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Turtle J, Ben-Nun M, Riley P. Enhancing seasonal influenza projections: A mechanistic metapopulation model for long-term scenario planning. Epidemics 2024; 47:100758. [PMID: 38574441 DOI: 10.1016/j.epidem.2024.100758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 04/06/2024] Open
Abstract
In temperate regions, annual preparation by public health officials for seasonal influenza requires early-season long-term projections. These projections are different from short-term (e.g., 1-4 weeks ahead) forecasts that are typically updated weekly. Whereas short-term forecasts estimate what "will" likely happen in the near term, the goal of scenario projections is to guide long-term decision-making using "what if" scenarios. We developed a mechanistic metapopulation model and used it to provide long-term influenza projections to the Flu Scenario Modeling Hub. The scenarios differed in their assumptions about influenza vaccine effectiveness and prior immunity. The parameters of the model were inferred from early season hospitalization data and then simulated forward in time until June 3, 2023. We submitted two rounds of projections (mid-November and early December), with the second round being a repeat of the first with three more weeks of data (and consequently different model parameters). In this study, we describe the model, its calibration, and projections targets. The scenario projection outcomes for two rounds are compared with each other at state and national level reported daily hospitalizations. We show that although Rounds 2 and 3 were identical in definition, the addition of three weeks of data produced an improvement to model fits. These changes resulted in earlier projections for peak incidence, lower projections for peak magnitude and relatively small changes to cumulative projections. In both rounds, all four scenarios presented conceivable outcomes, with some scenarios agreeing well with observations. We discuss how to interpret this agreement, emphasizing that this does not imply that one scenario or another provides the ground truth. Our model's performance suggests that its underlying assumptions provided plausible bounds for what could happen during an influenza season following two seasons of low circulation. We suggest that such projections would provide actionable estimates for public health officials.
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Affiliation(s)
- James Turtle
- Infectious Disease Group, Predictive Science Inc., San Diego, CA, United States.
| | - Michal Ben-Nun
- Infectious Disease Group, Predictive Science Inc., San Diego, CA, United States
| | - Pete Riley
- Infectious Disease Group, Predictive Science Inc., San Diego, CA, United States
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Nayak JL, Caserta MT. Cell-Culture-Based Influenza Vaccines: Don't Put All of Your Influenza Vaccines in the Egg Basket. Pediatrics 2022; 150:189690. [PMID: 36214054 DOI: 10.1542/peds.2022-058143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 02/25/2023] Open
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Aberrant Cellular Glycosylation May Increase the Ability of Influenza Viruses to Escape Host Immune Responses through Modification of the Viral Glycome. mBio 2022; 13:e0298321. [PMID: 35285699 PMCID: PMC9040841 DOI: 10.1128/mbio.02983-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Individuals with metabolic dysregulation of cellular glycosylation often experience severe influenza disease, with a poor immune response to the virus and low vaccine efficacy. Here, we investigate the consequences of aberrant cellular glycosylation for the glycome and the biology of influenza virus. We transiently induced aberrant N-linked glycosylation in cultured cells with an oligosaccharyltransferase inhibitor, NGI-1. Cells treated with NGI-1 produced morphologically unaltered viable influenza virus with sequence-neutral glycosylation changes (primarily reduced site occupancy) in the hemagglutinin and neuraminidase proteins. Hemagglutinin with reduced glycan occupancy required a higher concentration of surfactant protein D (an important innate immunity respiratory tract collectin) for inhibition compared to that with normal glycan occupancy. Immunization of mice with NGI-1-treated virus significantly reduced antihemagglutinin and antineuraminidase titers of total serum antibody and reduced hemagglutinin protective antibody responses. Our data suggest that aberrant cellular glycosylation may increase the risk of severe influenza as a result of the increased ability of glycome-modified influenza viruses to evade the immune response.
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Peck H, Laurie KL, Rockman S, Leung V, Lau H, Soppe S, Rynehart C, Baas C, Trusheim H, Barr IG. Enhanced isolation of influenza viruses in qualified cells improves the probability of well-matched vaccines. NPJ Vaccines 2021; 6:149. [PMID: 34887440 PMCID: PMC8660794 DOI: 10.1038/s41541-021-00415-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/12/2021] [Indexed: 01/04/2023] Open
Abstract
Influenza vaccines are utilised to combat seasonal and pandemic influenza. The key to influenza vaccination currently is the availability of candidate vaccine viruses (CVVs). Ideally, CVVs reflect the antigenic characteristics of the circulating virus, which may vary depending upon the isolation method. For traditional inactivated egg-based vaccines, CVVs are isolated in embryonated chicken eggs, while for cell-culture production, CVV's are isolated in either embryonated eggs or qualified cell lines. We compared isolation rates, growth characteristics, genetic stability and antigenicity of cell and egg CVV's derived from the same influenza-positive human clinical respiratory samples collected from 2008-2020. Influenza virus isolation rates in MDCK33016PF cells were twice that of eggs and mutations in the HA protein were common in egg CVVs but rare in cell CVVs. These results indicate that fully cell-based influenza vaccines will improve the choice, match and potentially the effectiveness, of seasonal influenza vaccines compared to egg-based vaccines.
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Affiliation(s)
- Heidi Peck
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.
| | | | - Steve Rockman
- Seqirus Ltd, Parkville, VIC, Australia.,Department of Immunology and Microbiology, The University of Melbourne, Parkville, VIC, Australia
| | - Vivian Leung
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | - Hilda Lau
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | - Sally Soppe
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | - Cleve Rynehart
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | | | | | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.,Department of Immunology and Microbiology, The University of Melbourne, Parkville, VIC, Australia
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Claudino Formiga FF, Silva CA, Pedrosa TDN, Aikawa NE, Pasoto SG, Garcia CC, Capão ASV, Martins VADO, Proença ACTD, Fuller R, Yuki EFN, Vendramini MBG, Rosário DCD, Brandão LMKR, Sartori AMC, Antonangelo L, Bonfá E, Borba EF. Influenza A/Singapore (H3N2) component vaccine in systemic lupus erythematosus: A distinct pattern of immunogenicity. Lupus 2021; 30:1915-1922. [PMID: 34459317 DOI: 10.1177/09612033211040371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Influenza A (H3N2) virus is the most important cause of seasonal influenza morbidity and mortality in the last 50 years, surpassing the impact of H1N1. Data assessing immunogenicity and safety of this virus component are lacking in systemic lupus erythematosus (SLE) and restricted to small reports with other H3N2 strains. OBJECTIVE This study aims to evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in SLE. METHODS 81 consecutive SLE patients and 81 age- and sex-matched healthy controls (HC) were vaccinated with the influenza A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus. Seroprotection (SP) and seroconversion (SC) rates, geometric mean titers(GMT), and factor increase in GMT(FI-GMT) and adverse events were assessed before and 4 weeks post-vaccination. Disease activity and therapies were also evaluated. RESULTS Before immunization, SLE and HC groups had high SP rates (89% vs 77%, p = 0.061) and elevated GMT titer with higher levels in SLE (129.1(104.1-154.1) vs 54.8(45.0-64.6), p < 0.001). Frequency of two previous years' influenza vaccination was high and comparable in SLE and HC (89% vs 90%, p = 1.000). Four weeks post-vaccination, median GMT increased for both groups and remained higher in SLE compared to HC (239.9(189.5-290.4) vs 94.5(72.6-116.4), p < 0.0001) with a comparable FI-GMT (2.3(1.8-2.9) vs 1.9(1.5-2.3), p = 0.051). SC rates were low and comparable for both groups (16% vs 11%, respectively, p = 0.974). Disease activity scores remained stable throughout the study (p = 1.000) and severe adverse events were not identified. CONCLUSION Influenza A/Singapore (H3N2) vaccine has an adequate safety profile. The distinct immunogenicity pattern from other influenza A components characterized by a remarkably high pre- and post-vaccination SP rate and high GMT levels may be associated with previous influenza A vaccination. (www.clinicaltrials.gov, NCT03540823).
