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Chen S, Xu J, Wu Y, Wang X, Fang S, Cheng J, Ma H, Zhang R, Liu Y, Zhang L, Zhang X, Chen L, Liu X. Predicting temporal propagation of seasonal influenza using improved gaussian process model. J Biomed Inform 2019; 93:103144. [PMID: 30905736 DOI: 10.1016/j.jbi.2019.103144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 03/05/2019] [Accepted: 03/08/2019] [Indexed: 10/27/2022]
Abstract
Influenza rapidly spreads in seasonal epidemics and imposes a considerable economic burden on hospitals and other healthcare costs. Thus, predicting the propagation of influenza accurately is crucial in preventing influenza outbreaks and protecting public health. Most current studies focus on the spread simulation of influenza. However, few studies have investigated the dependencies between meteorological variables and influenza activity. This study develops a non-parametric model based on Gaussian process regression for influenza prediction considering meteorological effect to capture temporal dependencies hidden in influenza time series. To identify the most explanatory external variables, L1-regularization is applied to identify meteorology factor subsets, and three types of covariance functions are designed to characterize non-stationary and periodic behavior in influenza activity. The dependencies of diseases and meteorology are modeled through the designed cross-covariance function. A real case in Shenzhen, China was studied to validate our proposed model along with comparisons to recently developed multivariate statistical models for influenza prediction. Results show that our proposed influenza prediction approach achieves superior performance in terms of one-week-ahead prediction of influenza-like illness.
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Affiliation(s)
- Shanen Chen
- Department of Industrial Engineering and Management, Peking University, Beijing 100871, China
| | - Jian Xu
- IBM Research China, Beijing 100193, China
| | - Yongsheng Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Xin Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Shisong Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Hanwu Ma
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Renli Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
| | - Yachuan Liu
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Li Zhang
- IBM Research China, Beijing 100193, China
| | - Xi Zhang
- Department of Industrial Engineering and Management, Peking University, Beijing 100871, China.
| | - Lili Chen
- IBM Research China, Beijing 100193, China.
| | - Xiaojian Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China.
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El Baz S, Kahime K. Waterborne Diseases Arising From Climate Change. ADVANCES IN ENVIRONMENTAL ENGINEERING AND GREEN TECHNOLOGIES 2019. [DOI: 10.4018/978-1-5225-7775-1.ch021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
As a result of increased frequency and intensity of heat waves, increased floods and droughts, change in climate will affect biological, physical, and chemical components of water through different paths thus enhancing the risk of waterborne diseases. Identifying the role of weather in waterborne infection is a priority public health research issue as climate change is predicted to increase the frequency of extreme precipitation and temperature events. This chapter provides evidence that precipitation and temperature can affect directly or indirectly water quality and consequently affect the health human. This chapter also highlights the complex relationship between precipitation or temperature and transmission of waterborne disease such as diarrheal disease, gastroenteritis, cryptosporidiosis, giardiasis, and cholera.
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Lam HM, Wesolowski A, Hung NT, Nguyen TD, Nhat NTD, Todd S, Vinh DN, Vy NHT, Thao TTN, Thanh NTL, Tin PT, Minh NNQ, Bryant JE, Buckee CO, Ngoc TV, Chau NVV, Thwaites GE, Farrar J, Tam DTH, Vinh H, Boni MF. Nonannual seasonality of influenza-like illness in a tropical urban setting. Influenza Other Respir Viruses 2018; 12:742-754. [PMID: 30044029 PMCID: PMC6185894 DOI: 10.1111/irv.12595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In temperate and subtropical climates, respiratory diseases exhibit seasonal peaks in winter. In the tropics, with no winter, peak timings are irregular. METHODS To obtain a detailed picture of influenza-like illness (ILI) patterns in the tropics, we established an mHealth study in community clinics in Ho Chi Minh City (HCMC). During 2009-2015, clinics reported daily case numbers via SMS, with a subset performing molecular diagnostics for influenza virus. This real-time epidemiology network absorbs 6000 ILI reports annually, one or two orders of magnitude more than typical surveillance systems. A real-time online ILI indicator was developed to inform clinicians of the daily ILI activity in HCMC. RESULTS From August 2009 to December 2015, 63 clinics were enrolled and 36 920 SMS reports were received, covering approximately 1.7M outpatient visits. Approximately 10.6% of outpatients met the ILI case definition. ILI activity in HCMC exhibited strong nonannual dynamics with a dominant periodicity of 206 days. This was confirmed by time series decomposition, stepwise regression, and a forecasting exercise showing that median forecasting errors are 30%-40% lower when using a 206-day cycle. In ILI patients from whom nasopharyngeal swabs were taken, 31.2% were positive for influenza. There was no correlation between the ILI time series and the time series of influenza, influenza A, or influenza B (all P > 0.15). CONCLUSION This suggests, for the first time, that a nonannual cycle may be an essential driver of respiratory disease dynamics in the tropics. An immunological interference hypothesis is discussed as a potential underlying mechanism.
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Affiliation(s)
- Ha Minh Lam
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Amy Wesolowski
- Center for Communicable Disease DynamicsDepartment of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusetts
- Department of Ecology and Evolutionary BiologyPrinceton UniversityPrincetonNew Jersey
| | - Nguyen Thanh Hung
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Tran Dang Nguyen
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Thi Duy Nhat
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Stacy Todd
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Liverpool School of Tropical MedicineLiverpoolUK
| | - Dao Nguyen Vinh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Ha Thao Vy
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Tran Thi Nhu Thao
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Thi Le Thanh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | | | - Ngo Ngoc Quang Minh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Children's Hospital No. 1Ho Chi Minh CityVietnam
| | - Juliet E. Bryant
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Caroline O. Buckee
- Center for Communicable Disease DynamicsDepartment of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - Tran Van Ngoc
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | | | - Guy E. Thwaites
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Jeremy Farrar
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Wellcome TrustLondonUK
| | - Dong Thi Hoai Tam
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Ha Vinh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
- Department of Infectious DiseasesPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Maciej F. Boni
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
- Center for Infectious Disease DynamicsDepartment of BiologyPennsylvania State UniversityUniversity ParkPennsylvania
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Althouse BM, Flasche S, Minh LN, Thiem VD, Hashizume M, Ariyoshi K, Anh DD, Rodgers GL, Klugman KP, Hu H, Yoshida LM. Seasonality of respiratory viruses causing hospitalizations for acute respiratory infections in children in Nha Trang, Vietnam. Int J Infect Dis 2018; 75:18-25. [PMID: 30118916 PMCID: PMC7110808 DOI: 10.1016/j.ijid.2018.08.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/21/2023] Open
Abstract
Hospitalizations for respiratory viruses are seasonal in Vietnam Respiratory syncytial virus peaks in the late summer months, and inuenza A in April to June No clear seasonality is seen for human rhinovirus Human parainuenza 3 and human rhinovirus are positively associated with dew point This work can inform the timing of inuenza and RSV vaccination and the judicious use of antibiotics in Vietnam
Background Acute respiratory infections (ARIs) are the most common causes of death in children under 5 years of age. While the etiology of most pneumonia and ARI episodes is undiagnosed, a broad range of ARI-causing viruses circulate widely in South East Asia. However, the patterns and drivers of the seasonal transmission dynamics are largely unknown. Here we identify the seasonal patterns of multiple circulating viruses associated with hospitalizations for ARIs in Nha Trang, Vietnam. Methods Hospital based enhanced surveillance of childhood ARI is ongoing at Khanh Hoa General Hospital in Nha Trang. RT-PCR was performed to detect 13 respiratory viruses in nasopharyngeal samples from enrolled patients. Seasonal patterns of childhood ARI hospital admissions of various viruses were assessed, as well as their association with rainfall, temperature, and dew point. Results Respiratory syncytial virus peaks in the late summer months, and influenza A in April to June. We find significant associations between detection of human parainfluenza 3 and human rhinovirus with the month's mean dew point. Using a cross-wavelet transform we find a significant out-of-phase relationship between human parainfluenza 3 and temperature and dew point. Conclusions Our results are important for understanding the temporal risk associated with circulating pathogens in Southern Central Vietnam. Specifically, our results can inform timing of routing seasonal influenza vaccination and for when observed respiratory illness is likely viral, leading to judicious use of antibiotics in the region.
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Affiliation(s)
- Benjamin M Althouse
- Institute for Disease Modeling, Bellevue, WA, USA; University of Washington, Seattle, WA, USA; New Mexico State University, Las Cruces, NM, USA.
| | - Stefan Flasche
- London School of Hygiene and Tropical Medicine, London, UK, USA
| | - Le Nhat Minh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Vu Dinh Thiem
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Koya Ariyoshi
- Institute of Tropical Medicine, Nagasaki University, Japan
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | - Hao Hu
- Institute for Disease Modeling, Bellevue, WA, USA
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Yang W, Cummings MJ, Bakamutumaho B, Kayiwa J, Owor N, Namagambo B, Byaruhanga T, Lutwama JJ, O'Donnell MR, Shaman J. Dynamics of influenza in tropical Africa: Temperature, humidity, and co-circulating (sub)types. Influenza Other Respir Viruses 2018; 12:446-456. [PMID: 29573157 PMCID: PMC6005592 DOI: 10.1111/irv.12556] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The association of influenza with meteorological variables in tropical climates remains controversial. Here, we investigate the impact of weather conditions on influenza in the tropics and factors that may contribute to this uncertainty. METHODS We computed the monthly viral positive rate for each of the 3 circulating influenza (sub)types (ie, A/H1N1, A/H3N2, and B) among patients presenting with influenza-like illness (ILI) or severe acute respiratory infections (SARI) in 2 Ugandan cities (Entebbe and Kampala). Using this measure as a proxy for influenza activity, we applied regression models to examine the impact of temperature, relative humidity, absolute humidity, and precipitation, as well as interactions among the 3 influenza viruses on the epidemic dynamics of each influenza (sub)type. A full analysis including all 4 weather variables was done for Entebbe during 2007-2015, and a partial analysis including only temperature and precipitation was done for both cities during 2008-2014. RESULTS For Entebbe, the associations with weather variables differed by influenza (sub)type; with adjustment for viral interactions, the models showed that precipitation and temperature were negatively correlated with A/H1N1 activity, but not for A/H3N2 or B. A mutually negative association between A/H3N2 and B activity was identified in both Entebbe and Kampala. CONCLUSION Our findings suggest that key interactions exist among influenza (sub)types at the population level in the tropics and that such interactions can modify the association of influenza activity with weather variables. Studies of the relationship between influenza and weather conditions should therefore determine and account for co-circulating influenza (sub)types.
