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Tsang TK, Du RQR, Fang VJ, Lau EHY, Chan KH, Chu DKW, Ip DKM, Peiris JSM, Leung GM, Cauchemez S, Cowling BJ. Decreased risk of non-influenza respiratory infection after influenza B virus infection in children. Epidemiol Infect 2024; 152:e60. [PMID: 38584132 PMCID: PMC11062782 DOI: 10.1017/s0950268824000542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Previous studies suggest that influenza virus infection may provide temporary non-specific immunity and hence lower the risk of non-influenza respiratory virus infection. In a randomized controlled trial of influenza vaccination, 1 330 children were followed-up in 2009-2011. Respiratory swabs were collected when they reported acute respiratory illness and tested against influenza and other respiratory viruses. We used Poisson regression to compare the incidence of non-influenza respiratory virus infection before and after influenza virus infection. Based on 52 children with influenza B virus infection, the incidence rate ratio (IRR) of non-influenza respiratory virus infection after influenza virus infection was 0.47 (95% confidence interval: 0.27-0.82) compared with before infection. Simulation suggested that this IRR was 0.87 if the temporary protection did not exist. We identified a decreased risk of non-influenza respiratory virus infection after influenza B virus infection in children. Further investigation is needed to determine if this decreased risk could be attributed to temporary non-specific immunity acquired from influenza virus infection.
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Affiliation(s)
- Tim K. Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Richael Q. R. Du
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Vicky J. Fang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric H. Y. Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Kwok Hung Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel K. W. Chu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Dennis K. M. Ip
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - J. S. Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong
- Centre for Immunology and Infection, Hong Kong Science and Technology Park, Hong Kong
| | - Gabriel M. Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong
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Xie LY, Wang T, Yu T, Hu X, Yang L, Zhong LL, Zhang B, Zeng SZ. Seasonality of respiratory syncytial virus infection in children hospitalized with acute lower respiratory tract infections in Hunan, China, 2013-2022. Virol J 2024; 21:62. [PMID: 38454522 PMCID: PMC10921640 DOI: 10.1186/s12985-024-02336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In China, respiratory syncytial virus (RSV) infections traditionally occur during the spring and winter seasons. However, a shift in the seasonal trend was noted in 2020-2022, during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study investigated the seasonal characteristics of RSV infection in children hospitalized with acute lower respiratory tract infections (ALRTIs). The RSV epidemic season was defined as RSV positivity in > 10% of the hospitalized ALRTI cases each week. Nine RSV seasons were identified between 2013 and 2022, and nonlinear ordinary least squares regression models were used to assess the differences in year-to-year epidemic seasonality trends. RESULTS We enrolled 49,658 hospitalized children diagnosed with ALRTIs over a 9-year period, and the RSV antigen-positive rate was 15.2% (n = 7,566/49,658). Between 2013 and 2022, the average onset and end of the RSV season occurred in week 44 (late October) and week 17 of the following year, respectively, with a typical duration of 27 weeks. However, at the onset of the COVID-19 pandemic, the usual spring RSV peak did not occur. Instead, the 2020 epidemic started in week 32, and RSV seasonality persisted into 2021, lasting for an unprecedented 87 weeks before concluding in March 2022. CONCLUSIONS RSV seasonality was disrupted during the COVID-19 pandemic, and the season exhibited an unusually prolonged duration. These findings may provide valuable insights for clinical practice and public health considerations.
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Affiliation(s)
- Le-Yun Xie
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tao Wang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tian Yu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
| | - Xian Hu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Le Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Li-Li Zhong
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Bing Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Sai-Zhen Zeng
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
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Waterlow NR, Kleynhans J, Wolter N, Tempia S, Eggo RM, Hellferscee O, Lebina L, Martinson N, Wagner RG, Moyes J, von Gottberg A, Cohen C, Flasche S. Transient increased risk of influenza infection following RSV infection in South Africa: findings from the PHIRST study, South Africa, 2016-2018. BMC Med 2023; 21:441. [PMID: 37968614 PMCID: PMC10647169 DOI: 10.1186/s12916-023-03100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Large-scale prevention of respiratory syncytial virus (RSV) infection may have ecological consequences for co-circulating pathogens, including influenza. We assessed if and for how long RSV infection alters the risk for subsequent influenza infection. METHODS We analysed a prospective longitudinal cohort study conducted in South Africa between 2016 and 2018. For participating households, nasopharyngeal samples were taken twice weekly, irrespective of symptoms, across three respiratory virus seasons, and real-time polymerase chain reaction (PCR) was used to identify infection with RSV and/or influenza. We fitted an individual-level hidden Markov transmission model in order to estimate RSV and influenza infection rates and their interdependence. RESULTS Of a total of 122,113 samples collected, 1265 (1.0%) were positive for influenza and 1002 (0.8%) positive for RSV, with 15 (0.01%) samples from 12 individuals positive for both influenza and RSV. We observed a 2.25-fold higher incidence of co-infection than expected if assuming infections were unrelated. We estimated that infection with influenza is 2.13 (95% CI 0.97-4.69) times more likely when already infected with, and for a week following, RSV infection, adjusted for age. This equates to 1.4% of influenza infections that may be attributable to RSV in this population. Due to the local seasonality (RSV season precedes the influenza season), we were unable to estimate changes in RSV infection risk following influenza infection. CONCLUSIONS We find no evidence to suggest that RSV was associated with a subsequent reduced risk of influenza infection. Instead, we observed an increased risk for influenza infection for a short period after infection. However, the impact on population-level transmission dynamics of this individual-level synergistic effect was not measurable in this setting.
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Affiliation(s)
- Naomi R Waterlow
- Centre for Mathematical Modelling of Infectious Disease, School of Hygiene and Tropical Medicine, London, UK.
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Pathology, Faculty of Medicine, University of the Witwatersand, Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Disease, School of Hygiene and Tropical Medicine, London, UK
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Pathology, Faculty of Medicine, University of the Witwatersand, Johannesburg, South Africa
| | - Limakatso Lebina
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Africa Health Research Institute, Durban, South Africa
| | - Neil Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- John Hopkins University Center for TB Research, Baltimore, MD, USA
| | - Ryan G Wagner
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, South African Medical Research Council/Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Pathology, Faculty of Medicine, University of the Witwatersand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, School of Hygiene and Tropical Medicine, London, UK.
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O’Neill GK, Taylor J, Kok J, Dwyer DE, Dilcher M, Hua H, Levy A, Smith D, Minney-Smith CA, Wood T, Jelley L, Huang QS, Trenholme A, McAuliffe G, Barr I, Sullivan SG. Circulation of influenza and other respiratory viruses during the COVID-19 pandemic in Australia and New Zealand, 2020-2021. Western Pac Surveill Response J 2023; 14:1-9. [PMID: 37946717 PMCID: PMC10630701 DOI: 10.5365/wpsar.2023,14.3.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Objective Circulation patterns of influenza and other respiratory viruses have been globally disrupted since the emergence of coronavirus disease (COVID-19) and the introduction of public health and social measures (PHSMs) aimed at reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Methods We reviewed respiratory virus laboratory data, Google mobility data and PHSMs in five geographically diverse regions in Australia and New Zealand. We also described respiratory virus activity from January 2017 to August 2021. Results We observed a change in the prevalence of circulating respiratory viruses following the emergence of SARS-CoV-2 in early 2020. Influenza activity levels were very low in all regions, lower than those recorded in 2017-2019, with less than 1% of laboratory samples testing positive for influenza virus. In contrast, rates of human rhinovirus infection were increased. Respiratory syncytial virus (RSV) activity was delayed; however, once it returned, most regions experienced activity levels well above those seen in 2017-2019. The timing of the resurgence in the circulation of both rhinovirus and RSV differed within and between the two countries. Discussion The findings of this study suggest that as domestic and international borders are opened up and other COVID-19 PHSMs are lifted, clinicians and public health professionals should be prepared for resurgences in influenza and other respiratory viruses. Recent patterns in RSV activity suggest that these resurgences in non-COVID-19 viruses have the potential to occur out of season and with increased impact.
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Affiliation(s)
- Genevieve K O’Neill
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Janette Taylor
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology-Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Meik Dilcher
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Harry Hua
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Avram Levy
- PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia
- Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - David Smith
- PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
| | | | - Timothy Wood
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Lauren Jelley
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q Sue Huang
- Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Gary McAuliffe
- Virology and Immunology Department, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases and Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
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5
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Imrie RM, Walsh SK, Roberts KE, Lello J, Longdon B. Investigating the outcomes of virus coinfection within and across host species. PLoS Pathog 2023; 19:e1011044. [PMID: 37216391 DOI: 10.1371/journal.ppat.1011044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Abstract
Interactions between coinfecting pathogens have the potential to alter the course of infection and can act as a source of phenotypic variation in susceptibility between hosts. This phenotypic variation may influence the evolution of host-pathogen interactions within host species and interfere with patterns in the outcomes of infection across host species. Here, we examine experimental coinfections of two Cripaviruses-Cricket Paralysis Virus (CrPV), and Drosophila C Virus (DCV)-across a panel of 25 Drosophila melanogaster inbred lines and 47 Drosophilidae host species. We find that interactions between these viruses alter viral loads across D. melanogaster genotypes, with a ~3 fold increase in the viral load of DCV and a ~2.5 fold decrease in CrPV in coinfection compared to single infection, but we find little evidence of a host genetic basis for these effects. Across host species, we find no evidence of systematic changes in susceptibility during coinfection, with no interaction between DCV and CrPV detected in the majority of host species. These results suggest that phenotypic variation in coinfection interactions within host species can occur independently of natural host genetic variation in susceptibility, and that patterns of susceptibility across host species to single infections can be robust to the added complexity of coinfection.
