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Assessment of Seasonal Influenza A Virus-Specific CD4 T-Cell Responses to 2009 Pandemic H1N1 Swine-Origin Influenza A Virus? †  

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Very limited evidence has been reported to show human adaptive immune responses to the 2009 pandemic H1N1 swine-origin influenza A virus (S-OIV). We studied 17 S-OIV peptides homologous to immunodominant CD4 T epitopes from hemagglutinin (HA), neuraminidase (NA), nuclear protein (NP), M1 matrix protein (MP), and PB1 of a seasonal H1N1 strain. We concluded that 15 of these 17 S-OIV peptides would induce responses of seasonal influenza virus-specific T cells. Of these, seven S-OIV sequences wer...

Ge, Xinhui; Tan, Venus; Bollyky, Paul L.; Standifer, Nathan E.; James, Eddie A.; Kwok, William W.

2010-01-01

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Immunization of pigs with an attenuated pseudorabies virus recombinant expressing the haemagglutinin of pandemic swine origin H1N1 influenza A virus.  

Science.gov (United States)

Pigs can be severely harmed by influenza, and represent important reservoir hosts, in which new human pathogens such as the recent pandemic swine-origin H1N1 influenza A virus can arise by mutation and reassortment of genome segments. To obtain novel, safe influenza vaccines for pigs, and to investigate the antigen-specific immune response, we modified an established live-virus vaccine against Aujeszky's disease of swine, pseudorabies virus (PrV) strain Bartha (PrV-Ba), to serve as vector for the expression of haemagglutinin (HA) of swine-origin H1N1 virus. To facilitate transgene insertion, the genome of PrV-Ba was cloned as a bacterial artificial chromosome. HA expression occurred under control of the human or murine cytomegalovirus immediate early promoters (P-HCMV, P-MCMV), but could be substantially enhanced by synthetic introns and adaptation of the codon usage to that of PrV. However, despite abundant expression, the heterologous glycoprotein was not detectably incorporated into mature PrV particles. Replication of HA-expressing PrV in cell culture was only slightly affected compared to that of the parental virus strain. A single immunization of pigs with the PrV vector expressing the codon-optimized HA gene under control of P-MCMV induced high levels of HA-specific antibodies. The vaccinated animals were protected from clinical signs after challenge with a related swine-origin H1N1 influenza A virus, and challenge virus shedding was significantly reduced. PMID:24431235

Klingbeil, Katharina; Lange, Elke; Teifke, Jens P; Mettenleiter, Thomas C; Fuchs, Walter

2014-04-01

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Recombinant Soluble, Multimeric HA and NA Exhibit Distinctive Types of Protection against Pandemic Swine-Origin 2009 A(H1N1) Influenza Virus Infection in Ferrets?  

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The emergence and subsequent swift and global spread of the swine-origin influenza virus A(H1N1) in 2009 once again emphasizes the strong need for effective vaccines that can be developed rapidly and applied safely. With this aim, we produced soluble, multimeric forms of the 2009 A(H1N1) HA (sHA3) and NA (sNA4) surface glycoproteins using a virus-free mammalian expression system and evaluated their efficacy as vaccines in ferrets. Immunization twice with 3.75-?g doses of these antigens elici...

Bosch, Berend Jan; Bodewes, Rogier; Vries, Robert P.; Kreijtz, Joost H. C. M.; Bartelink, Willem; Amerongen, Geert; Rimmelzwaan, Guus F.; Haan, Cornelis A. M.; Osterhaus, Albert D. M. E.; Rottier, Peter J. M.

2010-01-01

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Characterization of an Artificial Swine-Origin Influenza Virus with the Same Gene Combination as H1N1/2009 Virus: A Genesis Clue of Pandemic Strain  

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Pandemic H1N1/2009 influenza virus, derived from a reassortment of avian, human, and swine influenza viruses, possesses a unique gene segment combination that had not been detected previously in animal and human populations. Whether such a gene combination could result in the pathogenicity and transmission as H1N1/2009 virus remains unclear. In the present study, we used reverse genetics to construct a reassortant virus (rH1N1) with the same gene combination as H1N1/2009 virus (NA and M genes...

Zhao, Xueli; Sun, Yipeng; Pu, Juan; Fan, Lihong; Shi, Weimin; Hu, Yanxin; Yang, Jun; Xu, Qi; Wang, Jingjing; Hou, Dongjun; Ma, Guangpeng; Liu, Jinhua

2011-01-01

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Recombinant Soluble, Multimeric HA and NA Exhibit Distinctive Types of Protection against Pandemic Swine-Origin 2009 A(H1N1) Influenza Virus Infection in Ferrets?  

Science.gov (United States)

The emergence and subsequent swift and global spread of the swine-origin influenza virus A(H1N1) in 2009 once again emphasizes the strong need for effective vaccines that can be developed rapidly and applied safely. With this aim, we produced soluble, multimeric forms of the 2009 A(H1N1) HA (sHA3) and NA (sNA4) surface glycoproteins using a virus-free mammalian expression system and evaluated their efficacy as vaccines in ferrets. Immunization twice with 3.75-?g doses of these antigens elicited strong antibody responses, which were adjuvant dependent. Interestingly, coadministration of both antigens strongly enhanced the HA-specific but not the NA-specific responses. Distinct patterns of protection were observed upon challenge inoculation with the homologous H1N1 virus. Whereas vaccination with sHA3 dramatically reduced virus replication (e.g., by lowering pulmonary titers by about 5 log10 units), immunization with sNA4 markedly decreased the clinical effects of infection, such as body weight loss and lung pathology. Clearly, optimal protection was achieved by the combination of the two antigens. Our observations demonstrate the great vaccine potential of multimeric HA and NA ectodomains, as these can be easily, rapidly, flexibly, and safely produced in high quantities. In particular, our study underscores the underrated importance of NA in influenza vaccination, which we found to profoundly and specifically contribute to protection by HA. Its inclusion in a vaccine is likely to reduce the HA dose required and to broaden the protective immunity.

Bosch, Berend Jan; Bodewes, Rogier; de Vries, Robert P.; Kreijtz, Joost H. C. M.; Bartelink, Willem; van Amerongen, Geert; Rimmelzwaan, Guus F.; de Haan, Cornelis A. M.; Osterhaus, Albert D. M. E.; Rottier, Peter J. M.

2010-01-01

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Dynamic variations in the peripheral blood lymphocyte subgroups of patients with 2009 pandemic H1N1 swine-origin influenza A virus infection  

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Full Text Available Abstract Background Novel Influenza A (H1N1 is an acute respiratory infectious disease. Animal experiments indicated that when H1N1 virus infected early hosts, it showed strong CD4+, CD8+, and CD4+CD25+ T cell reactions. The aim of this study was to investigate the dynamic fluctuations of the peripheral blood lymphocyte subgroups in patients infected with H1N1 swine-origin influenza A virus (S-OIV. Methods The frequency of T cells, B cells, natural killer (NK cells, and regulatory T cells (Treg in 36 severe H1N1 and 40 moderate H1N1 patients were detected at different periods by flow cytometry. In parallel, serum cytokines were detected by enzyme-linked immunosorbent assay and C-reactive protein (CRP was analyzed through an image-type automatic biochemical analyzer. In addition, 20 healthy volunteers, who were not infected with 2009 H1N1 virus, were selected as controls. Results The frequency of NK cells were decreased in all cases and CD19+ B cells were increased in severe cases than those of the controls. At 1-2d from onset, the frequency of CD4+ and CD4+CD25+ T cells in moderate cases was higher than in the severe cases. Serum cytokines, specifically IL-2, IL-4, IL-6, IL-10, and IFN-? exhibited no significant change both in the moderate and the severe cases during the whole monitoring process. In the early stage of the disease, serum CRP levels in the severe and moderate groups were significantly higher than that in the control group. Conclusions Patients showed different lymphocyte subgroup distributions between mild and severe cases, which might affect the incidence and development of 2009 H1N1.

Wu Wei

2011-05-01

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Variant (Swine Origin) Influenza Viruses in Humans  

Science.gov (United States)

... States since 2005 Background On Variant Influenza Viruses Swine flu viruses do not normally infect humans. However, sporadic ... about 2009 H1N1 influenza (initially referred to as “swine flu” when it was first detected), visit the archived ...

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Utilizing spatiotemporal analysis of influenza-like illness and rapid tests to focus swine-origin influenza virus intervention  

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In the spring of 2009, a novel strain of H1N1 swine-origin influenza A virus (S-OIV) emerged in Mexico and the United States, and soon after was declared a pandemic by the World Health Organization. This work examined the ability of real-time reports of influenza-like illness (ILI) symptoms and rapid influenza diagnostic tests (RIDTs) to approximate the spatiotemporal distribution of PCR-confirmed S-OIV cases for the purposes of focusing local intervention efforts. Cluster and age-adjusted re...

Wilson, J. Gaines; Ballou, Jessica; Yan, Chris; Fisher-hoch, Susan P.; Reininger, Belinda; Gay, Jennifer; Salinas, Jennifer; Sanchez, Pablo; Salinas, Yvette; Calvillo, Fidel; Lopez, Leonel; Delima, Ionara P.; Mccormick, Joseph B.

2010-01-01

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Computer-aided assessment of pulmonary disease in novel swine-origin H1N1 influenza on CT  

Science.gov (United States)

The 2009 pandemic is a global outbreak of novel H1N1 influenza. Radiologic images can be used to assess the presence and severity of pulmonary infection. We develop a computer-aided assessment system to analyze the CT images from Swine-Origin Influenza A virus (S-OIV) novel H1N1 cases. The technique is based on the analysis of lung texture patterns and classification using a support vector machine (SVM). Pixel-wise tissue classification is computed from the SVM value. The method was validated on four H1N1 cases and ten normal cases. We demonstrated that the technique can detect regions of pulmonary abnormality in novel H1N1 patients and differentiate these regions from visually normal lung (area under the ROC curve is 0.993). This technique can also be applied to differentiate regions infected by different pulmonary diseases.

Yao, Jianhua; Dwyer, Andrew J.; Summers, Ronald M.; Mollura, Daniel J.

2011-03-01

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Utilizing spatiotemporal analysis of influenza-like illness and rapid tests to focus swine-origin influenza virus intervention.  

Science.gov (United States)

In the spring of 2009, a novel strain of H1N1 swine-origin influenza A virus (S-OIV) emerged in Mexico and the United States, and soon after was declared a pandemic by the World Health Organization. This work examined the ability of real-time reports of influenza-like illness (ILI) symptoms and rapid influenza diagnostic tests (RIDTs) to approximate the spatiotemporal distribution of PCR-confirmed S-OIV cases for the purposes of focusing local intervention efforts. Cluster and age adjusted relative risk patterns of ILI, RIDT, and S-OIV were assessed at a fine spatial scale at different time and space extents within Cameron County, Texas on the US-Mexico border. Space-time patterns of ILI and RIDT were found to effectively characterize the areas with highest geographical risk of S-OIV within the first two weeks of the outbreak. Based on these results, ILI and/or RIDT may prove to be acceptable indicators of the location of S-OIV hotspots. Given that S-OIV data is often difficult to obtain real-time during an outbreak; these findings may be of use to public health officials targeting prevention and response efforts during future flu outbreaks. PMID:20810301

Gaines Wilson, J; Ballou, Jessica; Yan, Chris; Fisher-Hoch, Susan P; Reininger, Belinda; Gay, Jennifer; Salinas, Jennifer; Sanchez, Pablo; Salinas, Yvette; Calvillo, Fidel; Lopez, Leonel; Delima, Ionara P; McCormick, Joseph B

2010-11-01

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Optimal Pandemic Influenza Vaccine Allocation Strategies for the Canadian Population  

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Background: The world is currently confronting the first influenza pandemic of the 21st century. Influenza vaccination is an effective preventive measure, but the unique epidemiological features of swine-origin influenza A (H1N1) (pH1N1) introduce uncertainty as to the best strategy for prioritization of vaccine allocation. We sought to determine optimal prioritization of vaccine distribution among different age and risk groups within the Canadian population, to minimize influenza-attribut...

2010-01-01

12

Is Swine-origin Influenza a Predisposing Factor for Deep Vein Thrombosis?  

Science.gov (United States)

Herein we report a sixteen-year-old female that developed deep vein thrombosis (DVT) while undergoing treatment for H1N1 pneumonia. To the best of our knowledge this is the first report of H1N1/09 infection complicated by DVT in an adolescent patient with no detected risk factors other than immobilization. Healthcare providers should be aware of the possibility of thrombosis in patients with swine-origin influenza, especially in those with additional risk factors.

Gokce, Muge; Unal, Sule; Aytac, Selin; Kara, Ates; Ceyhan, Mehmet; Tuncer, Murat; Gumruk, Fatma

2012-01-01

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Swine-Origin Influenza A Outbreak 2009 at Shinshu University, Japan  

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Full Text Available Abstract Background A worldwide outbreak of swine flu H1N1 pandemic influenza occurred in April 2009. To determine the mechanism underlying the spread of infection, we prospectively evaluated a survey implemented at a local university. Methods Between August 2009 and March 2010, we surveyed 3 groups of subjects: 2318 children in six schools attached to the Faculty of Education, 11424 university students, and 3344 staff members. Subjects with influenza-like symptoms who were diagnosed with swine flu at hospitals or clinics were defined as swine flu patients and asked to make a report using a standardized form. Results After the start of the pandemic, a total of 2002 patients (11.7% were registered in the survey. These patients included 928 schoolchildren (40.0%, 1016 university students (8.9%, and 58 staff members (1.7%. The incidence in schoolchildren was significantly higher than in the other 2 groups (P Conclusion Schoolchildren and university students are vulnerable to swine flu, suggesting that avoidance of close contact, especially among these young people, may be effective way in controlling future severe influenza pandemics, especially at educational institutions.

Washizuka Shinsuke

2011-02-01

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Genomic Signature and Mutation Trend Analysis of Pandemic (H1N1) 2009 Influenza A Virus  

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A novel swine-origin pandemic influenza A(H1N1) virus (H1N1pdm, also referred to as S-OIV) was identified as the causative agent of the 21st century's first influenza pandemic, but molecular features conferring its ability of human-to-human transmission has not been identified. Here we compared the protein sequences of 2009 H1N1pdm strains with those causing other pandemics and the viruses isolated from humans, swines and avians, and then analyzed the mutation trend of the residues at the sig...

Pan, Chungen; Cheung, Byron; Tan, Suiyi; Li, Chunling; Li, Lin; Liu, Shuwen; Jiang, Shibo

2010-01-01

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Pandemic Influenza and Mathematical Modelling  

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ABSTRACT The outbreaks of Avian Influenza H5N1 the recent years has increased our attention to a possible Pandemic Influenza. Mindful of the last century's pandemics, we fear that changes in the virus' surface antigens can cause a new virus capable of transmitting between humans. Statisticians use mathematical modelling as an instrument for predicting the pattern and intensity of the spreading of a pandemic; models can also help estimating the effects of measures such as antiviral drugs, vac...

Lande, Asgeir

2007-01-01

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Molecular epidemiology of novel swine origin influenza virus (S-OIV from Gwalior, India, 2009  

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Full Text Available Abstract Background The H1N1pandemic virus is a newly emergent human influenza A virus that is closely related to a number of currently circulating pig viruses in the 'classic North American' and 'Eurasian' swine influenza virus lineages and thus referred as S-OIV. Since the first reports of the virus in humans in April 2009, H1N1 virus has spread to 168 countries and overseas territories. India also witnessed severe H1N1 pandemic virus epidemic with considerable morbidity and mortality in different parts starting from May 2009. Findings The suspected swine flu outbreak from Gwalior India during October- December 2009 was confirmed through S-OIV HA gene specific RT-LAMP and real time RT-PCR. Positive samples through CDC real time and Lamp assay were further processed for isolation of the virus. Full HA gene sequencing of the H1N1 isolates of Gwalior, India revealed 99% homology with California and other circulating novel swine flu viruses. Three major changes were observed at nucleotide level, while two major amino acid shifts were observed at the position C9W and I30M corresponding to the ORF with prototype strain. The HA gene sequence phylogeny revealed the circulation of two genetically distinct lineages belonging to Clade VII and Clade I of S-OIV. Conclusions Our findings also supported the earlier report about circulation of mixed genogroups of S-OIV in India. Therefore continuous monitoring of the genetic makeup of this newly emergent virus is essential to understand its evolution within the country.

Shukla Jyoti

2011-06-01

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Integrative study of pandemic A/H1N1 influenza infections: design and methods of the CoPanFlu-France cohort  

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Abstract Background The risk of influenza infection depends on biological characteristics, individual or collective behaviors and the environmental context. The Cohorts for Pandemic Influenza (CoPanFlu) France study was set up in 2009 after the identification of the novel swine-origin A/H1N1 pandemic influenza virus. This cohort of 601 households (1450 subjects) representative for the general population aims at using an integrative approach to study the risk and characteristi...

Lapidus Nathanael; de Lamballerie Xavier; Salez Nicolas; Setbon Michel; Ferrari Pascal; Delabre Rosemary M; Gougeon Marie-Lise; Vely Frédéric; Leruez-Ville Marianne; Andreoletti Laurent; Cauchemez Simon; Boëlle Pierre-Yves; Vivier Eric; Abel Laurent; Schwarzinger Michaël

2012-01-01

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The evolutionary emergence of pandemic influenza  

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Pandemic influenza remains a serious public health threat and the processes involved in the evolutionary emergence of pandemic influenza strains remain incompletely understood. Here, we develop a stochastic model for the evolutionary emergence of pandemic influenza, and use it to address three main questions. (i) What is the minimum annual number of avian influenza virus infections required in humans to explain the historical rate of pandemic emergence? (ii) Are such avian influenza infection...

Day, Troy; Andre?, Jean-baptiste; Park, Andrew

2006-01-01

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Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian Influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Influenza virus (IV) infections are a major threat to human welfare and animal health worldwide. Anti-viral therapy includes vaccines and a few anti-viral drugs. However vaccines are not always available in time, as demonstrated by the emergence of the new 2009 H1N1-type pandemic strain of swine origin (S-OIV) in April 2009, and the acquisition of resistance to neuraminidase inhibitors such as Tamiflu® (oseltamivir) is a potential problem. Ther...

Pleschka Stephan; Stein Michael; Schoop Roland; Hudson James B

2009-01-01

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Rapid Detection and Differentiation of Swine-Origin Influenza A Virus (H1N1/2009) from Other Seasonal Influenza A Viruses  

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We previously developed a rapid and simple gold nanoparticle(NP)-based genomic microarray assay for identification of the avian H5N1 virus and its discrimination from other influenza A virus strains (H1N1, H3N2). In this study, we expanded the platform to detect the 2009 swine-origin influenza A virus (H1N1/2009). Multiple specific capture and intermediate oligonucleotides were designed for the matrix (M), hemagglutinin (HA), and neuraminidase (NA) genes of the H1N1/2009 virus. The H1N1/2009 ...

Zhao, Jiangqin; Wang, Xue; Ragupathy, Viswanath; Zhang, Panhe; Tang, Wei; Ye, Zhiping; Eichelberger, Maryna; Hewlett, Indira

2012-01-01

 
 
 
 
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Investigation of the first cases of human-to-human infection with the new swine-origin influenza A (H1N1) virus in Canada  

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The outbreak of human infection due to the novel swine-origin influenza A (H1N1) virus began in Mexico in March 2009. As of July 6, 2009, more than 94 000 laboratory-confirmed cases were reported in over 100 countries, including 7983 cases in Canada. In this report, we describe the epidemiologic and clinical characteristics of the first cluster of reported cases of human-to-human transmission of the new influenza virus in Canada.

Cutler, Jennifer; Schleihauf, Emily; Hatchette, Todd F.; Billard, Bev; Watson-creed, Gaynor; Davidson, Ross; Li, Yan; Bastien, Nathalie; Sarwal, Shelly

2009-01-01

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CT Utilization in the Prospective Diagnosis of a Case of Swine-Origin Influenza A (H1N1) Viral Infection  

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The purpose of this paper is to demonstrate the potential role of CT in the early diagnosis of swine-origin influenza A (H1N1) virus (S-OIV) pneumonia. We present a case of acute influenza-like illness in which the CT findings of peribronchovascular and subpleural ground-glass opacities and consolidation resembled organizing pneumonia, and lead the radiologist to prospectively and correctly suggest the diagnosis of S-OIV infection.

Ajlan, Amr M.; Khashoggi, Khalid; Nicolaou, Savvas; Mu?ller, Nestor L.

2010-01-01

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Involvement of type I immune responses in swine-origin H1N1 influenza virus infection.  

Science.gov (United States)

Swine-origin H1N1 influenza virus (S-OIV) appeared in 2009 with a higher incidence rate among children. Although fever was the most common symptom, some complicated cases occurred. We evaluated the percentages of effector T cells, B cells, and regulatory T cells in peripheral blood from 5 children infected by S-OIV (1 with acute necrotizing encephalitis, 2 with pneumonia, and 2 without complications), 5 children with seasonal influenza, and 5 healthy children. We found higher percentages of T-bet(+) CD4(+)CD8(+) T cells, monocytes, and B cells, granzyme B(+) and perforin(+) CD4(+), and CD8(+) T cells in affected children with both seasonal and H1N1 influenza than in controls, whereas both groups demonstrated similar percentages of CD4(+)CD25(+)Foxp3(+) regulatory T cells. In infected children with complications we observed high percentages of perforin(+) and interferon-?(+) CD4(+) and CD8(+) T cells associated with low percentages of T regulatory cells. Our data suggest a dysregulation of antipathogen type I immune responses in complicated S-OIV infections. PMID:21571020

Frisullo, Giovanni; Iorio, Raffaele; Plantone, Domenico; Nociti, Viviana; Patanella, Agata Katia; Marti, Alessandro; Palermo, Concetta; Valentini, Piero; Mariotti, Paolo; Batocchi, Anna Paola

2011-08-01

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Seasonal Influenza: Waiting for the Next Pandemic  

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With the ongoing cases of H1N1 influenza (aka Swine Flu) occurring around the globe, seasonal influenza has a tendency to be overlooked by the media and general population as a source of illness and death. Yet, these pandemic influenza viruses arise from these seasonal influenza viruses. This article will provide an overview of seasonal influenza, its prevention and treatment, and the global surveillance system in place, used to detect the next influenza pandemic.

