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Sočan M, Prosenc K, Mrzel M. Prevalence of Co-Infections in Primary Care Patients with Medically Attended Acute Respiratory Infection in the 2022/2023 Season. Viruses 2024; 16:1289. [PMID: 39205263 PMCID: PMC11359868 DOI: 10.3390/v16081289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
In the post-pandemic period, an endemic circulation of respiratory viruses has been re-established. Respiratory viruses are co-circulating with SARS-CoV-2. We performed a retrospective analysis of co-infections in primary care patients with medically attended acute respiratory infections (MAARI) who consulted from week 40/2022 to week 39/2023 and were tested for a panel of respiratory viruses. Out of 2099 samples tested, 1260 (60.0%) were positive for one virus. In 340 samples, co-infection was detected: two viruses in 281 (13.4%), three viruses in 51 (2.4%), and four viruses in eight (0.4%) samples. Respiratory viruses co-infected the patients with MAARI at very different rates. The lowest rates of co-infections were confirmed for influenza B (13.8%) and influenza A (22.9%) and the highest for human bocaviruses (84.0%) and human parechoviruses (82.1%). Co-infections were detected in 28.2% of SARS-CoV-2 positive samples. SARS-CoV-2 has never been co-infected with influenza B virus, enterovirus or adenovirus, although the latter was found as a co-infecting virus with all other respiratory viruses tested. The rate of co-infections decreased significantly with increasing age (p-value 0.000), and no difference was found regarding gender (p-value 0.672). It is important to understand the epidemiology of respiratory co-infections for prevention and management decisions in patients with MAARI.
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Affiliation(s)
- Maja Sočan
- National Institute of Public Health, 1000 Ljubljana, Slovenia;
| | - Katarina Prosenc
- National Laboratory for Health, Environment and Food, 1000 Ljubljana, Slovenia;
| | - Maja Mrzel
- National Institute of Public Health, 1000 Ljubljana, Slovenia;
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2
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Korsun N, Trifonova I, Madzharova I, Christova I. Resurgence of influenza with increased genetic diversity of circulating viruses during the 2022-2023 season. J Med Microbiol 2024; 73. [PMID: 39073070 DOI: 10.1099/jmm.0.001864] [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] [Indexed: 07/30/2024] Open
Abstract
Introduction. After two seasons of absence and low circulation, influenza activity increased significantly in the winter of 2022-2023. This study aims to characterize virological and epidemiological aspects of influenza infection in Bulgaria during the 2022-2023 season and perform a phylogenetic/molecular analysis of the hemagglutinin (HA) and neuraminidase (NA) sequences of representative influenza strains.Hypothesis/Gap Statement. Influenza A and B viruses generate new genetic groups/clades each season, replacing previously circulating variants. This results in increased antigenic distances from current vaccine strains. Strengthening existing influenza surveillance is essential to meet the challenges posed by the co-circulation of influenza and SARS-CoV-2.Methodology. We tested 2713 clinical samples from patients with acute respiratory illnesses using a multiplex real-time RT-PCR kit (FluSC2) to detect influenza A/B and Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) simultaneously. Representative Bulgarian influenza strains were sequenced at the WHO Collaborating Centres in London, UK, and Atlanta, USA.Results. Influenza virus was detected in 694 (25.6 %) patients. Of these, 364 (52.4 %), 213 (30.7 %) and 117 (16.9 %) were positive for influenza A(H1N1)pdm09, A(H3N2) and B/Victoria lineage virus, respectively. HA genes of the 47 influenza A(H1N1)pdm09 viruses fell into clades 5a.2. and 5a.2a.1 within the 6B.5A.1A.5a.2 group. Twenty-seven A(H3N2) viruses belonging to subclades 2b, 2a.1, 2a.1b and 2a.3a.1 within the 3C.2a1b.2a.2 group were analysed. All 23 sequenced B/Victoria lineage viruses were classified into the V1A.3a.2 group. We identified amino acid substitutions in HA and NA compared with the vaccine strains, including several substitutions in the HA antigenic sites.Conclusion. The study's findings showed genetic diversity among the influenza A viruses and, to a lesser extent, among B viruses, circulating in the first season after the lifting of anti-COVID-19 measures.
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MESH Headings
- Humans
- Influenza, Human/virology
- Influenza, Human/epidemiology
- Genetic Variation
- Phylogeny
- Influenza B virus/genetics
- Influenza B virus/classification
- Influenza B virus/isolation & purification
- SARS-CoV-2/genetics
- SARS-CoV-2/classification
- Neuraminidase/genetics
- Adult
- Male
- Middle Aged
- Female
- Bulgaria/epidemiology
- Young Adult
- Aged
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Child, Preschool
- Child
- Adolescent
- COVID-19/epidemiology
- COVID-19/virology
- Infant
- Seasons
- Influenza A virus/genetics
- Influenza A virus/classification
- Influenza A virus/isolation & purification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/isolation & purification
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Affiliation(s)
- Neli Korsun
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, 44A Stoletov Blvd, 1233 Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, 44A Stoletov Blvd, 1233 Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, 44A Stoletov Blvd, 1233 Sofia, Bulgaria
| | - Iva Christova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, 44A Stoletov Blvd, 1233 Sofia, Bulgaria
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Jeon K, Lee SK, Jeong S, Song W, Kim HS, Kim JS, Shin KS, Kim HS. Trends in the detection of viruses causing gastroenteritis over a 10-year period and impact of nonpharmaceutical interventions. J Clin Virol 2024; 172:105676. [PMID: 38636263 DOI: 10.1016/j.jcv.2024.105676] [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: 01/18/2024] [Revised: 03/27/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Viral gastroenteritis continues to be a leading cause of death in low-income countries. The impact of nonpharmaceutical interventions (NPIs) on the transmission of gastroenteritis-causing viruses during the COVID-19 pandemic is understudied. OBJECTIVES To investigate the 10-year trends of enteric viruses and estimate the impact of implementing and mitigating NPIs. STUDY DESIGN Data regarding norovirus, rotavirus, adenovirus, astrovirus, and sapovirus detection were collected from five Korean hospitals between January 2013 and April 2023. We compared positivity between the pre-pandemic, pandemic, and post-pandemic periods. The causal effects of implementing and mitigating NPIs were quantified using the Bayesian Structural Time Series (BSTS) model. RESULTS Norovirus was most frequently detected (9.9 %), followed by rotavirus (6.7 %), adenovirus (3.3 %), astrovirus (1.4 %), and sapovirus (0.6 %). During the pandemic, the positivity of all five viruses decreased, ranging from -1.0 % to -8.1 %, with rotavirus showing the greatest decrease. In the post-pandemic period, positivity rebounded for all viruses except for rotavirus. The BSTS model revealed that NPI implementation negatively affected the detection of all five viruses, resulting in reductions ranging from -73.0 % to -91.0 % compared to the prediction, with rotavirus being the least affected. Conversely, NPI mitigation positively affected the detection of all viruses, ranging from 79.0 % to 200.0 %, except for rotavirus. CONCLUSIONS Trends observed over 10 years show that NPIs have had a major impact on changes in enteric virus detection. The effect of vaccines, in addition to NPIs, on rotavirus detection requires further investigation. Our findings emphasize the importance of NPIs in infection control and prevention.
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Affiliation(s)
- Kibum Jeon
- Department of Laboratory Medicine, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 07247, Republic of Korea
| | - Su Kyung Lee
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, 18450, Republic of Korea
| | - Seri Jeong
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 07441, Republic of Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 07441, Republic of Korea
| | - Han-Sung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 14068, Republic of Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 05355, Republic of Korea
| | - Kyu Sung Shin
- Department of Laboratory Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 24253, Republic of Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, 18450, Republic of Korea.
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Kurz H, Sever-Yildiz G, Kocsisek CV, Resch E, Großschädl C, Totschnig L, Resch B. Respiratory Syncytial Virus and Influenza During the COVID-19 Pandemic: A Two-center Experience. Pediatr Infect Dis J 2024; 43:410-414. [PMID: 38266234 PMCID: PMC11003405 DOI: 10.1097/inf.0000000000004260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The aim of the study was to determine the burden of respiratory syncytial virus (RSV) and influenza disease during the COVID-19 pandemic at 2 Austrian urban pediatric centers between October 1, 2019 and April 30, 2022. METHODS We performed a retrospective observational 2-center study on RSV- and influenza virus-associated hospitalizations in infants and children up to 18 years at the University Hospital of Graz and the Clinic Donaustadt of Vienna from October 1, 2019 to April 30, 2022. Hospitalization had to be associated with the infectious disease, proven by polymerase chain reaction, including presence of respiratory symptoms. Demographic data including underlying diseases and treatment strategies were compared between centers and diseases, respectively. RESULTS There were 826 cases in Graz and 379 in Vienna with significant more RSV cases in Graz and more influenza cases in Vienna (RSV: 76% vs. 59%, influenza: 24% vs. 41%; both P < 0.001). One death occurred in Graz due to RSV and another due to influenza in Vienna. Seasonality only slightly differed between centers and severity of diseases was not aggravated when measured by pediatric intensive care unit admission rates, need for supplemental oxygen and respiratory support between first and last seasons. Treatment regimen differed regarding higher use of antibiotics and rates of intravenous fluids in Vienna compared to higher rates of bronchodilators, corticosteroids and nose drops in Graz. CONCLUSIONS We observed higher numbers of hospitalizations due to both viruses after the lockdown but not increased severity of the diseases; and mortality remained extremely low. Preventive measures should be implemented with high priority especially focused on infants with underlying diseases.
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Affiliation(s)
- Herbert Kurz
- From the Department of Pediatrics and Adolescents, Clinic Donaustadt, Vienna, Austria
| | - Gulsen Sever-Yildiz
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Corinna V. Kocsisek
- From the Department of Pediatrics and Adolescents, Clinic Donaustadt, Vienna, Austria
| | - Elisabeth Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Clara Großschädl
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Leonie Totschnig
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Nørgaard SK, Nielsen J, Nordholm AC, Richter L, Chalupka A, Sierra NB, Braeye T, Athanasiadou M, Lytras T, Denissov G, Luomala O, Fouillet A, Pontais I, An der Heiden M, Zacher B, Weigel A, Foppa I, Gkolfinopoulou K, Panagoulias I, Paldy A, Malnasi T, Domegan L, Kelly E, Rotem N, Rakhlin O, de'Donato FK, Di Blasi C, Hoffmann P, Velez T, England K, Calleja N, van Asten L, Jongenotter F, Rodrigues AP, Silva S, Klepac P, Gomez-Barroso D, Gomez IL, Galanis I, Farah A, Weitkunat R, Fehst K, Andrews N, Clare T, Bradley DT, O'Doherty MG, William N, Hamilton M, Søborg B, Krause TG, Bundle N, Vestergaard LS. Excess mortality in Europe coincides with peaks of COVID-19, influenza and respiratory syncytial virus (RSV), November 2023 to February 2024. Euro Surveill 2024; 29:2400178. [PMID: 38606570 PMCID: PMC11010589 DOI: 10.2807/1560-7917.es.2024.29.15.2400178] [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: 03/22/2024] [Accepted: 04/11/2024] [Indexed: 04/13/2024] Open
Abstract
Since the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023-6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI: 91.7-98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45 years and older, and coincides with widespread presence of COVID-19, influenza and respiratory syncytial virus (RSV) observed in many European countries during the 2023/24 winter season.
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Affiliation(s)
- Sarah K Nørgaard
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Christine Nordholm
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Alena Chalupka
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | - Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | - Oskari Luomala
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | | | | | - Alina Weigel
- Hessisches Landesamt für Gesundheit und Pflege, Dillenburg, Germany
| | - Ivo Foppa
- Hessisches Landesamt für Gesundheit und Pflege, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Tibor Malnasi
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Lisa Domegan
- Health-Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Eva Kelly
- Health-Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Naama Rotem
- Central Bureau of Statistics, Jerusalem, Israel
| | | | | | - Chiara Di Blasi
- Department of Epidemiology Lazio Regional Health System - ASL Roma 1, Rome, Italy
| | | | | | | | - Neville Calleja
- Directorate for Health Information and Research, Pieta, Malta
| | - Liselotte van Asten
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Femke Jongenotter
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ana Paula Rodrigues
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Susana Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Petra Klepac
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Diana Gomez-Barroso
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Inmaculada Leon Gomez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | | | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Nick Andrews
- UK Health Security Agency, London, United Kingdom
| | - Tom Clare
- UK Health Security Agency, London, United Kingdom
| | | | | | | | | | - Bolette Søborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Tyra G Krause
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lasse S Vestergaard
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Šošić M, Boban Z, Erceg M, Boban N. Excess Mortality Stratified by Age and Sex for Croatia and Croatian Counties during the 2020-2021 COVID-19 Pandemic. Infect Dis Rep 2024; 16:142-153. [PMID: 38390950 PMCID: PMC10885044 DOI: 10.3390/idr16020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
Excess mortality is often used to estimate the effect of a certain crisis on the population. It is defined as the number of deaths during a crisis exceeding the expected number based on historical trends. Here, we calculated excess mortality due to the COVID-19 pandemic for Croatia in the 2020-2021 period. The excess was calculated on the national and county level for different age and sex categories. In addition to the absolute number, the excess mortality was also expressed as a ratio of excess deaths to the predicted baseline and excess mortality rate. We showed that using both measures is necessary to avoid incorrect conclusions. The estimated excess mortality on the national level was 14,963, corresponding to an excess percentage of 14.3%. With respect to sex, there was a higher excess mortality rate for men compared to women. An exponential relationship was observed between age and the excess mortality rate.These trends wee representative of most counties as well, with large variations in the magnitude of the effect. However, there were also exceptions to the general rule. The reasons for these deviations were discussed in terms of between-county differences in demographic structure, population density and special events that took place during the pandemic.
