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Bergeri I, Boddington NL, Lewis HC, Subissi L, von Dobschuetz S, Rodriguez A, Jara J, El Naja HA, Barakat A, Rashidian A, Aly EA, Al Ariqi L, Wijesinghe P, Inbanathan F, Nguyen PN, Phengxay M, Le L, Enebish T, Okeibunor J, Herring B, Farley E, Jorgensen P, Vaughan AM, Mott J, Zhang W, Pebody R, Van Kerkhove MD. WHO's Investigations and Studies, Unity Studies: A global initiative creating equitable opportunities for enhanced surveillance, operational research, capacity building, and global knowledge sharing. Influenza Other Respir Viruses 2024; 18:e13256. [PMID: 38346794 PMCID: PMC10861351 DOI: 10.1111/irv.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/06/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
The World Health Organization's Unity Studies global initiative provides a generic preparedness and readiness framework for conducting detailed investigations and epidemiological studies critical for the early and ongoing assessment of emerging respiratory pathogens of pandemic potential. During the COVID-19 pandemic, the initiative produced standardized investigation protocols and supported Member States to generate robust and comparable data to inform public health decision making. The subsequent iteration of the initiative is being implemented to develop revised and new investigation protocols, implementation toolkits and work to build a sustainable global network of sites, enabling the global community to be better prepared for the next emerging respiratory pathogen with epidemic or pandemic potential.
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Affiliation(s)
- Isabel Bergeri
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Nicki L. Boddington
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Hannah C. Lewis
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Lorenzo Subissi
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Sophie von Dobschuetz
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Angel Rodriguez
- Pan American Health OrganizationWashingtonDistrict of ColumbiaUSA
| | - Jorge Jara
- Pan American Health OrganizationWashingtonDistrict of ColumbiaUSA
| | | | - Amal Barakat
- World Health Organization for the Eastern MediterraneanCairoEgypt
| | - Arash Rashidian
- World Health Organization for the Eastern MediterraneanCairoEgypt
| | | | - Lubna Al Ariqi
- World Health Organization for the Eastern MediterraneanCairoEgypt
| | - Pushpa Wijesinghe
- Regional Office for South‐East Asia, World Health OrganizationNew DelhiIndia
| | - Francis Inbanathan
- Regional Office for South‐East Asia, World Health OrganizationNew DelhiIndia
| | - Phuong Nam Nguyen
- Regional Office for the Western Pacific, World Health OrganizationManilaPhilippines
| | - Manilay Phengxay
- Regional Office for the Western Pacific, World Health OrganizationManilaPhilippines
| | - Linh‐Vi Le
- Regional Office for the Western Pacific, World Health OrganizationManilaPhilippines
| | - Temuulen Enebish
- Regional Office for the Western Pacific, World Health OrganizationManilaPhilippines
| | - Joseph Okeibunor
- Regional Office for Africa, World Health OrganizationBrazzavilleRepublic of the Congo
| | - Belinda Herring
- Regional Office for Africa, World Health OrganizationBrazzavilleRepublic of the Congo
| | - Elise Farley
- Regional Office for Africa, World Health OrganizationBrazzavilleRepublic of the Congo
| | | | | | - Joshua Mott
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Wenqing Zhang
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
| | - Richard Pebody
- Regional Office for Europe, World Health OrganizationCopenhagenDenmark
| | - Maria D. Van Kerkhove
- WHO Health Emergencies Programme, World Health Organization HeadquartersGenevaSwitzerland
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Rubin-Smith JE, Castro MYR, Preza I, Hasibra I, Sulo J, Fico A, Daja R, Vasili A, Kota M, Schmid A, Sridhar S, Guseinova A, Boshevska G, Bejtja G, Mühlemann B, Drosten C, Jorgensen P, Pebody R, Kissling E, Lafond KE, Katz MA, Bino S. Primary series COVID-19 vaccine effectiveness among healthcare workers in Albania, February-December 2021. IJID Reg 2023; 8:19-27. [PMID: 37317681 PMCID: PMC10106115 DOI: 10.1016/j.ijregi.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 06/16/2023]
Abstract
Background Healthcare workers have experienced high rates of morbidity and mortality from coronavirus disease 2019 (COVID-19). Methods A prospective cohort study was conducted in three Albanian hospitals between 19 February and 14 December 2021. All participants underwent polymerase chain reaction (PCR) and serological testing at enrolment, regular serology throughout, and PCR testing when symptomatic.Vaccine effectiveness (VE) against COVID-19 and against all severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections (symptomatic or asymptomatic) was estimated. VE was estimated using a Cox regression model, with vaccination status as a time-varying variable. Findings In total, 1504 HCWs were enrolled in this study; 70% had evidence of prior SARS-CoV-2 infection. VE was 65.1% [95% confidence interval (CI) 37.7-80.5] against COVID-19, 58.2% (95% CI 15.7-79.3) among participants without prior SARS-CoV-2 infection, and 73.6% (95% CI 24.3-90.8) among participants with prior SARS-CoV-2 infection. For BNT162b2 alone, VE was 69.5% (95% CI 44.5-83.2). During the period when the Delta variant was predominant, VE was 67.1% (95% CI 38.3-82.5). VE against SARS-CoV-2 infection for the full study period was 36.9% (95% CI 15.8-52.7). Interpretation This study found moderate primary series VE against COVID-19 among healthcare workers in Albania. These results support the continued promotion of COVID-19 vaccination in Albania, and highlight the benefits of vaccination in populations with high levels of prior infection.
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Affiliation(s)
- Julia E. Rubin-Smith
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | - Iria Preza
- Institute of Public Health, Tirana, Albania
| | | | - Jonilda Sulo
- Southeast European Centre for Surveillance and Control of Infectious Disease, Tirana, Albania
| | | | | | | | | | - Alexis Schmid
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Shela Sridhar
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Department of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - Alina Guseinova
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Gazmend Bejtja
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Barbara Mühlemann
- Institute of Virology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt – Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Centre for Infection Research, Partner Site Charité, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt – Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Centre for Infection Research, Partner Site Charité, Berlin, Germany
| | - Pernille Jorgensen
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Kathryn E. Lafond
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Katz
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Livingstone M, Jorgensen P, McCall M, Thomson J, Longbottom D. De Novo Whole-Genome Sequencing of Two Pathogenic Pasteurella multocida Type D:6 Strains Isolated from Pigs. Microbiol Resour Announc 2023; 12:e0009823. [PMID: 37010432 DOI: 10.1128/mra.00098-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Here, we report the complete genome sequences of Pasteurella multocida strains P504190 and P504188/1, which were isolated from the diseased lungs of a sow and her piglet, respectively. Despite the unusual clinical presentation, whole-genome sequence typing revealed both strains to be capsular type D and lipopolysaccharide (LPS) group 6, commonly found in pigs.
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Affiliation(s)
| | - Pernille Jorgensen
- Scotland's Rural College, Aberdeen Veterinary Disease Surveillance Centre, Bucksburn, Aberdeen, United Kingdom
| | - Margaret McCall
- Scotland's Rural College Veterinary Services, Veterinary and Analytical Laboratory, Edinburgh, Midlothian, United Kingdom
| | - Jill Thomson
- Scotland's Rural College Veterinary Services, Veterinary and Analytical Laboratory, Edinburgh, Midlothian, United Kingdom
| | - David Longbottom
- Moredun Research Institute, Edinburgh, Midlothian, United Kingdom
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4
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Jorgensen P, Schmid A, Sulo J, Preza I, Hasibra I, Kissling E, Fico A, Sridhar S, Rubin-Smith JE, Kota M, Vasili A, Daja R, Nika M, Pebody R, Lafond KE, Katz MA, Bino S. Factors associated with receipt of COVID-19 vaccination and SARS-CoV-2 seropositivity among healthcare workers in Albania (February 2021-June 2022): secondary analysis of a prospective cohort study. Lancet Reg Health Eur 2023; 27:100584. [PMID: 37013112 PMCID: PMC9969343 DOI: 10.1016/j.lanepe.2023.100584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 03/02/2023]
Abstract
Background Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis. Methods We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression. Findings By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75). Interpretation In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future. Funding This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe.
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Affiliation(s)
- Pernille Jorgensen
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Alexis Schmid
- Boston Children's Hospital Global Health Program, Boston, MA, USA
| | - Jonilda Sulo
- Southeast European Center for Surveillance and Control of Infectious Diseases, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iria Preza
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iris Hasibra
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | | | - Albana Fico
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Shela Sridhar
- Boston Children's Hospital Global Health Program, Boston, MA, USA
- Brigham and Women's Hospital, Department of Global Health Equity, 651 Huntington Avenue FXB, Building, 7th Floor, Boston, MA, USA
| | | | - Majlinda Kota
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Adela Vasili
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Rovena Daja
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Miljana Nika
- Tirana University Hospital “Mother Theresa”, Dibra Street N.372, 1001, Tirana, Albania
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Kathryn E. Lafond
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Katz
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Silvia Bino
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
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5
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Lewis HC, Marcato AJ, Meagher N, Valenciano M, Villanueva‐Cabezas J, Spirkoska V, Fielding JE, Karahalios A, Subissi L, Nardone A, Cheng B, Rajatonirina S, Okeibunor J, Aly EA, Barakat A, Jorgensen P, Azim T, Wijesinghe PR, Le L, Rodriguez A, Vicari A, Van Kerkhove MD, McVernon J, Pebody R, Price DJ, Bergeri I, Alemu MA, Alvi Y, Bukusi EA, Chung PS, Dambadarjaa D, Das AK, Dub T, Dulacha D, Ebrahim F, González‐Duarte MA, Guruge D, Heraud J, Heredia‐Melo DC, Herman‐Roloff A, Herring BL, Inbanathan FY, Islam F, Jeewandara KC, Kant S, Khan W, Lako R, Leite J, Malavige GN, Mandakh U, Mariam W, Mend T, Mize VA, Musa S, Nohynek H, Olu OO, Osorio‐Merchán MB, Pereyaslov D, Randremanana RV, de Dieu Randria MJ, Ransom J, Saxena S, Sharma P, Sreedevi A, Satheesh M, Subhashini KJ, Tippet‐Barr BA, Usha A, Wamala JF, Watare SH, Yadav K. Transmission of SARS-CoV-2 in standardised first few X cases and household transmission investigations: A systematic review and meta-analysis. Influenza Other Respir Viruses 2022; 16:803-819. [PMID: 36825117 PMCID: PMC9343340 DOI: 10.1111/irv.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
We aimed to estimate the household secondary infection attack rate (hSAR) of SARS-CoV-2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. We conducted a systematic review and meta-analysis according to PRISMA 2020 guidelines. We searched Medline, Embase, Web of Science, Scopus and medRxiv/bioRxiv for "Unity-aligned" First Few X cases (FFX) and HHTIs published 1 December 2019 to 26 July 2021. Standardised early results were shared by WHO Unity Studies collaborators (to 1 October 2021). We used a bespoke tool to assess investigation methodological quality. Values for hSAR and 95% confidence intervals (CIs) were extracted or calculated from crude data. Heterogeneity was assessed by visually inspecting overlap of CIs on forest plots and quantified in meta-analyses. Of 9988 records retrieved, 80 articles (64 from databases; 16 provided by Unity Studies collaborators) were retained in the systematic review; 62 were included in the primary meta-analysis. hSAR point estimates ranged from 2% to 90% (95% prediction interval: 3%-71%; I 2 = 99.7%); I 2 values remained >99% in subgroup analyses, indicating high, unexplained heterogeneity and leading to a decision not to report pooled hSAR estimates. FFX and HHTI remain critical epidemiological tools for early and ongoing characterisation of novel infectious pathogens. The large, unexplained variance in hSAR estimates emphasises the need to further support standardisation in planning, conduct and analysis, and for clear and comprehensive reporting of FFX and HHTIs in time and place, to guide evidence-based pandemic preparedness and response efforts for SARS-CoV-2, influenza and future novel respiratory viruses.
