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Jones RP, Ponomarenko A. Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths. Infect Dis Rep 2022; 14:710-758. [PMID: 36286197 PMCID: PMC9602062 DOI: 10.3390/idr14050076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 08/29/2023] Open
Abstract
Pathogen interference is the ability of one pathogen to alter the course and clinical outcomes of infection by another. With up to 3000 species of human pathogens the potential combinations are vast. These combinations operate within further immune complexity induced by infection with multiple persistent pathogens, and by the role which the human microbiome plays in maintaining health, immune function, and resistance to infection. All the above are further complicated by malnutrition in children and the elderly. Influenza vaccination offers a measure of protection for elderly individuals subsequently infected with influenza. However, all vaccines induce both specific and non-specific effects. The specific effects involve stimulation of humoral and cellular immunity, while the nonspecific effects are far more nuanced including changes in gene expression patterns and production of small RNAs which contribute to pathogen interference. Little is known about the outcomes of vaccinated elderly not subsequently infected with influenza but infected with multiple other non-influenza winter pathogens. In this review we propose that in certain years the specific antigen mix in the seasonal influenza vaccine inadvertently increases the risk of infection from other non-influenza pathogens. The possibility that vaccination could upset the pathogen balance, and that the timing of vaccination relative to the pathogen balance was critical to success, was proposed in 2010 but was seemingly ignored. Persons vaccinated early in the winter are more likely to experience higher pathogen interference. Implications to the estimation of vaccine effectiveness and influenza deaths are discussed.
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Affiliation(s)
- Rodney P Jones
- Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
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Suntronwong N, Vichaiwattana P, Klinfueng S, Korkong S, Thongmee T, Vongpunsawad S, Poovorawan Y. Climate factors influence seasonal influenza activity in Bangkok, Thailand. PLoS One 2020; 15:e0239729. [PMID: 32991630 PMCID: PMC7523966 DOI: 10.1371/journal.pone.0239729] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 09/12/2020] [Indexed: 12/05/2022] Open
Abstract
Yearly increase in influenza activity is associated with cold and dry winter in the temperate regions, while influenza patterns in tropical countries vary significantly by regional climates and geographic locations. To examine the association between influenza activity in Thailand and local climate factors including temperature, relative humidity, and rainfall, we analyzed the influenza surveillance data from January 2010 to December 2018 obtained from a large private hospital in Bangkok. We found that approximately one in five influenza-like illness samples (21.6% or 6,678/30,852) tested positive for influenza virus. Influenza virus typing showed that 34.2% were influenza A(H1N1)pdm09, 46.0% were influenza A(H3N2), and 19.8% were influenza B virus. There were two seasonal waves of increased influenza activity. Peak influenza A(H1N1)pdm09 activity occurred in February and again in August, while influenza A(H3N2) and influenza B viruses were primarily detected in August and September. Time series analysis suggests that increased relative humidity was significantly associated with increased influenza activity in Bangkok. Months with peak influenza activity generally followed the most humid months of the year. We performed the seasonal autoregressive integrated moving average (SARIMA) multivariate analysis of all influenza activity on the 2011 to 2017 data to predict the influenza activity for 2018. The resulting model closely resembled the actual observed overall influenza detected that year. Consequently, the ability to predict seasonal pattern of influenza in a large tropical city such as Bangkok may enable better public health planning and underscores the importance of annual influenza vaccination prior to the rainy season.
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Affiliation(s)
- Nungruthai Suntronwong
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sirapa Klinfueng
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sumeth Korkong
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanunrat Thongmee
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Jia P, Dong W, Yang S, Zhan Z, Tu L, Lai S. Spatial Lifecourse Epidemiology and Infectious Disease Research. Trends Parasitol 2020; 36:235-238. [PMID: 32044243 PMCID: PMC7172117 DOI: 10.1016/j.pt.2019.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/27/2019] [Accepted: 12/27/2019] [Indexed: 01/02/2023]
Abstract
Spatial lifecourse epidemiology aims to utilize advanced spatial, location-aware, and artificial intelligence technologies to investigate long-term effects of measurable biological, environmental, behavioral, and psychosocial factors on individual risk for chronic diseases. It could also further the research on infectious disease dynamics, risks, and consequences across the life course.
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Affiliation(s)
- Peng Jia
- School of Resources and Environmental Science, Wuhan University, Wuhan, China; Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China; International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China. @hotmail.com
| | - Weihua Dong
- State Key Laboratory of Remote Sensing Science, Beijing Normal University, Beijing, 100875, China; Faculty of Geography, Beijing Normal University, Beijing, 100875, China
| | - Shujuan Yang
- West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Zhicheng Zhan
- State Key Laboratory of Remote Sensing Science, Beijing Normal University, Beijing, 100875, China; Faculty of Geography, Beijing Normal University, Beijing, 100875, China
| | - La Tu
- Department of Information Art and Design, Tsinghua University, Beijing, 100084, China
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK; Flowminder Foundation, Stockholm, SE-113 55, Sweden; School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China
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