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Affiliation(s)
- Mara Šošić
- Department of Clinical Epidemiology, University Hospital of Split, 21000 Split, Croatia
| | - Zvonimir Boban
- Department of Medical Physics and Biophysics, University of Split School of Medicine, 21000 Split, Croatia
| | - Marijan Erceg
- Division for Epidemiology and Prevention of Noncommunicable Chronic Diseases, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Nataša Boban
- Department of Clinical Epidemiology, University Hospital of Split, 21000 Split, Croatia
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia
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Kolosova NP, Boldyrev ND, Svyatchenko SV, Danilenko AV, Goncharova NI, Shadrinova KN, Danilenko EI, Onkhonova GS, Kosenko MN, Antonets ME, Susloparov IM, Ilyicheva TN, Marchenko VY, Ryzhikov AB. An Investigation of Severe Influenza Cases in Russia during the 2022-2023 Epidemic Season and an Analysis of HA-D222G/N Polymorphism in Newly Emerged and Dominant Clade 6B.1A.5a.2a A(H1N1)pdm09 Viruses. Pathogens 2023; 13:1. [PMID: 38276147 PMCID: PMC10819184 DOI: 10.3390/pathogens13010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
In Russia, during the COVID-19 pandemic, a decrease in influenza circulation was initially observed. Influenza circulation re-emerged with the dominance of new clades of A(H3N2) viruses in 2021-2022 and A(H1N1)pdm09 viruses in 2022-2023. In this study, we aimed to characterize influenza viruses during the 2022-2023 season in Russia, as well as investigate A(H1N1)pdm09 HA-D222G/N polymorphism associated with increased disease severity. PCR testing of 780 clinical specimens showed 72.2% of them to be positive for A(H1N1)pdm09, 2.8% for A(H3N2), and 25% for influenza B viruses. The majority of A(H1N1)pdm09 viruses analyzed belonged to the newly emerged 6B.1A.5a.2a clade. The intra-sample predominance of HA-D222G/N virus variants was observed in 29% of the specimens from A(H1N1)pdm09 fatal cases. The D222N polymorphic variant was registered more frequently than D222G. All the B/Victoria viruses analyzed belonged to the V1A.3a.2 clade. Several identified A(H3N2) viruses belonged to one of the four subclades (2a.1b, 2a.3a.1, 2a.3b, 2b) within the 3C.2a1b.2a.2 group. The majority of antigenically characterized viruses bore similarities to the corresponding 2022-2023 NH vaccine strains. Only one influenza A(H1N1)pdm09 virus showed reduced inhibition by neuraminidase inhibitors. None of the influenza viruses analyzed had genetic markers of reduced susceptibility to baloxavir.
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8
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Boussarsar M, Ennouri E, Habbachi N, Bouguezzi N, Meddeb K, Gallas S, Hafdhi M, Zghidi M, Toumi R, Ben Saida I, Abid S, Boutiba-Ben Boubaker I, Maazaoui L, El Ghord H, Gzara A, Yazidi R, Ben Salah A. Epidemiology and burden of Severe Acute Respiratory Infections (SARI) in the aftermath of COVID-19 pandemic: A prospective sentinel surveillance study in a Tunisian Medical ICU, 2022/2023. PLoS One 2023; 18:e0294960. [PMID: 38100529 PMCID: PMC10723666 DOI: 10.1371/journal.pone.0294960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Severe Acute Respiratory Infections (SARI) caused by influenza and other respiratory viruses pose significant global health challenges, and the COVID-19 pandemic has further strained healthcare systems. As the focus shifts from the pandemic to other respiratory infections, assessing the epidemiology and burden of SARI is crucial for healthcare planning and resource allocation. Aim: to understand the impact of the post-pandemic period on the epidemiology of SARI cases, clinical outcomes, and healthcare resource utilization in Tunisia. METHODS This is a prospective study conducted in a Tunisian MICU part of a national sentinel surveillance system, focusing on enhanced SARI surveillance. SARI cases from week 39/2022, 26 September to week 19/2023, 13 May were included, according to a standardized case definition. Samples were collected for virological RT-PCR testing, and an electronic system ensured standardized and accurate data collection. Descriptive statistics were performed to assess epidemiology, trends, and outcomes of SARI cases, and univariate/multivariate analyses to assess factors associated with mortality. RESULTS Among 312 MICU patients, 164 SARI cases were identified during the study period. 64(39%) RT-PCR were returned positive for at least one pathogen, with influenza A and B strains accounting for 20.7% of cases at the early stages of the influenza season. The MICU experienced a significant peak in admissions during weeks 1-11/2023, leading to resource mobilization and the creation of a surge unit. SARI cases utilized 1664/3120 of the MICU-stay days and required 1157 mechanical ventilation days. The overall mortality rate among SARI cases was 22.6%. Age, non-COPD, and ARDS were identified as independent predictors of mortality. CONCLUSIONS The present study identified a relatively high rate of SARI cases, with 39% positivity for at least one respiratory virus, with influenza A and B strains occurring predominantly during the early stages of the influenza season. The findings shed light on the considerable resource utilization and mortality associated with these infections, underscoring the urgency for proactive management and efficient resource allocation strategies.
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Affiliation(s)
- Mohamed Boussarsar
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Emna Ennouri
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Naima Habbachi
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Nabil Bouguezzi
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Khaoula Meddeb
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Salma Gallas
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Malek Hafdhi
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Marwa Zghidi
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Radhouane Toumi
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Imen Ben Saida
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Medical Intensive Care Unit, Research Laboratory “Heart Failure”, Farhat Hached University Hospital, Sousse, Tunisia
| | - Salma Abid
- National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Ilhem Boutiba-Ben Boubaker
- National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | | | | | - Ahlem Gzara
- Primary Health Care Directorate, Tunis, Tunisia
| | - Rihab Yazidi
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia
- Service of Medical Epidemiology, Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia
- Laboratory of Transmission, Control and Immunobiology of Infections LR16IPT02, Institut Pasteur de Tunis, University of Tunis, El Manar, Tunis, Tunisia
| | - Afif Ben Salah
- Service of Medical Epidemiology, Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia
- Department of Family and Community Medicine, College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Manama, Bahrain
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Mubarak S, Alsmadi O, Tbakhi A, Ata OA, Hassan A, AlGhawrie H. Impact of the SARS-CoV-2 pandemic on the overall respiratory viruses' transmission in a cancer care setting. Immun Inflamm Dis 2023; 11:e1073. [PMID: 38018583 PMCID: PMC10664391 DOI: 10.1002/iid3.1073] [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: 03/14/2023] [Revised: 08/27/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE The emergence of the COVID-19 pandemic raised questions about the interaction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses. The objective of this study is to validate the impact of the SARS-CoV-2 pandemic and its interventional measures on the respiratory viruses' transmission/infection rates. METHODS A retrospective chart review was conducted for cancer patients who underwent laboratory-confirmed respiratory virus polymerase chain reaction (PCR) testing from January 2018 to June 2022. COVID-19 PCR tests from March 2020 to June 2022 were also included. Joinpoint regression analysis was applied to evaluate trends in respiratory virus rates. Statistical analysis was performed using Statistical Package for Social Science software. RESULTS A total of 6298 respiratory virus PCRs and 40,000 COVID-19 PCRs were performed. Data showed a significant decrease in respiratory viruses' positive cases, total respiratory tests, and respiratory viruses' activity during the pandemic period compared with the pre-pandemic period (p = .0209, .026, and .028, respectively). The joinpoint regression analysis showed a significant decrease of 13.85% in the tested positive cases of respiratory viruses between the years 2018 and 2022. Monthly, the analysis indicated a significant decrease in the positive cases by 13.46% from December 2019 to May 2021. Weekly analysis following lockdown initiation showed a reduction in respiratory virus cases. CONCLUSION This study provides valuable insights into the interplay between COVID-19 and other respiratory viruses, suggesting that the measures taken for COVID-19 were effective in reducing the spread of viral respiratory infections, aiding future infection control strategies to protect vulnerable populations, including cancer patients, from seasonal respiratory infections.
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Affiliation(s)
- Sawsan Mubarak
- Infection Control ProgramKing Hussein Cancer CenterAmmanJordan
| | - Osama Alsmadi
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
| | - Abdelghani Tbakhi
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
| | - Osama Abu Ata
- Department of Internal MedicineKing Hussein Cancer CenterAmmanJordan
| | - Ala'a Hassan
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
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10
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Toribio-Avedillo D, Gómez-Gómez C, Sala-Comorera L, Rodríguez-Rubio L, Carcereny A, García-Pedemonte D, Pintó RM, Guix S, Galofré B, Bosch A, Merino S, Muniesa M. Monitoring influenza and respiratory syncytial virus in wastewater. Beyond COVID-19. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 892:164495. [PMID: 37245831 PMCID: PMC10214770 DOI: 10.1016/j.scitotenv.2023.164495] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023]
Abstract
Wastewater-based surveillance can be a valuable tool to monitor viral circulation and serve as an early warning system. For respiratory viruses that share similar clinical symptoms, namely SARS-CoV-2, influenza, and respiratory syncytial virus (RSV), identification in wastewater may allow differentiation between seasonal outbreaks and COVID-19 peaks. In this study, to monitor these viruses as well as standard indicators of fecal contamination, a weekly sampling campaign was carried out for 15 months (from September 2021 to November 2022) in two wastewater treatment plants that serve the entire population of Barcelona (Spain). Samples were concentrated by the aluminum hydroxide adsorption-precipitation method and then analyzed by RNA extraction and RT-qPCR. All samples were positive for SARS-CoV-2, while the positivity rates for influenza virus and RSV were significantly lower (10.65 % for influenza A (IAV), 0.82 % for influenza B (IBV), 37.70 % for RSV-A and 34.43 % for RSV-B). Gene copy concentrations of SARS-CoV-2 were often approximately 1 to 2 logarithmic units higher compared to the other respiratory viruses. Clear peaks of IAV H3:N2 in February and March 2022 and RSV in winter 2021 were observed, which matched the chronological incidence of infections recorded in the Catalan Government clinical database. In conclusion, the data obtained from wastewater surveillance provided new information on the abundance of respiratory viruses in the Barcelona area and correlated favorably with clinical data.
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Affiliation(s)
- Daniel Toribio-Avedillo
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain
| | - Clara Gómez-Gómez
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain
| | - Laura Sala-Comorera
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain
| | - Lorena Rodríguez-Rubio
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain
| | - Albert Carcereny
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - David García-Pedemonte
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - Rosa Maria Pintó
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - Belén Galofré
- Aigües de Barcelona, Empresa Metropolitana de Gestió del Cicle Integral de l'Aigua, General Batet 1-7, Barcelona 08028, Spain
| | - Albert Bosch
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - Susana Merino
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain; Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet 08921, Spain
| | - Maite Muniesa
- MARS Group (Health Related Water Microbiology Group), Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, University of Barcelona, Diagonal 643, E-08028 Barcelona, Spain.