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Affiliation(s)
- Hannah C. Lewis
- World Health OrganizationGenevaSwitzerland,World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Adrian J. Marcato
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Niamh Meagher
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - Marta Valenciano
- World Health OrganizationGenevaSwitzerland,EpiconceptParisFrance
| | - Juan‐Pablo Villanueva‐Cabezas
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,The Nossal Institute for Global HealthThe University of MelbourneMelbourneAustralia
| | - Violeta Spirkoska
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - James E. Fielding
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia,Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | - Anthony Nardone
- World Health OrganizationGenevaSwitzerland,EpiconceptParisFrance
| | - Brianna Cheng
- World Health OrganizationGenevaSwitzerland,School of Population and Global HealthMcGill UniversityMontrealQuebecCanada
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Eman A. Aly
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | - Amal Barakat
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | | | - Tasnim Azim
- World Health Organization, Regional Office for South‐East AsiaNew DelhiIndia
| | | | - Linh‐Vi Le
- World Health Organization, Regional Office for the Western PacificManilaPhilippines
| | - Angel Rodriguez
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | - Andrea Vicari
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | | | - Jodie McVernon
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia,Murdoch Children's Research InstituteMelbourneAustralia
| | - Richard Pebody
- World Health Organization Regional Office for EuropeCopenhagenDenmark
| | - David J. Price
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | | | | | - Yasir Alvi
- Department of Community Medicine Hamdard Institute of Medical Sciences and Research New Delhi India
| | | | - Pui Shan Chung
- World Health Organization, Regional Office for the Western Pacific Manila Philippines
| | - Davaalkham Dambadarjaa
- School of Public Health Mongolian National University of Medical Sciences Ulaanbaatar Mongolia
| | - Ayan K. Das
- Department of Microbiology Hamdard Institute of Medical Science and Research New Delhi India
- Hakeem Abdul Hameed Centenary Hospital New Delhi India
| | - Timothée Dub
- Department of Health Security Finnish Institute for Health and Welfare Helsinki Finland
| | | | - Faiqa Ebrahim
- World Health Organization Country Office Addis Ababa Ethiopia
| | | | | | | | | | | | - Belinda L. Herring
- World Health Organization, Regional Office for Africa Brazzaville Republic of Congo
| | | | - Farzana Islam
- Hamdard Institute of Medical Sciences and Research (HIMSR) New Delhi India
| | - Kamal Chandima Jeewandara
- Allergy Immunology and Cell Biology Unit, Department of Immunology and Molecular Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura Nugegoda Sri Lanka
| | - Shashi Kant
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
| | - Wasiq Khan
- World Health Organization, Regional Office for the Eastern Mediterranean Cairo Egypt
| | | | - Juliana Leite
- World Health Organization, Regional Office for the Americas (Pan American Health Organization) Washington DC USA
| | | | - Undram Mandakh
- Mongolian National University of Medical Sciences Ulaanbaatar Mongolia
| | - Warisha Mariam
- Department of Community Medicine Maulana Azad Medical College New Delhi India
| | - Tsogt Mend
- National Center for Communicable Diseases Ulaanbaatar Mongolia
| | | | - Sanjin Musa
- Institute for Public Health of the Federation of Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina
- Sarajevo School of Science and Technology Sarajevo Bosnia and Herzegovina
| | - Hanna Nohynek
- Department of Health Security Finnish Institute for Health and Welfare Helsinki Finland
| | | | | | | | | | | | - James Ransom
- Centers for Disease Control and Prevention Juba South Sudan
| | - Sonal Saxena
- Department of Microbiology Maulana Azad Medical College New Delhi India
| | - Pragya Sharma
- Department of Community Medicine Maulana Azad Medical College New Delhi India
| | - Aswathy Sreedevi
- Department of Community Medicine Amrita Institute of Medical Sciences Kochi Kerala India
| | - Mini Satheesh
- Kerala University of Health Sciences Kerala India
- Government Medical College Thiruvananthapuram Kerala India
| | - K. J. Subhashini
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
| | - Beth A. Tippet‐Barr
- U.S. Centers for Disease Control and Prevention Nairobi Kenya
- Nyanja Health Research Institute Salima Malawi
| | - Anuja Usha
- Regional Prevention of Epidemic and Infectious Disease Cell Government of Kerala Kerala India
| | | | | | - Kapil Yadav
- Centre for Community Medicine All India Institute of Medical Sciences New Delhi India
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6
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Sridhar S, Fico A, Preza I, Hatibi I, Sulo J, Kissling E, Daja R, Ibrahim R, Lemos D, Rubin-Smith J, Schmid A, Vasili A, Valenciano M, Jorgensen P, Pebody R, Lafond KE, Katz MA, Bino S. COVID-19 vaccine effectiveness among healthcare workers in Albania (COVE-AL): protocol for a prospective cohort study and cohort baseline data. BMJ Open 2022; 12:e057741. [PMID: 35321895 PMCID: PMC8943479 DOI: 10.1136/bmjopen-2021-057741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Critical questions remain about COVID-19 vaccine effectiveness (VE) in real-world settings, particularly in middle-income countries. We describe a study protocol to evaluate COVID-19 VE in preventing laboratory-confirmed SARS-CoV-2 infection in health workers (HWs) in Albania, an upper-middle-income country. METHODS AND ANALYSIS In this 12-month prospective cohort study, we enrolled HWs at three hospitals in Albania. HWs are vaccinated through the routine COVID-19 vaccine campaign. Participants completed a baseline survey about demographics, clinical comorbidities, and infection risk behaviours. Baseline serology samples were also collected and tested against the SARS-CoV-2 spike protein, and respiratory swabs were collected and tested for SARS-CoV-2 by RT-PCR. Participants complete weekly symptom questionnaires and symptomatic participants have a respiratory swab collected, which is tested for SARS-CoV-2. At 3, 6, 9 months and 12 months of the study, serology will be collected and tested for antibodies against the SARS-CoV-2 nucleocapsid protein and spike protein. VE will be estimated using a piecewise proportional hazards model (VE=1-HR). BASELINE DATA From February to May 2021, 1504 HWs were enrolled. The median age was 44 (range: 22-71) and 78% were female. At enrolment, 72% of participants were seropositive for SARS-CoV-2. 56% of participants were vaccinated with one dose, of whom 98% received their first shot within 4 days of enrolment. All HWs received the Pfizer BNT162b2 mRNA COVID-19 vaccine. ETHICS AND DISSEMINATION The study protocol and procedures were reviewed and approved by the WHO Ethical Review Board, reference number CERC.0097A, and the Albanian Institute of Public Health Ethical Review Board, reference number 156. All participants have provided written informed consent to participate in this study. The primary results of this study will be published in a peer-reviewed journal at the time of completion. TRIAL REGISTRATION NUMBER NCT04811391.
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Affiliation(s)
- Shela Sridhar
- Global Health Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Iria Preza
- Institute of Public Health, Tirana, Albania
| | | | - Jonilda Sulo
- Southeast European Center for Surveillance and Control of Infectious Disease, Tirana, Albania
| | | | | | - Rawi Ibrahim
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Diogo Lemos
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Julia Rubin-Smith
- Global Health Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alexis Schmid
- Global Health Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | | | - Pernille Jorgensen
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Mark A Katz
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Silvia Bino
- Institute of Public Health, Southern European Centre for Surveillance and Control of Infectious Diseases (SECID), Tirana, Albania
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7
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Negro-Calduch E, Azzopardi-Muscat N, Nitzan D, Pebody R, Jorgensen P, Novillo-Ortiz D. Health Information Systems in the COVID-19 Pandemic: A Short Survey of Experiences and Lessons Learned From the European Region. Front Public Health 2021; 9:676838. [PMID: 34650946 PMCID: PMC8505771 DOI: 10.3389/fpubh.2021.676838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The COVID-19 crisis provides an opportunity to reflect on what worked during the pandemic, what could have been done differently, and what innovations should become part of an enhanced health information system in the future. Methods: An online qualitative survey was designed and administered online in November 2020 to all the 37 Member States that are part of the WHO European Health Information Initiative and the WHO Central Asian Republics Information Network. Results: Nineteen countries responded to the survey (Austria, Belgium, Croatia, Czech Republic, Finland, Greece, Iceland, Ireland, Israel, Italy, Kazakhstan, Latvia, Lithuania, Romania, Russian Federation, Sweden, Turkey, United Kingdom, and Uzbekistan). The COVID-19 pandemic required health information systems (HIS) to rapidly adapt to identify, collect, store, manage, and transmit accurate and timely COVID-19 related data. HIS stakeholders have been put to the test, and valuable experience has been gained. Despite critical gaps such as under-resourced public health services, obsolete health information technologies, and lack of interoperability, most countries believed that their information systems had worked reasonably well in addressing the needs arising during the COVID-19 pandemic. Conclusion: Strong enabling environments and advanced and digitized health information systems are vital to controlling epidemics. Sustainable finance and government support are required for the continued implementation and enhancement of HIS. It is important to promote digital solutions beyond the COVID-19 pandemic. Now is the time to discuss potential solutions to obtain timely, accurate, and reliable health information and steer policy-making while protecting privacy rights and meeting the highest ethical standards.
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Affiliation(s)
- Elsa Negro-Calduch
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | | | - Dorit Nitzan
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Pernille Jorgensen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
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8
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Bergeri I, Lewis HC, Subissi L, Nardone A, Valenciano M, Cheng B, Glonti K, Williams B, Abejirinde IOO, Simniceanu A, Cassini A, Grant R, Rodriguez A, Vicari A, Al Ariqi L, Azim T, Wijesinghe PR, Rajatonirina SC, Okeibunor JC, Le LV, Katz M, Vaughan A, Jorgensen P, Freidl G, Pebody R, Van Kerkhove MD. Early epidemiological investigations: World Health Organization UNITY protocols provide a standardized and timely international investigation framework during the COVID-19 pandemic. Influenza Other Respir Viruses 2021; 16:7-13. [PMID: 34611986 PMCID: PMC8652791 DOI: 10.1111/irv.12915] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The declaration of Coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 required rapid implementation of early investigations to inform appropriate national and global public health actions. METHODS The suite of existing pandemic preparedness generic epidemiological early investigation protocols was rapidly adapted for COVID-19, branded the 'UNITY studies' and promoted globally for the implementation of standardized and quality studies. Ten protocols were developed investigating household (HH) transmission, the first few cases (FFX), population seroprevalence (SEROPREV), health facilities transmission (n = 2), vaccine effectiveness (n = 2), pregnancy outcomes and transmission, school transmission, and surface contamination. Implementation was supported by WHO and its partners globally, with emphasis to support building surveillance and research capacities in low- and middle-income countries (LMIC). RESULTS WHO generic protocols were rapidly developed and published on the WHO website, 5/10 protocols within the first 3 months of the response. As of 30 June 2021, 172 investigations were implemented by 97 countries, of which 62 (64%) were LMIC. The majority of countries implemented population seroprevalence (71 countries) and first few cases/household transmission (37 countries) studies. CONCLUSION The widespread adoption of UNITY protocols across all WHO regions indicates that they addressed subnational and national needs to support local public health decision-making to prevent and control the pandemic.
