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Characterization of influenza infection in a high-income urban setting in Nairobi, Kenya. Trop Med Health 2022; 50:69. [PMID: 36114561 PMCID: PMC9479273 DOI: 10.1186/s41182-022-00463-y] [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: 06/20/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Influenza viruses are an important cause of respiratory infections across all age groups. Information on occurrence and magnitude of influenza virus infections in different populations in Kenya however remains scanty, compromising estimation of influenza disease burden. This study examined influenza infection in an urban high-income setting in Nairobi to establish its prevalence and activity of influenza viruses, and evaluated diagnostic performance of a rapid influenza diagnostic test. Methodology A cross-sectional hospital-based study was conducted in six private health facilities located within high-income residential areas in Nairobi from January 2019 to July 2020. Patients of all ages presenting with influenza-like illness (ILI) were recruited into the study. Detection of influenza virus was conducted using rapid diagnosis and reverse transcription–polymerase chain reaction (RT–PCR). Data were summarized using descriptive statistics and tests of association. Sensitivity, specificity and area under receiver operating characteristics curve was calculated to establish diagnostic accuracy of the rapid diagnosis test. Results The study recruited 125 participants with signs and symptoms of ILI, of whom 21 (16.8%) were positive for influenza viruses. Of all the influenza-positive cases, 17 (81.0%) were influenza type A of which 70.6% were pandemic H1N1 (A/H1N1 2009). Highest detection was observed among children aged 5–10 years. Influenza virus mostly circulated during the second half of the year, and fever, general fatigue and muscular and joint pain were significantly observed among participants with influenza virus. Sensitivity and specificity of the diagnostic test was 95% (95% confidence interval 75.1–99.9) and 100% (95% confidence interval 96.5–100.0), respectively. Conclusions Findings of this study shows continuous but variable activity of influenza virus throughout the year in this population, with substantial disease burden. The findings highlight the need for continuous epidemiologic surveillance including genetic surveillance to monitor activity and generate data to inform vaccine introduction or development, and other interventions.
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Kamata K, Thein KN, Di Ja L, Win NC, Win SMK, Suzuki Y, Ito A, Osada H, Chon I, Phyu WW, Aizawa Y, Ikuse T, Ota T, Kyaw Y, Tin HH, Shobugawa Y, Watanabe H, Saito R, Saitoh A. Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar. BMC Infect Dis 2022; 22:350. [PMID: 35395744 PMCID: PMC8992414 DOI: 10.1186/s12879-022-07342-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/25/2022] [Indexed: 02/03/2023] Open
Abstract
Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking. Methods This prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients’ samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization. Conclusions Viral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07342-1.
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Affiliation(s)
- Kazuhiro Kamata
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar.,Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | | | - Lasham Di Ja
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Nay Chi Win
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Su Mon Kyaw Win
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Yuko Suzuki
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Ai Ito
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Hidekazu Osada
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar.,Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Irina Chon
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Wint Wint Phyu
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Yuta Aizawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Tatsuki Ikuse
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Tomomi Ota
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Yadanar Kyaw
- Respiratory Medicine Department, Thingangyun Sanpya General Hospital, Yangon, Myanmar
| | - Htay Htay Tin
- Department of Medical Services, National Health Laboratory, Ministry of Health and Sports, Yangon, Myanmar
| | - Yugo Shobugawa
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Hisami Watanabe
- Infectious Diseases Research Center of Niigata University in Myanmar, Yangon, Myanmar
| | - Reiko Saito
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
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Otani Y, Kasai H, Tanigawara Y. Pharmacometric analysis of seasonal influenza epidemics and the effect of vaccination using sentinel surveillance data. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2021; 11:44-54. [PMID: 34676676 PMCID: PMC8752114 DOI: 10.1002/psp4.12732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
The identification of influenza epidemics and assessment of the efficacy of vaccination against this infection are major challenges for the implementation of effective public health strategies, such as vaccination programs. In this study, we developed a new pharmacometric model to evaluate the efficacy of vaccination based on infection surveillance data from the 2010/2011 to 2018/2019 influenza seasons in Japan. A novel susceptible‐infected‐removed plus vaccination model, based on an indirect response structure with the effect of vaccination, was applied to describe seasonal influenza epidemics using a preseasonal collection of data regarding serological H1 antibody titer positivity and the fraction of virus strains. Using this model, we evaluated Kin (a parameter describing the transmission rate of symptomatic influenza infection) for different age groups. Furthermore, we defined a new parameter (prevention factor) showing the efficacy of vaccination against each viral strain and in different age groups. We found that the prevention factor of vaccination against influenza varied among age groups. Notably, children aged 5–14 years showed the highest Kin value during the 10 influenza seasons and the greatest preventive effect of vaccination (prevention factor = 70.8%). The propagation of influenza epidemics varies in different age groups. Children aged 5–14 years most likely play a leading role in the transmission of influenza. Prioritized vaccination in this age group may be the most effective strategy for reducing the prevalence of influenza in the community.
