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Nham E, Sohn JW, Choi WS, Wie SH, Lee J, Lee JS, Jeong HW, Eom JS, Choi YJ, Seong H, Yoon JG, Noh JY, Song JY, Cheong HJ, Kim WJ. Effectiveness of COVID-19 XBB.1.5 monovalent mRNA vaccine in Korea: interim analysis. Front Immunol 2024; 15:1382944. [PMID: 38803497 PMCID: PMC11128628 DOI: 10.3389/fimmu.2024.1382944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/10/2024] [Indexed: 05/29/2024] Open
Abstract
As coronavirus disease-2019 (COVID-19) becomes an endemic disease, the virus continues to evolve and become immunologically distinct from previous strains. Immune imprinting has raised concerns about bivalent mRNA vaccines containing both ancestral virus and Omicron variant. To increase efficacy against the predominant strains as of the second half of 2023, the updated vaccine formulation contained only the mRNA of XBB.1.5 sublineage. We conducted a multicenter, test-negative, case-control study to estimate XBB.1.5 monovalent vaccine effectiveness (VE) and present the results of an interim analysis with data collected in November 2023. Patients who underwent COVID-19 testing at eight university hospitals were included and matched based on age (19-49, 50-64, and ≥65 years) and sex in a 1:1 ratio. VE was calculated using the adjusted odds ratio derived from multivariable logistic regression. Of the 992 patients included, 49 (5.3%) received the XBB.1.5 monovalent vaccine at least 7 days before COVID-19 testing. Patients with COVID-19 (cases) were less likely to have received the XBB.1.5 monovalent vaccine (case 3.5% vs. control 7.2%, p=0.019) and to have a history of COVID-19 within 6 months (2.2% vs. 4.6%, p=0.068). In contrast, patients with COVID-19 were more likely to be healthcare workers (8.2% vs. 3.0%, p=0.001) and to have chronic neurological diseases (16.7% vs. 11.9%, p=0.048). The adjusted VE of the XBB.1.5 monovalent mRNA vaccine was 56.8% (95% confidence interval: 18.7-77.9%). XBB.1.5 monovalent mRNA vaccine provided significant protection against COVID-19 in the first one to two months after vaccination.
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Affiliation(s)
- Eliel Nham
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Jang Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jin-Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hye Won Jeong
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Joong Sik Eom
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yu Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Hye Seong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center-Korea University (KU) Medicine (VIC-K), Seoul, Republic of Korea
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Kim TH. Amelioration of the Influenza Epidemic Alert. J Korean Med Sci 2024; 39:e58. [PMID: 38288544 PMCID: PMC10825451 DOI: 10.3346/jkms.2024.39.e58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024] Open
Affiliation(s)
- Tae Hyong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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Bae M, Park J, Seong H, Lee H, Choi W, Noh J, Kim W, Shin S. Rapid Extraction of Viral Nucleic Acids Using Rotating Blade Lysis and Magnetic Beads. Diagnostics (Basel) 2022; 12:diagnostics12081995. [PMID: 36010344 PMCID: PMC9407373 DOI: 10.3390/diagnostics12081995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
The complex and lengthy protocol of current viral nucleic acid extraction processes limits their use outside laboratory settings. Here, we describe a rapid and reliable method for extracting nucleic acids from viral samples using a rotating blade and magnetic beads. The viral membrane can be instantly lysed using a high-speed rotating blade, and nucleic acids can be immediately isolated using a silica magnetic surface. The process was completed within 60 s by this method. Routine washing and eluting processes were subsequently conducted within 5 min. The results achieved by this method were comparable to those of a commercially available method. When the blade-based lysis and magnetic bead adsorption processes were performed separately, the RNA recovery rate was very low, and the Ct value was delayed compared to simultaneous lysis and RNA adsorption. Overall, this method not only dramatically shortens the conventional extraction time but also allows for its convenient use outside the laboratory, such as at remote field sites and for point-of-care testing.
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Affiliation(s)
- Minju Bae
- School of Mechanical Engineering, Korea University, Seoul 02841, Korea
| | - Junsoo Park
- Department of Micro-Nano Systems, Korea University, Seoul 02841, Korea
| | - Hyeonah Seong
- School of Mechanical Engineering, Korea University, Seoul 02841, Korea
| | - Hansol Lee
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul 02841, Korea
| | - Wonsuk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Jiyun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Woojoo Kim
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul 02841, Korea
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea
- Correspondence: (W.K.); (S.S.); Tel.: +82-2-2626-3051 (W.K.); +82-2-3290-3377 (S.S.)
| | - Sehyun Shin
- School of Mechanical Engineering, Korea University, Seoul 02841, Korea
- Department of Micro-Nano Systems, Korea University, Seoul 02841, Korea
- Engineering Research Center for Biofluid Biopsy, Seoul 02841, Korea
- Correspondence: (W.K.); (S.S.); Tel.: +82-2-2626-3051 (W.K.); +82-2-3290-3377 (S.S.)