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Affiliation(s)
- Isabel Bergeri
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Hannah C Lewis
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Lorenzo Subissi
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Anthony Nardone
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland.,Epidemiology Departement, Epiconcept, Paris, France
| | - Marta Valenciano
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland.,Epidemiology Departement, Epiconcept, Paris, France
| | - Brianna Cheng
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Ketevan Glonti
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Bridget Williams
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | | | - Alice Simniceanu
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Alessandro Cassini
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | - Rebecca Grant
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
| | | | - Andrea Vicari
- Pan American Health Organization, Washington, D.C., USA
| | - Lubna Al Ariqi
- World Health Organization for the Eastern Mediterranean, Cairo, Egypt
| | - Tasnim Azim
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | | | | | | | - Linh-Vi Le
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - Mark Katz
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Aisling Vaughan
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Pernille Jorgensen
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Gudrun Freidl
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Richard Pebody
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Maria D Van Kerkhove
- WHO Health Emergencies Programme, World Health Organization Headquarters, Geneva, Switzerland
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9
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Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, Bella A, Sognamiglio P, Sierra Moros MJ, Riutort AN, Demina YV, Mahieu R, Broas M, Bengnér M, Buda S, Schilling J, Filleul L, Lepoutre A, Saura C, Mailles A, Levy-Bruhl D, Coignard B, Bernard-Stoecklin S, Behillil S, van der Werf S, Valette M, Lina B, Riccardo F, Nicastri E, Casas I, Larrauri A, Salom Castell M, Pozo F, Maksyutov RA, Martin C, Van Ranst M, Bossuyt N, Siira L, Sane J, Tegmark-Wisell K, Palmérus M, Broberg EK, Beauté J, Jorgensen P, Bundle N, Pereyaslov D, Adlhoch C, Pukkila J, Pebody R, Olsen S, Ciancio BC. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill 2020; 25:2000178. [PMID: 32156327 PMCID: PMC7068164 DOI: 10.2807/1560-7917.es.2020.25.9.2000178] [Citation(s) in RCA: 354] [Impact Index Per Article: 88.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/05/2020] [Indexed: 12/14/2022] Open
Abstract
In the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters' index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
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Affiliation(s)
| | - James Fielding
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | | | - Christine Campese
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Vincent Enouf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Alexandre Gaymard
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Paola Sognamiglio
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Maria José Sierra Moros
- Coordination Centre for Health Alerts and Emergencies. Spanish Ministry of Health, Madrid, Spain
| | | | - Yulia V Demina
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russia
| | - Romain Mahieu
- Department of Infectious Disease Prevention and Control, Common Community Commission, Brussels-Capital Region, Brussels, Belgium
| | - Markku Broas
- Chief Physician, Infection control unit, Lapland Hospital District, Rovaniemi, Finland
| | - Malin Bengnér
- County Medical Officer, Jönköping Region, Jönköping, Sweden
| | | | | | - Laurent Filleul
- Santé publique France - Direction des régions, Cellule régionale Nouvelle Aquitaine, Bordeaux, France
| | - Agnès Lepoutre
- Santé publique France - Direction des régions, Cellule régionale Ile-de-France, Paris, France
| | - Christine Saura
- Santé publique France - Direction des régions, Cellule régionale Auvergne-Rhône-Alpes, Lyon, France
| | - Alexandra Mailles
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Bruno Coignard
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | | | - Sylvie Behillil
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Sylvie van der Werf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Martine Valette
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | - Bruno Lina
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Emanuele Nicastri
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Inmaculada Casas
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III. Madrid, Spain
| | | | - Francisco Pozo
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Rinat A Maksyutov
- State Research Center of Virology and Biotechnology "Vector", Rospotrebnadzor, Moscow, Russia
| | | | - Marc Van Ranst
- Laboratory of Clinical Virology, Department of Microbiology and Immunology, Rega Institute, KU Leuven - University of Leuven, Leuven, Belgium
| | - Nathalie Bossuyt
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Lotta Siira
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jussi Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pernille Jorgensen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Dmitriy Pereyaslov
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jukka Pukkila
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Olsen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
- These authors have contributed equally to the manuscript
| | - Bruno Christian Ciancio
- European Centre for Disease Prevention and Control, Stockholm, Sweden
- These authors have contributed equally to the manuscript
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10
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Jorgensen P, Mereckiene J, Cotter S, Johansen K, Tsolova S, Brown C. How close are countries of the WHO European Region to achieving the goal of vaccinating 75% of key risk groups against influenza? Results from national surveys on seasonal influenza vaccination programmes, 2008/2009 to 2014/2015. Vaccine 2017; 36:442-452. [PMID: 29287683 PMCID: PMC5777640 DOI: 10.1016/j.vaccine.2017.12.019] [Citation(s) in RCA: 169] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/04/2022]
Abstract
Background Influenza vaccination is recommended especially for persons at risk of complications. In 2003, the World Health Assembly urged Member States (MS) to increase vaccination coverage to 75% among older persons by 2010. Objective To assess progress towards the 2010 vaccination goal and describe seasonal influenza vaccination recommendations in the World Health Organization (WHO) European Region. Methods Data on seasonal influenza vaccine recommendations, dose distribution, and target group coverage were obtained from two sources: European Union and European Economic Area MS data were extracted from influenza vaccination surveys covering seven seasons (2008/2009–2014/2015) published by the Vaccine European New Integrated Collaboration Effort and European Centre for Disease Prevention and Control. For the remaining WHO European MS, a separate survey on policies and uptake for all seasons (2008/2009–2014/2015) was distributed to national immunization programmes in 2015. Results Data was available from 49 of 53 MS. All but two had a national influenza vaccination policy. High-income countries distributed considerably higher number of vaccines per capita (median; 139.2 per 1000 population) compared to lower-middle-income countries (median; 6.1 per 1000 population). Most countries recommended vaccination for older persons, individuals with chronic disease, healthcare workers, and pregnant women. Children were included in < 50% of national policies. Only one country reached 75% coverage in older persons (2014/2015), while a number of countries reported declining vaccination uptake. Coverage of target groups was overall low, but with large variations between countries. Vaccination coverage was not monitored for several groups. Conclusions Despite policy recommendations, influenza vaccination uptake remains suboptimal. Low levels of vaccination is not only a missed opportunity for preventing influenza in vulnerable groups, but could negatively affect pandemic preparedness. Improved understanding of barriers to influenza vaccination is needed to increase uptake and reverse negative trends. Furthermore, implementation of vaccination coverage monitoring is critical for assessing performance and impact of the programmes.
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Affiliation(s)
- Pernille Jorgensen
- WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark.
| | - Jolita Mereckiene
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Suzanne Cotter
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Kari Johansen
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, 171 65 Solna, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, 171 65 Solna, Sweden
| | - Caroline Brown
- WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark
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11
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Fitzner J, Qasmieh S, Mounts AW, Alexander B, Besselaar T, Briand S, Brown C, Clark S, Dueger E, Gross D, Hauge S, Hirve S, Jorgensen P, Katz MA, Mafi A, Malik M, McCarron M, Meerhoff T, Mori Y, Mott J, Olivera MTDC, Ortiz JR, Palekar R, Rebelo-de-Andrade H, Soetens L, Yahaya AA, Zhang W, Vandemaele K. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection. Bull World Health Organ 2017; 96:122-128. [PMID: 29403115 PMCID: PMC5791775 DOI: 10.2471/blt.17.194514] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 12/24/2022] Open
Abstract
The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.
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Affiliation(s)
- Julia Fitzner
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Saba Qasmieh
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Anthony Wayne Mounts
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Burmaa Alexander
- National Centre for Communicable Diseases, Ulaanbataar, Mongolia
| | - Terry Besselaar
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Sylvie Briand
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Caroline Brown
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Seth Clark
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Erica Dueger
- Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - Diane Gross
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Siri Hauge
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Siddhivinayak Hirve
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Pernille Jorgensen
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Mark A Katz
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Ali Mafi
- Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Mamunur Malik
- Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Margaret McCarron
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Tamara Meerhoff
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yuichiro Mori
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Joshua Mott
- United States Centers for Disease Control and Prevention Kenya Office, Nairobi, Kenya
| | | | - Justin R Ortiz
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Rakhee Palekar
- Pan American Health Organization, World Health Organization, Washington, USA
| | | | - Loes Soetens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Ali Ahmed Yahaya
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Wenqing Zhang
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Katelijn Vandemaele
- Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
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12
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Ortiz JR, Perut M, Dumolard L, Wijesinghe PR, Jorgensen P, Ropero AM, Danovaro-Holliday MC, Heffelfinger JD, Tevi-Benissan C, Teleb NA, Lambach P, Hombach J. A global review of national influenza immunization policies: Analysis of the 2014 WHO/UNICEF Joint Reporting Form on immunization. Vaccine 2016; 34:5400-5405. [PMID: 27646030 PMCID: PMC5357765 DOI: 10.1016/j.vaccine.2016.07.045] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022]
Abstract
Introduction The WHO recommends annual influenza vaccination to prevent influenza illness in high-risk groups. Little is known about national influenza immunization policies globally. Material and Methods The 2014 WHO/UNICEF Joint Reporting Form (JRF) on Immunization was adapted to capture data on influenza immunization policies. We combined this dataset with additional JRF information on new vaccine introductions and strength of immunization programmes, as well as publicly available data on country economic status. Data from countries that did not complete the JRF were sought through additional sources. We described data on country influenza immunization policies and used bivariate analyses to identify factors associated with having such policies. Results Of 194 WHO Member States, 115 (59%) reported having a national influenza immunization policy in 2014. Among countries with a national policy, programmes target specific WHO-defined risk groups, including pregnant women (42%), young children (28%), adults with chronic illnesses (46%), the elderly (45%), and health care workers (47%). The Americas, Europe, and Western Pacific were the WHO regions that had the highest percentages of countries reporting that they had national influenza immunization policies. Compared to countries without policies, countries with policies were significantly more likely to have the following characteristics: to be high or upper middle income (p < 0.0001); to have introduced birth dose hepatitis B virus vaccine (p < 0.0001), pneumococcal conjugate vaccine (p = 0.032), or human papilloma virus vaccine (p = 0.002); to have achieved global goals for diphtheria-tetanus-pertussis vaccine coverage (p < 0.0001); and to have a functioning National Immunization Technical Advisory Group (p < 0.0001). Conclusions The 2014 revision of the JRF permitted a global assessment of national influenza immunization policies. The 59% of countries reporting that they had policies are wealthier, use more new or under-utilized vaccines, and have stronger immunization systems. Addressing disparities in public health resources and strengthening immunization systems may facilitate influenza vaccine introduction and use.