Clem, Angela; Galwankar, Sagar

2009-01-01

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Introduction of a Novel Swine-Origin Influenza A (H1N1 Virus into Milwaukee, Wisconsin in 2009  

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Full Text Available On 17 April 2009, novel swine origin influenza A virus (S-OIV cases appeared within the United States. Most influenza A diagnostic assays currently utilized in local clinical laboratories do not allow definitive subtype determination. Detailed subtype analysis of influenza A positive samples in our laboratory allowed early confirmation of a large outbreak of S-OIV in southeastern Wisconsin (SEW. The initial case of S-OIV in SEW was detected on 28 April 2009. All influenza A samples obtained during the 16 week period prior to 28 April 2009, and the first four weeks of the subsequent epidemic were sub typed. Four different multiplex assays were employed, utilizing real time PCR and end point PCR to fully subtype human and animal influenza viral components. Specific detection of S-OIV was developed within days. Data regarding patient demographics and other concurrently circulating viruses were analyzed. During the first four weeks of the epidemic, 679 of 3726 (18.2% adults and children tested for influenza A were identified with S-OIV infection. Thirteen patients (0.34% tested positive for seasonal human subtypes of influenza A during the first two weeks and none in the subsequent 2 weeks of the epidemic. Parainfluenza viruses were the most prevalent seasonal viral agents circulating during the epidemic (of those tested, with detection rates of 12% followed by influenza B and RSV at 1.9% and 0.9% respectively. S-OIV was confirmed on day 2 of instituting subtype testing and within 4 days of report of national cases of S-OIV. Novel surge capacity diagnostic infrastructure exists in many specialty and research laboratories around the world. The capacity for broader influenza A sub typing at the local laboratory level allows timely and accurate detection of novel strains as they emerge in the community, despite the presence of other circulating viruses producing identical illness. This is likely to become increasingly important given the need for appropriate subtype driven anti-viral therapy and the potential shortage of such medications in a large epidemic.

Swati Kumar

2009-06-01

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Influenza Pandemic Infrastructure Response in Thailand  

Centers for Disease Control (CDC) Podcasts

Influenza viruses change antigenic properties, or drift, every year and they create seasonal outbreaks. Occasionally, influenza viruses change in a major way, called a â??shift." If an influenza virus shifts, the entire human population is susceptible to the new influenza virus, creating the potential for a pandemic. On this podcast, CDC's Dr. Scott Dowell discusses responding to an influenza pandemic.  Created: 3/5/2009 by Emerging Infectious Diseases.   Date Released: 3/5/2009.

2009-03-05

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Dating the emergence of pandemic influenza viruses  

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Pandemic influenza viruses cause significant mortality in humans. In the 20th century, 3 influenza viruses caused major pandemics: the 1918 H1N1 virus, the 1957 H2N2 virus, and the 1968 H3N2 virus. These pandemics were initiated by the introduction and successful adaptation of a novel hemagglutinin subtype to humans from an animal source, resulting in antigenic shift. Despite global concern regarding a new pandemic influenza, the emergence pathway of pandemic strains remains unknown. Here we ...

Smith, Gavin J. D.; Bahl, Justin; Vijaykrishna, Dhanasekaran; Zhang, Jinxia; Poon, Leo L. M.; Chen, Honglin; Webster, Robert G.; Peiris, J. S. Malik; Guan, Yi

2009-01-01

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Chest Radiographic Findings of Novel Swine-Origin Influenza A (H1N1) Virus Infection in Children  

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To analyze chest radiographic findings in children infected with laboratory confirmed novel swine-origin influenza A (H1N1) virus. Three hundred seventy-two out of 2,014 children with laboratory confirmed H1N1 infection and who also underwent a chest radiograph from September to November 2009 were enrolled in this study. Patients were divided into in-patients, out-patients, and patients with co-infections and further subdivided into with underlying disease and without underlying disease as well as age (<2 years old, 2-5 years, 5-10 years, 10-18 years old). The initial radiographs were evaluated for radiographic findings and the anatomic distribution of abnormalities. The initial radiographs were abnormal in 154 (41.39%) patients. The predominant radiographic findings were peribronchial wall opacity found in 85 (22.84%) patients and hyperinflation observed in 69 (18.54%) patients. Further, 75 (71.42%) patients exhibited central predominance and the right lower lung zone was also commonly involved. There were statistically significant differences in the radiological findings between in-patient and out-patient groups. However, there were no significant differences in the radiographic findings between in-patients and the co-infection group with respect the presence of underlying disease and age. Initial radiographs of children with laboratory confirmed H1N1 virus were abnormal in 41.39% of cases. The common radiographic findings included peribronchial opacities, hyperinflation, lower lung zonal distribution, and central predominance

Bae, So Young; Hong, Eun Sook; Paik, Sang Hyun; Park, Seong Jin; Cha, Jang Gyu; Lee, Hae Kyung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jang, Yun Woo [Dept. of Radiology, Soonchunhyang University Hospital, Seoul (Korea, Republic of)

2011-06-15

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Pandemic Influenza Pediatric Office Plan Template  

Energy Technology Data Exchange (ETDEWEB)

This is a planning tool developed by pediatric stakeholders that is intended to assist pediatric medical offices that have no pandemic influenza plan in place, but may experience an increase in patient calls/visits or workload due to pandemic influenza.

HCTT CHE

2010-01-01

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Rapid Detection and Differentiation of Swine-Origin Influenza A Virus (H1N1/2009 from Other Seasonal Influenza A Viruses  

Directory of Open Access Journals (Sweden)

Full Text Available We previously developed a rapid and simple gold nanoparticle(NP-based genomic microarray assay for identification of the avian H5N1 virus and its discrimination from other influenza A virus strains (H1N1, H3N2. In this study, we expanded the platform to detect the 2009 swine-origin influenza A virus (H1N1/2009. Multiple specific capture and intermediate oligonucleotides were designed for the matrix (M, hemagglutinin (HA, and neuraminidase (NA genes of the H1N1/2009 virus. The H1N1/2009 microarrays were printed in the same format as those of the seasonal influenza H1N1 and H3N2 for the HA, NA, and M genes. Viral RNA was tested using capture-target-intermediate oligonucleotide hybridization and gold NP-mediated silver staining. The signal from the 4 capture-target-intermediates of the HA and NA genes was specific for H1N1/2009 virus and showed no cross hybridization with viral RNA from other influenza strains H1N1, H3N2, and H5N1. All of the 3 M gene captures showed strong affinity with H1N1/2009 viral RNA, with 2 out of the 3 M gene captures showing cross hybridization with the H1N1, H3N2, and H5N1 samples tested. The current assay was able to detect H1N1/2009 and distinguish it from other influenza A viruses. This new method may be useful for simultaneous detection and subtyping of influenza A viruses and can be rapidly modified to detect other emerging influenza strains in public health settings.

Indira Hewlett

2012-11-01

31

Mutations at positions 186 and 194 in the HA gene of the 2009 H1N1 pandemic influenza virus improve replication in cell culture and eggs  

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Abstract Obtaining suitable seed viruses for influenza vaccines poses a challenge for public health authorities and manufacturers. We used reverse genetics to generate vaccine seed-compatible viruses from the 2009 pandemic swine-origin influenza virus. Comparison of viruses recovered with variations in residues 186 and 194 (based on the H3 numbering system) of the viral hemagglutinin showed that these viruses differed with respect to their ability to grow in eggs and cultured cells....

Suphaphiphat Pirada; Franti Michael; Hekele Armin; Lilja Anders; Spencer Terika; Settembre Ethan; Palmer Gene; Crotta Stefania; Tuccino Annunziata B; Keiner Bjoern; Trusheim Heidi; Balabanis Kara; Sackal Melissa; Rothfeder Mithra; Mandl Christian W

2010-01-01

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Pneumonia in novel swine-origin influenza A (H1N1) virus infection: High-resolution CT findings  

Energy Technology Data Exchange (ETDEWEB)

Objective: The purpose of our study was to review the initial high-resolution CT (HRCT) findings in pneumonia patients with presumed/laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection and detect pneumonia earlier. Materials and methods: High-resolution CT (HRCT) findings of 106 patients with presumed/laboratory-confirmed novel S-OIV (H1N1) infection were reviewed. The 106 patients were divided into two groups according to the serious condition of the diseases. The pattern (consolidation, ground-glass, nodules, and reticulation), distribution, and extent of abnormality on the HRCT were evaluated in both groups. The dates of the onset of symptoms of the patients were recorded. Results: The predominant CT findings in the patients at presentation were unilateral or bilateral multifocal asymmetric ground-glass opacities alone (n = 29, 27.4%), with unilateral or bilateral consolidation (n = 50, 47.2%). The consolidation had peribronchovascular and subpleural predominance. The areas of consolidation were found mainly in the posterior, middle and lower regions of the lungs. Reticular opacities were found in 6 cases of the initial MDCT scan. The extent of disease was greater in group 1 patients requiring advanced mechanical ventilation, with diffuse involvement in 19 patients (63.3%) of group 1 patients, and only 15/76 (19.7%) of group 2 patients (p < 0.01, {chi}{sup 2} test). 20 cases (19%) of the 106 patients had small bilateral or unilateral pleural effusions. None had evidence of hilar or mediastinal lymph node enlargement on CT performed at admission or later. Conclusions: The most common radiographic and CT findings in patients with S-OIV infection are unilateral or bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. On HRCT, the ground-glass opacities had a predominant peribronchovascular and subpleural distribution. CT plays an important role in the early recognition of severe S-OIV (H1N1).

Li Ping, E-mail: pinglee_2000@yahoo.com [Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, 246 Xue Fu Road, Harbin 150086 (China); Su Dongju, E-mail: hyd_sdj@yahoo.com.cn [Department of Respiratory, The Second Affiliated Hospital of Harbin Medical University, 246 Xue Fu Road, Harbin 150086 (China); Zhang Jifeng, E-mail: zjf2005520@163.com [Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, 246 Xue Fu Road, Harbin 150086 (China); Xia Xudong, E-mail: xiaxd888@163.com [Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, 246 Xue Fu Road, Harbin 150086 (China); Sui Hong, E-mail: suisuihong@126.com [Department of Statistics, Harbin Medical University, 240 Xue Fu Road, Harbin 150086 (China); Zhao Donghui, E-mail: yhwoooooo@yahoo.com.cn [Centers for Disease Control and Prevention of Heilongjiang, 187 Xiang An Street, Harbin 150036 (China)

2011-11-15

33

1918 Influenza: the Mother of All Pandemics  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The "Spanish" influenza pandemic of 1918–1919, which caused ?50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for exam...

Taubenberger, Jeffery K.; Morens, David M.

2006-01-01

34

Tropism and Innate Host Responses of the 2009 Pandemic H1N1 Influenza Virus in ex Vivo and in Vitro Cultures of Human Conjunctiva and Respiratory Tract  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The novel pandemic influenza H1N1 (H1N1pdm) virus of swine origin causes mild disease but occasionally leads to acute respiratory distress syndrome and death. It is important to understand the pathogenesis of this new disease in humans. We compared the virus tropism and host-responses elicited by pandemic H1N1pdm and seasonal H1N1 influenza viruses in ex vivo cultures of human conjunctiva, nasopharynx, bronchus, and lung, as well as in vitro cultures of human nasopharyngeal, bronchial, and al...

Chan, Michael C. W.; Chan, Renee W. Y.; Yu, Wendy C. L.; Ho, Carol C. C.; Yuen, Kit M.; Fong, Joanne H. M.; Tang, Lynsia L. S.; Lai, Wico W.; Lo, Amy C. Y.; Chui, W. H.; Sihoe, Alan D. L.; Kwong, Dora L. W.; Wong, David S. H.; Tsao, George S. W.; Poon, Leo L. M.

2010-01-01

35

Pandemic influenza: overview of vaccines and antiviral drugs.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pandemic influenza has become a high priority item for all public health authorities. An influenza pandemic is believed to be imminent, and scientists agree that it will be a matter of when, where, and what will be the causative agent. Recently, most attention has been directed to human cases of avian influenza caused by a H5N1 avian influenza virus. An effective vaccine will be needed to substantially reduce the impact of an influenza pandemic. Current influenza vaccine manufacturing technol...

Cox, Manon M. J.

2005-01-01

36

Removing barriers to global pandemic influenza vaccination.  

Science.gov (United States)

This article clarifies the regulatory issues surrounding influenza pandemic vaccine for the larger policy community and describes the need for regulatory harmonization. Vaccination would save lives in an influenza pandemic, but a lack of global manufacturing capacity will leave most of the world without access to vaccine. Capacity can be expanded if governments harmonize their regulatory policies. This article details the regulatory approaches taken by the United States, the European Union, and Japan for pandemic vaccine development, three regions that produce the majority of the world's seasonal influenza vaccine. They should quickly converge on regulatory requirements, intellectual property considerations, the use of recombinant DNA techniques for vaccine production, and technical issues about the composition of pandemic vaccine. PMID:16792484

Gronvall, Gigi Kwik; Borio, Luciana L

2006-01-01

37

Development of live attenuated influenza vaccines against pandemic influenza strains.  

Science.gov (United States)

Avian and animal influenza viruses can sporadically transmit to humans, causing outbreaks of varying severity. In some cases, further human-to-human virus transmission does not occur, and the outbreak in humans is limited. In other cases, sustained human-to-human transmission occurs, resulting in worldwide influenza pandemics. Preparation for future pandemics is an important global public health goal. A key objective of preparedness is to gain an understanding of how to design, test, and manufacture effective vaccines that could be stockpiled for use in a pandemic. This review summarizes results of an ongoing collaboration to produce, characterize, and clinically test a library of live attenuated influenza vaccine strains (based on Ann Arbor attenuated Type A strain) containing protective antigens from influenza viruses considered to be of high pandemic potential. PMID:24867587

Coelingh, Kathleen L; Luke, Catherine J; Jin, Hong; Talaat, Kawsar R

2014-07-01

38

Co-infection of adenovirus with swine origin influenza A (H1N1 and report of adenovirus with respiratory syncytial virus: report of two cases  

Directory of Open Access Journals (Sweden)

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Respiratory virus infections represent a major public health problem because of their worldwide occurrence, ease of spread in the community and considerable morbidity and mortality. They are one of the most common reasons for hospitalization of children under the age of six. In some cases, infection with two different viruses increase the severity of disease which lead to the hospitalization."n"nCase presentation: Among 202 samples related to children under the age of six with respiratory infections, two dual infections of Adenovirus with other respiratory viruses with PCR test were detected."n"nConclusion: Mixed respiratory viral infections are sometimes associated with severe disease and recognition of coinfection is important. Dual infections of Adenovirus with respiratory syncytial virus (RSV and Swine origin influenza A (H1N1 virus were demonstrated. The evidence showed that the co-infection of Adenovirus with swine origin influenza A (H1N1, has increased the severity of disease which lead to the hospitalization.

Shatizadeh Malekshahi S

2010-12-01

39

Stockpiling Supplies for the Next Influenza Pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Faced with increasing concerns about the likelihood of an influenza pandemic, healthcare systems have been challenged to determine what specific medical supplies that should be procured and stockpiled as a component of preparedness. Despite publication of numerous pandemic planning recommendations, little or no specific guidance about the types of items and quantities of supplies needed has been available. The primary purpose of this report is to detail the approach of 1 healthcare system in ...

Radonovich, Lewis J.; Magalian, Paul D.; Hollingsworth, Mary Kay; Baracco, Gio

2009-01-01

40

Adjuvant solution for pandemic influenza vaccine production  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Extensive preparation is underway to mitigate the next pandemic influenza outbreak. New vaccine technologies intended to supplant egg-based production methods are being developed, with recombinant hemagglutinin (rHA) as the most advanced program for preventing seasonal and avian H5N1 Influenza. Increased efforts are being focused on adjuvants that can broaden vaccine immunogenicity against emerging viruses and maximize vaccine supply on a worldwide scale. Here, we test protection against avia...

2012-01-01

 
 
 
 
41

Monitoring vaccine safety during an influenza pandemic.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the event that a vaccine is available during an influenza pandemic, vaccine safety monitoring will occur as part of comprehensive public health surveillance of the vaccination campaign. Though inactivated influenza vaccines have been widely used in the United States and much is known about their safety profile, attention will need to be paid to both common self-limited adverse reactions and rarer, more serious events that may or may not be causally related to vaccination. The primary surve...

2005-01-01

42

Receptor binding properties, cell tropism and transmission of influenza A virus  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The first influenza pandemic of the 21st century was caused by the influenza A (H1N1) 2009 virus (A(H1N1)pdm09) that emerged from a swine-origin source. Although human infections with swine-origin influenza have been reported intermittently in the past decade, none went on to cause a pandemic or sustained human-to-human transmission. In previous pandemics, specific residues in the receptor binding site of the haemagglutinin (HA) protein of influenza have been associated with the ability of th...

Doremalen, Neeltje

2013-01-01

43

A Systematic Analytic Approach to Pandemic Influenza Preparedness Planning  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The World Health Organization warns that a flu pandemic is inevitable, and possibly imminent. Barnett and colleagues discuss a tool called the Haddon Matrix that could help in pandemic influenza planning.

Barnett Daniel J; Balicer Ran D; Lucey Daniel R; Everly George S; Omer Saad B; Steinhoff Mark C; Grotto Itamar

2005-01-01

44

Mutations at positions 186 and 194 in the HA gene of the 2009 H1N1 pandemic influenza virus improve replication in cell culture and eggs  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Obtaining suitable seed viruses for influenza vaccines poses a challenge for public health authorities and manufacturers. We used reverse genetics to generate vaccine seed-compatible viruses from the 2009 pandemic swine-origin influenza virus. Comparison of viruses recovered with variations in residues 186 and 194 (based on the H3 numbering system of the viral hemagglutinin showed that these viruses differed with respect to their ability to grow in eggs and cultured cells. Thus, we have demonstrated that molecular cloning of members of a quasispecies can help in selection of seed viruses for vaccine manufacture.

Balabanis Kara

2010-07-01

45

Developing Vaccines to Combat Pandemic Influenza  

Directory of Open Access Journals (Sweden)

Full Text Available Influenza vaccine manufacturers require antigenically relevant vaccine viruses that have good manufacturing properties and are safe to use. In developing pandemic vaccine viruses, reverse genetics has been employed as a rational approach that can also be used effectively to attenuate the highly virulent H5N1 virus and at the same time place the H5 HA and N1 NA on a background of PR8, a virus that has been used over many decades to provide high yielding vaccine viruses. Reverse genetics has also been used successfully alongside classical reassorting techniques in the development of (swine flu pandemic A(H1N1v vaccine viruses.

Othmar G. Engelhardt

2010-02-01

46

Influenza Transmission in Households During the 1918 Pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Analysis of historical data has strongly shaped our understanding of the epidemiology of pandemic influenza and informs analysis of current and future epidemics. Here, the authors analyzed previously unpublished documents from a large household survey of the “Spanish” H1N1 influenza pandemic, conducted in 1918, for the first time quantifying influenza transmissibility at the person-to-person level during that most lethal of pandemics. The authors estimated a low probability of person-to-p...

Fraser, Christophe; Cummings, Derek A. T.; Klinkenberg, Don; Burke, Donald S.; Ferguson, Neil M.

2011-01-01

47

Detection of novel swine origin influenza A virus (H1N1) by real-time nucleic acid sequence-based amplification.  

Science.gov (United States)

Rapid detection of novel swine origin influenza A virus (S-OIV) (H1N1) is crucial for timely implementation of infection control measures. In this study, a haemagglutinin (HA) gene-based real-time nucleic acid sequence-based amplification (NASBA) assay was developed for the specific detection of S-OIV (H1N1). The assay was evaluated and validated by comparing it with existing detection methods for S-OIV (H1N1). Results obtained in a 10-fold dilution series assay demonstrated the analytic sensitivity of the present assay was comparable to that of a commercial S-OIV (H1N1) real-time RT-PCR kit and higher than that of the Centers for Disease Control and Prevention (CDC) TaqMan assay. The actual detection limit of the real-time NASBA assay was approximately 50 copies per reaction. Compared with reference methods (viral culture, conventional RT-PCR, and real-time RT-PCR), the sensitivity, specificity, positive predictive value, and negative predictive value of the present assay were all 100%. Overall, the results showed that the real-time NASBA assay could be used for sensitive and specific detection of S-OIV (H1N1). PMID:19883690

Ge, Yiyue; Cui, Lunbiao; Qi, Xian; Shan, Jun; Shan, Yunfeng; Qi, Yuhua; Wu, Bing; Wang, Hua; Shi, Zhiyang

2010-02-01

48

Distribution of sialic acid receptors and influenza A viruses of avian and swine origin and in experimentally infected pigs  

DEFF Research Database (Denmark)

Background: Pigs are considered susceptible to influenza A virus infections from different host origins because earlier studies have shown that they have receptors for both avian (sialic acid-alpha-2,3-terminal saccharides (SAalpha- 2,3)) and swine/human (SA-alpha-2,6) influenza viruses in the upper respiratory tract. Furthermore, experimental and natural infections in pigs have been reported with influenza A virus from avian and human sources. Methods: This study investigated the receptor distribution in the entire respiratory tract of pigs using specific lectins Maackia Amurensis (MAA) I, and II, and Sambucus Nigra (SNA). Furthermore, the predilection sites of swine influenza virus (SIV) subtypes H1N1 and H1N2 as well as avian influenza virus (AIV) subtype H4N6 were investigated in the respiratory tract of experimentally infected pigs using immunohistochemical methods. Results: SIV antigen was widely distributed in bronchi, but was also present in epithelial cells of the nose, trachea, bronchioles, and alveolar type I and II epithelial cells in severely affected animals. AIV was found in the lower respiratory tract, especially in alveolar type II epithelial cells and occasionally in bronchiolar epithelial cells. SA-alpha- 2,6 was the predominant receptor in all areas of the respiratory tract with an average of 80-100% lining at the epithelial cells. On the contrary, the SA-alpha-2,3 was not present (0%) at epithelial cells of nose, trachea, and most bronchi, but was found in small amounts in bronchioles, and in alveoli reaching an average of 20-40% at the epithelial cells. Interestingly, the receptor expression of both SA-alpha-2,3 and 2,6 was markedly diminished in influenza infected areas compared to non-infected areas. Conclusions: A difference in predilection sites between SIV and AIV virus was found, and this difference was in accordance with the distribution of the SA-alpha-2,6 and SA-alpha-2,3 receptor, respectively. The results indicated that the distribution of influenza A virus receptors in pigs are similar to that of humans and therefore challenge the theory that the pig acts as a mixing vessel between human and avian influenza viruses. Furthermore, it was shown that AIV prefers to infect alveolar type II epithelial cells in pigs. This corresponds with findings in humans emphasising the resemblance between the two species.