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11
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Pendrey CG, Strachan J, Peck H, Aziz A, Moselen J, Moss R, Rahaman MR, Barr IG, Subbarao K, Sullivan SG. The re-emergence of influenza following the COVID-19 pandemic in Victoria, Australia, 2021 to 2022. Euro Surveill 2023; 28:2300118. [PMID: 37707981 PMCID: PMC10687983 DOI: 10.2807/1560-7917.es.2023.28.37.2300118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/28/2023] [Indexed: 09/16/2023] Open
Abstract
BackgroundCOVID-19 pandemic mitigation measures, including travel restrictions, limited global circulation of influenza viruses. In Australia, travel bans for non-residents and quarantine requirements for returned travellers were eased in November 2021, providing pathways for influenza viruses to be re-introduced.AimWe aimed to describe the epidemiological and virological characteristics of the re-emergence of influenza in Victoria, Australia to inform public health interventions.MethodsFrom 1 November 2021 to 30 April 2022, we conducted an epidemiological study analysing case notification data from the Victorian Department of Health to describe case demographics, interviewed the first 200 cases to establish probable routes of virus reintroduction and examined phylogenetic and antigenic data to understand virus diversity and susceptibility to current vaccines.ResultsOverall, 1,598 notifications and 1,064 positive specimens were analysed. The majority of cases (61.4%) occurred in the 15-34 years age group. Interviews revealed a higher incidence of international travel exposure during the first month of case detections, and high levels of transmission in university residential colleges were associated with return to campus. Influenza A(H3N2) was the predominant subtype, with a single lineage predominating despite multiple importations.ConclusionEnhanced testing for respiratory viruses during the COVID-19 pandemic provided a more complete picture of influenza virus transmission compared with previous seasons. Returned international travellers were important drivers of influenza reemergence, as were young adults, a group whose role has previously been under-recognised in the establishment of seasonal influenza epidemics. Targeting interventions, including vaccination, to these groups could reduce future influenza transmission.
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Affiliation(s)
- Catherine Ga Pendrey
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- Communicable Diseases, Health Protection Branch, Public Health Division, Department of Health, Victoria, Melbourne, Australia
| | - Janet Strachan
- Communicable Diseases, Health Protection Branch, Public Health Division, Department of Health, Victoria, Melbourne, Australia
| | - Heidi Peck
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Ammar Aziz
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Jean Moselen
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Rob Moss
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Md Rezanur Rahaman
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Immunology and Microbiology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Kanta Subbarao
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Immunology and Microbiology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Communicable Diseases, Health Protection Branch, Public Health Division, Department of Health, Victoria, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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12
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Ivashchenko AA, Jones JC, Shkil DO, Ivanenkov YA, Pascua PNQ, Penaflor MK, Karapetian RN, Govorkova EA, Ivachtchenko AV. Resistance profiles for the investigational neuraminidase inhibitor AV5080 in influenza A and B viruses. Antiviral Res 2023; 217:105701. [PMID: 37567255 PMCID: PMC10528385 DOI: 10.1016/j.antiviral.2023.105701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Neuraminidase inhibitors (NAIs) are recommended for influenza treatment and prevention worldwide. The most widely prescribed NAI is oral oseltamivir, while inhaled zanamivir is less commonly used. Using phenotypic neuraminidase (NA) enzymatic assays and molecular modeling approaches, we examined the ability of the investigational orally-dosed NAI AV5080 to inhibit viruses of the influenza A(H1N1)pdm09, A(H3N2), A(H5N1), and A(H7N9) subtypes and the influenza B/Victoria- and B/Yamagata-lineages containing NA substitutions conferring oseltamivir or zanamivir resistance including: NA-R292K, NA-E119G/V, NA-H274Y, NA-I122L/N, and NA-R150K. Broadly, AV5080 showed enhanced in vitro efficacy when compared with oseltamivir and/or zanamivir. Reduced AV5080 inhibition was determined for influenza A viruses with NA-E119G and NA-R292K, and for B/Victoria-lineage viruses with NA-I122N/L and B/Yamagata-lineage virus with NA-R150K. Molecular modeling suggested loss of the short hydrogen bond to the carboxyl group of AV5080 affected inhibition of NA-R292K viruses, whereas loss of the salt bridge with the guanidine group of AV5080 affected inhibition of NA-E119G. The resistance profiles and predicted binding modes of AV5080 and zanamivir are most similar, but dissimilar to those of oseltamivir, in part because of a guanidine moiety compensatory binding effect. Overall, our data suggests that AV5080 is a promising orally-dosed NAI that exhibited similar or superior in vitro efficacy against viruses with reduced or highly reduced inhibition phenotypes with respect to currently approved NAIs.
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Affiliation(s)
| | - Jeremy C Jones
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Dmitry O Shkil
- ChemDiv, 12760 High Bluff Drive, Ste. 370 San Diego, CA, 92130, USA
| | - Yan A Ivanenkov
- ChemDiv, 12760 High Bluff Drive, Ste. 370 San Diego, CA, 92130, USA
| | - Philippe Noriel Q Pascua
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Melissa K Penaflor
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | | | - Elena A Govorkova
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
| | - Alexandre V Ivachtchenko
- ChemDiv, 12760 High Bluff Drive, Ste. 370 San Diego, CA, 92130, USA; AVISA LLC, 1835 E. Hallandale Beach Blvd, #442, Hallandale Beach, FL, 33009, USA.
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13
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Losier A, Gupta G, Caldararo M, Dela Cruz CS. The Impact of Coronavirus Disease 2019 on Viral, Bacterial, and Fungal Respiratory Infections. Clin Chest Med 2023; 44:407-423. [PMID: 37085229 PMCID: PMC9968485 DOI: 10.1016/j.ccm.2022.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although coronavirus disease 2019 (COVID-19) remains an ongoing threat, concerns regarding other respiratory infections remain. Throughout the COVID-19 pandemic various epidemiologic trends have been observed in other respiratory viruses including a reduction in influenza and respiratory syncytial virus infections following onset of the COVID-19 pandemic. Observations suggest that infections with other respiratory viruses were reduced with social distancing, mask wearing, eye protection, and hand hygiene practices. Coinfections with COVID-19 exist not only with other respiratory viruses but also with bacterial pneumonias and other nosocomial and opportunistic infections. Coinfections have been associated with increased severity of illness and other adverse outcomes.
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Affiliation(s)
- Ashley Losier
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA.
| | - Gayatri Gupta
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Mario Caldararo
- Veteran's Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Charles S Dela Cruz
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
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14
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Moscovich DP, Averbuch D, Kerem E, Cohen-Cymberknoh M, Berkun Y, Brooks R, Reiff S, Meir MB, Wolf D, Breuer O. Pediatric respiratory admissions and related viral infections during the COVID-19 pandemic. Pediatr Pulmonol 2023. [PMID: 37097057 DOI: 10.1002/ppul.26434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected the incidence of respiratory viral infections. Our aim was to assess changes in pediatric admissions due to respiratory diseases and associated respiratory viral infections. METHODS An observational study including all respiratory admissions to the pediatric departments from January 2015 to August 2021. We compared respiratory admission percentage, respiratory viral panel results and clinical characteristics of these admissions between two study periods, January 2015 to February 2020 (pre-COVID-19 era) and March 2020 to August 2021 (COVID-19 era). RESULTS A total of 8774 respiratory admissions were included, 7157 pre-COVID-19 era and 1617 COVID-19 era. Relative to all pediatric admissions, there was a 17% decrease in respiratory admission percentage during the COVID-19 era (p < 0.001) and a 31% and 22% decreased in the admission percentages due to bronchiolitis (p < 0.001) and pneumonia (p < 0.001), respectively. However, admission percentages for asthma, wheezing illness, complicated pneumonia, and stridor remained the same. There was a significant decrease in the detection of a respiratory viral pathogen associated with these respiratory admissions (p < 0.001). This was related to a significant decrease in the detection of respiratory syncytial virus (RSV) (37% vs. 27%, p < 0.001) and influenza (5% vs. 0.3%, p < 0.001), but not other respiratory viruses. An alteration in the circulation pattern of most respiratory viruses, was observed. CONCLUSIONS During the COVID-19 pandemic, a decrease in the prevalence of RSV and influenza was associated with a significant decrease in admissions for bronchiolitis and pediatric pneumonia. This may allow us to estimate the significance of preventive measures for RSV and influenza on pediatric respiratory admissions.
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Affiliation(s)
- Dana Peer Moscovich
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Diana Averbuch
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Pediatric Infectious Diseases, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Eitan Kerem
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Malena Cohen-Cymberknoh
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yackov Berkun
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Rebecca Brooks
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Shimon Reiff
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Maskit Bar Meir
- Paediatrics and Infectious Diseases Division, Shaare Zedek Medical and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Dana Wolf
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Oded Breuer
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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15
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Łuniewska K, Szymański K, Kondratiuk K, Hallmann E, Brydak LB. The Impact of the COVID-19 Pandemic on Influenza Transmission in Poland. Microorganisms 2023; 11:microorganisms11040970. [PMID: 37110392 PMCID: PMC10145443 DOI: 10.3390/microorganisms11040970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The aim of this study was to determine whether the occurrence of the SARS-CoV-2 pandemic affected the incidence of influenza in Poland and the efficiency of the SENTINEL influenza surveillance system. METHODS The analysis was based on virologic data from the 2018/2019-2021/2022 epidemic seasons. The data in question were obtained from the SENTINEL influenza surveillance system, which is utilized in Poland. RESULTS In the 2020/2021 epidemic season, only one positive case was confirmed. In the epidemic season of 2021/2022, the number of positive cases increased. There was a delay in the peak of the season, since the start of pandemic, which was observed in the 14th week of 2022. Previously, it was recorded in the 5-10th week, depending on the season. Before the pandemic, the number of positive samples in relation to the tested ones oscillated between 41-49.4%. After the pandemic, it was 0.3% and below 20%, respectively, for season 2020/2021 and season 2021/2022. CONCLUSIONS The COVID-19 pandemic caused a decline in many other infectious diseases, including influenza, as a result of the numerous lockdowns and from people shifting to remote work. Other safety measures, such as obligatory protective masks and the use of disinfectants, had a significant impact on reducing the number of cases.
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Affiliation(s)
- Katarzyna Łuniewska
- National Influenza Centre, Department of Influenza Research, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
| | - Karol Szymański
- National Influenza Centre, Department of Influenza Research, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
| | - Katarzyna Kondratiuk
- National Influenza Centre, Department of Influenza Research, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
| | - Ewelina Hallmann
- National Influenza Centre, Department of Influenza Research, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
| | - Lidia Bernadeta Brydak
- National Influenza Centre, Department of Influenza Research, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland
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16
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Bonacina F, Boëlle PY, Colizza V, Lopez O, Thomas M, Poletto C. Global patterns and drivers of influenza decline during the COVID-19 pandemic. Int J Infect Dis 2023; 128:132-139. [PMID: 36608787 PMCID: PMC9809002 DOI: 10.1016/j.ijid.2022.12.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The influenza circulation reportedly declined during the COVID-19 pandemic in many countries. The occurrence of this change has not been studied worldwide nor its potential drivers. METHODS The change in the proportion of positive influenza samples reported by country and trimester was computed relative to the 2014-2019 period using the FluNet database. Random forests were used to determine predictors of change from demographical, weather, pandemic preparedness, COVID-19 incidence, and pandemic response characteristics. Regression trees were used to classify observations according to these predictors. RESULTS During the COVID-19 pandemic, the influenza decline relative to prepandemic levels was global but heterogeneous across space and time. It was more than 50% for 311 of 376 trimesters-countries and even more than 99% for 135. COVID-19 incidence and pandemic preparedness were the two most important predictors of the decline. Europe and North America initially showed limited decline despite high COVID-19 restrictions; however, there was a strong decline afterward in most temperate countries, where pandemic preparedness, COVID-19 incidence, and social restrictions were high; the decline was limited in countries where these factors were low. The "zero-COVID" countries experienced the greatest decline. CONCLUSION Our findings set the stage for interpreting the resurgence of influenza worldwide.
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Affiliation(s)
- Francesco Bonacina
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Tokyo Tech World Research Hub Initiative (WRHI), Tokyo Institute of Technology, Tokyo, Japan
| | - Olivier Lopez
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Maud Thomas
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Chiara Poletto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Department of Molecular Medicine, University of Padova, 35121 Padova, Italy.
