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Wang Y, Liu Y, Wang Y, Mai H, Chen Y, Zhang Y, Ji Y, Cong X, Gao Y. Clinical characteristics of outpatients with influenza-B-associated pneumonia and molecular evolution of influenza B virus in Beijing, China, during the 2021-2022 influenza season. Arch Virol 2024; 169:30. [PMID: 38233704 PMCID: PMC10794387 DOI: 10.1007/s00705-023-05957-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024]
Abstract
We analyzed the clinical characteristics of outpatients with influenza-B-associated pneumonia during the 2021-2022 influenza season and analyzed the molecular epidemiology and evolution of influenza B virus. The presence of influenza B virus was confirmed by reverse transcription polymerase chain reaction (RT-PCR). Electronic medical records were used to collect and analyze data of outpatients. The HA and NA genes were phylogenetically analyzed using ClustalW 2.10 and MEGA 11.0. Out of 1569 outpatients who tested positive for influenza B virus, 11.7% (184/1569) developed pneumonia, and of these, 19.0% (35/184) had underlying diseases. Fever, cough, and sore throat were the most common symptoms. Among the complications, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and shock accounted for 2.7% (5/184), 4.9% (9/184), and 1.6% (3/184), respectively. Of the outpatients, 2.7% (5/184) were admitted to the hospital, and 0.5% (1/184) of them died. All of the strains from Beijing were identified as belonging to the B/Victoria lineage. The HA and NA gene sequences of 41 influenza B viruses showed high similarity to each other, and all of them belonged to clade 1A.3. Compared with the vaccine strain B/Washington/02/2019, all of the isolates contained N150K, G181E, and S194D mutations. S194D, E195K, and K200R mutations were detected in the 190 helix of the receptor binding region of HA. Co-mutations of H122Q, A127T, P144L, N150K, G181E, S194D, and K200R in HA and D53N, N59S, and G233E in NA were detected in 78.0% (32/41) of the isolates, and 56.3% (18/32) of these were from outpatients with influenza-B-associated pneumonia. Influenza outpatients with underlying diseases were more likely to develop pneumonia. No significant differences were observed in clinical symptoms or laboratory results between outpatients with and without pneumonia, so testing for influenza virus seems to be a good choice. The observed amino acid variations suggest that current vaccines might not provide effective protection.
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Affiliation(s)
- Yanxin Wang
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Yafen Liu
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Yue Wang
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Huan Mai
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Yuanyuan Chen
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Yifan Zhang
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China
| | - Ying Ji
- Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China
| | - Xu Cong
- Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China
| | - Yan Gao
- Department of Infectious Diseases, Peking University People's Hospital, Beijing, China.
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Beran J, Ramirez Villaescusa A, Devadiga R, Nguyen TLA, Gruselle O, Pirçon JY, Struyf F, Devaster JM. Respiratory syncytial virus acute respiratory infections in ≥ 65-year-old adults in long-term care facilities in the Czech Republic. Cent Eur J Public Health 2021; 29:167-176. [PMID: 34623114 DOI: 10.21101/cejph.a6861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Due to immunosenescence and presence of comorbidities, respiratory syncytial virus (RSV) disease burden is a major health concern in older adults, which is expected to increase with the life expectancy rise. Data on RSV burden are scarce in older adults residing in long-term care facilities, a vulnerable population living in crowded settings. Therefore, two independent prospective studies were conducted during the 2003-2004 and 2004-2005 RSV seasons to assess RSV acute respiratory illnesses (ARIs) and lower respiratory tract infections (LRTIs) in ≥ 65-year-old adults residing in long-term care facilities in the Czech Republic. METHODS RSV ARI episodes were confirmed by polymerase chain reaction in nasal swabs collected within 3 days of symptoms onset. The mortality and morbidity of RSV-confirmed ARIs, as well as the risk factors associated with RSV-confirmed ARIs were evaluated. RESULTS Among 1,251 participants in the 2003-2004 season (ARI surveillance between October and March), there were no RSV-positive cases in 255 ARI and 105 LRTI episodes. Among 1,280 participants in the 2004-2005 season (ARI surveillance between October and April), there were 39 and 26 RSV-positive cases in 335 ARI and 217 LRTI episodes, respectively, and RSV-positive ARI and LRTI episode incidence rates were 45.82 and 30.40 per 1,000 person-years. Among 290 RSV-negative and 39 RSV-positive ARI cases in the 2004-2005 season, 15 and 4 hospitalizations, 188 and 26 LRTIs, and 11 and 3 deaths were reported. Risk factors associated with RSV-positive ARI were female gender (odds ratio: 4.98), chronic heart failure class II (odds ratio: 2.31) and diabetes requiring insulin treatment (odds ratio: 9.82). CONCLUSIONS These studies showed that RSV was an important cause of ARI in older adults living in long-term care facilities in the 2004-2005 season, with fluctuating yearly incidences.