Trebbien, Ramona; Larsen, Lars Erik

2011-01-01

49

Pandemic H1N1 influenza infections in 2009  

Directory of Open Access Journals (Sweden)

Full Text Available In early spring 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico, spreaded quickly, and on June 11 2009, World Health Organization raised its pandemic level to phase 6. This novel H1N1 pandemic influenza A virus represented a quadruple reassortment of swine, human and avian influenza virus strains. This pandemic 2009 H1N1 influenza A viruses in different regions of the world were found to be antigenically homogenous. Transmission features, incubation period and clinical findings wee similar with the seasonal influenza viruses, although the gastrointestinal manifestations were more common. Young children (<5years and some special risk groups are at increased risk for infection complications and mortality. The recommended test for diagnosis is real-time PCR. Pandemic 2009 H1N1 influenza A strains are sensitive to neuraminidase inhibitors (oseltamivir, zanamivir and resistant to amantadine and rimantadine. Oseltamivir and zanamivir are used for prophlaxis and therapy of infection. However, vaccination against pandemic 2009 H1N1 influenza A should be the main target for individual and population based prevention. Monovalent pandemic 2009 H1N1 influenza A vaccines are available in this (recent influenza season. According to CDC, the next (2010-2011 influenza season trivalent vaccines will coverage the pandemic 2009 H1N1 influenza A vaccine. (Turk Arch Ped 2010; 45: 80th Year: 31-6

Mustafa Hac?mustafao?lu

2010-05-01

50

Development and Evaluation of Reverse Transcription Loop-Mediated Isothermal Amplification Assay for Rapid and Real-Time Detection of the Swine-Origin Influenza A H1N1 Virus  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The recent emergence of the swine-origin influenza A H1N1 virus (S-OIV) poses a serious global health threat. Rapid detection and differentiation of S-OIV from seasonal influenza is crucial for patient management and control of the epidemics. A one-step, single-tube accelerated and quantitative S-OIV-specific H1 reverse transcription loop-mediated isothermal amplification (RTLAMP) assay for clinical diagnosis of S-OIV by targeting the H1 gene is reported in this article. A comparative evaluat...

Parida, Manmohan; Shukla, Jyoti; Sharma, Shashi; Ranghia Santhosh, Sanna; Ravi, Vasanthapuram; Mani, Reeta; Thomas, Maria; Khare, Shashi; Rai, Arvind; Kant Ratho, Radha; Pujari, Sujit; Mishra, Bijayanti; Lakshmana Rao, Putcha Venkata; Vijayaraghavan, Rajagopalan

2011-01-01

51

Pandemic influenza preparedness: Africa at the crossroads  

Directory of Open Access Journals (Sweden)

Full Text Available At least two distinct approaches to pandemic preparedness have arisen in response to the threats posed by pandemic influenza: a traditional public health approach and an increasingly securitised one. Traditional public health focuses on the population and their living conditions. In contrast, public health strategies informed by concerns with security focus on the resilience of critical infrastructure, such as electricity and communication, and on the ensuring good connections between different layers of government and any private bodies likely to be central to the response. Pandemic plans can be informed by one or a mix of both approaches. The securitised approach is more prevalent in the World Health Organization (WHO’s plans and Western countries’ plans. In contrast, the WHO-AFRO Regional Pandemic Influenza Preparedness Plan 2009 utilises the existing Integrated Diseases Surveillance and Response framework as its starting point. It is informed by both rationales. Will African preparedness efforts develop in the direction of those already more informed by concerns about security? This paper examines how a securitised approach glosses over the differences between existing and threatened diseases. This is a particular problem in the African context with a high burden of infectious disease and underfunded health systems. Rather than a diversion of resources into a securitised approach, we suggest that the preparedness needs of the African continent are best served by focussing political will, international aid, financial and technical resources on the development of the health sector, including the integrated diseases surveillance and response framework. By tracing the distinct rationales at work in preparedness plans, it becomes apparent that an emphasis on the population will better position the continent for the future pandemics.

Oluyemisi C. Ijamakinwa

2012-10-01

52

Adjuvant solution for pandemic influenza vaccine production  

Science.gov (United States)

Extensive preparation is underway to mitigate the next pandemic influenza outbreak. New vaccine technologies intended to supplant egg-based production methods are being developed, with recombinant hemagglutinin (rHA) as the most advanced program for preventing seasonal and avian H5N1 Influenza. Increased efforts are being focused on adjuvants that can broaden vaccine immunogenicity against emerging viruses and maximize vaccine supply on a worldwide scale. Here, we test protection against avian flu by using H5N1-derived rHA and GLA-SE, a two-part adjuvant system containing glucopyranosyl lipid adjuvant (GLA), a formulated synthetic Toll-like receptor 4 agonist, and a stable emulsion (SE) of oil in water, which is similar to the best-in-class adjuvants being developed for pandemic flu. Notably, a single submicrogram dose of rH5 adjuvanted with GLA-SE protects mice and ferrets against a high titer challenge with H5N1 virus. GLA-SE, relative to emulsion alone, accelerated induction of the primary immune response and broadened its durability against heterosubtypic H5N1 virus challenge. Mechanistically, GLA-SE augments protection via induction of a Th1-mediated antibody response. Innate signaling pathways that amplify priming of Th1 CD4 T cells will likely improve vaccine performance against future outbreaks of lethal pandemic flu.

Clegg, Christopher H.; Roque, Richard; Van Hoeven, Neal; Perrone, Lucy; Baldwin, Susan L.; Rininger, Joseph A.; Bowen, Richard A.; Reed, Steven G.

2012-01-01

53

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems pruden...

Kilic?, Selim; Gray, Gregory C.

2007-01-01

54

Antiviral Resistance and the Control of Pandemic Influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: The response to the next influenza pandemic will likely include extensive use of antiviral drugs (mainly oseltamivir), combined with other transmission-reducing measures. Animal and in vitro studies suggest that some strains of influenza may become resistant to oseltamivir while maintaining infectiousness (fitness). Use of antiviral agents on the scale anticipated for the control of pandemic influenza will create an unprecedented selective pressure for the emergence and spread of ...

2007-01-01

55

Inefficient Control of Host Gene Expression by the 2009 Pandemic H1N1 Influenza A Virus NS1 Protein?  

Science.gov (United States)

In 2009, a novel swine-origin H1N1 influenza A virus emerged. Here, we characterize the multifunctional NS1 protein of this human pandemic virus in order to understand factors that may contribute to replication efficiency or pathogenicity. Although the 2009 H1N1 virus NS1 protein (2009/NS1) is an effective interferon antagonist, we found that this NS1 (unlike those of previous human-adapted influenza A viruses) is unable to block general host gene expression in human or swine cells. This property could be restored in 2009/NS1 by replacing R108, E125, and G189 with residues corresponding to human virus consensus. Mechanistically, these previously undescribed mutations acted by increasing binding of 2009/NS1 to the cellular pre-mRNA processing protein CPSF30. A recombinant 2009 H1N1 influenza A virus (A/California/04/09) expressing NS1 with these gain-of-function substitutions was more efficient than the wild type at antagonizing host innate immune responses in primary human epithelial cells. However, such mutations had no significant effect on virus replication in either human or swine tissue culture substrates. Surprisingly, in a mouse model of pathogenicity, the mutant virus appeared to cause less morbidity, and was cleared faster, than the wild type. The mutant virus also demonstrated reduced titers in the upper respiratory tracts of ferrets; however, contact and aerosol transmissibility of the virus was unaffected. Our data highlight a potential human adaptation of NS1 that seems absent in “classically derived” swine-origin influenza A viruses, including the 2009 H1N1 virus. We discuss the impact that a natural future gain of this NS1 function may have on the new pandemic virus in humans.

Hale, Benjamin G.; Steel, John; Medina, Rafael A.; Manicassamy, Balaji; Ye, Jianqiang; Hickman, Danielle; Hai, Rong; Schmolke, Mirco; Lowen, Anice C.; Perez, Daniel R.; Garcia-Sastre, Adolfo

2010-01-01

56

Barriers to pandemic influenza vaccination and uptake of seasonal influenza vaccine in the post-pandemic season in Germany  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: In Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ?60 years, chronically ill persons, healthcare workers (HCW)). In season 2009/10, vaccination against pandemic influenza A(H1N1)pdm09, which was controversially discussed in the public, was recommended for the whole population. The objectives of this study were to assess vaccination coverage for seasonal (seasons 2008/09-2010/11) and pandemic influenza ...

2012-01-01

57

Immune Protection Induced on Day 10 Following Administration of the 2009 A/H1N1 Pandemic Influenza Vaccine  

Science.gov (United States)

Background The 2009 swine-origin influenza virus (S-OIV) H1N1 pandemic has caused more than 18,000 deaths worldwide. Vaccines against the 2009 A/H1N1 influenza virus are useful for preventing infection and controlling the pandemic. The kinetics of the immune response following vaccination with the 2009 A/H1N1 influenza vaccine need further investigation. Methodology/Principal Findings 58 volunteers were vaccinated with a 2009 A/H1N1 pandemic influenza monovalent split-virus vaccine (15 µg, single-dose). The sera were collected before Day 0 (pre-vaccination) and on Days 3, 5, 10, 14, 21, 30, 45 and 60 post vaccination. Specific antibody responses induced by the vaccination were analyzed using hemagglutination inhibition (HI) assay and enzyme-linked immunosorbent assay (ELISA). After administration of the 2009 A/H1N1 influenza vaccine, specific and protective antibody response with a major subtype of IgG was sufficiently developed as early as Day 10 (seroprotection rate: 93%). This specific antibody response could maintain for at least 60 days without significant reduction. Antibody response induced by the 2009 A/H1N1 influenza vaccine could not render protection against seasonal H1N1 influenza (seroconversion rate: 3% on Day 21). However, volunteers with higher pre-existing seasonal influenza antibody levels (pre-vaccination HI titer ?1?40, Group 1) more easily developed a strong antibody protection effect against the 2009 A/H1N1 influenza vaccine as compared with those showing lower pre-existing seasonal influenza antibody levels (pre-vaccination HI titer <1?40, Group 2). The titer of the specific antibody against the 2009 A/H1N1 influenza was much higher in Group 1 (geometric mean titer: 146 on Day 21) than that in Group 2 (geometric mean titer: 70 on Day 21). Conclusions/Significance Recipients could gain sufficient protection as early as 10 days after vaccine administration. The protection could last at least 60 days. Individuals with a stronger pre-existing seasonal influenza antibody response may have a relatively higher potential for developing a stronger humoral immune response after vaccination with the 2009 A/H1N1 pandemic influenza vaccine.

Hu, Weibin; Wang, Tongyan; Cui, Jun; Wu, Hongqiang; Ling, Zhiyang; Ji, Yongyong; Lin, Guomei; Tian, Lin; Zhou, Yanyan; Li, Bingnan; Hu, Guiyu; Yu, Ning; An, Wenqi; Pan, Ruowen; Zhou, Paul; Leng, Qibin; Huang, Zhong; Ma, Xiaowei; Sun, Bing

2010-01-01

58

Abbreviated Pandemic Influenza Planning Template for Primary Care Offices  

Energy Technology Data Exchange (ETDEWEB)

The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

HCTT CHE

2010-01-01

59

Barriers to pandemic influenza vaccination and uptake of seasonal influenza vaccine in the post-pandemic season in Germany  

Science.gov (United States)

Background In Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ?60 years, chronically ill persons, healthcare workers (HCW)). In season 2009/10, vaccination against pandemic influenza A(H1N1)pdm09, which was controversially discussed in the public, was recommended for the whole population. The objectives of this study were to assess vaccination coverage for seasonal (seasons 2008/09-2010/11) and pandemic influenza (season 2009/10), to identify predictors of and barriers to pandemic vaccine uptake and whether the controversial discussions on pandemic vaccination has had a negative impact on seasonal influenza vaccine uptake in Germany. Methods We analysed data from the ‘German Health Update’ (GEDA10) telephone survey (n=22,050) and a smaller GEDA10-follow-up survey (n=2,493), which were both representative of the general population aged ?18 years living in Germany. Results Overall only 8.8% of the adult population in Germany received a vaccination against pandemic influenza. High socioeconomic status, having received a seasonal influenza shot in the previous season, and belonging to a target group for seasonal influenza vaccination were independently associated with the uptake of pandemic vaccines. The main reasons for not receiving a pandemic vaccination were ‘fear of side effects’ and the opinion that ‘vaccination was not necessary’. Seasonal influenza vaccine uptake in the pre-pandemic season 2008/09 was 52.8% among persons aged ?60 years; 30.5% among HCW, and 43.3% among chronically ill persons. A decrease in vaccination coverage was observed across all target groups in the first post-pandemic season 2010/11 (50.6%, 25.8%, and 41.0% vaccination coverage, respectively). Conclusions Seasonal influenza vaccination coverage in Germany remains in all target groups below 75%, which is a declared goal of the European Union. Our results suggest that controversial public discussions about safety and the benefits of pandemic influenza vaccination may have contributed to both a very low uptake of pandemic vaccines and a decreased uptake of seasonal influenza vaccines in the first post-pandemic season. In the upcoming years, the uptake of seasonal influenza vaccines should be carefully monitored in all target groups to identify if this trend continues and to guide public health authorities in developing more effective vaccination and communication strategies for seasonal influenza vaccination.

2012-01-01

60

High-resolution computed tomography findings of swine-origin influenza A (H1N1) virus (S-OIV) infection: comparison with scrub typhus  

Energy Technology Data Exchange (ETDEWEB)

Background. Swine-origin influenza A (H1N1) virus (S-OIV) infection and scrub typhus, also known as tsutsugamushi disease can manifest as acute respiratory illnesses, particularly during the late fall or early winter, with similar radiographic findings, such as a predominance of ground-glass opacity (GGO). Purpose. To differentiate S-OIV infection from scrub typhus using high-resolution computed tomography (HRCT). Material and Methods. We retrospectively reviewed the HRCT findings of 14 patients with S-OIV infection and 10 patients with scrub typhus. We assessed the location, cross-sectional distribution, and the presence of a peribronchovascular distribution of GGO and consolidations on HRCT. We also assessed the presence of interlobular septal thickening, bronchial wall thickening, pneumothorax, pneumomediastinum, pleural effusion, and mediastinal or axillary lymph node enlargement. Results. Scrub typhus was more common than S-OIV in elderly patients (P < 0.001). The monthly incidences of S-OIV and scrub typhus infection reached a peak between October and November. About 86% of S-OIV patients and 80% of scrub typhus patients presented with GGO. About 67% of the GGO lesions in S-OIV had a peribronchovascular distribution, but this was absent in scrub typhus (P = 0.005). Consolidation (93% vs. 10%, P < 0.001) and bronchial wall thickening (43% vs. 0%, P = 0.024) were more frequent in S-OIV infection than scrub typhus. Interlobular septal thickening (90% vs. 36%, P = 0.013) and axillary lymphadenopathy (90% vs. 0%, P < 0.001) were more common in scrub typhus than S-OIV infection. Conclusion. There was considerable overlap in HRCT findings between S-OIV infection and scrub typhus. However, S-OIV showed a distinctive peribronchovascular distribution of GGO lesions. Consolidation and bronchial wall thickening were seen more frequently in S-OIV infection, whereas interlobular septal thickening and axillary lymphadenopathy were more common in scrub typhus. Thus, CT could be helpful for differential diagnosis between S-OIV infection and scrub typhus.

Jo, Bang Sil; Lee, In Jae; Lee, Kwanseop [Dept. of Radiology, Hallym Univ. College of Medicine, Seoul (Korea, Republic of)], E-mail: ijlee2003@medimail.co.kr; Im, Hyoung June [Dept. of Occupational Medicine, Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

2012-07-15

 
 
 
 
61

Genetic Analysis of Influenza A/H1N1 of Swine Origin Virus (SOIV) Circulating in Central and South America  

Science.gov (United States)

Since the first detection of swine origin virus (SOIV) on March 28, 2009, the virus has spread worldwide and oseltamivir-resistant strains have already been identified in the past months. Here, we show the phylogenetic analysis of 63 SOIV isolates from eight countries in Central and South America, and their sensitivity to oseltamivir.

Sovero, Merly; Garcia, Josefina; Laguna-Torres, V. Alberto; Gomez, Jorge; Aleman, Washington; Chicaiza, Wilson; Barrantes, Melvin; Sanchez, Felix; Jimenez, Mirna; Comach, Guillermo; de Rivera, Ivette Lorenzana; Barboza, Alma; Aguayo, Nicolas; Kochel, Tadeusz

2010-01-01

62

Methods for molecular surveillance of influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Molecular-based techniques for detecting influenza viruses have become an integral component of human and animal surveillance programs in the last two decades. The recent pandemic of the swine-origin influenza A virus (H1N1) and the continuing circulation of highly pathogenic avian influenza A virus (H5N1) further stress the need for rapid and accurate identification and subtyping of influenza viruses for surveillance, outbreak management, diagnosis and treatment. There has been remarkable pr...

2010-01-01

63

Pandemic Influenza Virus Surveillance, Izu-Oshima Island, Japan  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A population-based influenza surveillance study (using PCR virus subtyping) on Izu-Oshima Island, Japan, found that the cumulative incidence of influenza A(H1N1)pdm09 virus infections 2 seasons after the pandemic was highest for those 10–14 years of age (43.1%). No postpandemic A(H1N1)pdm09 case-patients had been infected with A(H1N1)pdm09 virus during the pandemic season.

Inamasu, Tomoko; Sudo, Kouji; Kato, Shingo; Deguchi, Hiroshi; Ichikawa, Manabu; Shimizu, Tadanori; Maeda, Tadami; Fujimoto, Shuhei; Takebayashi, Toru; Saito, Tomoya

2012-01-01

64

Antiviral Resistance and the Control of Pandemic Influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Emergence of oseltamivir-resistant influenza strains during a pandemic is likely given the heightened selective pressure if the drug is widely used. Marc Lipsitch and colleagues suggest that resistance would reduce but not completely offset the drug's benefits for pandemic control.

Lipsitch, Marc; Cohen, Ted; Murray, Megan; Levin, Bruce R.

2007-01-01

65

Preparedness planning for pandemic influenza among large US maternity hospitals  

Directory of Open Access Journals (Sweden)

Full Text Available The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done given the recent emphasis on hospital disaster planning and the disproportionate morbidity and mortality that pregnant women have suffered in previous influenza pandemics. An internet-based survey was sent to all 12 members of the Council of Women's and Infants' Specialty Hospitals. Questions addressed hospital demographics and overall pandemic preparedness planning, including presence of a pandemic planning committee and the existence of written plans addressing communications, surge capacity, degradation of services, and advance supply planning. Nine of 12 (75% hospitals responded. All had active pandemic planning committees with identified leadership. The majority (78% had written formal plans regarding back-up communications, surge/overflow capacity, and degradation of services. However, fewer (44% reported having written plans in place regarding supply-line/stockpiling of resources. The most common challenges noted were staff and supply coordination, ethical distribution of limited medical resources, and coordination with government agencies. In conclusion, the majority of the Council of Women's and Infants' Specialty Hospitals maternity hospitals have preliminary infrastructure for pandemic influenza planning, but many challenges exist to optimize maternal and fetal outcomes during the next influenza pandemic.

A Akers

2009-01-01

66

Pandemic influenza: A global challenge for social marketing marketing  

Directory of Open Access Journals (Sweden)

Full Text Available Recent years have seen increased attention and concern regarding the potential for pandemic influenza, following large-scale outbreaks of swine flu and bird flu. Governments and health agencies have time to develop social marketing strategies and specific messages that have the potential to minimize fear, refute or inoculate against misinformation that the public may encounter, and enhance the likelihood of the public taking the recommended preventive and remedial actions should these become necessary. This paper presents an overview of how social marketing can be used to tackle the global challenge of pandemic influenza. The potential pandemic influenza poses a major challenge for social marketers (along with governments, health services, and businesses. There are a number of critical factors about a potential pandemic influenza that make it fundamentally different to the majority of issues to which social marketing has previously been applied. The underlying principles of social marketing are equally applicable to a global infectious disease outbreak (such as pandemic influenza. Even if the current strains do not become pandemic, social marketers should use this impetus to develop the skills and resources to address future communicable disease outbreaks. This paper applies the concepts of social marketing to a unique health issue which has the potential to become one of the largest global public health crises in history, but which can be tackled with effective global social marketing.

Sandra C. Jones

2012-10-01

67

Pandemic H1N1 2009 Influenza A Virus Induces Weak Cytokine Response in Human Macrophages and Dendritic Cells and Is Highly Sensitive to Antiviral Actions of Interferons  

DEFF Research Database (Denmark)

In less than three months after the first cases of swine-origin 2009 influenza A (H1N1) virus infections were reported from Mexico, WHO declared a pandemic. The pandemic virus is antigenically distinct from seasonal influenza viruses and the majority of human population lacks immunity against this virus. We have studied the activation of innate immune responses in pandemic virus-infected human monocyte-derived dendritic cells (DC) and macrophages. Pandemic A/Finland/553/2009 virus, representing a typical North American/European lineage virus, replicated very well in these cells. The pandemic virus, as well as the seasonal A/Brisbane/59/07 (H1N1) and A/New Caledonia/20/99 (H1N1) viruses, induced type I (IFN-alpha/beta) and type III (IFN-lambda1-3) IFN, CXCL10 and TNF-alpha gene expression weakly in DCs. Mouse adapted A/WSN/33 (H1N1) and human A/Udorn/72 (H3N2) viruses, instead, induced efficiently the expression of antiviral and proinflammatory genes. Both IFN-alpha and IFN-beta inhibited the replication of the pandemic (H1N1) virus. The potential of IFN-lambda3 to inhibit the viral replication was lower than that of type I IFNs. However, the pandemic virus was more sensitive to the antiviral IFN-lambda3 than the seasonal A/Brisbane/59/07 (H1N1) virus. The present study demonstrates that the novel pandemic (H1N1) influenza A virus can readily replicate in human primary DCs and macrophages and efficiently avoid the activation of innate antiviral responses. It is, however, highly sensitive to the antiviral actions of IFNs, which may provide us an additional means to treat severe cases of infection especially if a significant drug resistance will emerge.