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17
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Domnich A, Bruzzone B, Trombetta CS, De Pace V, Ricucci V, Varesano S, Garzillo G, Ogliastro M, Orsi A, Icardi G. Rapid differential diagnosis of SARS-CoV-2, influenza A/B and respiratory syncytial viruses: Validation of a novel RT-PCR assay. J Clin Virol 2023; 161:105402. [PMID: 36805601 DOI: 10.1016/j.jcv.2023.105402] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Influenza and respiratory syncytial (RSV) viruses are expected to co-circulate with SARS-CoV-2 in the upcoming seasons and clinical differential diagnosis between them is difficult. Laboratory-based RT-PCR is a gold standard diagnostic method for influenza, RSV and SARS-CoV-2. The objective of this study was to estimate the diagnostic performance of a novel point-of-care RT-PCR assay STANDARD M10 Flu/RSV/SARS-CoV-2 (SD Biosensor) in a large number of clinical specimens with diversified (co)-infection patterns and viral loads. METHODS This was a retrospective study, in which all samples were tested in both STANDARD M10 Flu/RSV/SARS-CoV-2 index and Allplex SARS-CoV-2/Respiratory Panel 1 (Seegene) reference kits. Samples with discordant results were further processed in a third resolver test (Resp-4-Plex, Abbott). RESULTS A total of 1,019 naso-/oropharyngeal samples (50.3% positive for at least one virus) were processed in both STANDARD M10 Flu/RSV/SARS-CoV-2 and Allplex assays and the overall between-assay agreement was as high as 94.6%. Positive percent agreement of the STANDARD M10 Flu/RSV/SARS-CoV-2 was 100%, 96.6%, 97.3% and 99.4% for influenza A, B, RSV and SARS-CoV-2, respectively. The corresponding negative percent agreement was 99.7%. 100%, 100% and 98.4%, respectively. The expected positive and negative predictive values for all viruses were constantly above 96% in a reasonable range of disease prevalence. CONCLUSIONS STANDARD M10 Flu/RSV/SARS-CoV-2 is a reliable RT-PCR assay able to detect influenza A, influenza B, RSV and SARS-CoV-2 in one hour or less, fostering a rapid differential diagnosis of common respiratory viruses.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Serena Varesano
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giada Garzillo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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18
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Korsun N, Trifonova I, Dobrinov V, Madzharova I, Grigorova I, Christova I. Low prevalence of influenza viruses and predominance of A(H3N2) virus with respect to SARS-CoV-2 during the 2021-2022 season in Bulgaria. J Med Virol 2023; 95:e28489. [PMID: 36832544 PMCID: PMC10107854 DOI: 10.1002/jmv.28489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/24/2023]
Abstract
Social distancing, mask-wearing, and travel restrictions during the COVID-19 pandemic have significantly impacted the spread of influenza viruses. The objectives of this study were to analyze the pattern of influenza virus circulation with respect to that of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Bulgaria during the 2021-2022 season and to perform a phylogenetic/molecular analysis of the hemagglutinin (HA) and neuraminidase (NA) sequences of representative influenza strains. Influenza infection was confirmed using real-time reverse transcription polymerase chain reaction in 93 (4.2%) of the 2193 patients with acute respiratory illness tested wherein all detected viruses were subtyped as A(H3N2). SARS-CoV-2 was identified in 377 (24.3%) of the 1552 patients tested. Significant differences in the incidence of influenza viruses and SARS-CoV-2 were found between individual age groups, outpatients/inpatients, and in the seasonal distribution of cases. Two cases of coinfections were identified. In hospitalized patients, the Ct values of influenza viruses at admission were lower in adults aged ≥65 years (indicating higher viral load) than in children aged 0-14 years (p < 0.05). In SARS-CoV-2-positive inpatients, this association was not statistically significant. HA genes of all A(H3N2) viruses analyzed belonged to subclade 3C.2a1b.2a. The sequenced viruses carried 11 substitutions in HA and 5 in NA, in comparison to the vaccine virus A/Cambodia/e0826360/2020, including several substitutions in the HA antigenic sites B and C. This study revealed extensive changes in the typical epidemiology of influenza infection, including a dramatic reduction in the number of cases, diminished genetic diversity of circulating viruses, changes in age, and seasonal distribution of cases.
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Affiliation(s)
- Neli Korsun
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Veselin Dobrinov
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iliyana Grigorova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iva Christova
- National Laboratory "Influenza and ARI", Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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19
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Adlhoch C, Delgado-Sanz C, Carnahan A, Larrauri A, Popovici O, Bossuyt N, Thomas I, Kynčl J, Slezak P, Brytting M, Guiomar R, Redlberger-Fritz M, Maistre Melillo J, Melillo T, van Gageldonk-Lafeber AB, Marbus SD, O’Donnell J, Domegan L, Gomes Dias J, Olsen SJ. Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. Euro Surveill 2023; 28:2200340. [PMID: 36700868 PMCID: PMC9881178 DOI: 10.2807/1560-7917.es.2023.28.4.2200340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Odette Popovici
- National Institute of Public Health Romania-National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | | | | | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | | | - Tanya Melillo
- Infectious Disease prevention and Control unit, Malta
| | | | - Sierk D. Marbus
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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20
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Bianchi FP, Cuscianna E, Rizzi D, Signorile N, Daleno A, Migliore G, Tafuri S. Impact of COVID-19 pandemic on flu vaccine uptake in healthcare workers in Europe: a systematic review and meta-analysis. Expert Rev Vaccines 2023; 22:777-784. [PMID: 37605528 DOI: 10.1080/14760584.2023.2250437] [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: 02/27/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Influenza immunization policies in Europe primarily target at-risk and vulnerable subjects. Healthcare workers (HCWs) are a key focus of vaccination campaigns. Our systematic review and meta-analysis aim to evaluate the role of the COVID-19 pandemic on influenza vaccine uptake among HCWs since the 2020/21 influenza season. AREAS COVERED Fourteen studies were included in the meta-analysis and systematic review, selected from scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge, and Scopus databases between 1 January 2021 and 15 January 2023 The analysis revealed a significant relationship between influenza vaccine uptake and COVID-19 related determinants, such as willingness to receive COVID-19 vaccination, fear of COVID-19, and differentiating between influenza and COVID-19 symptoms (OR = 5.70; 95%CI = 2.08-15.60). Several studies reported higher vaccination coverages in the 2020/21 season compared to previous seasons, with VC values ranging from + 17% to + 38% compared to the 2019/20 season. The included studies identified a shift in HCWs' attitudes toward influenza vaccination, attributed to increased awareness due to the COVID-19 pandemic. EXPERT OPINION Vaccine hesitancy is common among HCWs in Europe, necessitating mutual strategies across all European countries. So far, mandatory vaccination policies have shown the most potential in achieving high and sustainable influenza vaccination rates among HCWs.
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Affiliation(s)
- Francesco Paolo Bianchi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
- Bari Policlinico General-University Hospital, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Donato Rizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Noemi Signorile
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Daleno
- Bari Policlinico General-University Hospital, Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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21
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Surveillance of Severe Acute Respiratory Infection and Influenza Vaccine Effectiveness among Hospitalized Italian Adults, 2021/22 Season. Vaccines (Basel) 2022; 11:vaccines11010083. [PMID: 36679928 PMCID: PMC9861626 DOI: 10.3390/vaccines11010083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Following an extremely low incidence of influenza during the first waves of the ongoing COVID-19 pandemic, the 2021/22 Northern Hemisphere winter season saw a resurgence of influenza virus circulation. The aim of this study was to describe epidemiology of severe acute respiratory infections (SARIs) among Italian adults and estimate the 2021/22 season influenza vaccine effectiveness. For this purpose, a test-negative case-control study was conducted in a geographically representative sample of Italian hospitals. Of 753 SARI patients analyzed, 2.5% (N = 19) tested positive for influenza, most of which belonged to the A(H3N2) subtype. Phylogenetic analysis showed that these belonged to the subclade 3C.2a1b.2a.2, which was antigenically different from the 2021/22 A(H3N2) vaccine component. Most (89.5%) cases were registered among non-vaccinated individuals, suggesting a protective effect of influenza vaccination. Due to a limited number of cases, vaccine effectiveness estimated through the Firth's penalized logistic regression was highly imprecise, being 83.4% (95% CI: 25.8-97.4%) and 83.1% (95% CI: 22.2-97.3%) against any influenza type A and A(H3N2), respectively. Exclusion of SARS-CoV-2-positive controls from the model did not significantly change the base-case estimates. Within the study limitations, influenza vaccination appeared to be effective against laboratory-confirmed SARI.
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22
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Ilyicheva TN, Netesov SV, Gureyev VN. COVID-19, Influenza, and Other Acute Respiratory Viral Infections: Etiology, Immunopathogenesis, Diagnosis, and Treatment. Part 2. Other Acute Respiratory Viral Infections. MOLECULAR GENETICS, MICROBIOLOGY AND VIROLOGY : MOLEKULYARNAYA GENETIKA, MIKROBIOLOGIYA I VIRUSOLOGIYA 2022; 37:107-116. [PMID: 36589522 PMCID: PMC9790183 DOI: 10.3103/s0891416822030053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/17/2021] [Accepted: 10/30/2021] [Indexed: 12/26/2022]
Abstract
The first part of this paper presented the current knowledge on two very significant respiratory diseases with high pandemic potential, COVID-19 and influenza. The second part reviews other pathogens that cause acute respiratory viral infections, ARVI, including parainfluenza viruses, adenoviruses, pneumoviruses and specifically respiratory syncytial virus, enteroviruses, rhinoviruses, bocaviruses, and seasonal coronaviruses. The review presents modern data on the structure and replication of viruses, epidemiology and immunopathogenesis of diseases, diagnostics, preventive vaccination, and antiviral drugs. Topical issues regarding ARVI vaccination and the search for new broad-spectrum antiviral drugs are discussed.
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Affiliation(s)
- T. N. Ilyicheva
- Novosibirsk State University, 630090 Novosibirsk, Russia
- State Research Center of Virology and Biotechnology VECTOR, 630559 Koltsovo, Russia
| | - S. V. Netesov
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | - V. N. Gureyev
- State Research Center of Virology and Biotechnology VECTOR, 630559 Koltsovo, Russia
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23
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Bert F, Cugudda E, Lo Moro G, Galvagno PF, Siliquini R. Exploring the drop in flu cases during the 2020–2021 season: The Italian case study. Ann Epidemiol 2022; 76:77-82. [DOI: 10.1016/j.annepidem.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/21/2022] [Accepted: 10/02/2022] [Indexed: 11/27/2022]
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24
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Essaidi-Laziosi M, Alvarez C, Puhach O, Sattonnet-Roche P, Torriani G, Tapparel C, Kaiser L, Eckerle I. Sequential infections with rhinovirus and influenza modulate the replicative capacity of SARS-CoV-2 in the upper respiratory tract. Emerg Microbes Infect 2022; 11:412-423. [PMID: 34931581 PMCID: PMC8803056 DOI: 10.1080/22221751.2021.2021806] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/19/2021] [Indexed: 01/07/2023]
Abstract
Although frequently reported since the beginning of the pandemic, questions remain regarding the impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) interaction with circulating respiratory viruses in coinfected patients. We here investigated dual infections involving early-pandemic SARS-CoV-2 and the Alpha variant and three of the most prevalent respiratory viruses, rhinovirus (RV) and Influenza A and B viruses (IAV and IBV), in reconstituted respiratory airway epithelial cells cultured at air-liquid interface. We found that SARS-CoV-2 replication was impaired by primary, but not secondary, rhino- and influenza virus infection. In contrast, SARS-CoV-2 had no effect on the replication of these seasonal respiratory viruses. Inhibition of SARS-CoV-2 correlated better with immune response triggered by RV, IAV and IBV than the virus entry. Using neutralizing antibody against type I and III interferons, SARS-CoV-2 blockade in dual infections could be partly prevented. Altogether, these data suggested that SARS-CoV-2 interaction with seasonal respiratory viruses would be modulated by interferon induction and could impact SARS-CoV-2 epidemiology when circulation of other respiratory viruses is restored.
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Affiliation(s)
- Manel Essaidi-Laziosi
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Catia Alvarez
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Olha Puhach
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pascale Sattonnet-Roche
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Giulia Torriani
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Caroline Tapparel
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Isabella Eckerle
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
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25
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Kolosova NP, Ilyicheva TN, Unguryan VV, Danilenko AV, Svyatchenko SV, Onhonova GS, Goncharova NI, Kosenko MN, Gudymo AS, Marchenko VY, Shvalov AN, Susloparov IM, Tregubchak TV, Gavrilova EV, Maksyutov RA, Ryzhikov AB. Re-Emergence of Circulation of Seasonal Influenza during COVID-19 Pandemic in Russia and Receptor Specificity of New and Dominant Clade 3C.2a1b.2a.2 A(H3N2) Viruses in 2021-2022. Pathogens 2022; 11:1388. [PMID: 36422639 PMCID: PMC9698969 DOI: 10.3390/pathogens11111388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2023] Open
Abstract
The circulation of seasonal influenza in 2020-2021 around the world was drastically reduced after the start of the COVID-19 pandemic and the implementation of mitigation strategies. The influenza virus circulation reemerged in 2021-2022 with the global spread of the new genetic clade 3C.2a1b.2a.2 of A(H3N2) viruses. The purpose of this study was to characterize influenza viruses in the 2021-2022 season in Russia and to analyze the receptor specificity properties of the 3C.2a1b.2a.2 A(H3N2) viruses. Clinical influenza samples were collected at the local Sanitary-and-Epidemiological Centers of Rospotrebnadzor. Whole genome sequencing was performed using NGS. The receptor specificity of hemagglutinin was evaluated using molecular modeling and bio-layer interferometry. Clinical samples from 854 cases of influenza A and B were studied; A(H3N2) viruses were in the majority of the samples. All genetically studied A(H3N2) viruses belonged to the new genetic clade 3C.2a1b.2a.2. Molecular modeling analysis suggested a higher affinity of hemagglutinin of 3C.2a1b.2a.2. A(H3N2) viruses to the α2,6 human receptor. In vitro analysis using a trisaccharide 6'-Sialyl-N-acetyllactosamine receptor analog did not resolve the differences in the receptor specificity of 3C.2a1b.2a.2 clade viruses from viruses belonging to the 3C.2a1b.2a.1 clade. Further investigation of the A(H3N2) viruses is required for the evaluation of their possible adaptive advantages. Constant monitoring and characterization of influenza are critical for epidemiological analysis.