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Affiliation(s)
- Jiří Beran
- Vaccination and Travel Medicine Centre, Hradec Kralove, Czech Republic
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BOCCALINI SARA, PARIANI ELENA, CALABRÒ GIOVANNAELISA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, LAI PIEROLUIGI, RIZZO CATERINA, AMODIO EMANUELE, VITALE FRANCESCO, CASUCCIO ALESSANDRA, DI PIETRO MARIALUISA, GALLI CRISTINA, BUBBA LAURA, PELLEGRINELLI LAURA, VILLANI LEONARDO, D’AMBROSIO FLORIANA, CAMINITI MARTA, LORENZINI ELISA, FIORETTI PAOLA, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, CANTOVA ELISA, PARENTE FLAVIO, TRENTO GIACOMO, SOTTILE SARA, PUGLIESE ANDREA, BIAMONTE MASSIMILIANOALBERTO, GIORGETTI DUCCIO, MENICACCI MARCO, D’ANNA ANTONIO, AMMOSCATO CLAUDIA, LA GATTA EMANUELE, BECHINI ANGELA, BONANNI PAOLO. [Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra ®]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E118. [PMID: 34909481 PMCID: PMC8639053 DOI: 10.15167/2421-4248/jpmh2021.62.2s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 - E-mail:
| | - ELENA PARIANI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
| | - GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), spin off dell’Università Cattolica del Sacro Cuore, Roma, Italia
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - DONATELLA PANATTO
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - DANIELA AMICIZIA
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - PIERO LUIGI LAI
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - CATERINA RIZZO
- Area Funzionale Percorsi Clinici ed Epidemiologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italia
| | - EMANUELE AMODIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - ALESSANDRA CASUCCIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - CRISTINA GALLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA BUBBA
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA PELLEGRINELLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LEONARDO VILLANI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - FLORIANA D’AMBROSIO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - MARTA CAMINITI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - ELISA LORENZINI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - PAOLA FIORETTI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - ELISA CANTOVA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - FLAVIO PARENTE
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - GIACOMO TRENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - SARA SOTTILE
- Università degli Studi di Trento, Trento, Italia
| | | | | | - DUCCIO GIORGETTI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - MARCO MENICACCI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ANTONIO D’ANNA
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - CLAUDIA AMMOSCATO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - EMANUELE LA GATTA
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
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Hu Y, Shao M, Hu Y, Liang Q, Jia N, Chu K, Xu L, Li J, Li C, Zhu F. Immunogenicity and safety of an inactivated quadrivalent influenza vaccine: a randomized, double-blind, controlled phase III clinical trial in children aged 6-35 months in China. Hum Vaccin Immunother 2020; 16:1691-1698. [PMID: 32347785 DOI: 10.1080/21645515.2020.1721994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Mismatch between circulating influenza B viruses and vaccine strains occurs frequently. In a randomized, double-blind, controlled phase III clinical study, healthy children aged 6-35 months were randomized into three groups at a ratio of 2:1:1, received two doses of quadrivalent influenza vaccines (QIVs) or licensed trivalent influenza vaccines (TIVs). The primary objective was to evaluate the non-inferiority immunogenicity of QIV compared with the two TIVs, containing B/Victoria or B/Yamagata strain. Safety information was collected for 28 days after each vaccination. Serious adverse events (SAEs) were monitored for 6 months after the second vaccination. A total of 2146 subjects (QIV: 1069, TIV-Vic: 540, TIV-Yam: 537) were enrolled in this study. QIV was found non-inferior to TIVs for shared strains (A/H1N1 and A/H3N2) and corresponding BY strain based on hemagglutination inhibition (HI) antibodies 28 days after the second dose of vaccination. The resulted geometric mean titer (GMT) ratios (QIV/TIV) were 0.98 (0.89, 1.07) for H1N1, 0.95 (0.85, 1.05) for H3N2 and 0.89 (0.81, 0.98) for BY. And the seroconversion rate differences (QIV-TIV) were -0.46% (-3.24%, 2.31%) for H1N1, -1.95% (-5.54%, 1.65%) for H3N2 and -3.58% (-8.11%, 0.95%) for BY. The BV strain in QIV did not reach the non-inferiority criteria, with GMT of 1:52.25 (vs. 1:61.02 of TIV-Vic) and seroconversion rate of 59.49% (vs. 66.85% of TIV-Vic). No increased safety concerns occurred in QIV group. Candidate QIV can provide good protection for children aged 6 to 35 months, and its immunogenicity and safety were proved. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov number: NCT03859141.