Osterlund, Pamela; Pirhonen, Jaana

2010-01-01

68

Conserved amino acid markers from past influenza pandemic strains  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Finding the amino acid mutations that affect the severity of influenza infections remains an open and challenging problem. Of special interest is better understanding how current circulating influenza strains could evolve into a new pandemic strain. Influenza proteomes from distinct viral phenotype classes were searched for class specific amino acid mutations conserved in past pandemics, using reverse engineered linear classifiers. Results Thirty-four amino acid markers associated with host specificity and high mortality rate were found. Some markers had little impact on distinguishing the functional classes by themselves, however in combination with other mutations they improved class prediction. Pairwise combinations of influenza genomes were checked for reassortment and mutation events needed to acquire the pandemic conserved markers. Evolutionary pathways involving H1N1 human and swine strains mixed with avian strains show the potential to acquire the pandemic markers with a double reassortment and one or two amino acid mutations. Conclusion The small mutation combinations found at multiple protein positions associated with viral phenotype indicate that surveillance tools could monitor genetic variation beyond single point mutations to track influenza strains. Finding that certain strain combinations have the potential to acquire pandemic conserved markers through a limited number of reassortment and mutation events illustrates the potential for reassortment and mutation events to lead to new circulating influenza strains.

Vitalis Elizabeth A

2009-04-01

69

Public health strategies for distribution of influenza vaccine during an influenza pandemic.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In order to consider the ethical issues around vaccine distribution during an influenza pandemic, it is critical to have an understanding of the role of influenza vaccine in a pandemic, the rate at which vaccine is likely to be come available, who will likely produce and "own" the vaccine, how vaccine distribution and administration might be accomplished, and which are the groups that might be deemed highest priority to be vaccinated against influenza. The United States and Connecticu...

2005-01-01

70

Comparative epidemiology of pandemic and seasonal influenza A in households.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND: There are few data on the comparative epidemiology and virology of the pandemic 2009 influenza A (H1N1) virus and cocirculating seasonal influenza A viruses in community settings. METHODS: We recruited 348 index patients with acute respiratory illness from 14 outpatient clinics in Hong Kong in July and August 2009. We then prospectively followed household members of 99 patients who tested positive for influenza A virus on rapid diagnostic testing. We collected nasal and throat swa...

Cowling, Benjamin J.; Chan, Kwok Hung; Fang, Vicky J.; Lau, Lincoln L. H.; So, Hau Chi; Fung, Rita O. P.; Ma, Edward S. K.; Kwong, Alfred S. K.; Chan, Chi-wai; Tsui, Wendy W. S.; Ngai, Ho-yin; Chu, Daniel W. S.; Lee, Paco W. Y.; Chiu, Ming-chee; Leung, Gabriel M.

2010-01-01

71

Contribución del Laboratorio Nacional de Influenza al enfrentamiento de la influenza pandémica 2009 en Cuba / Contribution of the National Influenza Laboratory to confront the 2009 pandemic influenza in Cuba  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: las infecciones respiratorias agudas son consideradas la causa más importante de morbilidad y mortalidad en todo el mundo. Estas infecciones adquieren mayor significación asociadas a eventos epidémicos y pandémicos ocasionados por los virus influenza. La necesidad de una vigilancia mun [...] dial para los virus influenza fue reconocida en 1947 y condujo a la creación de la Red Global de Vigilancia de los virus influenza por la Organización Mundial de la Salud. El Centro Nacional de Influenza de Cuba pertenece a esta red desde 1975. En el mes de abril de 2009 fue reconocido un nuevo virus influenza A (H1N1) de origen porcino que circulaban en humanos, identificado como el agente causal de la primera pandemia del siglo xxi por la Organización Mundial de la Salud. OBJETIVO: llevar a cabo la vigilancia nacional del nuevo virus pandémico. MÉTODOS: el Centro Nacional de Influenza de Cuba desarrolló y organizó un diagrama de diagnóstico para la confirmación en casos sospechosos de infección por este virus. Se emplearon diferentes ensayos de trancripción reversa-reacción en cadena de la polimerasa para el tipado y subtipado de los virus influenza A. RESULTADOS: entre abril y diciembre de 2009, un total de 6 900 muestras clínicas respiratorias fueron procesadas mediante el diagrama diagnóstico nacional y 980 casos fueron confirmados y notificados a las autoridades nacionales de salud y la Organización Panamericana de la Salud. Los rinovirus humanos resultaron otro de los agentes etiológicos de infecciones respiratorias agudas detectados con frecuencia. CONCLUSIÓN: mediante la estrategia nacional de vigilancia de laboratorio fue posible llevar a cabo un monitoreo efectivo de la circulación de los virus influenza y otros virus respiratorios para alertar a las autoridades nacionales de salud, con vistas a enfrentar la influenza pandémica 2009. Abstract in english INTRODUCTION: acute respiratory infections are considered the most important causes of morbidity and mortality around the world. These infections became more significant when associated to epidemics and pandemic events caused by influenza virus. The need for global surveillance of influenza viruses [...] was recognized as early as 1947 and led to the establishment of the World Health Organization (WHO) Global Influenza Surveillance Network (GISN). The Cuban National Influenza Centre (NIC) belongs to this network since 1975. On April 2009, the recognition of a new influenza A (H1N1) of swine origin circulating in humans was identified as the causative agent of the first pandemic in the 21st century declared by the WHO. OBJECTIVE: to carry out surveillance of the new pandemic virus nationwide. METHODS: the Cuban National Influenza Center developed a diagnostic diagram to confirm infection with the pandemic virus in suspected cases. Different PCR assays for typing and subtyping of influenza A virus were used. RESULTS: from April to December 2009, 6 900 clinical respiratory samples were processed by using this diagram, 980 cases were confirmed and notified to the national health authorities and to the Pan American Health Organization. Human rhinoviruses were other important etiologic agents of the frequently detected acute respiratory infections. CONCLUSION: with the national strategy for surveillance at lab, it was possible to effectively monitor the circulation of the influenza viruses and of other respiratory viruses in our country and to alert the national health authorities, with a view to facing up to the pandemic influenza (2009)

Acosta Herrera, Belsy; Piñón Ramos, Alexander; Valdés Ramírez, Odalys; Savón Valdés, Clara; Guzmán Tirado, María Guadalupe; Llop Hernández, Alina; Arencibia García, Amely; Guilarte García, Elias; González Muñoz, Grehete; González Báez, Guelsys; Oropesa Fernández, Suset; Hernández Espinosa, Bárbara; Goyenechea Hernández, Ángel; Kourí Cardellá, Vivian; Morier Díaz, Luis; Llanes Cordero, María Josefa; Herrada Rodríguez, Nilvia.

72

The first influenza pandemic in the new millennium: lessons learned hitherto for current control efforts and overall pandemic preparedness  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Influenza viruses pose a permanent threat to human populations due to their ability to constantly adapt to impact immunologically susceptible individuals in the forms of epidemic and pandemics through antigenic drifts and antigenic shifts, respectively. Pandemic influenza preparedness is a critical step in responding to future influenza outbreaks. In this regard, responding to the current pandemic and preparing for future ones requires critical planning for the early phases...

Franco-Paredes Carlos; Carrasco Peter; Preciado Jose

2009-01-01

73

An Agent-Based Modeling for Pandemic Influenza in Egypt  

CERN Multimedia

Pandemic influenza has great potential to cause large and rapid increases in deaths and serious illness. The objective of this paper is to develop an agent-based model to simulate the spread of pandemic influenza (novel H1N1) in Egypt. The proposed multi-agent model is based on the modeling of individuals' interactions in a space time context. The proposed model involves different types of parameters such as: social agent attributes, distribution of Egypt population, and patterns of agents' interactions. Analysis of modeling results leads to understanding the characteristics of the modeled pandemic, transmission patterns, and the conditions under which an outbreak might occur. In addition, the proposed model is used to measure the effectiveness of different control strategies to intervene the pandemic spread.

Khalil, Khaled M; Nazmy, Taymour T; Salem, Abdel-Badeeh M

2010-01-01

74

Clinical Profile of Patients Admitted with Swine-Origin Influenza A (H1N1) Virus Infection: An Experience from A Tertiary Care Hospital.  

Science.gov (United States)

Background: Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. H1N1 critical illness mostly affects young patients and is often fatal. Objective: Primary objective was to study clinical profile of the patients admitted with confirmed H1N1 swine flu infection. Secondary objective was to observe the risk factors associated with complications like need of mechanical ventilation and or death among H1N1 infected patients. Material and Methods: A prospective observational study was conducted in a tertiary care teaching hospital from June 2009, to December, 2011. H1N1 infection was confirmed by reverse transcriptase PCR. Statistical analysis was done by SPSS, version 11. Binary logistic regression was used to find out independent risk factors for morbidity. Results: Total 495 patients were tested for H1N1 infection. Among them, 115 (23%) were positive and 88(76%) required admission. Median age of cohort was 29 years and 87% of the patients were below 54 years of age. Most common presenting symptoms were fever (98%), followed by cough (86%) and sore throat (54%). Out of 88 patients, 14 (16%) required mechanical ventilation and 6(6.8%) died. Lymphopaenia (Lymphocytes swine flu mainly affected people who were < 54 years of age. Majority of patients improved with antiviral treatment. Lymphopaenia and CXR which showed bilateral pneumonia at time of presentation were found to be independent risk factors associated with requirement of mechanical ventilation and/or death in H1N1 infection. Pregnant females with flu constituted 33% of total mortality. High priority should be given to such patients. Further community based studies are required to analyze the actual impact of H1N1 infection in the community. PMID:24298482

Mehta, Asmita A; Kumar, V Anil; Nair, Suresh G; K Joseph, Fini; Kumar, Gireesh; Singh, Sanjeev K

2013-10-01

75

[Ethical principles of management and planning during influenza pandemic].  

Science.gov (United States)

The article is dedicated to an actual problem of ethical component inclusion into the system of management and planning of epidemic control measures during threat emergence and in the course of influenza pandemic (epidemic) progress. Data regarding development of international ethical guidelines during influenza including WHO recommendations are presented and analysis of normative documents in Russian Federation is given. A necessity of comprehension and accounting of ethical values in pandemic preparedness is shown, main directions of action and responsibility are revealed. Key ethical positions of planning and implementation of measures during influenza pandemic are outlined, compliance with those determines the level of public support and thus provides the effectiveness of the implemented measures. PMID:22442981

Kubar', O I; Asatrian, A Zh

2012-01-01

76

Optimal Vaccine Allocation for the Early Mitigation of Pandemic Influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

With new cases of avian influenza H5N1 (H5N1AV) arising frequently, the threat of a new influenza pandemic remains a challenge for public health. Several vaccines have been developed specifically targeting H5N1AV, but their production is limited and only a few million doses are readily available. Because there is an important time lag between the emergence of new pandemic strain and the development and distribution of a vaccine, shortage of vaccine is very likely at the beginning of a pandemi...

2013-01-01

77

Development of a Rapid Automated Influenza A, Influenza B, and Respiratory Syncytial Virus A/B Multiplex Real-Time RT-PCR Assay and Its Use during the 2009 H1N1 Swine-Origin Influenza Virus Epidemic in Milwaukee, Wisconsin  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Rapid, semiautomated, and fully automated multiplex real-time RT-PCR assays were developed and validated for the detection of influenza (Flu) A, Flu B, and respiratory syncytial virus (RSV) from nasopharyngeal specimens. The assays can detect human H1N1, H3N2, and swine-origin (S-OIV) H1N1 Flu A viruses and were effectively used to distinguish Flu A infections (of all subtypes) from Flu B and RSV infections during the current S-OIV outbreak in Milwaukee, WI. The analytical limits of detection...

Beck, Eric T.; Jurgens, Lisa A.; Kehl, Sue C.; Bose, Michael E.; Patitucci, Teresa; Lague, Elizabeth; Darga, Patrick; Wilkinson, Kimberly; Witt, Lorraine M.; Fan, Jiang; He, Jie; Kumar, Swati; Henrickson, Kelly J.

2010-01-01

78

Age-prioritized use of antivirals during an influenza pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background The WHO suggested that governments stockpile, as part of preparations for the next influenza pandemic, sufficient influenza antiviral drugs to treat approximately 25% of their populations. Our aim is two-fold: first, since in many countries the antiviral stockpile is well below this level, we search for suboptimal strategies based on treatment provided only to an age-dependent fraction of cases. Second, since in some countries the stockpile exceeds the sug...

Merler Stefano; Ajelli Marco; Rizzo Caterina

2009-01-01

79

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza  

Energy Technology Data Exchange (ETDEWEB)

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

HCTT-CHE

2011-04-14

80

Influenza pandemics in Singapore, a tropical, globally connected city.  

Science.gov (United States)

Tropical cities such as Singapore do not have well-defined influenza seasons but have not been spared from influenza pandemics. The 1918 epidemic in Singapore, which was then already a major global trading hub, occurred in 2 waves, June-July, and October-November, and resulted in > or = 2,870 deaths. The excess mortality rate was higher than that for industrialized nations in the Northern Hemisphere but lower than that for less industrialized countries in Asia and Africa. The 1957 epidemic occurred in May and resulted in widespread illness. The 1968 epidemic occurred in August and lasted a few weeks, again with widespread illness. Tropical cities may be affected early in a pandemic and have higher mortality rates. With the increase in travel and trade, a future pandemic may reach a globally connected city early and spread worldwide. Preparedness and surveillance plans must be developed to include the megacities of the tropical world. PMID:18214178

Lee, Vernon J; Chen, Mark I; Chan, Slew Pang; Wong, Chia Siong; Cutter, Jeffery; Goh, Kee Tai; Tambyah, Paul Anath

2007-07-01

 
 
 
 
81

Pandemic influenza and critical infrastructure dependencies: possible impact on hospitals.  

Science.gov (United States)

Hospitals will be particularly challenged when pandemic influenza spreads. Within the health sector in general, existing pandemic plans focus on health interventions to control outbreaks. The critical relationship between the health sector and other sectors is not well understood and addressed. Hospitals depend on critical infrastructure external to the organisation itself. Existing plans do not adequately consider the complexity and interdependency of systems upon which hospitals rely. The failure of one such system can trigger a failure of another, causing cascading breakdowns. Health is only one of the many systems that struggle at maximum capacity during "normal" times, as current business models operate with no or minimal "excess" staff and have become irreducible operations. This makes interconnected systems highly vulnerable to acute disruptions, such as a pandemic. Companies use continuity plans and highly regulated business continuity management to overcome process interruptions. This methodology can be applied to hospitals to minimise the impact of a pandemic. PMID:17115957

Itzwerth, Ralf L; Macintyre, C Raina; Shah, Smita; Plant, Aileen J

2006-11-20

82

Pandemic Influenza H1N1 2009, Innate Immunity, and the Impact of Immunosenescence on Influenza Vaccine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Seasonal and pandemic strains of influenza have widespread implications for the global economy and global health. This has been highlighted recently as the epidemiologic characteristics for hospitalization and mortality for pandemic influenza H1N1 2009 are now emerging. While treatment with neuraminidase inhibitors are effective for seasonal and pandemic influenza, prevention of morbidity and mortality through effective vaccines requires a rigorous process of research and development. Vulnera...

2009-01-01

83

Preparedness for pandemic influenza : hospital and intensive care resources  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The unfolding pandemic with "new influenza A/H1N1" in the spring and summer of 2009 has once again shown that disease outbreaks are inevitable and unpredictable events. The context surrounding outbreaks is unique and marked by uncertainty and confusion, in the general public, in public services and in health care which has to be taken into account in planning and preparing health care in general, and hospital health care in particular, for a flu pandemic. This thesis attempts to give some dir...

Nap, Raoul Ernesto

2009-01-01

84

The pandemic subject: Canadian pandemic plans and communicating with the public about an influenza pandemic.  

Science.gov (United States)

In this paper, I examine the goals for pandemic public communication as outlined in two Canadian plans for pandemic planning and infection control. I critique these strategies by drawing on Foucault's notions of governmentality and biopower. My argument is that the public health communication campaign goals reviewed rest upon a particular conceptualization of health in the context of pandemic planning as an individual/family duty, and that scientific/medical expert knowledge is most appropriate for guiding pandemic planning. This study contributes to a sociological understanding of how pandemic preparedness and infection control are represented in Canadian pandemic plans, how public health shapes pandemic communication messages in Canada, and the implications of those messages for subjectivity and notions of citizenship. PMID:24289936

Maunula, Laena

2013-10-01

85

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza  

Directory of Open Access Journals (Sweden)

Full Text Available Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems prudent that military public health officials employ at least several nonpharmaceutical interventions. For example frequent handwashing and respiratory hygiene/cough etiquette should be strongly encouraged among soldiers. Head-to-toe sleeping, a ?no-cost? intervention should be for crowded berthing areas. Isolation of patients with influenza and quarantine of their close contacts should be employed. Masks and alcohol-based hand rubs may be employed among those at highest risk. Finally, whenever possible military planners should, reduce crowding and limit the interaction of training cohorts to reduce risk of influenza virus transmission. [TAF Prev Med Bull. 2007; 6(4: 285-290

Selim Kilic

2007-08-01

86

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza  

Directory of Open Access Journals (Sweden)

Full Text Available Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems prudent that military public health officials employ at least several nonpharmaceutical interventions. For example frequent handwashing and respiratory hygiene/cough etiquette should be strongly encouraged among soldiers. Head-to-toe sleeping, a ?no-cost? intervention should be for crowded berthing areas. Isolation of patients with influenza and quarantine of their close contacts should be employed. Masks and alcohol-based hand rubs may be employed among those at highest risk. Finally, whenever possible military planners should, reduce crowding and limit the interaction of training cohorts to reduce risk of influenza virus transmission. [TAF Prev Med Bull 2007; 6(4.000: 285-290

Selim Kilic

2007-08-01

87

Outbreak of pandemic influenza A/H1N1 2009 in Nepal  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Results Out of 609 collected samples, 302 (49.6% were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3% were positive for Pandemic influenza A/H1N1 and 130 (21.3% were Seasonal influenza A. Most of the pandemic cases (53% were found among young people with ? 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1v type. Conclusion The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1v type.

Shrestha Sirjana

2011-03-01

88

Modeling the effects of drug resistant influenza virus in a pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Neuraminidase inhibitors (NI) play a major role in plans to mitigate future influenza pandemics. Modeling studies suggested that a pandemic may be contained at the source by early treatment and prophylaxis with antiviral drugs. Here, we examine the influence of NI resistant influenza strains on an influenza pandemic. We extend the freely available deterministic simulation program InfluSim to incorporate importations of resistant infections and the emergence of de novo resistance. The epidemic...

Brockmann, Stefan O.; Schwehm, Markus; Duerr, Hans-peter; Witschi, Mark; Koch, Daniel; Vidondo, Beatriz; Eichner, Martin

2008-01-01

89

Virus-like particle (VLP)-based vaccines for pandemic influenza: Performance of a VLP vaccine during the 2009 influenza pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The influenza pandemic of 2009 demonstrated the inability of the established global capacity for egg-based vaccine production technology to provide sufficient vaccine for the population in a timely fashion. Several alternative technologies for developing influenza vaccines have been proposed, among which non-replicating virus-like particles (VLPs) represent an attractive option because of their safety and immunogenic characteristics. VLP vaccines against pandemic influenza have been developed...

Lo?pez-maci?as, Constantino

2012-01-01

90

Clinical review: Mass casualty triage – pandemic influenza and critical care  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Worst case scenarios for pandemic influenza planning in the US involve over 700,000 patients requiring mechanical ventilation. UK planning predicts a 231% occupancy of current level 3 (intensive care unit) bed capacity. Critical care planners need to recognise that mortality is likely to be high and the risk to healthcare workers significant. Contingency planning should, therefore, be multi-faceted, involving a robust health command structure, the facility to expand critical care provision in...

2007-01-01

91

Pandemic influenza: A global challenge for social marketing marketing  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Recent years have seen increased attention and concern regarding the potential for pandemic influenza, following large-scale outbreaks of swine flu and bird flu. Governments and health agencies have time to develop social marketing strategies and specific messages that have the potential to minimize fear, refute or inoculate against misinformation that the public may encounter, and enhance the likelihood of the public taking the recommended preventive and remedial actions should these become ...

Jones, Sandra C.; Don Iverson

2012-01-01

92

Antiviral prophylaxis during pandemic influenza may increase drug resistance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Neuraminidase inhibitors (NI) and social distancing play a major role in plans to mitigate future influenza pandemics. Methods Using the freely available program InfluSim, the authors examine to what extent NI-treatment and prophylaxis promote the occurrence and transmission of a NI resistant strain. Results Under a basic reproduction number of R0 = 2.5, a NI resistant strain can only spread if its transmissi...

Eichner Martin; Schwehm Markus; Duerr Hans-Peter; Witschi Mark; Koch Daniel; Brockmann Stefan O; Vidondo Beatriz

2009-01-01

93

Age distribution of cases and deaths during the 1889 influenza pandemic.  