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Affiliation(s)
- Wan Yang
- Department of Environmental Health SciencesColumbia UniversityNew YorkNYUSA
| | - Matthew J. Cummings
- Division of Pulmonary, Allergy, and Critical Care MedicineColumbia UniversityNew YorkNYUSA
| | | | - John Kayiwa
- National Influenza CenterUganda Virus Research InstituteEntebbeUganda
| | - Nicholas Owor
- National Influenza CenterUganda Virus Research InstituteEntebbeUganda
| | - Barbara Namagambo
- National Influenza CenterUganda Virus Research InstituteEntebbeUganda
| | | | - Julius J. Lutwama
- National Influenza CenterUganda Virus Research InstituteEntebbeUganda
| | - Max R. O'Donnell
- Division of Pulmonary, Allergy, and Critical Care MedicineColumbia UniversityNew YorkNYUSA
- Department of EpidemiologyColumbia UniversityNew YorkNYUSA
| | - Jeffrey Shaman
- Department of Environmental Health SciencesColumbia UniversityNew YorkNYUSA
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Abhimanyu, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci 2018; 16:314-338. [PMID: 28078341 DOI: 10.1039/c6pp00355a] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The seasonality of infectious disease outbreaks suggests that environmental conditions have a significant effect on disease risk. One of the major environmental factors that can affect this is solar radiation, primarily acting through ultraviolet radiation (UVR), and its subsequent control of vitamin D production. Here we show how UVR and vitamin D, which are modified by latitude and season, can affect host and pathogen fitness and relate them to the outcomes of bacterial, viral and vector-borne infections. We conducted a thorough comparison of the molecular and cellular mechanisms of action of UVR and vitamin D on pathogen fitness and host immunity and related these to the effects observed in animal models and clinical trials to understand their independent and complementary effects on infectious disease outcome. UVR and vitamin D share common pathways of innate immune activation primarily via antimicrobial peptide production, and adaptive immune suppression. Whilst UVR can induce vitamin D-independent effects in the skin, such as the generation of photoproducts activating interferon signaling, vitamin D has a larger systemic effect due to its autocrine and paracrine modulation of cellular responses in a range of tissues. However, the seasonal patterns in infectious disease prevalence are not solely driven by variation in UVR and vitamin D levels across latitudes. Vector-borne pathogens show a strong seasonality of infection correlated to climatic conditions favoring their replication. Conversely, pathogens, such as influenza A virus, Mycobacterium tuberculosis and human immunodeficiency virus type 1, have strong evidence to support their interaction with vitamin D. Thus, UVR has both vitamin D-dependent and independent effects on infectious diseases; these effects vary depending on the pathogen of interest and the effects can be complementary or antagonistic.
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Affiliation(s)
- Abhimanyu
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa.
| | - Anna K Coussens
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa. and Division of Medical Microbiology, Department of Pathology, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa
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Hendaus MA, Alhammadi AH, Chandra P, Muneer E, Khalifa MS. Identifying agents triggering bronchiolitis in the State of Qatar. Int J Gen Med 2018; 11:143-149. [PMID: 29692622 PMCID: PMC5901157 DOI: 10.2147/ijgm.s154424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bronchiolitis is considered as the most frequent lower respiratory tract infection in infants and young children. This disorder is marked by acute inflammation, edema, damage of epithelial cells lining small airways, and augmentation of mucus production. OBJECTIVE The goal of the study was to identify agents triggering bronchiolitis in the State of Qatar. MATERIALS AND METHODS A cross-sectional retrospective study was performed at Hamad Medical Corporation, the only tertiary and academic medical center in the State of Qatar. The study included infants and young children aged 0-24 months who were admitted to our pediatric ward with diagnosis of acute bronchiolitis (2010-2012). RESULTS Eight hundred thirty-five infants and young children met the study inclusion criteria with mean age at diagnosis of 3.61±3.56 months. Respiratory virus real-time polymerase chain reaction was performed on 769 (92.0%) of the participants. Respiratory syncytial virus (RSV) was positive in 352 (45.7%) children admitted with clinical bronchiolitis. In addition, no viruses were identified in 142 (18.4%) of those admitted, and respiratory viruses other RSV were found in 275 (35.7%) of the children. Our investigations and observations show that there has been a steady and periodic seasonal variation in the RSV rate over the study period. A seasonal trend for the RSV (detected by respiratory virus real-time polymerase chain reaction) rate was evident, showing annual peaks in the months of October, November, December, and January, with a significant test for seasonality (test statistics [T]=3.15, P=0.009). CONCLUSION In countries with desert hot weather, bronchiolitis might affect children throughout the year. Our results suggest that the combination of date regarding uninterrupted RSV seasonality can provide guidance for health care planning and application of RSV prevention scheme, such as extending the palivizumab immunoglobulin series.
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Affiliation(s)
- Mohamed A Hendaus
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad General Corporation, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar
| | - Ahmed H Alhammadi
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad General Corporation, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar
| | - Prem Chandra
- Department of Statistics, Medical Research Center, Hamad General Corporation, Doha, Qatar
| | - Eshan Muneer
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad General Corporation, Doha, Qatar
| | - Mohamed S Khalifa
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad General Corporation, Doha, Qatar
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Keerqinfu, Zhang Q, Yan L, He J. Time series analysis of correlativity between pulmonary tuberculosis and seasonal meteorological factors based on theory of Human-Environmental Inter Relation. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Jennings L, Huang QS, Barr I, Lee PI, Kim WJ, Buchy P, Sanicas M, Mungall BA, Chen J. Literature review of the epidemiology of influenza B disease in 15 countries in the Asia-Pacific region. Influenza Other Respir Viruses 2018; 12:383-411. [PMID: 29127742 PMCID: PMC5907823 DOI: 10.1111/irv.12522] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 01/06/2023] Open
Abstract
Influenza control strategies focus on the use of trivalent influenza vaccines containing two influenza A virus subtypes and one of the two circulating influenza type B lineages (Yamagata or Victoria). Mismatches between the vaccine B lineage and the circulating lineage have been regularly documented in many countries, including those in the Asia‐Pacific region. We conducted a literature review with the aim of understanding the relative circulation of influenza B viruses in Asia‐Pacific countries. PubMed and Western Pacific Region Index Medicus were searched for relevant articles on influenza type B published since 1990 in English language for 15 Asia‐Pacific countries. Gray literature was also accessed. From 4834 articles identified, 121 full‐text articles were analyzed. Influenza was reported as an important cause of morbidity in the Asia‐Pacific region, affecting all age groups. In all 15 countries, influenza B was identified and associated with between 0% and 92% of laboratory‐confirmed influenza cases in any one season/year. Influenza type B appeared to cause more illness in children aged between 1 and 10 years than in other age groups. Epidemiological data for the two circulating influenza type B lineages remain limited in several countries in the Asia‐Pacific, although the co‐circulation of both lineages was seen in countries where strain surveillance data were available. Mismatches between circulating B lineages and vaccine strains were observed in all countries with available data. The data suggest that a shift from trivalent to quadrivalent seasonal influenza vaccines could provide additional benefits by providing broader protection.
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Affiliation(s)
- Lance Jennings
- Canterbury District Health Board, Christchurch, New Zealand
| | - Qiu Sue Huang
- WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, VIC, Australia
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Janet S, Broad J, Snape MD. Respiratory syncytial virus seasonality and its implications on prevention strategies. Hum Vaccin Immunother 2018; 14:234-244. [PMID: 29194014 PMCID: PMC5791579 DOI: 10.1080/21645515.2017.1403707] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/06/2017] [Indexed: 01/04/2023] Open
Abstract
With maternal and infant vaccines against respiratory syncytial virus (RSV) in development, it is timely to consider how the deployment of these vaccines might vary according to local RSV disease seasonality. In temperate regions RSV infection is predictably limited to a period of 3 to 5 months, while in tropical regions disease seasonality is often both more variable and more prolonged. Accordingly, in tropical regions a year-round immunisation schedule for both maternal and infant immunisation might be appropriate. In contrast, in temperate regions the benefit of year-round maternal immunisation would be heavily dependent on the duration of protection this provided, potentially necessitating a strategy directed at children due to be born in the months immediately prior to the RSV season. This review will consider the impact of seasonality on maternal and infant immunisation strategies against RSV, and the potential of an alternative approach of passive immunisation for all infants immediately prior to the RSV season.
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Affiliation(s)
- Sophie Janet
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Jonathan Broad
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Matthew D. Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
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Tsabouri S, Gkoutsias A, Lolis C, Makis A, Chaliasos N, Bartzokas A. Impact of meteorological factors on the emergence of bronchiolitis in North-western Greece. Allergol Immunopathol (Madr) 2018; 46:24-30. [PMID: 28483338 DOI: 10.1016/j.aller.2017.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/24/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the relationship between meteorological factors in North-western Greece and the incidence of bronchiolitis. METHODS Meteorological data (air temperature and rainfall) for Ioannina city in North-western Greece and medical data from hospitalised patients at University Hospital of Ioannina were collected between January 2002 and December 2013. The association between meteorological factors and rate of hospitalisation due to bronchiolitis was investigated. The data processing was done using the Pearson product-moment correlation coefficient and applying the chi-square test at contingency tables of the parameters. RESULTS Of the 792 hospitalised cases, 670 related to infants (<1 year) and 122 concerned patients aged 1-2 years old. The disease is more common among boys (59.5%) than girls (40.5%). The disease course through the year has a double variation with a main maximum in March and a main minimum in August. The statistical study showed statistically significant correlation of bronchiolitis with: (a) the temperature parameters on an annual basis; (b) precipitation in autumn and dryness in spring; and (c) with sudden changes in diurnal temperature range on an annual basis. CONCLUSION A peak incidence of bronchiolitis was noticed in cold and wet seasons during the five days preceding hospitalisation.
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Lee WY. Antibiotic Prescribing for Patients with Upper Respiratory Tract Infections by Emergency Physicians in a Singapore Tertiary Hospital. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective Despite the paucity of supporting evidence, the use of antibiotics in the management of upper respiratory tract infections (URTI) remains a persistent and worrying trend worldwide. This survey study set out to examine the antibiotic prescribing profile of emergency physicians for patients diagnosed with URTI at a local tertiary hospital. Methods Patients seeking treatment for URTI at the emergency department in the year 2001 were identified by their ICD-9 code. The electronic medical records of a random sample of these patients were reviewed. Patients with the following documented findings were excluded: (a) a duration of more than 7 days between disease onset and date of consultation, (b) prior antibiotic usage or medical consultation, (c) presentation of purulent sputum and/or purulent nasal discharge, and (d) existing medical conditions requiring antibiotic treatment/prophylaxis. Chi-square and multivariate analyses were performed to assess the association of patient-related factors with antibiotic prescribing. Results Of a random sample of 488 cases of URTI, inappropriate antibiotic prescribing was observed in 24% of cases (95% CI 20%, 28%). Significant associations were observed between antibiotic prescribing and month of consultation, patients' temperature and symptom of rhinorrhoea. Conclusion A substantial proportion of emergency department patients with URTI received antibiotics despite the lack of evidence supporting the drugs' effectiveness. Appropriate interventions to promote evidence-based prescribing amongst emergency physicians are required to reduce the extent of inappropriate antibiotic prescribing as well as to ensure the longevity of antibiotic effectiveness.
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Hsu PC, Liu C, Song AY, Zhang Z, Peng Y, Xie J, Liu K, Wu CL, Catrysse PB, Cai L, Zhai S, Majumdar A, Fan S, Cui Y. A dual-mode textile for human body radiative heating and cooling. SCIENCE ADVANCES 2017; 3:e1700895. [PMID: 29296678 PMCID: PMC5688747 DOI: 10.1126/sciadv.1700895] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 10/17/2017] [Indexed: 05/20/2023]
Abstract
Maintaining human body temperature is one of the most basic needs for living, which often consumes a huge amount of energy to keep the ambient temperature constant. To expand the ambient temperature range while maintaining human thermal comfort, the concept of personal thermal management has been recently demonstrated in heating and cooling textiles separately through human body infrared radiation control. Realizing these two opposite functions within the same textile would represent an exciting scientific challenge and a significant technological advancement. We demonstrate a dual-mode textile that can perform both passive radiative heating and cooling using the same piece of textile without any energy input. The dual-mode textile is composed of a bilayer emitter embedded inside an infrared-transparent nanoporous polyethylene (nanoPE) layer. We demonstrate that the asymmetrical characteristics of both emissivity and nanoPE thickness can result in two different heat transfer coefficients and achieve heating when the low-emissivity layer is facing outside and cooling by wearing the textile inside out when the high-emissivity layer is facing outside. This can expand the thermal comfort zone by 6.5°C. Numerical fitting of the data further predicts 14.7°C of comfort zone expansion for dual-mode textiles with large emissivity contrast.