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Affiliation(s)
- Yuemei Hu
- Clinical Trials Assessment Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, China
| | - Ming Shao
- Division of Respiratory Virus Vaccines, National Institutes for Food and Drug Control , Beijing, China
| | - Yuansheng Hu
- Clinical Research Department, Sinovac Biotech Co., LTD ., Beijing, China
| | - Qi Liang
- Clinical Trials Assessment Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, China
| | - Ningning Jia
- Clinical Research Department, Sinovac Biotech Co., LTD ., Beijing, China
| | - Kai Chu
- Clinical Trials Assessment Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, China
| | - Li Xu
- Quality Assurance Department, Sinovac Biotech Co., LTD ., Beijing, China
| | - Jing Li
- Quality Assurance Department, Sinovac Biotech Co., LTD ., Beijing, China
| | - Changgui Li
- Division of Respiratory Virus Vaccines, National Institutes for Food and Drug Control , Beijing, China
| | - Fengcai Zhu
- Clinical Trials Assessment Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, China
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5
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Rivas MJ, Alegretti M, Cóppola L, Ramas V, Chiparelli H, Goñi N. Epidemiology and Genetic Variability of Circulating Influenza B Viruses in Uruguay, 2012-2019. Microorganisms 2020; 8:E591. [PMID: 32325860 PMCID: PMC7232498 DOI: 10.3390/microorganisms8040591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/31/2020] [Accepted: 04/05/2020] [Indexed: 02/07/2023] Open
Abstract
Influenza B viruses (IBV) are an important cause of morbidity and mortality during interpandemic periods in the human population. Two phylogenetically distinct IBV lineages, B/Yamagata and B/Victoria, co-circulate worldwide and they present challenges for vaccine strain selection. Until the present study, there was little information regarding the pattern of the circulating strains of IBV in Uruguay. A subset of positive influenza B samples from influenza-like illness (ILI) outpatients and severe acute respiratory illness (SARI) inpatients detected in sentinel hospitals in Uruguay during 2012-2019 were selected. The sequencing of the hemagglutinin (HA) and neuraminidase (NA) genes showed substitutions at the amino acid level. Phylogenetic analysis reveals the co-circulation of both lineages in almost all seasonal epidemics in Uruguay, and allows recognizing a lineage-level vaccine mismatch in approximately one-third of the seasons studied. The epidemiological results show that the proportion of IBV found in ILI was significantly higher than the observed in SARI cases across different groups of age (9.7% ILI, 3.2% SARI) and patients between 5-14 years constituted the majority (33%) of all influenza B infection (p < 0.05). Interestingly, we found that individuals >25 years were particularly vulnerable to Yamagata lineage infections.
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Affiliation(s)
- María José Rivas
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Miguel Alegretti
- Departamento de Vigilancia en Salud, Ministerio de Salud, Montevideo 11200, Uruguay;
| | - Leticia Cóppola
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Viviana Ramas
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Héctor Chiparelli
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Natalia Goñi
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
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6
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Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G, Palmieri A, Affanni P, Camilloni B, Chironna M, D'Agaro P, Giannecchini S, Pariani E, Serra C, Rizzo C, Bella A, Donatelli I, Castrucci MR. Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017. BMC Infect Dis 2019; 19:990. [PMID: 31752738 PMCID: PMC6873537 DOI: 10.1186/s12879-019-4621-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Since 1985, two antigenically distinct lineages of influenza B viruses (Victoria-like and Yamagata-like) have circulated globally. Trivalent seasonal influenza vaccines contain two circulating influenza A strains but a single B strain and thus provide limited immunity against circulating B strains of the lineage not included in the vaccine. In this study, we describe the characteristics of influenza B viruses that caused respiratory illness in the population in Italy over 13 consecutive seasons of virological surveillance, and the match between the predominant influenza B lineage and the vaccine B lineage, in each season. METHODS From 2004 to 2017, 26,886 laboratory-confirmed influenza cases were registered in Italy, of which 18.7% were type B. Among them, the lineage of 2465 strains (49%) was retrieved or characterized in this study by a real-time RT-PCR assay and/or sequencing of the hemagglutinin (HA) gene. RESULTS Co-circulation of both B lineages was observed each season, although in different proportions every year. Overall, viruses of B/Victoria and B/Yamagata lineages caused 53.3 and 46.7% of influenza B infections, respectively. A higher proportion of infections with both lineages was detected in children, and there was a declining frequency of B/Victoria detections with age. A mismatch between the vaccine and the predominant influenza B lineage occurred in eight out of thirteen influenza seasons under study. Considering the seasons when B accounted for > 20% of all laboratory-confirmed influenza cases, a mismatch was observed in four out of six seasons. Phylogenetic analysis of the HA1 domain confirmed the co-circulation of both lineages and revealed a mixed circulation of distinct evolutionary viral variants, with different levels of match to the vaccine strains. CONCLUSIONS This study contributes to the understanding of the circulation of influenza B viruses in Italy. We found a continuous co-circulation of both B lineages in the period 2004-2017, and determined that children were particularly vulnerable to Victoria-lineage influenza B virus infections. An influenza B lineage mismatch with the trivalent vaccine occurred in about two-thirds of cases.