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Yoon JG, Noh JY, Choi WS, Lee J, Lee JS, Wie SH, Kim YK, Jeong HW, Kim SW, Park KH, Song JY, Cheong HJ, Kim WJ. A comparison of epidemiology and clinical outcomes between influenza A H1N1pdm09 and H3N2 based on multicenter surveillance from 2014 to 2018 in South Korea. Influenza Other Respir Viruses 2020; 15:99-109. [PMID: 32844596 PMCID: PMC7767957 DOI: 10.1111/irv.12795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND After pandemic, A(H1N1)pdm09 is generally known to be associated with younger adults' infection and greater severity than seasonal A(H3N2) but some inconsistences between recent studies exist. OBJECTIVES We aimed to compare the epidemiology and clinical outcomes of A(H1N1)pdm09 and A(H3N2) to verify and consolidate about the knowledge of known differences of subtypes. METHODS Data were retrospectively collected from the hospital-based influenza morbidity and mortality surveillance in South Korea in nine tertiary care hospitals, from August 31, 2014, to August 25, 2018. Patients with H1N1pdm09 or H3N2 infection admitted in the emergency room or ward were recruited. RESULTS A total of 1747 patients had influenza A and were divided into two groups those with A(H1N1)pdm09 (n = 240) and those with A(H3N2) (n = 1507). A(H1N1)pdm09 group had younger age (mean age ± standard deviation 50.0 ± 18.8 in H1N1 vs 53.4 ± 21.1 in H3N2, P = .030), lower influenza vaccination (27.9% vs 43.9%, P < .001) and pneumococcal vaccination rates (41.0% vs 51.9%, P < .001), and fewer underlying diseases (67.5% vs 74.0%, P = .035) than the A(H3N2) group. Influenza A subtypes were not associated with pneumonia risk (adjusted odds ratios [AOR] of A(H1N1)pdm09: 0.7 [95% confidence interval [CI]: 0.4-1.2, P = .172]) and in-hospital mortality (hazard ratio (HR) of A(H1N1)pdm09: 1.0 (95% CI: 0.3-3.1, P = .983)). Influenza vaccination reduced in-hospital mortality in hospitalized patients (HR: 0.3 (95% CI: 0.1-0.7), P = .005). CONCLUSIONS A(H1N1)pdm09 infection was more common in younger patients without significant difference in pneumonia risk and in-hospital mortality between subtypes. Influenza vaccination was associated with reduced in-hospital mortality.
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Affiliation(s)
- Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea College of Medicine, St. Vincent's Hospital, Suwon, Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shin Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kyung-Hwa Park
- Division of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asian Pacific Influenza Institute (APII), Seoul, Korea
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Song JY, Noh JY, Lee JS, Wie SH, Kim YK, Lee J, Jeong HW, Kim SW, Lee SH, Park KH, Choi WS, Cheong HJ, Kim WJ. Effectiveness of repeated influenza vaccination among the elderly population with high annual vaccine uptake rates during the three consecutive A/H3N2 epidemics. Vaccine 2019; 38:318-322. [PMID: 31690467 DOI: 10.1016/j.vaccine.2019.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Annually, about 80% of the Korean elderly aged ≥65 years receive influenza vaccination. Repeated annual vaccination has been suggested as an important factor of poor influenza vaccine effectiveness (VE), though reported conflicting results. METHODS During the consecutive A/H3N2-dominant influenza seasons between 2012 and 2015, we comparatively evaluated the VE (repeated vs. current season only) against laboratory-confirmed influenza, pneumonia and hospitalization in the elderly aged ≥65 years with influenza-like illness (ILI). Clinical and demographic data were collected prospectively, and vaccination status of prior and current seasons was verified using the immunization registry data of Korean Centers for Disease Control and Prevention. RESULTS During the first A/H3N2-dominant season in 2012-2013, influenza vaccine showed statistically significant effectiveness against influenza A infection only and when vaccinated in the current season only (VE 53%, 95% CI 15-77). In the latter two seasons (2013-2015 years), the adjusted VE for influenza A was indistinguishable between repeated vaccination and vaccination in the current season only. CONCLUSION During consecutive influenza A/H3N2 epidemics, poor influenza vaccine effectiveness may be more pronounced among the elderly population with a high annual vaccine uptake rate.
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Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, Catholic University Medical College, St. Vincent's Hospital, Suwon, South Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, South Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Shin Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Pusan, South Korea
| | - Kyung-Hwa Park
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea.
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Ng Y, Chua LAV, Ma S, Jian Ming Lee V. Estimates of influenza-associated hospitalisations in tropical Singapore, 2010-2017: Higher burden estimated in more recent years. Influenza Other Respir Viruses 2019; 13:574-581. [PMID: 31433131 PMCID: PMC6800300 DOI: 10.1111/irv.12676] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND We previously estimated Singapore's influenza-associated hospitalisation rate for pneumonia and influenza (P&I) in 2010-2012 to be 29.6 per 100 000 person-years, which corresponds to 11.2% of all P&I hospitalisations. OBJECTIVES This study aims to update Singapore's estimates of the influenza-associated pneumonia and influenza (P&I) hospitalisation burden using the latest data from 2010 to 2017. METHODS We estimated the number of P&I hospitalisations associated with influenza using generalised additive models. We specified the weekly number of admissions for P&I and the weekly influenza positivity in the models, along with potential confounders such as weekly respiratory syncytial virus (RSV) positivity and meteorological data. RESULTS In 2010-2017, 16.3% of all P&I hospitalisations in Singapore were estimated to be attributed to influenza, corresponding to an excess influenza-associated P&I hospitalisation rate of 50.1 per 100 000 person-years. Higher excess rates were estimated for children aged 0-4 years (186.8 per 100 000 person-years) and elderly aged ≥ 65 years (338.0 per 100 000 person-years). Higher influenza-associated hospitalisation rates were estimated for 2016 and 2017 (67.9 and 75.1 per 100 000 persons, respectively) years when the influenza A(H3N2) subtype was dominant. CONCLUSION Influenza burden in Singapore has increased since 2010. Influenza vaccination programmes should continue to be prioritised for the young and the elderly.