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Affiliation(s)
- Po-Chun Hsu
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Chong Liu
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Alex Y. Song
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Ze Zhang
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Yucan Peng
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Jin Xie
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Kai Liu
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Chun-Lan Wu
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Peter B. Catrysse
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Lili Cai
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Shang Zhai
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Arun Majumdar
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Shanhui Fan
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Yi Cui
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025, USA
- Corresponding author.
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Smith GS, Messier KP, Crooks JL, Wade TJ, Lin CJ, Hilborn ED. Extreme precipitation and emergency room visits for influenza in Massachusetts: a case-crossover analysis. Environ Health 2017; 16:108. [PMID: 29041975 PMCID: PMC5645981 DOI: 10.1186/s12940-017-0312-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/26/2017] [Indexed: 05/28/2023]
Abstract
BACKGROUND Influenza peaks during the wintertime in temperate regions and during the annual rainy season in tropical regions - however reasons for the observed differences in disease ecology are poorly understood. We hypothesize that episodes of extreme precipitation also result in increased influenza in the Northeastern United States, but this association is not readily apparent, as no defined 'rainy season' occurs. Our objective was to evaluate the association between extreme precipitation (≥ 99th percentile) events and risk of emergency room (ER) visit for influenza in Massachusetts during 2002-2008. METHODS A case-crossover analysis of extreme precipitation events and influenza ER visits was conducted using hospital administrative data including patient town of residence, date of visit, age, sex, and associated diagnostic codes. Daily precipitation estimates were generated for each town based upon data from the National Oceanic and Atmospheric Administration. Odds ratio (OR) and 95% confidence intervals (CI) for associations between extreme precipitation and ER visits for influenza were estimated using conditional logistic regression. RESULTS Extreme precipitation events were associated with an OR = 1.23 (95%CI: 1.16, 1.30) for ER visits for influenza at lag days 0-6. There was significant effect modification by race, with the strongest association observed among Blacks (OR = 1.48 (1.30, 1.68)). CONCLUSIONS We observed a positive association between extreme precipitation events and ER visits for influenza, particularly among Blacks. Our results suggest that influenza is associated with extreme precipitation in a temperate area; this association could be a result of disease ecology, behavioral changes such as indoor crowding, or both. Extreme precipitation events are expected to increase in the Northeastern United States as climate change progresses. Additional research exploring the basis of this association can inform potential interventions for extreme weather events and influenza transmission.
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Affiliation(s)
- Genee S. Smith
- Oak Ridge Institute for Science and Education, Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - Kyle P. Messier
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC USA
| | - James L. Crooks
- National Jewish Health, Division of Biostatistics and Bioinformatics, Denver, CO USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA
| | - Timothy J. Wade
- United States Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, MD 58A, Research Triangle Park, Chapel Hill, NC 27711 USA
| | - Cynthia J. Lin
- Oak Ridge Institute for Science and Education, Oak Ridge National Laboratory, Oak Ridge, TN USA
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC USA
| | - Elizabeth D. Hilborn
- United States Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, MD 58A, Research Triangle Park, Chapel Hill, NC 27711 USA
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Hoeppner T, Borland M, Babl FE, Neutze J, Phillips N, Krieser D, Dalziel SR, Davidson A, Donath S, Jachno K, South M, Williams A, Zhang G, Oakley E. Influence of weather on incidence of bronchiolitis in Australia and New Zealand. J Paediatr Child Health 2017; 53:1000-1006. [PMID: 28727197 DOI: 10.1111/jpc.13614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 02/23/2017] [Accepted: 03/02/2017] [Indexed: 01/19/2023]
Abstract
AIM We aimed to examine the impact of weather on hospital admissions with bronchiolitis in Australia and New Zealand. METHODS We collected data for inpatient admissions of infants aged 2-12 months to seven hospitals in four cities in Australia and New Zealand from 2009 until 2011. Correlation of hospital admissions with minimum daily temperature, wind speed, relative humidity and rainfall was examined using linear, Poisson and negative binomial regression analyses as well as general estimated equation models. To account for possible lag between exposure to weather and admission to hospital, analyses were conducted for time lags of 0-4 weeks. RESULTS During the study period, 3876 patients were admitted to the study hospitals. Hospital admissions showed strong seasonality with peaks in wintertime, onset in autumn and offset in spring. The onset of peak incidence was preceded by a drop in temperature. Minimum temperature was inversely correlated with hospital admissions, whereas wind speed was directly correlated. These correlations were sustained for time lags of up to 4 weeks. Standardised correlation coefficients ranged from -0.14 to -0.54 for minimum temperature and from 0.18 to 0.39 for wind speed. Relative humidity and rainfall showed no correlation with hospital admissions in our study. CONCLUSION A decrease in temperature and increasing wind speed are associated with increasing incidence of bronchiolitis hospital admissions in Australia and New Zealand.
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Affiliation(s)
- Tobias Hoeppner
- Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia
| | - Meredith Borland
- Department of Emergency Medicine, Princess Margaret Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health and School of Primary, Rural and Aboriginal Health, University of Western Australia, Perth, Western Australia, Australia
| | - Franz E Babl
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jocelyn Neutze
- Department of Emergency Medicine, Kidz First Children's Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Natalie Phillips
- Emergency Department, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.,Children's Health Research Centre, University of Queensland Medical Research Institute, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - David Krieser
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia
| | - Stuart R Dalziel
- Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Andrew Davidson
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Susan Donath
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Jachno
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Mike South
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Amanda Williams
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Centre for Genetic Origins of Health and Disease, Curtin University and University of Western Australia, Perth, Western Australia, Australia
| | - Ed Oakley
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Abstract
BACKGROUND Palivizumab is the standard immunoprophylaxis against serious disease due to respiratory syncytial virus infection. Current evidence-based prophylaxis guidelines may not address certain children with CHD within specific high-risk groups or clinical/management settings. METHODS An international steering committee of clinicians with expertise in paediatric heart disease identified key questions concerning palivizumab administration; in collaboration with an additional international expert faculty, evidence-based recommendations were formulated using a quasi-Delphi consensus methodology. RESULTS Palivizumab prophylaxis was recommended for children with the following conditions: <2 years with unoperated haemodynamically significant CHD, who are cyanotic, who have pulmonary hypertension, or symptomatic airway abnormalities; <1 year with cardiomyopathies requiring treatment; in the 1st year of life with surgically operated CHD with haemodynamically significant residual problems or aged 1-2 years up to 6 months postoperatively; and on heart transplant waiting lists or in their 1st year after heart transplant. Unanimous consensus was not reached for use of immunoprophylaxis in children with asymptomatic CHD and other co-morbid factors such as arrhythmias, Down syndrome, or immunodeficiency, or during a nosocomial outbreak. Challenges to effective immunoprophylaxis included the following: multidisciplinary variations in identifying candidates with CHD and prophylaxis compliance; limited awareness of severe disease risks/burden; and limited knowledge of respiratory syncytial virus seasonal patterns in subtropical/tropical regions. CONCLUSION Evidence-based immunoprophylaxis recommendations were formulated for subgroups of children with CHD, but more data are needed to guide use in tropical/subtropical countries and in children with certain co-morbidities.
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67
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Lim TK, Siow WT. Pneumonia in the tropics. Respirology 2017; 23:28-35. [PMID: 28763150 PMCID: PMC7169137 DOI: 10.1111/resp.13137] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/27/2017] [Accepted: 06/12/2017] [Indexed: 12/19/2022]
Abstract
Pneumonia in the tropics poses a heavy disease burden. The complex interplay of climate change, human migration influences and socio-economic factors lead to changing patterns of respiratory infections in tropical climate but also increasingly in temperate countries. Tropical and poorer countries, especially South East Asia, also bear the brunt of the global tuberculosis (TB) pandemic, accounting for almost one-third of the burden. But, as human migration patterns evolve, we expect to see more TB cases in higher income as well as temperate countries, and rise in infections like scrub typhus from ecotourism activities. Fuelled by the ease of air travel, novel zoonotic infections originating from the tropics have led to global respiratory pandemics. As such, clinicians worldwide should be aware of these new conditions as well as classical tropical bacterial pneumonias such as melioidosis. Rarer entities such as co-infections of leptospirosis and chikungunya or dengue will need careful consideration as well. In this review, we highlight aetiologies of pneumonia seen more commonly in the tropics compared with temperate regions, their disease burden, variable clinical presentations as well as impact on healthcare delivery.
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Affiliation(s)
- Tow Keang Lim
- Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore
| | - Wen Ting Siow
- Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore
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Jiang L, Lee VJM, Cui L, Lin R, Tan CL, Tan LWL, Lim WY, Leo YS, Low L, Hibberd M, Chen MIC. Detection of viral respiratory pathogens in mild and severe acute respiratory infections in Singapore. Sci Rep 2017; 7:42963. [PMID: 28218288 PMCID: PMC5317157 DOI: 10.1038/srep42963] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/17/2017] [Indexed: 11/09/2022] Open
Abstract
To investigate the performance of laboratory methods and clinical case definitions in detecting the viral pathogens for acute respiratory infections (ARIs) from a prospective community cohort and hospital inpatients, nasopharyngeal swabs from cohort members reporting ARIs (community-ARI) and inpatients admitted with ARIs (inpatient-ARI) were tested by Singleplex Real Time-Polymerase Chain Reaction (SRT-PCR), multiplex RT-PCR (MRT-PCR) and pathogen-chip system (PathChip) between April 2012 and December 2013. Community-ARI and inpatient-ARI was also combined with mild and severe cases of influenza from a historical prospective study as mild-ARI and severe-ARI respectively to evaluate the performance of clinical case definitions. We analysed 130 community-ARI and 140 inpatient-ARI episodes (5 inpatient-ARI excluded because multiple pathogens were detected), involving 138 and 207 samples respectively. Detection by PCR declined with days post-onset for influenza virus; decrease was faster for community-ARI than for inpatient-ARI. No such patterns were observed for non-influenza respiratory virus infections. PathChip added substantially to viruses detected for community-ARI only. Clinical case definitions discriminated influenza from other mild-ARI but performed poorly for severe-ARI and for older participants. Rational strategies for diagnosis and surveillance of influenza and other respiratory virus must acknowledge the differences between ARIs presenting in community and hospital settings.
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Affiliation(s)
- Lili Jiang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Vernon Jian Ming Lee
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.,Biodefence Centre, Singapore Armed Forces, Singapore
| | - Lin Cui
- National Public Health Laboratory, Ministry of Health, Singapore
| | - Raymond Lin
- National Public Health Laboratory, Ministry of Health, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
| | - Chyi Lin Tan
- Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Wei-Yen Lim
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Yee-Sin Leo
- Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
| | - Louie Low
- Genome Institute Singapore, Singapore
| | | | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.,Department of Clinical Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
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70
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Kamigaki T, Chaw L, Tan AG, Tamaki R, Alday PP, Javier JB, Olveda RM, Oshitani H, Tallo VL. Seasonality of Influenza and Respiratory Syncytial Viruses and the Effect of Climate Factors in Subtropical-Tropical Asia Using Influenza-Like Illness Surveillance Data, 2010 -2012. PLoS One 2016; 11:e0167712. [PMID: 28002419 PMCID: PMC5176282 DOI: 10.1371/journal.pone.0167712] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/18/2016] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION The seasonality of influenza and respiratory syncytial virus (RSV) is well known, and many analyses have been conducted in temperate countries; however, this is still not well understood in tropical countries. Previous studies suggest that climate factors are involved in the seasonality of these viruses. However, the extent of the effect of each climate variable is yet to be defined. MATERIALS AND METHODS We investigated the pattern of seasonality and the effect of climate variables on influenza and RSV at three sites of different latitudes: the Eastern Visayas region and Baguio City in the Philippines, and Okinawa Prefecture in Japan. Wavelet analysis and the dynamic linear regression model were applied. Climate variables used in the analysis included mean temperature, relative and specific humidity, precipitation, and number of rainy days. The Akaike Information Criterion estimated in each model was used to test the improvement of fit in comparison with the baseline model. RESULTS At all three study sites, annual seasonal peaks were observed in influenza A and RSV; peaks were unclear for influenza B. Ranges of climate variables at the two Philippine sites were narrower and mean variables were significantly different among the three sites. Whereas all climate variables except the number of rainy days improved model fit to the local trend model, their contributions were modest. Mean temperature and specific humidity were positively associated with influenza and RSV at the Philippine sites and negatively associated with influenza A in Okinawa. Precipitation also improved model fit for influenza and RSV at both Philippine sites, except for the influenza A model in the Eastern Visayas. CONCLUSIONS Annual seasonal peaks were observed for influenza A and RSV but were less clear for influenza B at all three study sites. Including additional data from subsequent more years would help to ascertain these findings. Annual amplitude and variation in climate variables are more important than their absolute values for determining their effect on the seasonality of influenza and RSV.