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Affiliation(s)
- Yuki Otani
- Laboratory of Pharmacometrics and Systems Pharmacology, Keio Frontier Research and Education Collaboration Square at Tonomachi, Kanagawa, Japan.,Keio University Graduate School of Medicine, Tokyo, Japan
| | - Hidefumi Kasai
- Laboratory of Pharmacometrics and Systems Pharmacology, Keio Frontier Research and Education Collaboration Square at Tonomachi, Kanagawa, Japan
| | - Yusuke Tanigawara
- Laboratory of Pharmacometrics and Systems Pharmacology, Keio Frontier Research and Education Collaboration Square at Tonomachi, Kanagawa, Japan
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4
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Takeoka H, Horibata K, Hiyoshi T, Noge I, Sakihara E, Sechi Y, Okutsu S, Suzuyama H, Nabeshima S. Useful clinical findings and simple laboratory data for the diagnosis of seasonal influenza. J Gen Fam Med 2021; 22:231-236. [PMID: 34484991 PMCID: PMC8411397 DOI: 10.1002/jgf2.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/24/2021] [Accepted: 02/07/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND When using rapid antigen test kits for the diagnosis of influenza, false-negative results may occur if done too soon after the onset of symptoms. The purpose of this study was done to determine clinical laboratory items other than rapid antigen testing are useful for diagnosing influenza. METHODS The subjects were 915 patients who visited the outpatient clinic of hospital between April 2010 and March 2017 during the influenza epidemic seasons, from December to April, and had both fever of 37.0 degrees or more and cold symptoms. RESULTS Of the 214 patients who met the inclusion criteria, 176 had influenza. Multivariate analysis extracted patient consultation within four days of onset, fever of 37 degrees or higher, posterior pharyngeal lymphoid follicles, CRP of 0.77 mg/dL or less, and a lymphocyte count of 900/μL less as independent variables. CONCLUSION In previous study, lymphoid follicles on the posterior pharyngeal wall and decreased lymphocyte count were reported as influenza-specific findings. Both were confirmed with high specificity in our study, indicating that both would be useful when patients with influenza-like symptoms were false-negative for the rapid antigen test.