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Affiliation(s)
- Yixiang Ng
- Epidemiology and Disease Control DivisionMinistry of HealthSingapore CitySingapore
| | - Lily Ai Vee Chua
- Epidemiology and Disease Control DivisionMinistry of HealthSingapore CitySingapore
| | - Stefan Ma
- Epidemiology and Disease Control DivisionMinistry of HealthSingapore CitySingapore
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Lee HS, Lim S, Noh JY, Song JY, Cheong HJ, Lee JH, Woo SI, Kim WJ. Identification of influenza C virus in young South Korean children, from October 2013 to September 2016. J Clin Virol 2019; 115:47-52. [PMID: 30978620 PMCID: PMC7106441 DOI: 10.1016/j.jcv.2019.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/08/2019] [Accepted: 03/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Influenza C virus has been largely neglected, compared to influenza A orB viruses, and is not routinely tested in clinical practices. However, several studies have indicated that influenza C virus causes severe acute respiratory illness and pneumonia in all ages. OBJECTIVE We conducted a study to identify influenza C virus among young children in South Korea. STUDY DESIGN From October 2013 to September 2016, 973 young children with influenzalike illness (ILI) were enrolled at three university hospitals. We tested nasopharyngeal samples for 16 types of respiratory viruses. Among the tested samples, 564 were positive for one or more respiratory viruses. Except for the samples where 16 types of respiratory viruses were found, 409 negative samples were examined for the presence of influenza C virus, using a matrix gene specific primer set. RESULTS Among 409 nasopharyngeal samples, five influenza C viruses were detected. The manifestation of influenza C virus infection in young children was observed acute respiratory illness, such as fever, rhinorrhea, and cough, but no pneumonia or severe respiratory illness. Nucleotide sequencing was conducted and a phylogenetic tree was generated. We found that C/Sao Paulo/387/82-like lineage viruses circulated in South Korea, and the fully sequenced virus (C/Seoul/APD462/2015) was closely related to C/Victoria/2/2012 and C/Tokyo/4/2014 strains. CONCLUSIONS This study was the first report of influenza C virus detection in South Korea. Although severe illness was not observed in this study, we suggest the necessity for influenza C virus testing in pediatric patients with ILI, considering other reports of severe illnesses caused by influenza C virus infections.
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Affiliation(s)
- Han Sol Lee
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sooyeon Lim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Division of Brain Korea 21 Program for Biomedicine Science, College of Medicine, Korea University, Seoul, South Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Jung Hwa Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Sung Il Woo
- Department of Pediatrics, Chungbuk National University Hospital and College of Medicine, Cheongju, South Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea.
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Yun JW, Choi MJ, Shin GS, Lim JO, Noh JY, Kim YK, Song JY, Kim WJ, Choi SE, Cheong HJ. Cost-effectiveness of influenza vaccine strategies for the elderly in South Korea. PLoS One 2019; 14:e0209643. [PMID: 30682030 PMCID: PMC6347274 DOI: 10.1371/journal.pone.0209643] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Despite a high vaccine uptake rate of over 80% in South Korea, the disease burden of influenza is still high among the elderly, which may be due to low effectiveness of vaccines. Therefore, the cost-effectiveness of use among the elderly was analyzed in order to compare the current trivalent influenza vaccine (TIV) with a quadrivalent influenza vaccine (QIV) or MF59-adjuvanted trivalent influenza vaccine (ATIV). METHODS A static lifetime Markov model was used. It was assumed that the model would be repeated until individuals reached the age of 100. Cost-effectiveness was analyzed across three age groups (65-74 years, 75-84 years, and ≥85 years), and the at-risk group was studied. RESULTS Compared to the TIV, the QIV was expected to reduce the number of influenza infections by 342,873, complications by 17,011, hospitalizations by 8,568, and deaths by 2,031. The QIV was highly cost-effective when compared to the TIV, with a base case incremental cost-effectiveness ratio (ICER) estimated at USD 17,699/QALY (1USD = 1,151KRW), and the ICER decreased with age and was USD 3,431/QALY in the group aged 85 and above. Sensitivity analysis revealed that the ICER was sensitive to the QIV price, the proportion of influenza B, and vaccine mismatching. On the other hand, the ATIV was expected to reduce the number of influenza cases and complications by 1,812,395 and 89,747, respectively, annually, yielding cost-saving among all ages. ATIV price and vaccine efficacy were the most influential parameters for the ICER of ATIV. CONCLUSIONS The QIV and ATIV strategies were considered more cost-effective in comparison to the TIV for vaccination strategies implemented for the elderly. However, owing to a lack of data on the effectiveness of ATIV among the elderly, a large-scale effectiveness study is required.
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Affiliation(s)
- Jae-Won Yun
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Min Joo Choi
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | - Jae-Ok Lim
- Korea University College of Pharmacy, Sejong, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Effectiveness of influenza and pneumococcal polysaccharide vaccines against influenza-related outcomes including pneumonia and acute exacerbation of cardiopulmonary diseases: Analysis by dominant viral subtype and vaccine matching. PLoS One 2018; 13:e0207918. [PMID: 30521553 PMCID: PMC6283593 DOI: 10.1371/journal.pone.0207918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/08/2018] [Indexed: 12/29/2022] Open
Abstract
Background Influenza and pneumonia are leading causes of morbidity and mortality among the elderly. Although vaccination is a main strategy to prevent these infectious diseases, concerns remain with respect to vaccine effectiveness. Methods During three influenza seasons (2014–2015, 2015–2016 and 2016–2017), we evaluated the effectiveness of the influenza and pneumococcal vaccines against pneumonia and acute exacerbation of cardiopulmonary diseases among the elderly aged ≥65 years with influenza-like illness (ILI). Demographic and clinical data were collected prospectively. Results Among 2,119 enrolled cases, 1,302 (61.4%) and 871 (41.1%) received the influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPV23), respectively. During an A/H3N2-dominant season with poor influenza vaccine effectiveness (2014–2015 season), neither the influenza vaccine nor PPV23 showed significant effectiveness against pneumonia or acute exacerbation of cardiopulmonary diseases. During seasons with good influenza vaccine effectiveness (2015–2016 and 2016–2017 seasons), the influenza vaccine was effective in preventing pneumonia, but PPV23 was not. In particular, the influenza vaccine was effective in preventing acute exacerbation of heart diseases (75.0%) during the A/H1N1-dominant 2015–2016 season. Conclusion The influenza vaccine was effective in preventing pneumonia only during vaccine-matched seasons with good effectiveness against circulating influenza viruses. In addition, the influenza vaccine was cardio-protective during a vaccine-matched A/H1N1-dominant season.
