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Li Q, Song M, Hu Z, Ding Y, Huang C, Liu J. Pediatric respiratory pathogen dynamics in Southern Sichuan, China: a retrospective analysis of gender, age, and seasonal trends. Front Pediatr 2024; 12:1374571. [PMID: 39086626 PMCID: PMC11288815 DOI: 10.3389/fped.2024.1374571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Objective To address the research gap in the epidemiology of pediatric respiratory tract infections (RTIs) in Luzhou, Southern Sichuan, China, by analyzing respiratory pathogens in a large pediatric cohort from 2018 to 2021, covering the pre- and during-COVID-19 periods. Methods This study conducted a retrospective analysis of children with RTIs in Luzhou from July 2018 to January 2021. Strict exclusion criteria were applied to ensure an accurate representation of the pediatric population. Pathogen detection included viruses, bacteria, and atypical agents. Results Pathogens were identified in 52.8% of 12,546 cases. Viruses accounted for 32.2% of infections, bacteria for 29.8%, and atypical agents for 29.7%, with significant findings of Staphylococcus aureus, Moraxella catarrhalis, and Mycoplasma pneumoniae. Age-related analysis indicated a higher incidence of bacterial infections in infants and viral infections in preschool-aged children, with atypical pathogens being most prevalent in 3-5-year-olds. Gender-based analysis, adjusted for age, revealed similar overall pathogen presence; however, females were more susceptible to viral infections, while males were more prone to Streptococcus pneumoniae. Notably, there was an unusual increase in pathogen cases during spring, potentially influenced by behavioral changes and public health measures related to COVID-19. Co-infections were identified as a significant risk factor for the development of pneumonia. Conclusion The study provides essential insights into the epidemiology of respiratory pathogens in pediatric populations, emphasizing the need for healthcare strategies tailored to age, gender, and seasonality. The findings highlight the impact of environmental and public health factors, including COVID-19 measures, on respiratory pathogen prevalence, underscoring the importance of targeted diagnostic and treatment protocols in pediatric respiratory infections.
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Affiliation(s)
- Qing Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Min Song
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhi Hu
- Department of Medical Laboratory, Southwest Medical University, Luzhou, China
| | - Yinhuan Ding
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chengliang Huang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jinbo Liu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Meijers M, Ruchnewitz D, Eberhardt J, Karmakar M, Łuksza M, Lässig M. Concepts and methods for predicting viral evolution. ARXIV 2024:arXiv:2403.12684v2. [PMID: 38745695 PMCID: PMC11092678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The seasonal human influenza virus undergoes rapid evolution, leading to significant changes in circulating viral strains from year to year. These changes are typically driven by adaptive mutations, particularly in the antigenic epitopes, the regions of the viral surface protein haemagglutinin targeted by human antibodies. Here we describe a consistent set of methods for data-driven predictive analysis of viral evolution. Our pipeline integrates four types of data: (1) sequence data of viral isolates collected on a worldwide scale, (2) epidemiological data on incidences, (3) antigenic characterization of circulating viruses, and (4) intrinsic viral phenotypes. From the combined analysis of these data, we obtain estimates of relative fitness for circulating strains and predictions of clade frequencies for periods of up to one year. Furthermore, we obtain comparative estimates of protection against future viral populations for candidate vaccine strains, providing a basis for pre-emptive vaccine strain selection. Continuously updated predictions obtained from the prediction pipeline for influenza and SARS-CoV-2 are available on the website previr.app.