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Affiliation(s)
- Justin R Ortiz
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
| | - Marc Perut
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Laure Dumolard
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Pushpa Ranjan Wijesinghe
- Immunization and Vaccine Development, World Health Organization (WHO), South-East Asia Regional Office, New Delhi, India
| | - Pernille Jorgensen
- Division of Communicable Diseases and Health Security, World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Alba Maria Ropero
- Immunization Unit, Pan American Health Organization, Washington, DC, United States
| | | | - James D Heffelfinger
- Expanded Programme on Immunization, World Health Organization (WHO) Regional Office for the Western Pacific, Manila, Philippines
| | - Carol Tevi-Benissan
- Immunization and Vaccine Development, World Health Organization, Regional Office for Africa, Brazzaville, People's Republic of Congo
| | - Nadia A Teleb
- Vaccine Preventable Diseases, World Health Organization (WHO) Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Philipp Lambach
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Joachim Hombach
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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13
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Vega T, Lozano JE, Meerhoff T, Snacken R, Beauté J, Jorgensen P, Ortiz de Lejarazu R, Domegan L, Mossong J, Nielsen J, Born R, Larrauri A, Brown C. Influenza surveillance in Europe: comparing intensity levels calculated using the moving epidemic method. Influenza Other Respir Viruses 2016; 9:234-46. [PMID: 26031655 PMCID: PMC4548993 DOI: 10.1111/irv.12330] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives Although influenza-like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge. The objective is to compare the intensity of ILI and ARI in some European countries. Design and setting Weekly ILI and ARI incidence rates and proportion of primary care consultations were modeled in 28 countries for the 1996/1997–2013/2014 seasons using the moving epidemic method (MEM). We calculated the epidemic threshold and three intensity thresholds, which delimit five intensity levels: baseline, low, medium, high, and very high. The intensity of 2013/2014 season is described and compared by country. Results The lowest ILI epidemic thresholds appeared in Sweden and Estonia (below 10 cases per 100 000) and the highest in Belgium, Denmark, Hungary, Poland, Serbia, and Slovakia (above 100 per 100 000). The 2009/2010 season was the most intense, with 35% of the countries showing high or very high intensity levels. The European epidemic period in season 2013/2014 started in January 2014 in Spain, Poland, and Greece. The intensity was between low and medium and only Greece reached the high intensity level, in weeks 7 to 9/2014. Some countries remained at the baseline level throughout the entire surveillance period. Conclusions Epidemic and intensity thresholds varied by country. Influenza-like illnesses and ARI levels normalized by MEM in 2013/2014 showed that the intensity of the season in Europe was between low and medium in most of the countries. Comparing intensity among seasons or countries is essential for understanding patterns in seasonal epidemics. An automated standardized model for comparison should be implemented at national and international levels.
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Affiliation(s)
- Tomás Vega
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - José E Lozano
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Tamara Meerhoff
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - René Snacken
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pernille Jorgensen
- Division of Health Security, Infectious Diseases and the Environment, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - Lisa Domegan
- Health Protection Surveillance Centre, Dublin, Ireland
| | - Joël Mossong
- Laboratoire National de Santé, Luxembourg, Luxembourg
| | | | - Rita Born
- Division of Communicable Diseases, Federal Office of Public Health, Directorates of Public Health, Bern, Switzerland
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Caroline Brown
- Division of Health Security, Infectious Diseases and the Environment, WHO Regional Office for Europe, Copenhagen, Denmark
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Soebiyanto RP, Gross D, Jorgensen P, Buda S, Bromberg M, Kaufman Z, Prosenc K, Socan M, Vega Alonso T, Widdowson MA, Kiang RK. Associations between Meteorological Parameters and Influenza Activity in Berlin (Germany), Ljubljana (Slovenia), Castile and León (Spain) and Israeli Districts. PLoS One 2015; 10:e0134701. [PMID: 26309214 PMCID: PMC4550247 DOI: 10.1371/journal.pone.0134701] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 07/13/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studies in the literature have indicated that the timing of seasonal influenza epidemic varies across latitude, suggesting the involvement of meteorological and environmental conditions in the transmission of influenza. In this study, we investigated the link between meteorological parameters and influenza activity in 9 sub-national areas with temperate and subtropical climates: Berlin (Germany), Ljubljana (Slovenia), Castile and León (Spain) and all 6 districts in Israel. METHODS We estimated weekly influenza-associated influenza-like-illness (ILI) or Acute Respiratory Infection (ARI) incidence to represent influenza activity using data from each country's sentinel surveillance during 2000-2011 (Spain) and 2006-2011 (all others). Meteorological data was obtained from ground stations, satellite and assimilated data. Two generalized additive models (GAM) were developed, with one using specific humidity as a covariate and another using minimum temperature. Precipitation and solar radiation were included as additional covariates in both models. The models were adjusted for previous weeks' influenza activity, and were trained separately for each study location. RESULTS Influenza activity was inversely associated (p<0.05) with specific humidity in all locations. Minimum temperature was inversely associated with influenza in all 3 temperate locations, but not in all subtropical locations. Inverse associations between influenza and solar radiation were found in most locations. Associations with precipitation were location-dependent and inconclusive. We used the models to estimate influenza activity a week ahead for the 2010/2011 period which was not used in training the models. With exception of Ljubljana and Israel's Haifa District, the models could closely follow the observed data especially during the start and the end of epidemic period. In these locations, correlation coefficients between the observed and estimated ranged between 0.55 to 0.91and the model-estimated influenza peaks were within 3 weeks from the observations. CONCLUSION Our study demonstrated the significant link between specific humidity and influenza activity across temperate and subtropical climates, and that inclusion of meteorological parameters in the surveillance system may further our understanding of influenza transmission patterns.
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Affiliation(s)
- Radina P. Soebiyanto
- Goddard Earth Sciences Technology and Research, Universities Space Research Associations, Columbia, Maryland, United States of America
- Global Change Data Center, NASA Goddard Space Flight Center, Greenbelt, Maryland, United States of America
| | - Diane Gross
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Pernille Jorgensen
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | | | - Michal Bromberg
- Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel
| | - Zalman Kaufman
- Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel
| | - Katarina Prosenc
- Laboratory for Virology, National Institute of Public Health Slovenia, Ljubljana, Slovenia
| | - Maja Socan
- Communicable Diseases and Environmental Health Care, National Institute of Public Health, Ljubljana, Slovenia
| | | | - Marc-Alain Widdowson
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Richard K. Kiang
- Global Change Data Center, NASA Goddard Space Flight Center, Greenbelt, Maryland, United States of America
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Muraro A, Agache I, Clark A, Sheikh A, Roberts G, Akdis CA, Borrego LM, Higgs J, Hourihane JO, Jorgensen P, Mazon A, Parmigiani D, Said M, Schnadt S, van Os-Medendorp H, Vlieg-Boerstra BJ, Wickman M. EAACI food allergy and anaphylaxis guidelines: managing patients with food allergy in the community. Allergy 2014; 69:1046-57. [PMID: 24905609 DOI: 10.1111/all.12441] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2014] [Indexed: 12/14/2022]
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level.
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Affiliation(s)
- A. Muraro
- Department of Mother and Child Health; The Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region; Padua General University Hospital; Padua Italy
| | - I. Agache
- Theramed Medical Center; Brasov Romania
| | - A. Clark
- Allergy Department; Addenbrookes NHS Foundation Trust; Cambridge UK
| | - A. Sheikh
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
- Division of General Internal Medicine and Primary Care; Brigham and Women's Hospital; Boston MA USA
- Department of Medicine; Harvard Medical School; Boston MA USA
| | - G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- Human Development in Health and Clinical and Experimental Sciences Academic Units; Faculty of Medicine; University of Southampton; Southampton UK
- Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne-Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - L. M. Borrego
- Centro de Alergia; Hospital CUF Descobertas and Departamento de Imunologia; NOVA Medical School; Lisboa Portugal
| | - J. Higgs
- Health Education Trust; Greens Norton; Northamptonshire UK
| | | | | | - A. Mazon
- Pediatric Allergy and Pneumology Unit; Children's Hospital La Fe; Instituto de Investigacion Sanitaria La Fe; Valencia Spain
| | - D. Parmigiani
- Association for Teacher Education in Europe; Bruxelles Belgium
- Department of Education; University of Genoa; Genoa Italy
| | - M. Said
- Allergy & Anaphylaxis Australia; Hornsby NSW Australia
| | - S. Schnadt
- Deutscher Allergie- und Asthmabund e.V.; Mönchengladbach Germany
| | - H. van Os-Medendorp
- Department of Dermatology & Allergology; UMC Utrecht; Utrecht The Netherlands
| | - B. J. Vlieg-Boerstra
- Department of Respiratory Medicine and Allergy; Emma Children's Hospital; Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | - M. Wickman
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Department of Pediatrics; Sachs’ Children's Hospital; Stockholm Sweden
- Centre for Allergy Research; Karolinska Institutet; Stockholm Sweden