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Noh JY, Choi WS, Song JY, Lee HS, Lim S, Lee J, Seo YB, Lee JS, Wie SH, Jeong HW, Heo JY, Kim YK, Park KH, Kim SW, Lee SH, Lee JH, Kim DH, Woo SI, Lim CS, Cho KS, Cheong HJ, Kim WJ. Significant circulation of influenza B viruses mismatching the recommended vaccine-lineage in South Korea, 2007-2014. Vaccine 2018; 36:5304-5308. [PMID: 30057284 DOI: 10.1016/j.vaccine.2018.07.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 11/17/2022]
Abstract
We aimed to characterize the lineages of influenza B viruses obtained from clinical specimens during the 2007-2014 seasons in South Korea. RT-PCR for the partial hemagglutinin gene of influenza B virus was performed on laboratory-confirmed influenza B samples from the 2007-2008 season to 2013-2014 season. A phylogenetic tree was generated, and current influenza vaccine strains for the Northern Hemisphere were used as representative strains of Victoria and Yamagata lineages. A total of 571 influenza B virus sequences were analyzed. During the 2009-2010 season, most of the circulating influenza B viruses matched the vaccine strain; 91.0% (91/100) of viruses belonged to the Victoria lineage. In the 2007-2008, 2011-2012, and 2013-2014 seasons, co-circulation of each influenza B lineage was found with a match ratio to the vaccine strain of 53.2% (42/79), 40.9% (63/154), and 58.3% (134/230), respectively. Overall, 41.7% (238/571) of the circulating influenza B viruses belonged to the lineage mismatching the vaccine strain. During the seven influenza seasons, influenza B epidemics were substantial in four seasons in South Korea. Significant mismatches of the vaccine and lineage of the circulating influenza B viruses were found. The current trivalent influenza vaccine may not be fully suitable for effective protection against influenza B.
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Affiliation(s)
- Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Han Sol Lee
- Brain Korea 21 Plus for Biomedical Science, Korea University College of Medicine, Seoul, South Korea
| | - Sooyeon Lim
- Brain Korea 21 Plus for Biomedical Science, Korea University College of Medicine, Seoul, South Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, South Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, South Korea
| | - Jin-Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, South Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, School of Medicine, St. Vincent's Hospital, Suwon, South Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jung Yeon Heo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Kyung Hwa Park
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Shin Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Jung Hwa Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Dong Hyun Kim
- Department of Pediatrics, Inha University College of Medicine, Incheon, South Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kyung Soon Cho
- Department of Food Science and Nutrition, College of Health, Welfare and Education, Tongmyong University, Busan, South Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea; Brain Korea 21 Plus for Biomedical Science, Korea University College of Medicine, Seoul, South Korea.
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11
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Lee HS, Noh JY, Song JY, Cheong HJ, Choi WS, Jeong HW, Wie S, Kim WJ. Molecular genetic characteristics of influenza A virus clinically isolated during 2011-2016 influenza seasons in Korea. Influenza Other Respir Viruses 2018; 12:497-507. [PMID: 29489060 PMCID: PMC6005628 DOI: 10.1111/irv.12549] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The influenza virus is reportedly associated with 3-5 million cases of severe illness and 250 000-500 000 deaths annually worldwide. OBJECTIVES We investigated the variation of influenza A virus in Korea and examined the association with death. METHODS A total of 13 620 cases were enrolled in the Hospital-based Influenza Morbidity & Mortality surveillance system in Korea during 2011-2016. Among these cases, a total of 4725 were diagnosed with influenza using RT-PCR (influenza A; n = 3696, influenza B; n = 928, co-infection; n = 101). We used 254 viral sequences from the 3696 influenza A cases for phylogenetic analysis using the BioEdit and MEGA 6.06 programs. RESULTS We found that the sequences of A/H3N2 in the 2011-2012 season belong to subgroup 3C.1, whereas the sequences in the 2012-2013 season pertain to subgroup 3C.2. The sequences in the 2013-2014 and 2014-2015 seasons involve subgroups 3C.3a and 3C.2a. The A/H1N1pdm09 subtype belongs to subgroup 6 and contains two clusters. In addition, sequence analysis confirmed the several substitutions of internal genes and gene substitutions associated with drug resistance (I222V in NA and S31N in M2) in the fatal cases. While statistical analysis found no significant associations between genetic differences in the viruses and mortality, mortality was associated with certain host factors, such as chronic lung disease. CONCLUSIONS In conclusion, influenza A virus clade changes occurred in Korea during the 2011-2016 seasons. These data, along with antigenic analysis, can aid in selecting effective vaccine strains. We confirmed that fatality in influenza A cases was related to underlying patient diseases, such as chronic lung disease, and further studies are needed to confirm associations between mortality and viral genetic substitutions.