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Affiliation(s)
- Natalia P. Kolosova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Tatiana N. Ilyicheva
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Vasily V. Unguryan
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
- Department of Physics, Novosibirsk State University, Novosibirsk 630090, Russia
| | - Alexey V. Danilenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Svetlana V. Svyatchenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Galina S. Onhonova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Natalia I. Goncharova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Maksim N. Kosenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Andrey S. Gudymo
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Vasiliy Y. Marchenko
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Alexander N. Shvalov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Ivan M. Susloparov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Tatiana V. Tregubchak
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Elena V. Gavrilova
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Rinat A. Maksyutov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
| | - Alexander B. Ryzhikov
- State Research Centre of Virology and Biotechnology “Vector”, Rospotrebnadzor, Koltsovo, Novosibirsk 630559, Russia
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26
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Nisavanh A, Horrigue I, Debin M, Turbelin C, Kengne-Kuetche C, Nassany O, Ambert-Balay K, Jourdan-Da Silva N, Pontais I, de Valk H, Jones G. Epidemiology of acute gastroenteritis in France from November 2019-August 2021, in light of reported adherence to COVID-19 barrier measures. Sci Rep 2022; 12:17504. [PMID: 36261604 PMCID: PMC9581450 DOI: 10.1038/s41598-022-22317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/12/2022] [Indexed: 01/12/2023] Open
Abstract
Since the start of the COVID-19 pandemic, French health authorities have encouraged barrier measures and implemented three lockdowns to slow SARS-CoV-2 transmission. We aimed to examine the impact of these measures on the epidemiology of acute gastroenteritis (AGE) in France, from November 2019 to August 2021. We describe trends in AGE indicators from syndromic surveillance and a sentinel surveillance network. Additionally, we describe reported AGE illness data from a community based cohort, and frequencies of adherence to COVID-19 barrier measures from repeated quantitative surveys. From week 7 in 2020, all AGE indicators reached the lowest levels observed since the last decade. During the first lockdown, the median incidence rate reported by the sentinel network was 32 per 100,000 inhabitants, 1.9 times lower than the minimum registered during the 2010-2019 period. Low activity persisted until April 2021. Reported illness from the community cohort mirrored these trends. Adherence to COVID-19 barrier measures was highest during the first lockdown, coinciding with the steep decrease in AGE incidence. Among children under 5 years, AGE incidence increased after the third lockdown in June and July 2021, but remained lower than previous winter-season peaks. Our study indicates that a reduction in adherence to COVID-19 barrier measures, and the end of the lockdowns, coincided with an increase in AGE incidence, particularly among young children. We therefore strongly recommend maintaining adherence to barrier measures in order to in order to limit the transmission of AGE related pathogens.
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Affiliation(s)
- Athinna Nisavanh
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France ,grid.418914.10000 0004 1791 8889ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Imene Horrigue
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
| | - Marion Debin
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, 75012 Paris, France
| | - Clément Turbelin
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, 75012 Paris, France
| | - Charly Kengne-Kuetche
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, 75012 Paris, France
| | - Oriane Nassany
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
| | - Katia Ambert-Balay
- grid.31151.37National Reference Centre for Gastroenteritis Viruses, University Hospital of Dijon, Dijon, France
| | - Nathalie Jourdan-Da Silva
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
| | - Isabelle Pontais
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
| | - Henriette de Valk
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
| | - Gabrielle Jones
- grid.493975.50000 0004 5948 8741French Public Health Agency, Santé Publique France, Saint-Maurice, France
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27
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Sominina A, Danilenko D, Komissarov A, Karpova L, Pisareva M, Fadeev A, Konovalova N, Eropkin M, Stolyarov K, Shtro A, Burtseva E, Lioznov D. Resurgence of Influenza Circulation in the Russian Federation during the Delta and Omicron COVID-19 Era. Viruses 2022; 14:1909. [PMID: 36146716 PMCID: PMC9506591 DOI: 10.3390/v14091909] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
Influenza circulation was substantially reduced after March 2020 in the European region and globally due to the wide introduction of non-pharmaceutical interventions (NPIs) against COVID-19. The virus, however, has been actively circulating in natural reservoirs. In summer 2021, NPIs were loosened in Russia, and influenza activity resumed shortly thereafter. Here, we summarize the epidemiological and virological data on the influenza epidemic in Russia in 2021-2022 obtained by the two National Influenza Centers. We demonstrate that the commonly used baseline for acute respiratory infection (ARI) is no longer sufficiently sensitive and BL for ILI incidence was more specific for early recognition of the epidemic. We also present the results of PCR detection of influenza, SARS-CoV-2 and other respiratory viruses as well as antigenic and genetic analysis of influenza viruses. Influenza A(H3N2) prevailed this season with influenza B being detected at low levels at the end of the epidemic. The majority of A(H3N2) viruses were antigenically and genetically homogenous and belonged to the clade 3C.2a1b.2a.2 of the vaccine strain A/Darwin/9/2021 for the season 2022-2023. All influenza B viruses belonged to the Victoria lineage and were similar to the influenza B/Austria/1359417/2021 virus. No influenza A(H1N1)pdm09 and influenza B/Yamagata lineage was isolated last season.
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Affiliation(s)
- Anna Sominina
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Andrey Komissarov
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Ludmila Karpova
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Maria Pisareva
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Artem Fadeev
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Nadezhda Konovalova
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Mikhail Eropkin
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Kirill Stolyarov
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Anna Shtro
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
| | - Elena Burtseva
- National Research Center for Epidemiology and Microbiology Named after N.F. Gamaleya, 123098 Moscow, Russia
| | - Dmitry Lioznov
- Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
- Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, 197022 Saint Petersburg, Russia
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28
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Mazagatos C, Delgado-Sanz C, Monge S, Pozo F, Oliva J, Sandonis V, Gandarillas A, Quiñones-Rubio C, Ruiz-Sopeña C, Gallardo-García V, Basile L, Barranco-Boada MI, Hidalgo-Pardo O, Vazquez-Cancela O, García-Vázquez M, Fernández-Sierra A, Milagro-Beamonte A, Ordobás M, Martínez-Ochoa E, Fernández-Arribas S, Lorusso N, Martínez A, García-Fulgueiras A, Sastre-Palou B, Losada-Castillo I, Martínez-Cuenca S, Rodríguez-Del Águila M, Latorre M, Larrauri A. COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain. Influenza Other Respir Viruses 2022; 16:1014-1025. [PMID: 35880469 PMCID: PMC9350393 DOI: 10.1111/irv.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background With the emergence of SARS‐CoV‐2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. Methods Using a test‐negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID‐19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS‐CoV‐2 variant. Results VE was 89% (95% CI: 83–93) against COVID‐19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS‐CoV‐2 variants, although variant‐specific VE was slightly higher against Alpha. Conclusions The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID‐19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID‐19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS‐CoV‐2 variants (Alpha vs. Delta).
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Affiliation(s)
- Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Susana Monge
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Francisco Pozo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Oliva
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Virginia Sandonis
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Ana Gandarillas
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Carmen Quiñones-Rubio
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Virtudes Gallardo-García
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Luca Basile
- Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | | | - Olga Hidalgo-Pardo
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Olalla Vazquez-Cancela
- Servicio de Medicina Preventiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miriam García-Vázquez
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Ana Milagro-Beamonte
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - María Ordobás
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Eva Martínez-Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Nicola Lorusso
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Ana Martínez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | - Ana García-Fulgueiras
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Salud, Murcia, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Isabel Losada-Castillo
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Silvia Martínez-Cuenca
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Miriam Latorre
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Yamana H, Sasabuchi Y, Matsui H, Michihata N, Jo T, Yasunaga H. Maoto plus neuraminidase inhibitor versus neuraminidase inhibitor alone for reducing hospitalization in older adults with seasonal influenza. ANNALS OF CLINICAL EPIDEMIOLOGY 2022; 4:120-128. [PMID: 38505252 PMCID: PMC10760488 DOI: 10.37737/ace.22015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/25/2022] [Indexed: 03/21/2024]
Abstract
BACKGROUND Maoto is a Japanese Kampo formula used for treating febrile illnesses. However, researchers have not yet clarified its effect in preventing severe influenza among older adults. We evaluated the association between the addition of maoto to a neuraminidase inhibitor in older adults and reduced hospitalization following influenza. METHODS Using a prefecture-wide health insurance claims database, we identified outpatients aged ≥60 years who were diagnosed with influenza between September 2012 and August 2017. We performed one-to-one propensity score matching between patients who received maoto in addition to a neuraminidase inhibitor and those who received a neuraminidase inhibitor alone. Hospitalization within 7 days of influenza diagnosis was compared using the McNemar's test. We performed subgroup analyses based on sex, age, and other characteristics. RESULTS We identified 57,366 eligible patients with influenza. Maoto was used in 8.1% of these patients. In 4,630 matched pairs, the 7-day hospitalization rate was 1.77% (n = 82) and 1.62% (n = 75) for patients with and without maoto, respectively; the difference between the groups was insignificant (P = 0.569). Subgroup analysis showed a tendency toward more hospitalizations within 7 days among patients aged 90 years or older who were prescribed maoto than those who were not (9.7% vs. 6.6%, P = 0.257). CONCLUSIONS Maoto use was not associated with decreased hospitalization rates in older adults with influenza. This warrants further research to evaluate the safety and effectiveness of maoto in different patient groups, particularly the oldest-old population.
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Affiliation(s)
- Hayato Yamana
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo
| | | | - Hiroki Matsui
- Data Science Center, Jichi Medical University
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo
| | - Taisuke Jo
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo
| | - Hideo Yasunaga
- Data Science Center, Jichi Medical University
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
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30
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Comparison of Clinical Profiles and Mortality Outcomes Between Influenza and COVID-19 Patients Invasively Ventilated in the ICU: A Retrospective Study From All Paris Public Hospitals From 2016 to 2021. Crit Care Explor 2022; 4:e0737. [PMID: 35923591 PMCID: PMC9324620 DOI: 10.1097/cce.0000000000000737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies comparing outcomes of ICU patients admitted for either COVID-19 or seasonal influenza are limited. Our objective was to describe baseline clinical profiles, care procedures, and mortality outcomes by infection status (influenza vs COVID-19) of patients who received invasive mechanical ventilation in the ICU.
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31
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Boender TS, Cai W, Schranz M, Kocher T, Wagner B, Ullrich A, Buda S, Zöllner R, Greiner F, Diercke M, Grabenhenrich L. Using routine emergency department data for syndromic surveillance of acute respiratory illness, Germany, week 10 2017 until week 10 2021. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35801521 PMCID: PMC9264729 DOI: 10.2807/1560-7917.es.2022.27.27.2100865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The COVID-19 pandemic expanded the need for timely information on acute respiratory illness at population level. Aim We explored the potential of routine emergency department data for syndromic surveillance of acute respiratory illness in Germany. Methods We used routine attendance data from emergency departments, which continuously transferred data between week 10 2017 and 10 2021, with ICD-10 codes available for > 75% of attendances. Case definitions for acute respiratory infection (ARI), severe acute respiratory infection (SARI), influenza-like illness (ILI), respiratory syncytial virus infection (RSV) and COVID-19 were based on a combination of ICD-10 codes, and/or chief complaints, sometimes combined with information on hospitalisation and age. Results We included 1,372,958 attendances from eight emergency departments. The number of attendances dropped in March 2020 during the first COVID-19 pandemic wave, increased during summer, and declined again during the resurge of COVID-19 cases in autumn and winter of 2020/21. A pattern of seasonality of respiratory infections could be observed. By using different case definitions (i.e. for ARI, SARI, ILI, RSV) both the annual influenza seasons in the years 2017–2020 and the dynamics of the COVID-19 pandemic in 2020/21 were apparent. The absence of the 2020/21 influenza season was visible, parallel to the resurge of COVID-19 cases. SARI among ARI cases peaked in April–May 2020 (17%) and November 2020–January 2021 (14%). Conclusion Syndromic surveillance using routine emergency department data can potentially be used to monitor the trends, timing, duration, magnitude and severity of illness caused by respiratory viruses, including both influenza viruses and SARS-CoV-2.