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Affiliation(s)
- Matthijs Meijers
- Institute for Biological Physics, University of Cologne, Zülpicherstr. 77, 50937, Köln, Germany
| | - Denis Ruchnewitz
- Institute for Biological Physics, University of Cologne, Zülpicherstr. 77, 50937, Köln, Germany
| | - Jan Eberhardt
- Institute for Biological Physics, University of Cologne, Zülpicherstr. 77, 50937, Köln, Germany
| | - Malancha Karmakar
- Institute for Biological Physics, University of Cologne, Zülpicherstr. 77, 50937, Köln, Germany
| | - Marta Łuksza
- Tisch Cancer Institute, Departments of Oncological Sciences and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Lässig
- Institute for Biological Physics, University of Cologne, Zülpicherstr. 77, 50937, Köln, Germany
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Han SM, Robert A, Masuda S, Yasaka T, Kanda S, Komori K, Saito N, Suzuki M, Endo A, Baguelin M, Ariyoshi K. Transmission dynamics of seasonal influenza in a remote island population. Sci Rep 2023; 13:5393. [PMID: 37012350 PMCID: PMC10068240 DOI: 10.1038/s41598-023-32537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Seasonal influenza outbreaks remain an important public health concern, causing large numbers of hospitalizations and deaths among high-risk groups. Understanding the dynamics of individual transmission is crucial to design effective control measures and ultimately reduce the burden caused by influenza outbreaks. In this study, we analyzed surveillance data from Kamigoto Island, Japan, a semi-isolated island population, to identify the drivers of influenza transmission during outbreaks. We used rapid influenza diagnostic test (RDT)-confirmed surveillance data from Kamigoto island, Japan and estimated age-specific influenza relative illness ratios (RIRs) over eight epidemic seasons (2010/11 to 2017/18). We reconstructed the probabilistic transmission trees (i.e., a network of who-infected-whom) using Bayesian inference with Markov-chain Monte Carlo method and then performed a negative binomial regression on the inferred transmission trees to identify the factors associated with onwards transmission risk. Pre-school and school-aged children were most at risk of getting infected with influenza, with RIRs values consistently above one. The maximal RIR values were 5.99 (95% CI 5.23, 6.78) in the 7-12 aged-group and 5.68 (95%CI 4.59, 6.99) in the 4-6 aged-group in 2011/12. The transmission tree reconstruction suggested that the number of imported cases were consistently higher in the most populated and busy districts (Tainoura-go and Arikawa-go) ranged from 10-20 to 30-36 imported cases per season. The number of secondary cases generated by each case were also higher in these districts, which had the highest individual reproduction number (Reff: 1.2-1.7) across the seasons. Across all inferred transmission trees, the regression analysis showed that cases reported in districts with lower local vaccination coverage (incidence rate ratio IRR = 1.45 (95% CI 1.02, 2.05)) or higher number of inhabitants (IRR = 2.00 (95% CI 1.89, 2.12)) caused more secondary transmissions. Being younger than 18 years old (IRR = 1.38 (95%CI 1.21, 1.57) among 4-6 years old and 1.45 (95% CI 1.33, 1.59) 7-12 years old) and infection with influenza type A (type B IRR = 0.83 (95% CI 0.77, 0.90)) were also associated with higher numbers of onwards transmissions. However, conditional on being infected, we did not find any association between individual vaccination status and onwards transmissibility. Our study showed the importance of focusing public health efforts on achieving high vaccine coverage throughout the island, especially in more populated districts. The strong association between local vaccine coverage (including neighboring regions), and the risk of transmission indicate the importance of achieving homogeneously high vaccine coverage. The individual vaccine status may not prevent onwards transmission, though it may reduce the severity of infection.
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Affiliation(s)
- Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Alexis Robert
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Shingo Masuda
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Internal Medicine, Kamigoto Hospital, Kamigoto, Japan
| | - Takahiro Yasaka
- Department of Internal Medicine, Kamigoto Hospital, Kamigoto, Japan
| | - Satoshi Kanda
- Department of Internal Medicine, Kamigoto Hospital, Kamigoto, Japan
| | - Kazuhiri Komori
- Department of Internal Medicine, Kamigoto Hospital, Kamigoto, Japan
| | - Nobuo Saito
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Motoi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Akira Endo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Marc Baguelin
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease, London, UK
| | - Koya Ariyoshi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Deng X, Chen Z, Zhao Z, Chen J, Li M, Yang J, Yu H. Regional characteristics of influenza seasonality patterns in mainland China, 2005-2017: a statistical modeling study. Int J Infect Dis 2023; 128:91-97. [PMID: 36581188 DOI: 10.1016/j.ijid.2022.12.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To quantify the seasonal and antigenic characteristics of influenza to help understand influenza activity and inform vaccine recommendations. METHODS We employed a generalized linear model with harmonic terms to quantify the seasonal pattern of influenza in China from 2005-2017, including amplitude (circulatory intensity), semiannual periodicity (given two peaks a year), annual peak time, and epidemic duration. The antigenic differences were distinguished as antigenic similarity between 2009 and 2020. We categorized regions above 33° N, between 27° N and 33° N, and below 27° N as the north, central, and south regions, respectively. RESULTS We estimated that the amplitude in the north region (median: 0.019, 95% CI: 0.018-0.021) was significantly higher than that in the central region (median: 0.011, 95% CI: 0.01-0.012, P <0.001) and south region (median: 0.008, 95% CI: 0.007-0.008, P <0.001) for influenza A virus subtype H3N2 (A/H3N2). The A/H3N2 in the central region had a semiannual periodicity (median: 0.548, 95% CI: 0.517-0.577), while no semiannual pattern was found in other regions or subtypes/lineages. The antigenic similarity was low (below 50% in the 2009-2010, 2014-2015, 2016-2018, and 2019-2020 seasons) for A/H3N2. CONCLUSION Our study depicted the seasonal pattern differences and antigenic differences of influenza in China, which provides information for vaccination strategies.