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Affiliation(s)
- Taro Kamigaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Liling Chaw
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Alvin G. Tan
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
| | - Raita Tamaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Portia P. Alday
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
| | - Jenaline B. Javier
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
| | - Remigio M. Olveda
- Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Veronica L. Tallo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
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Swamy MA, Malhotra B, Reddy PVJ, Kumar N, Tiwari JK, Gupta ML. Distribution and Trends of Human Parainfluenza Viruses in Hospitalised Children. Indian J Pediatr 2016; 83:1109-13. [PMID: 27173651 PMCID: PMC7091168 DOI: 10.1007/s12098-016-2139-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 04/27/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study the distribution of Human Parainfluenza viruses (HPIV) 1-4 and their trends in children ≤5 y of age, hospitalised at a tertiary care centre, Jaipur and co-infection with other respiratory viruses. METHODS Nasopharyngeal aspirate and throat swabs were collected and processed for extraction of nucleic acid using automated extraction system and real time RT-PCR was performed using primers and probes specific to HPIV 1-4 and other respiratory viruses on 743 samples. RESULTS Total positivity for Parainfluenza viruses 1-4 was found to be 69/743 (9.28 %), of which 50/533 (9.38 %) were boys and 19/210 (9.05 %) girls. Predominance of HPIV- 3 was observed [41/743 (5.52%)] followed by HPIV-1 in 13/743 (1.75%), HPIV-4 in 10/743 (1.34%) and HPIV-2 in 5/743 (0.67%) patients. Maximum positivity was observed in age group 25-36 mo (12.98%) followed by 13-24 mo group (11.96%). HPIVs were found to be circulating round the year and each year. Co-infections with other respiratory viruses were observed in 22/69 (31.88%) of HPIV positive patients. CONCLUSIONS All the four types of HPIV were found to be circulating in the index population during all the three years, predominantly during post monsoon and winter seasons. HPIV vaccination should be targeted for all types.
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Affiliation(s)
- M Anjaneya Swamy
- Department of Microbiology & Immunology, Advanced Basic Sciences & Clinical Research Laboratory, (ICMR Grade - I Viral Diagnostics & Research Laboratory), Sawai Man Singh Medical College, Jawahar Lal Nehru Marg, Jaipur, 302004, Rajasthan, India
| | - Bharti Malhotra
- Department of Microbiology & Immunology, Advanced Basic Sciences & Clinical Research Laboratory, (ICMR Grade - I Viral Diagnostics & Research Laboratory), Sawai Man Singh Medical College, Jawahar Lal Nehru Marg, Jaipur, 302004, Rajasthan, India.
| | - P V Janardhan Reddy
- Department of Microbiology & Immunology, Advanced Basic Sciences & Clinical Research Laboratory, (ICMR Grade - I Viral Diagnostics & Research Laboratory), Sawai Man Singh Medical College, Jawahar Lal Nehru Marg, Jaipur, 302004, Rajasthan, India
| | - Neeraj Kumar
- Department of Microbiology & Immunology, Advanced Basic Sciences & Clinical Research Laboratory, (ICMR Grade - I Viral Diagnostics & Research Laboratory), Sawai Man Singh Medical College, Jawahar Lal Nehru Marg, Jaipur, 302004, Rajasthan, India
| | - Jitendra Kumar Tiwari
- Department of Microbiology & Immunology, Advanced Basic Sciences & Clinical Research Laboratory, (ICMR Grade - I Viral Diagnostics & Research Laboratory), Sawai Man Singh Medical College, Jawahar Lal Nehru Marg, Jaipur, 302004, Rajasthan, India
| | - M L Gupta
- Department of Medicine Pediatrics, J. K. Lone Hospital, Jaipur, Rajasthan, India
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Yan XL, Li YN, Tang YJ, Xie ZP, Gao HC, Yang XM, Li YM, Liu LJ, Duan ZJ. Clinical characteristics and viral load of respiratory syncytial virus and human metapneumovirus in children hospitaled for acute lower respiratory tract infection. J Med Virol 2016; 89:589-597. [PMID: 27632796 PMCID: PMC7166468 DOI: 10.1002/jmv.24687] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 11/11/2022]
Abstract
Respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) are two common viral pathogens in acute lower respiratory tract infections (ALRTI). However, the association of viral load with clinical characteristics is not well‐defined in ALRTI. To explore the correlation between viral load and clinical characteristics of RSV and HMPV in children hospitalized for ALRTI in Lanzhou, China. Three hundred and eighty‐seven children hospitalized for ALRTI were enrolled. Nasopharyngeal aspirates (NPAs) were sampled from each children. Real‐time PCR was used to screen RSV, HMPV, and twelve additional respiratory viruses. Bronchiolitis was the leading diagnoses both in RSV and HMPV positive patients. A significantly greater frequency of wheezing (52% vs. 33.52%, P = 0.000) was noted in RSV positive and negative patients. The RSV viral load was significant higher in children aged <1 year (P = 0.003), children without fever and wheezing (P = 0.015 and P = 0.000), days of illness <14 days (P = 0.002), children with bronchiolitis (P = 0.012) and children with RSV single infections (P = 0.000). No difference was found in the clinical features of HMPV positive and negative patients. The HMPV viral load had no correlation with any clinical characteristics. The incidences of severe disease were similar between single infection and coinfection for the two viruses (RSV, P = 0.221; HMPV, P = 0.764) and there has no statistical significance between severity and viral load (P = 0.166 and P = 0.721). Bronchiolitis is the most common disease caused by RSV and HMPV. High viral load or co‐infection may be associated with some symptoms but neither has a significant impact on disease severity for the two viruses. J. Med. Virol. 89:589–597, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Xiao-Li Yan
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control, Beijing, China
| | - Yu-Ning Li
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yi-Jie Tang
- Department of Respiration, Beijing Electric Power Hospital of The North China Grid Company Limited, Beijing, China
| | - Zhi-Ping Xie
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control, Beijing, China
| | - Han-Chun Gao
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control, Beijing, China
| | - Xue-Mei Yang
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yu-Mei Li
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li-Jun Liu
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Zhao-Jun Duan
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control, Beijing, China
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Furuse Y, Oshitani H. Mechanisms of replacement of circulating viruses by seasonal and pandemic influenza A viruses. Int J Infect Dis 2016; 51:6-14. [PMID: 27569827 DOI: 10.1016/j.ijid.2016.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/10/2016] [Accepted: 08/21/2016] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Seasonal influenza causes annual epidemics by the accumulation of antigenic changes. Pandemic influenza occurs through a major antigenic change of the influenza A virus, which can originate from other hosts. Although new antigenic variants of the influenza A virus replace formerly circulating seasonal and pandemic viruses, replacement mechanisms remain poorly understood. METHODS A stochastic individual-based SEIR (susceptible-exposed-infectious-recovered) model with two viral strains (formerly circulating old strain and newly emerged strain) was developed for simulations to elucidate the replacement mechanisms. RESULTS Factors and conditions of virus and host populations affecting the replacement were identified. Replacement is more likely to occur in tropical regions than temperate regions. The magnitude of the ongoing epidemic by the old strain, herd immunity against the old strain, and timing of appearance of the new strain are not that important for replacement. It is probable that the frequency of replacement by a pandemic virus is higher than a seasonal virus because of the high initial susceptibility and high basic reproductive number of the pandemic virus. CONCLUSIONS The findings of this study on replacement mechanisms could lead to a better understanding of virus transmission dynamics and may possibly be helpful in establishing an effective strategy to mitigate the impact of seasonal and pandemic influenza.
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Affiliation(s)
- Yuki Furuse
- Department of Virology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan.
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan
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Abstract
Human parainfluenza viruses (HPIVs) are single-stranded, enveloped RNA viruses of the Paramyoviridaie family. There are four serotypes which cause respiratory illnesses in children and adults. HPIVs bind and replicate in the ciliated epithelial cells of the upper and lower respiratory tract and the extent of the infection correlates with the location involved. Seasonal HPIV epidemics result in a significant burden of disease in children and account for 40% of pediatric hospitalizations for lower respiratory tract illnesses (LRTIs) and 75% of croup cases. Parainfluenza viruses are associated with a wide spectrum of illnesses which include otitis media, pharyngitis, conjunctivitis, croup, tracheobronchitis, and pneumonia. Uncommon respiratory manifestations include apnea, bradycardia, parotitis, and respiratory distress syndrome and rarely disseminated infection. Immunity resulting from disease in childhood is incomplete and reinfection with HPIV accounts for 15% of respiratory illnesses in adults. Severe disease and fatal pneumonia may occur in elderly and immunocompromised adults. HPIV pneumonia in recipients of hematopoietic stem cell transplant (HSCT) is associated with 50% acute mortality and 75% mortality at 6 months. Though sensitive molecular diagnostics are available to rapidly diagnose HPIV infection, effective antiviral therapies are not available. Currently, treatment for HPIV infection is supportive with the exception of croup where the use of corticosteroids has been found to be beneficial. Several novel drugs including DAS181 appear promising in efforts to treat severe disease in immunocompromised patients, and vaccines to decrease the burden of disease in young children are in development.
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Affiliation(s)
- Angela R Branche
- Department of Medicine, University of Rochester, Rochester, New York
| | - Ann R Falsey
- Department of Medicine, University of Rochester, Rochester, New York
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Phylodynamics of influenza A(H3N2) in South America, 1999-2012. INFECTION GENETICS AND EVOLUTION 2016; 43:312-20. [PMID: 27275847 DOI: 10.1016/j.meegid.2016.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/26/2016] [Accepted: 06/04/2016] [Indexed: 11/21/2022]
Abstract
The limited influenza A(H3N2) genetic data available from the Southern Hemisphere (particularly from Africa and Latin America), constrains the accurate reconstruction of viral dissemination dynamics within those regions. Our objective was to describe the spatial dissemination dynamics of influenza A(H3N2) within South America. A total of 469 sequences of the HA1 portion of the hemagglutinin gene (HA) from influenza A(H3N2) viruses sampled in temperate and tropical South American countries between 1999 and 2012 were combined with available contemporary sequences from Australia, Hong Kong, United Kingdom and the United States. Phylogenetic analyses revealed that influenza A(H3N2) sequences from South America were highly intermixed with sequences from other geographical regions, although a clear geographic virus population structure was detected globally. We identified 14 clades mostly (≥80%) composed of influenza sequences from South American countries. Bayesian phylogeographic analyses of those clades support a significant role of both temperate and tropical regions in the introduction and dissemination of new influenza A(H3N2) strains within South America and identify an intensive bidirectional viral exchange between different geographical areas. These findings indicate that seasonal influenza A(H3N2) epidemics in South America are seeded by both the continuous importation of viral variants from other geographic regions and the short-term persistence of local lineages. This study also supports a complex metapopulation model of influenza A(H3N2) dissemination in South America, with no preferential direction in viral movement between temperate and tropical regions.
