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Low ZY, Wong KH, Wen Yip AJ, Choo WS. The convergent evolution of influenza A virus: Implications, therapeutic strategies and what we need to know. CURRENT RESEARCH IN MICROBIAL SCIENCES 2023; 5:100202. [PMID: 37700857 PMCID: PMC10493511 DOI: 10.1016/j.crmicr.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Influenza virus infection, more commonly known as the 'cold flu', is an etiological agent that gives rise to recurrent annual flu and many pandemics. Dated back to the 1918- Spanish Flu, the influenza infection has caused the loss of many human lives and significantly impacted the economy and daily lives. Influenza virus can be classified into four different genera: influenza A-D, with the former two, influenza A and B, relevant to humans. The capacity of antigenic drift and shift in Influenza A has given rise to many novel variants, rendering vaccines and antiviral therapies useless. In light of the emergence of a novel betacoronavirus, the SARS-CoV-2, unravelling the underpinning mechanisms that support the recurrent influenza epidemics and pandemics is essential. Given the symptom similarities between influenza and covid infection, it is crucial to reiterate what we know about the influenza infection. This review aims to describe the origin and evolution of influenza infection. Apart from that, the risk factors entail the implication of co-infections, especially regarding the COVID-19 pandemic is further discussed. In addition, antiviral strategies, including the potential of drug repositioning, are discussed in this context. The diagnostic approach is also critically discussed in an effort to understand better and prepare for upcoming variants and potential influenza pandemics in the future. Lastly, this review encapsulates the challenges in curbing the influenza spread and provides insights for future directions in influenza management.
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Affiliation(s)
- Zheng Yao Low
- School of Science, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
| | - Ka Heng Wong
- School of Science, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
| | - Ashley Jia Wen Yip
- School of Science, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
| | - Wee Sim Choo
- School of Science, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
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Li M, Zhao X, Liu B, Zhao Y, Li X, Ma Z, Yang Q. Predictors of rapidly progressive interstitial lung disease and prognosis in Chinese patients with anti-melanoma differentiation-associated gene 5-positive dermatomyositis. Front Immunol 2023; 14:1209282. [PMID: 37691917 PMCID: PMC10483132 DOI: 10.3389/fimmu.2023.1209282] [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: 04/20/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Background Rapidly progressive interstitial lung disease (RP-ILD) is the most serious complication of anti-melanoma differentiation-associated gene 5-positive dermatomyositis (anti-MDA5+ DM). This study was performed to assess the prognostic factors of patients with anti-MDA5+ DM and the clinical characteristics and predictors of anti-MDA5+ DM in combination with RP-ILD. Methods In total, 73 MDA5+ DM patients were enrolled in this study from March 2017 to December 2021. They were divided into survival and non-survival subgroups and non-RP-ILD and RP-ILD subgroups. Results The lactate dehydrogenase (LDH) concentration and prognostic nutritional index (PNI) were independent prognostic factors in patients with anti-MDA5+ DM: the elevated LDH was associated with increased mortality (p = 0.01), whereas the elevated PNI was associated with reduced mortality (p < 0.001). The elevated LDH was independent risk prognostic factor for patients with anti-MDA5+ DM (HR 2.42, 95% CI: 1.02-4.83, p = 0.039), and the elevated PNI was independent protective prognostic factor (HR, 0.27; 95% CI, 0.08 - 0.94; p = 0.039). Patients who had anti-MDA5+ DM with RP-ILD had a significantly higher white blood cell count and LDH concentration than those without RP-ILD (p = 0.007 and p = 0.019, respectively). In contrast, PNI was significantly lower in patients with RP-ILD than those without RP-ILD (p < 0.001). The white blood cell count and elevated LDH were independent and significant risk factors for RP-ILD (OR 1.54, 95% CI: 1.12 - 2.13, p = 0.009 and OR 8.68, 95% CI: 1.28 - 58.83, p = 0.027, respectively), whereas the lymphocyte was an independent protective factor (OR, 0.11; 95% CI, 0.01 - 0.81; p = 0.03). Conclusion The elevated LDH and elevated PNI were independent prognostic factors for patients with anti-MDA5+ DM. The elevated LDH was independent risk factor for RP-ILD. Patients with anti-MDA5+ DM could benefit from the measurement of LDH and PNI, which are inexpensive and simple parameters that could be used for diagnosis as well as prediction of the extent of lung involvement and prognosis.