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Affiliation(s)
- Xiaowei Deng
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Zhiyuan Chen
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Zeyao Zhao
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Junbo Chen
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Mei Li
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Juan Yang
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Hongjie Yu
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China; National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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Zhou L, Yang H, Pan W, Xu J, Feng Y, Zhang W, Shao Z, Li T, Li S, Huang T, Wang C, Li W, Li M, He S, Zhan Y, Pan M. Association between meteorological factors and the epidemics of influenza (sub)types in a subtropical basin of Southwest China. Epidemics 2022; 41:100650. [PMID: 36375312 DOI: 10.1016/j.epidem.2022.100650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The effects of climatic conditions on the prevalence of individual influenza (sub)types are not well understood in the subtropics. This study aims to evaluate the associations between meteorological factors and seasonal epidemics of A(H3N2), A(H1N1)pdm09, and type B influenza viruses, as well as to estimate the interactions between climatic variables in a subtropical basin region. METHODS The seasonality of influenza (sub)types during 2010-2019 were characterized in Chengdu Plain Economic Zone, a densely populated and highly humid plain area in Sichuan Basin in subtropical Southwest China. Generalized additive models were adopted to assess the independent exposure-response relationship between meteorological variables and influenza prevalence. The interactions of meteorological variables were further estimated using bivariate response surface models and strata models. RESULTS Our analyses indicated that the temperature, relative humidity, and absolute humidity have exhibited a major influence on influenza infection in Chengdu Plain Economic Zone. Low temperature was shown to promote the prevalence of A(H1N1)pdm09 and type B in winter-spring days at all levels of relative humidity. High risk of A(H3N2) infections was observed at low temperature or high temperature, and at higher relative humidity. Moreover, absolute humidity decreased or increased influenza (sub)type infections within different ranges. CONCLUSIONS This study found different nonlinear relationships between meteorological factors and the seasonality of influenza (sub)types, as well as significant interactive effects between climatic variables, contributing to the research on the climate drivers of influenza prevalence in warm-humid basin regions in the subtropics.
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Affiliation(s)
- Linlin Zhou
- Department of Pathogenic Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Huiping Yang
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Wen Pan
- College of Computer Science, Sichuan University, Chengdu 610065, China
| | - Jianan Xu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Yuliang Feng
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Weihua Zhang
- College of Computer Science, Sichuan University, Chengdu 610065, China
| | - Zerui Shao
- College of Computer Science, Sichuan University, Chengdu 610065, China
| | - Tianshu Li
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Shuang Li
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Ting Huang
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Chuang Wang
- Department of Medical Technology, West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - Wanyi Li
- Department of Pathogenic Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Mingyuan Li
- Department of Pathogenic Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Shusen He
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China.
| | - Ming Pan
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China.
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Influenza virus and its subtypes circulating during 2018-2019: A hospital-based study from Assam. Indian J Med Microbiol 2022; 40:525-530. [PMID: 36002356 DOI: 10.1016/j.ijmmb.2022.08.001] [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: 03/21/2022] [Revised: 07/23/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Influenza virus can cause serious respiratory illness sometimes resulting in epidemics and pandemics associated with significant morbidity and mortality across the globe. Hence, continuous surveillance of the activity of the influenza virus and its subtypes is necessary to help the policy makers to take effective and appropriate decisions regarding its control. The study aimed to determine distribution of influenza viruses in Assam of north-east India having subtropical climate that may lead to viral subtype divergence. METHODS Clinically suspected ninety cases with Influenza like illness (ILI) were included, irrespective of age and sex during the period 1st July 2018 to 30th June 2019. Aseptically collected Nasopharyngeal swabs in viral transport media (VTM) were tested by conventional Reverse Transcriptase Polymerase Chain Reaction (RT PCR) for detection of Influenza A and Influenza B viruses which were further processed for detection of subtypes such as H1N1 pdm09, H3N2 and Influenza B (Yamagata and Victoria lineage). Normally distributed continuous variables were summarised by mean and standard deviation. All categorical variables were summarised as percentages. RESULTS Influenza activity was seen in 42.2% of ILI cases with male predominance (57.9%). Influenza A was the predominant type (84.2%). Among the subtypes, A(H1N1) pdm09 was predominant (76.3%) followed by Influenza B (Victoria lineages) (15.8%) and AH3N2 (7.9%). Significant difference was observed between different subtypes with regard to age distribution only. Influenza activity in Assam showed two seasonal peaks; the primary one from May to July and the secondary from November to February. CONCLUSION The study described the distribution of different Influenza viruses and its subtypes in Assam along with their seasonal activities. These findings will help to formulate the policy for its prevention and control in Assam as well as to monitor the efficacy of the current influenza vaccine.