Science.gov (United States)

Using historical data taken from archival records from five European countries and the United States, we evaluate the age distributions of influenza cases and deaths during the 1889 influenza pandemic. We found that the clinical attack rate in 1889 was relatively high and constant between the ages of 1 and 60 years, but was lower outside of the extremes of this age range. By contrast, age-specific influenza-related mortality rates were J-shaped and increased with age beyond 20 years. We conclude that the age-specific attack rates of the 1889 pandemic were most similar to those of the 1968 pandemic and that influenza-related mortality rates did not follow a W-shaped curve as was observed during the 1918 pandemic. Adding 1889 to the short catalogue of influenza pandemics previously studied makes the 1918 pandemic even more exceptional in terms of mortality burden and age distribution of deaths. PMID:21757106

Valtat, Sophie; Cori, Anne; Carrat, Fabrice; Valleron, Alain-Jacques

2011-07-22

94

Rapid detection of pandemic influenza in the presence of seasonal influenza  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Key to the control of pandemic influenza are surveillance systems that raise alarms rapidly and sensitively. In addition, they must minimise false alarms during a normal influenza season. We develop a method that uses historical syndromic influenza data from the existing surveillance system 'SERVIS' (Scottish Enhanced Respiratory Virus Infection Surveillance for influenza-like illness (ILI in Scotland. Methods We develop an algorithm based on the weekly case ratio (WCR of reported ILI cases to generate an alarm for pandemic influenza. From the seasonal influenza data from 13 Scottish health boards, we estimate the joint probability distribution of the country-level WCR and the number of health boards showing synchronous increases in reported influenza cases over the previous week. Pandemic cases are sampled with various case reporting rates from simulated pandemic influenza infections and overlaid with seasonal SERVIS data from 2001 to 2007. Using this combined time series we test our method for speed of detection, sensitivity and specificity. Also, the 2008-09 SERVIS ILI cases are used for testing detection performances of the three methods with a real pandemic data. Results We compare our method, based on our simulation study, to the moving-average Cumulative Sums (Mov-Avg Cusum and ILI rate threshold methods and find it to be more sensitive and rapid. For 1% case reporting and detection specificity of 95%, our method is 100% sensitive and has median detection time (MDT of 4 weeks while the Mov-Avg Cusum and ILI rate threshold methods are, respectively, 97% and 100% sensitive with MDT of 5 weeks. At 99% specificity, our method remains 100% sensitive with MDT of 5 weeks. Although the threshold method maintains its sensitivity of 100% with MDT of 5 weeks, sensitivity of Mov-Avg Cusum declines to 92% with increased MDT of 6 weeks. For a two-fold decrease in the case reporting rate (0.5% and 99% specificity, the WCR and threshold methods, respectively, have MDT of 5 and 6 weeks with both having sensitivity close to 100% while the Mov-Avg Cusum method can only manage sensitivity of 77% with MDT of 6 weeks. However, the WCR and Mov-Avg Cusum methods outperform the ILI threshold method by 1 week in retrospective detection of the 2009 pandemic in Scotland. Conclusions While computationally and statistically simple to implement, the WCR algorithm is capable of raising alarms, rapidly and sensitively, for influenza pandemics against a background of seasonal influenza. Although the algorithm was developed using the SERVIS data, it has the capacity to be used at other geographic scales and for different disease systems where buying some early extra time is critical.

Robertson Chris

2010-11-01

95

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza  

Energy Technology Data Exchange (ETDEWEB)

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

2011-04-14

96

Antivirals in seasonal and pandemic influenza--future perspectives.  

Science.gov (United States)

Antiviral drugs continue to be an important option for the treatment of influenza disease and will likely be the only option during the early phases of pandemic. However, the limited number of drug classes licensed for treatment of influenza raises several issues, particularly in the face of drug resistance. Two classes of drugs are presently licensed for treatment of influenza, M2 and neuraminidase inhibitors. M2 inhibitors are currently not recommended for treatment of influenza because of widespread resistance and resistance to neuraminidase inhibitors has been observed during the past influenza seasonal outbreaks. Additional antiviral drugs with novel mechanisms of action are clearly needed for the treatment of influenza. Fortunately, the landscape of drugs in early and advanced development has dramatically increased over the last 5 years. Drugs targeting viral functions such as attachment, entry/fusion, transcription, and polymerase and drugs targeting host factors affecting viral replication are currently in clinical trials. Examples of these novel antiviral drugs and the challenges for influenza antiviral drug development are discussed in this article. PMID:23279900

Wathen, Michael W; Barro, Mario; Bright, Rick A

2013-01-01

97

Spatial Dynamics of Human-Origin H1 Influenza A Virus in North American Swine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The emergence and rapid global spread of the swine-origin H1N1/09 pandemic influenza A virus in humans underscores the importance of swine populations as reservoirs for genetically diverse influenza viruses with the potential to infect humans. However, despite their significance for animal and human health, relatively little is known about the phylogeography of swine influenza viruses in the United States. This study utilizes an expansive data set of hemagglutinin (HA1) sequences (n?=?151...

Nelson, Martha I.; Lemey, Philippe; Tan, Yi; Vincent, Amy; Lam, Tommy Tsan-yuk; Detmer, Susan; Viboud, Ce?cile; Suchard, Marc A.; Rambaut, Andrew; Holmes, Edward C.; Gramer, Marie

2011-01-01

98

Circulating avian influenza viruses closely related to the 1918 virus have pandemic potential.  

Science.gov (United States)

Wild birds harbor a large gene pool of influenza A viruses that have the potential to cause influenza pandemics. Foreseeing and understanding this potential is important for effective surveillance. Our phylogenetic and geographic analyses revealed the global prevalence of avian influenza virus genes whose proteins differ only a few amino acids from the 1918 pandemic influenza virus, suggesting that 1918-like pandemic viruses may emerge in the future. To assess this risk, we generated and characterized a virus composed of avian influenza viral segments with high homology to the 1918 virus. This virus exhibited pathogenicity in mice and ferrets higher than that in an authentic avian influenza virus. Further, acquisition of seven amino acid substitutions in the viral polymerases and the hemagglutinin surface glycoprotein conferred respiratory droplet transmission to the 1918-like avian virus in ferrets, demonstrating that contemporary avian influenza viruses with 1918 virus-like proteins may have pandemic potential. PMID:24922572

Watanabe, Tokiko; Zhong, Gongxun; Russell, Colin A; Nakajima, Noriko; Hatta, Masato; Hanson, Anthony; McBride, Ryan; Burke, David F; Takahashi, Kenta; Fukuyama, Satoshi; Tomita, Yuriko; Maher, Eileen A; Watanabe, Shinji; Imai, Masaki; Neumann, Gabriele; Hasegawa, Hideki; Paulson, James C; Smith, Derek J; Kawaoka, Yoshihiro

2014-06-11

99

Seasonal Influenza Vaccine Allocation in the Canadian Population during a Pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Introduction: Emerging data suggest that receipt of the seasonal influenza vaccine may be associated with an enhanced risk of infection with pandemic (H1N1) 2009 (pH1N1). We sought to evaluate different seasonal vaccination strategies during a pandemic in the presence of varying levels of pH1N1 infection risk following seasonal influenza vaccine receipt.

Tuite, Ashleigh; Fisman, David N.; Kwong, Jeffrey C.; Greer, Amy

2009-01-01

100

Comparison of Pandemic (H1N1) 2009 and Seasonal Influenza Viral Loads, Singapore  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Mean viral loads for patients with pandemic (H1N1) 2009 were ?1 log10 times lower than those for patients with seasonal influenza within the first week after symptom onset. Neither pandemic nor seasonal influenza viral loads correlated with clinical severity of illness. No correlation was found between viral loads and concurrent illness.

Lee, Chun K.; Lee, Hong K.; Loh, Tze P.; Lai, Florence Y. L.; Tambyah, Paul A.; Chiu, Lily; Koay, Evelyn S. C.; Tang, Julian W.

2011-01-01

 
 
 
 
101

CLINICAL CHARACTERIZATION OF H1N1 INFLUENZA TAQMAN REAL TIME PCR POSITIVE CASES  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: A novel swine origin influenza virus (H1N1) is spreading worldwide and become the first pandemic of the 21st century. The currently circulating strain of swine origin influenza virus of the H1N1 strain has undergone triple reassortment and contains genes from the avian, swine and human viruses. H1N1 critical illness mostly affects young patients and it is often fatal. Aim: The aim of the present study is to evaluate the clinical characteristic of H1N1 infection in a tertiary care ...

Sangita Revdiwala; Summaiya Mulla; Tanvi Panwala; Latika Shah; Arpita Shah

2012-01-01

102

Mortality from the influenza pandemic of 1918–19 in Indonesia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The influenza pandemic of 1918–19 was the single most lethal short-term epidemic of the twentieth century. For Indonesia, the world's fourth most populous country, the most widely used estimate of mortality from that pandemic is 1.5 million. We estimated mortality from the influenza pandemic in Java and Madura, home to the majority of Indonesia's population, using panel data methods and data from multiple quinquennial population counts and two decennial censuses. The new estimates suggest t...

Chandra, Siddharth

2013-01-01

103

Outbreak of pandemic influenza A/H1N1 2009 in Nepal  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Results Out of 609 collected samples, 302 (49.6%) were Universal Influenza A posi...

Adhikari Bal Ram; Shakya Geeta; Upadhyay Bishnu; Kc, Prakash Khagendra; Shrestha Sirjana; Dhungana Guna

2011-01-01

104

The first influenza pandemic of the 21st century  

Directory of Open Access Journals (Sweden)

Full Text Available The 2009 H1N1 influenza virus (formerly known as swine flu first appeared in Mexico and the United States in March and April 2009 and has swept the globe with unprecedented speed as a result of airline travel. On June 11, 2009, the World Health Organization raised its pandemic level to the highest level, Phase 6, indicating widespread community transmission on at least two continents. The 2009 H1N1 virus contains a unique combination of gene segments from human, swine and avian influenza A viruses. Children and young adults appear to be the most affected, perhaps reflecting protection in the elderly owing to exposure to H1N1 strains before 1957. Most clinical disease is relatively mild but complications leading to hospitalization, with the need for intensive care, can occur, especially in very young children, during pregnancy, in morbid obesity, and in those with underlying medical conditions such as chronic lung and cardiac diseases, diabetes, and immunosuppression. Bacterial co-infection has played a significant role in fatal cases. The case of fatality has been estimated at around 0.4%. Mathematical modeling suggests that the effect of novel influenza virus can be reduced by immunization, but the question remains: can we produce enough H1N1 vaccine to beat the pandemic?

Al Hajjar Sami

2010-01-01

105

Pandemic H1N1 influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The 2009 H1N1 influenza A virus that has targeted not only those with chronic medical illness, the very young and old, but also a large segment of the patient population that has previously been afforded relative protection - those who are young, generally healthy, and immune naive. The illness is mild in most, but results in hospitalization and severe ARDS in an important minority. Among those who become critically ill, 20-40% will die, predominantly of severe hypoxic respiratory failure. Ho...

Kumar, Anand

2011-01-01

106

Development of an Immunochromatographic Assay Specifically Detecting Pandemic H1N1 (2009) Influenza Virus ?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The pandemic caused by a new type of influenza virus, pandemic H1N1 (2009) influenza virus A (AH1pdm), has had a major worldwide impact. Since hemagglutinin (HA) genes are among the most specific genes in the influenza virus genome, AH1pdm can be definitively diagnosed by viral gene analysis targeting the HA genes. This type of analysis, however, cannot be easily performed in clinical settings. While commercially available rapid diagnosis kits (RDKs) based on immunochromatography can be used ...

Miyoshi-akiyama, Tohru; Narahara, Kenji; Mori, Sunao; Kitajima, Hirotake; Kase, Tetsuo; Morikawa, Saeko; Kirikae, Teruo

2010-01-01

107

Autopsy series of 68 cases dying before and during the 1918 influenza pandemic peak  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The 1918 to 1919 “Spanish” influenza pandemic virus killed up to 50 million people. We report here clinical, pathological, bacteriological, and virological findings in 68 fatal American influenza/pneumonia military patients dying between May and October of 1918, a period that includes ?4 mo before the 1918 pandemic was recognized, and 2 mo (September–October 1918) during which it appeared and peaked. The lung tissues of 37 of these cases were positive for influenza viral antigens or v...

Sheng, Zong-mei; Chertow, Daniel S.; Ambroggio, Xavier; Mccall, Sherman; Przygodzki, Ronald M.; Cunningham, Robert E.; Maximova, Olga A.; Kash, John C.; Morens, David M.; Taubenberger, Jeffery K.

2011-01-01

108

Direct association between pharyngeal viral secretion and host cytokine response in severe pandemic influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Severe disease caused by 2009 pandemic influenza A/H1N1virus is characterized by the presence of hypercytokinemia. The origin of the exacerbated cytokine response is unclear. As observed previously, uncontrolled influenza virus replication could strongly influence cytokine production. The objective of the present study was to evaluate the relationship between host cytokine responses and viral levels in pandemic influenza critically ill patients. Met...

Almansa Raquel; Anton Andres; Ramirez Paula; Martin-Loeches Ignacio; Banner David; Pumarola Tomás; Xu Luoling; Blanco Jesús; Ran Longsi; Lopez-Campos Guillermo; Martin-Sanchez Fernando; Socias Lorenzo; Loza Ana; Andaluz David; Maravi Enrique

2011-01-01

109

Potential for a global dynamic of Influenza A (H1N1)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Geographical and temporal diffusion patterns of a human pandemic due to Swine Origin Influenza Virus (S-OIV) remain uncertain. The extent to which national and international pandemic preparedness plans and control strategies can slow or stop the process is not known. However, despite preparedness efforts, it appears that, particularly in the USA, Mexico, Canada and the UK, local chains of virus transmission can sustain autonomous dynamics which may lead to...

Flahault Antoine; Vergu Elisabeta; Boëlle Pierre-Yves

2009-01-01

110

Transmissibility and geographic spread of the 1889 influenza pandemic.  

Science.gov (United States)

Until now, mortality and spreading mechanisms of influenza pandemics have been studied only for the 1918, 1957, and 1968 pandemics; none have concerned the 19th century. Herein, we examined the 1889 "Russian" pandemic. Clinical attack rates were retrieved for 408 geographic entities in 14 European countries and in the United States. Case fatality ratios were estimated from datasets in the French, British and German armies, and morbidity and mortality records of Swiss cities. Weekly all-cause mortality was analyzed in 96 European and American cities. The pandemic spread rapidly, taking only 4 months to circumnavigate the planet, peaking in the United States 70 days after the original peak in St. Petersburg. The median and interquartile range of clinical attack rates was 60% (45-70%). The case fatality ratios ranged from 0.1% to 0.28%, which is comparable to those of 1957 and 1968, and 10-fold lower than in 1918. The median basic reproduction number (R(0)) was 2.1, which is comparable to the values found for the other pandemics, despite the different viruses and contact networks. R(0) values varied widely from one city to another, and only a small minority of those values was within the range in which modelers' mitigation scenarios predicted effectiveness. The 1889 and 1918 R(0) correlated for the subset of cities for which both values were available. Social and geographic factors probably shape the local R(0) , and they could be identified to design optimal mitigation scenarios tailored to each city. PMID:20421481

Valleron, Alain-Jacques; Cori, Anne; Valtat, Sophie; Meurisse, Sofia; Carrat, Fabrice; Boëlle, Pierre-Yves

2010-05-11

111

Pandemic influenza A (H1N1) 2009 vaccine: An update  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The world witnessed a the first influenza pandemic in this century and fourth overall since first flu pandemic was reported during the World War I. The past experiences with influenza viruses and this pandemic of H1N1 place a consider-able strain on health services and resulted in serious illnesses and a large number of deaths. Develop-ing countries were declared more likely to be at risk from the pandemic effects, as they faced the dual problem of highly vulnerable populations and limited re...

Goel M; Khanna P; Mittal K

2011-01-01

112

Antiviral prophylaxis during pandemic influenza may increase drug resistance  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Neuraminidase inhibitors (NI and social distancing play a major role in plans to mitigate future influenza pandemics. Methods Using the freely available program InfluSim, the authors examine to what extent NI-treatment and prophylaxis promote the occurrence and transmission of a NI resistant strain. Results Under a basic reproduction number of R0 = 2.5, a NI resistant strain can only spread if its transmissibility (fitness is at least 40% of the fitness of the drug-sensitive strain. Although NI drug resistance may emerge in treated patients in such a late state of their disease that passing on the newly developed resistant viruses is unlikely, resistant strains quickly become highly prevalent in the population if their fitness is high. Antiviral prophylaxis further increases the pressure on the drug-sensitive strain and favors the spread of resistant infections. The authors show scenarios where pre-exposure antiviral prophylaxis even increases the number of influenza cases and deaths. Conclusion If the fitness of a NI resistant pandemic strain is high, any use of prophylaxis may increase the number of hospitalizations and deaths in the population. The use of neuraminidase inhibitors should be restricted to the treatment of cases whereas prophylaxis should be reduced to an absolute minimum in that case.

Koch Daniel

2009-01-01

113

Current status of live attenuated influenza vaccine in the United States for seasonal and pandemic influenza.  

Science.gov (United States)

A live attenuated influenza vaccine (LAIV) is currently approved in the United States for the prevention of influenza in individuals 2-49 years of age. This article summarizes the available data describing the safety and efficacy of LAIV for the prevention of influenza in both children and adults. LAIV is administered as an intranasal spray and has been shown to provide high levels of efficacy against influenza illness caused by both matched and mismatched strains in children and adults. In studies comparing LAIV and inactivated influenza vaccine in children, LAIV recipients experienced 35-53% fewer cases of culture-confirmed influenza illness caused by antigenically matched strains. Protection through a second influenza season against antigenically matched strains has also been seen in children. In adults, definitive comparative studies of LAIV and inactivated vaccine have not been conducted and no statistically significant differences in efficacy have been demonstrated. The most common adverse reactions with LAIV include runny nose/nasal congestion in all age groups, fever >100 degrees F in children, and sore throat in adults. Formulations of LAIV against pandemic influenza strains, including H5N1, H9N2, and H7N3, are currently being tested in preclinical and phase I clinical studies. PMID:19453395

Ambrose, Christopher S; Luke, Catherine; Coelingh, Kathleen

2008-11-01

114

Current status of live attenuated influenza vaccine in the United States for seasonal and pandemic influenza  

Science.gov (United States)

A live attenuated influenza vaccine (LAIV) is currently approved in the United States for the prevention of influenza in individuals 2–49 years of age. This article summarizes the available data describing the safety and efficacy of LAIV for the prevention of influenza in both children and adults. LAIV is administered as an intranasal spray and has been shown to provide high levels of efficacy against influenza illness caused by both matched and mismatched strains in children and adults. In studies comparing LAIV and inactivated influenza vaccine in children, LAIV recipients experienced 35–53% fewer cases of culture-confirmed influenza illness caused by antigenically matched strains. Protection through a second influenza season against antigenically matched strains has also been seen in children. In adults, definitive comparative studies of LAIV and inactivated vaccine have not been conducted and no statistically significant differences in efficacy have been demonstrated. The most common adverse reactions with LAIV include runny nose/nasal congestion in all age groups, fever >100°F in children, and sore throat in adults. Formulations of LAIV against pandemic influenza strains, including H5N1, H9N2, and H7N3, are currently being tested in preclinical and phase I clinical studies.

Ambrose, Christopher S; Luke, Catherine; Coelingh, Kathleen

2008-01-01

115

Pandemia de influenza: la respuesta de México / Influenza pandemic: Mexico's response  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish En 1992 apareció en el sureste asiático un nuevo tipo de virus de la influenza, el cual ha ocasionado hasta la fecha más de 120 casos y un poco más de 60 defunciones en humanos en Camboya, Vietnam, Indonesia y Tailandia. Esta situación es considerada por los expertos como la probable génesis de una [...] nueva pandemia de influenza, lo que podría traer graves consecuencias para la salud de la población, así como para la economía y el comercio mundial. Por lo anterior, la Organización Mundial de la Salud (OMS) ha instado a los países miembros a desarrollar planes de preparación y respuesta para hacer frente a esta eventualidad. En el marco del Comité Nacional para la Seguridad en Salud, México ha diseñado el Plan Nacional de Preparación y Respuesta ante una Pandemia de Influenza con objeto de proteger a la población mediante acciones efectivas y oportunas. El Plan utiliza una escala de riesgo y define cinco líneas de acción: Coordinación, Vigilancia Epidemiológica, Atención Médica, Difusión y Movilización Social, y Reserva Estratégica. Si bien es imposible predecir cuándo se presentará la próxima pandemia y su impacto, es fundamental que las autoridades de salud nacionales, estatales y locales establezcan los mecanismos para poner en marcha los componentes del Plan en forma oportuna y garantizar con ello la salud de la población en caso de influenza pandémica. Abstract in english In 1992, a new type of influenza virus appeared in Southeast Asia. This new strain has caused to date, more than 120 cases and over 60 deaths in Cambodia, Vietnam, Indonesia and Thailand. This situation is seen by the experts as the possible genesis of a new influenza pandemic with the corresponding [...] negative effects on the health of the population, international commerce and world economy. In order to face the coming challenge, the World Health Organization (WHO) has asked member countries to develop national preparedness and response plans for an influenza pandemic. Within the framework of the National Committee for Health Security, Mexico has developed a National Preparedness and Response Plan for an Influenza Pandemic with the aim of protecting the health of the population with timely and effective measures. The Plan is based on a risk scale and five lines of action: Coordination, Epidemiological Surveillance, Medical Care, Risk Communication and Strategic Stockpile. It is currently impossible to predict when the next pandemic will start or what will be its impact. Nevertheless, it is fundamental that national and regional health authorities establish measures for protecting the health of the population in case this emergency occurs.

Kuri-Morales, Pablo; Betancourt-Cravioto, Miguel; Velázquez-Monroy, Oscar; Alvarez-Lucas, Carlos; Tapia-Conyer, Roberto.