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Affiliation(s)
- Simona Puzelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy.
| | - Angela Di Martino
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Marzia Facchini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Concetta Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Laura Calzoletti
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Giuseppina Di Mario
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Annapina Palmieri
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | | | | | - Maria Chironna
- Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | | | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Caterina Rizzo
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Isabella Donatelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Maria Rita Castrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
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7
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Tramuto F, Restivo V, Costantino C, Colomba GME, Maida CM, Casuccio A, Vitale F. Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy. Am J Trop Med Hyg 2019; 101:1232-1239. [PMID: 31571567 DOI: 10.4269/ajtmh.19-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Influenza A and B outbreaks occur each year with different activity and molecular patterns. To date, knowledge of seasonal epidemiology remains a prerequisite not only to put in place the most effective immunization strategy against influenza but also to identify population groups at higher risk of developing serious complications. A retrospective analysis of influenza surveillance data from 2010 to 2018 aimed to explore the epidemiology of influenza in Sicily, at the primary care and hospital level. Overall, 6,740 patients with acute respiratory infection were tested, of which 3,032 (45.0%) were positive for influenza. The relative proportion of type A and B viruses markedly varied across seasons. Type A similarly spreads among children and adults, whereas type B was more commonly identified among pediatric population aged 5-9 years. The median age of confirmed influenza cases differed by health-care setting, increasing according to disease severity (range: 8-54 years). Among influenza-confirmed cases, more than 80% of hospitalized patients had an underlying medical condition. Cardiovascular disease, lung disease, diabetes, and obesity were some of the most frequent. Overall, patients admitted to an intensive care unit were more likely to have multiple comorbidities and being infected with influenza infection strongly increased the risk of severe clinical outcomes. Understanding of the epidemiology of influenza and the molecular features of circulating viruses is of paramount importance to optimize prevention and control strategies. Knowledge of predictors for the occurrence of severe forms of the disease may help to address adequate preventive measures to high-risk population groups.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy.,Clinical Epidemiology Unit, Regional Reference Laboratory for Molecular Surveillance of Influenza, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy
| | - Giuseppina Maria Elena Colomba
- Clinical Epidemiology Unit, Regional Reference Laboratory for Molecular Surveillance of Influenza, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Carmelo Massimo Maida
- Clinical Epidemiology Unit, Regional Reference Laboratory for Molecular Surveillance of Influenza, University Hospital "Paolo Giaccone", Palermo, Italy.,Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Clinical Epidemiology Unit, Regional Reference Laboratory for Molecular Surveillance of Influenza, University Hospital "Paolo Giaccone", Palermo, Italy.,Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy
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8
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Trucchi C, Paganino C, Orsi A, Amicizia D, Tisa V, Piazza MF, Gallo D, Simonetti S, Buonopane B, Icardi G, Ansaldi F. Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old. BMC Health Serv Res 2019; 19:585. [PMID: 31426795 PMCID: PMC6700791 DOI: 10.1186/s12913-019-4412-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/08/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Influenza-like illnesses (ILIs) and lower respiratory tract infections (LRTIs) cause substantial morbidity and mortality worldwide. The study assessed the health and economic burden of ILI and LRTI according to age and comorbidities, since available evidence is limited and heterogeneous. METHOD The prevalence of comorbidities, the seasonal incidence rates and the mean and per capita direct costs of ED accesses for ILI/LRTI, whether followed by hospitalization or not, recorded in adults aged ≥50 years over the last 6 years, in the referral hospitals located in the Genoese metropolitan area (Liguria, Italy) where the syndromic surveillance system is active, were evaluated through a retrospective observational study. Comorbidities were estimated through the Chronic Condition Data Warehouse that integrates multiple Medicare data sources. A comparison with the administrative healthcare International Classification of Diseases-9th revision-Clinical Modification (ICD-9-CM)-based data was also conducted. RESULTS The prevalence of subjects with ≥1 comorbidity ranged from 23.49 to 59.92%. The most prevalent all-age comorbidities were cardiovascular diseases and cancer. The overall ILI/LRTI incidence rate was 6.73/1000 person-years, almost double the value derived from routine data, and increased with age. The highest rates were observed in patients with renal failure and bronchopneumopathies. The mean cost of ED accesses/hospitalization for ILI/LRTI was €3353 and was almost twice as high in the ≥85 years as in the youngest age-group. The highest mean costs were observed in patients with renal failure and cancer. The per capita costs increased from €4 to €71 with age, and were highest in patients with renal failure and bronchopneumopathy. CONCLUSION The burden of ILIs/LRTIs in terms of ED accesses and hospitalizations in adults aged ≥50 years is heavy, and is related to increasing age and, especially, to specific comorbidities. These results could contribute to revising age- and risk-based anti-influenza and -pneumococcus immunization strategies.
