1
|
Neyra J, Kambhampati AK, Calderwood LE, Romero C, Soto G, Campbell WR, Tinoco YO, Hall AJ, Ortega-Sanchez IR, Mirza SA. Household economic costs of norovirus gastroenteritis in two community cohorts in Peru, 2012-2019. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002748. [PMID: 38985718 PMCID: PMC11236139 DOI: 10.1371/journal.pgph.0002748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 06/17/2024] [Indexed: 07/12/2024]
Abstract
While costs of norovirus acute gastroenteritis (AGE) to healthcare systems have been estimated, out-of-pocket and indirect costs incurred by households are not well documented in community settings, particularly in developing countries. We conducted active surveillance for AGE in two communities in Peru: Puerto Maldonado (October 2012-August 2015) and San Jeronimo (April 2015-April 2019). Norovirus AGE events with PCR-positive stool specimens were included. Data collected in follow-up interviews included event-related medical resource utilization, associated out-of-pocket costs, and indirect costs. There were 330 norovirus-associated AGE events among 3,438 participants from 685 households. Approximately 49% of norovirus events occurred among children <5 years of age and total cost to the household per episode was highest in this age group. Norovirus events cost a median of US $2.95 (IQR $1.04-7.85) in out-of-pocket costs and $12.58 (IQR $6.39-25.16) in indirect costs. Medication expenses accounted for 53% of out-of-pocket costs, and productivity losses accounted for 59% of the total financial burden on households. The frequency and associated costs of norovirus events to households in Peruvian communities support the need for prevention strategies including vaccines. Norovirus interventions targeting children <5 years of age and their households may have the greatest economic benefit.
Collapse
Affiliation(s)
- Joan Neyra
- U.S. Naval Medical Research Unit SOUTH, Lima, Peru
| | - Anita K Kambhampati
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Laura E Calderwood
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Cherokee Nation Operational Solutions, Tulsa, Oklahoma, United States of America
| | - Candice Romero
- Vysnova Partners, LLC, Greater Landover, Maryland, United States of America
| | - Giselle Soto
- U.S. Naval Medical Research Unit SOUTH, Lima, Peru
| | - Wesley R Campbell
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | | | - Aron J Hall
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ismael R Ortega-Sanchez
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sara A Mirza
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| |
Collapse
|
2
|
Rogers JH, Link AC, McCulloch D, Brandstetter E, Newman KL, Jackson ML, Hughes JP, Englund JA, Boeckh M, Sugg N, Ilcisin M, Sibley TR, Fay K, Lee J, Han P, Truong M, Richardson M, Nickerson DA, Starita LM, Bedford T, Chu HY. Characteristics of COVID-19 in Homeless Shelters : A Community-Based Surveillance Study. Ann Intern Med 2021; 174:42-49. [PMID: 32931328 PMCID: PMC7517131 DOI: 10.7326/m20-3799] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Homeless shelters are a high-risk setting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission because of crowding and shared hygiene facilities. OBJECTIVE To investigate SARS-CoV-2 case counts across several adult and family homeless shelters in a major metropolitan area. DESIGN Cross-sectional, community-based surveillance study. (ClinicalTrials.gov: NCT04141917). SETTING 14 homeless shelters in King County, Washington. PARTICIPANTS A total of 1434 study encounters were done in shelter residents and staff, regardless of symptoms. INTERVENTION 2 strategies were used for SARS-CoV-2 testing: routine surveillance and contact tracing ("surge testing") events. MEASUREMENTS The primary outcome measure was test positivity rate of SARS-CoV-2 infection at shelters, determined by dividing the number of positive cases by the total number of participant encounters, regardless of symptoms. Sociodemographic, clinical, and virologic variables were assessed as correlates of viral positivity. RESULTS Among 1434 encounters, 29 (2% [95% CI, 1.4% to 2.9%]) cases of SARS-CoV-2 infection were detected across 5 shelters. Most (n = 21 [72.4%]) were detected during surge testing events rather than routine surveillance, and most (n = 21 [72.4% {CI, 52.8% to 87.3%}]) were asymptomatic at the time of sample collection. Persons who were positive for SARS-CoV-2 were more frequently aged 60 years or older than those without SARS-CoV-2 (44.8% vs. 15.9%). Eighty-six percent of persons with positive test results slept in a communal space rather than in a private or shared room. LIMITATION Selection bias due to voluntary participation and a relatively small case count. CONCLUSION Active surveillance and surge testing were used to detect multiple cases of asymptomatic and symptomatic SARS-CoV-2 infection in homeless shelters. The findings suggest an unmet need for routine viral testing outside of clinical settings for homeless populations. PRIMARY FUNDING SOURCE Gates Ventures.