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Affiliation(s)
- Meiqi Li
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xuli Zhao
- Department of Pain Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Baocheng Liu
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yaqi Zhao
- Department of Rheumatology and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xinya Li
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhenzhen Ma
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Rheumatology and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qingrui Yang
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Rheumatology and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Risk factors for influenza B virus-associated pneumonia in adults. Am J Infect Control 2020; 48:194-198. [PMID: 31431289 DOI: 10.1016/j.ajic.2019.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is limited knowledge regarding the risk factors for influenza B virus-associated pneumonia in adults. This study aimed to determine the risk factors for influenza B virus-associated pneumonia in adults. METHODS We used viral surveillance data during the pandemic season between November 2017 and April 2018 from the University of Hong Kong-Shenzhen Hospital medical record database. The files of patients ages 18 years or older were reviewed for demographics, clinical characteristics, laboratory findings, and outcome. Multivariate logistic regression analysis was performed to identify risk factors associated with influenza B virus-associated pneumonia. RESULTS A total of 78 patients with influenza B, ages 20 to 87 years, were identified. Comparing cases with pneumonia vs cases without pneumonia, there were significant differences in the following: age in years (67.41 ± 16.63 vs 58.16 ± 17.65; P = .028), age group (74.1% vs 51.0%; P = .049), chronic respiratory diseases (70.4% vs 21.6%; P = .000), shortness of breath (40.7% vs13.7%; P = .007), abnormal breath sounds on auscultation (51.9% vs 21.6%; P = .006), and serum alanine transaminase level (30.07 ± 10.73 vs 38.64 ± 21.68; P = .022). Logistic regression models indicated that chronic respiratory diseases (odds ratio, 8.452; 95% confidence interval, 2.768-25.808; P = .000) and shortness of breath (odds ratio, 1.261; 95% confidence interval, 1.015-1.566; P = .036) were independent risk factors. CONCLUSIONS This study suggests that chronic respiratory diseases and shortness of breath are independent risk factors for influenza B virus-associated pneumonia in adult patients.
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Salto-Quintana JN, Rivera-Alfaro G, Sánchez-Ramos EL, Gómez-Gómez A, Noyola DE. Post-pandemic influenza-associated mortality in Mexico. Pathog Glob Health 2019; 113:67-74. [PMID: 30895882 PMCID: PMC6493299 DOI: 10.1080/20477724.2019.1589211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Influenza is a leading cause of respiratory tract infections worldwide and there is limited information on the impact of the influenza A(H1N1)pdm virus on mortality after the 2009 pandemic. Using national mortality register data through 1998-2015 in Mexico, influenza-associated mortality was estimated for respiratory, cardiovascular, and all-cause events. The proportion of influenza-associated respiratory and cardiovascular deaths among different age groups were compared. There were 8,853,986 death registries included for the 1998-2015 winter seasons, average influenza-associated respiratory, cardiovascular, and all-cause mortality rates were 5.2, 6.3, and 19.6 deaths/100,000 population, respectively. The largest number of respiratory influenza-associated deaths occurred in adults 60 years of age and older, followed by children <5 years of age; during the 2009 pandemic, 2011-2012, and 2013-2014 winter seasons there was a larger number of deaths in the 20-59 years old group. Influenza-associated mortality rates showed a continuous reduction in children <5 years of age. After the 2009 pandemic, influenza A(H1N1)pdm09 virus-associated mortality in Mexico showed a persistent change in the demographic pattern of the most severely affected population, particularly during the 2013-2014 season. Influenza associated-mortality has decreased in children <5 years of age and continue to be elevated in adults >60 years of age.