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Affiliation(s)
| | | | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Daniela Amicizia
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Valentino Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Maria Francesca Piazza
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | | | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Filippo Ansaldi
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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9
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Trucchi C, Paganino C, Amicizia D, Orsi A, Tisa V, Piazza MF, Icardi G, Ansaldi F. Universal influenza virus vaccines: what needs to happen next? Expert Opin Biol Ther 2019; 19:671-683. [PMID: 30957589 DOI: 10.1080/14712598.2019.1604671] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Influenza occurs worldwide and causes significant disease burden in terms of morbidity, associated complications, hospitalizations, and deaths. Vaccination constitutes the primary approach for controlling influenza. Current influenza vaccines elicit a strain-specific response yet occasionally exhibit suboptimal effectiveness. This review describes the limits of available immunization tools and the future prospects and potentiality of universal influenza vaccines. AREAS COVERED New 'universal' vaccines, which are presently under development, are expected to overcome the problems related to the high variability of influenza viruses, such as the need for seasonal vaccine updates and re-vaccination. Here, we explore vaccines based on the highly conserved epitopes of the HA, NA, or extracellular domain of the influenza M2 protein, along with those based on the internal proteins such as NP and M1. EXPERT OPINION The development of a universal influenza vaccine that confers protection against homologous, drifted, and shifted influenza virus strains could obviate the need for annual reformulation and mitigate disease burden. The scientific community has long been awaiting the advent of universal influenza vaccines; these are currently under development in laboratories worldwide. If such vaccines are immunogenic, efficacious, and able to confer long-lasting immunity, they might be integrated with or supplant traditional influenza vaccines.
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Affiliation(s)
- Cecilia Trucchi
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy
| | - Chiara Paganino
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy
| | - Daniela Amicizia
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Andrea Orsi
- b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Valentino Tisa
- c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Maria Francesca Piazza
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Giancarlo Icardi
- b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Filippo Ansaldi
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
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10
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BUTERA F, SCHENONE S, GRAMMATICO F, TISA V, BARISIONE G, GUARONA G, BRUZZONE B, MURDACA G, SETTI M, ORSI A. Detection of influenza A(H1N1)pdm09 virus in a patient travelling from Shanghai to Italy in July 2018: an uncommon clinical presentation in a non-seasonal period. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E4. [PMID: 31041403 PMCID: PMC6477558 DOI: 10.15167/2421-4248/jpmh2019.60.1.1214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 02/12/2019] [Indexed: 01/19/2023]
Abstract
Influenza is one of the most common infectious diseases in travellers, especially in those returning from subtropical and tropical regions. In late June 2018 an influenza A(H1N1)pdm09 virus infection was diagnosed in a 36-years-old man, returned from a travel in Shanghai and hospitalized at the Ospedale Policlinico San Martino, Genoa, Italy, with a diagnosis of fever and an uncommon clinical presentation characterised by a persistent leukopenia. Phylogenetic analysis revealed a closeness with influenza A(H1N1)pdm09 strains circulating in the US in May-June 2018. Prompt recognition of influenza infection led to a proper case management, demonstrating the crucial role of the continuous influenza surveillance programme.