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Affiliation(s)
- Han Sol Lee
- Brain Korea 21 Plus for Biomedical ScienceCollege of MedicineKorea UniversitySeoulKorea
| | - Ji Yun Noh
- Division of Infectious DiseasesDepartment of Internal MedicineGuro HospitalCollege of MedicineKorea UniversitySeoulKorea
| | - Joon Young Song
- Division of Infectious DiseasesDepartment of Internal MedicineGuro HospitalCollege of MedicineKorea UniversitySeoulKorea
| | - Hee Jin Cheong
- Division of Infectious DiseasesDepartment of Internal MedicineGuro HospitalCollege of MedicineKorea UniversitySeoulKorea
| | - Won Suk Choi
- Division of Infectious DiseasesDepartment of Internal MedicineAnsan HospitalCollege of MedicineKorea UniversityAnsanKorea
| | - Hye Won Jeong
- Division of Infectious DiseasesDepartment of Internal MedicineCollege of MedicineChungbuk National UniversityCheongjuKorea
| | - Seong‐Heon Wie
- Division of Infectious DiseasesDepartment of Internal MedicineSt. Vincent's HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea
| | - Woo Joo Kim
- Brain Korea 21 Plus for Biomedical ScienceCollege of MedicineKorea UniversitySeoulKorea
- Division of Infectious DiseasesDepartment of Internal MedicineGuro HospitalCollege of MedicineKorea UniversitySeoulKorea
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12
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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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13
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Song JY, Noh JY, Lee J, Woo HJ, Lee JS, Wie SH, Kim YK, Jeong HW, Kim SW, Lee SH, Park KH, Kang SH, Kee SY, Kim TH, Choo EJ, Lee HS, Choi WS, Cheong HJ, Kim WJ. Hospital-based Influenza Morbidity and Mortality (HIMM) Surveillance for A/H7N9 Influenza Virus Infection in Returning Travelers. J Korean Med Sci 2018; 33:e49. [PMID: 29359537 PMCID: PMC5785625 DOI: 10.3346/jkms.2018.33.e49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/30/2017] [Indexed: 12/19/2022] Open
Abstract
Since 2013, the Hospital-based Influenza Morbidity and Mortality (HIMM) surveillance system began a H7N9 influenza surveillance scheme for returning travelers in addition to pre-existing emergency room (ER)-based influenza-like illness (ILI) surveillance and severe acute respiratory infection (SARI) surveillance. Although limited to eastern China, avian A/H7N9 influenza virus is considered to have the highest pandemic potential among currently circulating influenza viruses. During the study period between October 1st, 2013 and April 30th, 2016, 11 cases presented with ILI within seven days of travel return. These patients visited China, Hong Kong, or neighboring Southeast Asian countries, but none of them visited a livestock market. Seasonal influenza virus (54.5%, 6 among 11) was the most common cause of ILI among returning travelers, and avian A/H7N9 influenza virus was not detected during the study period.
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Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Heung Jeong Woo
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seong Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea College of Medicine, St. Vincent's Hospital, Suwon, Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shin Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kyung Hwa Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Hui Kang
- Division of Infectious Diseases, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Sae Yoon Kee
- Division of Infectious Diseases, Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Tae Hyong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Eun Ju Choo
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Han Sol Lee
- BK21 Plus Graduate Program Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea.
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14
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Noh JY, Lim S, Song JY, Choi WS, Jeong HW, Heo JY, Lee J, Seo YB, Lee JS, Wie SH, Kim YK, Park KH, Jung SI, Kim SW, Lee SH, Lee HS, Yoon YH, Cheong HJ, Kim WJ. Interim estimates of the effectiveness of the influenza vaccine against A(H3N2) influenza in adults in South Korea, 2016-2017 season. PLoS One 2017; 12:e0178010. [PMID: 28542417 PMCID: PMC5444786 DOI: 10.1371/journal.pone.0178010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/06/2017] [Indexed: 11/18/2022] Open
Abstract
In the 2016-2017 season, the A(H3N2) influenza epidemic presented an unusual early peak pattern compared with past seasons in South Korea. The interim vaccine effectiveness (VE) of influenza vaccination in preventing laboratory-confirmed influenza was estimated using test-negative design through the tertiary hospital-based influenza surveillance system in South Korea. From 1 September, 2016 to 7 January, 2017, adjusted VE of influenza vaccination in preventing laboratory-confirmed A(H3N2) was -52.1% (95% confidence interval [CI], -147.2 to 6.4); -70.0% (95% CI, -212.0 to 7.4) in 19-64 years and 4.3% (95% CI, -137.8 to 61.5) in the elderly. Circulating A(H3N2) viruses belonged to the three phylogenetic subclades of 3C.2a, differently to A/Hong Kong/4801/2014, the current vaccine strain. Amino acid substitutions in hemagglutinin of circulating viruses seem to contribute to low VE. In conclusion, interim VE analysis presented that the protection of laboratory-confirmed influenza by seasonal influenza vaccination did not show the statistical significance in South Korea in the 2016-2017 influenza season.
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Affiliation(s)
- Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Sooyeon Lim
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jung Yeon Heo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, South Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, South Korea
| | - Jin-Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, South Korea
| | - Seong Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, School of Medicine, St. Vincent's Hospital, Suwon, South Korea
| | - Young Keun Kim
- Department of Infectious Diseases, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Kyung Hwa Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook-In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Shin Woo Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Han Sol Lee
- Brain Korea 21 Plus for Biomedical Science, Korea University College of Medicine, Seoul, South Korea
| | - Young Hoon Yoon
- Department of Emergency Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, South Korea
- Brain Korea 21 Plus for Biomedical Science, Korea University College of Medicine, Seoul, South Korea
- * E-mail:
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15
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Ray R, Dos Santos G, Buck PO, Claeys C, Matias G, Innis BL, Bekkat-Berkani R. A review of the value of quadrivalent influenza vaccines and their potential contribution to influenza control. Hum Vaccin Immunother 2017; 13:1640-1652. [PMID: 28532276 PMCID: PMC5512791 DOI: 10.1080/21645515.2017.1313375] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The contribution of influenza B to the seasonal influenza burden varies from year-to-year. Although 2 antigenically distinct influenza B virus lineages have co-circulated since 2001, trivalent influenza vaccines (TIVs) contain antigens from only one influenza B virus. B-mismatch or co-circulation of both B lineages results in increased morbidity and mortality attributable to the B lineage absent from the vaccine. Quadrivalent vaccines (QIVs) contain both influenza B lineages. We reviewed currently licensed QIVs and their value by focusing on the preventable disease burden. Modeling studies support that QIVs are expected to prevent more influenza cases, hospitalisations and deaths than TIVs, although estimates of the case numbers prevented vary according to local specificities. The value of QIVs is demonstrated by their capacity to broaden the immune response and reduce the likelihood of a B-mismatched season. Some health authorities have preferentially recommended QIVs over TIVs in their influenza prevention programmes.