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Affiliation(s)
- Ryan M Imrie
- Centre for Ecology & Conservation, Faculty of Environment, Science, and Economy, Biosciences, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Sarah K Walsh
- Centre for Ecology & Conservation, Faculty of Environment, Science, and Economy, Biosciences, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Katherine E Roberts
- Centre for Ecology & Conservation, Faculty of Environment, Science, and Economy, Biosciences, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Joanne Lello
- School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Ben Longdon
- Centre for Ecology & Conservation, Faculty of Environment, Science, and Economy, Biosciences, University of Exeter, Penryn Campus, Penryn, United Kingdom
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6
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Torres AR, Guiomar RG, Verdasca N, Melo A, Rodrigues AP. Resurgence of Respiratory Syncytial Virus in Children: An Out-of-Season Epidemic in Portugal. ACTA MEDICA PORT 2023; 36:343-352. [PMID: 36705636 DOI: 10.20344/amp.18589] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/13/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION An out-of-season increase in respiratory syncytial virus (RSV) incidence was observed in Portugal from June 2021 onwards, revealing a continuing surge in cases throughout 2021/2022 autumn/winter. We aimed to describe this out-of-season epidemic and define its epidemic period, by analysing RSV incidence from week 40 of 2020 (2020-W40) to week 18 of 2022 (2022-W18). MATERIAL AND METHODS Surveillance data on weekly RSV laboratory confirmed cases, in Portugal, was used to monitor RSV incidence using CUSUM test methodology for count data. RESULTS In 2021-W23, the CUSUM score identified a significant increase in the risk of RSV. By that time, the percentage of RSV positive tests rose from 1% in 2021-W22 (3/265) to 6% in 2021-W23 (18/298). Despite a sharp decrease in RSV incidence on 2021-W33 and on 2022-W02, the CUSUM score stayed over the limit up to 2022-W07, indicating that the RSV activity remained at an epidemic level. Distinct peaks of RSV cases were observed between 2021-W30 and 2021-W32 (average of 77 RSV cases per week) and between 2021-W39 and 2021-W41 (average of 79 RSV cases per week) with positivity rates around 60%. CONCLUSION An out-of-season RSV epidemic was identified, with a longer epidemic period compared with previous seasons. Possible reasons include relaxation of COVID-19 physical distancing measures and a greater proportion of population susceptible to disease. As several factors may change the pattern of RSV activity, countries should implement year-round surveillance RSV surveillance systems. These findings might have an impact on public health planning regarding future RSV surges, namely, on the palivizumab prophylaxis period for high-risk infants.
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Affiliation(s)
- Ana Rita Torres
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Raquel Guiomar Guiomar
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Nuno Verdasca
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Aryse Melo
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
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A multiplex-NGS approach to identifying respiratory RNA viruses during the COVID-19 pandemic. Arch Virol 2023; 168:87. [PMID: 36786897 PMCID: PMC9926447 DOI: 10.1007/s00705-023-05717-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/06/2023] [Indexed: 02/15/2023]
Abstract
A methodological approach based on reverse transcription (RT)-multiplex PCR followed by next-generation sequencing (NGS) was implemented to identify multiple respiratory RNA viruses simultaneously. A convenience sampling from respiratory surveillance and SARS-CoV-2 diagnosis in 2020 and 2021 in Montevideo, Uruguay, was analyzed. The results revealed the cocirculation of SARS-CoV-2 with human rhinovirus (hRV) A, B and C, human respiratory syncytial virus (hRSV) B, influenza A virus, and metapneumovirus B1. SARS-CoV-2 coinfections with hRV or hRSV B and influenza A virus coinfections with hRV C were identified in adults and/or children. This methodology combines the benefits of multiplex genomic amplification with the sensitivity and information provided by NGS. An advantage is that additional viral targets can be incorporated, making it a helpful tool to investigate the cocirculation and coinfections of respiratory viruses in pandemic and post-pandemic contexts.
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8
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Waterlow NR, Toizumi M, van Leeuwen E, Thi Nguyen HA, Myint-Yoshida L, Eggo RM, Flasche S. Evidence for influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study. PLoS Comput Biol 2022; 18:e1010234. [PMID: 35749561 PMCID: PMC9262224 DOI: 10.1371/journal.pcbi.1010234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/07/2022] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Influenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for impacts on heterologous viruses following vaccination. We aimed to estimate the population level impact of their interaction. We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit its parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam. The data supported either a 41% (95%CrI: 36–54) reduction in susceptibility following infection and for 10.0 days (95%CrI 7.1–12.8) thereafter, or no change in susceptibility following infection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0–11.4); or 16.6 fold (95%CrI 14.5–18.4) in the moderate or low interaction scenarios. Absence of either pathogen was not to the detriment of the other. We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other. Influenza and Respiratory Syncytial Virus (RSV) cause large burdens of disease. Instead of acting independently, there may be short term cross-protection between them. The evidence of this to date comes from ecological studies which are unable to test the mechanism, or biological studies that are unable to determine the population level impacts of such cross-protection. We create a mathematical model that simulates the circulation of these two viruses, and allows for cross-protection between them. We then fit this model to hospital reported cases of confirmed infection from Nha Trang, Vietnam in order to estimate whether any cross-protection exists in this setting. We show that there are two possibilities—either no interaction or moderate interaction that can result in the observed circulation patterns. However, we further show that co-infection results in an increased reporting rate, presumably due to increased severity.
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Affiliation(s)
- Naomi R. Waterlow
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Edwin van Leeuwen
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Statistics, Modelling and Economics Department, UKHSA, London, United Kingdom
| | | | - Lay Myint-Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Rosalind M. Eggo
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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9
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Off-season RSV epidemics in Australia after easing of COVID-19 restrictions. Nat Commun 2022; 13:2884. [PMID: 35610217 PMCID: PMC9130497 DOI: 10.1038/s41467-022-30485-3] [Citation(s) in RCA: 131] [Impact Index Per Article: 65.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Human respiratory syncytial virus (RSV) is an important cause of acute respiratory infection with the most severe disease in the young and elderly. Non-pharmaceutical interventions and travel restrictions for controlling COVID-19 have impacted the circulation of most respiratory viruses including RSV globally, particularly in Australia, where during 2020 the normal winter epidemics were notably absent. However, in late 2020, unprecedented widespread RSV outbreaks occurred, beginning in spring, and extending into summer across two widely separated regions of the Australian continent, New South Wales (NSW) and Australian Capital Territory (ACT) in the east, and Western Australia. Through genomic sequencing we reveal a major reduction in RSV genetic diversity following COVID-19 emergence with two genetically distinct RSV-A clades circulating cryptically, likely localised for several months prior to an epidemic surge in cases upon relaxation of COVID-19 control measures. The NSW/ACT clade subsequently spread to the neighbouring state of Victoria and to cause extensive outbreaks and hospitalisations in early 2021. These findings highlight the need for continued surveillance and sequencing of RSV and other respiratory viruses during and after the COVID-19 pandemic, as mitigation measures may disrupt seasonal patterns, causing larger or more severe outbreaks. Non-pharmaceutical interventions for COVID-19 also reduced incidence of respiratory pathogens such as respiratory syncytial virus (RSV). Here, the authors report the resurgence of RSV in Australia following lifting of some of the restrictions and describe reduction in genetic diversity in circulating clades.
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10
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Dai Y, Zhong J, Lan Y. Virus-virus interactions of febrile respiratory syndrome among patients in China based on surveillance data from February 2011 to December 2020. J Med Virol 2022; 94:4369-4377. [PMID: 35514049 DOI: 10.1002/jmv.27833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/17/2022] [Accepted: 05/02/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The burden of acute respiratory infections is still considerable, and virus-virus interactions may affect their epidemics, but previous evidence is inconclusive. OBJECTIVE To quantitatively investigate the interactions among respiratory viruses at both the population and individual levels. METHODS Cases tested for influenza virus (IV), respiratory syncytial virus (RSV), human parainfluenza virus (PIV), human Adenovirus (AdV), human coronavirus (CoV), human bocavirus (BoV) and rhinoviruses (RV) were collected from the pathogen surveillance for febrile respiratory syndrome (FRS) in China from February 2011 to December 2020. We used spearman's rank correlation coefficients and binary logistic regression models to analyze the interactions between any two of the viruses at the population and individual levels, respectively. RESULTS Among 120,237 cases, 4.5% were co-infected with two or more viruses. Correlation coefficients showed 7 virus pairs were positively correlated, namely: IV and RSV, PIV and AdV, PIV and CoV, PIV and BoV, PIV and RV, AdV and BoV, CoV and RV. Regression models showed except for the negative interaction between IV and RV (OR=0.70, 95%CI: 0.61-0.81), all other virus pairs had positive interactions. CONCLUSION Most of the respiratory viruses interact positively, while IV and RV interact negatively. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yucen Dai
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China, 610041
| | - Jiao Zhong
- Department of Occupational and Environmental Medicine, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China, 610041.,Department of Osteoporosis, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China, 610041
| | - Yajia Lan
- Department of Occupational and Environmental Medicine, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China, 610041
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11
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Abstract
Multiple respiratory viruses can concurrently or sequentially infect the respiratory tract and lead to virus‒virus interactions. Infection by a first virus could enhance or reduce infection and replication of a second virus, resulting in positive (additive or synergistic) or negative (antagonistic) interaction. The concept of viral interference has been demonstrated at the cellular, host, and population levels. The mechanisms involved in viral interference have been evaluated in differentiated airway epithelial cells and in animal models susceptible to the respiratory viruses of interest. A likely mechanism is the interferon response that could confer a temporary nonspecific immunity to the host. During the coronavirus disease pandemic, nonpharmacologic interventions have prevented the circulation of most respiratory viruses. Once the sanitary restrictions are lifted, circulation of seasonal respiratory viruses is expected to resume and will offer the opportunity to study their interactions, notably with severe acute respiratory syndrome coronavirus 2.