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Affiliation(s)
- T Sonia Boender
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Wei Cai
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Madlen Schranz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Public Health, Berlin, Germany.,Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Theresa Kocher
- Robert Koch Institute, Department for Methodology and Research Infrastructure, Berlin, Germany.,Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Birte Wagner
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Alexander Ullrich
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Silke Buda
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | | | - Felix Greiner
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,AKTIN-Emergency Department Data Registry, Magdeburg/Aachen, Germany.,Department of Trauma Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Michaela Diercke
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Linus Grabenhenrich
- Robert Koch Institute, Department for Methodology and Research Infrastructure, Berlin, Germany
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32
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Wagatsuma K, Koolhof IS, Saito R. Was the Reduction in Seasonal Influenza Transmission during 2020 Attributable to Non-Pharmaceutical Interventions to Contain Coronavirus Disease 2019 (COVID-19) in Japan? Viruses 2022; 14:v14071417. [PMID: 35891397 PMCID: PMC9320739 DOI: 10.3390/v14071417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/04/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
We quantified the effects of adherence to various non-pharmaceutical interventions (NPIs) on the seasonal influenza epidemic dynamics in Japan during 2020. The total monthly number of seasonal influenza cases per sentinel site (seasonal influenza activity) reported to the National Epidemiological Surveillance of Infectious Diseases and alternative NPI indicators (retail sales of hand hygiene products and number of airline passenger arrivals) from 2014−2020 were collected. The average number of monthly seasonal influenza cases in 2020 had decreased by approximately 66.0% (p < 0.001) compared to those in the preceding six years. An increase in retail sales of hand hygiene products of ¥1 billion over a 3-month period led to a 15.5% (95% confidence interval [CI]: 10.9−20.0%; p < 0.001) reduction in seasonal influenza activity. An increase in the average of one million domestic and international airline passenger arrivals had a significant association with seasonal influenza activity by 11.6% at lag 0−2 months (95% CI: 6.70−16.5%; p < 0.001) and 30.9% at lag 0−2 months (95% CI: 20.9−40.9%; p < 0.001). NPI adherence was associated with decreased seasonal influenza activity during the COVID-19 pandemic in Japan, which has crucial implications for planning public health interventions to minimize the health consequences of adverse seasonal influenza epidemics.
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Affiliation(s)
- Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
- Correspondence: ; Tel.: +81-25-227-2129
| | - Iain S. Koolhof
- College of Health and Medicine, School of Medicine, University of Tasmania, Hobart 7000, Australia;
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
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Rybak A, Levy C, Angoulvant F, Auvrignon A, Gembara P, Danis K, Vaux S, Levy-Bruhl D, van der Werf S, Béchet S, Bonacorsi S, Assad Z, Lazzati A, Michel M, Kaguelidou F, Faye A, Cohen R, Varon E, Ouldali N. Association of Nonpharmaceutical Interventions During the COVID-19 Pandemic With Invasive Pneumococcal Disease, Pneumococcal Carriage, and Respiratory Viral Infections Among Children in France. JAMA Netw Open 2022; 5:e2218959. [PMID: 35763298 PMCID: PMC9240903 DOI: 10.1001/jamanetworkopen.2022.18959] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IMPORTANCE An association between pneumococcal nasopharyngeal carriage and invasive pneumococcal disease (IPD) has been previously established. However, it is unclear whether the decrease in IPD incidence observed after implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic was associated with concomitant changes in pneumococcal carriage and respiratory viral infections. OBJECTIVE To assess changes in IPD incidence after the implementation of NPIs during the COVID-19 pandemic and examine their temporal association with changes in pneumococcal carriage rate and respiratory viral infections (specifically respiratory syncytial virus [RSV] and influenza cases) among children in France. DESIGN, SETTING, AND PARTICIPANTS This cohort study used interrupted time series analysis of data from ambulatory and hospital-based national continuous surveillance systems of pneumococcal carriage, RSV and influenza-related diseases, and IPD between January 1, 2007, and March 31, 2021. Participants included 11 944 children younger than 15 years in France. EXPOSURES Implementation of NPIs during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES The estimated fraction of IPD change after implementation of NPIs and the association of this change with concomitant changes in pneumococcal carriage rate and RSV and influenza cases among children younger than 15 years. The estimated fraction of change was analyzed using a quasi-Poisson regression model. RESULTS During the study period, 5113 children (median [IQR] age, 1.0 [0.6-4.0] years; 2959 boys [57.9%]) had IPD, and 6831 healthy children (median [IQR] age, 1.5 [0.9-3.9] years; 3534 boys [51.7%]) received a swab test. Data on race and ethnicity were not collected. After NPI implementation, IPD incidence decreased by 63% (95% CI, -82% to -43%; P < .001) and was similar for non-13-valent pneumococcal conjugate vaccine serotypes with both high disease potential (-63%; 95% CI, -77% to -48%; P < .001) and low disease potential (-53%; 95% CI, -70% to -35%; P < .001). The overall pneumococcal carriage rate did not significantly change after NPI implementation (-12%; 95% CI, -37% to 12%; P = .32), nor did the carriage rate for non-PCV13 serotypes with high disease potential (-26%; 95% CI, -100% to 52%; P = .50) or low disease potential (-7%; 95% CI, -34% to 20%; P = .61). After NPI implementation, the estimated number of influenza cases decreased by 91% (95% CI, -74% to -97%; P < .001), and the estimated number of RSV cases decreased by 74% (95% CI, -55% to -85%; P < .001). Overall, the decrease in influenza and RSV cases accounted for 53% (95% CI, -28% to -78%; P < .001) and 40% (95% CI, -15% to -65%; P = .002) of the decrease in IPD incidence during the NPI period, respectively. The decrease in IPD incidence was not associated with pneumococcal carriage, with carriage accounting for only 4% (95% CI, -7% to 15%; P = .49) of the decrease. CONCLUSIONS AND RELEVANCE In this cohort study of data from multiple national continuous surveillance systems, a decrease in pediatric IPD incidence occurred after the implementation of NPIs in France; this decrease was associated with a decrease in viral infection cases rather than pneumococcal carriage rate. The association between pneumococcal carriage and IPD was potentially modified by changes in the number of RSV and influenza cases, suggesting that interventions targeting respiratory viruses, such as immunoprophylaxis or vaccines for RSV and influenza, may be able to prevent a large proportion of pediatric IPD cases.
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Affiliation(s)
- Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Assistance Publique–Hôpitaux de Paris, Service d'Accueil des Urgences Pédiatriques, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - François Angoulvant
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Unité Mixte de Recherche Scientifique 1138, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Anne Auvrignon
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Piotr Gembara
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
| | - Kostas Danis
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Sophie Vaux
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Sylvie van der Werf
- Centre National de Référence des Infections Respiratoires, Institut Pasteur, Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
| | - Stéphane Bonacorsi
- Assistance Publique–Hôpitaux de Paris, Service de Microbiologie, Robert Debré University Hospital, Université de Paris, Paris, France
- Infection Antimicrobials Modelling Evolution, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1137, Université de Paris, Paris, France
| | - Zein Assad
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
- Service de Pédiatrie Médicale, Centre Hospitalier Universitaire Caen-Normandie, Caen, France
| | - Andréa Lazzati
- Chirurgie Générale, Digestive et de l'Obésité, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, L’Institut Mondor de Recherche Biomédicale, Unité 955, Université Paris-Est Créteil, Créteil, France
| | - Morgane Michel
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
| | - Florentia Kaguelidou
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Centre d’Investigation Clinique 1426, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Albert Faye
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Néonatalogie et Réanimation Néonatale, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Emmanuelle Varon
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Microbiologie et Centre National de Référence du Pneumocoque, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Naïm Ouldali
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
- Service des Maladies Infectieuses Pédiatriques, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Québec, Canada
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Wang C, Yang YN, Xi L, Yang LL, Du J, Zhang ZS, Lian XY, Cui Y, Li HJ, Zhang WX, Liu B, Cui F, Lu QB. Dynamics of influenza-like illness under urbanization procedure and COVID-19 pandemic in the sub-center of Beijing during 2013-2021. J Med Virol 2022; 94:3801-3810. [PMID: 35451054 PMCID: PMC9088387 DOI: 10.1002/jmv.27803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 12/02/2022]
Abstract
Influenza‐like illness (ILI) varies in intensity year by year, generally keeping a stable pattern except for great changes of its epidemic pattern. Of the most impacting factors, urbanization has been suggested as shaping the intensity of influenza epidemics. Besides, growing evidence indicates the nonpharmaceutical interventions (NPIs) to severe acute respiratory syndrome coronavirus 2 offer great advantages in controlling infectious diseases. The present study aimed to evaluate the impact of urbanization and NPIs on the dynamic of ILI in Tongzhou, Beijing, during January 2013 to March 2021. ILI epidemiological surveillance data in Tongzhou district were obtained from Beijing Influenza Surveillance Network and separated into three periods of urbanization and four intervals of coronavirus disease 2019 pandemic. Standardized average incidence rates of ILI in each separate stages were calculated and compared by using Wilson method and time series model of seasonal ARIMA. Influenza seasonal outbreaks showed similar epidemic size and intensity before urbanization during 2013–2016. Increased ILI activity was found during the process of Tongzhou's urbanization during 2017–2019, with the rate difference of 2.48 (95% confidence interva [CI]: 2.44, 2.52) and the rate ratio of 1.75 (95% CI: 1.74, 1.76) of ILI incidence between preurbanization and urbanization periods. ILI activity abruptly decreased from the beginning of 2020 and kept at the bottom level almost in every epidemic interval. The top decrease in ILI activity by NPIs was shown in 5–14 years group in 2020–2021 influenza season, as 92.2% (95% CI: 78.3%, 95.2%). The results indicated that both urbanization and NPIs interrupted the epidemic pattern of ILI. We should pay more attention to public health when facing increasing population density, human contact, population mobility, and migration in the process of urbanization. NPIs and influenza vaccination should be implemented as necessary measures to protect people from common infectious diseases like ILI.
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Affiliation(s)
- Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yan-Na Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Lu Xi
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Li-Li Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zhong-Song Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xin-Yao Lian
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Hong-Jun Li
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, People's Republic of China
| | - Wan-Xue Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
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Melidou A, Ködmön C, Nahapetyan K, Kraus A, Alm E, Adlhoch C, Mooks P, Dave N, Carvalho C, Meslé MMI, Daniels R, Pebody R. Influenza returns with a season dominated by clade 3C.2a1b.2a.2 A(H3N2) viruses, WHO European Region, 2021/22. Euro Surveill 2022; 27. [PMID: 35426364 PMCID: PMC9012087 DOI: 10.2807/1560-7917.es.2022.27.15.2200255] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the WHO European Region, COVID-19 non-pharmaceutical interventions continued slowing influenza circulation in the 2021/22 season, with reduced characterisation data. A(H3) predominated and, in some countries, co-circulated with A(H1)pdm09 and B/Victoria viruses. No B/Yamagata virus detections were confirmed. Substantial proportions of characterised circulating virus subtypes or lineages differed antigenically from their respective northern hemisphere vaccine components. Appropriate levels of influenza virus characterisations should be maintained until the season end and in future seasons, when surveillance is adapted to integrate SARS-CoV-2.
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Affiliation(s)
- Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Csaba Ködmön
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Karen Nahapetyan
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Annette Kraus
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Erik Alm
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Piers Mooks
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Nishi Dave
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Carlos Carvalho
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Margaux MI Meslé
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Rodney Daniels
- WHO Collaborating Centre, Francis Crick Institute, London, United Kingdom
| | - Richard Pebody
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
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Krauland MG, Galloway DD, Raviotta JM, Zimmerman RK, Roberts MS. Impact of Low Rates of Influenza on Next-Season Influenza Infections. Am J Prev Med 2022; 62:503-510. [PMID: 35305778 PMCID: PMC8866158 DOI: 10.1016/j.amepre.2021.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/05/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Interventions to curb the spread of COVID-19 during the 2020-2021 influenza season essentially eliminated influenza during that season. Given waning antibody titers over time, future residual population immunity against influenza will be reduced. The implication for the subsequent 2021-2022 influenza season is unknown. METHODS An agent-based model of influenza implemented in the Framework for Reconstructing Epidemiological Dynamics simulation platform was used to estimate cases and hospitalizations over 2 successive influenza seasons. The impact of reduced residual immunity owing to protective measures in the first season was estimated over varying levels of similarity (cross-immunity) between influenza strains over the seasons. RESULTS When cross-immunity between first- and second-season strains was low, a decreased first season had limited impact on second-season cases. High levels of cross-immunity resulted in a greater impact on the second season. This impact was modified by the transmissibility of strains in the 2 seasons. The model estimated a possible increase of 13.52%-46.95% in cases relative to that in a normal season when strains have the same transmissibility and 40%-50% cross-immunity in a season after a very low one. CONCLUSIONS Given the light 2020-2021 influenza season, cases may increase by as much as 50% in 2021-2022, although the increase could be much less, depending on cross-immunity from past infection and transmissibility of strains. Enhanced vaccine coverage or continued interventions to reduce transmission could reduce this high season. Young children may have a higher risk in 2021-2022 owing to limited exposure to infection in the previous year.