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Affiliation(s)
| | - Gaël Dos Santos
- b Business & Decision Life Sciences , Brussels , Belgium (on behalf of GSK)
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16
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Choi WS, Cowling BJ, Noh JY, Song JY, Wie SH, Lee JS, Seo YB, Lee J, Jeong HW, Kim YK, Kim SW, Park KH, Lee SH, Cheong HJ, Kim WJ. Disease burden of 2013-2014 seasonal influenza in adults in Korea. PLoS One 2017; 12:e0172012. [PMID: 28278158 PMCID: PMC5344334 DOI: 10.1371/journal.pone.0172012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 01/30/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study was performed to investigate the disease burden of seasonal influenza in adults ≥20 years of age in Korea, based on surveillance data from the Hospital-based Influenza Morbidity & Mortality Surveillance (HIMM) network. MATERIALS AND METHODS The HIMM network is composed of two surveillance systems: emergency room-based and inpatients-based surveillance. A total of ten university hospitals all over the country are included in the surveillance network. The adult catchment population of the HIMM network was calculated by using the data of each hospital and the database of the Health Insurance Review and Assessment Service (HIRA) of Korea. The incidence rates of laboratory-confirmed medically-attended influenza, laboratory-confirmed influenza-related admission and laboratory-confirmed influenza-related death were calculated based on the catchment population. The socioeconomic burden of influenza was estimated using the human capital approach. RESULTS During the 2013-2014 influenza season, the calculated adult catchment population of the HIMM network was 1,380,000. The incidence of medically-attended laboratory-confirmed influenza infection was 242.8 per 100,000 adults. The incidence of laboratory-confirmed influenza-related admission was 57.9 per 100,000 adults. The incidence of laboratory-confirmed influenza-related death was 3.1 per 100,000 adults. The total socioeconomic cost of 2013-2014 seasonal influenza in Korean adult population was estimated as 125 million USD (1 USD = 1,100 KRW). CONCLUSION The disease burden of 2013-2014 seasonal influenza in Korean adult population is very high and indicates that more active prevention and control policies will be needed to decrease the burden. Additional researches will be needed to assess the burden of seasonal influenza in the Korean child population.
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Affiliation(s)
- Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Republic of Korea
| | - Kyong-Hwa Park
- Division of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sun Hee Lee
- Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Transgovernmental Enterprise for Pandemic Influenza in Korea, Seoul, Republic of Korea
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17
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Kim WJ, Lee JS, Lee CK, Cheong HJ, Kim M, Monegal JS, Carneiro R, Kyaw MH, Haguinet F, Ray R, Matias G. Clinical Features of Influenza and Acute Respiratory Illness in Older Adults at Least 50 Years of Age in an Outpatient Setting in the Republic of Korea: a Prospective, Observational, Cohort Study. J Korean Med Sci 2017; 32:407-414. [PMID: 28145642 PMCID: PMC5290098 DOI: 10.3346/jkms.2017.32.3.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 11/20/2016] [Indexed: 11/20/2022] Open
Abstract
Two prospective, multi-centre, observational studies (GlaxoSmithKline [GSK] identifier No. 110938 and 112519) were performed over 2 influenza seasons (2007-2008 and 2008-2009) in the Republic of Korea (ROK) with the aim to evaluate the burden of laboratory-confirmed influenza (LCI) in patients ≥ 50 years of age seeking medical attention for acute respiratory illness (ARI). The median participant age was 58 years in the 2007-2008 season and 60 years in the 2008-2009 season. LCI was observed in 101/346 (29.2%) of ARI patients in the 2007-2008 season and in 166/443 (37.5%) of ARI patients in the 2008-2009 season. Compared to patients with non-influenza ARI, those with LCI had higher rates of decreased daily activities (60.4% vs. 32.9% in 2007-2008 and 46.4% vs. 25.8% in 2008-2009), work absenteeism (51.1% vs. 25.6% and 14.4% vs. 7.7%), and longer duration of illness. These results indicated that influenza is an important cause of ARI in adults aged 50 and older causing more severe illness than non-influenza related ARI.
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Affiliation(s)
- Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University Inha Hospital, Incheon, Korea
| | - Chang Kyu Lee
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Mijeong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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18
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Gonçalves AR, Iten A, Suter‐Boquete P, Schibler M, Kaiser L, Cordey S. Hospital surveillance of influenza strains: a concordant image of viruses identified by the Swiss Sentinel system? Influenza Other Respir Viruses 2017; 11:41-47. [PMID: 27441401 PMCID: PMC5155643 DOI: 10.1111/irv.12417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Swiss Sentinel system for influenza virus surveillance reports influenza-like illness in the community through a network of primary care practitioners, but the epidemiologic, demographic, and virological characterization may differ from that observed in hospitalized patients with influenza. OBJECTIVE To compare demographic and virological data from hospital influenza cases with Sentinel system data during the 2014-2015 season. METHODS We included 2623 in- and outpatients with a screening request for influenza A/B in a university teaching hospital in Geneva, Switzerland, and 933 participants from the Swiss Sentinel surveillance system and compared the demographic and virological data of the two populations, including the respective distribution of influenza subtypes, and conducted a phylogenetic comparison at the HA1 level of influenza viruses recovered in community and hospital cases. RESULTS There were similar proportions of influenza strains recovered in the hospital and in the community (H3N2, 57.1% and 56.9%; H1N1pdm09, 15.5% and 14.2%; B, 27.4% and 28.8%, respectively). HA1 sequence analysis confirmed that all three strains were genetically similar between the two populations. During this particular season, influenza cases were detected earlier in the hospital than in the Sentinel system. CONCLUSIONS Although an influenza surveillance system based on the community can predict the type of influenza strains that will be associated with hospitalizations, it fails to estimate the potential virulence of circulating strains. Further, the population characteristics in the community differ from those in hospitalized patients. This suggests that any national influenza surveillance system should include both community- and hospital-based surveys.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Community Health Services
- Female
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hospitalization
- Humans
- Infant
- Infant, Newborn
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Male
- Middle Aged
- Phylogeny
- Seasons
- Sentinel Surveillance
- Switzerland/epidemiology
- Young Adult
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Affiliation(s)
- Ana Rita Gonçalves
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Anne Iten
- University of Geneva Medical SchoolGenevaSwitzerland
- Infection Control Program and WHO Collaborating Centre on Patient SafetyGeneva University HospitalsGenevaSwitzerland
| | - Patricia Suter‐Boquete
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Manuel Schibler
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Laurent Kaiser
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Samuel Cordey
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
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Park M, Wu P, Goldstein E, Joo Kim W, Cowling BJ. Influenza-Associated Excess Mortality in South Korea. Am J Prev Med 2016; 50:e111-e119. [PMID: 26610897 PMCID: PMC4805525 DOI: 10.1016/j.amepre.2015.09.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 09/11/2015] [Accepted: 09/22/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION It is important to determine the health impact of influenza in order to calibrate public health measures. The objective of this study was to estimate excess mortality associated with influenza in Korea in 2003-2013. METHODS The authors constructed multiple linear regression models in 2014 with weekly mortality rates stratified by age, region, and cause of death against weekly surveillance data on influenza virus collected in 2003-2013. Excess mortality rates were estimated using the difference between predicted mortality rates from the fitted model versus predicted mortality rates with the influenza covariate for each strain set to 0. RESULTS During the study period, influenza was associated with an average of 2,900 excess deaths per year. The impact of influenza on mortality was significantly higher in older people; the overall all-cause excess annual mortality rate per 100,000 people was 5.97 (95% CI=4.89, 7.19), whereas it was 46.98 (95% CI=36.40, 55.82) for adults aged ≥65 years. It also greatly varied from year to year, ranging from 2.04 in 2009-2010 to 18.76 in 2011-2012. CONCLUSIONS The impact of influenza on mortality in Korea is substantial, particularly among the elderly and the rural population. More-comprehensive studies may be needed to estimate the full impact of influenza.