116

Pandemia de influenza: la respuesta de México / Influenza pandemic: Mexico's response  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish En 1992 apareció en el sureste asiático un nuevo tipo de virus de la influenza, el cual ha ocasionado hasta la fecha más de 120 casos y un poco más de 60 defunciones en humanos en Camboya, Vietnam, Indonesia y Tailandia. Esta situación es considerada por los expertos como la probable génesis de una [...] nueva pandemia de influenza, lo que podría traer graves consecuencias para la salud de la población, así como para la economía y el comercio mundial. Por lo anterior, la Organización Mundial de la Salud (OMS) ha instado a los países miembros a desarrollar planes de preparación y respuesta para hacer frente a esta eventualidad. En el marco del Comité Nacional para la Seguridad en Salud, México ha diseñado el Plan Nacional de Preparación y Respuesta ante una Pandemia de Influenza con objeto de proteger a la población mediante acciones efectivas y oportunas. El Plan utiliza una escala de riesgo y define cinco líneas de acción: Coordinación, Vigilancia Epidemiológica, Atención Médica, Difusión y Movilización Social, y Reserva Estratégica. Si bien es imposible predecir cuándo se presentará la próxima pandemia y su impacto, es fundamental que las autoridades de salud nacionales, estatales y locales establezcan los mecanismos para poner en marcha los componentes del Plan en forma oportuna y garantizar con ello la salud de la población en caso de influenza pandémica. Abstract in english In 1992, a new type of influenza virus appeared in Southeast Asia. This new strain has caused to date, more than 120 cases and over 60 deaths in Cambodia, Vietnam, Indonesia and Thailand. This situation is seen by the experts as the possible genesis of a new influenza pandemic with the corresponding [...] negative effects on the health of the population, international commerce and world economy. In order to face the coming challenge, the World Health Organization (WHO) has asked member countries to develop national preparedness and response plans for an influenza pandemic. Within the framework of the National Committee for Health Security, Mexico has developed a National Preparedness and Response Plan for an Influenza Pandemic with the aim of protecting the health of the population with timely and effective measures. The Plan is based on a risk scale and five lines of action: Coordination, Epidemiological Surveillance, Medical Care, Risk Communication and Strategic Stockpile. It is currently impossible to predict when the next pandemic will start or what will be its impact. Nevertheless, it is fundamental that national and regional health authorities establish measures for protecting the health of the population in case this emergency occurs.

Kuri-Morales, Pablo; Betancourt-Cravioto, Miguel; Velázquez-Monroy, Oscar; Alvarez-Lucas, Carlos; Tapia-Conyer, Roberto.

117

Mortality from the influenza pandemic of 1918-19 in Indonesia.  

Science.gov (United States)

The influenza pandemic of 1918-19 was the single most lethal short-term epidemic of the twentieth century. For Indonesia, the world's fourth most populous country, the most widely used estimate of mortality from that pandemic is 1.5 million. We estimated mortality from the influenza pandemic in Java and Madura, home to the majority of Indonesia's population, using panel data methods and data from multiple quinquennial population counts and two decennial censuses. The new estimates suggest that, for Java alone, population loss was in the range of 4.26-4.37 million, or more than twice the established estimate for mortality for all of Indonesia. We conclude that the standing estimates of mortality from influenza in Java and Indonesia need to be revised upward significantly. We also present new findings on geographic patterns of population loss across Java, and pre-pandemic and post-pandemic population growth rates. PMID:23339482

Chandra, Siddharth

2013-07-01

118

Lessons from the NSW laboratory response to pandemic (H1N1) 2009 influenza.  

Science.gov (United States)

Procedures undertaken by NSW Health in the laboratory response to pandemic (H1N1) 2009 influenza were reviewed to assist planning for a future infectious disease emergency. Laboratory plans developed prior to the pandemic sought rapid detection of pandemic virus in the early phases of the pandemic response until demonstration of widespread community transmission, followed then by limited testing when indicated clinically. As planned, the laboratory response was based on the Pandemic Influenza Management System with a web-based outbreak management tool, NetEpi, as the single public health database used for cases and test results. This was found to be effective for tracking specimens and results, and enhanced the public health response. The sustained large volume of community testing during this mild pandemic had an adverse effect on the timely delivery of priority results. PMID:20374693

Adamson, Sheena; Fizzell, Jan; Dwyer, Dominic E; Rawlinson, William; Armstrong, Paul K

2010-01-01

119

Discovery and characterization of the 1918 pandemic influenza virus in historical context.  

Science.gov (United States)

The 2005 completion of the entire genome sequence of the 1918 H1N1 pandemic influenza virus represents both a beginning and an end. Investigators have already begun to study the virus in vitro and in vivo to better understand its properties, pathogenicity, transmissibility and elicitation of host responses. Although this is an exciting new beginning, characterization of the 1918 virus also represents the culmination of over a century of scientific research aiming to understand the causes of pandemic influenza. In this brief review we attempt to place in historical context the identification and sequencing of the 1918 virus, including the alleged discovery of a bacterial cause of influenza during the 1889-1893 pandemic, the controversial detection of 'filter-passing agents' during the 1918-1919 pandemic, and subsequent breakthroughs in the 1930s that led to isolation of human and swine influenza viruses, greatly influencing the development of modern virology. PMID:17944266

Taubenberger, Jeffery K; Hultin, Johan V; Morens, David M

2007-01-01

120

Characterizing the Epidemiology of the 2009 Influenza A/H1N1 Pandemic in Mexico  

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Gerardo Chowell and colleagues address whether school closures and other social distancing strategies were successful in reducing pandemic flu transmission in Mexico by analyzing the age- and state-specific incidence of influenza morbidity and mortality in 32 Mexican states.

Chowell, Gerardo; Echevarri?a-zuno, Santiago; Viboud, Ce?cile; Simonsen, Lone; Tamerius, James; Miller, Mark A.; Borja-aburto, Vi?ctor H.

2011-01-01

 
 
 
 
121

Hedging against Antiviral Resistance during the Next Influenza Pandemic Using Small Stockpiles of an Alternative Chemotherapy  

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Mathematically simulating an influenza pandemic, Joseph Wu and colleagues predict that using a secondary antiviral drug early in local epidemics would reduce global emergence of resistance to the primary stockpiled drug.

Wu, Joseph T.; Leung, Gabriel M.; Lipsitch, Marc; Cooper, Ben S.; Riley, Steven

2009-01-01

122

Pandemic influenza: implications for preparation and delivery of critical care services.  

Science.gov (United States)

In a 5-week span during the 1918 influenza A pandemic, more than 2000 patients were admitted to Cook County Hospital in Chicago, with a diagnosis of either influenza or pneumonia; 642 patients, approximately 31% of those admitted, died, with deaths occurring predominantly in patients of age 25 to 30 years. This review summarizes basic information on the biology, epidemiology, control, treatment and prevention of influenza overall, and then addresses the potential impact of pandemic influenza in an intensive care unit setting. Issues that require consideration include workforce staffing and safety, resource management, alternate sites of care surge of patients, altered standards of care, and crisis communication. PMID:21220275

Manuell, Mary-Elise; Co, Mary Dawn T; Ellison, Richard T

2011-01-01

123

Factors associated with 2009 pandemic influenza A (H1N1) vaccination acceptance among university students from India during the post-pandemic phase  

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Background: There was a low adherence to influenza A (H1N1) vaccination program among university students and health care workers during the pandemic influenza in many parts of the world. Vaccination of high risk individuals is one of the recommendations of World Health Organization during the post-pandemic period. It is not documented about the student's knowledge, attitude and willingness to accept H1N1 vaccination during the post-pandemic period. We aimed to analyze the student's knowledge...

2011-01-01

124

Antiviral resistance during pandemic influenza: implications for stockpiling and drug use  

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Abstract Background The anticipated extent of antiviral use during an influenza pandemic can have adverse consequences for the development of drug resistance and rationing of limited stockpiles. The strategic use of drugs is therefore a major public health concern in planning for effective pandemic responses. Methods We employed a mathematical model that includes both sensitive and resistant strains of a virus with pandemic potential, and applies antiviral drugs...

Arino Julien; Bowman Christopher S; Moghadas Seyed M

2009-01-01

125

THE POLITICS OF MEDICINE AND THE GLOBAL GOVERNANCE OF PANDEMIC INFLUENZA  

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While still significant, the 2009 H1N1 (A) influenza pandemic was generally viewed as comparatively mild in contrast to past influenza pandemics. Even so, the conventional response of many governments to protect their populations against the threat from the H1N1 virus was to ensure adequate vaccine production and/or access to supplies of vaccines and antiviral medications. In this article, I examine the influence of biomedical knowledge (and the professionals that wield it) in determining the...

2013-01-01

126

Pandemic influenza control in Europe and the constraints resulting from incoherent public health laws.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND: With the emergence of influenza H1N1v the world is facing its first 21st century global pandemic. Severe Acute Respiratory Syndrome (SARS) and avian influenza H5N1 prompted development of pandemic preparedness plans. National systems of public health law are essential for public health stewardship and for the implementation of public health policy. International coherence will contribute to effective regional and global responses. However little research has been undertaken on how...

Martin, Robyn; Conseil, Alexandra; Longstaff, Abie; Kodo, Jimmy; Siegert, Joachim; Duguet, Anne-marie; Lobato Faria, Paula; Haringhuizen, George; Espin, Jaime; Coker, Richard

2010-01-01

127

Serological Analysis of Human Pandemic Influenza (H1N1) in Thailand  

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The study was aimed at determining the prevalence of pandemic influenza (H1N1) 2009 among patients with respiratory tract diseases during July-December 2009 using real-time reverse transcription polymerase chain reaction. Haemagglutination inhibition (HI) assay was performed to detect antibody titres against pandemic influenza in 255 medical personnel, 307 members of the general population during the second week of December 2009 in Khon Kaen province, Thailand, and in 100 stored sera collecte...

Prachayangprecha, Slinporn; Makkoch, Jarika; Payungporn, Sunchai; Chieochansin, Thaweesak; Vuthitanachot, Chanpim; Vuthitanachot, Viboonsuk; Theamboonlers, Apiradee; Poovorawan, Yong

2010-01-01

128

Variations in the Hemagglutinin of the 2009 H1N1 Pandemic Virus: Potential for Strains with Altered Virulence Phenotype?  

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A novel, swine-origin influenza H1N1 virus (H1N1pdm) caused the first pandemic of the 21st century. This pandemic, although efficient in transmission, is mild in virulence. This atypical mild pandemic season has raised concerns regarding the potential of this virus to acquire additional virulence markers either through further adaptation or possibly by immune pressure in the human host. Using the mouse model we generated, within a single round of infection with A/California/04/09/H1N1 (Ca/04)...

2010-01-01

129

Comparative age distribution of influenza morbidity and mortality during seasonal influenza epidemics and the 2009 H1N1 pandemic  

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Full Text Available Abstract Background Several studies have shown a relatively high mortality rate among young people infected by the 2009 pandemic influenza A (H1N1 virus. Here we compared the age distributions of morbidity and mortality during two seasonal influenza epidemics (H1N1 and H3N2 in France and the United States with those of the 2009 H1N1 pandemic waves in the same countries. Methods Age-standardized ratios were used to compare the age distribution of morbidity and mortality due to influenza between the two countries and across the different years. Non parametric analysis of variance was used to compare these ratios between epidemic and pandemic influenza. Results Age distribution of morbidity was similar between the 2009 pandemic and seasonal epidemics due to H1N1 (p = 0.72 and H3N2 viruses (p = 0.68. In contrast, the proportion of under-60s among influenza deaths was markedly higher during the 2009 pandemic (peak Conclusions Young age was a principal mortality risk factor due to the 2009 H1N1 pandemic.

Lemaitre Magali

2010-06-01

130

Pandemic Influenza as 21st Century Urban Public Health Crisis  

Science.gov (United States)

The percentage of the world’s population living in urban areas will increase from 50% in 2008 to 70% (4.9 billion) in 2025. Crowded urban areas in developing and industrialized countries are uniquely vulnerable to public health crises and face daunting challenges in surveillance, response, and public communication. The revised International Health Regulations require all countries to have core surveillance and response capacity by 2012. Innovative approaches are needed because traditional local-level strategies may not be easily scalable upward to meet the needs of huge, densely populated cities, especially in developing countries. The responses of Mexico City and New York City to the initial appearance of influenza A pandemic (H1N1) 2009 virus during spring 2009 illustrate some of the new challenges and creative response strategies that will increasingly be needed in cities worldwide.

Weisfuse, Isaac B.; Hernandez-Avila, Mauricio; del Rio, Carlos; Bustamante, Xinia; Rodier, Guenael

2009-01-01

131

Age-prioritized use of antivirals during an influenza pandemic  

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Full Text Available Abstract Background The WHO suggested that governments stockpile, as part of preparations for the next influenza pandemic, sufficient influenza antiviral drugs to treat approximately 25% of their populations. Our aim is two-fold: first, since in many countries the antiviral stockpile is well below this level, we search for suboptimal strategies based on treatment provided only to an age-dependent fraction of cases. Second, since in some countries the stockpile exceeds the suggested minimum level, we search for optimal strategies for post-exposure prophylactic treatment of close contacts of cases. Methods We used a stochastic, spatially structured individual-based model, considering explicit transmission in households, schools and workplaces, to simulate the spatiotemporal spread of an influenza pandemic in Italy and to evaluate the efficacy of interventions based on age-prioritized use of antivirals. Results Our results show that the antiviral stockpile required for treatment of cases ranges from 10% to 35% of the population for R0 in 1.4 – 3. No suboptimal strategies, based on treatment provided to an age-dependent fraction of cases, were found able to remarkably reduce both clinical attack rate and antiviral drugs needs, though they can contribute to largely reduce the excess mortality. Treatment of all cases coupled with prophylaxis provided to younger individuals is the only intervention resulting in a significant reduction of the clinical attack rate and requiring a relatively small stockpile of antivirals. Conclusion Our results strongly suggest that governments stockpile sufficient influenza antiviral drugs to treat approximately 25% of their populations, under the assumption that R0 is not much larger than 2. In countries where the number of antiviral stockpiled exceeds the suggested minimum level, providing prophylaxis to younger individuals is an option that could be taken into account in preparedness plans. In countries where the number of antivirals stockpiled is well below 25% of the population, priority should be decided based on age-specific case fatality rates. However, late detection of cases (administration of antivirals 48 hours after the clinical onset of symptoms dramatically affects the efficacy of both treatment and prophylaxis.

Ajelli Marco

2009-07-01

132

Cross Sectional Survey of Influenza Antibodies before and during the 2009 Pandemic in Shenzhen, China  

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Much information is available for the 2009 H1N1 influenza immunity response, but little is known about the antibody change in seasonal influenza before and during the novel influenza A pandemic. In this study, we conducted a cross-sectional serological survey of 4 types of major seasonal influenza in March and September 2009 on a full range of age groups, to investigate seasonal influenza immunity response before and during the outbreak of the sH1N1 influenza in Shenzhen – the largest migra...

Wu, Chun-li; Lu, Juan; Wang, Maggie Haitian; Lv, Xing; Chen, Ying; Kung, Hsiang-fu; Zee, Benny; Cheng, Xiao-wen; He, Ming-liang

2013-01-01

133

Inactivated Seasonal Influenza Vaccines Increase Serum Antibodies to the Neuraminidase of Pandemic Influenza A(H1N1) 2009 Virus in an Age-Dependent Manner  

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Levels of preexisting antibodies to the hemagglutinin of pandemic influenza A(H1N1) 2009 (hereafter pandemic H1N1) virus positively correlate with age. The impact of contemporary seasonal influenza vaccines on establishing immunity to other pandemic H1N1 proteins is unknown. We measured serum antibodies to the neuraminidase (NA) of pandemic H1N1 in adults prior to and after vaccination with seasonal trivalent inactivated influenza vaccines. Serum antibodies to pandemic H1N1 NA were observed i...

Marcelin, Glendie; Bland, Hilliary M.; Negovetich, Nicholas J.; Sandbulte, Matthew R.; Ellebedy, Ali H.; Webb, Ashley D.; Griffin, Yolanda S.; Debeauchamp, Jennifer L.; Mcelhaney, Janet E.; Webby, Richard J.

2010-01-01

134

The investigation of Risk factors of influenza pandemic H1N1  

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Full Text Available Introduction: Influenza pandemic H1N1 is an acute respiratory infectious disease that is combination of two types of influenza virus type A (H1N1. This study aimed to identify risk factors affecting influenza pandemic H1N1. Methods: In this case-control study, the cases were 18 positive cases of pandemic influenza H1N1 and the controls were the patients who were admitted during the same time as the cases to sections of Orthopedics, Urology, Surgery and Women of the same hospital for reasons other than influenza. The data were collected through a form by two experienced nurses and then were fed into SPSS, and were analyzed using independent T-test and chi-square. Results: A significant relationship was observed between pandemic H1N1 influenza infection and a history of domestic travel, contact with confirmed patients, respiratory diseases, and diabetes (P0.05. Conclusion: People with underlying diseases, especially respiratory diseases, diabetes, heart disease and a secondary infection and cardiovascular disease most likely are susceptible to influenza pandemic H1N1.

koorosh Holakooyi Naeini

2010-01-01

135

Efficacy of a pandemic (H1N1) 2009 virus vaccine in pigs against the pandemic influenza virus is superior to commercially available swine influenza vaccines.  

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In April 2009 a new influenza A/H1N1 strain, currently named “pandemic (H1N1) influenza 2009? (H1N1v), started the first official pandemic in humans since 1968. Several incursions of this virus in pig herds have also been reported from all over the world. Vaccination of pigs may be an option to reduce exposure of human contacts with infected pigs, thereby preventing cross-species transfer, but also to protect pigs themselves, should this virus cause damage in the pig population. Three swi...

Loeffen, W. L. A.; Stockhofe-zurwieden, N.; Weesendorp, E.; Zoelen-bos, D. J.; Heutink, R.; Quak, J.; Goovaerts, D.; Heldens, J.; Maas, H. A.; Moormann, R. J. M.; Koch, G.

2011-01-01

136

Pandemic (H1N1) 2009 Surveillance and Prevalence of Seasonal Influenza, Singapore  

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On April 25, 2009, Singapore implemented strict containment measures for pandemic (H1N1) 2009 with enhanced surveillance and hospital isolation. In the first month, seasonal influenza, predominantly virus subtype H3N2, was diagnosed for 32% of patients with acute febrile respiratory illness. Our findings underscore the high prevalence of seasonal influenza in Singapore.

Leo, Yee-sin; Lye, David C.; Barkham, Timothy; Krishnan, Prabha; Seow, Eillyne; Chow, Angela

2010-01-01

137

Cross Sectional Survey of Influenza Antibodies before and during the 2009 Pandemic in Shenzhen, China  

Science.gov (United States)

Much information is available for the 2009 H1N1 influenza immunity response, but little is known about the antibody change in seasonal influenza before and during the novel influenza A pandemic. In this study, we conducted a cross-sectional serological survey of 4 types of major seasonal influenza in March and September 2009 on a full range of age groups, to investigate seasonal influenza immunity response before and during the outbreak of the sH1N1 influenza in Shenzhen – the largest migration city in China. We found that the 0–5 age group had an increased antibody level for all types of seasonal influenza during the pandemic compared to the pre-outbreak level, in contrast with almost all other age groups, in which the antibody level decreased. Also, distinct from the antibodies of A/H3N2, B/Yamagata and B/Victoria that decreased significantly during the 2009 H1N1 pandemic, the antibody of A/H1N1 showed no statistical difference from the pre-outbreak level. The results suggest that the antibodies against the 2009 sH1N1 cross-reacted with seasonal H1N1. Moreover, the 0–5 age group was under attack by both seasonal and 2009 H1N1 influenza during the pandemic, hence vaccination merely against a new strain of flu might not be enough to protect the youngest group.

Lv, Xing; Chen, Ying; Kung, Hsiang-fu; Zee, Benny; Cheng, Xiao-wen; He, Ming-Liang

2013-01-01

138

Influenza and SARS: the impact of viral pandemics on maritime health.  

Science.gov (United States)

Global travel and transport play a critical role in the spread of infections. We see this clearly in the first two pandemics of the 21st century: SARS and influenza H1N1-2009. Although air travel contributed to dissemination in these two pandemics, the travel restrictions, quarantines, and heightened vigilance which resulted had an impact on maritime health. Seasonal, pandemic, and avian influenza have some important differences with regards to exposure risks, infectivity, and severity. Most of the data for maritime influenza outbreaks focus on seasonal influenza on cruise ships, but influenza among crew members occurs due to close working conditions and is potentially preventable with staff vaccination programs. To date, avian influenza has low human-to-human transmission; infection typically requires close contact with poultry, but presents with severe disease and a high fatality rate. Pandemic (swine) influenza was readily transmitted between people, including young adults, and caused severe illness in high-risk groups including pregnant women, children, and those with co-morbidities and obesity. In contrast, SARS had lower infectivity compared to influenza, and a longer incubation period. These characteristics slowed its propagation enough that outbreak control measures, such as isolation of infected cases and quarantine of exposed but well persons, were effective in terminating this pandemic. No effective vaccine exists for SARS at this time, whereas countries were able to deploy millions of doses of pandemic influenza vaccine within 7 months after the outbreak was first recognized in Mexico. The lack of a protective vaccine and the higher case fatality rate in SARS will mean that stringent quarantine measures may still be required for outbreak control if SARS ever occurs again. Compliance with international health regulations, and the ability to adapt these to maritime health needs, will be important in the shipping industry. PMID:22258842

Lim, Poh Lian

2011-01-01

139

Pandemic influenza control in Europe and the constraints resulting from incoherent public health laws  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background With the emergence of influenza H1N1v the world is facing its first 21st century global pandemic. Severe Acute Respiratory Syndrome (SARS and avian influenza H5N1 prompted development of pandemic preparedness plans. National systems of public health law are essential for public health stewardship and for the implementation of public health policy1. International coherence will contribute to effective regional and global responses. However little research has been undertaken on how law works as a tool for disease control in Europe. With co-funding from the European Union, we investigated the extent to which laws across Europe support or constrain pandemic preparedness planning, and whether national differences are likely to constrain control efforts. Methods We undertook a survey of national public health laws across 32 European states using a questionnaire designed around a disease scenario based on pandemic influenza. Questionnaire results were reviewed in workshops, analysing how differences between national laws might support or hinder regional responses to pandemic influenza. Respondents examined the impact of national laws on the movements of information, goods, services and people across borders in a time of pandemic, the capacity for surveillance, case detection, case management and community control, the deployment of strategies of prevention, containment, mitigation and recovery and the identification of commonalities and disconnects across states. Results Results of this study show differences across Europe in the extent to which national pandemic policy and pandemic plans have been integrated with public health laws. We found significant differences in legislation and in the legitimacy of strategic plans. States differ in the range and the nature of intervention measures authorized by law, the extent to which borders could be closed to movement of persons and goods during a pandemic, and access to healthcare of non-resident persons. Some states propose use of emergency powers that might potentially override human rights protections while other states propose to limit interventions to those authorized by public health laws. Conclusion These differences could create problems for European strategies if an evolving influenza pandemic results in more serious public health challenges or, indeed, if a novel disease other than influenza emerges with pandemic potential. There is insufficient understanding across Europe of the role and importance of law in pandemic planning. States need to build capacity in public health law to support disease prevention and control policies. Our research suggests that states would welcome further guidance from the EU on management of a pandemic, and guidance to assist in greater commonality of legal approaches across states.