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12
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Domenech de Cellès M, Casalegno JS, Lina B, Opatowski L. Estimating the impact of influenza on the epidemiological dynamics of SARS-CoV-2. PeerJ 2021; 9:e12566. [PMID: 34950537 PMCID: PMC8647717 DOI: 10.7717/peerj.12566] [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: 06/04/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
As in past pandemics, co-circulating pathogens may play a role in the epidemiology of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In particular, experimental evidence indicates that influenza infection can up-regulate the expression of ACE2-the receptor of SARS-CoV-2 in human cells-and facilitate SARS-CoV-2 infection. Here we hypothesized that influenza impacted the epidemiology of SARS-CoV-2 during the early 2020 epidemic of COVID-19 in Europe. To test this hypothesis, we developed a population-based model of SARS-CoV-2 transmission and of COVID-19 mortality, which simultaneously incorporated the impact of non-pharmaceutical control measures and of influenza on the epidemiological dynamics of SARS-CoV-2. Using statistical inference methods based on iterated filtering, we confronted this model with mortality incidence data in four European countries (Belgium, Italy, Norway, and Spain) to systematically test a range of assumptions about the impact of influenza. We found consistent evidence for a 1.8-3.4-fold (uncertainty range across countries: 1.1 to 5.0) average population-level increase in SARS-CoV-2 transmission associated with influenza during the period of co-circulation. These estimates remained robust to a variety of alternative assumptions regarding the epidemiological traits of SARS-CoV-2 and the modeled impact of control measures. Although further confirmatory evidence is required, our results suggest that influenza could facilitate the spread and hamper effective control of SARS-CoV-2. More generally, they highlight the possible role of co-circulating pathogens in the epidemiology of COVID-19.
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Affiliation(s)
| | - Jean-Sebastien Casalegno
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Bruno Lina
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-Infective Evasion and Pharma- Coepidemiology Team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Evasion to Antibiotics, Paris, France
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13
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Abstract
Influenza virus infections are common in people of all ages. Epidemics occur in the winter months in temperate locations and at varying times of the year in subtropical and tropical locations. Most influenza virus infections cause mild and self-limiting disease, and around one-half of all infections occur with a fever. Only a small minority of infections lead to serious disease requiring hospitalization. During epidemics, the rates of influenza virus infections are typically highest in school-age children. The clinical severity of infections tends to increase at the extremes of age and with the presence of underlying medical conditions, and impact of epidemics is greatest in these groups. Vaccination is the most effective measure to prevent infections, and in recent years influenza vaccines have become the most frequently used vaccines in the world. Nonpharmaceutical public health measures can also be effective in reducing transmission, allowing suppression or mitigation of influenza epidemics and pandemics.
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Affiliation(s)
- Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon 35365, South Korea
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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14
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Lee YM, Kim T, Park KH, Choi SH, Kwak YG, Choo EJ, Chung JW, Lee MS. Dual respiratory virus detection in adult patients with acute respiratory illness. BMC Infect Dis 2021; 21:997. [PMID: 34556046 PMCID: PMC8460188 DOI: 10.1186/s12879-021-06699-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nonrandom multiple respiratory virus (RV) detection provides evidence for viral interference among respiratory viruses. However, little is known as to whether it occurs randomly. METHODS The prevalence of dual RV detection (DRVD) in patients with acute respiratory illnesses (ARIs) at 4 academic medical centers was investigated; data about the prevalence of 8 RVs were collected from the Korean national RV surveillance dataset. Linear regression analysis was performed to assess the correlation between observed and estimated prevalence of each type of DRVD. RESULTS In total, 108 patients with ARIs showing DRVD were included in this study between 2011 and 2017. In several types of regression analysis, a strong correlation was observed between the observed and estimated prevalence of each type of DRVD. Excluding three DRVD types (influenza/picornavirus, influenza/human metapneumovirus, and adenovirus/respiratory syncytial virus), the slope of the regression line was higher than that of the line of random occurrence (1.231 > 1.000) and the 95% confidence interval of the regression line was located above the line of random occurrence. CONCLUSIONS Contrary to the results of previous epidemiologic studies, most types of DRVD occur more frequently than expected from the prevalence rates of individual RV, except for three underrepresented pairs above.
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Affiliation(s)
- Yu-Mi Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Tark Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Ki-Ho Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Seong-Ho Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
| | - Yee Gyung Kwak
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Eun Ju Choo
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jin-Won Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Mi Suk Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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15
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Kiseleva I, Ksenafontov A. COVID-19 Shuts Doors to Flu but Keeps Them Open to Rhinoviruses. BIOLOGY 2021; 10:biology10080733. [PMID: 34439965 PMCID: PMC8389621 DOI: 10.3390/biology10080733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 12/23/2022]
Abstract
Simple Summary Ten years have passed since the beginning of the H1N1pdm09 flu pandemic. No sooner had humanity recovered from its consequences than a new attack came—the COVID-19 pandemic. What happens to other respiratory infectious diseases during a global disaster such as the COVID-19 pandemic? The pandemic brought about by the novel SARS-CoV-2 virus has disrupted many well-established epidemiological and pathogenetic relationships, as well as mechanisms affecting infections with other respiratory viruses. The level of circulation of many respiratory pathogens has changed significantly. For instance, global influenza activity is at much lower levels than expected. In many regions, the influenza season has not started. Intriguingly, the COVID-19 pandemic did not substantially affect the spread of human rhinoviruses. In this review, the main properties of epidemiologically significant respiratory viruses such as SARS-CoV-2, influenza virus, and human rhinovirus are described. Abstract It is well known that rhinoviruses are distributed across the globe and are the most common cause of the common cold in all age groups. Rhinoviruses are widely considered to be harmless because they are generally perceived as respiratory viruses only capable of causing mild disease. However, they may also infect the lower respiratory tract, inducing chronic obstructive pulmonary disease and exacerbations of asthma, bronchiolitis, etc. The role of rhinoviruses in pathogenesis and the epidemiological process is underestimated, and they need to be intensively studied. In the light of recent data, it is now known that rhinoviruses could be one of the key epidemiological barriers that may influence the spread of influenza and novel coronaviruses. It has been reported that endemic human rhinoviruses delayed the development of the H1N1pdm09 influenza pandemic through viral interference. Moreover, human rhinoviruses have been suggested to block SARS-CoV-2 replication in the airways by triggering an interferon response. In this review, we summarized the main biological characteristics of genetically distinct viruses such as rhinoviruses, influenza viruses, and SARS-CoV-2 in an attempt to illuminate their main discrepancies and similarities. We hope that this comparative analysis will help us to better understand in which direction research in this area should move.
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Affiliation(s)
- Irina Kiseleva
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia
- Correspondence:
| | - Andrey Ksenafontov
- Department of Etiology and Epidemiology, Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia;
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16
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Social Distancing, Lockdown and the Wide Use of Mask; A Magic Solution or a Double-Edged Sword for Respiratory Viruses Epidemiology? Vaccines (Basel) 2021; 9:vaccines9060595. [PMID: 34205119 PMCID: PMC8228489 DOI: 10.3390/vaccines9060595] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022] Open
Abstract
The use of non-pharmaceutical interventions (NPIs), such as social distancing, lockdowns and the massive use of masks, have not only largely prevented the spread of SARS-CoV-2, but also of other respiratory viruses such as influenza or respiratory syncytial virus (RSV). This decrease has been so high that, in most countries, the influenza and RSV epidemic has not occurred. Far from being a beneficial fact, this can be problematic, since the absence of circulation of certain pathogens can lead to a decrease in herd immunity against them. This can promote the rise of more serious, longer-lasting epidemics that start sooner. To alleviate the collateral effects that may occur due to the decrease in circulation of viruses such as influenza, it is necessary to increase the production of influenza vaccines, carry out mass vaccination campaigns and focus on vaccinating the main drivers of this virus, children.
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17
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Waterlow NR, Flasche S, Minter A, Eggo RM. Competition between RSV and influenza: Limits of modelling inference from surveillance data. Epidemics 2021; 35:100460. [PMID: 33838587 PMCID: PMC8193815 DOI: 10.1016/j.epidem.2021.100460] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/28/2022] Open
Abstract
Respiratory Syncytial Virus (RSV) and Influenza cause a large burden of disease. Evidence of their interaction via temporary cross-protection implies that prevention of one could inadvertently lead to an increase in the burden of the other. However, evidence for the public health impact of such interaction is sparse and largely derives from ecological analyses of peak shifts in surveillance data. To test the robustness of estimates of interaction parameters between RSV and Influenza from surveillance data we conducted a simulation and back-inference study. We developed a two-pathogen interaction model, parameterised to simulate RSV and Influenza epidemiology in the UK. Using the infection model in combination with a surveillance-like stochastic observation process we generated a range of possible RSV and Influenza trajectories and then used Markov Chain Monte Carlo (MCMC) methods to back-infer parameters including those describing competition. We find that in most scenarios both the strength and duration of RSV and Influenza interaction could be estimated from the simulated surveillance data reasonably well. However, the robustness of inference declined towards the extremes of the plausible parameter ranges, with misleading results. It was for instance not possible to tell the difference between low/moderate interaction and no interaction. In conclusion, our results illustrate that in a plausible parameter range, the strength of RSV and Influenza interaction can be estimated from a single season of high-quality surveillance data but also highlights the importance to test parameter identifiability a priori in such situations.
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Affiliation(s)
- Naomi R Waterlow
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK.
| | - Stefan Flasche
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
| | - Amanda Minter
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
| | - Rosalind M Eggo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
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18
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Boechat JL, Wandalsen GF, Kuschnir FC, Delgado L. COVID-19 and Pediatric Asthma: Clinical and Management Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031093. [PMID: 33530624 PMCID: PMC7908623 DOI: 10.3390/ijerph18031093] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 12/15/2022]
Abstract
Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents than on adults. Fever, cough and shortness of breath are the most common symptoms and signs in children; wheezing has not been frequently reported. Published studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This hypothesis raises two issues: is asthma (and/or atopy) an independent protective factor for COVID-19? If yes, why? Explanations for this could include the lower IFN-α production, protective role of eosinophils in the airway, and antiviral and immunomodulatory proprieties of inhaled steroids. Additionally, recent evidence supports that allergic sensitization is inversely related to ACE2 expression. Obesity is a known risk factor for COVID-19 in adults. However, in the childhood asthma–obesity phenotype, the classic atopic Th2 pattern seems to predominate, which could hypothetically be a protective factor for severe SARS-CoV-2 infection in children with both conditions. Finally, the return to school activities raises concerns, as asymptomatic children could act as vectors for the spread of the disease. Although this is still a controversial topic, the identification and management of asymptomatic children is an important approach during the SARS-CoV-2 epidemic. Focus on asthma control, risk stratification, and medication adherence will be essential to allow children with asthma to return safely to school.