Collapse
Affiliation(s)
- Julia H Rogers
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Amy C Link
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Denise McCulloch
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Elisabeth Brandstetter
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Kira L Newman
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington (M.L.J.)
| | - James P Hughes
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Janet A Englund
- Seattle Children's Research Institute, University of Washington, Seattle, Washington (J.A.E.)
| | - Michael Boeckh
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Nancy Sugg
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Misja Ilcisin
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Thomas R Sibley
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Kairsten Fay
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Jover Lee
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Peter Han
- University of Washington and Brotman Baty Institute for Precision Medicine, Seattle, Washington (P.H., M.T., L.M.S.)
| | - Melissa Truong
- University of Washington and Brotman Baty Institute for Precision Medicine, Seattle, Washington (P.H., M.T., L.M.S.)
| | - Matthew Richardson
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Deborah A Nickerson
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | - Lea M Starita
- University of Washington and Brotman Baty Institute for Precision Medicine, Seattle, Washington (P.H., M.T., L.M.S.)
| | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle, Washington (M.B., M.I., T.R.S., K.F., J.L., T.B.)
| | - Helen Y Chu
- University of Washington, Seattle, Washington (J.H.R., A.C.L., D.M., E.B., K.L.N., J.P.H., N.S., M.R., D.A.N., H.Y.C.)
| | | |
Collapse
|
3
|
Bennett AJ, Goldberg TL. Pteropine Orthoreovirus in an Angolan Soft-Furred Fruit Bat ( Lissonycteris angolensis) in Uganda Dramatically Expands the Global Distribution of an Emerging Bat-Borne Respiratory Virus. Viruses 2020; 12:E740. [PMID: 32659960 PMCID: PMC7412351 DOI: 10.3390/v12070740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 01/01/2023] Open
Abstract
Pteropine orthoreovirus (PRV; Reoviridae: Spinareovirinae) is an emerging bat-borne zoonotic virus that causes influenza-like illness (ILI). PRV has thus far been found only in Australia and Asia, where diverse old-world fruit bats (Pteropodidae) serve as hosts. In this study, we report the discovery of PRV in Africa, in an Angolan soft-furred fruit bat (Lissonycteris angolensis ruwenzorii) from Bundibugyo District, Uganda. Metagenomic characterization of a rectal swab yielded 10 dsRNA genome segments, revealing this virus to cluster within the known diversity of PRV variants detected in bats and humans in Southeast Asia. Phylogeographic analyses revealed a correlation between geographic distance and genetic divergence of PRVs globally, which suggests a geographic continuum of PRV diversity spanning Southeast Asia to sub-Saharan Africa. The discovery of PRV in an African bat dramatically expands the geographic range of this zoonotic virus and warrants further surveillance for PRVs outside of Southeast Asia.
Collapse
Affiliation(s)
- Andrew J. Bennett
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Tony L. Goldberg
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA;
- Global Health Institute, University of Wisconsin-Madison, Madison, WI 53706, USA
| |
Collapse
|
4
|
Salmon-Mulanovich G, Simons MP, Flores-Mendoza C, Loyola S, Silva M, Kasper M, Rázuri HR, Canal LE, Leguia M, Bausch DG, Richards AL. Seroprevalence and Risk Factors for Rickettsia and Leptospira Infection in Four Ecologically Distinct Regions of Peru. Am J Trop Med Hyg 2020; 100:1391-1400. [PMID: 30938281 DOI: 10.4269/ajtmh.18-0029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Rickettsia and Leptospira spp. are under-recognized causes of acute febrile disease worldwide. Rickettsia species are often placed into the spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR). We explored the antibody prevalence among humans for these two groups of rickettsiae in four regions of Peru (Lima, Cusco, Puerto Maldonado, and Tumbes) and for Leptospira spp. in Puerto Maldonado and Tumbes. We also assessed risk factors for seropositivity and collected serum samples and ectoparasites from peri-domestic animals from households in sites with high human seroprevalence. In total, we tested 2,165 human sera for antibodies (IgG) against SFGR and TGR by ELISA and for antibodies against Leptospira by a microscopic agglutination test. Overall, human antibody prevalence across the four sites was 10.6% for SFGR (ranging from 6.2% to 14.0%, highest in Tumbes) and 3.3% for TGR (ranging from 2.6% to 6.4%, highest in Puerto Maldonado). Factors associated with seroreactivity against SFGR were male gender, older age, contact with backyard birds, and working in agriculture or with livestock. However, exposure to any kind of animal within the household decreased the odds ratio by half. Age was the only variable associated with higher TGR seroprevalence. The prevalence of Leptospira was 11.3% in Puerto Maldonado and 5.8% in Tumbes, with a borderline association with keeping animals in the household. We tested animal sera for Leptospira and conducted polymerase chain reaction (PCR) to detect Rickettsia species among ectoparasites collected from domestic animals in 63 households of seropositive participants and controls. We did not find any association between animal infection and human serostatus.