Martin Robyn

2010-09-01

140

Interleukin-6 Is a Potential Biomarker for Severe Pandemic H1N1 Influenza A Infection  

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Pandemic H1N1 influenza A (H1N1pdm) is currently a dominant circulating influenza strain worldwide. Severe cases of H1N1pdm infection are characterized by prolonged activation of the immune response, yet the specific role of inflammatory mediators in disease is poorly understood. The inflammatory cytokine IL-6 has been implicated in both seasonal and severe pandemic H1N1 influenza A (H1N1pdm) infection. Here, we investigated the role of IL-6 in severe H1N1pdm infection. We found IL-6 to be an...

Paquette, Ste?phane G.; Banner, David; Zhao, Zhen; Fang, Yuan; Huang, Stephen S. H.; Le??n, Alberto J.; Ng, Derek C. K.; Almansa, Raquel; Martin-loeches, Ignacio; Ramirez, Paula; Socias, Lorenzo; Loza, Ana; Blanco, Jesus; Sansonetti, Paola; Rello, Jordi

2012-01-01

 
 
 
 
141

Experimental Infection of Pigs with the Human 1918 Pandemic Influenza Virus?  

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Swine influenza was first recognized as a disease entity during the 1918 “Spanish flu” pandemic. The aim of this work was to determine the virulence of a plasmid-derived human 1918 pandemic H1N1 influenza virus (reconstructed 1918, or 1918/rec, virus) in swine using a plasmid-derived A/swine/Iowa/15/1930 H1N1 virus (1930/rec virus), representing the first isolated influenza virus, as a reference. Four-week-old piglets were inoculated intratracheally with either the 1930/rec or the 1918/re...

Weingartl, Hana M.; Albrecht, Randy A.; Lager, Kelly M.; Babiuk, Shawn; Marszal, Peter; Neufeld, James; Embury-hyatt, Carissa; Lekcharoensuk, Porntippa; Tumpey, Terrence M.; Garci?a-sastre, Adolfo; Richt, Ju?rgen A.

2009-01-01

142

Chest radiography findings in adults with pandemic H1N1 2009 influenza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The current pandemic of a novel influenza A (H1N1) virus, commonly referred to as “swine flu”, began in Mexico in March 2009 and reached the UK in April 2009. By 21 July 2009, more than 850 suspected cases of influenza had been seen at Birmingham Heartlands Hospital (BHH), including 52 adults with laboratory-confirmed pandemic H1N1 influenza who were admitted. Of seven patients (13%) requiring intensive care, six needed mechanical ventilation, two needed extra-corporeal membrane oxygenati...

Mcewen, R. E.; Scriven, J. E.; Green, C. A.; Bailey, M. S.; Banerjee, A. K.

2010-01-01

143

Are we prepared to help low-resource communities cope with a severe influenza pandemic?  

Science.gov (United States)

Recent research involving lab-modified H5N1 influenza viruses with increased transmissibility and the ongoing evolution of the virus in nature should remind us of the continuing importance of preparedness for a severe influenza pandemic. Current vaccine technology and antiviral supply remain inadequate, and in a severe pandemic, most low-resource communities will fail to receive adequate medical supplies. However, with suitable guidance, these communities can take appropriate actions without substantial outside resources to reduce influenza transmission and care for the ill. Such guidance should be completed, and support provided to developing countries to adapt it for their settings and prepare for implementation. PMID:23145978

Starbuck, Eric S; von Bernuth, Rudolph; Bolles, Kathryn; Koepsell, Jeanne

2013-11-01

144

DNA Vaccination Elicits Protective Immune Responses against Pandemic and Classic Swine Influenza Viruses in Pigs ? †  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Swine influenza is a highly contagious viral infection in pigs that significantly impacts the pork industry due to weight loss and secondary infections. There is also the potential of a significant threat to public health, as was seen in 2009 when the pandemic H1N1 influenza virus strain emerged from reassortment events among avian, swine, and human influenza viruses within pigs. As classic and pandemic H1N1 strains now circulate in swine, an effective vaccine may be the best strategy to prot...

Gorres, J. Patrick; Lager, Kelly M.; Kong, Wing-pui; Royals, Michael; Todd, John-paul; Vincent, Amy L.; Wei, Chih-jen; Loving, Crystal L.; Zanella, Eraldo L.; Janke, Bruce; Kehrli, Marcus E.; Nabel, Gary J.; Rao, Srinivas S.

2011-01-01

145

The human potential of a recombinant pandemic influenza vaccine produced in tobacco plants  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Rapid production of influenza vaccine antigen is an important challenge when a new pandemic occurs. Production of recombinant antigens in plants is a quick, cost effective and up scalable new strategy for influenza vaccine production. In this study, we have characterized a recombinant influenza haemagglutinin antigen (HAC1) that was derived from the 2009 pandemic H1N1 (pdmH1N1) virus and expressed in tobacco plants. Volunteers vaccinated with the 2009 pdmH1N1 oil-in-water adjuvanted vaccine p...

Jul-larsen, A?sne; Madhun, Abdullah S.; Brokstad, Karl A.; Montomoli, Emanuele; Yusibov, Vidadi; Cox, Rebecca J.

2012-01-01

146

Ostrich produce cross-reactive neutralization antibodies against pandemic influenza virus A/H1N1 following immunization with a seasonal influenza vaccine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An outbreak of influenza in 2009 was found to be caused by a novel strain of influenza virus designated as pandemic influenza A/H1N1 2009. Vaccination with recent seasonal influenza vaccines induced little or no cross-reactive antibody response to the pandemic influenza virus A/H1N1 2009 in any age group in human populations. Accordingly, most people had low immunity against this pathogen, thus resulting in the worldwide spread of the infection to produce a so-called ‘pandemic’. This repo...

Adachi, Kazuhide; Takama, Kentaro; Tsukamoto, Masaya; Inai, Marie; Handharyani, Ekowati; Hiroi, Satoshi; Tsukamoto, Yasuhiro

2011-01-01

147

Tracking the evolution and geographic spread of Influenza A  

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The 2009 swine-origin strain of Influenza A H1N1 has spread to nearly all parts of the world, with 175 countries reporting confirmed cases thus far. Consistent with seasonal flu outbreaks, the current pandemic strain has shown rapid dispersal, with multiple examples of introduction into different geographic regions. Here we use an automated pipeline to collect data for analysis in the geospatial package GenGIS, which allows the geographic and temporal tracking of new sequence types and polymo...

Donovan Parks; Macdonald, Norman; Beiko, Robert

2009-01-01

148

“It's as Bad as Anything Can Be”: Patients, Identity, and the Influenza Pandemic  

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Americans were stunned when pandemic influenza hit the United States in 1918. Recent advances in bacteriology and public health allowed Americans to imagine a future free of infectious disease, even as their familiarity with influenza tempered their fears of it. They soon realized this influenza was something unprecedented, as it shocked them with its pace, virulence, mortality patterns, and symptoms. Patients endured and frequently succumbed to a miserable illness, their suffering often made...

Bristow, Nancy K.

2010-01-01

149

Capacity Building in Response to Pandemic Influenza Threats: Lao PDR Case Study  

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The Lao People's Democratic Republic (PDR) committed to pandemic detection and response preparations when faced with the threat of avian influenza. Since 2006, the National Center for Laboratory and Epidemiology of Lao PDR has developed credible laboratory, surveillance, and epidemiological (human) capacity and as a result was designated a World Health Organization National Influenza Center in 2010. The Lao PDR experience in building influenza capacities provides a case study of the considera...

Phommasack, Bounlay; Moen, Ann; Vongphrachanh, Phengta; Tsuyuoka, Reiko; Cox, Nancy; Khamphaphongphanh, Bouaphanh; Phonekeo, Darouny; Kasai, Takeshi; Ketmayoon, Pakapak; Lewis, Hannah; Kounnavong, Bounheuang; Khanthamaly, Viengphone; Corwin, Andrew

2012-01-01

150

Pandemic influenza H1N1 outbreak in the military school  

Directory of Open Access Journals (Sweden)

Full Text Available Background/Aim. The first cases of the pandemic pH1N1 influenza virus infection was observed in the United States and Mexico in April 2009 and the first laboratory confirmed case in Serbia was registered in June 2009. The aim of this paper was to report on the investigation of the first confirmed outbreak of the 2009 pandemic H1N1 influenza in Serbia and to describe the clinical and epidemiologic findings from this investigation. Methods. Descriptive and analytical epidemiological methods were used. Data were collected from medical records of the Military School students and epidemiological questionnaire. Pandemic H1N1 infection was initially confirmed by the RT-PCR assay in nasopharyngeal and oropharyngeal swabs and subsequently by the complement fixation test in serum samples. Results. The attack rate of acute respiratory illness was 70.8% (204/288. Pandemic H1N1 virus infection was confirmed in 44 of 82 tested cases of acute respiratory illness (53.7% The most common clinical manifestations of pandemic influenza H1N1 were fever (88.6%, cough (61.4%, malaise (38.6%, runny nose (36.4%, headache (29.6%, sore throat (20.5% and muscle pain (15.9%. Conclusion. The findings from this investigation suggest that pandemic H1N1 influenza in a high military school was widespread but did not cause severe illness.

Mladenovi? Jovan

2013-01-01

151

Inactivated seasonal influenza vaccines increase serum antibodies to the neuraminidase of pandemic influenza A(H1N1) 2009 virus in an age-dependent manner.  

Science.gov (United States)

Levels of preexisting antibodies to the hemagglutinin of pandemic influenza A(H1N1) 2009 (hereafter pandemic H1N1) virus positively correlate with age. The impact of contemporary seasonal influenza vaccines on establishing immunity to other pandemic H1N1 proteins is unknown. We measured serum antibodies to the neuraminidase (NA) of pandemic H1N1 in adults prior to and after vaccination with seasonal trivalent inactivated influenza vaccines. Serum antibodies to pandemic H1N1 NA were observed in all age groups; however, vaccination elevated levels of pandemic H1N1 NA antibodies predominately in elderly individuals (age, ?60 years). Therefore, contemporary seasonal vaccines likely contribute to reduction of pandemic H1N1-associated disease in older individuals. PMID:20979454

Marcelin, Glendie; Bland, Hilliary M; Negovetich, Nicholas J; Sandbulte, Matthew R; Ellebedy, Ali H; Webb, Ashley D; Griffin, Yolanda S; DeBeauchamp, Jennifer L; McElhaney, Janet E; Webby, Richard J

2010-12-01

152

Influenza surveillance in the Pacific Island countries and territories during the 2009 pandemic: an observational study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Historically, Pacific island countries and territories (PICTs have been more severely affected by influenza pandemics than any other part of the world. We herein describe the emergence and epidemiologic characteristics of pandemic influenza H1N1 in PICTs from 2009 to 2010. Methods The World Health Organization gathered reports of influenza-like-illness and laboratory-confirmed pandemic H1N1 cases from all 23 Pacific island countries and territories, from April 2009 through August 2010. Data were gathered through weekly email reports from Pacific island countries and territories and through email or telephone follow-up. Results Pacific island countries and territories started detecting pandemic H1N1 cases in June 2009, firstly in French Polynesia, with the last new detection occurring in August 2009 in Tuvalu. Nineteen Pacific island countries and territories reported 1,972 confirmed cases, peaking in August 2009. No confirmed pandemic H1N1 cases were identified in Niue, Pitcairn and Tokelau; the latter instituted strict maritime quarantine. Influenza-like-illness surveillance showed trends similar to surveillance of confirmed cases. Seven Pacific island countries and territories reported 21 deaths of confirmed pandemic H1N1. Case-patients died of acute respiratory distress syndrome or multi-organ failure, or both. The most reported pre-existing conditions were obesity, lung disease, heart disease, and pregnancy. Pacific island countries and territories instituted a variety of mitigation measures, including arrival health screening. Multiple partners facilitated influenza preparedness planning and outbreak response. Conclusions Pandemic influenza spread rapidly throughout the Pacific despite enormous distances and relative isolation. Tokelau and Pitcairn may be the only jurisdictions to have remained pandemic-free. Despite being well-prepared, Pacific island countries and territories experienced significant morbidity and mortality, consistent with other indigenous and low-resource settings. For the first time, regional influenza-like-illness surveillance was conducted in the Pacific, allowing health authorities to monitor the pandemic’s spread and severity in real-time. Future regional outbreak responses will likely benefit from the lessons learned during this outbreak.

Kool Jacobus Leen

2013-01-01

153

The Low-pH Stability Discovered in Neuraminidase of 1918 Pandemic Influenza A Virus Enhances Virus Replication  

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The “Spanish” pandemic influenza A virus, which killed more than 20 million worldwide in 1918-19, is one of the serious pathogens in recorded history. Characterization of the 1918 pandemic virus reconstructed by reverse genetics showed that PB1, hemagglutinin (HA), and neuraminidase (NA) genes contributed to the viral replication and virulence of the 1918 pandemic influenza virus. However, the function of the NA gene has remained unknown. Here we show that the avian-like low-pH stability ...

Takahashi, Tadanobu; Kurebayashi, Yuuki; Ikeya, Kumiko; Mizuno, Takashi; Fukushima, Keijo; Kawamoto, Hiroko; Kawaoka, Yoshihiro; Suzuki, Yasuo; Suzuki, Takashi

2010-01-01

154

Glycans on influenza hemagglutinin affect receptor binding and immune response  

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Recent cases of avian influenza H5N1 and the swine-origin 2009 H1N1 have caused a great concern that a global disaster like the 1918 influenza pandemic may occur again. Viral transmission begins with a critical interaction between hemagglutinin (HA) glycoprotein, which is on the viral coat of influenza, and sialic acid (SA) containing glycans, which are on the host cell surface. To elucidate the role of HA glycosylation in this important interaction, various defined HA glycoforms were prepare...

2009-01-01

155

Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective  

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Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic–economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, G...

2011-01-01

156

Influenza Vaccine Coverage among Pregnant Women in a Public Hospital System during the 2009-2010 Pandemic Influenza Season  

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The purpose of this study was to compare influenza vaccination rates of pregnant women in a public safety-net health system to national coverage rates during the 2009-2010 pandemic influenza season. A chart review of a random sample of deliveries was undertaken to determine rates of coverage and predictors of vaccine coverage of women who obtained prenatal care and delivered in our health system. Rates were calculated from deliveries from when the vaccine was first available through April 30,...

2012-01-01

157

Differential Mortality Rates by Ethnicity in 3 Influenza Pandemics Over a Century, New Zealand  

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Evidence suggests that indigenous populations have suffered disproportionately from past influenza pandemics. To examine any such patterns for M?ori in New Zealand, we searched the literature and performed new analyses by using additional datasets. The M?ori death rate in the 1918 pandemic (4,230/100,000 population) was 7.3× the European rate. In the 1957 pandemic, the M?ori death rate (40/100,000) was 6.2× the European rate. In the 2009 pandemic, the M?ori rate was higher than the European rate (rate ratio 2.6, 95% confidence interval 1.3–5.3). These findings suggest some decline in pandemic-related ethnic inequalities in death rates over the past century. Nevertheless, the persistent excess in adverse outcomes for M?ori, and for Pacific persons residing in New Zealand, highlights the need for improved public health responses.

Barnard, Lucy Telfar; Summers, Jennifer A.; Shanks, G. Dennis; Baker, Michael G.

2012-01-01

158

Assessing exposure risks for aquatic organisms posed by Tamiflu use under seasonal influenza and pandemic conditions  

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Environmental pollution by anti-influenza drugs is increasingly recognized as a threat to aquatic environments. However, little is known about empirical data on risk effects posed by environmentally relevant concentrations of anti-influenza drug based on recently published ecotoxicological researches in Taiwan. Here we linked ecotoxicology models with an epidemiological scheme to assess exposure risks of aquatic organisms and environmental hazards posed by antiviral oseltamivir (Tamiflu) use in Taiwan. Built on published bioassays, we used probabilistic risk assessment model to estimate potential threats of environmentally relevant hazards on algae, daphnid, and zerbrafish. We found that Tamiflu use was unlikely to pose a significant chronic environmental risk to daphnia and zebrafish during seasonal influenza. However, the chronic environmental risk posed by Tamiflu use during pandemic was alarming. We conclude that no significant risk to algal growth was found during seasonal influenza and high pandemic Tamiflu use. -- Highlights: • Environmentally relevant concentrations of anti-influenza drug have ecotoxicologically important effects. • Tamiflu is unlikely to pose a significant chronic environmental risk during seasonal influenza. • Chronic environmental risk posed by Tamiflu during pandemic is alarming. • Tertiary process in sewage treatment plants is crucial in mitigating Tamiflu exposure risk. -- A probabilistic framework can be used for assessing exposure risks posed by environmentally relevant concentrations of anti-influenza drug in aquatic ecosystems

2014-01-01

159

Novel Reassortment of Eurasian Avian-Like and Pandemic/2009 Influenza Viruses in Swine: Infectious Potential for Humans ? †  

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Pigs are considered to be intermediate hosts and “mixing vessels,” facilitating the genesis of pandemic influenza viruses, as demonstrated by the emergence of the 2009 H1N1 pandemic (pdm/09) virus. The prevalence and repeated introduction of the pdm/09 virus into pigs raises the possibility of generating novel swine influenza viruses with the potential to infect humans. To address this, an active influenza surveillance program was conducted with slaughtered pigs in abattoirs in southern C...

Zhu, Huachen; Zhou, Boping; Fan, Xiaohui; Lam, Tommy T. Y.; Wang, Jia; Chen, Antony; Chen, Xinchun; Chen, Honglin; Webster, Robert G.; Webby, Richard; Peiris, Joseph S. M.; Smith, David K.; Guan, Yi

2011-01-01

160

The 2009 pandemic H1N1 influenza vaccination in France: who accepted to receive the vaccine and why?  

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Introduction: Previous studies investigating determinants of 2009 (H1N1) pandemic influenza vaccine acceptance have focused on target groups such as healthcare workers. Few studies in the European Union have examined the self-reported reasons as well as predictive socio-demographic and health factors for pandemic influenza vaccine acceptance in the general population, even though influenza vaccine was recommended for all people.

Raude, Jocelyn; Caille-brillet, Anne-laure; Setbon, Michel

2010-01-01

 
 
 
 
161

Comparison between pandemic H1N1 2009 influenza pneumonia and seasonal influenza pneumonia in adults  

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We compared 126 cases of seasonal influenza pneumonia (seasonal flu) reported between January, 1996 and March, 2009, with 10 cases of laboratory-confirmed pandemic influenza (H1N1) 2009 influenza virus pneumonia (novel flu), based on clinical condition, computed tomography (CT) findings, severity, treatment, and prognosis, to clarify the characteristics of this novel flu. The mean age of subjects was 52.4 years in the novel flu group and 64 years in the seasonal flu group, and novel flu patients were younger than seasonal flu patients. Seasonal flu patients had more underlying diseases than did novel flu patients. The median duration from illness onset to hospitalization was 4 days in both groups. Primary viral pneumonia was present in 70% of novel flu cases and 31% of seasonal flu cases. The proportion of primary virus pneumonia was higher in novel flu patients, and the disease severity of the seasonal flu group was more severe than that of the novel flu group. White blood cell and lymphocyte counts were lower in novel flu patients, and chest CT images showed bilateral shadows and pure ground-glass opacities more frequently in the novel flu cases. There were no differences in treatment, number of days required for the fever to subside, or mortality between the groups. (author)

2011-04-01

162

Protecting public health and global freight transportation systems during an influenza pandemic.  

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The H5N1 influenza threat is resulting in global preparations for the next influenza pandemic. Pandemic influenza planners are prioritizing scarce vaccine, antivirals, and public health support for different segments of society. The freight, bulk goods, and energy transportation network comprise the maritime, rail, air, and trucking industries. It relies on small numbers of specialized workers who cannot be rapidly replaced if lost due to death, illness, or voluntary absenteeism. Because transportation networks link economies, provide critical infrastructures with working material, and supply citizens with necessary commodities, disrupted transportation systems can lead to cascading failures in social and economic systems. However, some pandemic influenza plans have assigned transportation workers a low priority for public health support, vaccine, and antivirals. The science of Transportation Geography demonstrates that transportation networks and workers are concentrated at, or funnel through, a small number of chokepoints and corridors. Chokepoints should be used to rapidly and efficiently vaccinate and prophylax the transportation worker cohort and to implement transmission prevention measures and thereby protect the ability to move goods. Nations, states, the transportation industry and unions, businesses, and other stakeholders must plan, resource, and exercise, and then conduct a transportation health assurance and security campaign for an influenza pandemic. PMID:18522251

Luke, Thomas C; Rodrigue, Jean-Paul

2008-01-01

163

Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base  

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Full Text Available Abstract Background In an influenza pandemic, the benefit of vaccines and antiviral medications will be constrained by limitations on supplies and effectiveness. Non-pharmaceutical public health interventions will therefore be vital in curtailing disease spread. However, the most comprehensive assessments of the literature to date recognize the generally poor quality of evidence on which to base non-pharmaceutical pandemic planning decisions. In light of the need to prepare for a possible pandemic despite concerns about the poor quality of the literature, combining available evidence with expert opinion about the relative merits of non-pharmaceutical interventions for pandemic influenza may lead to a more informed and widely accepted set of recommendations. We evaluated the evidence base for non-pharmaceutical public health interventions. Then, based on the collective evidence, we identified a set of recommendations for and against interventions that are specific to both the setting in which an intervention may be used and the pandemic phase, and which can be used by policymakers to prepare for a pandemic until scientific evidence can definitively respond to planners' needs. Methods Building on reviews of past pandemics and recent historical inquiries, we evaluated the relative merits of non-pharmaceutical interventions by combining available evidence from the literature with qualitative and quantitative expert opinion. Specifically, we reviewed the recent scientific literature regarding the prevention of human-to-human transmission of pandemic influenza, convened a meeting of experts from multiple disciplines, and elicited expert recommendation about the use of non-pharmaceutical public health interventions in a variety of settings (healthcare facilities; community-based institutions; private households and pandemic phases (no pandemic; no US pandemic; early localized US pandemic; advanced US pandemic. Results The literature contained a dearth of evidence on the efficacy or effectiveness of most non-pharmaceutical interventions for influenza. In an effort to inform decision-making in the absence of strong scientific evidence, the experts ultimately endorsed hand hygiene and respiratory etiquette, surveillance and case reporting, and rapid viral diagnosis in all settings and during all pandemic phases. They also encouraged patient and provider use of masks and other personal protective equipment as well as voluntary self-isolation of patients during all pandemic phases. Other non-pharmaceutical interventions including mask-use and other personal protective equipment for the general public, school and workplace closures early in an epidemic, and mandatory travel restrictions were rejected as likely to be ineffective, infeasible, or unacceptable to the public. Conclusion The demand for scientific evidence on non-pharmaceutical public health interventions for influenza is pervasive, and present policy recommendations must rely heavily on expert judgment. In the absence of a definitive science base, our assessment of the evidence identified areas for further investigation as well as non-pharmaceutical public health interventions that experts believe are likely to be beneficial, feasible and widely acceptable in an influenza pandemic.