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Affiliation(s)
- José Laerte Boechat
- Clinical Immunology Service, Internal Medicine Department, Faculty of Medicine, Universidade Federal Fluminense, Niterói 24070-035, Brazil
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal;
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
- Correspondence:
| | - Gustavo Falbo Wandalsen
- Department of Pediatrics, Faculty of Medicine, Universidade Federal de Sao Paulo, São Paulo 04025-002, Brazil;
| | - Fabio Chigres Kuschnir
- Department of Pediatrics, Faculty of Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20943-000, Brazil;
| | - Luís Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal;
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
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19
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COVID-19 in Light of Seasonal Respiratory Infections. BIOLOGY 2020; 9:biology9090240. [PMID: 32825427 PMCID: PMC7564908 DOI: 10.3390/biology9090240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/23/2022]
Abstract
A wide diversity of zoonotic viruses that are capable of overcoming host range barriers facilitate the emergence of new potentially pandemic viruses in the human population. When faced with a new virus that is rapidly emerging in the human population, we have a limited knowledge base to work with. The pandemic invasion of the new SARS-CoV-2 virus in 2019 provided a unique possibility to quickly learn more about the pathogenesis of respiratory viruses. In this review, the impact of pandemics on the circulation of seasonal respiratory viruses is considered. The emergence of novel respiratory viruses has often been accompanied by the disappearance of existing circulating strains. Some issues arising from the spread of pandemic viruses and underlying the choices of a strategy to fight the coronavirus infection are discussed.
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20
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Virus-virus interactions impact the population dynamics of influenza and the common cold. Proc Natl Acad Sci U S A 2019; 116:27142-27150. [PMID: 31843887 PMCID: PMC6936719 DOI: 10.1073/pnas.1911083116] [Citation(s) in RCA: 267] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
When multiple pathogens cocirculate this can lead to competitive or cooperative forms of pathogen–pathogen interactions. It is believed that such interactions occur among cold and flu viruses, perhaps through broad-acting immunity, resulting in interlinked epidemiological patterns of infection. However, to date, quantitative evidence has been limited. We analyzed a large collection of diagnostic reports collected over multiple years for 11 respiratory viruses. Our analyses provide strong statistical support for the existence of interactions among respiratory viruses. Using computer simulations, we found that very short-lived interferences may explain why common cold infections are less frequent during flu seasons. Improved understanding of how the epidemiology of viral infections is interlinked can help improve disease forecasting and evaluation of disease control interventions. The human respiratory tract hosts a diverse community of cocirculating viruses that are responsible for acute respiratory infections. This shared niche provides the opportunity for virus–virus interactions which have the potential to affect individual infection risks and in turn influence dynamics of infection at population scales. However, quantitative evidence for interactions has lacked suitable data and appropriate analytical tools. Here, we expose and quantify interactions among respiratory viruses using bespoke analyses of infection time series at the population scale and coinfections at the individual host scale. We analyzed diagnostic data from 44,230 cases of respiratory illness that were tested for 11 taxonomically broad groups of respiratory viruses over 9 y. Key to our analyses was accounting for alternative drivers of correlated infection frequency, such as age and seasonal dependencies in infection risk, allowing us to obtain strong support for the existence of negative interactions between influenza and noninfluenza viruses and positive interactions among noninfluenza viruses. In mathematical simulations that mimic 2-pathogen dynamics, we show that transient immune-mediated interference can cause a relatively ubiquitous common cold-like virus to diminish during peak activity of a seasonal virus, supporting the potential role of innate immunity in driving the asynchronous circulation of influenza A and rhinovirus. These findings have important implications for understanding the linked epidemiological dynamics of viral respiratory infections, an important step towards improved accuracy of disease forecasting models and evaluation of disease control interventions.
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21
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Al-Romaihi HE, Smatti MK, Ganesan N, Nadeem S, Farag E, Coyle PV, Nader JD, Al-Khatib HA, Elmagboul EB, Al Dhahry S, Al-Marri SA, Al Thani AA, Al Khal A, Al Maslamani MA, Yassine HM. Epidemiology of respiratory infections among adults in Qatar (2012-2017). PLoS One 2019; 14:e0218097. [PMID: 31194775 PMCID: PMC6563968 DOI: 10.1371/journal.pone.0218097] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/24/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Limited data is available about the etiology of influenza like illnesses (ILIs) in Qatar. OBJECTIVES This study aimed at providing preliminary estimates of influenza and other respiratory infections circulating among adults in Qatar. METHODS We retrospectively collected data of about 44,000 patients who visited Hamad General Hospital clinics, sentinel sites, and all primary healthcare centers in Qatar between 2012 and 2017. All samples were tested for influenza viruses, whereas about 38,000 samples were tested for influenza and a panel of respiratory viruses using Fast Track Diagnostics (FTD) RT-PCR kit. RESULTS Among all ILIs cases, 20,278 (46.5%) tested positive for at least one respiratory pathogen. Influenza virus was predominating (22.6%), followed by human rhinoviruses (HRVs) (9.5%), and human coronaviruses (HCoVs) (5%). A detection rate of 2-3% was recorded for mycoplasma pneumonia, adenoviruses, human parainfluenza viruses (HPIVs), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ILIs cases were reported throughout the year, however, influenza, RSV, and HMPV exhibited strong seasonal peaks in the winter, while HRVs circulated more during fall and spring. Elderly (>50 years) had the lowest rates of influenza A (13.9%) and B (4.2%), while presenting the highest rates of RSV (3.4%) and HMPV (3.3%). While males had higher rates of HRVs (11.9%), enteroviruses (1.1%) and MERS CoV (0.2%), females had higher proportions of influenza (26.3%), HPIVs (3.2%) and RSV (3.6%) infections. CONCLUSION This report provides a comprehensive insight about the epidemiology of ILIs among adults in the Qatar, as a representative of Gulf States. These results would help in improvement and optimization of diagnostic procedures, as well as control and prevention of the respiratory infections.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Asmaa A. Al Thani
- Biomedical Research Center, Qatar University, Doha, Qatar
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | - Hadi M. Yassine
- Biomedical Research Center, Qatar University, Doha, Qatar
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- * E-mail: (MAA); (HMY)
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22
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Price OH, Sullivan SG, Sutterby C, Druce J, Carville KS. Using routine testing data to understand circulation patterns of influenza A, respiratory syncytial virus and other respiratory viruses in Victoria, Australia. Epidemiol Infect 2019; 147:e221. [PMID: 31364539 PMCID: PMC6625191 DOI: 10.1017/s0950268819001055] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/18/2019] [Accepted: 03/27/2019] [Indexed: 12/29/2022] Open
Abstract
Several studies have reported evidence of interference between respiratory viruses: respiratory viruses rarely reach their epidemic peak concurrently and there appears to be a negative association between infection with one respiratory virus and co-infection with another. We used results spanning 16 years (2002-2017) of a routine diagnostic multiplex panel that tests for nine respiratory viruses to further investigate these interactions in Victoria, Australia. Time series analyses were used to plot the proportion positive for each virus. The seasonality of all viruses included was compared with respiratory syncytial virus (RSV) and influenza A virus using cross-correlations. Logistic regression was used to explore the likelihood of co-infection with one virus given infection with another. Seasonal peaks were observed each year for influenza A and RSV and less frequently for influenza B, coronavirus and parainfluenza virus. RSV circulated an average of 6 weeks before influenza A. Co-infection with another respiratory virus was less common with picornavirus, RSV or influenza A infection. Our findings provide further evidence of a temporal relationship in the circulation of respiratory viruses. A greater understanding of the interaction between respiratory viruses may enable better prediction of the timing and magnitude of respiratory virus epidemics.
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Affiliation(s)
- O. H. Price
- WHO Collaborating Centre for Reference and Research on Influenza, at the Peter Doherty Institute for Infection and Immunity, Victoria 3000, Australia
| | - S. G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, at the Peter Doherty Institute for Infection and Immunity, Victoria 3000, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - C. Sutterby
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - J. Druce
- Victorian Infectious Diseases Reference Laboratory, at the Peter Doherty Institute for Infection and Immunity, Victoria 3000, Australia
| | - K. S. Carville
- Victorian Infectious Diseases Reference Laboratory, at the Peter Doherty Institute for Infection and Immunity, Victoria 3000, Australia
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23
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Pisareva MM, Eder VA, Buzitskaya ZV, Musaeva TD, Afanaseva VS, Go AA, Obraztsova EA, Sukhovetskaya VF, Komissarov AB. [Etiological structure of influenza and other ARVI in St. Petersburg during epidemic seasons 2012-2016.]. Vopr Virusol 2018; 63:233-239. [PMID: 30550100 DOI: 10.18821/0507-4088-2018-63-5-233-239] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/06/2018] [Indexed: 11/17/2022]
Abstract
The etiological structure of influenza and other acute respiratory viral infections including their rate of incidence in St. Petersburg and Leningrad region during 4 epidemic seasons has been studied. Seasonality of some respiratory viruses was shown and peaks of circulation of RSV, adenovirus, parainfluenza viruses, rhinovirus, bocavirus, metapneumovirus and coronavirus were marked. The interference of influenza A viruses and RSV, RSV and rhinoviruses was highlighted. A high incidence of adenovirus infection in organized communities and RSV infection in children was revealed.