Collapse
Affiliation(s)
| | - Mark P Simons
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | | | - Steev Loyola
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - María Silva
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - Matthew Kasper
- Armed Forces Health Surveillance Center, Silver Spring, Maryland
| | - Hugo R Rázuri
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | | | | | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Allen L Richards
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
| |
Collapse
|
5
|
Caini S, Spreeuwenberg P, Kusznierz GF, Rudi JM, Owen R, Pennington K, Wangchuk S, Gyeltshen S, Ferreira de Almeida WA, Pessanha Henriques CM, Njouom R, Vernet MA, Fasce RA, Andrade W, Yu H, Feng L, Yang J, Peng Z, Lara J, Bruno A, de Mora D, de Lozano C, Zambon M, Pebody R, Castillo L, Clara AW, Matute ML, Kosasih H, Nurhayati, Puzelli S, Rizzo C, Kadjo HA, Daouda C, Kiyanbekova L, Ospanova A, Mott JA, Emukule GO, Heraud JM, Razanajatovo NH, Barakat A, El Falaki F, Huang SQ, Lopez L, Balmaseda A, Moreno B, Rodrigues AP, Guiomar R, Ang LW, Lee VJM, Venter M, Cohen C, Badur S, Ciblak MA, Mironenko A, Holubka O, Bresee J, Brammer L, Hoang PVM, Le MTQ, Fleming D, Séblain CEG, Schellevis F, Paget J. Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014. BMC Infect Dis 2018; 18:269. [PMID: 29884140 PMCID: PMC5994061 DOI: 10.1186/s12879-018-3181-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/30/2018] [Indexed: 11/23/2022] Open
Abstract
Background Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases). Methods For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity. Results The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I2>90%) for most sRIRs. The variations of countries’ geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play. Conclusions These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type. Electronic supplementary material The online version of this article (10.1186/s12879-018-3181-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands.
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands
| | - Gabriela F Kusznierz
- Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Santa Fe, Argentina
| | - Juan Manuel Rudi
- Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Santa Fe, Argentina
| | - Rhonda Owen
- Vaccine Preventable Diseases Surveillance Section, Health Policy Protection branch, Office for Health Protection, Department of Health, Woden, Canberra, Australia
| | - Kate Pennington
- Vaccine Preventable Diseases Surveillance Section, Health Policy Protection branch, Office for Health Protection, Department of Health, Woden, Canberra, Australia
| | - Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Sonam Gyeltshen
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | | | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | | | - Rodrigo A Fasce
- Sección Virus Respiratorios, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Winston Andrade
- Sección Virus Respiratorios, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhibin Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jenny Lara
- National Influenza Center, Ministry of Health, San José, Costa Rica
| | - Alfredo Bruno
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Doménica de Mora
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Celina de Lozano
- National Influenza Center, Ministry of Health, San Salvador, El Salvador
| | - Maria Zambon
- Respiratory Virus Unit, Public Health England, London, Colindale, UK
| | - Richard Pebody
- Respiratory Diseases Department, Public Health England, London, Colindale, UK
| | - Leticia Castillo
- National Influenza Center, Ministry of Health, Guatemala City, Guatemala
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | | | | | - Nurhayati
- US Naval Medical Research Unit No.2, Jakarta, Indonesia
| | - Simona Puzelli
- National Influenza Center, National Institute of Health, Rome, Italy
| | - Caterina Rizzo
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Herve A Kadjo
- Department of Epidemic Virus, Institut Pasteur, Abidjan, Côte d'Ivoire
| | - Coulibaly Daouda
- Service of Epidemiological Diseases Surveillance, National Institute of Public Hygiene, Abidjan, Côte d'Ivoire
| | - Lyazzat Kiyanbekova
- National Center of Expertise, Committee of Consumer Right Protection, Astana, Kazakhstan
| | - Akerke Ospanova
- Zonal Virology Laboratory, National Center of Expertise, Committee of Consumer Right Protection, Astana, Kazakhstan
| | - Joshua A Mott
- Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya.,US Public Health Service, Rockville, Maryland, USA
| | - Gideon O Emukule
- Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar
| | | | - Amal Barakat
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Fatima El Falaki
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Sue Q Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Liza Lopez
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Angel Balmaseda
- National Influenza Center, Ministry of Health, Managua, Nicaragua
| | - Brechla Moreno
- National Influenza Center, IC Gorgas, Panama City, Panama
| | - Ana Paula Rodrigues
- Department of epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore