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Affiliation(s)
| | - Clovis Artur Silva
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tatiana do Nascimento Pedrosa
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nadia Emi Aikawa
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sandra Gofinet Pasoto
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Cristiana Couto Garcia
- Laboratory of Respiratory Virus and Measles, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Artur Silva Vidal Capão
- Laboratory of Respiratory Virus and Measles, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Adriana Coracini Tonacio de Proença
- Department of Infectious and Parasitic Diseases, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ricardo Fuller
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Emily Figueiredo Neves Yuki
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Debora Cordeiro do Rosário
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Ana Marli Christovam Sartori
- Department of Infectious and Parasitic Diseases, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Leila Antonangelo
- Clinical Laboratory Division - Department of Pathology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eloisa Bonfá
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferreira Borba
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Bolge SC, Gutierrez C, Kariburyo F, He D. Burden of Pneumonia Among Hospitalized Patients with Influenza: Real-World Evidence from a US Managed Care Population. Pulm Ther 2021; 7:517-532. [PMID: 34398424 PMCID: PMC8365129 DOI: 10.1007/s41030-021-00169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/29/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Pneumonia is among the most prevalent complications of influenza. The purpose of this study is to quantify the burden of pneumonia among hospitalized patients with influenza. Methods Real-world retrospective data from 01JAN2014-30JUN2019 (study period) were obtained from Optum’s de-identified Clinformatics® Data Mart Database (2007–2020) for patients who had ≥ 1 diagnosis for influenza during the identification period and ≥ 1 all-cause inpatient visit within 1 day of diagnosis. Cases had ≥ 1 diagnosis claim for an influenza-related pneumonia within the 30 days after the initial influenza diagnosis date. Controls had no evidence of influenza-related pneumonia in the 30 days following the initial influenza diagnosis. Final 1:1 matching was determined using propensity score matching (PSM). Statistical significance between the cohorts was tested. Results After PSM, there were 4878 hospitalized patients with influenza in each of the case and control groups. During the index hospitalization, cases vs. controls had longer length of stay [Mean (standard deviation): 6.5 (8.3) vs. 1.9 (3.7)], greater intensive care unit (ICU) use (38.4 vs. 16.8%), and greater mechanical ventilation use (invasive: 11.4 vs. 2.3%; non-invasive: 6.8 vs. 2.6%) (all p < 0.001). Cases also had higher readmission rates than controls (12.3 vs. 3.5% within 30 days; 20.0 vs. 6.1% within 90 days; p < 0.001 for both). Post-index date direct all-cause healthcare costs were higher for cases than for controls (median total cost: $18,428 vs. $621 for 30 days; $21,774 vs. $3312 for 90 days; $25,960 vs. $8699 for 6 months; $35,875 vs. $21,619 for 1 year; all p < 0.001). Conclusions Pneumonia as a complication of influenza increases risk of mortality and leads to greater healthcare resource use and direct medical costs among patients hospitalized with influenza. These effects are seen early during the index hospitalization and within the first 30 days after diagnosis, but their impact continues throughout a year of follow-up. Supplementary Information The online version contains supplementary material available at 10.1007/s41030-021-00169-2.
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Affiliation(s)
| | | | | | - Ding He
- SIMR, LLC, 4110 Varsity Dr, Ann Arbor, MI, 48108, USA
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Harris GH, Rak KJ, Kahn JM, Angus DC, Mancing OR, Driessen J, Wallace DJ. US Hospital Capacity Managers' Experiences and Concerns Regarding Preparedness for Seasonal Influenza and Influenza-like Illness. JAMA Netw Open 2021; 4:e212382. [PMID: 33739431 PMCID: PMC7980097 DOI: 10.1001/jamanetworkopen.2021.2382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
IMPORTANCE The 2017-2018 influenza season in the US was marked by a high severity of illness, wide geographic spread, and prolonged duration compared with recent previous seasons, resulting in increased strain throughout acute care hospital systems. OBJECTIVE To characterize self-reported experiences and views of hospital capacity managers regarding the 2017-2018 influenza season in the US. DESIGN, SETTING, AND PARTICIPANTS In this qualitative study, semistructured telephone interviews were conducted between April 2018 and January 2019 with a random sample of capacity management administrators responsible for throughput and hospital capacity at short-term, acute care hospitals throughout the US. MAIN OUTCOMES AND MEASURES Each participant's self-reported experiences and views regarding high patient volumes during the 2017-2018 influenza season, lessons learned, and the extent of hospitals' preparedness planning for future pandemic events. Interviews were recorded and transcribed and then analyzed using thematic content analysis. Outcomes included themes and subthemes. RESULTS A total of 53 key hospital capacity personnel at 53 hospitals throughout the US were interviewed; 39 (73.6%) were women, 48 (90.6%) had a nursing background, and 29 (54.7%) had been in the occupational role for more than 4 years. Participants' experiences were categorized into several domains: (1) perception of strain, (2) effects of influenza and influenza-like illness on staff and patient care, (3) immediate staffing and capacity responses to influenza and influenza-like illness, and (4) future staffing and capacity preparedness for influenza and influenza-like illness. Participants reported experiencing perceived strain associated with concerns about preparedness for seasonal influenza and influenza-like illness as well as concerns about staffing, patient care, and capacity, but future pandemic planning within hospitals was not reported as being a high priority. CONCLUSIONS AND RELEVANCE The findings of this qualitative study suggest that during the 2017-2018 influenza season, there were systemic vulnerabilities as well as a lack of hospital preparedness planning for future pandemics at US hospitals. These issues should be addressed given the current coronavirus disease 2019 pandemic.
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Affiliation(s)
- Gavin H. Harris
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Kimberly J. Rak
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jeremy M. Kahn
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Derek C. Angus
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Olivia R. Mancing
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Julia Driessen
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - David J. Wallace
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Mathewson K, Sundaram M, Bednarczyk RA. Young Adult Human Papillomavirus and Influenza Vaccine Coverage: A Comparison Across College Enrollment Status. J Community Health 2021; 46:13-21. [PMID: 32415521 PMCID: PMC7666656 DOI: 10.1007/s10900-020-00833-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To determine human papillomavirus and influenza vaccine coverage among young adults in the US and assess differences in vaccine uptake by college enrollment status, we conducted an online survey of young adults aged 18-26 (n = 417) using Survey Monkey, with recruitment occurring through Amazon's Mechanical Turk (MTurk) platform. We collected data on self-reported preventive health behaviors, including vaccine receipt, current college enrollment status, and other demographics. Overall, 49% of participants reported receiving at least one dose of human papillomavirus vaccine and 57% reported receiving at least one influenza vaccine over the past three years. Vaccine coverage estimates did not differ between college-enrolled and non-enrolled respondents. Low vaccine coverage rates demonstrate the need to improve vaccine strategies for young adults. The strongest predictor of vaccine receipt was having received a provider recommendation. There does not appear to be healthcare utilization differences related to ability to access care through student health or community-based settings. Additional research is needed to develop interventions to improve vaccination coverage among young adults, both currently enrolled and not enrolled in college.
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Affiliation(s)
- Kara Mathewson
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Maria Sundaram
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Robert A Bednarczyk
- Rollins School of Public Health, CNR 7019, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, 1365-C Clifton Road NE, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University, 954 Gatewood Road, Atlanta, GA, USA.
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Rockman S, Laurie KL, Parkes S, Wheatley A, Barr IG. New Technologies for Influenza Vaccines. Microorganisms 2020; 8:microorganisms8111745. [PMID: 33172191 PMCID: PMC7694987 DOI: 10.3390/microorganisms8111745] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/22/2022] Open
Abstract
Vaccine development has been hampered by the long lead times and the high cost required to reach the market. The 2020 pandemic, caused by a new coronavirus (SARS-CoV-2) that was first reported in late 2019, has seen unprecedented rapid activity to generate a vaccine, which belies the traditional vaccine development cycle. Critically, much of this progress has been leveraged off existing technologies, many of which had their beginnings in influenza vaccine development. This commentary outlines the most promising of the next generation of non-egg-based influenza vaccines including new manufacturing platforms, structure-based antigen design/computational biology, protein-based vaccines including recombinant technologies, nanoparticles, gene- and vector-based technologies, as well as an update on activities around a universal influenza vaccine.
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Affiliation(s)
- Steven Rockman
- Technical Development, Seqirus Ltd, Parkville, Victoria 3052, Australia; (S.R.); (S.P.)
- Department of Immunology and Microbiology, The University of Melbourne, Parkville, Victoria 3052, Australia; (A.W.); (I.G.B.)
| | - Karen L. Laurie
- Technical Development, Seqirus Ltd, Parkville, Victoria 3052, Australia; (S.R.); (S.P.)
- Correspondence:
| | - Simone Parkes
- Technical Development, Seqirus Ltd, Parkville, Victoria 3052, Australia; (S.R.); (S.P.)
| | - Adam Wheatley
- Department of Immunology and Microbiology, The University of Melbourne, Parkville, Victoria 3052, Australia; (A.W.); (I.G.B.)
| | - Ian G. Barr
- Department of Immunology and Microbiology, The University of Melbourne, Parkville, Victoria 3052, Australia; (A.W.); (I.G.B.)