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Hogan AB, Anderssen RS, Davis S, Moore HC, Lim FJ, Fathima P, Glass K. Time series analysis of RSV and bronchiolitis seasonality in temperate and tropical Western Australia. Epidemics 2016; 16:49-55. [PMID: 27294794 DOI: 10.1016/j.epidem.2016.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/08/2016] [Accepted: 05/09/2016] [Indexed: 12/26/2022] Open
Abstract
Respiratory syncytial virus (RSV) causes respiratory illness in young children and is most commonly associated with bronchiolitis. RSV typically occurs as annual or biennial winter epidemics in temperate regions, with less pronounced seasonality in the tropics. We sought to characterise and compare the seasonality of RSV and bronchiolitis in temperate and tropical Western Australia. We examined over 13 years of RSV laboratory identifications and bronchiolitis hospitalisations in children, using an extensive linked dataset from Western Australia. We applied mathematical time series analyses to identify the dominant seasonal cycle, and changes in epidemic size and timing over this period. Both the RSV and bronchiolitis data showed clear winter epidemic peaks in July or August in the southern Western Australia regions, but less identifiable seasonality in the northern regions. Use of complex demodulation proved very effective at comparing disease epidemics. The timing of RSV and bronchiolitis epidemics coincided well, but the size of the epidemics differed, with more consistent peak sizes for bronchiolitis than for RSV. Our results show that bronchiolitis hospitalisations are a reasonable proxy for the timing of RSV detections, but may not fully capture the magnitude of RSV epidemics.
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Affiliation(s)
- Alexandra B Hogan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Australia.
| | - Robert S Anderssen
- CSIRO Data61; Mathematical Sciences Institute, The Australian National University; Mathematics and Statistics, La Trobe University, Australia
| | - Stephanie Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Australia
| | - Faye J Lim
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Australia
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Roussos AJ, Gomez Penedo JM, Muiños R. A time-series analysis of therapeutic alliance, interventions, and client’s clinical status in an evidence-based single-case study: Evidence for establishing change mechanisms in psychotherapy. Psychother Res 2016; 28:137-149. [DOI: 10.1080/10503307.2016.1174346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Andrés J. Roussos
- Psychology Research Institute, Universidad de Buenos Aires, Ciudad de Buenos Aires, Argentina
- Consejo nacional de investigaciones científicas y técnicas, CONICET, Ciudad de Buenos Aires, Argentina
| | - Juan Martin Gomez Penedo
- Psychology Research Institute, Universidad de Buenos Aires, Ciudad de Buenos Aires, Argentina
- Consejo nacional de investigaciones científicas y técnicas, CONICET, Ciudad de Buenos Aires, Argentina
| | - Roberto Muiños
- Psychology Research Institute, Universidad de Buenos Aires, Ciudad de Buenos Aires, Argentina
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Hogan AB, Glass K, Moore HC, Anderssen RS. Exploring the dynamics of respiratory syncytial virus (RSV) transmission in children. Theor Popul Biol 2016; 110:78-85. [PMID: 27155294 DOI: 10.1016/j.tpb.2016.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 04/12/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
Respiratory syncytial virus (RSV) is the main cause of lower respiratory tract infections in children. Whilst highly seasonal, RSV dynamics can have either one-year (annual) or two-year (biennial) cycles. Furthermore, some countries show a 'delayed biennial' pattern, where the epidemic peak in low incidence years is delayed. We develop a compartmental model for RSV infection, driven by a seasonal forcing function, and conduct parameter space and bifurcation analyses to document parameter ranges that give rise to these different seasonal patterns. The model is sensitive to the birth rate, transmission rate, and seasonality parameters, and can replicate RSV dynamics observed in different countries. The seasonality parameter must exceed a threshold for the model to produce biennial cycles. Intermediate values of the birth rate produce the greatest delay in these biennial cycles, while the model reverts to annual cycles if the duration of immunity is too short. Finally, the existence of period doubling and period halving bifurcations suggests robust model dynamics, in agreement with the known regularity of RSV outbreaks. These findings help explain observed RSV data, such as regular biennial dynamics in Western Australia, and delayed biennial dynamics in Finland. From a public health perspective, our findings provide insight into the drivers of RSV transmission, and a foundation for exploring RSV interventions.
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Affiliation(s)
- Alexandra B Hogan
- National Centre for Epidemiology and Population Health, Building 62, Corner Mills and Eggleston Roads, The Australian National University, Canberra ACT 2601, Australia.
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Building 62, Corner Mills and Eggleston Roads, The Australian National University, Canberra ACT 2601, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Western Australia, Australia
| | - Robert S Anderssen
- CSIRO Data61; Mathematical Sciences Institute, The Australian National University; Mathematics and Statistics, La Trobe University, Australia
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80
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Oliveira CR, Costa GSR, Paploski IAD, Kikuti M, Kasper AM, Silva MMO, Tavares AS, Cruz JS, Queiroz TL, Lima HCAV, Calcagno J, Reis MG, Weinberger DM, Shapiro ED, Ko AI, Ribeiro GS. Influenza-like illness in an urban community of Salvador, Brazil: incidence, seasonality and risk factors. BMC Infect Dis 2016; 16:125. [PMID: 26975185 PMCID: PMC4791800 DOI: 10.1186/s12879-016-1456-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 03/07/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Our understanding of the epidemiology of influenza is limited in tropical regions, which in turn has hampered identifying optimal region-specific policy to diminish disease burden. Influenza-like illness (ILI) is a clinical diagnosis that can be used as a surrogate for influenza. This study aimed to define the incidence and seasonality of ILI and to assess its association with climatic variables and school calendar in an urban community in the tropical region of Salvador, Brazil. METHODS Between 2009 and 2013, we conducted enhanced community-based surveillance for acute febrile illnesses (AFI) among patients ≥ 5 years of age in a slum community emergency unit in Salvador, Brazil. ILI was defined as a measured temperature of ≥ 37.8 °C or reported fever in a patient with cough or sore throat for ≤ 7 days, and negative test results for dengue and leptospirosis. Seasonality was analyzed with a harmonic regression model. Negative binomial regression models were used to correlate ILI incidence with rainfall, temperature, relative humidity and the number of days per month that schools were in session while controlling for seasonality. RESULTS There were 2,651 (45.6% of 5,817 AFI patients) ILI cases with a mean annual incidence of 60 cases/1,000 population (95% CI 58-62). Risk of ILI was highest among 5-9 year olds with an annual incidence of 105 cases/1,000 population in 2009. ILI had a clear seasonal pattern with peaks between the 35-40th week of the year. ILI peaks were higher and earlier in 5-9 year olds compared with > 19 year olds. No association was seen between ILI and precipitation, relative humidity or temperature. There was a significant association between the incidence of ILI in children 5-9 years of age and number of scheduled school days per month. CONCLUSIONS We identified a significant burden of ILI with distinct seasonality in the Brazilian tropics and highest rates among young school-age children. Seasonal peaks of ILI in children 5-9 years of age were positively associated with the number of school days, indicating that children may play a role in the timing of seasonal influenza transmission.
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Affiliation(s)
- Carlos R. Oliveira
- Department of Pediatrics, School of Medicine, Yale University, New Haven, USA
| | - Gisela S. R. Costa
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Igor A. D. Paploski
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Mariana Kikuti
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Amelia M. Kasper
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Monaise M. O. Silva
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Aline S. Tavares
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Jaqueline S. Cruz
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Tássia L. Queiroz
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Helena C. A. V. Lima
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Juan Calcagno
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Mitermayer G. Reis
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
| | - Eugene D. Shapiro
- Department of Pediatrics, School of Medicine, Yale University, New Haven, USA
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
- Department of Investigative Medicine, School of Medicine, Yale University, New Haven, USA
| | - Albert I. Ko
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
| | - Guilherme S. Ribeiro
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
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81
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Virk RK, Gunalan V, Tambyah PA. Influenza infection in human host: challenges in making a better influenza vaccine. Expert Rev Anti Infect Ther 2016; 14:365-75. [PMID: 26885890 DOI: 10.1586/14787210.2016.1155450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Influenza is a ubiquitous infection with a spectrum ranging from mild to severe. The mystery regarding such variability in the clinical spectrum has not been fully unravelled, although a role for the complex interplay among virus characteristics, host immune response and environmental factors has been suggested. Antivirals and current vaccines have a limited role in prophylaxis and treatment because they primarily target surface glycoproteins which undergo antigenic/genetic changes under host immune pressure. Targeting conserved internal proteins could lead the way to a universal vaccine which can be used against various types/subtypes. However, this is on the distant horizon, so in the meantime, developing improved vaccines should be given high priority. In this review, we discuss where the current influenza research stands in terms of vaccines, adjuvants, and how we can better predict the vaccine strains for upcoming influenza seasons by understanding complex phenomena which drive the continuous antigenic evolution.
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Affiliation(s)
| | - Vithiagaran Gunalan
- b Bioinformatics Institute (BII), Agency for Science Technology and Research (A*STAR) , Singapore
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82
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Ho ZJM, Zhao X, Cook AR, Loh JP, Ng SH, Tan BH, Lee VJ. Clinical differences between respiratory viral and bacterial mono- and dual pathogen detected among Singapore military servicemen with febrile respiratory illness. Influenza Other Respir Viruses 2016; 9:200-8. [PMID: 25827870 PMCID: PMC4474496 DOI: 10.1111/irv.12312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2015] [Indexed: 01/04/2023] Open
Abstract
Background Although it is known that febrile respiratory illnesses (FRI) may be caused by multiple respiratory pathogens, there are no population-level studies describing its impact on clinical disease. Methods Between May 2009 and October 2012, 7733 FRI patients and controls in the Singapore military had clinical data and nasal wash samples collected prospectively and sent for PCR testing. Patients with one pathogen detected (mono-pathogen) were compared with those with two pathogens (dual pathogen) for differences in basic demographics and clinical presentation. Results In total, 45.8% had one pathogen detected, 20.2% had two pathogens detected, 30.9% had no pathogens detected, and 3.1% had more than two pathogens. Multiple pathogens were associated with recruits, those with asthma and non-smokers. Influenza A (80.0%), influenza B (73.0%) and mycoplasma (70.6%) were most commonly associated with mono-infections, while adenovirus was most commonly associated with dual infections (62.9%). Influenza A paired with S. pneumoniae had higher proportions of chills and rigors than their respective mono-pathogens (P = 0.03, P = 0.009). H. influenzae paired with either enterovirus or parainfluenzae had higher proportions of cough with phlegm than their respective mono-pathogens. Although there were observed differences in mean proportions of body temperature, nasal symptoms, sore throat, body aches and joint pains between viral and bacterial mono-pathogens, there were few differences between distinct dual-pathogen pairs and their respective mono-pathogen counterparts. Conclusion A substantial number of FRI patients have multiple pathogens detected. Observed clinical differences between patients of dual pathogen and mono-pathogen indicate the likely presence of complex microbial interactions between the various pathogens.