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Affiliation(s)
- M M Pisareva
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - V A Eder
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - Zh V Buzitskaya
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - T D Musaeva
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - V S Afanaseva
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - A A Go
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - E A Obraztsova
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - V F Sukhovetskaya
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
| | - A B Komissarov
- Federal State Research Institute of Influenza, St. Petersburg, 197376, Russian Federation
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24
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Lam HM, Wesolowski A, Hung NT, Nguyen TD, Nhat NTD, Todd S, Vinh DN, Vy NHT, Thao TTN, Thanh NTL, Tin PT, Minh NNQ, Bryant JE, Buckee CO, Ngoc TV, Chau NVV, Thwaites GE, Farrar J, Tam DTH, Vinh H, Boni MF. Nonannual seasonality of influenza-like illness in a tropical urban setting. Influenza Other Respir Viruses 2018; 12:742-754. [PMID: 30044029 PMCID: PMC6185894 DOI: 10.1111/irv.12595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In temperate and subtropical climates, respiratory diseases exhibit seasonal peaks in winter. In the tropics, with no winter, peak timings are irregular. METHODS To obtain a detailed picture of influenza-like illness (ILI) patterns in the tropics, we established an mHealth study in community clinics in Ho Chi Minh City (HCMC). During 2009-2015, clinics reported daily case numbers via SMS, with a subset performing molecular diagnostics for influenza virus. This real-time epidemiology network absorbs 6000 ILI reports annually, one or two orders of magnitude more than typical surveillance systems. A real-time online ILI indicator was developed to inform clinicians of the daily ILI activity in HCMC. RESULTS From August 2009 to December 2015, 63 clinics were enrolled and 36 920 SMS reports were received, covering approximately 1.7M outpatient visits. Approximately 10.6% of outpatients met the ILI case definition. ILI activity in HCMC exhibited strong nonannual dynamics with a dominant periodicity of 206 days. This was confirmed by time series decomposition, stepwise regression, and a forecasting exercise showing that median forecasting errors are 30%-40% lower when using a 206-day cycle. In ILI patients from whom nasopharyngeal swabs were taken, 31.2% were positive for influenza. There was no correlation between the ILI time series and the time series of influenza, influenza A, or influenza B (all P > 0.15). CONCLUSION This suggests, for the first time, that a nonannual cycle may be an essential driver of respiratory disease dynamics in the tropics. An immunological interference hypothesis is discussed as a potential underlying mechanism.
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Affiliation(s)
- Ha Minh Lam
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Amy Wesolowski
- Center for Communicable Disease DynamicsDepartment of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusetts
- Department of Ecology and Evolutionary BiologyPrinceton UniversityPrincetonNew Jersey
| | - Nguyen Thanh Hung
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Tran Dang Nguyen
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Thi Duy Nhat
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Stacy Todd
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Liverpool School of Tropical MedicineLiverpoolUK
| | - Dao Nguyen Vinh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Ha Thao Vy
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Tran Thi Nhu Thao
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Nguyen Thi Le Thanh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | | | - Ngo Ngoc Quang Minh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Children's Hospital No. 1Ho Chi Minh CityVietnam
| | - Juliet E. Bryant
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Caroline O. Buckee
- Center for Communicable Disease DynamicsDepartment of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - Tran Van Ngoc
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | | | - Guy E. Thwaites
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Jeremy Farrar
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Wellcome TrustLondonUK
| | - Dong Thi Hoai Tam
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
| | - Ha Vinh
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
- Department of Infectious DiseasesPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Maciej F. Boni
- Oxford University Clinical Research UnitWellcome Trust Major Overseas ProgrammeHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK
- Center for Infectious Disease DynamicsDepartment of BiologyPennsylvania State UniversityUniversity ParkPennsylvania
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Rikin S, Jia H, Vargas CY, Castellanos de Belliard Y, Reed C, LaRussa P, Larson EL, Saiman L, Stockwell MS. Assessment of temporally-related acute respiratory illness following influenza vaccination. Vaccine 2018. [PMID: 29525279 PMCID: PMC7115556 DOI: 10.1016/j.vaccine.2018.02.105] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We investigated risk of acute respiratory illness post-influenza vaccination. Post-vaccination risk of non-influenza respiratory pathogen was higher in children. Patient perceptions of illness following influenza vaccination may be supported. Assessments of potential mechanisms for findings are needed.
Background A barrier to influenza vaccination is the misperception that the inactivated vaccine can cause influenza. Previous studies have investigated the risk of acute respiratory illness (ARI) after influenza vaccination with conflicting results. We assessed whether there is an increased rate of laboratory-confirmed ARI in post-influenza vaccination periods. Methods We conducted a cohort sub-analysis of children and adults in the MoSAIC community surveillance study from 2013 to 2016. Influenza vaccination was confirmed through city or hospital registries. Cases of ARI were ascertained by twice-weekly text messages to household to identify members with ARI symptoms. Nasal swabs were obtained from ill participants and analyzed for respiratory pathogens using multiplex PCR. The primary outcome measure was the hazard ratio of laboratory-confirmed ARI in individuals post-vaccination compared to other time periods during three influenza seasons. Results Of the 999 participants, 68.8% were children, 30.2% were adults. Each study season, approximately half received influenza vaccine and one third experienced ≥1 ARI. The hazard of influenza in individuals during the 14-day post-vaccination period was similar to unvaccinated individuals during the same period (HR 0.96, 95% CI [0.60, 1.52]). The hazard of non-influenza respiratory pathogens was higher during the same period (HR 1.65, 95% CI [1.14, 2.38]); when stratified by age the hazard remained higher for children (HR 1·71, 95% CI [1.16, 2.53]) but not for adults (HR 0.88, 95% CI [0.21, 3.69]). Conclusion Among children there was an increase in the hazard of ARI caused by non-influenza respiratory pathogens post-influenza vaccination compared to unvaccinated children during the same period. Potential mechanisms for this association warrant further investigation. Future research could investigate whether medical decision-making surrounding influenza vaccination may be improved by acknowledging patient experiences, counseling regarding different types of ARI, and correcting the misperception that all ARI occurring after vaccination are caused by influenza.
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Affiliation(s)
- Sharon Rikin
- Department of Medicine, Columbia University, New York, NY, USA
| | - Haomiao Jia
- School of Nursing, Columbia University, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philip LaRussa
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Elaine L Larson
- School of Nursing, Columbia University, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Saiman
- Department of Pediatrics, Columbia University, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA
| | - Melissa S Stockwell
- Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Pediatrics, Columbia University, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA.
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Opatowski L, Baguelin M, Eggo RM. Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling. PLoS Pathog 2018; 14:e1006770. [PMID: 29447284 PMCID: PMC5814058 DOI: 10.1371/journal.ppat.1006770] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Evidence is mounting that influenza virus interacts with other pathogens colonising or infecting the human respiratory tract. Taking into account interactions with other pathogens may be critical to determining the real influenza burden and the full impact of public health policies targeting influenza. This is particularly true for mathematical modelling studies, which have become critical in public health decision-making. Yet models usually focus on influenza virus acquisition and infection alone, thereby making broad oversimplifications of pathogen ecology. Herein, we report evidence of influenza virus interactions with bacteria and viruses and systematically review the modelling studies that have incorporated interactions. Despite the many studies examining possible associations between influenza and Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Neisseria meningitidis, respiratory syncytial virus (RSV), human rhinoviruses, human parainfluenza viruses, etc., very few mathematical models have integrated other pathogens alongside influenza. The notable exception is the pneumococcus-influenza interaction, for which several recent modelling studies demonstrate the power of dynamic modelling as an approach to test biological hypotheses on interaction mechanisms and estimate the strength of those interactions. We explore how different interference mechanisms may lead to unexpected incidence trends and possible misinterpretation, and we illustrate the impact of interactions on public health surveillance using simple transmission models. We demonstrate that the development of multipathogen models is essential to assessing the true public health burden of influenza and that it is needed to help improve planning and evaluation of control measures. Finally, we identify the public health, surveillance, modelling, and biological challenges and propose avenues of research for the coming years.
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Affiliation(s)
- Lulla Opatowski
- Université de Versailles Saint Quentin, Institut Pasteur, Inserm, Paris, France
| | - Marc Baguelin
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Public Health England, London, United Kingdom
| | - Rosalind M. Eggo
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Zheng X, Song Z, Li Y, Zhang J, Wang XL. Possible interference between seasonal epidemics of influenza and other respiratory viruses in Hong Kong, 2014-2017. BMC Infect Dis 2017; 17:772. [PMID: 29246199 PMCID: PMC5732536 DOI: 10.1186/s12879-017-2888-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/06/2017] [Indexed: 12/03/2022] Open
Abstract
Background Unlike influenza viruses, little is known about the prevalence and seasonality of other respiratory viruses because laboratory surveillance for non-influenza respiratory viruses is not well developed or supported in China and other resource-limited countries. We studied the interference between seasonal epidemics of influenza viruses and five other common viruses that cause respiratory illnesses in Hong Kong from 2014 to 2017. Methods The weekly laboratory-confirmed positive rates of each virus were analyzed from 2014 to 2017 in Hong Kong to describe the epidemiological trends and interference between influenza viruses, respiratory syncytial virus (RSV), parainfluenza virus (PIV), adenovirus, enterovirus and rhinovirus. A sinusoidal model was established to estimate the peak timing of each virus by phase angle parameters. Results Seasonal features of the influenza viruses, PIV, enterovirus and adenovirus were obvious, whereas annual peaks of RSV and rhinovirus were not observed. The incidence of the influenza viruses usually peaked in February and July, and the summer peaks in July were generally caused by the H3 subtype of influenza A alone. When influenza viruses were active, other viruses tended to have a low level of activity. The peaks of the influenza viruses were not synchronized. An epidemic of rhinovirus tended to shift the subsequent epidemics of the other viruses. Conclusion The evidence from recent surveillance data in Hong Kong suggests that viral interference during the epidemics of influenza viruses and other common respiratory viruses might affect the timing and duration of subsequent epidemics of a certain or several viruses.