| | | | - Marietjie Venter
- Global Disease Detection, US-CDC, Pretoria, South Africa.,Zoonoses Research Center, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Alla Mironenko
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Reiv, Ukraine
| | - Olha Holubka
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Reiv, Ukraine
| | - Joseph Bresee
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynnette Brammer
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands
| | | |
Collapse
|
6
|
Romero C, Tinoco YO, Loli S, Razuri H, Soto G, Silva M, Galvan P, Kambhampati A, Parashar UD, Kasper MR, Bausch DG, Simons MP, Lopman B. Incidence of Norovirus-Associated Diarrhea and Vomiting Disease Among Children and Adults in a Community Cohort in the Peruvian Amazon Basin. Clin Infect Dis 2018; 65:833-839. [PMID: 29017284 DOI: 10.1093/cid/cix423] [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: 01/31/2017] [Accepted: 05/02/2017] [Indexed: 11/13/2022] Open
Abstract
Background Data on norovirus epidemiology among all ages in community settings are scarce, especially from tropical settings. Methods We implemented active surveillance in 297 households in Peru from October 2012 to August 2015 to assess the burden of diarrhea and acute gastroenteritis (AGE) due to norovirus in a lower-middle-income community. During period 1 (October 2012-May 2013), we used a "traditional" diarrhea case definition (≥3 loose/liquid stools within 24 hours). During period 2 (June 2013-August 2015), we used an expanded case definition of AGE (by adding ≥2 vomiting episodes without diarrhea or 1-2 vomiting episodes plus 1-2 loose/liquid stools within 24 hours). Stool samples were tested for norovirus by reverse-transcription polymerase chain reaction. Results During period 1, overall diarrhea and norovirus-associated diarrhea incidence was 37.2/100 person-years (PY) (95% confidence interval [CI], 33.2-41.7) and 5.7/100 PY (95% CI, 3.9-8.1), respectively. During period 2, overall AGE and norovirus-associated AGE incidence was 51.8/100 PY (95% CI, 48.8-54.9) and 6.5/100 PY (95% CI, 5.4-7.8), respectively. In both periods, children aged <2 years had the highest incidence of norovirus. Vomiting without diarrhea occurred among norovirus cases in participants <15 years old, but with a higher proportion among children <2 years, accounting for 35% (7/20) of all cases in this age group. Noroviruses were identified in 7% (23/335) of controls free of gastroenteric symptoms. Conclusions Norovirus was a significant cause of AGE in this community, especially among children <2 years of age. Inclusion of vomiting in the case definition resulted in a 20% improvement for detection of norovirus cases.
Collapse
Affiliation(s)
| | | | | | - Hugo Razuri
- US Naval Medical Research Unit No. 6, Lima, Peru
| | - Giselle Soto
- US Naval Medical Research Unit No. 6, Lima, Peru
| | - María Silva
- US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Anita Kambhampati
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Daniel G Bausch
- US Naval Medical Research Unit No. 6, Lima, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | | | - Benjamin Lopman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
7
|
Ankrah DNA, Darko DM, Sabblah G, Mantel-Teeuwisse A, Leufkens HMG. Reporting of adverse events following immunizations in Ghana - Using disproportionality analysis reporting ratios. Hum Vaccin Immunother 2017; 14:172-178. [PMID: 29172941 DOI: 10.1080/21645515.2017.1384105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Timely reporting of safety information post vaccination is pivotal for the success of any vaccination program. Reports of adverse events following immunization (AEFI) of 6 different vaccinations from Ghana were analysed for signals. METHODS De-identified data from active surveillance for AEFIs after 2009 AH1N1 influenza, yellow fever, meningitis, measles-rubella, pneumococcal-rotavirus and human papilloma virus vaccinations were used. All vaccinations occurred between January 2010 and December 2013. The ten most occurring events for each vaccination were captured and arranged using Medical Dictionary for Regulatory Authorities (MedDRA) Preferred Term (PT) and System Organ Classification (SOC) codes. Adverse event incidence rates were calculated for each vaccine type, and signals were generated using proportional reporting ratios (PRR). RESULTS A total number of 5,141 reports were analysed ranging from 33 (human papilloma virus) to 1958 (measles-rubella). Between 22% and 55% of all AEFIs per vaccine type were collected on the day of vaccination. For each vaccine type, at least 87% of all reported AEFIs occurred in the first 7 days post-vaccination. Multiple reports were received per vaccine type. For the MR vaccine, urticarial recorded the highest attack rate of 6.6 (95% CI 6.2, 7.1) per 100,000 vaccines. The AEFI with the highest PRR for both human papilloma and measles-rubella vaccines was abdominal pain, recording a PRR of 8.15 (95% CI 3.46, 19.23) and 43.75 (95% CI 17.81, 107.45) respectively. CONCLUSION These results underscore the competency of public health systems in sub-Saharan African countries (like Ghana) to identify most frequently occurring and important vaccine related safety issues.