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Affiliation(s)
| | - Ken Horibata
- General MedicineFukuoka University HospitalFukuokaJapan
| | | | - Ikuma Noge
- General MedicineFukuoka University HospitalFukuokaJapan
| | | | - Yusuke Sechi
- General MedicineFukuoka University HospitalFukuokaJapan
| | - Shota Okutsu
- General MedicineFukuoka University HospitalFukuokaJapan
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5
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Dronova M, Ikeoka H, Itsumura N, Hirotsu N, Ansaripour A, Aballéa S, Onishi Y, Hill M, Igarashi A. Cost-effectiveness of baloxavir marboxil compared with laninamivir for the treatment of influenza in patients at high risk for complications in Japan. Curr Med Res Opin 2021; 37:1135-1148. [PMID: 33858277 DOI: 10.1080/03007995.2021.1914942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Baloxavir marboxil (baloxavir) is a single-dose antiviral which was previously found to be a cost-effective alternative to laninamivir in otherwise healthy adults in Japan. This study aimed at investigating the cost-effectiveness of baloxavir versus laninamivir in patients with influenza at high risk for complications. METHODS A decision tree was utilized to estimate costs and health gains associated with the use of antivirals. A lifetime horizon was applied to capture the long-term impact of influenza complications, and other events with associated costs and health outcomes were accounted for one influenza season. The study population was stratified into three categories: adolescents and non-elderly adults with high-risk conditions (HRC), elderly without other HRC, and elderly with other HRC. The cost-effectiveness was assessed from a public healthcare payer's perspective. The duration of influenza symptoms, probabilities of complications and probabilities of adverse events were obtained from a clinical trial and network meta-analysis. The costs of influenza and adverse events management were derived from the JammNet claims database. Utility values were informed by the clinical trial data and literature. Sensitivity analyses were also performed. RESULTS The baloxavir strategy was associated with higher costs (+¥144) and higher quality-adjusted life-years (QALYs) in adults with HRC, elderly without HRC and elderly with HRC (+0.00078, +0.00183 and +0.00350 respectively). The overall incremental cost/QALY for baloxavir versus laninamivir was ¥68,855, which was below the willingness-to-pay threshold of ¥5 million/QALY gained. Key drivers of the model results were the probability of pneumonia and bronchitis. The probability of baloxavir being cost-effective was 72%. CONCLUSIONS This study suggests that influenza treatment with baloxavir is cost-effective compared with laninamivir in the adult high-risk population in Japan.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ataru Igarashi
- Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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6
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Skrzeczek A, Ikeoka H, Hirotsu N, Ansaripour A, Aballéa S, Onishi Y, Hill M, Igarashi A. Cost-effectiveness of baloxavir marboxil compared to laninamivir for the treatment of influenza in Japan. J Infect Chemother 2021; 27:296-305. [DOI: 10.1016/j.jiac.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/08/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
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Tsuzuki S, Ishikane M, Matsunaga N, Morioka S, Yu J, Inagaki T, Yamamoto M, Ohmagari N. Interim 2019/2020 Influenza Vaccine Effectiveness in Japan from October 2019 to January 2020. Jpn J Infect Dis 2020; 74:175-179. [PMID: 32999182 DOI: 10.7883/yoken.jjid.2020.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Herein, we report the interim vaccine effectiveness (VE) of a quadrivalent inactivated influenza vaccine, during the 2019/2020 influenza season, in Japan. We conducted a retrospective observational cohort study of 381 patients aged ≥15 years, who were enrolled with influenza like illnesses and examined via the rapid influenza diagnostic test, at the Ambulatory Care unit of the National Center for Global Health and Medicine in Tokyo, Japan, from the beginning of October 2019 to the end of January 2020. VE was estimated using a test-negative design. VE was calculated as (1 - odds ratio) × 100%, comparing influenza A test positivity between vaccinated and unvaccinated patients. Of the 381 patients initially screened for inclusion, 314 were enrolled in the study. Of these, 105 were vaccinated, 98 were diagnosed with influenza A, and 5 were diagnosed with influenza B. Overall VE against influenza A was 27.6% (95% confidence interval [CI], ‒21.1 to +57.4), and in patients aged ≥65 years, it was 47.3% (95% CI, ‒76.0 to +86.0). This indicates that the influenza vaccination offered continued protection during the 2019/2020 influenza season, but a detailed analysis of more cases with a careful consideration of methodology is necessary to estimate VE more precisely.