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Affiliation(s)
- Minah Park
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Edward Goldstein
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Song JY, Noh JY, Choi WS, Cheong HJ, Kim WJ. Antiviral therapy in seasonal influenza and 2009 H1N1 pandemic influenza: Korean experiences and perspectives. Expert Rev Anti Infect Ther 2015; 13:1361-72. [PMID: 26256778 DOI: 10.1586/14787210.2015.1076334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Influenza is a major cause of substantial morbidity and mortality in humans every year. Vaccination is the main strategy to prevent influenza infection, but antiviral agents also play an important role in the control of both seasonal and pandemic influenza. During the influenza A/H1N1 pandemic in 2009, early prompt antiviral therapy may have reduced the severity of the influenza outcomes including pneumonia, hospitalization and mortality in the Republic of Korea. Since the 2009 H1N1 pandemic, there have been increasing usages of antiviral agents for the treatment of patients with seasonal influenza. Although currently rare, antiviral resistance among influenza viruses may emerge and increase with increased use of neuraminidase inhibitors. New agents with different modes of action are under investigation, including favipiravir, DAS181, nitazoxanide and broad-spectrum neutralizing monoclonal antibodies. Data are limited with respect to high-dose and combination antiviral therapies. So, clinical trials are warranted to evaluate diverse antiviral combinations that may be synergistic and less likely to induce breakthrough resistance.
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Affiliation(s)
- Joon Young Song
- a 1 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.,b 2 Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
| | - Ji Yun Noh
- a 1 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.,b 2 Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
| | - Won Suk Choi
- a 1 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.,b 2 Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
| | - Hee Jin Cheong
- a 1 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.,b 2 Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
| | - Woo Joo Kim
- a 1 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.,b 2 Transgovernmental Enterprise for Pandemic Influenza in Korea (TEPIK), Seoul, Republic of Korea
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21
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Prospective cohort study on the effectiveness of influenza and pneumococcal vaccines in preventing pneumonia development and hospitalization. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 22:229-34. [PMID: 25540271 DOI: 10.1128/cvi.00673-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pneumonia and acute exacerbation of chronic illness are leading causes of influenza-related hospitalization. Therefore, influenza and pneumococcal vaccinations are strongly recommended for adults with comorbidities. Using a hospital-based influenza surveillance system, we performed a multicenter, prospective cohort study of patients visiting emergency rooms with influenza-like illness (ILI) during the influenza epidemic period in 2013 to 2014. Patients aged ≥ 19 years were enrolled, and clinical data were collected. Multivariate analyses were performed to estimate the effectiveness of influenza and pneumococcal vaccination in preventing pneumonia development and hospitalization. During study periods, 2,262 patients with ILI were registered. Among 2,217 patients with available vaccination records, 31.9% (707 patients) and 9.7% (216 patients) had received influenza and pneumococcal vaccines, respectively. Among patients who had been administered a pneumococcal vaccine, 94.4% had received the 23-valent polysaccharide vaccine (PPV23). The adjusted rates of effectiveness of the influenza vaccine for preventing pneumonia development and hospitalization were 64.0% (95% confidence interval [CI] = 29% to 81%) and 35.0% (95% CI = 12% to 52%), respectively. Pneumococcal vaccination did not reduce pneumonia development or hospitalization. In conclusion, influenza rather than PPV23 vaccination may reduce pneumonia development and hospitalization in patients with preceding ILI.