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Affiliation(s)
| | - Xiahong Zhao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | | | | | - Vernon J Lee
- HQ Medical Corps, Singapore Armed Forces, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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83
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Furuse Y, Odagiri T, Tamaki R, Kamigaki T, Otomaru H, Opinion J, Santo A, Dolina-Lacaba D, Daya E, Okamoto M, Saito-Obata M, Inobaya M, Tan A, Tallo V, Lupisan S, Suzuki A, Oshitani H. Local persistence and global dissemination play a significant role in the circulation of influenza B viruses in Leyte Island, Philippines. Virology 2016; 492:21-4. [PMID: 26896931 DOI: 10.1016/j.virol.2016.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/31/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
The local and global transmission dynamics of influenza B virus is not completely understood mainly because of limited epidemiological and sequence data for influenza B virus. Here we report epidemiological and molecular characteristics of influenza B viruses from 2010 to 2013 in Leyte Island, Philippines. Phylogenetic analyses showed global dissemination of the virus among both neighboring and distant areas. The analyses also suggest that southeast Asia is not a distributor of influenza B virus and can introduce the virus from other areas. Furthermore, we found evidence on the local persistence of the virus over years in the Philippines. Taken together, both local persistence and global dissemination play a significant role in the circulation of influenza B virus.
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Affiliation(s)
- Yuki Furuse
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Odagiri
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Raita Tamaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taro Kamigaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirono Otomaru
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jamie Opinion
- Tacloban City Health Office, Tacloban City, Philippines
| | | | | | - Edgard Daya
- Leyte Provincial Health Office, Palo, Philippines
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mariko Saito-Obata
- Tohoku-RITM Research Center for Emerging and Reemerging Infectious Diseases, Muntinlupa City, Philippines
| | | | - Alvin Tan
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Socorro Lupisan
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Akira Suzuki
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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84
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Granbom E, Fernlund E, Sunnegårdh J, Lundell B, Naumburg E. Respiratory Tract Infection and Risk of Hospitalization in Children with Congenital Heart Defects During Season and Off-Season: A Swedish National Study. Pediatr Cardiol 2016; 37:1098-105. [PMID: 27090653 PMCID: PMC7080007 DOI: 10.1007/s00246-016-1397-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/05/2016] [Indexed: 01/09/2023]
Abstract
Respiratory tract infections (RTI) are common among young children, and congenital heart defect (CHD) is a risk factor for severe illness and hospitalization. This study aims to assess the relative risk of hospitalization due to RTI in winter and summer seasons for different types of CHD. All children born in Sweden and under the age of two, in 2006-2011, were included. Heart defects were grouped according to type. Hospitalization rates for respiratory syncytial virus (RSV) infection and RTI in general were retrieved from the national inpatient registry. The relative risk of hospitalization was calculated by comparing each subgroup to other types of CHD and otherwise healthy children. The relative risk of hospitalization was increased for all CHD subgroups, and there was a greater increase in risk in summer for the most severe CHD. This included RSV infection, as well as RTI in general. The risk of hospitalization due to RTI is greater for CHD children. Prophylactic treatment with palivizumab, given to prevent severe RSV illness, is only recommended during winter. We argue that information to healthcare staff and parents should include how the risk of severe infectious respiratory tract illnesses, RSV and others, is present all year round for children with CHD.
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Affiliation(s)
- Elin Granbom
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden. .,Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden.
| | - Eva Fernlund
- Pediatric Heart Center, Lund University and Linköping University, Lund, Linköping, Sweden
| | - Jan Sunnegårdh
- Department of Cardiology at the Queen Silvias Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bo Lundell
- Department of Women’s and Children’s Health, Karolinska University Hospital, Stockholm, Sweden
| | - Estelle Naumburg
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden ,Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
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85
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Davis RE, McGregor GR, Enfield KB. Humidity: A review and primer on atmospheric moisture and human health. ENVIRONMENTAL RESEARCH 2016; 144:106-116. [PMID: 26599589 DOI: 10.1016/j.envres.2015.10.014] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 05/18/2023]
Abstract
Research examining associations between weather and human health frequently includes the effects of atmospheric humidity. A large number of humidity variables have been developed for numerous purposes, but little guidance is available to health researchers regarding appropriate variable selection. We examine a suite of commonly used humidity variables and summarize both the medical and biometeorological literature on associations between humidity and human health. As an example of the importance of humidity variable selection, we correlate numerous hourly humidity variables to daily respiratory syncytial virus isolates in Singapore from 1992 to 1994. Most water-vapor mass based variables (specific humidity, absolute humidity, mixing ratio, dewpoint temperature, vapor pressure) exhibit comparable correlations. Variables that include a thermal component (relative humidity, dewpoint depression, saturation vapor pressure) exhibit strong diurnality and seasonality. Humidity variable selection must be dictated by the underlying research question. Despite being the most commonly used humidity variable, relative humidity should be used sparingly and avoided in cases when the proximity to saturation is not medically relevant. Care must be taken in averaging certain humidity variables daily or seasonally to avoid statistical biasing associated with variables that are inherently diurnal through their relationship to temperature.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, 291 McCormick Road, Charlottesville, VA 22904-4123, USA.
| | - Glenn R McGregor
- Department of Geography, Durham University, Durham DH1 3LE, United Kingdom.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
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86
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Sirimi N, Miligkos M, Koutouzi F, Petridou E, Siahanidou T, Michos A. Respiratory syncytial virus activity and climate parameters during a 12-year period. J Med Virol 2015; 88:931-7. [PMID: 26575521 DOI: 10.1002/jmv.24430] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 11/06/2022]
Abstract
The epidemic pattern of respiratory syncytial virus (RSV) infection during long periods and the factors that determine seasonality are not well studied. In order to correlate the RSV epidemic activity with climate parameters, we conducted a retrospective study of children (0-14 year) who were hospitalized because of respiratory tract infection and had an RSV test performed in the major tertiary pediatric hospital of Greece during a 12-year period (2002-2013). Daily data regarding temperature and humidity were obtained from the Hellenic National Meteorological Service. A total of 2030/7516 (27%) children were tested positive for RSV infection. Among RSV positive children 1945/2030 (95.8%) were infants <1 year. A peak of RSV activity was measured in years 2002, 2003, and 2006 (>35% positive). The RSV season in our area spanned from December to April, with higher incidence during January through March. The peak monthly RSV incidence was observed during February with mean temperature 10.34 °C and mean relative humidity 69.16%. Regarding climate conditions, a statistically significant positive correlation was found between monthly RSV activity and mean monthly relative humidity (rho = 0.66, P-value = 0.02), whereas a negative correlation was found with mean monthly temperature (rho = -0.81, P-value = 0.002). However, in the multivariable analysis, only the effect of mean monthly temperature remained statistically significant (IRR = 0.72, 95% CI: 0.68, 0.80). Further understanding of RSV seasonality in different geographic areas would be important in order to timely implement preventing strategies with immunoprophylaxis or future RSV vaccines.
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Affiliation(s)
- Natalia Sirimi
- Division of Infectious Diseases, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Michael Miligkos
- Division of Infectious Diseases, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Foteini Koutouzi
- Division of Infectious Diseases, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Evi Petridou
- Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Tania Siahanidou
- Department of Neonatology, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Athanasios Michos
- Division of Infectious Diseases, First Department of Pediatrics, University of Athens, Athens, Greece
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Modeling Seasonal Influenza Transmission and Its Association with Climate Factors in Thailand Using Time-Series and ARIMAX Analyses. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:436495. [PMID: 26664492 PMCID: PMC4667155 DOI: 10.1155/2015/436495] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/31/2015] [Accepted: 11/01/2015] [Indexed: 12/01/2022]
Abstract
Influenza is a worldwide respiratory infectious disease that easily spreads from one person to another. Previous research has found that the influenza transmission process is often associated with climate variables. In this study, we used autocorrelation and partial autocorrelation plots to determine the appropriate autoregressive integrated moving average (ARIMA) model for influenza transmission in the central and southern regions of Thailand. The relationships between reported influenza cases and the climate data, such as the amount of rainfall, average temperature, average maximum relative humidity, average minimum relative humidity, and average relative humidity, were evaluated using cross-correlation function. Based on the available data of suspected influenza cases and climate variables, the most appropriate ARIMA(X) model for each region was obtained. We found that the average temperature correlated with influenza cases in both central and southern regions, but average minimum relative humidity played an important role only in the southern region. The ARIMAX model that includes the average temperature with a 4-month lag and the minimum relative humidity with a 2-month lag is the appropriate model for the central region, whereas including the minimum relative humidity with a 4-month lag results in the best model for the southern region.
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88
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Shaw Stewart PD. Seasonality and selective trends in viral acute respiratory tract infections. Med Hypotheses 2015; 86:104-19. [PMID: 26608252 PMCID: PMC7116927 DOI: 10.1016/j.mehy.2015.11.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/28/2015] [Accepted: 11/01/2015] [Indexed: 12/21/2022]
Abstract
Influenza A and B, and many unrelated viruses including rhinovirus, RSV, adenovirus, metapneumovirus and coronavirus share the same seasonality, since these viral acute respiratory tract infections (vARIs) are much more common in winter than summer. Unfortunately, early investigations that used recycled “pedigree” virus strains seem to have led microbiologists to dismiss the common folk belief that vARIs often follow chilling. Today, incontrovertible evidence shows that ambient temperature dips and host chilling increase the incidence and severity of vARIs. This review considers four possible mechanisms, M1 - 4, that can explain this link: (M1) increased crowding in winter may enhance viral transmission; (M2) lower temperatures may increase the stability of virions outside the body; (M3) chilling may increase host susceptibility; (M4) lower temperatures or host chilling may activate dormant virions. There is little evidence for M1 or M2, which are incompatible with tropical observations. Epidemiological anomalies such as the repeated simultaneous arrival of vARIs over wide geographical areas, the rapid cessation of influenza epidemics, and the low attack rate of influenza within families are compatible with M4, but not M3 (in its simple form). M4 seems to be the main driver of seasonality, but M3 may also play an important role.
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89
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Soebiyanto RP, Gross D, Jorgensen P, Buda S, Bromberg M, Kaufman Z, Prosenc K, Socan M, Vega Alonso T, Widdowson MA, Kiang RK. Associations between Meteorological Parameters and Influenza Activity in Berlin (Germany), Ljubljana (Slovenia), Castile and León (Spain) and Israeli Districts. PLoS One 2015; 10:e0134701. [PMID: 26309214 PMCID: PMC4550247 DOI: 10.1371/journal.pone.0134701] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 07/13/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studies in the literature have indicated that the timing of seasonal influenza epidemic varies across latitude, suggesting the involvement of meteorological and environmental conditions in the transmission of influenza. In this study, we investigated the link between meteorological parameters and influenza activity in 9 sub-national areas with temperate and subtropical climates: Berlin (Germany), Ljubljana (Slovenia), Castile and León (Spain) and all 6 districts in Israel. METHODS We estimated weekly influenza-associated influenza-like-illness (ILI) or Acute Respiratory Infection (ARI) incidence to represent influenza activity using data from each country's sentinel surveillance during 2000-2011 (Spain) and 2006-2011 (all others). Meteorological data was obtained from ground stations, satellite and assimilated data. Two generalized additive models (GAM) were developed, with one using specific humidity as a covariate and another using minimum temperature. Precipitation and solar radiation were included as additional covariates in both models. The models were adjusted for previous weeks' influenza activity, and were trained separately for each study location. RESULTS Influenza activity was inversely associated (p<0.05) with specific humidity in all locations. Minimum temperature was inversely associated with influenza in all 3 temperate locations, but not in all subtropical locations. Inverse associations between influenza and solar radiation were found in most locations. Associations with precipitation were location-dependent and inconclusive. We used the models to estimate influenza activity a week ahead for the 2010/2011 period which was not used in training the models. With exception of Ljubljana and Israel's Haifa District, the models could closely follow the observed data especially during the start and the end of epidemic period. In these locations, correlation coefficients between the observed and estimated ranged between 0.55 to 0.91and the model-estimated influenza peaks were within 3 weeks from the observations. CONCLUSION Our study demonstrated the significant link between specific humidity and influenza activity across temperate and subtropical climates, and that inclusion of meteorological parameters in the surveillance system may further our understanding of influenza transmission patterns.