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, The Peter Doherty Institute for Infection and Immunity, Parkville, Victoria 3052, Australia
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Taubenberger JK, Morens DM. The 1918 Influenza Pandemic and Its Legacy. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a038695. [PMID: 31871232 DOI: 10.1101/cshperspect.a038695] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Just over a century ago in 1918-1919, the "Spanish" influenza pandemic appeared nearly simultaneously around the world and caused extraordinary mortality-estimated at 50-100 million fatalities-associated with unexpected clinical and epidemiological features. The pandemic's sudden appearance and high fatality rate were unprecedented, and 100 years later still serve as a stark reminder of the continual threat influenza poses. Sequencing and reconstruction of the 1918 virus have allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. Several of the unusual features of the 1918-1919 pandemic, including age-specific mortality patterns and the high frequency of severe pneumonias, are still not fully understood. The 1918 pandemic virus initiated a pandemic era still ongoing. The descendants of the 1918 virus remain today as annually circulating and evolving influenza viruses causing significant mortality each year. This review summarizes key findings and unanswered questions about this deadliest of human events.
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Affiliation(s)
- Jeffery K Taubenberger
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - David M Morens
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
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Jackson AM, Mullican LA, Tse ZTH, Yin J, Zhou X, Kumar D, Fung ICH. Unplanned Closure of Public Schools in Michigan, 2015-2016: Cross-Sectional Study on Rurality and Digital Data Harvesting. THE JOURNAL OF SCHOOL HEALTH 2020; 90:511-519. [PMID: 32383235 DOI: 10.1111/josh.12901] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 08/05/2019] [Accepted: 10/22/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND For pandemic preparedness, researchers used online systematic searches to track unplanned school closures (USCs). We determine if Twitter provides complementary data. METHODS Twitter handles of Michigan public schools and school districts were identified. All tweets associated with these handles were downloaded. USC-related tweets were identified using 5 keywords. Descriptive statistics and multivariable logistic regression were performed in R. RESULTS Among 3469 Michigan public schools, 2003 maintained their own active Twitter accounts or belonged to school districts with active Twitter accounts. Of these 2003 schools, in 2015-2016 school year, at least 1 USC announcement was identified for 349 schools via the current method only, 678 schools via Twitter only, and 562 schools via both methods. No USC announcements were identified for 414 schools. Rural schools were less likely than city schools to have active Twitter coverage (adjusted relative risk [adjRR] = 0.3956, 95% confidence interval [CI] 0.3312-0.4671), and to announce USCs on Twitter (adjRR = 0.5692, 95% CI 0.4645-0.6823), but more likely to have USCs identified by the current method (adjRR = 1.4545, 95% CI 1.3545-1.5490). CONCLUSIONS Each method identified USCs that were missed by the other. Our results suggested that identifying USCs on Twitter is complementary to the current method.
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Affiliation(s)
- Ashley M Jackson
- Graduate student, , Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460., USA
- ORISE Fellow, Community Interventions for Infection Control Unit, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333., USA
| | - Lindsay A Mullican
- Graduate student, , Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460., USA
| | - Zion T H Tse
- Professor, , College of Engineering, The University of Georgia, Athens, GA 30602., USA
- Department of Electronic Engineering, University of York, Heslington, York YO10 5DD., UK
| | - Jingjing Yin
- Associate Professor of Biostatistics, , Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460., USA
| | - Xiaolu Zhou
- Assistant Professor of Geography, , Department of Geology and Geography, Georgia Southern University, Statesboro, GA 30460., USA
- Department of Geography, Texas Christian University, Fort Worth, Texas 76129., USA
| | - Dharamendra Kumar
- Graduate student, , Department of Computer Science, The University of Georgia, Athens, GA 30602., USA
| | - Isaac C-H Fung
- Associate Professor of Epidemiology, , Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460., USA
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O’Neil B, Ison MG, Hallouin-Bernard MC, Nilsson AC, Torres A, Wilburn JM, van Duijnhoven W, Van Dromme I, Anderson D, Deleu S, Kosoglou T, Vingerhoets J, Rossenu S, Leopold L. A Phase 2 Study of Pimodivir (JNJ-63623872) in Combination With Oseltamivir in Elderly and Nonelderly Adults Hospitalized With Influenza A Infection: OPAL Study. J Infect Dis 2020; 226:109-118. [PMID: 32604406 PMCID: PMC9373154 DOI: 10.1093/infdis/jiaa376] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/25/2020] [Indexed: 11/15/2022] Open
Abstract
Background Both the elderly and individuals with comorbidities are at increased risk of developing influenza-related complications. Novel influenza antivirals are required, given limitations of current drugs (eg, resistance emergence and poor efficacy). Pimodivir is a first-in-class antiviral for influenza A under development for these patients. Methods Hospitalized patients with influenza A infection were randomized 2:1 to receive pimodivir 600 mg plus oseltamivir 75 mg or placebo plus oseltamivir 75 mg twice daily for 7 days in this phase 2b study. The primary objective was to compare pimodivir pharmacokinetics in elderly (aged 65–85 years) versus nonelderly adults (aged 18–64 years). Secondary end points included time to patient-reported symptom resolution. Results Pimodivir pharmacokinetic parameters in nonelderly and elderly patients were similar. Time to influenza symptom resolution was numerically shorter with pimodivir (72.45 hours) than placebo (94.15 hours). There was a lower incidence of influenza-related complications in the pimodivir group (7.9%) versus placebo group (15.6%). Treatment was generally well tolerated. Conclusions No apparent relationship was observed between pimodivir pharmacokinetics and age. Our data demonstrate the need for a larger study of pimodivir in addition to oseltamivir to test whether it results in a clinically significant decrease in time-to-influenza-symptom alleviation and/or the frequency of influenza complications. Clinical trials registration NCT02532283.
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Affiliation(s)
- Brian O’Neil
- Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA
| | - Michael G Ison
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Anna C Nilsson
- Infectious Disease Research Unit, Department of Translational Medicine, Skåne University Hospital, Malmö, Sweden
| | - Antoni Torres
- Servei de Pneumologia Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, Biomedical Research Networking Center on Respiratory Diseases, University of Barcelona, Barcelona, Spain
| | - John M Wilburn
- Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA
| | | | | | - David Anderson
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
| | | | - Teddy Kosoglou
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
| | | | | | - Lorant Leopold
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
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13
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Xia J, Adam DC, Moa A, Chughtai AA, Barr IG, Komadina N, MacIntyre CR. Comparative epidemiology, phylogenetics, and transmission patterns of severe influenza A/H3N2 in Australia from 2003 to 2017. Influenza Other Respir Viruses 2020; 14:700-709. [PMID: 32558378 PMCID: PMC7578330 DOI: 10.1111/irv.12772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 12/30/2022] Open
Abstract
Background Over the last two decades, Australia has experienced four severe influenza seasons caused by a predominance of influenza A (A/H3N2): 2003, 2007, 2012, and 2017. Methods We compared the epidemiology, genetics, and transmission dynamics of severe A/H3N2 seasons in Australia from 2003 to 2017. Results Since 2003, the proportion of notifications in 0‐4 years old has decreased, while it has increased in the age group >80 years old (P < .001). The genetic diversity of circulating influenza A/H3N2 viruses has also increased over time with the number of single nucleotide polymorphisms significantly (P < .05) increasing. We also identified five residue positions within or near the receptor binding site of HA (144, 145, 159, 189, and 225) undergoing frequent mutations that are likely involved in significant antigenic drift and possibly severity. The Australian state of Victoria was identified as a frequent location for transmission either to or from other states and territories over the study years. The states of New South Wales and Queensland were also frequently implicated as locations of transmission to other states and territories but less so over the years. This indicates a stable but also changing dynamic of A/H3N2 circulation in Australia. Conclusion These results have important implications for future influenza surveillance and control policy in the country. Reasons for the change in age‐specific infection and increased genetic diversity of A/H3N2 viruses in recent years should be explored.