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Affiliation(s)
- Xueying Zheng
- Department of Biostatistics and Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Zhengyu Song
- Department of Biostatistics and Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yapeng Li
- Department of Biostatistics and Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Juanjuan Zhang
- Department of Biostatistics and Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Xi-Ling Wang
- Department of Biostatistics and Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China. .,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. .,Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
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28
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Liu XX, Qin G, Li X, Zhang J, Zhao K, Hu M, Wang XL. Excess mortality associated with influenza after the 2009 H1N1 pandemic in a subtropical city in China, 2010–2015. Int J Infect Dis 2017; 57:54-60. [DOI: 10.1016/j.ijid.2017.01.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 11/17/2022] Open
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van Asten L, Bijkerk P, Fanoy E, van Ginkel A, Suijkerbuijk A, van der Hoek W, Meijer A, Vennema H. Early occurrence of influenza A epidemics coincided with changes in occurrence of other respiratory virus infections. Influenza Other Respir Viruses 2016; 10:14-26. [PMID: 26369646 PMCID: PMC4687500 DOI: 10.1111/irv.12348] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Viral interaction in which outbreaks of influenza and other common respiratory viruses might affect each other has been postulated by several short studies. Regarding longer time periods, influenza epidemics occasionally occur very early in the season, as during the 2009 pandemic. Whether early occurrence of influenza epidemics impacts outbreaks of other common seasonal viruses is not clear. OBJECTIVES We investigated whether early occurrence of influenza outbreaks coincides with shifts in the occurrence of other common viruses, including both respiratory and non-respiratory viruses. METHODS We investigated time trends of and the correlation between positive laboratory diagnoses of eight common viruses in the Netherlands over a 10-year time period (2003-2012): influenza viruses types A and B, respiratory syncytial virus (RSV), rhinovirus, coronavirus, norovirus, enterovirus, and rotavirus. We compared trends in viruses between early and late influenza seasons. RESULTS Between 2003 and 2012, influenza B, RSV, and coronavirus showed shifts in their occurrence when influenza A epidemics occurred earlier than usual (before week 1). Although shifts were not always consistently of the same type, when influenza type A hit early, RSV outbreaks tended to be delayed, coronavirus outbreaks tended to be intensified, and influenza virus type B tended not to occur at all. Occurrence of rhinovirus, norovirus, rotavirus, and enterovirus did not change. CONCLUSION When influenza A epidemics occured early, timing of the epidemics of several respiratory winter viruses usually occurring close in time to influenza A was affected, while trends in rhinoviruses (occurring in autumn) and trends in enteral viruses were not.
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Affiliation(s)
- Liselotte van Asten
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Paul Bijkerk
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ewout Fanoy
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Annemarijn van Ginkel
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Anita Suijkerbuijk
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Harry Vennema
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Hamilton JR, Sachs D, Lim JK, Langlois RA, Palese P, Heaton NS. Club cells surviving influenza A virus infection induce temporary nonspecific antiviral immunity. Proc Natl Acad Sci U S A 2016; 113:3861-6. [PMID: 27001854 PMCID: PMC4833272 DOI: 10.1073/pnas.1522376113] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A brief window of antigen-nonspecific protection has been observed after influenza A virus (IAV) infection. Although this temporary immunity has been assumed to be the result of residual nonspecific inflammation, this period of induced immunity has not been fully studied. Because IAV has long been characterized as a cytopathic virus (based on its ability to rapidly lyse most cell types in culture), it has been a forgone conclusion that directly infected cells could not be contributing to this effect. Using a Cre recombinase-expressing IAV, we have previously shown that club cells can survive direct viral infection. We show here not only that these cells can eliminate all traces of the virus and survive but also that they acquire a heightened antiviral response phenotype after surviving. Moreover, we experimentally demonstrate temporary nonspecific viral immunity after IAV infection and show that surviving cells are required for this phenotype. This work characterizes a virally induced modulation of the innate immune response that may represent a new mechanism to prevent viral diseases.
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Affiliation(s)
- Jennifer R Hamilton
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - David Sachs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Ryan A Langlois
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029; Department of Microbiology and Immunology, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Nicholas S Heaton
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029; Department of Molecular Genetics and Microbiology, Duke University, Durham, NC 27710
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Similar virus spectra and seasonality in paediatric patients with acute respiratory disease, Ghana and Germany. Clin Microbiol Infect 2015; 22:340-346. [PMID: 26585774 PMCID: PMC7172147 DOI: 10.1016/j.cmi.2015.11.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/22/2015] [Accepted: 11/03/2015] [Indexed: 11/22/2022]
Abstract
Epidemiological differences between tropical and temperate regions regarding viruses causing acute respiratory infection are poorly understood. This is in part because methodological differences limit the comparability of data from these two regions. Using identical molecular detection methods, we tested 1174 Ghanaian and 539 German children with acute respiratory infections sampled over 12 months for the 15 most common respiratory viruses by PCR. A total 43.2% of the Ghanaian and 56.6% of the German children tested positive for at least one respiratory virus. The pneumoviruses respiratory syncytial virus and human metapneumovirus were most frequently detected, in 13.1% and 25.1% within the Ghanaian and German children, respectively. At both study sites, pneumoviruses were more often observed at younger ages (p <0.001). In the Ghanaian rainy season, enveloped viruses were detected twice as often as non-enveloped viruses (prevalence rate ratio (PR) 2.0, 95% CI 1.7-2.4). In contrast, non-enveloped viruses were more frequent during the Ghanaian dry season (PR 0.6, 95% CI 0.4-0.8). In Germany, enveloped viruses were also more frequently detected during the relatively colder winter season (PR 1.6, 95% CI 1.2-2.1) and non-enveloped viruses during summer (PR 0.7, 95% CI 0.5-0.9). Despite a distance of about 5000 km and a difference of 44° latitude separating Germany and Ghana, virus spectra, age associations and seasonal fluctuation showed similarities between sites. Neither respiratory viruses overall, nor environmentally stable (non-enveloped) viruses in particular were more frequent in tropical Ghana. The standardization of our sampling and laboratory testing revealed similarities in acute respiratory infection virus patterns in tropical and temperate climates.
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Otomaru H, Kamigaki T, Tamaki R, Opinion J, Santo A, Daya E, Okamoto M, Saito M, Tallo V, Lupisan S, Suzuki A, Oshitani H. Influenza and other respiratory viruses detected by influenza-like illness surveillance in Leyte Island, the Philippines, 2010-2013. PLoS One 2015; 10:e0123755. [PMID: 25893441 PMCID: PMC4404362 DOI: 10.1371/journal.pone.0123755] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/23/2015] [Indexed: 01/06/2023] Open
Abstract
This study aimed to determine the role of influenza-like illness (ILI) surveillance conducted on Leyte Island, the Philippines, including involvement of other respiratory viruses, from 2010 to 2013. ILI surveillance was conducted from January 2010 to March 2013 with 3 sentinel sites located in Tacloban city, Palo and Tanauan of Leyte Island. ILI was defined as fever ≥38°C or feverish feeling and either cough or running nose in a patient of any age. Influenza virus and other 5 respiratory viruses were searched. A total of 5,550 ILI cases visited the 3 sites and specimens were collected from 2,031 (36.6%) cases. Among the cases sampled, 1,637 (75.6%) were children aged <5 years. 874 (43.0%) cases were positive for at least one of the respiratory viruses tested. Influenza virus and respiratory syncytial virus (RSV) were predominantly detected (both were 25.7%) followed by human rhinovirus (HRV) (17.5%). The age distributions were significantly different between those who were positive for influenza, HRV, and RSV. ILI cases were reported throughout the year and influenza virus was co-detected with those viruses on approximately half of the weeks of study period (RSV in 60.5% and HRV 47.4%). In terms of clinical manifestations, only the rates of headache and sore throat were significantly higher in influenza positive cases than cases positive to other viruses. In conclusion, syndromic ILI surveillance in this area is difficult to detect the start of influenza epidemic without laboratory confirmation which requires huge resources. Age was an important factor that affected positive rates of influenza and other respiratory viruses. Involvement of older age children may be useful to detect influenza more effectively.
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Affiliation(s)
- Hirono Otomaru
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Taro Kamigaki
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
- * E-mail:
| | - Raita Tamaki
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Jamie Opinion
- Tacloban City Health Office, Tacloban City, the Philippines
| | - Arlene Santo
- Tanauan Rural Health Unit, Tanauan, the Philippines
| | - Edgard Daya
- Leyte Provincial Health Office, Palo, the Philippines
| | - Michiko Okamoto
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Mariko Saito
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
- Tohoku-RITM Research Center for Emerging and Reemerging Infections, Muntinlupa City, the Philippines
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Soccoro Lupisan
- Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Akira Suzuki
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
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Zhou Y, Cowling BJ, Wu P, Chan WM, Lee SY, Lau EHY, Schooling CM. Adiposity and influenza-associated respiratory mortality: a cohort study. Clin Infect Dis 2015; 60:e49-57. [PMID: 25645211 DOI: 10.1093/cid/civ060] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/17/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Obesity was first noted as a risk factor for severe illness associated with pandemic H1N1 infection in 2009, but the relationship between obesity and seasonal influenza remains unclear. METHODS We used data from a population-based cohort comprising 66 820 older (≥65 years) participants with a follow-up period from 1998 to 2012. The impact of influenza activity on respiratory mortality rates was estimated using a Cox proportional hazards model adjusted for comorbidities, meteorological factors, and other co-circulating respiratory viruses. We also tested whether the association of influenza with respiratory mortality varied with obesity and/or health status. As a control outcome, we similarly assessed the association of influenza with deaths from external causes, because these deaths should be unrelated to influenza. RESULTS Seasonal influenza activity was associated with higher respiratory mortality (hazard ratio [HR], 1.13 for influenza activity in the influenza season vs noninfluenza season; 95% confidence interval [CI], 1.05-1.22). The effect of seasonal influenza was 19% greater in obese individuals than normal-weight individuals (HR, 1.19; 95% CI, 1.01-1.42). The marginally significant and greater effect modification of obesity status on the association between seasonal influenza and respiratory mortality was also observed among older people in good health (HR, 1.35; 95% CI, .97-1.87). No such relations were observed for death from external causes. CONCLUSIONS Obesity aggravates the effect of seasonal influenza on respiratory mortality. Priority for influenza vaccine should be considered for obese older people to decrease the burden of influenza.