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Affiliation(s)
- Mary G Krauland
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Public Health Dynamics Laboratory, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - David D Galloway
- Public Health Dynamics Laboratory, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan M Raviotta
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Richard K Zimmerman
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mark S Roberts
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Public Health Dynamics Laboratory, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Ktena D, Kourkouni E, Kontopidou F, Gkolfinopoulou K, Papadima K, Georgakopoulou T, Magaziotou I, Andreopoulou A, Tzanakaki G, Zaoutis T, Papaevangelou V. Population-based study of influenza and invasive meningococcal disease among Greek children during the COVID-19 pandemic. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001391. [PMID: 36053653 PMCID: PMC8905915 DOI: 10.1136/bmjpo-2021-001391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/21/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Aiming to the containment of the coronavirus disease 2019 (COVID-19) pandemic, governments worldwide have implemented a series of non-pharmaceutical interventions. Many of them and especially school closures have impacted the circulation of multiple airborne pathogens among children and adolescents. This study investigates the incidence of influenza and invasive meningococcal disease among children aged 0-14 years in Greece during the COVID-19 pandemic. METHODS Data regarding the number of influenza-like illness cases, influenza-related paediatric intensive care unit (PICU) admissions and invasive meningococcal disease cases among children 0-14 years old were obtained from the National Public Health Organization. The incidence of the two diseases during the COVID-19 pandemic period (2020/2021) was compared with that of the six preceding seasons (2014-2019). RESULTS A notable decrease was observed in both influenza and invasive meningococcal disease cases during the period 2020/2021 compared with the years 2014-2019. The mean annual rate of influenza-like illness cases and influenza-related PICU admissions in children 0-14 years old has reduced by 66.9% and 100%, respectively, while the mean annual invasive meningococcal disease rate has declined by 70%. Both weekly influenza-like illness and monthly invasive meningococcal disease rates were significantly decreased. CONCLUSIONS The activity of influenza and invasive meningococcal disease in the children and adolescents of Greece has decreased during the COVID-19 pandemic period. Reduced transmission is likely related to the public health measures that were implemented to control the pandemic. The value of these measures may have relevance to the future management of influenza or invasive meningococcal disease epidemics.
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Affiliation(s)
- Danai Ktena
- Third Department of Pediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Eleni Kourkouni
- Centre for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece
| | - Flora Kontopidou
- Department of Healthcare-Associated Infections and Antimicrobial Resistance, Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Kassiani Gkolfinopoulou
- Department of Surveillance Systems, Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Kalliopi Papadima
- Department of Respiratory Diseases, Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Theano Georgakopoulou
- Department for Vaccine Preventable Diseases and Congenital Diseases, Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Ioanna Magaziotou
- Department for Vaccine Preventable Diseases and Congenital Diseases, Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Anastasia Andreopoulou
- Department of Respiratory Diseases, Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, University of West Attica, Athens, Greece
| | - Theoklis Zaoutis
- Second Department of Pediatrics, P&A Kyriakou Children's Hospital, National and Kapodistrian University of Athens, Athens, Attica, Greece.,National Public Health Organization, Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Pediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Attica, Greece
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Comparative Analysis of Clinical and Epidemiological Characteristics in Patients with SARI Confirmed as Influenza or COVID-19 Admitted in a Tertiary Care Hospital in Bucharest, Romania. Processes (Basel) 2022. [DOI: 10.3390/pr10020327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic has influenced the epidemiology of other respiratory pathogens, and this was most evident in the 2020–2021 season, which was characterized by a low circulation of influenza viruses. We aim to present a comparative analysis of clinical and epidemiological characteristics of 2018–2019 influenza cases and 2020–2021 COVID-19 cases, hospitalized at a tertiary infectious diseases hospital in Bucharest. We used data collected from patients admitted for severe acute respiratory infection (SARI) and subsequently confirmed with either influenza or COVID-19. During the 2018–2019 season, 208 patients over 18 years of age were confirmed with influenza (median age = 53 years, 59.6% were female) and 6.7% had been vaccinated against influenza. The most frequent symptoms were fever (97.1%) and cough (94.7%), and 77.4% had at least one chronic condition. 90.4% received influenza antiviral therapy. During the 2020–2021 season, 191 patients were confirmed with COVID-19 (median age = 56 years, 67% were male). The most frequent symptoms were cough (85.9%) and fever (80.6%), and 75.9% had at least one chronic condition. This analysis highlights the main similarities and differences between influenza and COVID-19 and could help to optimize the management of cases.
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Ng DCE, Tan KK, Ting GSS, Ling C, Fadzilah NFB, Tan SF, Subramaniam T, Zailanalhuddin NEB, Lim HY, Baharuddin SB, Lee YL, Mohamad Nor A, Khoo EJ. Comparison of Severe Viral Pneumonia Caused by SARS-CoV-2 and Other Respiratory Viruses Among Malaysian Children During the COVID-19 Pandemic. Front Pediatr 2022; 10:865099. [PMID: 35547549 PMCID: PMC9082799 DOI: 10.3389/fped.2022.865099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES We described the etiology of severe pneumonia in children during the height of the COVID-19 pandemic in Malaysia and compared the clinical features of severe SARS-CoV-2 to other respiratory viruses. METHODS This retrospective study included all children aged 12 years and below hospitalized with severe pneumonia in Negeri Sembilan, Malaysia, between 1 April 2021 and 31 October 2021. We extracted demographic and clinical data and used logistic regression to examine risk factors associated with severe SARS-CoV-2 or other viral pneumonia. RESULTS A total of 111 children were included. The median age was 15 months. Human rhinovirus/enterovirus, SARS-CoV-2 and respiratory syncytial virus were the most common etiology of severe pneumonia. Codetection of >1 viral pathogen was present in 14 (12.6%) patients. Children with severe COVID-19 presented early in the course of illness and had lower rates of pediatric intensive care admission. The presence of sick contact with an adult was a predictor for SARS-CoV-2, whereas adventitious breath sounds were predictive of other respiratory viruses. CONCLUSIONS The etiology of severe pneumonia in children evolved with the epidemic curve of COVID-19 and school closures. Children with severe pneumonia due to SARS-CoV-2 experienced a milder clinical course when compared to other respiratory viruses.
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Affiliation(s)
- David Chun-Ern Ng
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Kah Kee Tan
- Department of Pediatrics, Perdana University-Royal College of Surgeons in Ireland School of Medicine, Seremban, Malaysia
| | | | - Chin Ling
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | | | - Shir Fong Tan
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | | | | | - Hui Yi Lim
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Suhaila Binti Baharuddin
- Microbiology Unit, Department of Pathology, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Yee Lean Lee
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Airena Mohamad Nor
- Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Pediatrics, International Medical University, Seremban, Malaysia
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Dos Santos G, Wang H, Jindal P, Rybo M, Roul H, Pallem S, Eckermann T, Godderis L, Martínez Gómez X, Godard E, Soler M, Yousefi M, Salamanca de la Cueva I, Nwoji U. Brand-Specific Enhanced Safety Surveillance Study of GSK's Quadrivalent Seasonal Influenza Vaccine, Conducted During the COVID-19 Pandemic, in Belgium, Germany and Spain, for the 2020/21 Season. Infect Dis Ther 2021; 11:463-483. [PMID: 34961900 PMCID: PMC8711683 DOI: 10.1007/s40121-021-00571-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Seasonal influenza poses a major public health burden worldwide. Influenza vaccines, updated yearly to match circulating strains based on World Health Organization (WHO) recommendations, are the cornerstone of prevention and require regular monitoring. The COVID-19 pandemic is expected to cause logistical, site access and medical staff constraints and could affect the safety profile of influenza vaccines. METHODS Following European Medicines Agency guidance, an enhanced safety surveillance (ESS) study assessed the frequency and severity of predefined and other adverse events (AEs) occurring within 7 days of receiving GSK's inactivated quadrivalent seasonal influenza vaccine (IIV4), in Belgium, Germany and Spain in 2020/21, using adverse drug reaction (ADR) cards. RESULTS During the 2020/21 influenza season, 1054 participants vaccinated with GSK's IIV4 were enrolled (all adults in Belgium and Germany, 30% adults/70% children in Spain); 96 eligible children received a second dose. Overall, 1042 participants completed the study. After doses 1 and 2, 98.9% and 100% of participants, respectively, returned their completed ADR card. After doses 1 and 2, 37.8% (398/1054) and 13.5% (13/96) of participants, respectively, reported at least one AE. The most frequently reported categories of AEs were "general disorders and administration site conditions" (e.g. injection site pain) and "nervous system disorders" (e.g. headache). There were no deaths or serious AEs deemed related to GSK's IIV4. CONCLUSION This ESS study assessed AEs in near real time. The COVID-19 pandemic did not alter the safety profile of GSK's IIV4. No safety signals were detected during the study, which confirms the excellent safety profile of GSK's IIV4.
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Affiliation(s)
| | | | - Pooja Jindal
- Parexel International, Chandigarh, India, C/O GSK, Rockville, MD, USA
| | | | - Hélène Roul
- Keyrus Life Science, Levallois-Perret, France, C/O GSK, Wavre, Belgium
| | - Sridevi Pallem
- Keyrus Life Science, New York, NY, USA, C/O GSK, New York, NY, USA
| | | | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
| | | | | | - Muriel Soler
- 4Clinics, Waterloo, Belgium, C/O GSK, Wavre, Belgium
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Delayed Bronchiolitis Epidemic in French Primary Care Setting Driven by Respiratory Syncytial Virus: Preliminary Data from the Oursyn Study, March 2021. Pediatr Infect Dis J 2021; 40:e511-e514. [PMID: 34260480 DOI: 10.1097/inf.0000000000003270] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report early results from a prospective primary care bronchiolitis surveillance study in France in which a 10-week delayed epidemic was detected from February to March 2021. Among 225 children under 2 years with swab testing for a first bronchiolitis episode, 55% had a positive test for RSV, 0 for influenza, and 1 for severe acute respiratory syndrome coronavirus 2.
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Pariani E, Pasciuta R, Novazzi F, Baj A, Galli C, Pellegrinelli L, Bubba L, Cereda D, Puzelli S, Focosi D, Agosti M, Stefanelli P, Maggi F. How multiplex testing approach to respiratory viruses detection can enhance influenza surveillance. JOURNAL OF CLINICAL VIROLOGY PLUS 2021. [DOI: 10.1016/j.jcvp.2021.100050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kim D, Kim SB, Jeon S, Kim S, Lee KH, Lee HS, Han SH. No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses. J Fungi (Basel) 2021; 7:jof7110990. [PMID: 34829277 PMCID: PMC8624436 DOI: 10.3390/jof7110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Consolidated infection control measures imposed by the government and hospitals during COVID-19 pandemic resulted in a sharp decline of respiratory viruses. Based on the issue of whether Pneumocystis jirovecii could be transmitted by airborne and acquired from the environment, we assessed changes in P. jirovecii pneumonia (PCP) cases in a hospital setting before and after COVID-19. We retrospectively collected data of PCP-confirmed inpatients aged ≥18 years (N = 2922) in four university-affiliated hospitals between January 2015 and June 2021. The index and intervention dates were defined as the first time of P. jirovecii diagnosis and January 2020, respectively. We predicted PCP cases for post-COVID-19 and obtained the difference (residuals) between forecasted and observed cases using the autoregressive integrated moving average (ARIMA) and the Bayesian structural time-series (BSTS) models. Overall, the average of observed PCP cases per month in each year were 36.1 and 47.3 for pre- and post-COVID-19, respectively. The estimate for residuals in the ARIMA model was not significantly different in the total PCP-confirmed inpatients (7.4%, p = 0.765). The forecasted PCP cases by the BSTS model were not significantly different from the observed cases in the post-COVID-19 (−0.6%, 95% credible interval; −9.6~9.1%, p = 0.450). The unprecedented strict non-pharmacological interventions did not affect PCP cases.
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Affiliation(s)
- Dayeong Kim
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Sun Bean Kim
- Department of Internal Medicine, Division of Infectious Diseases, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea;
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
| | - Subin Kim
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Kyoung Hwa Lee
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Correspondence: (H.S.L.); (S.H.H.)
| | - Sang Hoon Han
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
- Correspondence: (H.S.L.); (S.H.H.)