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Caiani E, Pellegrini A, Carminati M, Lang R, Auricchio A, Vaida P, Obase K, Sakakura T, Komeda M, Okura H, Yoshida K, Zeppellini R, Noni M, Rigo T, Erente G, Carasi M, Costa A, Ramondo B, Thorell L, Akesson-Lindow T, Shahgaldi K, Germanakis I, Fotaki A, Peppes S, Sifakis S, Parthenakis F, Makrigiannakis A, Richter U, Sveric K, Forkmann M, Wunderlich C, Strasser R, Djikic D, Potpara T, Polovina M, Marcetic Z, Peric V, Ostenfeld E, Werther-Evaldsson A, Engblom H, Ingvarsson A, Roijer A, Meurling C, Holm J, Radegran G, Carlsson M, Tabuchi H, Yamanaka T, Katahira Y, Tanaka M, Kurokawa T, Nakajima H, Ohtsuki S, Saijo Y, Yambe T, D'alto M, Romeo E, Argiento P, D'andrea A, Vanderpool R, Correra A, Sarubbi B, Calabro' R, Russo M, Naeije R, Saha SK, Warsame TA, Caelian AG, Malicse M, Kiotsekoglou A, Omran AS, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Erturk M, Oner E, Kalkan A, Pusuroglu H, Ozyilmaz S, Akgul O, Aksu H, Akturk F, Celik O, Uslu N, Bandera F, Pellegrino M, Generati G, Donghi V, Alfonzetti E, Guazzi M, Rangel I, Goncalves A, Sousa C, Correia A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Lee S, Kim W, Yun H, Jung L, Kim E, Ko J, Enescu O, Florescu M, Rimbas R, Cinteza M, Vinereanu D, Kosmala W, Rojek A, Cielecka-Prynda M, Laczmanski L, Mysiak A, Przewlocka-Kosmala M, Liu D, Hu K, Niemann M, Herrmann S, Cikes M, Gaudron P, Knop S, Ertl G, Bijnens B, Weidemann F, Saravi M, Tamadoni A, Jalalian R, Hojati M, Ramezani S, Yildiz A, Inci U, Bilik M, Yuksel M, Oyumlu M, Kayan F, Ozaydogdu N, Aydin M, Akil M, Tekbas E, Shang Q, Zhang Q, Fang F, Wang S, Li R, Lee AP, Yu C, Mornos C, Ionac A, Cozma D, Popescu I, Ionescu G, Dan R, Petrescu L, Sawant A, Srivatsa S, Adhikari P, Mills P, Srivatsa S, Boshchenko A, Vrublevsky A, Karpov R, Trifunovic D, Stankovic S, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Banovic M, Tesic M, Petrovic M, Dragovic M, Ostojic M, Zencirci E, Esen Zencirci A, Degirmencioglu A, Karakus G, Ekmekci A, Erdem A, Ozden K, Erer H, Akyol A, Eren M, Zamfir D, Tautu O, Onciul S, Marinescu C, Onut R, Comanescu I, Oprescu N, Iancovici S, Dorobantu M, Melao F, Pereira M, Ribeiro V, Oliveira S, Araujo C, Subirana I, Marrugat J, Dias P, Azevedo A, Grillo MT, Piamonti B, Abate E, Porto A, Dell'angela L, Gatti G, Poletti A, Pappalardo A, Sinagra G, Pinto-Teixeira P, Galrinho A, Branco L, Fiarresga A, Sousa L, Cacela D, Portugal G, Rio P, Abreu J, Ferreira R, Fadel B, Abdullah N, Al-Admawi M, Pergola V, Bech-Hanssen O, Di Salvo G, Tigen MK, Pala S, Karaahmet T, Dundar C, Bulut M, Izgi A, Esen AM, Kirma C, Boerlage-Van Dijk K, Yamawaki M, Wiegerinck E, Meregalli P, Bindraban N, Vis M, Koch K, Piek J, Bouma B, Baan J, Mizia M, Sikora-Puz A, Gieszczyk-Strozik K, Lasota B, Chmiel A, Chudek J, Jasinski M, Deja M, Mizia-Stec K, Silva Fazendas Adame PR, Caldeira D, Stuart B, Almeida S, Cruz I, Ferreira A, Lopes L, Joao I, Cotrim C, Pereira H, Unger P, Dedobbeleer C, Stoupel E, Preumont N, Argacha J, Berkenboom G, Van Camp G, Malev E, Reeva S, Vasina L, Pshepiy A, Korshunova A, Timofeev E, Zemtsovsky E, Jorgensen PG, Jensen J, Fritz-Hansen T, Biering-Sorensen T, Jons C, Olsen N, Henri C, Magne J, Dulgheru R, Laaraibi S, Voilliot D, Kou S, Pierard L, Lancellotti P, Tayyareci Y, Dworakowski R, Kogoj P, Reiken J, Kenny C, Maccarthy P, Wendler O, Monaghan M, Song J, Ha T, Jung Y, Seo M, Choi S, Kim Y, Sun B, Kim D, Kang D, Song J, Le Tourneau T, Topilsky Y, Inamo J, Mahoney D, Suri R, Schaff H, Enriquez-Sarano M, Bonaque Gonzalez J, Sanchez Espino A, Merchan Ortega G, Bolivar Herrera N, Ikuta I, Macancela Quinonez J, Munoz Troyano S, Ferrer Lopez R, Gomez Recio M, Dreyfus J, Cimadevilla C, Brochet E, Himbert D, Iung B, Vahanian A, Messika-Zeitoun D, Izumo M, Takeuchi M, Seo Y, Yamashita E, Suzuki K, Ishizu T, Sato K, Aonuma K, Otsuji Y, Akashi Y, Muraru D, Addetia K, Veronesi F, Corsi C, Mor-Avi V, Yamat M, Weinert L, Lang R, Badano L, Minamisawa M, Koyama J, Kozuka A, Motoki H, Izawa A, Tomita T, Miyashita Y, Ikeda U, Florescu C, Niemann M, Liu D, Hu K, Herrmann S, Gaudron P, Scholz F, Stoerk S, Ertl G, Weidemann F, Marchel M, Serafin A, Kochanowski J, Piatkowski R, Madej-Pilarczyk A, Filipiak K, Hausmanowa-Petrusewicz I, Opolski G, Meimoun P, M'barek D, Clerc J, Neikova A, Elmkies F, Tzvetkov B, Luycx-Bore A, Cardoso C, Zemir H, Mansencal N, Arslan M, El Mahmoud R, Pilliere R, Dubourg O, Ikonomidis I, Lambadiari V, Pavlidis G, Koukoulis C, Kousathana F, Varoudi M, Tritakis V, Triantafyllidi H, Dimitriadis G, Lekakis I, Kovacs A, Kosztin A, Solymossy K, Celeng C, Apor A, Faludi M, Berta K, Szeplaki G, Foldes G, Merkely B, Kimura K, Daimon M, Nakajima T, Motoyoshi Y, Komori T, Nakao T, Kawata T, Uno K, Takenaka K, Komuro I, Gabric ID, Vazdar L, Pintaric H, Planinc D, Vinter O, Trbusic M, Bulj N, Nobre Menezes M, Silva Marques J, Magalhaes R, Carvalho V, Costa P, Brito D, Almeida A, Nunes-Diogo A, Davidsen ES, Bergerot C, Ernande L, Barthelet M, Thivolet S, Decker-Bellaton A, Altman M, Thibault H, Moulin P, Derumeaux G, Huttin O, Voilliot D, Frikha Z, Aliot E, Venner C, Juilliere Y, Selton-Suty C, Yamada T, Ooshima M, Hayashi H, Okabe S, Johno H, Murata H, Charalampopoulos A, Tzoulaki I, Howard L, Davies R, Gin-Sing W, Grapsa J, Wilkins M, Gibbs J, Castillo J, Bandeira A, Albuquerque E, Silveira C, Pyankov V, Chuyasova Y, Lichodziejewska B, Goliszek S, Kurnicka K, Dzikowska Diduch O, Kostrubiec M, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Arana X, Oria G, Onaindia J, Rodriguez I, Velasco S, Cacicedo A, Palomar S, Subinas A, Zumalde J, Laraudogoitia E, Saeed S, Kokorina M, Fromm A, Oeygarden H, Waje-Andreassen U, Gerdts E, Gomez E, Vallejo N, Pedro-Botet L, Mateu L, Nunyez R, Llobera L, Bayes A, Sabria M, Antonini-Canterin F, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Pudil R, Praus R, Vasatova M, Vojacek J, Palicka V, Hulek P, Pradel S, Mohty D, Damy T, Echahidi N, Lavergne D, Virot P, Aboyans V, Jaccard A, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Doulaptsis C, Symons R, Matos A, Florian A, Masci P, Dymarkowski S, Janssens S, Bogaert J, Lestuzzi C, Moreo A, Celik S, Lafaras C, Dequanter D, Tomkowski W, De Biasio M, Cervesato E, Massa L, Imazio M, Watanabe N, Kijima Y, Akagi T, Toh N, Oe H, Nakagawa K, Tanabe Y, Ikeda M, Okada K, Ito H, Milanesi O, Biffanti R, Varotto E, Cerutti A, Reffo E, Castaldi B, Maschietto N, Vida V, Padalino M, Stellin G, Bejiqi R, Retkoceri R, Bejiqi H, Retkoceri A, Surdulli S, Massoure P, Cautela J, Roche N, Chenilleau M, Gil J, Fourcade L, Akhundova A, Cincin A, Sunbul M, Sari I, Tigen M, Basaran Y, Suermeci G, Butz T, Schilling I, Sasko B, Liebeton J, Van Bracht M, Tzikas S, Prull M, Wennemann R, Trappe H, Attenhofer Jost CH, Pfyffer M, Scharf C, Seifert B, Faeh-Gunz A, Naegeli B, Candinas R, Medeiros-Domingo A, Wierzbowska-Drabik K, Roszczyk N, Sobczak M, Plewka M, Krecki R, Kasprzak J, Ikonomidis I, Varoudi M, Papadavid E, Theodoropoulos K, Papadakis I, Pavlidis G, Triantafyllidi H, Anastasiou - Nana M, Rigopoulos D, Lekakis J, Tereshina O, Surkova E, Vachev A, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Bravo Bustos D, Ikuta I, Aguado Martin M, Navarro Garcia F, Ruiz Lopez F, Gomez Recio M, Merchan Ortega G, Bonaque Gonzalez J, Bravo Bustos D, Sanchez Espino A, Bolivar Herrera N, Bonaque Gonzalez J, Navarro Garcia F, Aguado Martin M, Ruiz Lopez M, Gomez Recio M, Eguchi H, Maruo T, Endo K, Nakamura K, Yokota K, Fuku Y, Yamamoto H, Komiya T, Kadota K, Mitsudo K, Nagy AI, Manouras A, Gunyeli E, Shahgaldi K, Winter R, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Gaudron P, Knop S, Ertl G, Bijnens B, Weidemann F, Di Salvo G, Al Bulbul Z, Issa Z, Khan A, Faiz A, Rahmatullah S, Fadel B, Siblini G, Al Fayyadh M, Menting ME, Van Den Bosch A, Mcghie J, Cuypers J, Witsenburg M, Van Dalen B, Geleijnse M, Roos-Hesselink J, Olsen F, Jorgensen P, Mogelvang R, Jensen J, Fritz-Hansen T, Bech J, Biering-Sorensen T, Agoston G, Pap R, Saghy L, Forster T, Varga A, Scandura S, Capodanno D, Dipasqua F, Mangiafico S, Caggegi AM, Grasso C, Pistritto AM, Imme' S, Ministeri M, Tamburino C, Cameli M, Lisi M, D'ascenzi F, Cameli P, Losito M, Sparla S, Lunghetti S, Favilli R, Fineschi M, Mondillo S, Ojaghihaghighi Z, Javani B, Haghjoo M, Moladoust H, Shahrzad S, Ghadrdoust B, Altman M, Aussoleil A, Bergerot C, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Shkolnik E, Vasyuk Y, Nesvetov V, Shkolnik L, Varlan G, Gronkova N, Kinova E, Borizanova A, Goudev A, Saracoglu E, Ural D, Sahin T, Al N, Cakmak H, Akbulut T, Akay K, Ural E, Mushtaq S, Andreini D, Pontone G, Bertella E, Conte E, Baggiano A, Annoni A, Formenti A, Fiorentini C, Pepi M, Cosgrove C, Carr L, Chao C, Dahiya A, Prasad S, Younger J, Biering-Sorensen T, Christensen L, Krieger D, Mogelvang R, Jensen J, Hojberg S, Host N, Karlsen F, Christensen H, Medressova A, Abikeyeva L, Dzhetybayeva S, Andossova S, Kuatbayev Y, Bekbossynova M, Bekbossynov S, Pya Y, Farsalinos K, Tsiapras D, Kyrzopoulos S, Spyrou A, Stefopoulos C, Romagna G, Tsimopoulou K, Tsakalou M, Voudris V, Cacicedo A, Velasco Del Castillo S, Anton Ladislao A, Aguirre Larracoechea U, Onaindia Gandarias J, Romero Pereiro A, Arana Achaga X, Zugazabeitia Irazabal G, Laraudogoitia Zaldumbide E, Lekuona Goya I, Varela A, Kotsovilis S, Salagianni M, Andreakos V, Davos C, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Macancela Quinones J, Ikuta I, Ferrer Lopez R, Munoz Troyano S, Bravo Bustos D, Gomez Recio M. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zolotusca L, Jorgensen P, Popovici O, Pistol A, Popovici F, Widdowson MA, Alexandrescu V, Ivanciuc A, Cheng PY, Gross D, Brown CS, Mott JA. Risk factors associated with fatal influenza, Romania, October 2009-May 2011. Influenza Other Respir Viruses 2013; 8:8-12. [PMID: 24251915 PMCID: PMC4177790 DOI: 10.1111/irv.12209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 11/30/2022] Open
Abstract
Background Limited data are available from Central and Eastern Europe on risk factors for severe complications of influenza. Such data are essential to prioritize prevention and treatment resources and to adapt influenza vaccination recommendations. Objectives To use sentinel surveillance data to identify risk factors for fatal outcomes among hospitalized patients with severe acute respiratory infections (SARI) and among hospitalized patients with laboratory-confirmed influenza. Methods Retrospective analysis of case-based surveillance data collected from sentinel hospitals in Romania during the 2009/2010 and 2010/2011 winter influenza seasons was performed to evaluate risk factors for fatal outcomes using multivariate logistic regression. Results During 2009/2010 and 2010/2011, sentinel hospitals reported 661 SARI patients of which 230 (35%) tested positive for influenza. In the multivariate analyses, infection with influenza A(H1N1)pdm09 was the strongest risk factor for death among hospitalized SARI patients (OR: 6·6; 95% CI: 3·3–13·1). Among patients positive for influenza A(H1N1)pdm09 virus infection (n = 148), being pregnant (OR: 7·1; 95% CI: 1·6–31·2), clinically obese (OR: 2·9;95% CI: 1·6–31·2), and having an immunocompromising condition (OR: 3·7;95% CI: 1·1–13·4) were significantly associated with fatal outcomes. Conclusion These findings are consistent with several other investigations of risk factors associated with influenza A(H1N1)pdm09 virus infections. They also support the more recent 2012 recommendations by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) that pregnant women are an important risk group for influenza vaccination. Ongoing sentinel surveillance can be useful tool to monitor risk factors for complications of influenza virus infections during each influenza season, and pandemics as well.