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Affiliation(s)
- Jing Xia
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Dillon C Adam
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Aye Moa
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Abrar A Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza (VIDRL), Doherty Institute, Melbourne, Vic., Australia.,Department of Microbiology and Immunology, Doherty Institute, University of Melbourne, Melbourne, Vic., Australia
| | - Naomi Komadina
- WHO Collaborating Centre for Reference and Research on Influenza (VIDRL), Doherty Institute, Melbourne, Vic., Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - C Raina MacIntyre
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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14
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Lu Y, Chillarige Y, Izurieta HS, Wei Y, Xu W, Lu M, Sung HM, Lindaas A, Wernecke M, Macurdy T, Kelman J, Forshee RA. Effect of Age on Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccines Among US Medicare Beneficiaries Aged ≥65 Years. J Infect Dis 2020; 220:1511-1520. [PMID: 31290553 DOI: 10.1093/infdis/jiz360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/08/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Studies have found that the high-dose influenza vaccine has a higher relative vaccine effectiveness (RVE) versus standard-dose vaccines in some seasons. We evaluated the effect of age on the RVE of high-dose versus standard-dose influenza vaccines among Medicare beneficiaries. METHODS A 6-season retrospective cohort study from 2012 to 2018 among Medicare beneficiaries aged ≥65 years was performed. Poisson regression was used to evaluate the effect of age on the RVE of high-dose versus standard-dose influenza vaccines in preventing influenza-related hospitalizations. RESULTS The study included >19 million vaccinated beneficiaries in a community pharmacy setting. The Poisson models indicated a slightly increasing trend in RVE with age in all seasons. The high-dose vaccine was more effective than standard-dose vaccines in preventing influenza-related hospital encounters (ie, influenza-related inpatient stays and emergency department visits) in the 2012-2013 (RVE, 23.1%; 95% confidence interval [CI], 17.6%-28.3%), 2013-2014 (RVE, 15.3%; 95% CI, 7.8%-22.3%), 2014-2015 (RVE, 8.9%; 95% CI, 5.6%-12.1%), and 2016-2017 (RVE, 12.6%; 95% CI, 6.3%-18.4%) seasons and was at least as effective in all other seasons. We also found that the high-dose vaccine was consistently more effective than standard-dose vaccines across all seasons for people aged ≥85 years. Similar trends were observed for influenza-related inpatient stays. CONCLUSIONS The RVE of high-dose versus standard-dose influenza vaccines increases with age.
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Affiliation(s)
- Yun Lu
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | | | - Hector S Izurieta
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland.,Universidad Rey Juan Carlos, Madrid, Spain
| | - Yuqin Wei
- Acumen, Burlingame, Stanford University, Stanford, California
| | - Wenjie Xu
- Acumen, Burlingame, Stanford University, Stanford, California
| | - Michael Lu
- Acumen, Burlingame, Stanford University, Stanford, California
| | - Heng-Ming Sung
- Acumen, Burlingame, Stanford University, Stanford, California
| | | | | | - Thomas Macurdy
- Acumen, Burlingame, Stanford University, Stanford, California.,Department of Economics, Stanford University, Stanford, California
| | - Jeffrey Kelman
- Centers for Medicare and Medicaid Services, Washington, D. C
| | - Richard A Forshee
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
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15
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Martinez-Sobrido L, Blanco-Lobo P, Rodriguez L, Fitzgerald T, Zhang H, Nguyen P, Anderson CS, Holden-Wiltse J, Bandyopadhyay S, Nogales A, DeDiego ML, Wasik BR, Miller BL, Henry C, Wilson PC, Sangster MY, Treanor JJ, Topham DJ, Byrd-Leotis L, Steinhauer DA, Cummings RD, Luczo JM, Tompkins SM, Sakamoto K, Jones CA, Steel J, Lowen AC, Danzy S, Tao H, Fink AL, Klein SL, Wohlgemuth N, Fenstermacher KJ, el Najjar F, Pekosz A, Sauer L, Lewis MK, Shaw-Saliba K, Rothman RE, Liu ZY, Chen KF, Parrish CR, Voorhees IEH, Kawaoka Y, Neumann G, Chiba S, Fan S, Hatta M, Kong H, Zhong G, Wang G, Uccellini MB, García-Sastre A, Perez DR, Ferreri LM, Herfst S, Richard M, Fouchier R, Burke D, Pattinson D, Smith DJ, Meliopoulos V, Freiden P, Livingston B, Sharp B, Cherry S, Dib JC, Yang G, Russell CJ, Barman S, Webby RJ, Krauss S, Danner A, Woodard K, Peiris M, Perera RAPM, Chan MCW, Govorkova EA, Marathe BM, Pascua PNQ, Smith G, Li YT, Thomas PG, Schultz-Cherry S. Characterizing Emerging Canine H3 Influenza Viruses. PLoS Pathog 2020; 16:e1008409. [PMID: 32287326 PMCID: PMC7182277 DOI: 10.1371/journal.ppat.1008409] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/24/2020] [Accepted: 02/19/2020] [Indexed: 01/06/2023] Open
Abstract
The continual emergence of novel influenza A strains from non-human hosts requires constant vigilance and the need for ongoing research to identify strains that may pose a human public health risk. Since 1999, canine H3 influenza A viruses (CIVs) have caused many thousands or millions of respiratory infections in dogs in the United States. While no human infections with CIVs have been reported to date, these viruses could pose a zoonotic risk. In these studies, the National Institutes of Allergy and Infectious Diseases (NIAID) Centers of Excellence for Influenza Research and Surveillance (CEIRS) network collaboratively demonstrated that CIVs replicated in some primary human cells and transmitted effectively in mammalian models. While people born after 1970 had little or no pre-existing humoral immunity against CIVs, the viruses were sensitive to existing antivirals and we identified a panel of H3 cross-reactive human monoclonal antibodies (hmAbs) that could have prophylactic and/or therapeutic value. Our data predict these CIVs posed a low risk to humans. Importantly, we showed that the CEIRS network could work together to provide basic research information important for characterizing emerging influenza viruses, although there were valuable lessons learned.
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MESH Headings
- Animals
- Communicable Diseases, Emerging/transmission
- Communicable Diseases, Emerging/veterinary
- Communicable Diseases, Emerging/virology
- Dog Diseases/transmission
- Dog Diseases/virology
- Dogs
- Ferrets
- Guinea Pigs
- Humans
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza A Virus, H3N8 Subtype/classification
- Influenza A Virus, H3N8 Subtype/genetics
- Influenza A Virus, H3N8 Subtype/isolation & purification
- Influenza A virus/classification
- Influenza A virus/genetics
- Influenza A virus/isolation & purification
- Influenza, Human/transmission
- Influenza, Human/virology
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Inbred DBA
- United States
- Zoonoses/transmission
- Zoonoses/virology
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Affiliation(s)
- Luis Martinez-Sobrido
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Pilar Blanco-Lobo
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Laura Rodriguez
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Theresa Fitzgerald
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Hanyuan Zhang
- Department of Dermatology, University of Rochester, Rochester, New York, United States of America
- Materials Science Program, University of Rochester, Rochester, New York, United States of America
| | - Phuong Nguyen
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Christopher S. Anderson
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Jeanne Holden-Wiltse
- Department of Biostatistics and Computational Biology and Clinical and Translational Science Institute, University of Rochester, Rochester, New York, United States of America
| | - Sanjukta Bandyopadhyay
- Department of Biostatistics and Computational Biology and Clinical and Translational Science Institute, University of Rochester, Rochester, New York, United States of America
| | - Aitor Nogales
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Marta L. DeDiego
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Brian R. Wasik
- Baker Institute for Animal Health, Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Benjamin L. Miller
- Department of Dermatology, University of Rochester, Rochester, New York, United States of America
- Materials Science Program, University of Rochester, Rochester, New York, United States of America
| | - Carole Henry
- The Department of Medicine, Section of Rheumatology, The Knapp Center for Lupus and Immunology Research, The University of Chicago, Chicago, Illinois, United States of America
| | - Patrick C. Wilson
- The Department of Medicine, Section of Rheumatology, The Knapp Center for Lupus and Immunology Research, The University of Chicago, Chicago, Illinois, United States of America
| | - Mark Y. Sangster
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - John J. Treanor
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - David J. Topham
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, United States of America
| | - Lauren Byrd-Leotis
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Beth Israel Deaconess Medical Center, Department of Surgery and Harvard Medical School Center for Glycoscience, Harvard Medical School, Boston, Massachusetts, United States of America
| | - David A. Steinhauer
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Richard D. Cummings
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Beth Israel Deaconess Medical Center, Department of Surgery and Harvard Medical School Center for Glycoscience, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jasmina M. Luczo
- Center for Vaccines and Immunology, University of Georgia, Athens, Georgia, United States of America
| | - Stephen M. Tompkins
- Center for Vaccines and Immunology, University of Georgia, Athens, Georgia, United States of America
| | - Kaori Sakamoto
- Department of Pathology, University of Georgia, Athens, Georgia, United States of America
| | - Cheryl A. Jones
- Center for Vaccines and Immunology, University of Georgia, Athens, Georgia, United States of America
| | - John Steel
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Anice C. Lowen
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Shamika Danzy
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Hui Tao
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Ashley L. Fink
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Sabra L. Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Nicholas Wohlgemuth
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Katherine J. Fenstermacher
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Farah el Najjar
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Mitra K. Lewis
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Richard E. Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Zhen-Ying Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taiwan
| | - Kuan-Fu Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taiwan
| | - Colin R. Parrish
- Baker Institute for Animal Health, Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Ian E. H. Voorhees
- Baker Institute for Animal Health, Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Yoshihiro Kawaoka
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Gabriele Neumann
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Shiho Chiba
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Shufang Fan
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Masato Hatta