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Affiliation(s)
- Radina P. Soebiyanto
- Goddard Earth Sciences Technology and Research, Universities Space Research Associations, Columbia, Maryland, United States of America
- Global Change Data Center, NASA Goddard Space Flight Center, Greenbelt, Maryland, United States of America
| | - Diane Gross
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Pernille Jorgensen
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | | | - Michal Bromberg
- Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel
| | - Zalman Kaufman
- Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel
| | - Katarina Prosenc
- Laboratory for Virology, National Institute of Public Health Slovenia, Ljubljana, Slovenia
| | - Maja Socan
- Communicable Diseases and Environmental Health Care, National Institute of Public Health, Ljubljana, Slovenia
| | | | - Marc-Alain Widdowson
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Richard K. Kiang
- Global Change Data Center, NASA Goddard Space Flight Center, Greenbelt, Maryland, United States of America
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90
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Prachayangprecha S, Vichaiwattana P, Korkong S, Felber JA, Poovorawan Y. Influenza activity in Thailand and occurrence in different climates. SPRINGERPLUS 2015; 4:356. [PMID: 26191483 PMCID: PMC4503703 DOI: 10.1186/s40064-015-1149-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 07/09/2015] [Indexed: 11/10/2022]
Abstract
This study observed influenza activity between June 2009 and July 2014 in Thailand, a country in the Northern hemisphere with a tropical climate, and compared the results to activity in the United States (US) and Australia, which represent temperate climates in the Northern and Southern hemispheres, respectively. From Thailand, a total of 17,416 specimens were collected from patients exhibiting influenza-like illnesses and subjected to real-time PCR for the detection of influenza viruses. For comparison, laboratory confirmations of influenza originating from the US and Australia were obtained from the US CDC's FluView surveillance reports and the Australian Government's Department of Health and Ageing websites. We found that, generally, the influenza season in Thailand starts with the rainy season. This observation of influenza's annual incidence pattern provides a better understanding of its occurrence, suggesting that vaccination campaigns should be started before the influenza season begins in order to reduce transmission.
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Affiliation(s)
- Slinporn Prachayangprecha
- />Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Preeyaporn Vichaiwattana
- />Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Sumeth Korkong
- />Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Joshua A Felber
- />Josef Korbel School of International Studies, University of Denver, Denver, CO 80210 USA
| | - Yong Poovorawan
- />Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, 10330 Thailand
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91
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Clinical and epidemiological characteristics of acute respiratory virus infections in Vietnamese children. Epidemiol Infect 2015; 144:527-36. [PMID: 26145204 DOI: 10.1017/s095026881500134x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Information about viral acute respiratory infections (ARIs) is essential for prevention, diagnosis and treatment, but it is limited in tropical developing countries. This study described the clinical and epidemiological characteristics of ARIs in children hospitalized in Vietnam. Nasopharyngeal samples were collected from children with ARIs at Ho Chi Minh City Children's Hospital 2 between April 2010 and May 2011 in order to detect respiratory viruses by polymerase chain reaction. Viruses were found in 64% of 1082 patients, with 12% being co-infections. The leading detected viruses were human rhinovirus (HRV; 30%), respiratory syncytial virus (RSV; 23·8%), and human bocavirus (HBoV; 7·2%). HRV was detected all year round, while RSV epidemics occurred mainly in the rainy season. Influenza A (FluA) was found in both seasons. The other viruses were predominant in the dry season. HRV was identified in children of all age groups. RSV, parainfluenza virus (PIV) 1, PIV3 and HBoV, and FluA were detected predominantly in children aged 24 months, respectively. Significant associations were found between PIV1 with croup (P < 0·005) and RSV with bronchiolitis (P < 0·005). HBoV and HRV were associated with hypoxia (P < 0·05) and RSV with retraction (P < 0·05). HRV, RSV, and HBoV were detected most frequently and they may increase the severity of ARIs in children.
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92
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Passos SD, Gazeta RE, Felgueiras AP, Beneli PC, Coelho MDSZS. Do pollution and climate influence respiratory tract infections in children? Rev Assoc Med Bras (1992) 2015; 60:276-82. [PMID: 25004275 DOI: 10.1590/1806-9282.60.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 01/09/2014] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED To review if pollution and climate changes can influence respiratory tract infections in children. DATA SOURCE Articles published on the subject in PubMed, SciELO, Bireme, EBSCO and UpTodate were reviewed. The following inclusion criteria were considered: scientific papers between 2002 and 2012, study design, the pediatric population, reference documents such as the CETESB and World Health Organization Summary of the data: We analyzed research that correlated respiratory viruses and climate and/or pollution changes. Respiratory syncytial virus has been the virus related most to changes in climate and humidity. Other "old and new" respiratory viruses such as Human Bocavirus, Metapneumovirus, Parechovirus and Parainfuenza would need to be investigated owing to their clinical importance. Although much has been studied with regard to the relationship between climate change and public health, specific studies about its influence on children's health remain scarce.
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93
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Cui B, Zhang D, Pan H, Zhang F, Farrar J, Law F, van Doorn HR, Wu B, Ba-Thein W. Viral aetiology of acute respiratory infections among children and associated meteorological factors in southern China. BMC Infect Dis 2015; 15:124. [PMID: 25884513 PMCID: PMC4365542 DOI: 10.1186/s12879-015-0863-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 03/02/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) are common in children and mostly caused by viruses, but the significance of the detection of multiple viruses in ARIs is unclear. This study investigated 14 respiratory viruses in ARIs among children and associated meteorological factors in Shantou, southern China. METHODS Paired nasal/throat-flocked swabs collected from 1,074 children with ARIs, who visited outpatient walk-in clinics in a tertiary hospital between December 2010 and November 2011, were examined for fourteen respiratory viruses--influenza viruses (FluA, FluB), respiratory syncytial viruses (RSV A and B), human coronaviruses (hCoV: 229E, OC43, HKU1, NL63), human metapneumoviruses (hMPV A and B), parainfluenza viruses (PIV1-4), human rhinoviruses (HRV A, B, C), enteroviruses (EV), adenoviruses (ADV), human bocavirus (hBoV), and human parechoviruses (hPeV)--by multiplex real-time PCR. RESULTS We identified at least one virus in 82.3% (884/1,074) and multiple viruses in 38.6% (415/1,074) of patients. EV and HRV were the most frequently detected single viruses (42.3%, 374/884 and 39.9%, 353/884 respectively) and co-detected pair (23.1%, 96/415). Overlapping seasonal trends of viruses were recorded over the year, with dual peaks for EV and single peaks for the others. By logistic regression analysis, EV was positively associated with the average temperature and humidity, hCoV, and PIV4, but negatively with HRV, PIV3, and hBoV. HRV was inversely associated with EV and PIV3. CONCLUSIONS This study reports high viral detection and co-detection rates in pediatric ARI cases mainly due to EV and HRV. Many viruses circulated throughout the year with similar seasonal trends in association with temperature, humidity, and wind velocity. Statistically significant associations were present among the viruses. Understanding the polyviral etiology and viral interactions in the cases with multiple viruses warrants further studies.
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Affiliation(s)
- Binglin Cui
- Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Dangui Zhang
- The Research Center of Translational Medicine, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Hui Pan
- Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Fan Zhang
- Oncology Research Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - Jeremy Farrar
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam.
| | - Frieda Law
- Consultant Office, Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Viet Nam.
| | - Beiyan Wu
- Pediatric Department, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.
| | - William Ba-Thein
- Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, P.R. China.
- Department of Microbiology and Immunology, Shantou University Medical College, Shantou, Guangdong, 515041, P.R. China.
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94
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Hardjojo A, Goh A, Shek LPC, Van Bever HPS, Teoh OH, Soh JY, Thomas B, Tan BH, Chan YH, Ramamurthy MB, Goh DYT, Soh SE, Saw SM, Kwek K, Chong YS, Godfrey KM, Gluckman PD, Lee BW. Rhinitis in the first 18 months of life: exploring the role of respiratory viruses. Pediatr Allergy Immunol 2015; 26:25-33. [PMID: 25557088 PMCID: PMC7167939 DOI: 10.1111/pai.12330] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rhinitis is common in early childhood, but allergic rhinitis is considered a later manifestation of the atopic march. This study aimed to evaluate rhinitis (allergic and non-allergic) in the first 18 months of life, its link with other atopic manifestations and the role of respiratory viruses. METHODS Subjects (n = 1237) of the Singapore GUSTO birth cohort were followed up quarterly until 18 months of age with questionnaires to screen for rhinitis symptoms lasting at least 2 wk and with monthly calls to positive subjects to detect prolonged/recurrent rhinitis symptoms (total duration ≥ 4 wk). Anterior nasal swabbing for molecular-based virus detection was conducted during these visits and near (within a month) rhinitis episodes. Skin prick testing to common environmental and food allergens was conducted at the 18 month visit. RESULTS Prolonged/recurrent rhinitis was significantly associated with history of parental atopy (mother: aOR = 2.17; father: aOR = 1.82) and atopic comorbidities of eczema (aOR = 2.53) and wheeze (aOR = 4.63) (p < 0.05), though not with allergen sensitization. Although the frequency of nasal respiratory virus detection during scheduled quarterly visits did not differ between prolonged/recurrent rhinitis and matched controls (p > 0.05), virus detection was higher in swabs obtained within a month following rhinitis episodes in prolonged/recurrent rhinitis subjects compared with scheduled visits (adjusted p = 0.04). CONCLUSIONS Based on the duration of rhinitis symptoms, this study defined a subset of early childhood rhinitis which was associated with atopic predisposition and comorbidities. Persistent respiratory viral shedding may contribute to the symptomatology. Whether this entity is a precursor of subsequent childhood allergic rhinitis will require longer follow-up.
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Affiliation(s)
- Antony Hardjojo
- Department of Paediatrics, National University of Singapore, Singapore, Singapore
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95
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Relationship between meteorological conditions and respiratory syncytial virus in a tropical country. Epidemiol Infect 2015; 143:2679-86. [PMID: 25591796 DOI: 10.1017/s0950268814003793] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study aimed to determine which meteorological conditions are associated with respiratory syncytial virus (RSV) isolates in a population of children hospitalized with acute lower respiratory infection (ALRI) in Bogota, Colombia. In an analytical cross-sectional study, links were examined between the number of monthly RSV infections and monthly average climatic variation (temperature, relative humidity, rainfall, wind speed, solar radiation) between 1 January 2010 and 30 April 2011 in a population of hospitalized children aged <3 years with ALRI caused by RSV. Out of a total of 1548 children included in the study (mean age 9·2 ± 8·5 months), 1194 (77·1%) presented RSV infection during the 3-month period from March to May. In the multivariate analysis, after controlling for wind speed, relative humidity, and solar radiation, monthly average temperature [incident rate ratio (IRR) 3·14, 95% confidence interval (CI) 1·56-6·30, P = 0·001] and rainfall (IRR 1·008, 95% CI 1·00-1·01, P = 0·048) were independently associated with the monthly number of RSV infections. In conclusion, in Bogota, a tropical Latin American city, average temperature and rainfall are the meteorological variables most strongly associated with RSV isolation in children hospitalized with ALRI in the city.