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Affiliation(s)
- Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Masahiro Ishikane
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Jiefu Yu
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Takeshi Inagaki
- General Internal Medicine, National Center for Global Health and Medicine, Japan.,Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Japan
| | - Makiko Yamamoto
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
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Clinical evaluation of fully automated molecular diagnostic system "Simprova" for influenza virus, respiratory syncytial virus, and human metapneumovirus. Sci Rep 2020; 10:13496. [PMID: 32782312 PMCID: PMC7419501 DOI: 10.1038/s41598-020-70090-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022] Open
Abstract
Influenza virus, respiratory syncytial virus, and human metapneumovirus commonly cause acute upper and lower respiratory tract infections, especially in children and the elderly. Although rapid antigen detection tests for detecting these infections have been introduced recently, these are less sensitive than nucleic acid amplification tests. More recently, highly sensitive point-of-care testings (POCTs) have been developed based on nucleic acid amplification tests, which are easy to use in clinical settings. In this study, loop-mediated isothermal amplification (LAMP)-based POCT “Simprova” to detect influenza A and B viruses, respiratory syncytial virus, and human metapneumovirus was developed. Simprova system is fully automated and does not require skilled personnel. In addition, positive results can be achieved faster than with PCR. In this study, the accuracy of the POCT was retrospectively analyzed using 241 frozen stocked specimens. Additionally, the usability of the Simprova at clinical sites was assessed in a prospective clinical study using 380 clinical specimens and compared to those of real-time PCR and rapid antigen detection test. The novel LAMP-based POCT demonstrated high sensitivity and specificity in characterizing clinical specimens from patients with influenza-like illnesses. The Simprova is a powerful tool for early diagnosis of respiratory viral infections in point-of-care settings.
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Tsuzuki S, Yoshihara K. The characteristics of influenza-like illness management in Japan. BMC Public Health 2020; 20:568. [PMID: 32345248 PMCID: PMC7189553 DOI: 10.1186/s12889-020-08603-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to make a quantitative assessment of the management of influenza-like illnesses (ILI) in Japanese healthcare settings. Methods We analysed participants’ healthcare-seeking behaviour and physicians’ practice in January 2019 using an online survey of 200 households in Japan. Quality of life score, quality-adjusted life years lost, the duration of symptoms, and the duration of absence from work were compared between the influenza ILI group and the non-influenza ILI group with one-to-one propensity score matching. Missing data were imputed using multiple imputation. Results In total, 261 of the 600 (43.5%) participants had at least one episode of influenza-like illness during January 2019. Of these, 194 (75.5%) visited healthcare facilities, 167 (86.1%) within 2 days of onset of symptoms. A total of 169 out of 191 (88.5%) received a rapid influenza diagnostic test and 101 were diagnosed with influenza, of whom 95.0% were treated with antivirals. The median quality-adjusted life-years (QALYs) lost was 0.0055 (interquartile range, IQR 0.0040–0.0072) and median absence from work for a single episode of influenza-like illness was 2 days (IQR 1–5 days). Albeit QALYs lost per episode was not different between two groups, the influenza ILI group showed longer duration of absence from work (5 days, IQR 4–6 days) than the non-influenza ILI group (2 days, IQR 1–3 days). Conclusions In Japan, most people with influenza-like illnesses visit healthcare facilities soon after symptoms first occur and receive a diagnostic test. Those with influenza are usually treated with antivirals. Absence from work was longer for influenza than other similar illnesses.