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Affiliation(s)
- F. BUTERA
- Department of Health Sciences, University of Genoa, Italy
| | - S. SCHENONE
- Department of Health Sciences, University of Genoa, Italy
| | - F. GRAMMATICO
- Department of Health Sciences, University of Genoa, Italy
| | - V. TISA
- Department of Health Sciences, University of Genoa, Italy
| | - G. BARISIONE
- Department of Health Sciences, University of Genoa, Italy
| | - G. GUARONA
- Department of Health Sciences, University of Genoa, Italy
| | - B. BRUZZONE
- Hygiene Unit, Ospedale Policlinico San Martino, Genoa, Italy
| | - G. MURDACA
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - M. SETTI
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - A. ORSI
- Department of Health Sciences, University of Genoa, Italy
- Hygiene Unit, Ospedale Policlinico San Martino, Genoa, Italy
- Andrea Orsi, Department of Health Sciences, University of Genoa, and Hygiene Unit, Ospedale Policlinico San Martino, Genoa, Italy - Tel. +39 010 5552996 - Fax +39 010 5556745 - E-mail:
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11
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De Conto F, Conversano F, Medici MC, Ferraglia F, Pinardi F, Arcangeletti MC, Chezzi C, Calderaro A. Epidemiology of human respiratory viruses in children with acute respiratory tract infection in a 3-year hospital-based survey in Northern Italy. Diagn Microbiol Infect Dis 2019; 94:260-267. [PMID: 30745224 PMCID: PMC7126416 DOI: 10.1016/j.diagmicrobio.2019.01.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/13/2022]
Abstract
Acute respiratory tract infections (ARTIs) are among the leading causes of morbidity and mortality in children. The viral etiology of ARTIs was investigated over 3 years (October 2012–September 2015) in 2575 children in Parma, Italy, using indirect immunofluorescent staining of respiratory samples for viral antigens, cell culture, and molecular assays. Respiratory viruses were detected in 1299 cases (50.44%); 1037 (79.83%) were single infections and 262 (20.17%) mixed infections. The highest infection incidence was in children aged >6 months to ≤3 years (57.36%). Human respiratory syncytial virus (27.12%) and human adenovirus (23.58%) were the most common viruses identified. The virus detection rate decreased significantly between the first and third epidemic season (53.9% vs. 43.05%, P < 0.0001). The simultaneous use of different diagnostic tools allowed us to identify a putative viral etiology in half the children examined and to provide an estimate of the epidemiology and seasonality of respiratory viruses associated with ARTIs. Respiratory viruses were assessed in children from October 2012 to September 2015. Viruses were detected using antigen and molecular assays, and cell culture. Respiratory syncytial virus and adenovirus were the most common viruses detected. Influenza virus and respiratory syncytial virus detection showed seasonal variation. Respiratory virus detection was highest in children aged >6 months to ≤3 years.
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Affiliation(s)
- Flora De Conto
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy.
| | - Francesca Conversano
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
| | - Maria Cristina Medici
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
| | - Francesca Ferraglia
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
| | - Federica Pinardi
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
| | | | - Carlo Chezzi
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
| | - Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy
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12
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Mosnier A, Launay O, Martinez L, Gavazzi G, Josset L, Crepey P, Hannoun C, Weil-Olivier C, Gaillat J. [Quadrivalent influenza vaccine: What is changed and what are the benefits?]. Presse Med 2018; 47:842-853. [PMID: 30219205 DOI: 10.1016/j.lpm.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Currently, circulating viruses responsible for annual seasonal influenza epidemics belong to two influenza A subtypes, A(H1N1) and A(H3N2), and to two antigenically distinct type B lineages, B/Yamagata and B/Victoria lineages. Like diseases due to influenza A virus, influenza B virus diseases may have severe consequences and should be prevented. Until now, in France, the vaccines used to prevent seasonal influenza were trivalent, systematically targeting viruses belonging to both A subtypes and to one or other of the B lineages. The protective efficacy of trivalent vaccines is diminished during the seasons when viruses belonging to both B lineages cocirculated or when the circulating dominant type B virus belonged to a lineage different from that targeted by the vaccine strain. By targeting viruses belonging to both B lineages, quadrivalent vaccines improve the antigenic concordance between circulating and vaccine type B strains. Three inactivated quadrivalent vaccines are authorized for marketing in France and should be available for the 2018-2019 season. It is expected that, by providing enlarged protection, these quadrivalent influenza vaccines will improve vaccine efficacy, the confidence in immunization of the public, the satisfaction of health professionals, and ultimately will help to complete immunization coverage.
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Affiliation(s)
- Anne Mosnier
- Open Rome & Réseau des GROG, 67, rue du Poteau, 75018 Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble-Alpes, clinique universitaire de gériatrie, pavillon Elisée-Chatin, et GREPI EA 7408, université Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France
| | - Laurence Josset
- Institut des agents infectieux, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | | | | | | | - Jacques Gaillat
- Centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Metz-Tessy, France.