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Yang Z, Feng T, Guan W, He J, Jiang R, Liu G, Lu G, Lu Q, Shen A, Sun L, Sun X, Yang Y, Zeng M, Zhou J, Shen K, Zhong N. Chinese expert consensus on immunoprophylaxis of common respiratory pathogens in children (2021 edition). J Thorac Dis 2022; 14:749-768. [PMID: 35399246 PMCID: PMC8987824 DOI: 10.21037/jtd-21-1613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
Respiratory tract infections are infectious diseases involving the respiratory tract (such as the sinuses, throat, airways or lungs), which are the common respiratory disorders in children. With the development of society and the improvement of economic conditions, great progress has been made in China in the prevention of common respiratory pathogens in children. As a result, the incidence and mortality of respiratory tract infections in children have dropped sharply in the past decades. However, there is still a certain gap compared with the international leading levels, which can be partly attribute to insufficient public awareness of vaccination, uneven vaccination services of vaccinators, and so on. On the basis of comprehensive analysis of the clinical evidence of immunoprophylaxis of common respiratory pathogens among children in China and abroad, combined with the clinical situation and the experience of experts, the consensus focuses on the characteristics of transmission, clinical manifestations and immunoprophylaxis of common respiratory pathogens in children, so as to provide reference for clinical practice. This consensus document applies to all Centers for Disease Control and Prevention (CDC) staff levels engaged in the prevention and control of related pathogens, vaccinators at vaccination sites, and medical staff in pediatric, respiratory, and infectious diseases departments at all levels in medical institutions.
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Affiliation(s)
- Zifeng Yang
- National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Tiejian Feng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wenda Guan
- National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jianfeng He
- Guangdong Center for Disease Control and Prevention, Guangzhou, China
| | - Rongmeng Jiang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Gang Liu
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Gen Lu
- Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Quan Lu
- Children’s Hospital of Shanghai, Shanghai, China
| | - Adong Shen
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Lihong Sun
- National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Xiaodong Sun
- Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Yonghong Yang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Mei Zeng
- Children’s Hospital of Fudan University, Shanghai, China
| | - Jiushun Zhou
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Kunling Shen
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Nanshan Zhong
- National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Guangzhou, China
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Diamond C, Gong H, Sun FY, Liu Y, Quilty BJ, Jit M, Yang J, Yu H, Edmunds WJ, Baguelin M. Regional-based within-year seasonal variations in influenza-related health outcomes across mainland China: a systematic review and spatio-temporal analysis. BMC Med 2022; 20:58. [PMID: 35139857 PMCID: PMC8830135 DOI: 10.1186/s12916-022-02269-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/19/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND China experiences large variations in influenza seasonal activity. We aim to update and improve the current understanding of regional-based within-year variations of influenza activity across mainland China to provide evidence for the planning and optimisation of healthcare strategies. METHODS We conducted a systematic review and spatio-temporal meta-analysis to assess regional-based within-year variations of ILI outpatient consultation rates, influenza test positivity rates amongst both ILI outpatients and SARI inpatients, and influenza-associated excess mortality rates. We searched English and Chinese databases for articles reporting time-series data on the four influenza-related outcomes at the sub-national and sub-annual level. After synthesising the data, we reported on the mean monthly rate, epidemic onset, duration, peak and intensity. RESULTS We included 247 (7.7%) eligible studies in the analysis. We found within-year influenza patterns to vary across mainland China in relation to latitude and geographic location. High-latitude provinces were characterised by having short and intense annual winter epidemics, whilst most mid-latitude and low-latitude provinces experience semi-annual epidemics or year-round activity. Subtype activity varied across the country, with A/H1N1pdm09 and influenza B occurring predominantly in the winter, whereas A/H3N2 activity exhibited a latitudinal divide with high-latitude regions experiencing a winter peak, whilst mid and low-latitude regions experienced a summer epidemic. Epidemic onsets and peaks also varied, occurring first in the north and later in the southeast. We found positive associations between all influenza health outcomes. In addition, seasonal patterns at the prefecture and county-level broadly resembled their wider province. CONCLUSIONS This is the first systematic review to simultaneously examine the seasonal variation of multiple influenza-related health outcomes at multiple spatial scales across mainland China. The seasonality information provided here has important implications for the planning and optimisation of immunisation programmes and healthcare provision, supporting the need for regional-based approaches to address variations in local epidemiology.