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96
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Pitzer VE, Viboud C, Alonso WJ, Wilcox T, Metcalf CJ, Steiner CA, Haynes AK, Grenfell BT. Environmental drivers of the spatiotemporal dynamics of respiratory syncytial virus in the United States. PLoS Pathog 2015; 11:e1004591. [PMID: 25569275 PMCID: PMC4287610 DOI: 10.1371/journal.ppat.1004591] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/25/2014] [Indexed: 11/25/2022] Open
Abstract
Epidemics of respiratory syncytial virus (RSV) are known to occur in wintertime in temperate countries including the United States, but there is a limited understanding of the importance of climatic drivers in determining the seasonality of RSV. In the United States, RSV activity is highly spatially structured, with seasonal peaks beginning in Florida in November through December and ending in the upper Midwest in February-March, and prolonged disease activity in the southeastern US. Using data on both age-specific hospitalizations and laboratory reports of RSV in the US, and employing a combination of statistical and mechanistic epidemic modeling, we examined the association between environmental variables and state-specific measures of RSV seasonality. Temperature, vapor pressure, precipitation, and potential evapotranspiration (PET) were significantly associated with the timing of RSV activity across states in univariate exploratory analyses. The amplitude and timing of seasonality in the transmission rate was significantly correlated with seasonal fluctuations in PET, and negatively correlated with mean vapor pressure, minimum temperature, and precipitation. States with low mean vapor pressure and the largest seasonal variation in PET tended to experience biennial patterns of RSV activity, with alternating years of “early-big” and “late-small” epidemics. Our model for the transmission dynamics of RSV was able to replicate these biennial transitions at higher amplitudes of seasonality in the transmission rate. This successfully connects environmental drivers to the epidemic dynamics of RSV; however, it does not fully explain why RSV activity begins in Florida, one of the warmest states, when RSV is a winter-seasonal pathogen. Understanding and predicting the seasonality of RSV is essential in determining the optimal timing of immunoprophylaxis. Respiratory syncytial virus (RSV) causes annual outbreaks of respiratory disease every winter in temperate climates, which can be severe particularly among infants. In the United States, RSV activity begins each autumn in Florida and appears to spread from the southeast to the northwest. Using data on hospitalizations and laboratory tests for RSV, we show that the timing of epidemics is associated with a variety of climatic factors, including temperature, vapor pressure, precipitation, and potential evapotranspiration (PET). Furthermore, using a dynamic model, we show that seasonal variation in the transmission rate of RSV can be correlated with the amplitude and timing of variation in PET, which is a measure of demand for water from the atmosphere. States with colder, drier weather and a large seasonal swing in PET tended to experience an alternating pattern of “early-big” RSV epidemics one year followed by a “late-small” epidemic the next year, which our model was able to reproduce based on the interaction between susceptible and infectious individuals. However, we cannot fully explain why epidemics begin in Florida. Being able to understand and predict the timing of RSV activity is important for optimizing the delivery of immunoprophylaxis to high-risk individuals.
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Affiliation(s)
- Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Wladimir J. Alonso
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Tanya Wilcox
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - C. Jessica Metcalf
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
| | - Claudia A. Steiner
- Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland, United States of America
| | - Amber K. Haynes
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bryan T. Grenfell
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
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97
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Hu W, Zhang W, Huang X, Clements A, Mengersen K, Tong S. Weather variability and influenza A (H7N9) transmission in Shanghai, China: a Bayesian spatial analysis. ENVIRONMENTAL RESEARCH 2015; 136:405-412. [PMID: 25460662 DOI: 10.1016/j.envres.2014.07.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/05/2014] [Accepted: 07/09/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND A novel avian influenza A (H7N9) virus was first found in humans in Shanghai, and infected over 433 patients in China. To date, very little is known about the spatiotemporal variability or environmental drivers of the risk of H7N9 infection. This study explored the spatial and temporal variation of H7N9 infection and assessed the effects of temperature and rainfall on H7N9 incidence. METHODS A Bayesian spatial conditional autoregressive (CAR) model was used to assess the spatiotemporal distribution of the risk of H7N9 infection in Shanghai, by district and fortnight for the period 19th February-14th April 2013. Data on daily laboratory-confirmed H7N9 cases, and weather variability including temperature (°C) and rainfall (mm) were obtained from the Chinese Information System for Diseases Control and Prevention and Chinese Meteorological Data Sharing Service System, respectively, and aggregated by fortnight. RESULTS High spatial variations in the H7N9 risk were mainly observed in the east and centre of Shanghai municipality. H7N9 incidence rate was significantly associated with fortnightly mean temperature (Relative Risk (RR): 1.54; 95% credible interval (CI): 1.22-1.94) and fortnightly mean rainfall (RR: 2.86; 95% CI: 1.47-5.56). CONCLUSION There was a substantial variation in the spatiotemporal distribution of H7N9 infection across different districts in Shanghai. Optimal temperature and rainfall may be one of the driving forces for H7N9.
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Affiliation(s)
- Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Wenyi Zhang
- Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China
| | - Xiaodong Huang
- School of Population Health, the University of Queensland, Brisbane, Queensland, Australia
| | - Archie Clements
- Research School of Population Health, The Australian National University, Australia
| | - Kerrie Mengersen
- Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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98
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Lim C, Ang LW, Ma S, Lai FYL, James L, Cutter J. Comparison of severely ill patients with influenza A(H1N1)pdm09 infection during the pandemic and post-pandemic periods in Singapore. Vaccine 2014; 33:615-20. [PMID: 25545594 DOI: 10.1016/j.vaccine.2014.12.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 12/01/2014] [Accepted: 12/15/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND/OBJECTIVES Singapore is a tropical country with influenza seasons occurring bi-annually. We compared the profile of severely ill patients with laboratory confirmed influenza A(H1N1)pdm09 infection in Singapore during the pandemic and post-pandemic periods, and studied their risk factors associated with mortality. PATIENTS/METHODS Three periods were defined for this study; pandemic period from 18 June to 29 August 2009, early post-pandemic period from 30 August 2009 to 12 February 2010, and late post-pandemic period from 13 February to 10 August 2010. RESULTS A total of 172 severely ill patients were admitted to hospitals from 18 June 2009 to 10 August 2010, of whom 23.8% died. The median age in the late post-pandemic period was significantly older than that in the early post-pandemic period (52 years versus 35 years, P=0.02). The median age of patients who died was significantly older than those who survived (52 years versus 44 years, P<0.01). The median length of stay under intensive care in the late post-pandemic period was twice that in the early post-pandemic (6 days versus 3 days, P=0.045). The proportion who died in the late post-pandemic period was more than 2.5 times that in the early post-pandemic period (29.8% versus 11.1%, P=0.043). CONCLUSIONS Severely ill patients were of older age in the late post-pandemic period. Older age was also significantly associated with mortality. It is important to maintain heightened vigilance and continue the surveillance of severely ill patients with influenza post-pandemic, so that patients with suspected infections could be promptly identified for early diagnosis and treatment.
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Affiliation(s)
- Cindy Lim
- Epidemiology and Disease Control Division, Ministry of Health, Singapore.
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | - Stefan Ma
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | | | - Lyn James
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | - Jeffery Cutter
- Communicable Diseases Division, Ministry of Health, Singapore
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99
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Paynter S, Sly PD, Ware RS, Williams G, Weinstein P. The importance of the local environment in the transmission of respiratory syncytial virus. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 493:521-525. [PMID: 24973721 DOI: 10.1016/j.scitotenv.2014.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/08/2014] [Accepted: 06/08/2014] [Indexed: 06/03/2023]
Abstract
The role of the environment in the spread of respiratory infections is poorly understood, and consequently probably underappreciated. To improve our understanding of the environmental drivers of respiratory syncytial virus (RSV) transmission, we examined RSV seasonality in two settings with unusual seasonal patterns: The Gambia (where RSV epidemics occur at different times of the year) and Southeast Florida (where RSV seasonality differs from the rest of mainland USA). We used published data to correlate the seasonality of RSV with rainfall and child nutrition in the Gambia, and with rainfall and temperature in Florida. In the Gambia, RSV incidence was more strongly and more consistently correlated with child nutrition (r = -0.73 [95%CI -0.90 to -0.38]) than with rainfall (r = 0.37 [95%CI 0.20 to 0.52]). In Southeast Florida RSV incidence was strongly correlated with rainfall two months previously (r = 0.65 [95%CI 0.40 to 0.81]) compared to North Florida where RSV incidence was strongly correlated with temperature (r = -0.75 [95%CI -0.87 to -0.56]). We propose that nutrition is the dominant environmental driver of RSV seasonality in the Gambia, while rainfall is the dominant driver of RSV seasonality in Southeast Florida. This reinforces the importance of an ecological scale understanding of disease transmission: only with such an evidence base can setting-specific recommendations be made for public health interventions that are targeted for maximum efficacy.
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Affiliation(s)
- Stuart Paynter
- School of Population Health, University of Queensland, Brisbane, Australia.
| | - Peter D Sly
- Queensland Children's Medical Research Institute, University of Queensland, Australia
| | - Robert S Ware
- School of Population Health, University of Queensland, Brisbane, Australia; Queensland Children's Medical Research Institute, University of Queensland, Australia
| | - Gail Williams
- School of Population Health, University of Queensland, Brisbane, Australia
| | - Philip Weinstein
- Faculty of Science, University of Adelaide, Australia; School of Pharmacy and Health Sciences, University of South Australia, Adelaide, Australia
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100
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Chi H, Hsu CH, Chang JH, Chiu NC, Hung HY, Kao HA, Weng LC, Huang FY, Chiu YY, Chang LY, Huang LM. A novel six consecutive monthly doses of palivizumab prophylaxis protocol for the prevention of respiratory syncytial virus infection in high-risk preterm infants in Taiwan. PLoS One 2014; 9:e100981. [PMID: 24971565 PMCID: PMC4074126 DOI: 10.1371/journal.pone.0100981] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/02/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) circulates year round in Taiwan. A novel six consecutive monthly doses of palivizumab for RSV prevention protocol has been approved for high risk preterm infants since December 2010. This study aimed to determine the clinical effectiveness and safety of this novel protocol for the prevention of RSV infection. METHODS From April 2011 to March 2013, we enrolled infants born at ≤28 weeks gestation and infants born at ≤35 weeks gestation with chronic lung disease (CLD) who received palivizumab prophylaxis as study group and followed up for 12 months. Historic control, those who were born and followed up between July 2000 and June 2008, were retrieved for propensity score matching. Primary endpoint was RSV-related hospitalization, and secondary endpoints included the length of hospital stay and intensive care unit (ICU) care. RESULTS We enrolled 127 infants (108 infants born at ≤28 weeks and 19 infants born at 29-35 weeks with CLD). They completed 6-dose palivizumab as scheduled. Among the study group, the RSV-related hospitalizations were 2 (1.6%) within 6 months and 5 (3.9%) within 12 months after discharge. We matched 127 infants in the control group with 127 infants in the study group by propensity score matching. The reduction of RSV-related hospitalization rates were 86% (10.2% vs 1.6%, p = 0.002) within 6 months after discharge and 78% (15.7% vs 3.9%, p = 0.004) within 12 months after discharge. Compared to the control group, the rate of ICU care significantly decreased from 7.1% to 0.8% (p = 0.024) within 6 months after discharge and from 7.9% to 0.8% (p = 0.014) within 12 months after discharge. Adverse events were recorded in 6.4% injections. CONCLUSIONS Six monthly intramuscular administration of palivizumab is effective for prevention of RSV hospitalization in regions with no single seasonal peak of RSV infection such as Taiwan.
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Affiliation(s)
- Hsin Chi
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Chyong-Hsin Hsu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Jui-Hsing Chang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Han-Yang Hung
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsin-An Kao
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Li-Chuan Weng
- Department of Medical Research, Mackay Memorial Hospital, Tamshui, Taiwan
| | - Fu-Yuan Huang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Ying Chiu
- Department of Clinical Virology of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Luan-Yin Chang
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Min Huang
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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