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13
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Cross-Protective Efficacy of Monovalent Live Influenza B Vaccines against Genetically Different Lineages of B/Victoria and B/Yamagata in Ferrets. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9695628. [PMID: 30246028 PMCID: PMC6136522 DOI: 10.1155/2018/9695628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/12/2018] [Indexed: 01/30/2023]
Abstract
Background Currently, two genetic lineages of influenza B virus, B/Victoria and B/Yamagata, are cocirculating in humans in various countries. This situation has raised a question regarding the possibility of cross-protection between B components of live attenuated influenza vaccine (LAIV) belonging to different lineages. This study aimed to assess in naïve ferrets the potential protective activity of monovalent B-LAIVs against challenge with homologous and heterologous wild-type (WT) influenza B viruses. Methods Groups of seronegative female ferrets 5-6 months of age were given one dose of monovalent LAIV based on B/Victoria or B/Yamagata lineage virus. Ferrets were challenged 21 days later with B/Victoria or B/Yamagata WT virus. Ferrets were monitored closely for clinical signs and morbidity outcomes including febrile response, body weight loss, nasal symptoms, and level of activity one week prior to vaccination and for three days following vaccination/challenge. Nasal washes were collected three days after vaccination/challenge. Samples of lung tissue were taken three days after challenge. All samples were analyzed for the presence of challenge virus by culturing in embryonated chicken eggs and real-time polymerase chain reaction. Antibody response to vaccination was assessed by routine hemagglutination inhibition assay and microneutralization test. Results Vaccination led to intensive production of specific neutralizing and antihemagglutinating antibodies to vaccine virus, protected ferrets from homologous challenge infection, and significantly reduced clinical signs and replication of homologous challenge virus. In contrast, cross-lineage serum antibodies were not detected. However, ferrets vaccinated with monovalent B-LAIV had a significantly lower level of heterologous challenge virus in the respiratory tract than those given challenge virus only. Conclusions Monovalent B-LAIV has the potential to be cross-protective against infection with genetically different influenza lineages. Further studies are required to confirm this effect.
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14
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Boccalini S, Bechini A, Innocenti M, Sartor G, Manzi F, Bonanni P, Panatto D, Lai PL, Zangrillo F, Rizzitelli E, Iovine M, Amicizia D, Bini C, Marcellusi A, Mennini FS, Rinaldi A, Trippi F, Ferriero AM, Lisi GC. [The universal influenza vaccination in children with Vaxigrip Tetra ® in Italy: an evaluation of Health Technology Assessment]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E1-E86. [PMID: 30465031 PMCID: PMC6219245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Angela Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - Gino Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Federico Manzi
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Piero Luigi Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | | | | | - Daniela Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Chiara Bini
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
| | - Andrea Marcellusi
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
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15
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Orsi A, Colomba GME, Pojero F, Calamusa G, Alicino C, Trucchi C, Canepa P, Ansaldi F, Vitale F, Tramuto F. Trends of influenza B during the 2010-2016 seasons in 2 regions of north and south Italy: The impact of the vaccine mismatch on influenza immunisation strategy. Hum Vaccin Immunother 2018; 14:523-531. [PMID: 28708953 PMCID: PMC5861802 DOI: 10.1080/21645515.2017.1342907] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/22/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022] Open
Abstract
Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012-2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population.
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Affiliation(s)
- Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS University Hospital “San Martino” - IST National Institute for Cancer Research, Genoa, Italy
| | - Giuseppina Maria Elena Colomba
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | - Fanny Pojero
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | - Giuseppe Calamusa
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | | | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paola Canepa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS University Hospital “San Martino” - IST National Institute for Cancer Research, Genoa, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
- Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
- Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
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16
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Bonanni P, Boccalini S, Zanobini P, Dakka N, Lorini C, Santomauro F, Bechini A. The appropriateness of the use of influenza vaccines: Recommendations from the latest seasons in Italy. Hum Vaccin Immunother 2018; 14:699-705. [PMID: 29059004 PMCID: PMC5861775 DOI: 10.1080/21645515.2017.1388480] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/08/2017] [Accepted: 09/30/2017] [Indexed: 02/06/2023] Open
Abstract
Influenza is one of the major infectious causes of excess mortality, hospitalization, and an increase in healthcare expenditure in all countries. In an increasingly ageing population, many members are exposed to flu-related complications. Vaccination coverage rates for the elderly in most European countries, such as Italy, are not satisfactory, and have been decreasing with time due to a sense of skepticism toward vaccination. Nowadays, many types of vaccines are available on the Italian market to prevent influenza illness. Many studies have proven their effectiveness in preventing influenza-related complications in specific risk groups. Any vaccine can be crucial to avoid complications, hospitalizations and death, but use of the most appropriate vaccine could optimize the result at a very modest cost. General practitioners (GPs) should encourage their patients to take the influenza vaccination to prevent complications or deaths. Health authorities should give GPs the opportunity to choose the appropriate vaccines tailored to specific patients.