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22
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Jeong HW, Heo JY, Park JS, Kim WJ. Effect of the influenza virus rapid antigen test on a physician's decision to prescribe antibiotics and on patient length of stay in the emergency department. PLoS One 2014; 9:e110978. [PMID: 25375835 PMCID: PMC4222913 DOI: 10.1371/journal.pone.0110978] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/17/2014] [Indexed: 12/02/2022] Open
Abstract
Background Influenza virus infection is a common reason for visits to the emergency department (ED) during the influenza season. A rapid and accurate diagnosis of influenza virus infection is important to reduce unnecessary antibiotic prescription and to improve patient care. The aim of this study was to examine whether using the Influenza Virus Rapid Antigen Test (IVRAT) in the ED affects the decision to prescribe antibiotics or the length of hospital stay (LOS). Methods Data from patients suffering from an influenza-like illness (ILI) and who were discharged after visiting the ED at Chungbuk National University Hospital were reviewed over two influenza seasons: 2010–2011, when IVRAT was not used in the ED, and 2011–2012, when it was. The numbers of antibiotic prescriptions issued and the ED LOS during these two seasons were then compared. Results The number of antibiotic prescriptions was significantly lower in 2011–2012 (54/216, 25.0%) than in 2010–2011 (97/221, 43.9%; P<0.01). However, the median ED LOS for patients in 2011–2012 was much longer than that of patients in 2010–2011 (213 minutes vs. 257 minutes; P<0.01). During the 2011–2012 influenza season, 73 ILI patients showed a positive IVRAT result whereas 123 showed a negative result. Upon discharge, antibiotics were given to 42/123 (34.1%) ILI patients with a negative IVRAT result, but to only 7/73 (9.6%) patients with a positive IVRAT result (P<0.01). Conclusions Performing IVRAT in the ED reduced the prescription of antibiotics to ILI patients discharged after ED care. However, the ED LOS for patients who underwent IVRAT was longer than that for patients who did not. Thus, performing IVRAT in the ED reduces the unnecessary prescription of antibiotics to ILI patients during the influenza season.
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Affiliation(s)
- Hye Won Jeong
- Department of Internal Medicine, Chungbuk National University College of Medicine, Heungduk-gu, Cheongju, Republic of Korea
- * E-mail:
| | - Jung Yeon Heo
- Department of Internal Medicine, Chungbuk National University College of Medicine, Heungduk-gu, Cheongju, Republic of Korea
| | - Jung Soo Park
- Department of Emergency Medicine, Chungbuk National University College of Medicine, Heungduk-gu, Cheongju, Republic of Korea
| | - Woo Joo Kim
- Division of Infections Disease, Department of Internal Medicine, Korea University College of Medicine, Guro-dong, Guro-gu, Seoul, Republic of Korea
- Transgovernmental Enterprise for Pandemic Influenza in Korea, Seoul, Republic of Korea
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23
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Song JY, Nahm MH, Cheong HJ, Kim WJ. Impact of preceding flu-like illness on the serotype distribution of pneumococcal pneumonia. PLoS One 2014; 9:e93477. [PMID: 24691515 PMCID: PMC3972234 DOI: 10.1371/journal.pone.0093477] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 03/03/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Even though the pathogenicity and invasiveness of pneumococcus largely depend on capsular types, the impact of serotypes on post-viral pneumococcal pneumonia is unknown. METHODS AND FINDINGS This study was performed to evaluate the impact of capsular serotypes on the development of pneumococcal pneumonia after preceding respiratory viral infections. Patients with a diagnosis of pneumococcal pneumonia were identified. Pneumonia patients were divided into two groups (post-viral pneumococcal pneumonia versus primary pneumococcal pneumonia), and then their pneumococcal serotypes were compared. Nine hundred and nineteen patients with pneumococcal pneumonia were identified during the study period, including 327 (35.6%) cases with post-viral pneumococcal pneumonia and 592 (64.4%) cases with primary pneumococcal pneumonia. Overall, serotypes 3 and 19A were the most prevalent, followed by serotypes 19F, 6A, and 11A/11E. Although relatively uncommon (33 cases, 3.6%), infrequently colonizing invasive serotypes (4, 5, 7F/7A, 8, 9V/9A, 12F, and 18C) were significantly associated with preceding respiratory viral infections (69.7%, P<0.01). Multivariate analysis revealed several statistically significant risk factors for post-viral pneumococcal pneumonia: immunodeficiency (OR 1.66; 95% CI, 1.10-2.53), chronic lung diseases (OR 1.43; 95% CI, 1.09-1.93) and ICI serotypes (OR 4.66; 95% CI, 2.07-10.47). CONCLUSIONS Infrequently colonizing invasive serotypes would be more likely to cause pneumococcal pneumonia after preceding respiratory viral illness, particularly in patients with immunodeficiency or chronic lung diseases.
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Affiliation(s)
- Joon Young Song
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of medicine, Seoul, Republic of Korea
| | - Moon H. Nahm
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Department of Microbiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of medicine, Seoul, Republic of Korea
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Yang TU, Cheong HJ, Song JY, Lee JS, Wie SH, Kim YK, Choi WS, Lee J, Jeong HW, Kim WJ. Age- and influenza activity-stratified case definitions of influenza-like illness: experience from hospital-based influenza surveillance in South Korea. PLoS One 2014; 9:e84873. [PMID: 24475034 PMCID: PMC3901651 DOI: 10.1371/journal.pone.0084873] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 11/19/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aims to identify clinical case definitions of influenza with higher accuracy in patients stratified by age group and influenza activity using hospital-based surveillance system. METHODS In seven tertiary hospitals across South Korea during 2011-2012 influenza season, respiratory specimens were obtained from patients presenting an influenza-like illness (ILI), defined as having fever plus at least one of following symptoms: cough, sore throat or rhinorrhea. Influenza was confirmed by reverse transcriptase-polymerase chain reaction. We performed multivariate logistic regression analyses to identify clinical variables with better relation with laboratory-confirmed influenza, and compared the accuracy of combinations. RESULTS Over the study period, we enrolled 1417 patients, of which 647 had laboratory-confirmed influenza. Patients with cough, rhinorrhea, sore throat or headache were more likely to have influenza (p<0.05). The most accurate criterion across the study population was the combination of cough, rhinorrhea, sore throat and headache (sensitivity 71.3%, specificity 60.1% and AUROC 0.66). The combination of rhinorrhea, sore throat and sputum during the peak influenza activity period in the young age group showed higher accuracy than that using the whole population (sensitivity 89.3%, specificity 72.1%, and AUROC 0.81). CONCLUSIONS The accuracy of clinical case definitions of influenza differed across age groups and influenza activity periods. Categorizing the entire population into subgroups would improve the detection of influenza patients in the hospital-based surveillance system.
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Affiliation(s)
- Tae Un Yang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, Catholic University Medical College, St. Vincent's Hospital, Suwon, Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute (APII), Seoul, Korea
- * E-mail:
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