Collapse
Affiliation(s)
- Daniel N A Ankrah
- a Department of Pharmacy , Korle-Bu Teaching Hospital , Korle-Bu, Accra , Ghana.,b Division of Pharmacoepidemiology & Clinical Pharmacology , Utrecht Institute for Pharmaceutical Sciences (UIPS) , Utrecht , the Netherlands
| | | | | | - Aukje Mantel-Teeuwisse
- b Division of Pharmacoepidemiology & Clinical Pharmacology , Utrecht Institute for Pharmaceutical Sciences (UIPS) , Utrecht , the Netherlands
| | - Hubert M G Leufkens
- b Division of Pharmacoepidemiology & Clinical Pharmacology , Utrecht Institute for Pharmaceutical Sciences (UIPS) , Utrecht , the Netherlands.,d Medicines Evaluation Board , Utrecht , the Netherlands
| |
Collapse
|
8
|
Tinoco YO, Azziz-Baumgartner E, Uyeki TM, Rázuri HR, Kasper MR, Romero C, Silva ME, Simons MP, Soto GM, Widdowson MA, Gilman RH, Bausch DG, Montgomery JM. Burden of Influenza in 4 Ecologically Distinct Regions of Peru: Household Active Surveillance of a Community Cohort, 2009-2015. Clin Infect Dis 2017; 65:1532-1541. [PMID: 29020267 PMCID: PMC5850002 DOI: 10.1093/cid/cix565] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There are limited data on the burden of disease posed by influenza in low- and middle-income countries. Furthermore, most estimates of influenza disease burden worldwide rely on passive sentinel surveillance at health clinics and hospitals that lack accurate population denominators. METHODS We documented influenza incidence, seasonality, health-system utilization with influenza illness, and vaccination coverage through active community-based surveillance in 4 ecologically distinct regions of Peru over 6 years. Approximately 7200 people in 1500 randomly selected households were visited 3 times per week. Naso- and oropharyngeal swabs were collected from persons with influenza-like illness and tested for influenza virus by real-time reverse-transcription polymerase chain reaction. RESULTS We followed participants for 35353 person-years (PY). The overall incidence of influenza was 100 per 1000 PY (95% confidence interval [CI], 97-104) and was highest in children aged 2-4 years (256/1000 PY [95% CI, 236-277]). Seasonal incidence trends were similar across sites, with 61% of annual influenza cases occurring during the austral winter (May-September). Of all participants, 44 per 1000 PY (95% CI, 42-46) sought medical care, 0.7 per 1000 PY (95% CI, 0.4-1.0) were hospitalized, and 1 person died (2.8/100000 PY). Influenza vaccine coverage was 27% among children aged 6-23 months and 26% among persons aged ≥65 years. CONCLUSIONS Our results indicate that 1 in 10 persons develops influenza each year in Peru, with the highest incidence in young children. Active community-based surveillance allows for a better understanding of the true burden and seasonality of disease that is essential to plan the optimal target groups, timing, and cost of national influenza vaccination programs.
Collapse
Affiliation(s)
- Yeny O Tinoco
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hugo R Rázuri
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | | | - Maria E Silva
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Mark P Simons
- US Naval Medical Research Unit No. 6, Bellavista, Peru
| | | | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert H Gilman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel G Bausch
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana; and
| | - Joel M Montgomery
- US Naval Medical Research Unit No. 6, Bellavista, Peru
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
9
|
Ochomo E, Chahilu M, Cook J, Kinyari T, Bayoh NM, West P, Kamau L, Osangale A, Ombok M, Njagi K, Mathenge E, Muthami L, Subramaniam K, Knox T, Mnavaza A, Donnelly MJ, Kleinschmidt I, Mbogo C. Insecticide-Treated Nets and Protection against Insecticide-Resistant Malaria Vectors in Western Kenya. Emerg Infect Dis 2017; 23:758-764. [PMID: 28418293 PMCID: PMC5403037 DOI: 10.3201/eid2305.161315] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Insecticide resistance might reduce the efficacy of malaria vector control. In 2013 and 2014, malaria vectors from 50 villages, of varying pyrethroid resistance, in western Kenya were assayed for resistance to deltamethrin. Long-lasting insecticide-treated nets (LLIN) were distributed to households at universal coverage. Children were recruited into 2 cohorts, cleared of malaria-causing parasites, and tested every 2 weeks for reinfection. Infection incidence rates for the 2 cohorts were 2.2 (95% CI 1.9–2.5) infections/person-year and 2.8 (95% CI 2.5–3.0) infections/person-year. LLIN users had lower infection rates than non-LLIN users in both low-resistance (rate ratio 0.61, 95% CI 0.42–0.88) and high-resistance (rate ratio 0.55, 95% CI 0.35–0.87) villages (p = 0.63). The association between insecticide resistance and infection incidence was not significant (p = 0.99). Although the incidence of infection was high among net users, LLINs provided significant protection (p = 0.01) against infection with malaria parasite regardless of vector insecticide resistance.