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Affiliation(s)
- Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Patrizio Zanobini
- Specialization Medical School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Nawal Dakka
- Specialization Medical School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Angela Bechini
- Department of Health Sciences, University of Florence, Florence, Italy
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Weinberger B. Vaccines for the elderly: current use and future challenges. IMMUNITY & AGEING 2018; 15:3. [PMID: 29387135 PMCID: PMC5778733 DOI: 10.1186/s12979-017-0107-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/28/2017] [Indexed: 12/30/2022]
Abstract
Age-related changes of the immune system contribute to increased incidence and severity of infections in the elderly. Vaccination is the most effective measure to prevent infections and vaccination recommendations in most countries include specific guidelines for the elderly. Vaccination against influenza and Streptococcus pneumoniae is usually recommended for persons with underlying diseases and for the elderly with heterogeneous age limits between ≥ 50 years and ≥ 65 years. Some countries also recommend vaccination against herpes zoster. Several vaccines are recommended for all adults, such as regular booster shots against tetanus/diphtheria/pertussis/polio, or for specific groups, e.g. vaccination against tick-borne encephalitis in endemic areas or travel vaccines. These are also relevant for the elderly. Most currently used vaccines are less immunogenic and effective in the elderly compared to younger adults. Potential strategies to improve their immunogenicity include higher antigen dose, alternative routes of administration, and the use of adjuvants, which were all implemented for influenza vaccines, and induce moderately higher antibody concentrations. Research on universal vaccines against influenza and S. pneumoniae is ongoing in order to overcome the limitations of the current strain-specific vaccines. Respiratory syncytial virus causes significant morbidity in the elderly. Novel vaccines against this and other pathogens, for instance bacterial nosocomial infections, have tremendous potential impact on health in old age and are intensively studied by many academic and commercial organizations. In addition to novel vaccine developments, it is crucial to increase awareness for the importance of vaccination beyond the pediatric setting, as vaccination coverage is still far from optimal for the older population.
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Affiliation(s)
- Birgit Weinberger
- Universität Innsbruck, Institute for Biomedical Aging Research, Rennweg 10, 6020 Innsbruck, Austria
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18
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Puig-Barberà J, Guglieri-López B, Tortajada-Girbés M, López-Labrador FX, Carballido-Fernández M, Mollar-Maseres J, Schwarz-Chavarri G, Baselga-Moreno V, Mira-Iglesias A, Díez-Domingo J. Low influenza vaccine effectiveness and the effect of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-Lineage in patients 60 years old or older during the 2015/2016 influenza season. Vaccine 2017; 35:7331-7338. [PMID: 29128380 DOI: 10.1016/j.vaccine.2017.10.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/15/2017] [Accepted: 10/31/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The 2015/2016 influenza season was characterized in Europe by the circulation of A(H1N1)pdm09 clade 6B.1 and B/Victoria-lineage influenza viruses. The components of the vaccines used in the current and past two seasons in the Valencia region were similar but not well matched to the 2015/2016 dominant influenza-circulating strains. We estimate influenza vaccine effectiveness (IVE) and interference of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-lineage in this particular season. METHODS The Valencia Hospital Network for the Study of Influenza runs an active surveillance hospital-based study to collect clinical and virological data from consecutive admissions possibly related to influenza. Combined nasopharyngeal and pharyngeal swabs are analyzed by reverse transcription polymerase chain reaction, and the hemagglutinin is sequenced in a sample of positive influenza specimens. Vaccination is ascertained consulting a population vaccine information system. We estimate IVE using a test-negative approach. RESULTS During the 2015-2016 season, we recruited 1049 eligible admissions of patients 60 years or older, and 187 tested positive for influenza. The adjusted IVE in preventing admission with A(H1N1)pdm09 was 20.2%; 95% confidence interval (CI) -21.3-47.5% and -33.2%; 95% CI, -140.1-26.1% in preventing admission with B/Victoria-lineage. The majority of A(H1N1)pdm09 sequenced viruses belonged to the emerging 6B.1 subclade, defined by S162N and I216T mutations in the hemagglutinin protein. When we restricted our analysis to those not vaccinated in the previous year, unadjusted IVE was 84.9% (95% CI 9.9-100.0) overall, 77.9% (-32.7-100.0%) in preventing A(H1N1)pdm09 and 48.8% (-219.5-100.0%) in preventing B/Yamagata-lineage admission. CONCLUSIONS Our findings indicate that IVE was low in preventing A(H1N1)pdm09 and strongly correlated with vaccination in the previous season. No effect in preventing admission with B/Victoria-lineage was observed. For the 2015/2016 season, IVE was low due to a mismatch and lack of concordance between the circulating and vaccine viruses.
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Affiliation(s)
- Joan Puig-Barberà
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain; Centro de Salud Pública de Castellón, Castellón, Spain.
| | - Beatriz Guglieri-López
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | | | - F Xavier López-Labrador
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Víctor Baselga-Moreno
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Ainara Mira-Iglesias
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Javier Díez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
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