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Affiliation(s)
- Shinya Tsuzuki
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan. .,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Keisuke Yoshihara
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Le Thi N, Ikuyo T, Nguyen Gia B, Truong Thai P, Vu Thi TV, Bui Minh V, Dao Xuan C, Le Trung D, Phan Thu P, Do Duy C, Pham The T, Do VT, Pham Thi PT, Ngo Quy C, Dang Quoc T, Jin T, Shohei S, Takato O, Noriko N, Tsutomu K. A clinic-based direct real-time fluorescent reverse transcription loop-mediated isothermal amplification assay for influenza virus. J Virol Methods 2019; 277:113801. [PMID: 31838003 DOI: 10.1016/j.jviromet.2019.113801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 02/08/2023]
Abstract
Seasonal influenza virus causes acute respiratory tract infections, which can be severe in children and the elderly. At present, rapid influenza diagnostic tests (RIDTs) are popular at clinical sites because they enable early diagnosis and avoid unnecessary use of antibiotics; in addition, high risk patients with underlying disease can be given antiviral drugs. However, the sensitivity and specificity of some of those tests are relatively poor. To overcome these problems, nucleic acid-based molecular point-of-care tests have been developed; however, they are significantly more expensive than RIDTs. Previously, the authors developed real-time reverse transcription loop-mediated isothermal amplification (rRT-LAMP) assays using a quenching primer to detect influenza viruses. However, the assay is limited to laboratory use because it requires a nucleic acid purification step and preparation of reaction mixtures on ice. Therefore, the authors developed and validated direct rRT-LAMP assays that require no nucleic acid purification steps using commercial RNA isolation kits, and no storage and handling of reagents on ice. These assays can be performed within 10-30 min and require only mixing a clinical specimen with extraction reagent followed by addition of a lyophilized detection reagent. The established assay showed high sensitivity and specificity when validated using 310 clinical specimens. Thus, the assay is a powerful tool for molecular diagnosis of seasonal influenza virus infection in the clinic.
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Affiliation(s)
- Ngan Le Thi
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Takayama Ikuyo
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011, Japan
| | - Binh Nguyen Gia
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Phuong Truong Thai
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Tuong Van Vu Thi
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Vuong Bui Minh
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Co Dao Xuan
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Dung Le Trung
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Phuong Phan Thu
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Cuong Do Duy
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Thach Pham The
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Van Thanh Do
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Phuong Thuy Pham Thi
- NCGM-Bach Mai Hospital Medical Collaboration Center, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Chau Ngo Quy
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Tuan Dang Quoc
- Bach Mai Hospital, 78 Giai Phong Street, Dong Da District, Hanoi, Viet Nam
| | - Takasaki Jin
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Semba Shohei
- Eiken Chemical Co., Ltd, 4-19-9 Taito, Taito-ku, Tokyo, 110-8408, Japan
| | - Odagiri Takato
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011, Japan
| | - Nakajima Noriko
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
| | - Kageyama Tsutomu
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011, Japan
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Ultrasensitive Electrical Detection of Hemagglutinin for Point-of-Care Detection of Influenza Virus Based on a CMP-NANA Probe and Top-Down Processed Silicon Nanowire Field-Effect Transistors. SENSORS 2019; 19:s19204502. [PMID: 31627298 PMCID: PMC6832293 DOI: 10.3390/s19204502] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 01/15/2023]
Abstract
Rather than the internal genome nucleic acids, the biomolecules on the surface of the influenza virus itself should be detected for a more exact and rapid point-of-care yes/no decision for influenza virus-induced infectious diseases. This work demonstrates the ultrasensitive electrical detection of the HA1 domain of hemagglutinin (HA), a representative viral surface protein of the influenza virus, using the top-down complementary metal oxide semiconductor (CMOS) processed silicon nanowire (SiNW) field-effect transistor (FET) configuration. Cytidine-5′-monophospho-N-acetylneuraminic acid (CMP-NANA) was employed as a probe that specifically binds both to the aldehyde self-aligned monolayer on the SiNWs and to HA1 simultaneously. CMP-NANA was serially combined with two kinds of linkers, namely 3-aminopropyltriethoxysilane and glutaraldehyde. The surface functionalization used was verified using the purification of glutathione S-transferase-tagged HA1, contact angle measurement, enzyme-linked immunosorbent assay test, and isoelectric focusing analysis. The proposed functionalized SiNW FET showed high sensitivities of the threshold voltage shift (ΔVT) ~51 mV/pH and the ΔVT = 112 mV (63 mV/decade) with an ultralow detectable range of 1 fM of target protein HA1.
