better understanding the illness burden of influenza on the continent, which limited evidence suggests is greater than that in the developed world. In southern Africa HIV and TB coinfections play a major role in increasing hospitalisation and mortality, while elsewhere in Africa other cofactors still need to be determined. There is currently no indigenous vaccine production in sub-Saharan Africa and only one facility, based in South Africa, capable of filling imported bulk. Innovative vaccine strategies will need to be explored, such as maternal immunisation, and also the possibility of other influenza vaccine options, such as live attenuated influenza vaccine for young children. Sustained indigenous vaccine production is essential for the continent to have vaccine security in the event of a pandemic even though establishing local production faces considerable challenges especially ensuring adequate markets on the continent. There is an urgent need to develop effective communication messages for decision makers as well as healthcare workers addressing the importance of influenza even in the face of the major competing health burdens of the continent.
Collapse
|
49
|
Abstract
With growing concerns about international spread of disease and expanding use of early disease detection surveillance methods, the field of syndromic surveillance has received increased attention over the last decade. The purpose of this article is to clarify the various meanings that have been assigned to the term syndromic surveillance and to propose a refined categorization of the characteristics of these systems. Existing literature and conference proceedings were examined on syndromic surveillance from 1998 to 2010, focusing on low- and middle-income settings. Based on the 36 unique definitions of syndromic surveillance found in the literature, five commonly accepted principles of syndromic surveillance systems were identified, as well as two fundamental categories: specific and non-specific disease detection. Ultimately, the proposed categorization of syndromic surveillance distinguishes between systems that focus on detecting defined syndromes or outcomes of interest and those that aim to uncover non-specific trends that suggest an outbreak may be occurring. By providing an accurate and comprehensive picture of this field's capabilities, and differentiating among system types, a unified understanding of the syndromic surveillance field can be developed, encouraging the adoption, investment in, and implementation of these systems in settings that need bolstered surveillance capacity, particularly low- and middle-income countries.
Collapse
Affiliation(s)
- Rebecca Katz
- School of Public Health and Health Services, George Washington University, 2021 K Street, NW, Suite 800, Washington, DC 20006, USA
| | - Larissa May
- Department of Emergency Medicine, George Washington University, 2150 Pennsylvania Ave., NW, Suite 2B, Washington, DC 20037, USA
| | - Julia Baker
- School of Public Health and Health Services, George Washington University, 2021 K Street, NW, Suite 800, Washington, DC 20006, USA
| | - Elisa Test
- School of Public Health and Health Services, George Washington University, 2021 K Street, NW, Suite 800, Washington, DC 20006, USA
| |
Collapse
|