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Affiliation(s)
- Jack N. Salto-Quintana
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Internal Medicine Division, Hospital Central “Dr. Ignacio Morones Prieto”, San Luis Potosí, México
| | - Gerardo Rivera-Alfaro
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Evelyn L. Sánchez-Ramos
- Childhood and Adolescence Health Care Department, Servicios de Salud de San Luis Potosí, San Luis Potosí, México
| | - Alejandro Gómez-Gómez
- Internal Medicine Division, Hospital Central “Dr. Ignacio Morones Prieto”, San Luis Potosí, México
| | - Daniel E. Noyola
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
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Lee EC, Viboud C, Simonsen L, Khan F, Bansal S. Detecting signals of seasonal influenza severity through age dynamics. BMC Infect Dis 2015; 15:587. [PMID: 26715193 PMCID: PMC4696185 DOI: 10.1186/s12879-015-1318-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measures of population-level influenza severity are important for public health planning, but estimates are often based on case-fatality and case-hospitalization risks, which require multiple data sources, are prone to surveillance biases, and are typically unavailable in the early stages of an outbreak. To address the limitations of traditional indicators, we propose a novel severity index based on influenza age dynamics estimated from routine physician diagnosis data that can be used retrospectively and for early warning. METHODS We developed a quantitative 'ground truth' severity benchmark that synthesizes multiple traditional severity indicators from publicly available influenza surveillance data in the United States. Observing that the age distribution of cases may signal severity early in an epidemic, we constructed novel retrospective and early warning severity indexes based on the relative risk of influenza-like illness (ILI) among working-age adults to that among school-aged children using weekly outpatient medical claims. We compared our relative risk-based indexes to the composite benchmark and estimated seasonal severity for flu seasons from 2001-02 to 2008-09 at the national and state levels. RESULTS The severity classifications made by the benchmark were not uniquely captured by any single contributing metric, including pneumonia and influenza mortality; the influenza epidemics of 2003-04 and 2007-08 were correctly identified as the most severe of the study period. The retrospective index was well correlated with the severity benchmark and correctly identified the two most severe seasons. The early warning index performance varied, but it projected 2007-08 as relatively severe 10 weeks prior to the epidemic peak. Influenza severity varied significantly among states within seasons, and four states were identified as possible early warning sentinels for national severity. CONCLUSIONS Differences in age patterns of ILI may be used to characterize seasonal influenza severity in the United States in real-time and in a spatially resolved way. Future research on antigenic changes among circulating viruses, pre-existing immunity, and changing contact patterns may better elucidate the mechanisms underlying these indexes. Researchers and practitioners should consider the use of composite or ILI-based severity metrics in addition to traditional severity measures to inform epidemiological understanding and situational awareness in future seasonal outbreaks.
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Affiliation(s)
- Elizabeth C Lee
- Department of Biology, Georgetown University, Washington, District of Columbia, USA.
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.
| | - Lone Simonsen
- Department of Global Health, George Washington University, Washington, District of Columbia, USA.
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Farid Khan
- IMS Health, Plymouth Meeting, Pennsylvania, USA.
- Pfizer Inc., Collegeville, Pennsylvania, USA.
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, District of Columbia, USA.
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.
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Dávila-Torres J, Chowell G, Borja-Aburto VH, Viboud C, Grajalez-Muñiz C, Miller MA. WITHDRAWN: Intense Seasonal A/H1N1 Influenza in Mexico, Winter 2013-2014. Arch Med Res 2014:S0188-4409(14)00230-6. [PMID: 25446616 PMCID: PMC4439383 DOI: 10.1016/j.arcmed.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/10/2014] [Indexed: 11/29/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.arcmed.2014.11.005. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Javier Dávila-Torres
- Direction of Medical Benefits, Mexican Institute of Social Security, Mexico City, Mexico
| | - Gerardo Chowell
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- Mathematical, Computational and Modeling Sciences Center, School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Víctor H. Borja-Aburto
- Direction of Medical Benefits, Mexican Institute of Social Security, Mexico City, Mexico
| | - Cécile Viboud
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Concepción Grajalez-Muñiz
- Coordination of Epidemiological Surveillance and Contingency Support, Mexican Institute of Social Security, Mexico, City, Mexico
| | - Mark. A. Miller
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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Dávila-Torres J, Chowell G, Borja-Aburto VH, Viboud C, Grajalez-Muñiz C, Miller MA. Intense seasonal A/H1N1 influenza in Mexico, winter 2013-2014. Arch Med Res 2014; 46:63-70. [PMID: 25446618 DOI: 10.1016/j.arcmed.2014.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/10/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013-2014 following a mild 2012-2013 A/H3N2 influenza season. METHODS We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013-2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. RESULTS A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30-59 years and lower among younger age groups for the 2013-2014 A/H1N1 season compared to the previous A/H1N1 season in 2011-2012 (χ(2) test, p <0.001). The reproduction number for the winter 2013-2014 influenza season in central Mexico was estimated at 1.3-1.4, in line with that reported for the 2011-2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. CONCLUSIONS We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013-March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011-2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics.
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Affiliation(s)
- Javier Dávila-Torres
- Direction of Medical Benefits, Mexican Institute of Social Security, Mexico City, Mexico
| | - Gerardo Chowell
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA; Mathematical, Computational and Modeling Sciences Center, School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA.
| | - Víctor H Borja-Aburto
- Direction of Medical Benefits, Mexican Institute of Social Security, Mexico City, Mexico
| | - Cécile Viboud
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Concepción Grajalez-Muñiz
- Coordination of Epidemiological Surveillance and Contingency Support, Mexican Institute of Social Security, Mexico, City, Mexico
| | - Mark A Miller
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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