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Affiliation(s)
- Charlie Diamond
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Hui Gong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Fiona Yueqian Sun
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Billy J Quilty
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - W John Edmunds
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Baguelin
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.,MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
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Zhan Y, Chen X, Guan W, Guan W, Yang C, Pan S, Wong SS, Chen R, Ye F. Clinical impact of nosocomial infection with pandemic influenza A (H1N1) 2009 in a respiratory ward in Guangzhou. J Thorac Dis 2021; 13:5851-5862. [PMID: 34795934 PMCID: PMC8575854 DOI: 10.21037/jtd-21-897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
Background Nosocomial outbreaks of pandemic influenza A (H1N1) 2009 virus [A(H1N1)pdm09] easily develop due to its high transmissibility. This study aimed to investigate the clinical impacts of a nosocomial outbreak of A(H1N1)pdm09 between 21 January and 17 February 2016. Methods Patients who developed influenza-like illness (ILI) more than 48 hours after hospitalization in the index ward were enrolled as suspected patients, defined as group A and quarantined. Patients in other wards were defined as group B. A phylogenetic tree was constructed to determine the origins of the hemagglutinin and neuraminidase genes. Results After the implementation of an infection control measure bundle, the outbreak was limited to eight patients with ILIs in group A. Nasal swabs from seven patients were positive for A(H1N1)pdm09. All the patients recovered after treatment. Prolonged viral shedding was observed in a patient with bronchiectasis and Penicillium marneffei infection. Compared to the expected duration of hospitalization in patients without fever, those with fever had a median 7-day delay in discharge and a mean excess cost of 3,358 RMB. The four influenza strains identified were genetically identical to the A/California/115/2015 strain. Six of the 54 patients in group B who underwent bronchoscopy developed transient fever. These patients were hospitalized in various wards of the hospital and recovered after a short-term course of empirical antibiotics. Conclusions After the implementation of infection control measures, the nosocomial A(H1N1)pdm09 outbreak was rapidly contained; infected patients had a delay in discharge and excess costs, but no deaths occurred.
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Affiliation(s)
- Yangqing Zhan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Xiaojuan Chen
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Weijie Guan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wenda Guan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Chunguang Yang
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Sihua Pan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Sook-San Wong
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Rongchang Chen
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.,Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Feng Ye
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
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10
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Caetano-Anollés K, Hernandez N, Mughal F, Tomaszewski T, Caetano-Anollés G. The seasonal behaviour of COVID-19 and its galectin-like culprit of the viral spike. METHODS IN MICROBIOLOGY 2021; 50:27-81. [PMID: 38620818 PMCID: PMC8590929 DOI: 10.1016/bs.mim.2021.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Seasonal behaviour is an attribute of many viral diseases. Like other 'winter' RNA viruses, infections caused by the causative agent of COVID-19, SARS-CoV-2, appear to exhibit significant seasonal changes. Here we discuss the seasonal behaviour of COVID-19, emerging viral phenotypes, viral evolution, and how the mutational landscape of the virus affects the seasonal attributes of the disease. We propose that the multiple seasonal drivers behind infectious disease spread (and the spread of COVID-19 specifically) are in 'trade-off' relationships and can be better described within a framework of a 'triangle of viral persistence' modulated by the environment, physiology, and behaviour. This 'trade-off' exists as one trait cannot increase without a decrease in another. We also propose that molecular components of the virus can act as sensors of environment and physiology, and could represent molecular culprits of seasonality. We searched for flexible protein structures capable of being modulated by the environment and identified a galectin-like fold within the N-terminal domain of the spike protein of SARS-CoV-2 as a potential candidate. Tracking the prevalence of mutations in this structure resulted in the identification of a hemisphere-dependent seasonal pattern driven by mutational bursts. We propose that the galectin-like structure is a frequent target of mutations because it helps the virus evade or modulate the physiological responses of the host to further its spread and survival. The flexible regions of the N-terminal domain should now become a focus for mitigation through vaccines and therapeutics and for prediction and informed public health decision making.