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Huihui Kong
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Gongxun Zhong
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison. Madison, Wisconsin, United States of America
| | - Guojun Wang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Melissa B. Uccellini
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Daniel R. Perez
- Department of Population Health, University of Georgia, Athens, Georgia, United States of America
| | - Lucas M. Ferreri
- Department of Population Health, University of Georgia, Athens, Georgia, United States of America
| | - Sander Herfst
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Mathilde Richard
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Ron Fouchier
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - David Burke
- Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, United Kingdom
| | - David Pattinson
- Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, United Kingdom
| | - Derek J. Smith
- Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, United Kingdom
| | - Victoria Meliopoulos
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Pamela Freiden
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Brandi Livingston
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Bridgett Sharp
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Sean Cherry
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Juan Carlos Dib
- Tropical Health Foundation, Santa Marta, Magdalena, Colombia
| | - Guohua Yang
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Charles J. Russell
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Subrata Barman
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Richard J. Webby
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Scott Krauss
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Angela Danner
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Karlie Woodard
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Malik Peiris
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Republic of China
| | - R. A. P. M. Perera
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Republic of China
| | - M. C. W. Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Republic of China
| | - Elena A. Govorkova
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Bindumadhav M. Marathe
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Philippe N. Q. Pascua
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Gavin Smith
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Yao-Tsun Li
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Paul G. Thomas
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Stacey Schultz-Cherry
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
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16
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Potter BI, Kondor R, Hadfield J, Huddleston J, Barnes J, Rowe T, Guo L, Xu X, Neher RA, Bedford T, Wentworth DE. Evolution and rapid spread of a reassortant A(H3N2) virus that predominated the 2017-2018 influenza season. Virus Evol 2019; 5:vez046. [PMID: 33282337 DOI: 10.1093/ve/vez046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The 2017-2018 North American influenza season caused more hospitalizations and deaths than any year since the 2009 H1N1 pandemic. The majority of recorded influenza infections were caused by A(H3N2) viruses, with most of the virus's North American diversity falling into the A2 clade. Within A2, we observe a subclade which we call A2/re that rose to comprise almost 70 per cent of A(H3N2) viruses circulating in North America by early 2018. Unlike most fast-growing clades, however, A2/re contains no amino acid substitutions in the hemagglutinin (HA) segment. Moreover, hemagglutination inhibition assays did not suggest substantial antigenic differences between A2/re viruses and viruses sampled during the 2016-2017 season. Rather, we observe that the A2/re clade was the result of a reassortment event that occurred in late 2016 or early 2017 and involved the combination of the HA and PB1 segments of an A2 virus with neuraminidase (NA) and other segments a virus from the clade A1b. The success of this clade shows the need for antigenic analysis that targets NA in addition to HA. Our results illustrate the potential for non-HA drivers of viral success and necessitate the need for more thorough tracking of full viral genomes to better understand the dynamics of influenza epidemics.
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Affiliation(s)
- Barney I Potter
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Rebecca Kondor
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
| | - James Hadfield
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - John Huddleston
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA.,Molecular and Cellular Biology Program, University of Washington, 4109 E Stevens Way NE, Seattle, WA 98105, USA
| | - John Barnes
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Thomas Rowe
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Lizheng Guo
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Xiyan Xu
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Richard A Neher
- Biozentrum, University of Basel, Klingelbergstrasse 70, 4056 Basel, Switzerland.,SIB Swiss Institute of Bioinformatics, Klingelbergstrasse 70, 4056 Basel, Switzerland
| | - Trevor Bedford
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - David E Wentworth
- Virology Surveillance and Diagnosis Branch, Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA
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17
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Adlhoch C, Snacken R, Melidou A, Ionescu S, Penttinen P. Dominant influenza A(H3N2) and B/Yamagata virus circulation in EU/EEA, 2016/17 and 2017/18 seasons, respectively. ACTA ACUST UNITED AC 2019; 23. [PMID: 29616611 PMCID: PMC5883452 DOI: 10.2807/1560-7917.es.2018.23.13.18-00146] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We use surveillance data to describe influenza A and B virus circulation over two consecutive seasons with excess all-cause mortality in Europe, especially in people aged 60 years and older. Influenza A(H3N2) virus dominated in 2016/17 and B/Yamagata in 2017/18. The latter season was prolonged with positivity rates above 50% among sentinel detections for at least 12 weeks. With a current west–east geographical spread, high influenza activity might still be expected in eastern Europe.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - René Snacken
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angeliki Melidou
- Microbiology Department, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Silviu Ionescu
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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- The members of the European Influenza Surveillance Network are listed at the end of article
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18
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A Severe Seasonal Influenza Epidemic During 2017–2018 in China After the 2009 Pandemic Influenza: A Modeling Study. INFECTIOUS MICROBES AND DISEASES 2019. [DOI: 10.1097/im9.0000000000000006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Taubenberger JK, Kash JC, Morens DM. The 1918 influenza pandemic: 100 years of questions answered and unanswered. Sci Transl Med 2019; 11:eaau5485. [PMID: 31341062 PMCID: PMC11000447 DOI: 10.1126/scitranslmed.aau5485] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 02/11/2019] [Indexed: 12/13/2022]
Abstract
The 2018-2019 period marks the centennial of the "Spanish" influenza pandemic, which caused at least 50 million deaths worldwide. The unprecedented nature of the pandemic's sudden appearance and high fatality rate serve as a stark reminder of the threat influenza poses. Unusual features of the 1918-1919 pandemic, including age-specific mortality and the high frequency of severe pneumonias, are still not fully understood. Sequencing and reconstruction of the 1918 virus has allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. This Review summarizes key findings and still-to-be answered questions about this deadliest of human events.
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Affiliation(s)
- Jeffery K Taubenberger
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
| | - John C Kash
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - David M Morens
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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Akpalu Y, Karaye I, Anderson J, Mgbere O, Horney JA. Demographic Determinants of Influenza Vaccination and Infection, Brazos County, Texas, 2017. Infect Dis (Lond) 2019; 12:1178633719863815. [PMID: 31320802 PMCID: PMC6630077 DOI: 10.1177/1178633719863815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/25/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity. METHODS Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers. RESULTS A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized. DISCUSSION Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.
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Affiliation(s)
- Yao Akpalu
- Brazos County Health Department, Bryan, TX, USA
| | - Ibraheem Karaye
- Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, TX, USA
| | | | | | - Jennifer A Horney
- Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, TX, USA
- Department of Epidemiology, College of Health Sciences, University of Delaware, Newark, DE, USA
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21
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Banerjee D, Kanwar N, Hassan F, Lankachandra K, Selvarangan R. Comparative analysis of Four sample-to-answer influenza A/B and RSV nucleic acid amplification assays using adult respiratory specimens. J Clin Virol 2019; 118:9-13. [PMID: 31302479 DOI: 10.1016/j.jcv.2019.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/14/2019] [Accepted: 07/03/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND The use of Sample-to-answer (STA) platforms for the detection of influenza A/B and respiratory syncytial virus (RSV) have greatly improved patient care. These diagnostic assays based on nucleic acid amplification are rapid, accurate and relatively easy to perform. OBJECTIVES We compared four such platforms for detecting FluA, FluB, and RSV from adult respiratory specimens: Hologic Panther Fusion® Flu A/B/RSV (Fusion), Cobas® Influenza A/B & RSV (Liat), Luminex Aries® Flu A/B & RSV (Aries), and Diasorin SimplexaTM Flu A/B & RSV (Simplexa). STUDY DESIGN Nasopharyngeal (NP) swabs (n = 224) from adults were tested on these platforms and results were compared to Center for Disease Control and Prevention recommended real-time RT-PCR assay for influenza A/B and RSV. Subtyping for FluA and FluB was performed for discrepant analysis where applicable. RESULTS Of the 82 FluA, 26 FluB, 15 RSV-positive specimens tested, the positive and negative percentage agreements (PPA and NPA respectively) for FluA detection were 100/100 (Fusion), 95.1/100 (Liat), 92.5/100 (Aries), and 84.1/99.3 (Simplexa); PPA and NPA for FluB detection were 92.3/99.5 (Fusion), 96/99.5 (Liat), 100/99.5 (Aries), and 80.8/100 (Simplexa); and for RSV detection were 100/100 (Fusion), 100/100 (Liat), 88.6/99.5 (Aries), and 73.3/100 (Simplexa). 82 confirmed FluA included 23 pH1N1 and 57 H3N2 strains with 2 strains remaining untyped. Of the 26 confirmed FluB, 25 were of the Yamagata lineage and 1 of unknown lineage. CONCLUSION Only 2 STA platforms demonstrated >95% PPA for the detection of all three targets while all the 4 platforms demonstrated >95% NPA for FluA, FluB and RSV.