Collapse
|
10
|
Pollett S, Boscardin WJ, Azziz-Baumgartner E, Tinoco YO, Soto G, Romero C, Kok J, Biggerstaff M, Viboud C, Rutherford GW. Evaluating Google Flu Trends in Latin America: Important Lessons for the Next Phase of Digital Disease Detection. Clin Infect Dis 2016; 64:34-41. [PMID: 27678084 DOI: 10.1093/cid/ciw657] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 08/25/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Latin America has a substantial burden of influenza and rising Internet access and could benefit from real-time influenza epidemic prediction web tools such as Google Flu Trends (GFT) to assist in risk communication and resource allocation during epidemics. However, there has never been a published assessment of GFT's accuracy in most Latin American countries or in any low- to middle-income country. Our aim was to evaluate GFT in Argentina, Bolivia, Brazil, Chile, Mexico, Paraguay, Peru, and Uruguay. METHODS Weekly influenza-test positive proportions for the eight countries were obtained from FluNet for the period January 2011-December 2014. Concurrent weekly Google-predicted influenza activity in the same countries was abstracted from GFT. Pearson correlation coefficients between observed and Google-predicted influenza activity trends were determined for each country. Permutation tests were used to examine background seasonal correlation between FluNet and GFT by country. RESULTS There were frequent GFT prediction errors, with correlation ranging from r = -0.53 to 0.91. GFT-predicted influenza activity best correlated with FluNet data in Mexico follow by Uruguay, Argentina, Chile, Brazil, Peru, Bolivia and Paraguay. Correlation was generally highest in the more temperate countries with more regular influenza seasonality and lowest in tropical regions. A substantial amount of autocorrelation was noted, suggestive that GFT is not fully specific for influenza virus activity. CONCLUSIONS We note substantial inaccuracies with GFT-predicted influenza activity compared with FluNet throughout Latin America, particularly among tropical countries with irregular influenza seasonality. Our findings offer valuable lessons for future Internet-based biosurveillance tools.
Collapse
Affiliation(s)
- Simon Pollett
- Department of Epidemiology & Biostatistics, University of California at San Francisco.,Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney
| | - W John Boscardin
- Department of Epidemiology & Biostatistics, University of California at San Francisco
| | | | - Yeny O Tinoco
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Giselle Soto
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Candice Romero
- Department of Virology & Emerging Infectious Diseases, US Naval Medical Research Unit No 6, Callao, Peru
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Level 3 Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, New South Wales, Australia
| | - Matthew Biggerstaff
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - George W Rutherford
- Department of Epidemiology & Biostatistics, University of California at San Francisco
| |
Collapse
|
11
|
Tinoco YO, Montgomery JM, Kasper MR, Nelson MI, Razuri H, Guezala MC, Azziz-Baumgartner E, Widdowson MA, Barnes J, Gilman RH, Bausch DG, Gonzalez AE. Transmission dynamics of pandemic influenza A(H1N1)pdm09 virus in humans and swine in backyard farms in Tumbes, Peru. Influenza Other Respir Viruses 2016; 10:47-56. [PMID: 26011186 PMCID: PMC4687498 DOI: 10.1111/irv.12329] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/31/2022] Open
Abstract
Objectives We aimed to determine the frequency of pH1N1 transmission between humans and swine on backyard farms in Tumbes, Peru. Design Two‐year serial cross‐sectional study comprising four sampling periods: March 2009 (pre‐pandemic), October 2009 (peak of the pandemic in Peru), April 2010 (1st post‐pandemic period), and October 2011 (2nd post‐pandemic period). Sample Backyard swine serum, tracheal swabs, and lung sample were collected during each sampling period. Main outcome measures We assessed current and past pH1N1 infection in swine through serological testing, virus culture, and RT‐PCR and compared the results with human incidence data from a population‐based active surveillance cohort study in Peru. Results Among 1303 swine sampled, the antibody prevalence to pH1N1 was 0% pre‐pandemic, 8% at the peak of the human pandemic (October 2009), and 24% in April 2010 and 1% in October 2011 (post‐pandemic sampling periods). Trends in swine seropositivity paralleled those seen in humans in Tumbes. The pH1N1 virus was isolated from three pigs during the peak of the pandemic. Phylogenetic analysis revealed that these viruses likely represent two separate human‐to‐swine transmission events in backyard farm settings. Conclusions Our findings suggest that human‐to‐swine pH1N1 transmission occurred during the pandemic among backyard farms in Peru, emphasizing the importance of interspecies transmission in backyard pig populations. Continued surveillance for influenza viruses in backyard farms is warranted.
Collapse
Affiliation(s)
- Yeny O Tinoco
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Joel M Montgomery
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,U.S. Centers for Disease Control and Prevention, Division of Global Health Protection, Nairobi, Kenya
| | | | - Martha I Nelson
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Hugo Razuri
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | | | | | - John Barnes
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | |
Collapse
|
12
|
Pollett S, Nelson MI, Kasper M, Tinoco Y, Simons M, Romero C, Silva M, Lin X, Halpin RA, Fedorova N, Stockwell TB, Wentworth D, Holmes EC, Bausch DG. Phylogeography of Influenza A(H3N2) Virus in Peru, 2010-2012. Emerg Infect Dis 2016. [PMID: 26196599 PMCID: PMC4517729 DOI: 10.3201/eid2108.150084] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
It remains unclear whether lineages of influenza A(H3N2) virus can persist in the tropics and seed temperate areas. We used viral gene sequence data sampled from Peru to test this source-sink model for a Latin American country. Viruses were obtained during 2010-2012 from influenza surveillance cohorts in Cusco, Tumbes, Puerto Maldonado, and Lima. Specimens positive for influenza A(H3N2) virus were randomly selected and underwent hemagglutinin sequencing and phylogeographic analyses. Analysis of 389 hemagglutinin sequences from Peru and 2,192 global sequences demonstrated interseasonal extinction of Peruvian lineages. Extensive mixing occurred with global clades, but some spatial structure was observed at all sites; this structure was weakest in Lima and Puerto Maldonado, indicating that these locations may experience greater viral traffic. The broad diversity and co-circulation of many simultaneous lineages of H3N2 virus in Peru suggests that this country should not be overlooked as a potential source for novel pandemic strains.