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Affiliation(s)
| | - Nicolas Hernandez
- Evolutionary Bioinformatics Laboratory, Department of Crop Sciences, University of Illinois, Urbana, IL, United States
| | - Fizza Mughal
- Evolutionary Bioinformatics Laboratory, Department of Crop Sciences, University of Illinois, Urbana, IL, United States
| | - Tre Tomaszewski
- Evolutionary Bioinformatics Laboratory, Department of Crop Sciences, University of Illinois, Urbana, IL, United States
| | - Gustavo Caetano-Anollés
- Evolutionary Bioinformatics Laboratory, Department of Crop Sciences, University of Illinois, Urbana, IL, United States
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11
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Li ZJ, Zhang HY, Ren LL, Lu QB, Ren X, Zhang CH, Wang YF, Lin SH, Zhang XA, Li J, Zhao SW, Yi ZG, Chen X, Yang ZS, Meng L, Wang XH, Liu YL, Wang X, Cui AL, Lai SJ, Jiang T, Yuan Y, Shi LS, Liu MY, Zhu YL, Zhang AR, Zhang ZJ, Yang Y, Ward MP, Feng LZ, Jing HQ, Huang LY, Xu WB, Chen Y, Wu JG, Yuan ZH, Li MF, Wang Y, Wang LP, Fang LQ, Liu W, Hay SI, Gao GF, Yang WZ. Etiological and epidemiological features of acute respiratory infections in China. Nat Commun 2021; 12:5026. [PMID: 34408158 PMCID: PMC8373954 DOI: 10.1038/s41467-021-25120-6] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
Nationwide prospective surveillance of all-age patients with acute respiratory infections was conducted in China between 2009‒2019. Here we report the etiological and epidemiological features of the 231,107 eligible patients enrolled in this analysis. Children <5 years old and school-age children have the highest viral positivity rate (46.9%) and bacterial positivity rate (30.9%). Influenza virus, respiratory syncytial virus and human rhinovirus are the three leading viral pathogens with proportions of 28.5%, 16.8% and 16.7%, and Streptococcus pneumoniae, Mycoplasma pneumoniae and Klebsiella pneumoniae are the three leading bacterial pathogens (29.9%, 18.6% and 15.8%). Negative interactions between viruses and positive interactions between viral and bacterial pathogens are common. A Join-Point analysis reveals the age-specific positivity rate and how this varied for individual pathogens. These data indicate that differential priorities for diagnosis, prevention and control should be highlighted in terms of acute respiratory tract infection patients' demography, geographic locations and season of illness in China.
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Affiliation(s)
- Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Li-Li Ren
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cui-Hong Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi-Fei Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng-Hong Lin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jun Li
- Sun Yat-sen University, Guangzhou, China
| | - Shi-Wen Zhao
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Zhi-Gang Yi
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Xiao Chen
- Zhejiang University, Hangzhou, China
| | - Zuo-Sen Yang
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Lei Meng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xin-Hua Wang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | | | - Xin Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ai-Li Cui
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng-Jie Lai
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Geography and Environmental Science, University of Southampton, Southampton, UK.,School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Tao Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yang Yuan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Lu-Sha Shi
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meng-Yang Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yu-Liang Zhu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - An-Ran Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Zhi-Jie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, Camden, NSW, Australia
| | - Lu-Zhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huai-Qi Jing
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liu-Yu Huang
- The Institute for Disease Prevention and Control of PLA, Beijing, China
| | - Wen-Bo Xu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Chen
- Zhejiang University, Hangzhou, China
| | | | | | | | - Yu Wang
- Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| | - Simon I Hay
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - George F Gao
- Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Wei-Zhong Yang
- Chinese Centre for Disease Control and Prevention, Beijing, China
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12
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Yang Q, Xiao X, Gu X, Liang D, Cao T, Mou J, Huang C, Chen L, Liu J. Surveillance of common respiratory infections during the COVID-19 pandemic demonstrates the preventive efficacy of non-pharmaceutical interventions. Int J Infect Dis 2021; 105:442-447. [PMID: 33582375 PMCID: PMC7877810 DOI: 10.1016/j.ijid.2021.02.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
Objective The emergence of a novel coronavirus, SARS-CoV-2, and its subsequent spread outside of Wuhan, China, led to the human society experiencing a pandemic of coronavirus disease 2019 (COVID-19). While the development of vaccines and pharmaceutical treatments are ongoing, government authorities in China have implemented unprecedented non-pharmaceutical interventions as primary barriers to curb the spread of the deadly SARS-CoV-2 virus. Although the decline of COVID-19 cases coincided with the implementation of such interventions, we searched for evidence to demonstrate the efficacy of these interventions, since artifactual factors, such as the environment, the pathogen itself, and the phases of epidemic, may also alter the patterns of case development. Methods We surveyed common viral respiratory infections that have a similar pattern of transmission, tropism, and clinical manifestation, as COVID-19 under a series of non-pharmaceutical interventions during the current pandemic season. We then compared this data with historical data from previous seasons without such interventions. Results Our survey showed that the rates of common respiratory infections, such as influenza and respiratory syncytial virus infections, decreased dramatically from 13.7% (95% CI, 10.82–16.58) and 4.64% (95% CI, 2.88–7.64) in previous years to 0.73% (95% CI, 0.02–1.44) and 0.0%, respectively, in the current season. Conclusions Our surveillance provides compelling evidence that non-pharmaceutical interventions are cost-effective ways to curb the spread of contagious agents, and may represent the only practical approach to limit the evolving epidemic until specific vaccines and pharmaceutical treatments are available.