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Affiliation(s)
- Dithi Banerjee
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA.
| | - Neena Kanwar
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Ferdaus Hassan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Kamani Lankachandra
- Department of Pathology and Laboratory Medicine, Truman Medical Center, Kansas City, Missouri, USA
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA
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22
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Fogerty RL, Cabie M, Doyle D, Brien P, Beley P, Jansen L, Stump L, Gaffney J, Ferencz KW, Lourenco C, Cushing W, Williams E, Marseglia J, Martinello RA, Morris V. Conversion of a Conference Room into a Low-Acuity Inpatient Medical Unit: A Creative Response to Influenza-Related Surge. Jt Comm J Qual Patient Saf 2019; 45:524-529. [PMID: 31164262 DOI: 10.1016/j.jcjq.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/15/2022]
Abstract
The 2017-2018 influenza season was associated with high demand for both emergency department (ED) care and inpatient acute care for influenza-like illness (ILI). This high demand resulted in increased numbers of inpatients and ED patients, including prolonged ED length of stay. A large, urban, academic medical center in a cold-weather region was limited in its ability to expand its footprint to create de novo locations of care, such as temporary outbuildings or tents. As such, a large conference room was rapidly converted and placed in service as a temporary inpatient unit for adults requiring inpatient admission. LOGISTICS AND IMPLEMENTATION: The logistical, infection prevention, safety, information technology, staffing, and other concerns of creating a clinical environment during a high demand scenario is challenging. However, the lessons learned in this study are reproducible despite the complexity of this issue. CONCLUSION: This is believed to be the first published account of successful conversion of a nonclinical area to an operational clinical unit in response to a surge in demand for hospital care and admission. This may be a valid option for hospitals of all sizes as part of a surge or disaster plan.
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23
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Ali ST, Cowling BJ, Lau EHY, Fang VJ, Leung GM. Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018. Emerg Infect Dis 2019; 24:2071-2073. [PMID: 30334723 PMCID: PMC6200008 DOI: 10.3201/eid2411.180612] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In winter 2018, schools in Hong Kong were closed 1 week before the scheduled Chinese New Year holiday to mitigate an influenza B virus epidemic. The intervention occurred after the epidemic peak and reduced overall incidence by ≈4.2%. School-based vaccination programs should be implemented to more effectively reduce influenza illnesses.
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24
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Abstract
Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Despite broad literature including basic and translational scientific studies, many gaps in our understanding of host-pathogen interactions remain. In this review, pathogen virulence factors that drive lung infection and injury are discussed in relation to their associated host immune pathways. CAP epidemiology is considered, with a focus on Staphylococcus aureus and Streptococcus pneumoniae as primary pathogens. Bacterial factors involved in nasal colonization and subsequent virulence are illuminated. A particular emphasis is placed on bacterial pore-forming toxins, host cell death, and inflammasome activation. Identified host-pathogen interactions are then examined by linking pathogen factors to aberrant host response pathways in the context of acute lung injury in both primary and secondary infection. While much is known regarding bacterial virulence and host immune responses, CAP management is still limited to mostly supportive care. It is likely that improvements in therapy will be derived from combinatorial targeting of both pathogen virulence factors and host immunomodulation.
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25
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Abstract
BACKGROUND The influenza virus is a pathogenic virus responsible for large numbers of deaths and long-term disabilities worldwide. Although the very young, the very old, and immunocompromised individuals are most susceptible, the effects of the influenza virus can be observed across the entire spectrum of individuals. DISCUSSION Infection with the influenza virus induces a substantial inflammatory and immunologic response and induces marked pulmonary inflammation. Many aspects of influenza affect surgical patients directly. Vaccines are one of the most effective measures aimed at reducing the prevalence and severity of many infectious diseases, including the influenza virus. Vaccination programs remain one of the highest priorities across the spectrum of countries, research institutions such as the National Institutes of Health, international health agencies such as the World Health Organization (WHO), and major non-profit organizations. CONCLUSION This review addresses aspects of the immune and inflammatory response to influenza, with a focus on the elderly population and healthcare providers who may act as reservoirs for virus transmission to the vulnerable surgical population.
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Affiliation(s)
- Daithi S Heffernan
- Division of Surgical Research, Department of Surgery, Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
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26
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Shirey KA, Sunday ME, Lai W, Patel M, Blanco JCG, Cuttitta F, Vogel SN. Novel role of gastrin releasing peptide-mediated signaling in the host response to influenza infection. Mucosal Immunol 2019; 12:223-231. [PMID: 30327535 PMCID: PMC6301097 DOI: 10.1038/s41385-018-0081-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/19/2018] [Accepted: 08/08/2018] [Indexed: 02/04/2023]
Abstract
Gastrin-releasing peptide (GRP) is an evolutionarily well-conserved neuropeptide that was originally recognized for its ability to mediate gastric acid secretion in the gut. More recently, however, GRP has been implicated in pulmonary lung inflammatory diseases including bronchopulmonary dysplasia, chronic obstructive pulmonary disease, emphysema, and others. Antagonizing GRP or its receptor mitigated lethality associated with the onset of viral pneumonia in a well-characterized mouse model of influenza. In mice treated therapeutically with the small-molecule GRP inhibitor, NSC77427, increased survival was accompanied by decreased numbers of GRP-producing pulmonary neuroendocrine cells, improved lung histopathology, and suppressed cytokine gene expression. In addition, in vitro studies in macrophages indicate that GRP synergizes with the prototype TLR4 agonist, lipopolysaccharide, to induce cytokine gene expression. Thus, these findings reveal that GRP is a previously unidentified mediator of influenza-induced inflammatory disease that is a potentially novel target for therapeutic intervention.
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Affiliation(s)
- Kari Ann Shirey
- Dept. of Microbiology and Immunology, Univ. of Maryland, School of Medicine, Baltimore, MD USA 21201
| | - Mary E. Sunday
- Dept. of Pathology, Duke University Medical Center, Durham, NC USA 27710
| | - Wendy Lai
- Dept. of Microbiology and Immunology, Univ. of Maryland, School of Medicine, Baltimore, MD USA 21201
| | - Mira Patel
- Sigmovir Biosystems, Inc., Rockville, MD USA 20850
| | | | - Frank Cuttitta
- Mouse Cancer Genetics Program, National Cancer Institute, NIH, Frederick, MD USA 21702
| | - Stefanie N. Vogel
- Dept. of Microbiology and Immunology, Univ. of Maryland, School of Medicine, Baltimore, MD USA 21201
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27
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Granwehr BP. In acute uncomplicated influenza, single-dose baloxavir decreased time to symptom relief compared with placebo. Ann Intern Med 2018; 169:JC63. [PMID: 30557416 DOI: 10.7326/acpjc-2018-169-12-063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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28
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Wang Y, Deng L, Kang SM, Wang BZ. Universal influenza vaccines: from viruses to nanoparticles. Expert Rev Vaccines 2018; 17:967-976. [PMID: 30365905 DOI: 10.1080/14760584.2018.1541408] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The current seasonal influenza vaccine confers only limited protection due to waning antibodies or the antigenic shift and drift of major influenza surface antigens. A universal influenza vaccine which induces broad cross-protection against divergent influenza viruses with a comparable or better efficacy to seasonal influenza vaccines against matched strains will negate the need for an annual update of vaccine strains and protect against possible influenza pandemics. AREAS COVERED In this review, we summarize the recent progress in nanoparticle-based universal influenza vaccine development. We compared the most potent nanoparticle categories, focusing on how they encapsulate conserved influenza epitopes, stimulate the innate and adaptive immune systems, exhibit antigen depot effect, extend the period for antigen-processing and presentation, and exert an intrinsic adjuvant effect on inducing robust immune responses. EXPERT COMMENTARY The development of an effective universal influenza vaccine is an urgent task. Traditional influenza vaccine approaches are not sufficient for preventing recurrent epidemics or occasional pandemics. Nanoparticles are compatible with different immunogens and immune stimulators and can overcome the intrinsically low immunogenicity of conserved influenza virus antigens. We foresee that an affordable universal influenza vaccine will be available within ten years by integrating nanoparticles with other targeted delivery and controlled release technology.