Collapse
|
13
|
Tinoco YO, Azziz-Baumgartner E, Rázuri H, Kasper MR, Romero C, Ortiz E, Gomez J, Widdowson MA, Uyeki TM, Gilman RH, Bausch DG, Montgomery JM. A population-based estimate of the economic burden of influenza in Peru, 2009-2010. Influenza Other Respir Viruses 2016; 10:301-9. [PMID: 26547629 PMCID: PMC4910177 DOI: 10.1111/irv.12357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 12/05/2022] Open
Abstract
Introduction Influenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource‐limited settings. We therefore studied the cost of influenza in Peru. Methods We used data collected during June 2009–December 2010 from laboratory‐confirmed influenza cases identified through a household cohort in Peru. We determined the self‐reported direct and indirect costs of self‐treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15‐day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health‐related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household. Results There were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5–26] for self‐treatment, $19 (IQR 9–34) for ambulatory non‐medical attended illness, $29 (IQR 14–51) for ambulatory medical attended illness, and $171 (IQR 113–258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83–$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile). Conclusion Influenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza.
Collapse
Affiliation(s)
- Yeny O Tinoco
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Hugo Rázuri
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | | | | | - Ernesto Ortiz
- U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - Jorge Gomez
- General Directorate of Epidemiology, Ministry of Health, Lima, Peru
| | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert H Gilman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Joel M Montgomery
- U.S. Naval Medical Research Unit No. 6, Callao, Peru.,Division of Global Disease Detection International Emerging Infections Program, Centers for Disease Control and Prevention, Nairobi, Kenya
| | | |
Collapse
|
14
|
Razuri H, Malecki M, Tinoco Y, Ortiz E, Guezala MC, Romero C, Estela A, Breña P, Morales ML, Reaves EJ, Gomez J, Uyeki TM, Widdowson MA, Azziz-Baumgartner E, Bausch DG, Schildgen V, Schildgen O, Montgomery JM. Human Coronavirus-Associated Influenza-Like Illness in the Community Setting in Peru. Am J Trop Med Hyg 2015; 93:1038-40. [PMID: 26324726 DOI: 10.4269/ajtmh.15-0271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/29/2015] [Indexed: 12/28/2022] Open
Abstract
We present findings describing the epidemiology of non-severe acute respiratory syndrome human coronavirus-associated influenza-like illness from a population-based active follow-up study in four different regions of Peru. In 2010, the prevalence of infections by human coronaviruses 229E, OC43, NL63, or HKU1 was 6.4% in participants with influenza-like illness who tested negative for influenza viruses. Ten of 11 human coronavirus infections were identified in the fall-winter season. Human coronaviruses are present in different regions of Peru and are relatively frequently associated with influenza-like illness in Peru.
Collapse
Affiliation(s)
- Hugo Razuri
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Monika Malecki
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Yeny Tinoco
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Ernesto Ortiz
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - M Claudia Guezala
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Candice Romero
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Abel Estela
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Patricia Breña
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Maria-Luisa Morales
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Erik J Reaves
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Jorge Gomez
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Timothy M Uyeki
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Marc-Alain Widdowson
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Eduardo Azziz-Baumgartner
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Daniel G Bausch
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Verena Schildgen
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Oliver Schildgen
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Joel M Montgomery
- United States Naval Medical Research Unit No. 6, Lima, Peru; Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Institut für Pathologie, Cologne, Germany; Clinica San Pablo, Lima, Peru; Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| |
Collapse
|
15
|
Drumright LN, Frost SDW, Elliot AJ, Catchpole M, Pebody RG, Atkins M, Harrison J, Parker P, Holmes AH. Assessing the use of hospital staff influenza-like absence (ILA) for enhancing hospital preparedness and national surveillance. BMC Infect Dis 2015; 15:110. [PMID: 25886745 PMCID: PMC4381490 DOI: 10.1186/s12879-015-0789-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/30/2015] [Indexed: 11/16/2022] Open
Abstract
Background Early warning and robust estimation of influenza burden are critical to inform hospital preparedness and operational, treatment, and vaccination policies. Methods to enhance influenza-like illness (ILI) surveillance are regularly reviewed. We investigated the use of hospital staff ‘influenza-like absences’ (hospital staff-ILA), i.e. absence attributed to colds and influenza, to improve capture of influenza dynamics and provide resilience for hospitals. Methods Numbers and rates of hospital staff-ILA were compared to regional surveillance data on ILI primary-care presentations (15–64 years) and to counts of laboratory confirmed cases among hospitalised patients from April 2008 to April 2013 inclusive. Analyses were used to determine comparability of the ILI and hospital-ILA and how systems compared in early warning and estimating the burden of disease. Results Among 20,021 reported hospital-ILA and 4661 community ILI cases, correlations in counts were high and consistency in illness measurements was observed. In time series analyses, both hospital-ILA and ILI showed similar timing of the seasonal component. Hospital-ILA data often commenced and peaked earlier than ILI according to a Bayesian prospective alarm algorithm. Hospital-ILA rates were more comparable to model-based estimates of ‘true’ influenza burden than ILI. Conclusions Hospital-ILA appears to have the potential to be a robust, yet simple syndromic surveillance method that could be used to enhance estimates of disease burden and early warning, and assist with local hospital preparedness. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0789-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lydia N Drumright
- Department of Medicine, University of Cambridge, Cambridge, UK. .,National Centre for Infection Prevention and Management and National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance Imperial College London, London, UK.