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Jorgensen P, Wasley A, Mereckiene J, Cotter S, Weber JT, Brown CS. Unequal access to vaccines in the WHO European Region during the A(H1N1) influenza pandemic in 2009. Vaccine 2013; 31:4060-2. [DOI: 10.1016/j.vaccine.2013.06.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/21/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022]
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Hellenbrand W, Jorgensen P, Schweiger B, Falkenhorst G, Nachtnebel M, Greutélaers B, Traeder C, Wichmann O. Prospective hospital-based case-control study to assess the effectiveness of pandemic influenza A(H1N1)pdm09 vaccination and risk factors for hospitalization in 2009-2010 using matched hospital and test-negative controls. BMC Infect Dis 2012; 12:127. [PMID: 22650369 PMCID: PMC3464893 DOI: 10.1186/1471-2334-12-127] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 05/31/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND We performed a case-control study to estimate vaccine effectiveness (VE) for prevention of hospitalization due to pandemic influenza A(H1N1)pdm09 (pH1N1) and to identify risk factors for pH1N1 and acute respiratory infection (ARI) in 10 hospitals in Berlin from December 2009 to April 2010. METHODS Cases were patients aged 18-65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1) matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2) ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio) for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis. RESULTS Of 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%). The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100%) in the matched multivariate analysis and 46% (95%CI: -376-100%) in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI. CONCLUSIONS Though limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted the integrated assessment of risk factors for pH1N1-infection. To increase statistical power and to permit stratified analyses (e.g. VE for specific risk groups), the authors suggest pooling of future studies assessing effectiveness of influenza vaccines for prevention of severe disease from different centres.
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Affiliation(s)
- Wiebke Hellenbrand
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin, Germany.
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Nachtnebel M, Greutelaers B, Falkenhorst G, Jorgensen P, Dehnert M, Schweiger B, Träder C, Buda S, Eckmanns T, Wichmann O, Hellenbrand W. Lessons from a one-year hospital-based surveillance of acute respiratory infections in Berlin- comparing case definitions to monitor influenza. BMC Public Health 2012; 12:245. [PMID: 22452874 PMCID: PMC3362781 DOI: 10.1186/1471-2458-12-245] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 03/27/2012] [Indexed: 12/19/2022] Open
Abstract
Background Surveillance of severe acute respiratory infections (SARI) in sentinel hospitals is recommended to estimate the burden of severe influenza-cases. Therefore, we monitored patients admitted with respiratory infections (RI) in 9 Berlin hospitals from 7.12.2009 to 12.12.2010 according to different case definitions (CD) and determined the proportion of cases with influenza A(H1N1)pdm09 (pH1N1). We compared the sensitivity and specificity of CD for capturing pandemic pH1N1 cases. Methods We established an RI-surveillance restricted to adults aged ≤ 65 years within the framework of a pH1N1 vaccine effectiveness study, which required active identification of RI-cases. The hospital information-system was screened daily for newly admitted RI-patients. Nasopharyngeal swabs from consenting patients were tested by PCR for influenza-virus subtypes. Four clinical CD were compared in terms of capturing pH1N1-positives among hospitalized RI-patients by applying sensitivity and specificity analyses. The broadest case definition (CD1) was used for inclusion of RI-cases; the narrowest case definition (CD4) was identical to the SARI case definition recommended by ECDC/WHO. Results Over the study period, we identified 1,025 RI-cases, of which 283 (28%) met the ECDC/WHO SARI case definition. The percentage of SARI-cases among internal medicine admissions decreased from 3.2% (calendar-week 50-2009) to 0.2% (week 25-2010). Of 354 patients tested by PCR, 20 (6%) were pH1N1-positive. Two case definitions narrower than CD1 but -in contrast to SARI- not requiring shortness of breath yielded the largest areas under the Receiver-Operator-Curve. Heterogeneity of proportions of patients admitted with RI between hospitals was significant. Conclusions Comprehensive surveillance of RI cases was feasible in a network of community hospitals. In most settings, several hospitals should be included to ensure representativeness. Although misclassification resulting from failure to obtain symptoms in the hospital information-system cannot be ruled out, a high proportion of hospitalized PCR-positive pH1N1-patients (45%) did not fulfil the SARI case-definition that included shortness of breath or difficulty breathing. Thus, to assess influenza-related disease burden in hospitals, broader, alternative case definitions should be considered.
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Affiliation(s)
- Matthias Nachtnebel
- Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, Berlin 13086, Germany.
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Martirosyan L, Paget WJ, Jorgensen P, Brown CS, Meerhoff TJ, Pereyaslov D, Mott JA. The community impact of the 2009 influenza pandemic in the WHO European region: a comparison with historical seasonal data from 28 countries. BMC Infect Dis 2012; 12:36. [PMID: 22325082 PMCID: PMC3292513 DOI: 10.1186/1471-2334-12-36] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 02/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The world has recently experienced the first influenza pandemic of the 21st century that lasted 14 months from June 2009 to August 2010. This study aimed to compare the timing, geographic spread and community impact during the winter wave of influenza pandemic A (H1N1) 2009 to historical influenza seasons in countries of the WHO European region. METHODS We assessed the timing of pandemic by comparing the median peak of influenza activity in countries of the region during the last seven influenza seasons. The peaks of influenza activity were selected by two independent researchers using predefined rules. The geographic spread was assessed by correlating the peak week of influenza activity in included countries against the longitude and latitude of the central point in each country. To assess the community impact of pandemic influenza, we constructed linear regression models to compare the total and age-specific influenza-like-illness (ILI) or acute respiratory infection (ARI) rates reported by the countries in the pandemic season to those observed in the previous six influenza seasons. RESULTS We found that the influenza activity reached its peak during the pandemic, on average, 10.5 weeks (95% CI 6.4-14.2) earlier than during the previous 6 seasons in the Region, and there was a west to east spread of pandemic A(H1N1) influenza virus in the western part of the Region. A regression analysis showed that the total ILI or ARI rates were not higher than historical rates in 19 of the 28 countries. However, in countries with age-specific data, there were significantly higher consultation rates in the 0-4 and/or 5-14 age groups in 11 of the 20 countries. CONCLUSIONS Using routine influenza surveillance data, we found that pandemic influenza had several differential features compared to historical seasons in the region. It arrived earlier, caused significantly higher number of outpatient consultations in children in most countries and followed west to east spread that was previously observed during some influenza seasons with dominant A (H3N2) ifluenza viruses. The results of this study help to understand the epidemiology of 2009 influenza pandemic and can be used for pandemic preparedness planning.
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Affiliation(s)
- Liana Martirosyan
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
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Dueland S, Hagness M, Line PD, Scholz T, Jorgensen P, Fosby B, Mathisen O, Gladhaug I, Foss A. Liver transplantation (Ltx) in patients with nonresectable liver metastases from colorectal carcinoma. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
577 Background: Liver resection is considered the only curative treatment of liver metastases (mets) from colo-rectal (CRC) tumors. Ltx is standard of care in selected patients with hepatocellular carcinoma, cholangiocarcinoma and neuroendocrine tumors. Patients with non-resectable liver metastases (mets) from colo-rectal cancer (CRC) receiving palliative chemotherapy have a median survival of about 2 and 1 year from start of 1. and 2. line chemotherapy, respectively. Overall 5 years survival in CRC patients after start of palliative chemotherapy is about 5-10%. In this study we examined overall survival after Ltx in selected CRC patients. The primary endpoint of the study was overall survival at 2 years after Ltx Methods: Major inclusion criteria were: non-resectable liver mets, no extra hepatic disease or local relapse determined by PET/CT scan, CT- or MRI scan and colonoscopy. No mets. on frozen section biopsies at time of surgery, ECOG 0-1, at least one line of chemotherapy for metastatic disease. Postoperative immunosuppresion: mTOR inhibitor (Rapamune), mycofpenolmofetil and tapering doses of prednisolon. Quality of life questionnaire (EORTC-C30) pre Ltx, 3, 6 and 12 months post Ltx. Results: Thirteen men and 8 women with non-resectable liver only CRC liver mets received Ltx in the period of Nov 2006 to March 2011. Median age was 56 years (range 45-65 years). Thirteen patients had colon cancer and 8 patients had rectal cancer. The T-stage of the primary tumor was T2,T3 and T4 in 2, 16 and 3 patients, respectively. N status of the primary tumor was: pN0, pN1 and pN2 all 7 patients. Nine patients had received 1.line chemotherapy and 12 patients had received 2. or 3.line therapy. The median number of liver mets was 8 (range 2-40) and the median size of the largest lesion was 4.5cm (range 2.8-13cm). The patients had good, stabile or increased Global Health Score and Physical Function at all time points after Ltx. Fifteen patients with follow-up of 2 years or more or death within 2 years of Ltx had 2 years overall survival of 87%. Conclusions: Long term survival is obtained after Ltx in selected patients with non-resectable liver mets from CRC. The patients reported good quality of life and physical function after Ltx.
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Affiliation(s)
- Svein Dueland
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Morten Hagness
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Pal-Dag Line
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Tim Scholz
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - P. Jorgensen
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Bjarte Fosby
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Ostein Mathisen
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Ivar Gladhaug
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Aksel Foss
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway
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Mereckiene J, Cotter S, Weber JT, Nicoll A, D'Ancona F, Lopalco PL, Johansen K, Wasley AM, Jorgensen P, Lévy-Bruhl D, Giambi C, Stefanoff P, Dematte L, O'Flanagan D. Influenza A(H1N1)pdm09 vaccination policies and coverage in Europe. ACTA ACUST UNITED AC 2012; 17. [PMID: 22297139 DOI: 10.2807/ese.17.04.20064-en] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In August 2010 the Vaccine European New Integrated Collaboration Effort (VENICE) project conducted a survey to collect information on influenza A(H1N1)pdm09 vaccination policies and vaccination coverage in the European Union (EU), Norway and Iceland. Of 29 responding countries, 26 organised national pandemic influenza vaccination and one country had recommendations for vaccination but did not have a specific programme. Of the 27 countries with vaccine recommendations, all recommended it for healthcare workers and pregnant women. Twelve countries recommended vaccine for all ages. Six and three countries had recommendations for specific age groups in children and in adults, countries for specific adult age groups. Most countries recommended vaccine for those in new risk groups identified early in the pandemic such as morbid obese and people with neurologic diseases. Two thirds of countries started their vaccination campaigns within a four week period after week 40/2009. The reported vaccination coverage varied between countries from 0.4% to 59% for the entire population (22 countries); 3% to 68% for healthcare workers (13 countries); 0% to 58% for pregnant women (12 countries); 0.2% to 74% for children (12 countries). Most countries identified similar target groups for pandemic vaccine, but substantial variability in vaccination coverage was seen. The recommendations were in accordance with policy advice from the EU Health Security Committee and the World Health Organization.
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Affiliation(s)
- J Mereckiene
- Health Protection Surveillance Centre, Dublin, Ireland.