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12
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Zhu D, Lok C, Chao S, Chen L, Li R, Zhao Z, Dong J, Qin K, Zhao X. Detection and characterization of type B influenza virus from influenza-like illness cases during the 2017-2018 winter influenza season in Beijing, China. Arch Virol 2019; 164:995-1003. [PMID: 30729995 DOI: 10.1007/s00705-019-04160-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/04/2019] [Indexed: 12/15/2022]
Abstract
In the winter of 2017-2018, there was significant influenza activity in China, resulting in unprecedented usage of influenza rapid antigen tests (IRAT) and neuraminidase inhibitors (NAIs). The aim of this study was to characterize the most prevalent influenza virus type in a clinical setting with respect to diagnosis and concomitant NAI treatment. From Dec 2017 to Jan 2018, 3257 patients with influenza-like illness (ILI) were screened using IRAT. We summarized and compared the results with the last influenza season. Subtyping of influenza B viruses and identification of NAI drug resistance mutations were carried out by sequencing the HA and NA genes and aligning these with genetic isotypes. The performance of IRAT and RT-PCR was compared. Screening results indicated that influenza B virus was the leading cause of this influenza epidemic, with children being more susceptible to infection than adults. Phylogenetic analysis revealed that the prevailing influenza B virus belonged to the Yamagata lineage and were genetically similar to strains isolated from North America in the same influenza season. Cross-continental spread of influenza/B/Yamagata occurred. NAI resistance mutations were not identified in the 18 samples analyzed. The current antiviral protocol was still effective for influenza B control. RT-PCR positivity was significantly higher than that of IRAT (P = 0.004). IRAT and RT-PCR had a consistency rate of 86.9%, with the consistency rates of the positive and negative cases being 54.3% and 97.3%, respectively. Clinicians should be alert to the possibility of obtaining false negative results when using IRAT, and RT-PCR is recommended to improve the accuracy of pathogen detection.
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Affiliation(s)
- Dong Zhu
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Chonghou Lok
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Shuang Chao
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Lingling Chen
- Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, China CDC, National Health and Family Planning Commission, Beijing, People's Republic of China
| | - Runqing Li
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Zhipeng Zhao
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Jingxiao Dong
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Kun Qin
- Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, China CDC, National Health and Family Planning Commission, Beijing, People's Republic of China.
| | - Xiuying Zhao
- School of Clinical Medicine, Beijing Tsinghua Chang-gung Hospital, Tsinghua University, Beijing, People's Republic of China.
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13
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Dziąbowska K, Czaczyk E, Nidzworski D. Detection Methods of Human and Animal Influenza Virus-Current Trends. BIOSENSORS-BASEL 2018; 8:bios8040094. [PMID: 30340339 PMCID: PMC6315519 DOI: 10.3390/bios8040094] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/11/2022]
Abstract
The basic affairs connected to the influenza virus were reviewed in the article, highlighting the newest trends in its diagnostic methods. Awareness of the threat of influenza arises from its ability to spread and cause a pandemic. The undiagnosed and untreated viral infection can have a fatal effect on humans. Thus, the early detection seems pivotal for an accurate treatment, when vaccines and other contemporary prevention methods are not faultless. Public health is being attacked with influenza containing new genes from a genetic assortment between animals and humankind. Unfortunately, the population does not have immunity for mutant genes and is attacked in every viral outbreak season. For these reasons, fast and accurate devices are in high demand. As currently used methods like Rapid Influenza Diagnostic Tests lack specificity, time and cost-savings, new methods are being developed. In the article, various novel detection methods, such as electrical and optical were compared. Different viral elements used as detection targets and analysis parameters, such as sensitivity and specificity, were presented and discussed.
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Affiliation(s)
- Karolina Dziąbowska
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland.
- SensDx SA, 14b Postepu St., 02-676 Warsaw, Poland.
| | - Elżbieta Czaczyk
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland.
- SensDx SA, 14b Postepu St., 02-676 Warsaw, Poland.
| | - Dawid Nidzworski
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland.
- SensDx SA, 14b Postepu St., 02-676 Warsaw, Poland.