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Affiliation(s)
- Ying Zhou
- Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong
| | - Benjamin J Cowling
- Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong
| | - Peng Wu
- Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong
| | - Wai Man Chan
- Department of Health, Hong Kong Government, Hong Kong Special Administrative Region, China
| | - Siu Yin Lee
- Department of Health, Hong Kong Government, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong
| | - C Mary Schooling
- Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong School of Public Health at Hunter College, City University of New York, New York
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de-Paris F, Beck C, Pires MR, dos Santos RP, Kuchenbecker RDS, Barth AL. Viral epidemiology of respiratory infections among children at a tertiary hospital in Southern Brazil. Rev Soc Bras Med Trop 2014; 47:223-6. [PMID: 24861298 DOI: 10.1590/0037-8682-0080-2013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/27/2013] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION This study reports the pediatric epidemiology of respiratory syncytial virus (RSV), influenza (IF), parainfluenza (PIV), and adenovirus (ADV) at Hospital de Clínicas de Porto Alegre. METHODS Cases of infection, hospitalizations in intensive care units (ICUs), nosocomial infections, and lethality rates were collected from 2007 to 2010. RESULTS RSV accounted for most nosocomial infections. Intensive care units admission rates for ADV and RSV infections were highest in 2007 and 2010. During 2008-2009, H1N1 and ADV had the highest ICU admission rates. ADV had the highest fatality rate during 2007-2009. CONCLUSIONS Each virus exhibited distinct behavior, causing hospitalization, outbreaks, or lethality.
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Affiliation(s)
- Fernanda de-Paris
- Laboratório de Biologia Molecular, Serviço de Patologia Clínica, Unidade de Pesquisa Biomédica, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Caroline Beck
- Programa de Pós-Graduação em Epidemiologia, Instituto de Avaliação de Tecnologia em Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Márcia Rosane Pires
- Comissão de Controle de Infecção Hospitalar, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rodrigo Pires dos Santos
- Comissão de Controle de Infecção Hospitalar, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ricardo de Souza Kuchenbecker
- Programa de Pós-Graduação em Epidemiologia, Instituto de Avaliação de Tecnologia em Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Afonso Luis Barth
- Laboratório de Biologia Molecular, Serviço de Patologia Clínica, Unidade de Pesquisa Biomédica, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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He Y, Lin GY, Wang Q, Cai XY, Zhang YH, Lin CX, Lu CD, Lu XD. A 3-year prospective study of the epidemiology of acute respiratory viral infections in hospitalized children in Shenzhen, China. Influenza Other Respir Viruses 2014; 8:443-51. [PMID: 24828783 PMCID: PMC4181804 DOI: 10.1111/irv.12257] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 12/22/2022] Open
Abstract
Background The epidemiology of local viral etiologies is essential for the management of viral respiratory tract infections. Limited data are available in China to describe the epidemiology of viral respiratory infections, especially in small–medium cities and rural areas. Objectives To determine the viral etiology and seasonality of acute respiratory infections in hospitalized children, a 3-year study was conducted in Shenzhen, China. Methods Nasopharyngeal aspirates from eligible children were collected. Influenza and other respiratory viruses were tested by molecular assays simultaneously. Data were analyzed to describe the frequency and seasonality. Results Of the 2025 children enrolled in the study, 971 (48·0%) were positive for at least one viral pathogen, in which 890 (91·7%) were <4 years of age. The three most prevalent viruses were influenza A (IAV; 35·8%), respiratory syncytial virus (RSV; 30·5%) and human rhinovirus (HRV; 21·5%). Co-infections were found in 302 cases (31·1%), and dual viral infection was dominant. RSV, HRV and IAV were the most frequent viral agents involved in co-infection. On the whole, the obvious seasonal peaks mainly from March to May were observed with peak strength varying from 1 year to another. Conclusions This study provides a basic profile of the epidemiology of acute respiratory viral infection in hospitalized children in Shenzhen. The spectrum of viruses in the study site is similar to that in other places, but the seasonality is closely related to geographic position, different from that in big cities in northern China and neighboring Hong Kong.
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Affiliation(s)
- Ying He
- Department of Laboratory Medicine, Affiliated Futian People's Hospital, Guangdong Medical College, Shenzhen, China; Institute of Clinical Microbiology, Affiliated Futian People's Hospital, Guangdong Medical College, Shenzhen, China
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36
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Meningher T, Hindiyeh M, Regev L, Sherbany H, Mendelson E, Mandelboim M. Relationships between A(H1N1)pdm09 influenza infection and infections with other respiratory viruses. Influenza Other Respir Viruses 2014; 8:422-30. [PMID: 24698156 PMCID: PMC4181801 DOI: 10.1111/irv.12249] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND A(H1N1)pdm09, a new influenza pandemic virus emerged in 2009. The A(H1N1)pdm09 infection had several unique characteristics which included rapid transmissibility and high morbidity in obese individuals, pregnant women and individuals suffering from chronic diseases. OBJECTIVES To study the relationships between A(H1N1)pdm09 influenza infection and infections with other respiratory viruses such as respiratory syncytial virus (RSV), human metapneumo virus (hMPV), adenovirus and seasonal influenza. METHODS Samples (nasopharyngeal swabs or aspirates) collected between 2007 until 2012 from patients of various ages that were hospitalized due to respiratory virus infections were analyzed for the presence of various respiratory viruses, using qRT-PCR. RESULTS In 2009-2010, when the pandemic influenza A(H1N1)pdm09 first appeared, two major infection peaks were noted and individuals of various ages were infected. Following the decline of the A(H1N1)pdm09 virus infection, the percentages of patients infected with adenovirus and hMPV increased, while infection frequency with RSV B and with seasonal influenza virus decreased. Furthermore, RSV infections were delayed and very few percentages of patients were co-infected with more than one virus. Interestingly, the A(H1N1)pdm09 virus lost its dominancy when it reappeared in the winter of 2010-2011, and at this time, only the incidence of RSV infections was affected by the A(H1N1)pdm09 virus. CONCLUSIONS The A(H1N1)pdm09 virus had distinct effects on other respiratory viruses when it first appeared versus later, when it evolved from being a pandemic to a seasonal virus.
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Affiliation(s)
- Tal Meningher
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel; The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
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Navarro-Marí JM, Pérez-Ruiz M, Galán Montemayor JC, Marcos Maeso MÁ, Reina J, de Oña Navarro M, Cilla Eguiluz CG. Circulation of other respiratory viruses and viral co-infection during the 2009 pandemic influenza. Enferm Infecc Microbiol Clin 2013; 30 Suppl 4:25-31. [PMID: 23116789 PMCID: PMC7130202 DOI: 10.1016/s0213-005x(12)70101-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Coinciding with the pandemic wave of the influenza A(H1N1)pdm09 virus, other respiratory viruses have co-circulated in our area and were responsible for many acute respiratory infections and influenza-like illness (ILI). Apart from the pandemic virus that was responsible for most ILI cases, incidence rates of other viruses have varied among geographical areas. In general, human rhinovirus was the most frequent among individuals from the community, and respiratory syncytial virus among hospitalized patients. Detection rates of other respiratory viruses such as human metapneumovirus, adenovirus or parainfluenza viruses have been much lower. On the basis of an interference mechanism, human rhinovirus may contribute to modulate the pandemic wave, although available data are not conclusive to support this hypothesis. In contrast, the epidemic wave of respiratory syncytial virus during 2009–2010 was similar to previous seasons. Overall, incidence rates of respiratory viruses other than influenza did not change significantly during the pandemic season compared to other seasons. No association has been found between coinfection of pandemic influenza and other respiratory viruses with the prognosis of patients with influenza. The involvement of clinical virology laboratories in the etiological diagnosis of ILI cases has improved and has optimized diagnostic procedures.
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Wu P, Goldstein E, Ho LM, Wu JT, Tsang T, Leung GM, Cowling BJ. Excess mortality impact of two epidemics of pandemic influenza A(H1N1pdm09) virus in Hong Kong. Influenza Other Respir Viruses 2013; 8:1-7. [PMID: 24373289 PMCID: PMC3877676 DOI: 10.1111/irv.12196] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 11/28/2022] Open
Abstract
Hong Kong experienced two large epidemics of pandemic influenza A(H1N1pdm09). We used regression methods to estimate the excess mortality associated with each epidemic. The first epidemic of H1N1pdm09 peaked in September 2009 and was associated with 2·13 [95% confidence interval (CI): -8·08, 11·82] excess all-cause deaths per 100 000 population. The second epidemic of H1N1pdm09 in early 2011 was associated with 4·72 [95% CI: -0·70, 10·50] excess deaths per 100 000 population. More than half of the estimated excess all-cause deaths were attributable to respiratory causes in each epidemic. The reasons for substantial impact in the second wave remain to be clarified.
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Affiliation(s)
- Peng Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Landes MB, Neil RB, McCool SS, Mason BP, Woron AM, Garman RL, Smalley DL. The frequency and seasonality of influenza and other respiratory viruses in Tennessee: two influenza seasons of surveillance data, 2010-2012. Influenza Other Respir Viruses 2013; 7:1122-7. [PMID: 23962104 PMCID: PMC4634273 DOI: 10.1111/irv.12145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2013] [Indexed: 12/01/2022] Open
Abstract
Background In 2010, the Tennessee Department of Health, in collaboration with the Centers for Disease Control and Prevention (CDC), expanded influenza surveillance in Tennessee to include other respiratory viruses. Objectives To determine the prevalence and seasonality of influenza and other respiratory viruses during the influenza seasons of 2010–2012. Methods Nasal and nasopharangeal swabs/washings from persons with influenza‐like illness were collected across Tennessee. Influenza and other respiratory viruses were identified using a molecular‐based respiratory virus panel. Influenza A positives were subtyped using real‐time PCR according to the CDC protocol. Data were analyzed to describe frequency and seasonality of circulating strains. Results Of the 933 positive specimens, 60·3% were identified as influenza viruses, 19·8% rhinovirus/enterovirus, 8·6% respiratory syncytial virus (RSV), 5·8% metapneumovirus, 3·0% adenovirus, and 2·5% parainfluenza viruses. In the 2010–2011 season, influenza B was prominent during weeks 48–3, while influenza A(H1N1) was most frequently identified during weeks 4–10. Influenza A(H3N2) was present at lower levels during weeks 48–17. However, in the 2011–2012 season, overall numbers of influenza cases were reduced and influenza A (H3N2) was the most abundant influenza strain. The expanded surveillance for other respiratory viruses noted an increase in identified specimens from the first to the second season for adenovirus, metapneumovirus, RSV, and rhinovirus/enterovirus. Conclusions This study provides data of the influenza strains in circulation in Tennessee. It also establishes a baseline and time of year to expect other respiratory viruses that will aid in detecting outbreaks of non‐influenza respiratory viruses in Tennessee.