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Affiliation(s)
- Qi Yang
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xia Xiao
- Chengdu CapitalBio Medical Laboratory, Chengdu, China
| | - Xinxia Gu
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Dong Liang
- Chengdu CapitalBio Medical Laboratory, Chengdu, China
| | - Ting Cao
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jun Mou
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Chunxu Huang
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Clinical Research, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jie Liu
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
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13
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Zhu A, Liu J, Ye C, Yu J, Peng Z, Feng L, Wang L, Qin Y, Zheng Y, Li Z. Characteristics of Seasonal Influenza Virus Activity in a Subtropical City in China, 2013-2019. Vaccines (Basel) 2020; 8:vaccines8010108. [PMID: 32121519 PMCID: PMC7157579 DOI: 10.3390/vaccines8010108] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To optimize seasonal influenza vaccination programs in regions with potentially complicated seasonal patterns, the epidemiological characteristics of seasonal influenza activity in a subtropical city of China were explored. MATERIALS AND METHODS Influenza virus data of patients with influenza-like illness (ILI) during 2013-2019 were collected from two sentinel hospitals in a subtropical region of China, Yichang city. The influenza virus positive rate among sampled ILI cases served as a proxy to estimate influenza seasonal characteristics, including periodicity, duration, peaks, and predominant subtypes/lineages. Epidemiological features of different years, seasons and age groups were analyzed, and vaccine mismatches were identified. RESULTS In total, 8693 ILI cases were included; 1439 (16.6%) were laboratory-confirmed influenza cases. The influenza A positive rate (10.6%) was higher than the influenza B positive rate (5.9%). There were three influenza circulation patterns in Yichang: (1) annual periodicity (in 2013-2014, 2015-2016 and 2018-2019), (2) semiannual periodicity (in 2014-2015), and (3) year-round periodicity (in 2016-2017 and 2017-2018). Summer epidemics existed in two of the six years and were dominated by influenza A/H3N2. Winter and spring epidemics occurred in five of the six years, and A/H1N1, A/H3N2, B/Victoria, and B/Yamagata were codominant. During the study period, the predominant lineages, B/Victoria in 2015-16 and B/Yamagata in 2017-2018, were both mismatched with the influenza B component of the trivalent vaccine. Children 5-14 years old (26.4%) and individuals over 60 years old (16.9%) had the highest influenza positive rates. CONCLUSIONS The seasonal epidemic period and the predominant subtype/lineage of influenza viruses in Yichang city are complex. Influenza vaccination timing and strategies need to be optimized according to the local features of influenza virus activity.
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Affiliation(s)
- Aiqin Zhu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Jianhua Liu
- Yichang Center for Disease Control and Prevention, Yichang 443003, China;
| | - Chuchu Ye
- Research Base of Key Laboratory of Surveillance and Early Warning of Infectious Disease, Pudong New Area Center for Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Shanghai 200136, China;
| | - Jianxing Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Zhibing Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Liping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Ying Qin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Yaming Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (A.Z.); (J.Y.); (Z.P.); (L.F.); (L.W.); (Y.Q.); (Y.Z.)