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14
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Antoniol S, Fidouh N, Ghazali A, Ichou H, Bouzid D, Kenway P, Choquet C, Visseaux B, Casalino E. Diagnostic performances of the Xpert ® Flu PCR test and the OSOM ® immunochromatographic rapid test for influenza A and B virus among adult patients in the Emergency Department. J Clin Virol 2017; 99-100:5-9. [PMID: 29257982 DOI: 10.1016/j.jcv.2017.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/08/2017] [Accepted: 12/12/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND New rapid influenza diagnostic tests (RIDT) are available but their clinical utility in adults has not been validated. OBJECTIVES To evaluate the diagnostic performances of OSOM® Ultra Flu A&B a RIDT on viral strains of influenza A/B from the last epidemic season, and its feasibility by Emergency Department (ED) physicians and nurses. STUDY DESIGN Of the 1099 patients admitted to the ED with suspected influenza, all having a nasopharyngeal swab tested by the Xpert® Flu PCR and then stored at -20 °C; 500 were selected at random and their samples were tested using the RIDT. Two experts reviewed ED and hospital medical records and all virological data to define influenza cases. Intra- and inter-observer variability were calculated. RESULTS Of the 500 patients included 45% were ≥75 years, 122 (24.4%) presented with influenza based on clinical and virological criteria. PCR test performances (%) were Se 98.4 (95% CI 93.6-99.7), Spe 99.7 (98.3-100), PPV 99.2 (94.8-100) and NPV 99.5 (97.9-100); and RIDT performances were Se 95.1 (89.2-97.9), Spe 98.4 (96.4-99.4), PPV 95.1 (87.2-99.9) and NPV 98.4 (96.4-98). There was no difference in test performance between influenza A and B virus nor between the influenza A subtypes. Intra- and inter-observer variability of RIDT were 0.94 (0.89-0.99) and 0.96 (0.92-1). CONCLUSION Our results show that the Xpert® Flu PCR and the OSOM® Ultra Flu A&B Test perform very well in diagnosing strains of circulating virus in adults and elderly. Our results also confirm the feasibility of this RIDT at point-of-care by ED staff.
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Affiliation(s)
- Stephanie Antoniol
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334, Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Nadhira Fidouh
- IAME (Infection, Antimicrobials, Modelling, Evolution), Université Paris Diderot, Sorbonne Paris Cité, UMR 1137, INSERM, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Aiham Ghazali
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334, Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Houria Ichou
- IAME (Infection, Antimicrobials, Modelling, Evolution), Université Paris Diderot, Sorbonne Paris Cité, UMR 1137, INSERM, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Donia Bouzid
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334, Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Philippe Kenway
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Christophe Choquet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Benoit Visseaux
- IAME (Infection, Antimicrobials, Modelling, Evolution), Université Paris Diderot, Sorbonne Paris Cité, UMR 1137, INSERM, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Enrique Casalino
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334, Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France.
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15
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Early Detection of Circulating Antigen and IgM-Associated Immune Complexes during Experimental Mycobacterium bovis Infection in Cattle. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017; 24:CVI.00069-17. [PMID: 28404571 DOI: 10.1128/cvi.00069-17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/07/2017] [Indexed: 11/20/2022]
Abstract
The presence of circulating antigen in cattle experimentally infected with Mycobacterium bovis was demonstrated using dual-path platform (DPP) technology. The antigen capture immunoassays employed rabbit polyclonal antibody recognizing predominantly M. tuberculosis complex-specific epitopes and were able to detect soluble substances and whole cells of mycobacteria. The antigen found in serum appeared to be mostly bound to IgM, but not to IgG, within the immune complexes formed at early stages of M. bovis infection. The antigen was also detected in bile and urine, indicating possible clearance pathways. The data correlation analyses supported the idea of the role of IgM responses in antigen persistence during M. bovis infection. The antigen was detectable in serum months prior to detectable antibody seroconversion. This proof-of-concept study suggested the potential for improved immunodiagnostics for bovine tuberculosis.
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