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Affiliation(s)
- Michelle B Landes
- Division of Laboratory Services, Tennessee Department of Health, Nashville, TN, USA
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McCaw JM, Glass K, Mercer GN, McVernon J. Pandemic controllability: a concept to guide a proportionate and flexible operational response to future influenza pandemics. J Public Health (Oxf) 2013; 36:5-12. [PMID: 23735960 PMCID: PMC7313947 DOI: 10.1093/pubmed/fdt058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The 2009 H1N1 influenza pandemic posed challenges for governments worldwide. Strategies designed to limit community transmission, such as antiviral deployment, were largely ineffective due to both feasibility constraints and the generally mild nature of disease, resulting in incomplete case ascertainment. Reviews of national pandemic plans have identified pandemic impact, primarily linked to measures of transmissibility and severity, as a key concept to incorporate into the next generation of plans. While an assessment of impact provides the rationale under which interventions may be warranted, it does not directly provide an assessment on whether particular interventions may be effective. Such considerations motivate our introduction of the concept of pandemic controllability. For case-targeted interventions, such as antiviral treatment and post-exposure prophylaxis, we identify the visibility and transmissibility of a pandemic as the key drivers of controllability. Taking a case-study approach, we suggest that high-impact pandemics, for which control is most desirable, are likely uncontrollable with case-targeted interventions. Strategies that do not rely on the identification of cases may prove relatively more effective. By introducing a pragmatic framework for relating the assessment of impact to the ability to mitigate an epidemic (controllability), we hope to address a present omission identified in pandemic response plans.
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Affiliation(s)
- J M McCaw
- Melbourne School of Population Health, The University of Melbourne, Melbourne, Australia
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Genetic characterization of human respiratory syncytial virus detected in hospitalized children in the Philippines from 2008 to 2012. J Clin Virol 2013; 57:59-65. [PMID: 23357644 DOI: 10.1016/j.jcv.2013.01.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/13/2012] [Accepted: 01/02/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Human respiratory syncytial virus (HRSV) is the leading cause of acute lower respiratory tract infection in infants and young children. However, molecular characteristic of HRSV is still unknown in the Philippines. OBJECTIVE To describe the molecular epidemiology of circulating HRSV detected in the Philippines. STUDY DESIGN From May 2008 to April 2012, nasopharyngeal swabs were collected from infants and children aged between 7 days and 14 years who were hospitalized with severe pneumonia. HRSV was detected by nested PCR targeting M2 gene, and C-terminus of the G gene was sequenced for phylogenetic analysis. RESULT Out of total 2150 samples, 19.3% (n = 415) were positive for HRSV, and 65.0% of them (n = 270) were identified as HRSV-A and 35.0% (n = 145) as HRSV-B. There were two major HRSV outbreaks: between June 2008 and February 2009, and between June and March 2012. Majority of HRSV strains detected during the former outbreak were HRSV-A (97.5%, 203/208) whereas during the later outbreak, both HRSV-A (54/158, 34.2%) and HRSV-B (104/158, 65.8%) were detected. All HRSV-A strains were classified as genotype NA1 and all HRSV-B as genotype BA, which had 60-nucleotide duplication in secondary hypervariable region of the G gene. Among HRSV-B positive samples, there were 2 distinct clusters with unique amino acid changes and low homology in compared to other strains in BA, suggesting emergence of new variant of HRSV-B. CONCLUSION The study provides an overview of the genetic variation in circulating HRSV viruses in the Philippines along with identification of possibly a novel variant of HRSV-B.
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Wu P, Goldstein E, Ho LM, Yang L, Nishiura H, Wu JT, Ip DKM, Chuang SK, Tsang T, Cowling BJ. Excess mortality associated with influenza A and B virus in Hong Kong, 1998-2009. J Infect Dis 2012; 206:1862-71. [PMID: 23045622 PMCID: PMC3502382 DOI: 10.1093/infdis/jis628] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although deaths associated with laboratory-confirmed influenza virus infections are rare, the excess mortality burden of influenza estimated from statistical models may more reliably quantify the impact of influenza in a population. METHODS We applied age-specific multiple linear regression models to all-cause and cause-specific mortality rates in Hong Kong from 1998 through 2009. The differences between estimated mortality rates in the presence or absence of recorded influenza activity were used to estimate influenza-associated excess mortality. RESULTS The annual influenza-associated all-cause excess mortality rate was 11.1 (95% confidence interval [CI], 7.2-14.6) per 100,000 person-years. We estimated an average of 751 (95% CI, 488-990) excess deaths associated with influenza annually from 1998 through 2009, with 95% of the excess deaths occurring in persons aged ≥65 years. Most of the influenza-associated excess deaths were from respiratory (53%) and cardiovascular (18%) causes. Influenza A(H3N2) epidemics were associated with more excess deaths than influenza A(H1N1) or B during the study period. CONCLUSIONS Influenza was associated with a substantial number of excess deaths each year, mainly among the elderly, in Hong Kong in the past decade. The influenza-associated excess mortality rates were generally similar in Hong Kong and the United States.
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Affiliation(s)
- Peng Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
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Yang Y, Wang Z, Ren L, Wang W, Vernet G, Paranhos-Baccalà G, Jin Q, Wang J. Influenza A/H1N1 2009 pandemic and respiratory virus infections, Beijing, 2009-2010. PLoS One 2012; 7:e45807. [PMID: 23029253 PMCID: PMC3447804 DOI: 10.1371/journal.pone.0045807] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 08/23/2012] [Indexed: 12/26/2022] Open
Abstract
To determine the role of the pandemic influenza A/H1N1 2009 (A/H1N1 2009pdm) in acute respiratory tract infections (ARTIs) and its impact on the epidemic of seasonal influenza viruses and other common respiratory viruses, nasal and throat swabs taken from 7,776 patients with suspected viral ARTIs from 2006 through 2010 in Beijing, China were screened by real-time PCR for influenza virus typing and subtyping and by multiplex or single PCR tests for other common respiratory viruses. We observed a distinctive dual peak pattern of influenza epidemic during the A/H1N1 2009pdm in Beijing, China, which was formed by the A/H1N1 2009pdm, and a subsequent influenza B epidemic in year 2009/2010. Our analysis also shows a small peak formed by a seasonal H3N2 epidemic prior to the A/H1N1 2009pdm peak. Parallel detection of multiple respiratory viruses shows that the epidemic of common respiratory viruses, except human rhinovirus, was delayed during the pandemic of the A/H1N1 2009pdm. The H1N1 2009pdm mainly caused upper respiratory tract infections in the sampled patients; patients infected with H1N1 2009pdm had a higher percentage of cough than those infected with seasonal influenza or other respiratory viruses. Our findings indicate that A/H1N1 2009pdm and other respiratory viruses except human rhinovirus could interfere with each other during their transmission between human beings. Understanding the mechanisms and effects of such interference is needed for effective control of future influenza epidemics.
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Affiliation(s)
- Yaowu Yang
- MOH Key Laboratory for Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
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Wu P, Cowling BJ, Wu JT, Lau EHY, Ip DKM, Nishiura H. The epidemiological and public health research response to 2009 pandemic influenza A(H1N1): experiences from Hong Kong. Influenza Other Respir Viruses 2012; 7:367-82. [PMID: 22883352 PMCID: PMC3705741 DOI: 10.1111/j.1750-2659.2012.00420.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In recent years, Hong Kong has invested in research infrastructure to appropriately respond to novel infectious disease epidemics. Research from Hong Kong made a strong contribution to the international response to the 2009 influenza A (H1N1) pandemic (pH1N1). Summarizing, describing, and reviewing Hong Kong’s response to the 2009 pandemic, this article aimed to identify key elements of a real‐time research response. A systematic search in PubMed and EMBASE for research into the infection dynamics and natural history, impact, or control of pH1N1 in Hong Kong. Eligible articles were analyzed according to their scope. Fifty‐five articles were included in the review. Transmissibility of pH1N1 was similar in Hong Kong to elsewhere, and only a small fraction of infections were associated with severe disease. School closures were effective in reducing pH1N1 transmission, oseltamivir was effective for treatment of severe cases while convalescent plasma therapy has the potential to mitigate future pandemics. There was a rapid and comprehensive research response to pH1N1 in Hong Kong, providing important information on the epidemiology of the novel virus with relevance internationally as well as locally. The scientific knowledge gained through these detailed studies of pH1N1 is now being used to revise and update pandemic plans. The experiences of the research response in Hong Kong could provide a template for the research response to future emerging and reemerging disease epidemics.
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Affiliation(s)
- Peng Wu
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Cowling BJ, Fang VJ, Nishiura H, Chan KH, Ng S, Ip DKM, Chiu SS, Leung GM, Peiris JSM. Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine. Clin Infect Dis 2012; 54:1778-83. [PMID: 22423139 PMCID: PMC3404712 DOI: 10.1093/cid/cis307] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We randomized 115 children to trivalent inactivated influenza vaccine (TIV) or placebo. Over the following 9 months, TIV recipients had an increased risk of virologically-confirmed non-influenza infections (relative risk: 4.40; 95% confidence interval: 1.31-14.8). Being protected against influenza, TIV recipients may lack temporary non-specific immunity that protected against other respiratory viruses.
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Affiliation(s)
- Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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