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Thiam S, Thior M, Faye B, Ndiop M, Diouf ML, Diouf MB, Diallo I, Fall FB, Ndiaye JL, Albertini A, Lee E, Jorgensen P, Gaye O, Bell D. Major reduction in anti-malarial drug consumption in Senegal after nation-wide introduction of malaria rapid diagnostic tests. PLoS One 2011; 6:e18419. [PMID: 21494674 PMCID: PMC3071817 DOI: 10.1371/journal.pone.0018419] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 03/05/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND While WHO recently recommended universal parasitological confirmation of suspected malaria prior to treatment, debate has continued as to whether wide-scale use of rapid diagnostic tests (RDTs) can achieve this goal. Adherence of health service personnel to RDT results has been poor in some settings, with little impact on anti-malarial drug consumption. The Senegal national malaria control programme introduced universal parasite-based diagnosis using malaria RDTs from late 2007 in all public health facilities. This paper assesses the impact of this programme on anti-malarial drug consumption and disease reporting. METHODS AND FINDINGS Nationally-collated programme data from 2007 to 2009 including malaria diagnostic outcomes, prescription of artemisinin-based combination therapy (ACT) and consumption of RDTs in public health facilities, were reviewed and compared. Against a marked seasonal variation in all-cause out-patient visits, non-malarial fever and confirmed malaria, parasite-based diagnosis increased nationally from 3.9% of reported malaria-like febrile illness to 86.0% over a 3 year period. The prescription of ACT dropped throughout this period from 72.9% of malaria-like febrile illness to 31.5%, reaching close equivalence to confirmed malaria (29.9% of 584,873 suspect fever cases). An estimated 516,576 courses of inappropriate ACT prescription were averted. CONCLUSIONS The data indicate high adherence of anti-malarial prescribing practice to RDT results after an initial run-in period. The large reduction in ACT consumption enabled by the move from symptom-based to parasite-based diagnosis demonstrates that effective roll-out and use of malaria RDTs is achievable on a national scale through well planned and structured implementation. While more detailed information on management of parasite-negative cases is required at point of care level to assess overall cost-benefits to the health sector, considerable cost-savings were achieved in ACT procurement. Programmes need to be allowed flexibility in management of these funds to address increases in other programmatic costs that may accrue from improved diagnosis of febrile disease.
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Affiliation(s)
- Sylla Thiam
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Moussa Thior
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Babacar Faye
- Faculté de Médecine,
Université Cheikh Anta Diop de Dakar, Fann Dakar,
Sénégal
| | - Médoune Ndiop
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Mamadou Lamine Diouf
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Mame Birame Diouf
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Ibrahima Diallo
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Fatou Ba Fall
- Programme National de lutte contre le
Paludisme, Ministère de la Santé, Dakar Fann, Senegal
| | - Jean Louis Ndiaye
- Faculté de Médecine,
Université Cheikh Anta Diop de Dakar, Fann Dakar,
Sénégal
| | - Audrey Albertini
- Foundation for Innovative New Diagnostics
(FIND), Geneva, Switzerland
| | - Evan Lee
- Foundation for Innovative New Diagnostics
(FIND), Geneva, Switzerland
| | | | - Oumar Gaye
- Faculté de Médecine,
Université Cheikh Anta Diop de Dakar, Fann Dakar,
Sénégal
| | - David Bell
- Global Malaria Programme, World Health
Organization, Geneva, Switzerland
- * E-mail:
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26
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Jorgensen P, Nambanya S, Gopinath D, Hongvanthong B, Luangphengsouk K, Bell D, Phompida S, Phetsouvanh R. High heterogeneity in Plasmodium falciparum risk illustrates the need for detailed mapping to guide resource allocation: a new malaria risk map of the Lao People's Democratic Republic. Malar J 2010; 9:59. [PMID: 20181273 PMCID: PMC2841197 DOI: 10.1186/1475-2875-9-59] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Accepted: 02/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate information on the geographical distribution of malaria is important for efficient resource allocation. The Lao People's Democratic Republic has experienced a major decline in malaria morbidity and mortality in the past decade. However, efforts to respond effectively to these changes have been impeded by lack of detailed data on malaria distribution. In 2008, a countrywide survey on Plasmodium falciparum diagnosed in health centres and villages was initiated to develop a detailed P. falciparum risk map with the aim to identify priority areas for malaria control, estimate population at risk, and guide resource allocation in the Lao People's Democratic Republic. METHODS P. falciparum incidence data were collected from point-referenced villages and health centres for the period 2006-2008 during a country-wide survey between December 2008 and January 2009. Using the highest recorded annual rate, continuous surfaces of P. falciparum incidence were produced by the inverse distance weighted interpolation technique. RESULTS Incidence rates were obtained from 3,876 villages and 685 health centres. The risk map shows that P. falciparum is highly heterogeneous in the northern and central regions of the country with large areas of no transmission. In the southern part, transmission is pervasive and the risk of P. falciparum is high. It was estimated that 3.4 million people (60% of the population) live at risk of malaria. CONCLUSIONS This paper presents the first comprehensive malaria risk map of the Lao People's Democratic Republic based entirely on empirical data. The estimated population at risk is substantially lower than previous estimates, reflecting the presence of vast areas with focal or no malaria transmission as identified in this study. These findings provide important guidance for malaria control interventions in the Lao People's Democratic Republic, and underline the need for detailed data on malaria to accurately predict risk in countries with heterogeneous transmission.
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Jorgensen P, Marcus U, Albrecht H, Suttorp N, Schürmann D. Serial knife stabbings with HIV exposure--implications for post-exposure prophylaxis. J Infect 2009; 60:76-8. [PMID: 19840818 DOI: 10.1016/j.jinf.2009.10.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 08/20/2009] [Accepted: 10/14/2009] [Indexed: 10/20/2022]
Abstract
Thirty-three persons became victims of a serial knife stabbing incident. One of the first victims one day later disclosed that he was HIV-infected. Thereafter thirty-one victims initiated HIV post-exposure prophylaxis (PEP), one exposed patient declined. None of the victims evaluated had seroconverted six months later. In most such incidents HIV exposure will be difficult to rule out as reliable information on the HIV serostatus of all serial victims will be lacking. It appears prudent, however, to inform serial stab victims about the potential risk of HIV transmission and to at least consider PEP in such scenarios.
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Affiliation(s)
- Pernille Jorgensen
- Department of Infectious Diseases Epidemiology, Robert Koch Institute, Berlin, Germany
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Abstract
We estimated the total number of human alveolar echinococcosis cases in Germany from 2003 through 2005 using the multiple source capture-recapture method. We found a 3-fold higher incidence of the disease than that shown by national surveillance data. We propose a revision of the reporting system to increase case ascertainment.
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Bakulin A, Mateeva A, Mehta K, Jorgensen P, Ferrandis J, Herhold IS, Lopez J. Virtual source applications to imaging and reservoir monitoring. ACTA ACUST UNITED AC 2007. [DOI: 10.1190/1.2748490] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chiodini PL, Bowers K, Jorgensen P, Barnwell JW, Grady KK, Luchavez J, Moody AH, Cenizal A, Bell D. The heat stability of Plasmodium lactate dehydrogenase-based and histidine-rich protein 2-based malaria rapid diagnostic tests. Trans R Soc Trop Med Hyg 2007; 101:331-7. [PMID: 17212967 DOI: 10.1016/j.trstmh.2006.09.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Revised: 09/01/2006] [Accepted: 09/26/2006] [Indexed: 11/22/2022] Open
Abstract
Malaria rapid diagnostic tests (RDTs) have performed well in a variety of studies, but recent reports have described sensitivity for Plasmodium falciparum as significantly lower than that required for operational deployment. Exposure to high temperature has been suggested as an explanation. This study assessed the temperature stability of two different Plasmodium lactate dehydrogenase (pLDH)- and three histidine-rich protein 2 (HRP2)-detecting RDTs. One HRP2 test proved insufficiently sensitive for assessment. After incubation at 35, 45 and 60 degrees C, two RDTs detecting pLDH showed a substantial fall in percentage test line positivity over time, which was not seen with the remaining two HRP-2-based RDTs. For the particular products studied, variability was high, with the pLDH-based RDTs being less sensitive than HRP2-based RDTs against the sample of P. falciparum used and more susceptible to heat-induced damage, but the reasons for this are unclear. The performance of malaria RDTs can be adversely affected at the temperatures to which they will be exposed when transported to, and used in, the rural tropics.
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Affiliation(s)
- Peter L Chiodini
- Department of Clinical Parasitology, Hospital for Tropical Diseases, London, UK.
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Rennie W, Phetsouvanh R, Lupisan S, Vanisaveth V, Hongvanthong B, Phompida S, Alday P, Fulache M, Lumagui R, Jorgensen P, Bell D, Harvey S. Minimising human error in malaria rapid diagnosis: clarity of written instructions and health worker performance. Trans R Soc Trop Med Hyg 2006; 101:9-18. [PMID: 17049572 DOI: 10.1016/j.trstmh.2006.03.011] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2005] [Revised: 11/23/2005] [Accepted: 03/31/2006] [Indexed: 11/24/2022] Open
Abstract
The usefulness of rapid diagnostic tests (RDT) in malaria case management depends on the accuracy of the diagnoses they provide. Despite their apparent simplicity, previous studies indicate that RDT accuracy is highly user-dependent. As malaria RDTs will frequently be used in remote areas with little supervision or support, minimising mistakes is crucial. This paper describes the development of new instructions (job aids) to improve health worker performance, based on observations of common errors made by remote health workers and villagers in preparing and interpreting RDTs, in the Philippines and Laos. Initial preparation using the instructions provided by the manufacturer was poor, but improved significantly with the job aids (e.g. correct use both of the dipstick and cassette increased in the Philippines by 17%). However, mistakes in preparation remained commonplace, especially for dipstick RDTs, as did mistakes in interpretation of results. A short orientation on correct use and interpretation further improved accuracy, from 70% to 80%. The results indicate that apparently simple diagnostic tests can be poorly performed and interpreted, but provision of clear, simple instructions can reduce these errors. Preparation of appropriate instructions and training as well as monitoring of user behaviour are an essential part of rapid test implementation.
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Jorgensen P, Chanthap L, Rebueno A, Tsuyuoka R, Bell D. Malaria rapid diagnostic tests in tropical climates: the need for a cool chain. Am J Trop Med Hyg 2006; 74:750-4. [PMID: 16687674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Malaria control programs in endemic countries increasingly rely on early case detection and treatment at village level. The rapid diagnostic tests (RDTs) and accompanying drugs on which the success of these programs depends deteriorate to varying degrees at high temperatures. To assess the ability of health systems to maintain RDTs within manufacturers' specifications, we monitored temperatures in the delivery chain from manufacturer through to the village health worker in Cambodia and the Philippines. In both countries, storage temperatures regularly exceeded those recommended for most RDTs intended for field use, whereas temperatures during transport greatly exceeded the lower and upper limits. These results emphasize the need for good logistical planning during the introduction of point-of-care tests in tropical countries and the importance of considering the stability of diagnostic tests during procurement.
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Affiliation(s)
- Pernille Jorgensen
- World Health Organization-Regional Office for the Western Pacific, Manila, The Philippines
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Abstract
Accurate estimates of the global burden of malaria are important for planning, monitoring and advocacy. Snow et al. attempt to address the shortcomings of previous estimates of the incidence of malaria caused by Plasmodium falciparum by combining current and historical data. However, we believe that the design of their model and its inputs have led to a significant overestimate of the malaria burden outside Africa--as in the example of the World Health Organization (WHO) western Pacific region (WPR), for which their model predicts 60 times the 2002 incidence reported by national malaria-control programmes.
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Affiliation(s)
- David R Bell
- Malaria, Other Vector-borne and Parasitic Diseases Unit, World Health Organization Regional Office for the Western Pacific, PO Box 2932, Manila, Philippines.