| | - Simon D W Frost
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
| | - Alex J Elliot
- Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
| | - Mike Catchpole
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
| | - Richard G Pebody
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
| | - Mark Atkins
- Department of Virology, Imperial College Healthcare NHS Trust, London, UK.
| | - John Harrison
- Department of Occupational Health, Imperial College Healthcare NHS Trust, London, UK.
| | - Penny Parker
- Department of Human Resources, Imperial College Healthcare NHS Trust, London, UK.
| | - Alison H Holmes
- National Centre for Infection Prevention and Management and National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance Imperial College London, London, UK. .,Department of Infection Prevention and Control, Imperial College Healthcare NHS Trust, London, UK.
| |
Collapse
|
16
|
Estimation of the national disease burden of influenza-associated severe acute respiratory illness in Kenya and Guatemala: a novel methodology. PLoS One 2013; 8:e56882. [PMID: 23573177 PMCID: PMC3584100 DOI: 10.1371/journal.pone.0056882] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 01/15/2013] [Indexed: 11/19/2022] Open
Abstract
Background Knowing the national disease burden of severe influenza in low-income countries can inform policy decisions around influenza treatment and prevention. We present a novel methodology using locally generated data for estimating this burden. Methods and Findings This method begins with calculating the hospitalized severe acute respiratory illness (SARI) incidence for children <5 years old and persons ≥5 years old from population-based surveillance in one province. This base rate of SARI is then adjusted for each province based on the prevalence of risk factors and healthcare-seeking behavior. The percentage of SARI with influenza virus detected is determined from provincial-level sentinel surveillance and applied to the adjusted provincial rates of hospitalized SARI. Healthcare-seeking data from healthcare utilization surveys is used to estimate non-hospitalized influenza-associated SARI. Rates of hospitalized and non-hospitalized influenza-associated SARI are applied to census data to calculate the national number of cases. The method was field-tested in Kenya, and validated in Guatemala, using data from August 2009–July 2011. In Kenya (2009 population 38.6 million persons), the annual number of hospitalized influenza-associated SARI cases ranged from 17,129–27,659 for children <5 years old (2.9–4.7 per 1,000 persons) and 6,882–7,836 for persons ≥5 years old (0.21–0.24 per 1,000 persons), depending on year and base rate used. In Guatemala (2011 population 14.7 million persons), the annual number of hospitalized cases of influenza-associated pneumonia ranged from 1,065–2,259 (0.5–1.0 per 1,000 persons) among children <5 years old and 779–2,252 cases (0.1–0.2 per 1,000 persons) for persons ≥5 years old, depending on year and base rate used. In both countries, the number of non-hospitalized influenza-associated cases was several-fold higher than the hospitalized cases. Conclusions Influenza virus was associated with a substantial amount of severe disease in Kenya and Guatemala. This method can be performed in most low and lower-middle income countries.
Collapse
|
17
|
Tokarz R, Hirschberg DL, Sameroff S, Haq S, Luna G, Bennett AJ, Silva M, Leguia M, Kasper M, Bausch DG, Lipkin WI. Genomic analysis of two novel human enterovirus C genotypes found in respiratory samples from Peru. J Gen Virol 2012; 94:120-127. [PMID: 23034595 DOI: 10.1099/vir.0.046250-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We report the discovery of two enteroviruses detected in nasopharyngeal samples obtained from subjects with respiratory disease in Peru. Phylogenetic analysis indicated that both viruses belong to a clade within the species Human enterovirus C, which includes the recently characterized human enteroviruses 109 and 104. Members of this clade have undergone significant genomic rearrangement, as indicated by deletions in the hypervariable region of the 5' UTR and the VP1 protein, as well as recombination within the non-structural genes. Our findings and review of published sequences suggests that several novel human enterovirus C serotypes are currently circulating worldwide.
Collapse
Affiliation(s)
- Rafal Tokarz
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David L Hirschberg
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Stephen Sameroff
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Saddef Haq
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Andrew J Bennett
- US Naval Medical Research Unit 6, Lima, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Maria Silva
- US Naval Medical Research Unit 6, Lima, Peru
| | | | | | | | - W Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|