- Correspondence: ; Tel.: +86-010-5890-0543
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14
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Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010-2018. Epidemiol Infect 2020; 148:e29. [PMID: 32054544 PMCID: PMC7026897 DOI: 10.1017/s0950268820000151] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In recent years, there have been a significant influenza activity and emerging influenza strains in China, resulting in an increasing number of influenza virus infections and leading to public health concerns. The aims of this study were to identify the epidemiological and aetiological characteristics of influenza and establish seasonal autoregressive integrated moving average (SARIMA) models for forecasting the percentage of visits for influenza-like illness (ILI%) in urban and rural areas of Shenyang. Influenza surveillance data were obtained for ILI cases and influenza virus positivity from 18 sentinel hospitals. The SARIMA models were constructed to predict ILI% for January–December 2019. During 2010–2018, the influenza activity was higher in urban than in rural areas. The age distribution of ILI cases showed the highest rate in young children aged 0–4 years. Seasonal A/H3N2, influenza B virus and pandemic A/H1N1 continuously co-circulated in winter and spring seasons. In addition, the SARIMA (0, 1, 0) (0, 1, 2)12 model for the urban area and the SARIMA (1, 1, 1) (1, 1, 0)12 model for the rural area were appropriate for predicting influenza incidence. Our findings suggested that there were regional and seasonal distinctions of ILI activity in Shenyang. A co-epidemic pattern of influenza strains was evident in terms of seasonal influenza activity. Young children were more susceptible to influenza virus infection than adults. These results provide a reference for future influenza prevention and control strategies in the study area.
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15
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Quadrivalent Influenza Vaccine Prevents Illness and Reduces Healthcare Utilization Across Diverse Geographic Regions During Five Influenza Seasons: A Randomized Clinical Trial. Pediatr Infect Dis J 2020; 39:e1-e10. [PMID: 31725115 PMCID: PMC7004464 DOI: 10.1097/inf.0000000000002504] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We evaluated an inactivated quadrivalent influenza vaccine (IIV4) in children 6-35 months of age in a phase III, observer-blind trial. METHODS The aim of this analysis was to estimate vaccine efficacy (VE) in preventing laboratory-confirmed influenza in each of 5 independent seasonal cohorts (2011-2014), as well as vaccine impact on healthcare utilization in 3 study regions (Europe/Mediterranean, Asia-Pacific and Central America). Healthy children were randomized 1:1 to IIV4 or control vaccines. VE was estimated against influenza confirmed by reverse transcription polymerase chain reaction on nasal swabs. Cultured isolates were characterized as antigenically matched/mismatched to vaccine strains. RESULTS The total vaccinated cohort included 12,018 children (N = 1777, 2526, 1564, 1501 and 4650 in cohorts 1-5, respectively). For reverse transcription polymerase chain reaction confirmed influenza of any severity (all strains combined), VE in cohorts 1-5 was 57.8%, 52.9%, 73.4%, 30.3% and 41.4%, respectively, with the lower limit of the 95% confidence interval >0 for all estimates. The proportion of vaccine match for all strains combined in each cohort was 0.9%, 79.3%, 72.5%, 24.1% and 28.6%, respectively. Antibiotic use associated with influenza illness was reduced with IIV4 by 71% in Europe, 36% in Asia Pacific and 59% in Central America. CONCLUSIONS IIV4 prevented influenza in children 6-35 months of age in each of 5 separate influenza seasons in diverse geographical regions. A possible interaction between VE, degree of vaccine match and socioeconomic status was observed. The IIV4 attenuated the severity of breakthrough influenza illness and reduced healthcare utilization, particularly antibiotic use.
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16
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Zhou L, Yang H, Kuang Y, Li T, Xu J, Li S, Huang T, Wang C, Li W, Li M, He S, Pan M. Correction to: Temporal patterns of influenza A subtypes and B lineages across age in a subtropical city, during pre-pandemic, pandemic, and post-pandemic seasons. BMC Infect Dis 2019; 19:290. [PMID: 30922223 PMCID: PMC6437956 DOI: 10.1186/s12879-019-3807-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 11/24/2022] Open
Abstract
Following publication of the original article [1], the author reported an error in the title.
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Affiliation(s)
- Linlin Zhou
- Department of Microbiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Huiping Yang
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yu Kuang
- Department of Microbiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Tianshu Li
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jianan Xu
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Shuang Li
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Ting Huang
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Chuan Wang
- Department of Medical Technology, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Wanyi Li
- Department of Microbiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Mingyuan Li
- Department of Microbiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Shusen He
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Ming Pan
- Sichuan Center for Disease Control and Prevention, No. 6 Zhongxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
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