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Jorgensen P, Breitkreutz BJ, Breitkreutz K, Stark C, Liu G, Cook M, Sharom J, Nishikawa JL, Ketela T, Bellows D, Breitkreutz A, Rupes I, Boucher L, Dewar D, Vo M, Angeli M, Reguly T, Tong A, Andrews B, Boone C, Tyers M. Harvesting the genome's bounty: integrative genomics. Cold Spring Harb Symp Quant Biol 2004; 68:431-43. [PMID: 15338646 DOI: 10.1101/sqb.2003.68.431] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- P Jorgensen
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada M5G 1X5
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Bellows D, Jorgensen P, Tyers M, Bellows D. 102 The synthetic lethal trap: a general approach for screening small-molecule protein inhibitors using genetic triangulation in the yeast Saccharomyces cerevisiae. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Trautmann S, Wolfe BA, Jorgensen P, Tyers M, Gould KL, McCollum D. Fission yeast Clp1p phosphatase regulates G2/M transition and coordination of cytokinesis with cell cycle progression. Curr Biol 2001; 11:931-40. [PMID: 11448769 DOI: 10.1016/s0960-9822(01)00268-8] [Citation(s) in RCA: 154] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Saccharomyces cerevisiae the mitotic-exit network (MEN) functions in anaphase to promote the release of the Cdc14p phosphatase from the nucleolus. This release causes mitotic exit via inactivation of the cyclin-dependent kinase (Cdk). Cdc14p-like proteins are highly conserved; however, it is unclear if these proteins regulate mitotic exit as in S. cerevisiae. In Schizosaccharomyces pombe a signaling pathway homologous to the MEN and termed the septation initiation network (SIN) is required not for mitotic exit, but for initiation of cytokinesis and for a cytokinesis checkpoint that inhibits further cell cycle progression until cytokinesis is complete. RESULTS We have identified the S. pombe Cdc14p homolog, Clp1p, and show that it is not required for mitotic exit but rather functions together with the SIN in coordinating cytokinesis with the nuclear-division cycle. As cells enter mitosis, Clp1p relocalizes from the nucleolus to the spindle and site of cell division. Clp1p exit from the nucleolus does not depend on the SIN, but the SIN is required for keeping Clp1p out of the nucleolus until completion of cytokinesis. Clp1p, in turn, may promote the activation of the SIN by antagonizing Cdk activity until cytokinesis is complete and thus ensuring that cytokinesis is completed prior to the initiation of the next cell cycle. In addition to its roles in anaphase, Clp1p regulates the G2/M transition since cells deleted for clp1 enter mitosis precociously and cells overexpressing Clp1p delay mitotic entry. Unlike Cdc14p, Clp1p appears to antagonize Cdk activity by preventing dephosphorylation of Cdc2p on tyrosine. CONCLUSIONS S. pombe Clp1p affects cell cycle progression in a markedly different manner than its S. cerevisiae homolog, Cdc14p. This finding raises the possibility that related phosphatases in animal cells will prove to have important roles in coordinating the onset of cytokinesis with the events of mitosis.
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Affiliation(s)
- S Trautmann
- Department of Molecular Genetics and Microbiology, University of Massachusetts Medical School, Worcester, MA 01605, USA
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Abstract
The ubiquitin system drives the cell division cycle by the timely destruction of numerous regulatory proteins. Remarkably, the two main activities that catalyze substrate ubiquitination in the cell cycle, the Skp1-Cdc53/cullin-F-box protein (SCF) complexes and the anaphase-promoting complex/cyclosome (APC/C), define a new superfamily of E3 ubiquitin ligases, all based on related cullin and RING-H2 finger protein subunits. The circuits that interconnect the SCF, APC/C and cyclin-dependent kinase activities form a master oscillator that coordinates the replication and segregation of the genome.
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Affiliation(s)
- M Tyers
- Programme in Molecular Biology and Cancer, Graduate Department of Molecular and Medical Genetics, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, M5G 1X5, M5S 1A8, Canada.
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Abstract
The recent identification of an essential RING-H2 finger protein in the SCF E3 ubiquitin ligase complex of budding yeast has uncovered a family of related E3 enzymes, including the other main cell cycle E3 complex, the anaphase promoting complex (APC). Recent insights into APC-dependent proteolysis include a novel protease activity that dissolves cohesion between sister chromatids at anaphase, and a crucial phosphatase, Cdc14, whose release from the nucleolus eliminates cyclin-dependent kinase activity and thereby drives exit from mitosis.
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Affiliation(s)
- P Jorgensen
- Programme in Molecular Biology and Cancer, Graduate Department of Molecular and Medical Genetics, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, M5G 1X5, M5S 1A8, Canada
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Hartmann R, Norby PL, Martensen PM, Jorgensen P, James MC, Jacobsen C, Moestrup SK, Clemens MJ, Justesen J. Activation of 2'-5' oligoadenylate synthetase by single-stranded and double-stranded RNA aptamers. J Biol Chem 1998; 273:3236-46. [PMID: 9452437 DOI: 10.1074/jbc.273.6.3236] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A number of small RNA molecules that are high affinity ligands for the 46-kDa form of human 2'-5' oligoadenylate synthetase have been identified by the SELEX method. Surface plasmon resonance analysis indicates that these RNAs bind to the enzyme with dissociation constants in the nanomolar range. Competition experiments indicate that the binding site for the small RNAs on the 2'-5' oligoadenylate synthetase molecule at least partially overlaps that for the synthetic double-stranded RNA, poly(I).poly(C). Several of the RNAs function as potent activators of 2'-5' oligoadenylate synthetase in vitro, although there is no correlation between binding affinity and ability to activate. The RNA aptamers having the strongest activation potential appear to have few base-paired regions. This suggests that 2'-5' oligoadenylate synthetase, which has previously been believed to be activated only by double-stranded RNA, can also be activated by RNA ligands with little secondary structure. Since 2'-5' oligoadenylate synthetase possesses no homology to other known RNA-binding proteins, the development of small specific ligands by SELEX should facilitate studies of RNA-protein interactions and may reveal novel features of the structure-function relationships involving this enzyme.
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Affiliation(s)
- R Hartmann
- Department of Molecular and Structural Biology, University of Aarhus, C. F. Mollers Allé, Building 130, DK-8000 Aarhus C, Denmark
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Nielsen AL, Norby PL, Pedersen FS, Jorgensen P. E-box sequence and context-dependent TAL1/SCL modulation of basic helix-loop-helix protein-mediated transcriptional activation. J Biol Chem 1996; 271:31463-9. [PMID: 8940159 DOI: 10.1074/jbc.271.49.31463] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
TAL1/SCL is a basic helix-loop-helix (bHLH) oncoprotein that is expressed in several cell lines including many hematolymphoid cells, but not in T- and B-lineage cells. The TAL1 gene was originally discovered as being transcriptionally activated by chromosomal rearrangements in T-cell acute lymphoblastic leukemia (T-ALL). Here we have shown that TAL1 and the ubiquitously expressed murine bHLH transcription factor ALF1 formed heterodimers that, compared with ALF1 homodimers, had a more restricted E-box specificity and bound preferentially to the glucocorticoid-responsive E-box (Egre) motif (AACAGATGGT). Overexpression of the dominant inhibitory HLH protein Id1 in NIH3T3 cells reduced the transcriptional activity mediated by ALF1 homodimers, whereas the transcriptional activity mediated by TAL1/ALF1 heterodimers was resistant to Id overexpression. Our results show that ALF1 may serve as a dimerization partner for the bHLH oncoprotein TAL1 and form a complex with a distinctive DNA binding property. These findings support the hypothesis that the leukemic characteristics of the TAL1 oncoprotein could be mediated by activation of a set of target genes as heterodimeric complexes with ubiquitously expressed bHLH transcription factors such as ALF1 and that a principal role of TAL1 might be to neutralize an Id-mediated inactivation.
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Affiliation(s)
- A L Nielsen
- Department of Molecular Biology, Aarhus University, C. F. Mollers Allé 130, DK-8000 Aarhus C, Denmark.
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Affiliation(s)
- A L Nielsen
- Department of Molecular Biology, Aarhus University, Denmark
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Luo Y, gren H, Koch H, Jorgensen P, Helgaker T. Random-phase calculations of frequency-dependent polarizabilities and hyperpolarizabilities of long polyene chains. Phys Rev B Condens Matter 1995; 51:14949-14957. [PMID: 9978448 DOI: 10.1103/physrevb.51.14949] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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gren H, Carravetta V, Jensen HJ, Jorgensen P, Olsen J. Multiconfiguration linear-response approaches to the calculation of absolute photoionization cross sections: HF, H2O, and Ne. Phys Rev A 1993; 47:3810-3823. [PMID: 9909388 DOI: 10.1103/physreva.47.3810] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
A characterization of a specialized transducing lambda phage for the deo operon (lambdaddeo), and some composite colE1-deo plasmids is given in this paper. This includes localization of the RSmaI, RHind/III, RBamI, and REcoRI sensitive sites. The deo genes have been localized by construction of composite colE1-deo plasmids. Using the DNA fragments, obtained by digestion with REcoRI and RHindIII, respectively, as templates in an in vitro protein synthesizing system, it has been possible to give the direction of transcription and the exact location of the deo genes, relative to the endonuclease sites. Furthermore, the cytO,P and deoO,P regions have been mapped relative to the structural genes. Supercoiled co1E1-deo DNA has been used as template in the in vitro system; this DNA gives essentially the same results as the endonuclease-fragmented DNA. The use of the different types of templates is discussed.
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Abstract
Lambda-transducing phages carrying segments of the Escherichia coli chromosome in the aroE-trkA region have been isolated and shown by hybridization to carry an rRNA gene (rrnD). The most likely gene order is trkA aroE rrnD. The EcoRI and SmaI endonuclease cutting pattern of the rrnD gene is identical with the one of rrnB, differented from rrnC.
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Abstract
We have studied the mechanism of the specific inhibition of ribosomal RNA synthesis by ppGpp in a purified system using as templates E. coli DNA and DNA from lambdad5ilv, which carries a rRNA cistron from E. coli. Ribosomal RNA synthesis, as well as its inhibition by ppGpp, are critically salt-dependent. Of a number of guanosine phosphates tested, only pppGpp (MS II) mimicked the action of ppGpp, establishing the specificity of ppGpp. The two templates gave similar results for rRNA synthesis in all experiments. By using the initiation inhibitor rifampicin, we could show that the specific inhibition of rRNA synthesis by ppGpp is due to its effect on rRNA initiation. The somewhat variable inhibition of RNA synthesis in general by ppGpp is mainly or wholly a consequence of premature chain termination. We propose that ppGpp specifically inhibits rRNA synthesis by acting on the formation of the so-called "closed-promoter complex".
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Lorentzen F, Jorgensen P, Nielsen E, Nyberg G, Hvidt S. Alprenolol in angina pectoris. A comparative study of the tablet form and slow-release formulation. Med J Aust 1975; 2:668-73. [PMID: 1107769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In a double-blind crossover trial in angina pectoris patients, alprenolol in a slow-release formulation (Aptin Durules) was compared with ordinary Aptin tablets. Four hundred mg per day in tablets given four times a day produced the same increase in exercise tolerance five hours after last intake as did an equivalent dose of slow-release formulation given twice per day nine hours after intake. Aptin Durules in double the dosage had a considerably greater effect. An optimal, sustained and antianginal effect of alprenolol is best achieved by giving 400 to 800 mg per day of slow-release formulation with 10 to 12 hours' dosage interval.
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