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Affiliation(s)
- Ye Wang
- a Center for Inflammation, Immunity & Infection , Georgia State University Institute for Biomedical Sciences , Atlanta , GA , USA
| | - Lei Deng
- a Center for Inflammation, Immunity & Infection , Georgia State University Institute for Biomedical Sciences , Atlanta , GA , USA
| | - Sang-Moo Kang
- a Center for Inflammation, Immunity & Infection , Georgia State University Institute for Biomedical Sciences , Atlanta , GA , USA
| | - Bao-Zhong Wang
- a Center for Inflammation, Immunity & Infection , Georgia State University Institute for Biomedical Sciences , Atlanta , GA , USA
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29
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Bekkat-Berkani R, Romano-Mazzotti L. Understanding the unique characteristics of seasonal influenza illness to improve vaccine uptake in the US. Vaccine 2018; 36:7276-7285. [PMID: 30366802 DOI: 10.1016/j.vaccine.2018.10.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 12/31/2022]
Abstract
Seasonal influenza results in substantial morbidity, mortality and socio-economic burden. The US Advisory Committee on Immunization Practices recommends vaccination of everyone over 6 months of age, but coverage remains substantially below the Healthy People 2020 target of 70% in most age groups. Influenza is different from other vaccine-preventable diseases in several ways that influence vaccine uptake. Although the incidence of most vaccine-preventable diseases is low, there is a perception that these diseases result in significant illness or death. In contrast, seasonal influenza has a relatively high incidence, but there is an incorrect perception of a lower disease severity. The vaccine effectiveness of seasonal influenza vaccines is less than other routine vaccines, varies from season to season between northern and southern hemispheres, and can be low in some seasons. It is also not well recognized that vaccination can attenuate the severity of influenza illness. Finally, the need for annual vaccination is perceived as a burden to busy people. Understanding these differences from the perspective of caregivers and vaccinees might help to improve influenza vaccine uptake. Presenting vaccine effectiveness in terms of clinical outcomes that have the most impact might help to overcome the perceptions that influenza is a non-serious disease and that the vaccine is not effective. The benefits of disease attenuation need to be emphasized in terms of reduced mortality, hospitalization, absenteeism and disruption to daily life. Innovative communication strategies should be adopted, including stronger recommendations from and to healthcare providers, continuous patient education, and social media initiatives employing more emotional and narrative approaches than traditionally used. Finally, access to seasonal influenza vaccination needs to be improved, and barriers such as cost and inconvenience removed. Multiple initiatives have already been successful. The remaining challenge is to translate individual successes into public health policies with corresponding funding and implementation.
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30
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Barr IG, Donis RO, Katz JM, McCauley JW, Odagiri T, Trusheim H, Tsai TF, Wentworth DE. Cell culture-derived influenza vaccines in the severe 2017-2018 epidemic season: a step towards improved influenza vaccine effectiveness. NPJ Vaccines 2018; 3:44. [PMID: 30323955 PMCID: PMC6177469 DOI: 10.1038/s41541-018-0079-z] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 11/21/2022] Open
Abstract
The 2017–2018 seasonal influenza epidemics were severe in the US and Australia where the A(H3N2) subtype viruses predominated. Although circulating A(H3N2) viruses did not differ antigenically from that recommended by the WHO for vaccine production, overall interim vaccine effectiveness estimates were below historic averages (33%) for A(H3N2) viruses. The majority (US) or all (Australian) vaccine doses contained multiple amino-acid changes in the hemagglutinin protein, resulting from the necessary adaptation of the virus to embryonated hen’s eggs used for most vaccine manufacturing. Previous reports have suggested a potential negative impact of egg-driven substitutions on vaccine performance. With BARDA support, two vaccines licensed in the US are produced in cell culture: recombinant influenza vaccine (RIV, Flublok™) manufactured in insect cells and inactivated mammalian cell-grown vaccine (ccIIV, Flucelvax™). Quadrivalent ccIIV (ccIIV4) vaccine for the 2017–2018 influenza season was produced using an A(H3N2) seed virus propagated exclusively in cell culture and therefore lacking egg adaptative changes. Sufficient ccIIV doses were distributed (but not RIV doses) to enable preliminary estimates of its higher effectiveness relative to the traditional egg-based vaccines, with study details pending. The increased availability of comparative product-specific vaccine effectiveness estimates for cell-based and egg-based vaccines may provide critical clues to inform vaccine product improvements moving forward.
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Affiliation(s)
- Ian G Barr
- 1WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute For Infection And Immunity, 792 Elizabeth Street, Melbourne, 3000 Australia
| | - Ruben O Donis
- Biomedical Advanced Research and Development Authority, Influenza and Emerging Infectious Diseases Division, 300 Independence Avenue, SW, Washington, DC 20201 USA
| | - Jacqueline M Katz
- 3Influenza Division, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road MS A-20, Atlanta, GA 30329-4027 USA
| | - John W McCauley
- 4WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, The Francis Crick Institute, 1, Midland Road, London, NW1 1AT UK
| | - Takato Odagiri
- WHO Collaborating Centre for Reference and Research on Influenza, National Institute of Infectious Diseases, Influenza Virus Research Center, 4-7-1 Gakuen, Musashi-Murayama-shi, Tokyo 208-0011 Japan
| | - Heidi Trusheim
- IDT Biologika GmbH, Am Pharmapark, 06861 Dessau-Rosslau, Germany
| | - Theodore F Tsai
- 7Takeda Vaccines (USA), 75 Sidney St, Cambridge, MA 02139 USA
| | - David E Wentworth
- 8Influenza Division, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road MS A-20, Atlanta, GA 30329-4027 USA
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31
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Liu STH, Behzadi MA, Sun W, Freyn AW, Liu WC, Broecker F, Albrecht RA, Bouvier NM, Simon V, Nachbagauer R, Krammer F, Palese P. Antigenic sites in influenza H1 hemagglutinin display species-specific immunodominance. J Clin Invest 2018; 128:4992-4996. [PMID: 30188868 DOI: 10.1172/jci122895] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/21/2018] [Indexed: 12/12/2022] Open
Abstract
Hemagglutination inhibition (HI) titers are a major correlate of protection for influenza-related illness. The influenza virus hemagglutinin possesses antigenic sites that are the targets of HI active antibodies. Here, a panel of mutant viruses each lacking a classically defined antigenic site was created to compare the species-specific immunodominance of the antigenic sites in a clinically relevant hemagglutinin. HI active antibodies of antisera from influenza virus-infected mice targeted sites Sb and Ca2. HI active antibodies of guinea pigs were not directed against any specific antigenic site, although trends were observed toward Sb, Ca2, and Sa. HI titers of antisera from infected ferrets were significantly affected by site Sa. HI active antibodies of adult humans followed yet another immunodominance pattern, in which sites Sb and Sa were immunodominant. When comparing the HI profiles among different species by antigenic cartography, animals and humans grouped separately. This study provides characterizations of the antibody-mediated immune responses against the head domain of a recent H1 hemagglutinin in animals and humans.
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Affiliation(s)
- Sean T H Liu
- Department of Microbiology.,Division of Infectious Diseases, and
| | | | | | | | | | | | - Randy A Albrecht
- Department of Microbiology.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicole M Bouvier
- Department of Microbiology.,Division of Infectious Diseases, and
| | - Viviana Simon
- Department of Microbiology.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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32
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Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness—United States, February 2018. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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33
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Bailey ES, Choi JY, Fieldhouse JK, Borkenhagen LK, Zemke J, Zhang D, Gray GC. The continual threat of influenza virus infections at the human-animal interface: What is new from a one health perspective? EVOLUTION MEDICINE AND PUBLIC HEALTH 2018; 2018:192-198. [PMID: 30210800 PMCID: PMC6128238 DOI: 10.1093/emph/eoy013] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/18/2018] [Indexed: 12/15/2022]
Abstract
This year, in 2018, we mark 100 years since the 1918 influenza pandemic. In the last 100 years, we have expanded our knowledge of public health and increased our ability to detect and prevent influenza; however, we still face challenges resulting from these continually evolving viruses. Today, it is clear that influenza viruses have multiple animal reservoirs (domestic and wild), making infection prevention in humans especially difficult to achieve. With this report, we summarize new knowledge regarding influenza A, B, C and D viruses and their control. We also introduce how a multi-disciplinary One Health approach is necessary to mitigate these threats.