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Mack D, Gohl P, Kolbert M, Schui D, Küsters U, Harzer O, Pum J, Zöllner B. Where have the enteric viruses gone? - Differential effects on frequent causes of infectious diarrhoea by SARS-CoV-2 pandemic lockdown measures. Infect Prev Pract 2021; 3:100184. [PMID: 34786553 PMCID: PMC8579700 DOI: 10.1016/j.infpip.2021.100184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/03/2021] [Indexed: 10/24/2022] Open
Abstract
Background Measures of distancing, wearing face/medical masks and lockdown introduced in many countries to meet the challenges of the SARS-CoV-2 pandemic have led to gross changes in the epidemiology of important infections. The observation of decline of positive norovirus tests after introduction of lockdown in Germany led us to investigate changes in the detection of major causes of diarrhoea by comparing pre-pandemic quarters (PPQ: 1Q/17 through 1Q/20) since 2017 and pandemic quarters (PQ: 2Q/20 through 1Q/21). Methods and setting Bioscientia Laboratory Ingelheim is a large regional clinical pathology laboratory serving > 50 hospitals and > 5000 general practitioners and specialist outpatient practices located in the federal states Hesse, Rhineland-Palatinate and North Rhine-Westphalia, Germany. Antigen detection assays were used for detection of astrovirus, adenovirus, rotavirus, and Campylobacter antigen and Clostridium difficile Toxin A/B, while norovirus was detected by qualitative RT-PCR. Findings The mean positivity-ratios of norovirus, adenovirus and astrovirus assays were 3-20 fold lower in periods PQ (2Q/20 through 1Q/21) compared to PPQ (1Q/17 through 1Q/20) (p<.01). The mean positivity-ratio was lower in PQ compared to PPQ for rotavirus (p=.31), but failed to reach statistical significance, while for campylobacter antigen (p=.91) and C. difficile Toxin A/B (p=.17) the mean positivity-ratio was even higher in PQ compared to PPQ. Conclusions Apparently, hygienic measures used to contain the SARS-CoV-2 pandemic have differential effects on incidence of diarrhoea viruses as compared to bacterial gastrointestinal agents, particularly C. difficile, which may lead to re-evaluate measures implemented against this important cause of nosocomial diarrhoea.
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Affiliation(s)
| | - Peter Gohl
- Bioscientia Labor Ingelheim, Ingelheim, Germany
| | | | | | - Uta Küsters
- Bioscientia Labor Ingelheim, Ingelheim, Germany
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Li ZJ, Yu LJ, Zhang HY, Shan CX, Lu QB, Zhang XA, Ren X, Zhang CH, Wang YF, Lin SH, Xu Q, Jiang BG, Jiang T, Lv CL, Chen JJ, Gao GF, Yang WZ, Wang LP, Yang Y, Fang LQ, Liu W. Broad Impacts of Coronavirus Disease 2019 (COVID-19) Pandemic on Acute Respiratory Infections in China: An Observational Study. Clin Infect Dis 2021; 75:e1054-e1062. [PMID: 34788811 PMCID: PMC8767888 DOI: 10.1093/cid/ciab942] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND To combat the coronavirus disease 2019 (COVID-19) pandemic, nonpharmaceutical interventions (NPIs) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARIs). METHODS Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for 8 viral pathogens (influenza virus [IFV], respiratory syncytial virus [RSV], human parainfluenza virus [HPIV], human adenovirus [HAdV], human metapneumovirus [HMPV], human coronavirus [HCoV], human bocavirus [HBoV], and human rhinovirus [HRV]) between 2012 and 2021, were analyzed to assess the changes in respiratory infections in China during the first COVID-19 pandemic year compared with pre-pandemic years. RESULTS Test-positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012-2019, with changes ranging from -17.2% for RSV to -87.6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year-round, RSV, HPIV, HCoV, HRV, and HBoV resurged and went beyond historical levels during September 2020-January 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children <18 years and in northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. CONCLUSIONS Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children.
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Affiliation(s)
- Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin-Jie Yu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China,Center for Disease Control and Prevention of Central Theater Command, Shijingshan District, Beijing, China
| | - Chun-Xi Shan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cui-Hong Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi-Fei Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng-Hong Lin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Tao Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - George F Gao
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei-Zhong Yang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China,Correspondence author: Dr. Wei Liu, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing 100071, P. R. China,
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Adlhoch C, Baldinelli F, Fusaro A, Terregino C. Avian influenza, a new threat to public health in Europe? Clin Microbiol Infect 2021; 28:149-151. [PMID: 34763057 DOI: 10.1016/j.cmi.2021.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna, Sweden.
| | | | - Alice Fusaro
- European Union Reference Laboratory for Avian Influenza and Newcastle Disease, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro (PD), Italy
| | - Calogero Terregino
- European Union Reference Laboratory for Avian Influenza and Newcastle Disease, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro (PD), Italy
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Stacevičienė I, Burokienė S, Steponavičienė A, Vaičiūnienė D, Puronaitė R, Jankauskienė A. Screening for Coronavirus Disease 2019 (COVID-19) at the Pediatric Emergency Department During Different Pandemic Phases. Front Pediatr 2021; 9:749641. [PMID: 34805046 PMCID: PMC8603807 DOI: 10.3389/fped.2021.749641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
The wide spectrum of COVID-19 symptoms complicates the selection of target groups for screening. We aimed to compare data of children screened for COVID-19 at the pediatric emergency department in Vilnius between different phases throughout 1 year (Phase I: March-May, 2020; Phase II: June-September, 2020; and Phase III: October, 2020-February, 2021) and to evaluate the possible predictors of the disease. SARS-CoV-2 PCR tests were positive for 2.7% of tested children (248/9,238), significantly higher during the Phase III (5.5%) compared with the Phase I (0.6%, p = 0.000) and Phase II (0.3%, p = 0.000). Infants and teenagers (12-17 years) accounted for a larger proportion of COVID-19 patients (24.6 and 26.2%, respectively) compared to other age groups: 1-2 years (18.9%), 3-6 years (14.9%), and 7-11 years (15.3%). There were more COVID-19 cases among children with a known SARS-CoV-2 exposure compared to those who did not declare any contact (18.2 vs. 1.1%, p = 0000). When symptoms were adjusted for age, gender and known exposure to SARS-CoV-2, we found that fever (OR 2.66; 95% CI 1.89-3.81), pharyngitis (OR 1.35; 95% CI 1.01-1.80), headache (OR 1.81; 95% CI 1.09-2.90), and anosmia/ageusia (OR 6.47; 95% CI 1.61-22.47) were the most significant predictors. Conclusion: Although high numbers of testing were maintained throughout the year, the positive test results were significantly higher during the Phase III. Age (<1 year, 12-17 years), a history of exposure to SARS-CoV-2 and some symptoms, such as fever, pharyngitis, headache and anosmia/ageusia could aid in targeting groups for screening for COVID-19 in children.
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Affiliation(s)
- Indrė Stacevičienė
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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48
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Heinzinger S, Eberle U, Angermeier H, Flechsler J, Konrad R, Dangel A, Berger C, Sprenger A, Hepner S, Biere B, Liebl B, Ackermann N, Sing A. Reciprocal circulation pattern of SARS-CoV-2 and influenza viruses during the influenza seasons 2019/2020 and 2020/2021 in the Bavarian Influenza Sentinel (Germany). Epidemiol Infect 2021; 149:e226. [PMID: 35142278 PMCID: PMC8576129 DOI: 10.1017/s0950268821002296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022] Open
Abstract
The corona virus disease-2019 (COVID-19) pandemic began in Wuhan, China, and quickly spread around the world. The pandemic overlapped with two consecutive influenza seasons (2019/2020 and 2020/2021). This provided the opportunity to study community circulation of influenza viruses and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in outpatients with acute respiratory infections during these two seasons within the Bavarian Influenza Sentinel (BIS) in Bavaria, Germany. From September to March, oropharyngeal swabs collected at BIS were analysed for influenza viruses and SARS-CoV-2 by real-time polymerase chain reaction. In BIS 2019/2020, 1376 swabs were tested for influenza viruses. The average positive rate was 37.6%, with a maximum of over 60% (in January). The predominant influenza viruses were Influenza A(H1N1)pdm09 (n = 202), Influenza A(H3N2) (n = 144) and Influenza B Victoria lineage (n = 129). In all, 610 of these BIS swabs contained sufficient material to retrospectively test for SARS-CoV-2. SARS-CoV-2 RNA was not detectable in any of these swabs. In BIS 2020/2021, 470 swabs were tested for influenza viruses and 457 for SARS-CoV-2. Only three swabs (0.6%) were positive for Influenza, while SARS-CoV-2 was found in 30 swabs (6.6%). We showed that no circulation of SARS-CoV-2 was detectable in BIS during the 2019/2020 influenza season, while virtually no influenza viruses were found in BIS 2020/2021 during the COVID-19 pandemic.
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Affiliation(s)
- Susanne Heinzinger
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Ute Eberle
- Department of Virology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Hildegard Angermeier
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Jennifer Flechsler
- Department of Virology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Regina Konrad
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Alexandra Dangel
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Carola Berger
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Annika Sprenger
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Sabrina Hepner
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Barbara Biere
- State Institute of Public Health, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Bernhard Liebl
- National Reference Center for Influenza, Robert Koch Institute, Berlin, Germany
- Ludwig Maximilians-Universität, Munich, Germany
| | - Nikolaus Ackermann
- Department of Virology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Andreas Sing
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- National Reference Center for Influenza, Robert Koch Institute, Berlin, Germany
- Ludwig Maximilians-Universität, Munich, Germany
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49
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Larrauri A, Prosenc Trilar K. Preparing for an influenza season 2021/22 with a likely co-circulation of influenza virus and SARS-CoV-2. ACTA ACUST UNITED AC 2021; 26. [PMID: 34651574 PMCID: PMC8518305 DOI: 10.2807/1560-7917.es.2021.26.41.2100975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Amparo Larrauri
- National Center of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Katarina Prosenc Trilar
- Laboratory for Public Health Virology, National Laboratory for Health, Environment and Food, Ljubljana, Slovenia
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50
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Lescure D, van der Velden J, Nieboer D, van Oorschot W, Brouwer R, Huijser van Reenen N, Tjon-A-Tsien A, Erdem Ö, Vos M, van der Velden A, Richardus JH, Voeten H. Reducing antibiotic prescribing by enhancing communication of general practitioners with their immigrant patients: protocol for a randomised controlled trial (PARCA study). BMJ Open 2021; 11:e054674. [PMID: 34635534 PMCID: PMC8506856 DOI: 10.1136/bmjopen-2021-054674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Although antibiotic use and antimicrobial resistance in the Netherlands is comparatively low, inappropriate prescription of antibiotics is substantial, mainly for respiratory tract infections (RTIs). General practitioners (GPs) experience pressure from patients with an immigration background to prescribe antibiotics and have difficulty communicating in a culturally sensitive way. Multifaceted interventions including communication skills training for GPs are shown to be most effective in reducing antibiotic prescription. The PARCA study aims to reduce the number of antibiotic prescriptions for RTIs through implementing a culturally sensitive communication intervention for GPs and evaluate it in a randomised controlled trial (RCT). METHODS AND ANALYSIS A non-blinded RCT including 58 GPs (29 for each arm). The intervention consists of: (1) An E-learning with 4 modules of 10-15 min each; (2) A face-to-face training session in (intercultural) communication skills including role plays with a training actor and (3) Availability of informative patient-facing materials that use simple words (A2/B1 level) in multiple languages. The primary outcome measure is the number of dispensed antibiotic courses qualifying for RTIs in primary care, per 1000 registered patients. The secondary outcome measure is the number of all dispensed antibiotic courses, per 1000 registered patients. The intervention arm will receive the training in Autumn 2021, followed by an observation period of 6 winter months for which numbers of antibiotics will be collected for both trial arms. The GPs/practices in the control arm can attend the training after the observation period. ETHICS AND DISSEMINATION The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, University Medical Center Rotterdam (MEC-2020-0142). The results of the trial will be published in international peer-reviewed scientific journals and will be disseminated through national and international congresses. The project is funded by The Netherlands Organisation for Health Research and Development (ZonMw). TRIAL REGISTRATION NUMBER NL9450.
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Affiliation(s)
- Dominique Lescure
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | | | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Rob Brouwer
- Health Centre Levinas, Pharmacy Ramleh, Rotterdam, The Netherlands
| | | | - Aimée Tjon-A-Tsien
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Özcan Erdem
- Department of Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, The Netherlands
| | - Margreet Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alike van der Velden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Hélène Voeten
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
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