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Affiliation(s)
- Emily S Bailey
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
| | - Jessica Y Choi
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
| | - Jane K Fieldhouse
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
| | - Laura K Borkenhagen
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
| | - Juliana Zemke
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
| | - Dingmei Zhang
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA.,School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Gregory C Gray
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA.,Global Health Research Center, Duke-Kunshan University, Kunshan, China.,Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore
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34
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Elliott ST, Keaton AA, Chu JD, Reed CC, Garman B, Patel A, Yan J, Broderick KE, Weiner DB. A Synthetic Micro-Consensus DNA Vaccine Generates Comprehensive Influenza A H3N2 Immunity and Protects Mice Against Lethal Challenge by Multiple H3N2 Viruses. Hum Gene Ther 2018; 29:1044-1055. [PMID: 30062926 PMCID: PMC6152850 DOI: 10.1089/hum.2018.102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Influenza A H3N2 viruses circulate globally, leading to substantial morbidity and mortality. Commercially available, antigen-matched influenza vaccines must be updated frequently to match dynamic sequence variability in immune epitopes, especially within viral influenza A H3N2 hemagglutinin (H3). In an effort to create comprehensive immune responses against H3N2, four micro-consensus antigens were designed to mimic the sequence and antigenic diversity of H3. Synthetic plasmid DNA constructs were developed to express each micro-consensus immunogen and combined into a multi-antigen DNA vaccine cocktail, pH3HA. Facilitated delivery of pH3HA via intramuscular electroporation in mice induced comprehensive, potent humoral responses against diverse seasonal H3N2 viruses that circulated between 1968 and the present. Vaccination with pH3HA also induced an antigen-specific cellular cytokine response. Mice immunized with pH3HA were protected against lethal challenge using two distinct H3N2 viruses, highlighting the heterologous protection afforded by synthetic micro-consensus immunogens. These findings warrant further study of the DNA vaccine micro-consensus platform for broad protection against influenza viruses.
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Affiliation(s)
| | - Amelia A. Keaton
- The Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania
| | - Jacqueline D. Chu
- The Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania
| | | | | | - Ami Patel
- The Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania
| | - Jian Yan
- Inovio Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - David B. Weiner
- The Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania.,Correspondence: Dr. David B. Weiner, The Wistar Institute of Anatomy and Biology, 3601 Spruce Street, Philadelphia, PA, 19104.
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Agarwal D, Schmader KE, Kossenkov AV, Doyle S, Kurupati R, Ertl HCJ. Immune response to influenza vaccination in the elderly is altered by chronic medication use. Immun Ageing 2018; 15:19. [PMID: 30186359 PMCID: PMC6119322 DOI: 10.1186/s12979-018-0124-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/21/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The elderly patient population is the most susceptible to influenza virus infection and its associated complications. Polypharmacy is common in the aged, who often have multiple co-morbidities. Previous studies have demonstrated that commonly used prescription drugs can have extensive impact on immune defenses and responses to vaccination. In this study, we examined how the dynamics of immune responses to the two influenza A virus strains of the trivalent inactivated influenza vaccine (TIV) can be affected by patient's history of using the prescription drugs Metformin, NSAIDs or Statins. RESULTS We provide evidence for differential antibody (Ab) production, B-cell phenotypic changes, alteration in immune cell proportions and transcriptome-wide perturbation in individuals with a history of long-term medication use, compared with non-users. We noted a diminished response to TIV in the elderly on Metformin, whereas those on NSAIDs or Statins had higher baseline responses but reduced relative increases in virus-neutralizing Abs (VNAs) or Abs detected by an enzyme-linked immunosorbent assay (ELISA) following vaccination. CONCLUSION Collectively, our findings suggest novel pathways that might underlie how long-term medication use impacts immune response to influenza vaccination in the elderly. They provide a strong rationale for targeting the medication-immunity interaction in the aged population to improve vaccination responses.
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Affiliation(s)
- Divyansh Agarwal
- Genomics and Computational Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Kenneth E. Schmader
- Division of Geriatrics, Duke University Medical Center; Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, NC 27705 USA
| | | | - Susan Doyle
- Division of Geriatrics, Duke University Medical Center; Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, NC 27705 USA
| | - Raj Kurupati
- The Wistar Institute, Philadelphia, PA 19104 USA
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Hsieh IN, De Luna X, White MR, Hartshorn KL. The Role and Molecular Mechanism of Action of Surfactant Protein D in Innate Host Defense Against Influenza A Virus. Front Immunol 2018; 9:1368. [PMID: 29951070 PMCID: PMC6008380 DOI: 10.3389/fimmu.2018.01368] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/01/2018] [Indexed: 12/16/2022] Open
Abstract
Influenza A viruses (IAVs) continue to pose major risks of morbidity and mortality during yearly epidemics and periodic pandemics. The genomic instability of IAV allows it to evade adaptive immune responses developed during prior infection. Of particular concern are pandemics which result from wholesale incorporation of viral genome sections from animal sources. These pandemic strains are radically different from circulating human strains and pose great risk for the human population. For these reasons, innate immunity plays a strong role in the initial containment of IAV infection. Soluble inhibitors present in respiratory lining fluids and blood provide a level of early protection against IAV. In general, these inhibitors act by binding to the viral hemagglutinin (HA). Surfactant protein D (SP-D) and mannose-binding lectin (MBL) attach to mannosylated glycans on the HA in a calcium dependent manner. In contrast, surfactant protein A, ficolins, and other inhibitors present sialic acid rich ligands to which the HA can bind. Among these inhibitors, SP-D seems to be the most potent due to its specific mode of binding to viral carbohydrates and its ability to strongly aggregate viral particles. We have studied specific properties of the N-terminal and collagen domain of SP-D that enable formation of highly multimerized molecules and cooperative binding among the multiple trimeric lectin domains in the protein. In addition, we have studied in depth the lectin activity of SP-D through expression of isolated lectin domains and targeted mutations of the SP-D lectin binding site. Through modifying specific residues around the saccharide binding pocket, antiviral activity of isolated lectin domains of SP-D can be markedly increased for seasonal strains of IAV. Wild-type SP-D causes little inhibition of pandemic IAV, but mutated versions of SP-D were able to inhibit pandemic IAV through enhanced binding to the reduced number of mannosylated glycans present on the HA of these strains. Through collaborative studies involving crystallography of isolated lectin domains of SP-D, glycomics analysis of the HA, and molecular modeling, the mechanism of binding of wild type and mutant forms of SP-D have been determined. These studies could guide investigation of the interactions of SP-D with other pathogens.
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Affiliation(s)
- I-Ni Hsieh
- Boston University School of Medicine, Boston, MA, United States
| | - Xavier De Luna
- Boston University School of Medicine, Boston, MA, United States
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Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Foust A, Sessions W, Berman L, Barnes JR, Spencer S, Fry AM. Interim estimates of 2017-18 seasonal influenza vaccine effectiveness - United States, February 2018. Am J Transplant 2018. [DOI: 10.1111/ajt.14730] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Brendan Flannery
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Jessie R. Chung
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | | | | | - Manjusha Gaglani
- Baylor Scott & White Health; Texas A&M University Health Science Center College of Medicine; Temple TX USA
| | - Kempapura Murthy
- Baylor Scott & White Health; Texas A&M University Health Science Center College of Medicine; Temple TX USA
| | - Richard K. Zimmerman
- University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - Mary Patricia Nowalk
- University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center; Pittsburgh PA USA
| | | | - Lisa A. Jackson
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
| | | | | | - Angie Foust
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Wendy Sessions
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - LaShondra Berman
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - John R. Barnes
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Sarah Spencer
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
| | - Alicia M. Fry
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA USA
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Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Foust A, Sessions W, Berman L, Barnes JR, Spencer S, Fry AM. Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness - United States, February 2018. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2018; 67:180-185. [PMID: 29447141 PMCID: PMC5815489 DOI: 10.15585/mmwr.mm6706a2] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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