Wasserman Jeffrey

2007-08-01

164

Seroepidemiology of pandemic influenza A (H1N1 2009 virus infections in Pune, India  

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Full Text Available Abstract Background In India, Pune was one of the badly affected cities during the influenza A (H1N1 2009 pandemic. We undertook serosurveys among the risk groups and general population to determine the extent of pandemic influenza A (H1N1 2009 virus infections. Methods Pre-pandemic sera from the archives, collected during January 2005 to March 2009, were assayed for the determination of baseline seropositivity. Serosurveys were undertaken among the risk groups such as hospital staff, general practitioners, school children and staff and general population between 15th August and 11th December 2009. In addition, the PCR-confirmed pandemic influenza A (H1N1 2009 cases and their household contacts were also investigated. Haemagglutination-inhibition (HI assays were performed using turkey red blood cells employing standard protocols. A titre of ?1:40 was considered seropositive. Results Only 2 (0.9% of the 222 pre-pandemic sera were positive. The test-retest reliability of HI assay in 101 sera was 98% for pandemic H1N1, 93.1% for seasonal H1N1 and 94% for seasonal H3N2. The sera from 48 (73.8% of 65 PCR-confirmed pandemic H1N1 cases in 2009 were positive. Seropositivity among general practitioners increased from 4.9% in August to 9.4% in November and 15.1% in December. Among hospital staff, seropositivity increased from 2.8% in August to 12% in November. Seropositivity among the schools increased from 2% in August to 10.7% in September. The seropositivity among students (25% was higher than the school staff in September. In a general population survey in October 2009, seropositivity was higher in children (9.1% than adults (4.3%. The 15-19 years age group showed the highest seropositivity of 20.3%. Seropositivity of seasonal H3N2 (55.3% and H1N1 (26.4% was higher than pandemic H1N1 (5.7% (n = 2328. In households of 74 PCR-confirmed pandemic H1N1 cases, 25.6% contacts were seropositive. Almost 90% pandemic H1N1 infections were asymptomatic or mild. Considering a titre cut off of 1:10, seropositivity was 1.5-3 times as compared to 1:40. Conclusions Pandemic influenza A (H1N1 2009 virus infection was widespread in all sections of community. However, infection was significantly higher in school children and general practitioners. Hospital staff had the lowest infections suggesting the efficacy of infection-control measures.

Tandale Babasaheb V

2010-08-01

165

A model for the spread and control of pandemic influenza in an isolated geographical region  

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In the event of an influenza pandemic, the most probable way in which the virus would be introduced to an isolated geographical area is by an infected traveller. We use a mathematical model, structured on the location at which infection occurs and based on published parameters for influenza, to describe an epidemic in a community of one million people. The model is then modified to reflect a variety of control strategies based on social distancing measures, targeted antiviral treatment and an...

Roberts, M. G.; Baker, M.; Jennings, L. C.; Sertsou, G.; Wilson, N.

2007-01-01

166

Pandemic Influenza A (H1N1 virus-associated acute myopericarditis  

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Full Text Available Although pandemic influenza A (H1N1 virus may cause an upper respiratory tract infection similar to that caused by seasonal influenza, it can lead to serious complications such as pneumonia, encephalitis, and myocarditis. We describe a 2-year-old girl admitted with fever, cough, and vomiting followed by acute respiratory distress and diagnosed as H1N1-related myopericarditis. (Turk Arch Ped 2011; 46: 337-9

Yakup

2011-12-01

167

Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1  

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Full Text Available Abstract Here we present a review of the literature of influenza modeling studies, and discuss how these models can provide insights into the future of the currently circulating novel strain of influenza A (H1N1, formerly known as swine flu. We discuss how the feasibility of controlling an epidemic critically depends on the value of the Basic Reproduction Number (R0. The R0 for novel influenza A (H1N1 has recently been estimated to be between 1.4 and 1.6. This value is below values of R0 estimated for the 1918–1919 pandemic strain (mean R0~2: range 1.4 to 2.8 and is comparable to R0 values estimated for seasonal strains of influenza (mean R0 1.3: range 0.9 to 2.1. By reviewing results from previous modeling studies we conclude it is theoretically possible that a pandemic of H1N1 could be contained. However it may not be feasible, even in resource-rich countries, to achieve the necessary levels of vaccination and treatment for control. As a recent modeling study has shown, a global cooperative strategy will be essential in order to control a pandemic. This strategy will require resource-rich countries to share their vaccines and antivirals with resource-constrained and resource-poor countries. We conclude our review by discussing the necessity of developing new biologically complex models. We suggest that these models should simultaneously track the transmission dynamics of multiple strains of influenza in bird, pig and human populations. Such models could be critical for identifying effective new interventions, and informing pandemic preparedness planning. Finally, we show that by modeling cross-species transmission it may be possible to predict the emergence of pandemic strains of influenza.

Blower Sally

2009-06-01

168

Facing pandemic influenza threats: the importance of including poultry and swine workers in preparedness plans.  

Science.gov (United States)

Recent research has shown that poultry and swine workers, especially those with intense exposures, are at increased risk of zoonotic influenza virus infections. In multiple studies, US poultry workers and poultry veterinarians have evidence of previous infections with avian influenza virus. Similarly, US swine workers have strong evidence of previous and acute infections with swine influenza viruses. Mathematical modeling has demonstrated that such workers may accelerate the spread of pandemic viruses in their rural communities. Because these workers may contribute to the novel generation of viruses and serve as a bridging population in the cross-species sharing of influenza viruses, it seems prudent to include poultry and swine workers in influenza preparedness programs. Possible preventive and control interventions include special education programs to increase workers' use of personal protective equipment such as gloves, increased surveillance for influenza viruses among workers and their animals, recommendations that workers seek medical attention should they develop influenza-like illness, and workers' priority receipt of annual and pandemic influenza vaccines. PMID:19276439

Gray, G C; Kayali, G

2009-04-01

169

Modeling uncertainties in workforce disruptions from influenza pandemics using dynamic input-output analysis.  

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Influenza pandemic is a serious disaster that can pose significant disruptions to the workforce and associated economic sectors. This article examines the impact of influenza pandemic on workforce availability within an interdependent set of economic sectors. We introduce a simulation model based on the dynamic input-output model to capture the propagation of pandemic consequences through the National Capital Region (NCR). The analysis conducted in this article is based on the 2009 H1N1 pandemic data. Two metrics were used to assess the impacts of the influenza pandemic on the economic sectors: (i) inoperability, which measures the percentage gap between the as-planned output and the actual output of a sector, and (ii) economic loss, which quantifies the associated monetary value of the degraded output. The inoperability and economic loss metrics generate two different rankings of the critical economic sectors. Results show that most of the critical sectors in terms of inoperability are sectors that are related to hospitals and health-care providers. On the other hand, most of the sectors that are critically ranked in terms of economic loss are sectors with significant total production outputs in the NCR such as federal government agencies. Therefore, policy recommendations relating to potential mitigation and recovery strategies should take into account the balance between the inoperability and economic loss metrics. PMID:24033717

El Haimar, Amine; Santos, Joost R

2014-03-01

170

Coordination Costs for School-Located Influenza Vaccination Clinics, Maine, 2009 H1N1 Pandemic  

Science.gov (United States)

School nurses played a key role in Maine's school-located influenza vaccination (SLV) clinics during the 2009-2010 pandemic season. The objective of this study was to determine, from the school district perspective, the labor hours and costs associated with outside-clinic coordination activities (OCA). The authors defined OCA as labor hours spent…

Asay, Garrett R. Beeler; Cho, Bo-Hyun; Lorick, Suchita A.; Tipton, Meredith L.; Dube, Nancy L.; Messonnier, Mark L.

2012-01-01

171

A Two-Year Surveillance of 2009 Pandemic Influenza A (H1N1) in Guangzhou, China: From Pandemic to Seasonal Influenza?  

Science.gov (United States)

In this two-years surveillance of 2009 pandemic influenza A (H1N1) (pH1N1) in Guangzhou, China, we reported here that the scale and duration of pH1N1 outbreaks, severe disease and fatality rates of pH1N1 patients were significantly lower or shorter in the second epidemic year (May 2010-April 2011) than those in the first epidemic year (May 2009-April 2010) (P0.05). Similar to seasonal influenza, pre-existing chronic pulmonary diseases was a risk factor associated with fatal cases of pH1N1 influenza. Different from seasonal influenza, which occurred in spring/summer seasons annually, pH1N1 influenza mainly occurred in autumn/winter seasons in the first epidemic year, but prolonged to winter/spring season in the second epidemic year. The information suggests a tendency that the epidemics of pH1N1 influenza may probably further shift to spring/summer seasons and become a predominant subtype of seasonal influenza in coming years in Guangzhou, China.

Yang, Zhicong; Wang, Yulin; Li, Meixia; Lu, Jianyun; Chen, Yiyun; Lu, Enjie; Geng, Jinmei; Hu, Wensui; Dong, Zhiqiang; Li, Meng-feng; Zheng, Bo-Jian; Cao, Kai-yuan; Wang, Ming

2011-01-01

172

Association between 2009 seasonal influenza vaccine and influenza-like illness during the 2009 pandemic: preliminary results of a large household transmission study in Western Australia.  

Science.gov (United States)

We conducted a prospective household transmission study to examine whether receipt of 2009 trivalent influenza vaccine (TIV) was associated with increased risk of influenza-like illness (ILI) among contacts of confirmed pandemic influenza A(H1N1) 2009 patients. In the week following onset of pandemic illness in a household member, 46 (15%) of 304 TIV-vaccinated contacts, and 174 (15%) of 1,162 unvaccinated contacts developed ILI (p=0.95). Receipt of 2009 TIV had no effect on one's risk of pandemic illness. PMID:20650055

Carcione, D; Giele, C; Goggin, L S; Kwan, K S; Smith, D W; Dowse, G K; Mak, D B; Effler, P

2010-01-01

173

Improving pandemic H5N1 influenza vaccines by combining different vaccine platforms.  

Science.gov (United States)

A variety of platforms are being explored for the development of vaccines for pandemic influenza. Observations that traditional inactivated subvirion vaccines and live-attenuated vaccines against H5 and some H7 influenza viruses were poorly immunogenic spurred efforts to evaluate new approaches, including whole virus vaccines, higher doses of antigen, addition of adjuvants and combinations of different vaccine modalities in heterologous prime-boost regimens to potentiate immune responses. Results from clinical trials of prime-boost regimens have been very promising. Further studies are needed to determine optimal combinations of platforms, intervals between doses of vaccines and the logistics of deployment in pre-pandemic and early pandemic settings. PMID:24855993

Luke, Catherine J; Subbarao, Kanta

2014-07-01

174

Spatiotemporal patterns of pandemic influenza-related deaths in Allied naval forces during 1918.  

Science.gov (United States)

This paper draws on the mortality records of the French, US and UK Royal navies to reconstruct the spatiotemporal evolution of the 1918–1919 influenza pandemic in global Allied naval forces. For a total of 7658 deaths attributed to respiratory diseases (French and US navies) and all diseases (UK Royal Navy) at 514 locations worldwide, techniques of spatial point pattern analysis were used to generate weekly maps of global mortality intensity in 1918. The map sequence for the main period of pandemic mortality, mid-August to mid-November 1918, revealed a near-simultaneous development of mutiple foci of high disease intensity in three distant locations (Europe, North America, West Africa). Given the relatively slow speed of naval ships in convoy at this time (<12 knots), our findings suggest that the pandemic influenza virus was circulating on three continents at the observed onset of the main mortality wave. PMID:23324307

Shanks, G D; Waller, M; Smallman-Raynor, M

2013-10-01

175

Prior immunity helps to explain wave-like behaviour of pandemic influenza in 1918-9  

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Full Text Available Abstract Background The ecology of influenza may be more complex than is usually assumed. For example, despite multiple waves in the influenza pandemic of 1918-19, many people in urban locations were apparently unaffected. Were they unexposed, or protected by pre-existing cross-immunity in the first wave, by acquired immunity in later waves, or were their infections asymptomatic? Methods We modelled all these possibilities to estimate parameters to best explain patterns of repeat attacks in 24,706 individuals potentially exposed to summer, autumn and winter waves in 12 English populations during the 1918-9 pandemic. Results Before the summer wave, we estimated that only 52% of persons (95% credibility estimates 41-66% were susceptible, with the remainder protected by prior immunity. Most people were exposed, as virus transmissibility was high with R0 credibility estimates of 3.10-6.74. Because of prior immunity, estimates of effective R at the start of the summer wave were lower at 1.57-3.96. Only 25-66% of exposed and susceptible persons reported symptoms. After each wave, 33-65% of protected persons became susceptible again before the next wave through waning immunity or antigenic drift. Estimated rates of prior immunity were less in younger populations (19-59% than in adult populations (38-66%, and tended to lapse more frequently in the young (49-92% than in adults (34-76%. Conclusions Our model for pandemic influenza in 1918-9 suggests that pre-existing immune protection, presumably induced by prior exposure to seasonal influenza, may have limited the pandemic attack-rate in urban populations, while the waning of that protection likely contributed to recurrence of pandemic waves in exposed cities. In contrast, in isolated populations, pandemic attack rates in 1918-9 were much higher than in cities, presumably because prior immunity was less in populations with infrequent prior exposure to seasonal influenza. Although these conclusions cannot be verified by direct measurements of historical immune mechanisms, our modelling inferences from 1918-9 suggest that the spread of the influenza A (H1N1 2009 pandemic has also been limited by immunity from prior exposure to seasonal influenza. Components of that immunity, which are measurable, may be short-lived, and not necessarily correlated with levels of HI antibody.

Pallaghy Paul K

2010-05-01

176

Real-time characterization of the molecular epidemiology of an influenza pandemic  

Science.gov (United States)

Early characterization of the epidemiology and evolution of a pandemic is essential for determining the most appropriate interventions. During the 2009 H1N1 influenza A pandemic, public databases facilitated widespread sharing of genetic sequence data from the outset. We use Bayesian phylogenetics to simulate real-time estimates of the evolutionary rate, date of emergence and intrinsic growth rate (r0) of the pandemic from whole-genome sequences. We investigate the effects of temporal range of sampling and dataset size on the precision and accuracy of parameter estimation. Parameters can be accurately estimated as early as two months after the first reported case, from 100 genomes and the choice of growth model is important for accurate estimation of r0. This demonstrates the utility of simple coalescent models to rapidly inform intervention strategies during a pandemic.

Hedge, J.; Lycett, S. J.; Rambaut, A.

2013-01-01

177

Swine influenza (H1N1) pandemic: developing countries' perspective.  

Science.gov (United States)

Since the first case of the current pandemic (H1N1) 2009 virus reported to WHO on 24 April 2009 on the American continent, the virus has spread in 160 countries and territories. By mid-2009, there were 135,000 cases and 816 deaths recorded. Pandemic preparedness is not advanced in most developing countries. Effective and essential measures include heightened surveillance, early detection and appropriate medical care. The use of local resources and capacity building with the assistance of developed nations will reduce the impact of this pandemic in the developing world. PMID:19681650

Khan, S I; Akbar, S M F; Hossain, S T; Mahtab, M A

2009-01-01

178

Case-based reported mortality associated with laboratory-confirmed influenza A(H1N1) 2009 virus infection in the Netherlands: the 2009-2010 pandemic season versus the 2010-2011 influenza season  

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Abstract Background In contrast to seasonal influenza epidemics, where the majority of deaths occur amongst elderly, a considerable part of the 2009 pandemic influenza related deaths concerned relatively young people. In the Netherlands, all deaths associated with laboratory-confirmed influenza A(H1N1) 2009 virus infection had to be notified, both during the 2009-2010 pandemic season and the 2010-2011 influenza season. To assess whether and to what extent pandemic mortality p...

Ab, Gageldonk-lafeber Rianne; Riesmeijer Rob M; Hm, Friesema Ingrid; Meijer Adam; Isken Leslie D; Timen Aura; Ab, Sande Marianne

2011-01-01

179

Two resource distribution strategies for dynamic mitigation of influenza pandemics  

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Andrés Uribe-Sánchez, Alex Savachkin1Department of Industrial and Management Systems Engineering University of South Florida, Tampa, FL 33620, USAAbstract: As recently pointed out by the Institute of Medicine, the existing pandemic ­containment and mitigation models lack the dynamic decision support capabilities. We ­present two simulation-based optimization models for developing dynamic predictive resource ­distribution strategies for cross-regional pandemic outbrea...

Uribe-s Aacute Nchez, Andr Eacute S.; Alex Savachkin

2010-01-01

180

The potential impact of the next influenza pandemic on a national primary care medical workforce  

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Full Text Available Abstract Background Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. Methods The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta was applied to the New Zealand primary care medical workforce (i.e., general practitioners. Results At its peak (week 4 the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88% would be lost due to illness, followed by hospitalisation (8%, and then premature death (4%. Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64% of lost workdays would be due to illness, followed by caring for others (31%, hospitalisation (4%, and then premature death (1%. Conclusion Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

Crampton Peter

2005-08-01

 
 
 
 
181

Theodore E. Woodward Award Non-Pharmaceutical Interventions Employed By Major American Cities During the 1918–19 Influenza Pandemic  

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A critical question in pandemic influenza planning is the role that non-pharmaceutical interventions (NPI) such as isolation and quarantine, social distancing, and school closure, might play in delaying the temporal impact of a pandemic, reducing the overall and peak attack rate, and reducing the number of cumulative deaths. Such measures could potentially provide valuable time for pandemic-strain vaccine and antiviral medication production and distribution. Optimally, appropriate NPI impleme...

Markel, Howard; Stern, Alexandra M.; Cetron, Martin S.

2008-01-01

182

The 2009 Influenza A (H1N1) Pandemic: What Have We Learned in the Past 6 Months  

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The present review describes how the first influenza pandemic of the XXI century occurred, the characteristics of the virus that produced it, its epidemiology, clinical and pathological presentation, and the treatment and prevention methods that have been instituted. The lessons that have been learned in the first 6 months of the pandemic include: 1) predictions were not fulfilled (it was not an avian virus but a swine virus that caused the pandemic, it started in the American continent not i...

Del Rio, Carlos; Guarner, Jeannette

2010-01-01

183

The Anticipated Severity of a “1918-Like” Influenza Pandemic in Contemporary Populations: The Contribution of Antibacterial Interventions  

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Recent studies have shown that most of deaths in the 1918 influenza pandemic were caused by secondary bacterial infections, primarily pneumococcal pneumonia. Given the availability of antibiotics and pneumococcal vaccination, how will contemporary populations fare when they are next confronted with pandemic influenza due to a virus with the transmissibility and virulence of that of 1918? To address this question we use a mathematical model and computer simulations. Our model considers the epi...

Chien, Yu-wen; Levin, Bruce R.; Klugman, Keith P.

2012-01-01

184

Pandemic influenza A (H1N1 2009 vaccine: An update  

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Full Text Available The world witnessed a the first influenza pandemic in this century and fourth overall since first flu pandemic was reported during the World War I. The past experiences with influenza viruses and this pandemic of H1N1 place a consider-able strain on health services and resulted in serious illnesses and a large number of deaths. Develop-ing countries were declared more likely to be at risk from the pandemic effects, as they faced the dual problem of highly vulnerable populations and limited resources to respond H1N1. The public health experts agreed that vaccination is the most effective ways to mitigate the negative effects of the pandemic. The vaccines for H1N1 virus have been used in over 40 coun-tries and administered to over 200 million people helped in a great way and on August 10, 2010, World Health Organization (WHO announced H1N1 to be in postpandemic period. But based on knowledge about past pandemics, the H1N1 (2009 virus is expected to continue to circulate as a seasonal virus and may undergo some agenic-variation. As WHO strongly recommends vaccination, vigilance for regular updating of the composition of influenza vaccines, based on an assessment of the future impact of circulating viruses along with safety surveillance of the vaccines is necessary. This review has been done to take a stock of the currently available H1N1 vaccines and their possible use as public health intervention in the postpandemic period.

Goel M

2011-01-01

185

Predicting the Antigenic Structure of the Pandemic (H1N1) 2009 Influenza Virus Hemagglutinin  

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The pandemic influenza virus (2009 H1N1) was recently introduced into the human population. The hemagglutinin (HA) gene of 2009 H1N1 is derived from “classical swine H1N1” virus, which likely shares a common ancestor with the human H1N1 virus that caused the pandemic in 1918, whose descendant viruses are still circulating in the human population with highly altered antigenicity of HA. However, information on the structural basis to compare the HA antigenicity among 2009 H1N1, the 1918 pan...

Igarashi, Manabu; Ito, Kimihito; Yoshida, Reiko; Tomabechi, Daisuke; Kida, Hiroshi; Takada, Ayato

2010-01-01

186

DNA Vaccination Elicits Protective Immune Responses against Pandemic and Classic Swine Influenza Viruses in Pigs ? †  

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Swine influenza is a highly contagious viral infection in pigs that significantly impacts the pork industry due to weight loss and secondary infections. There is also the potential of a significant threat to public health, as was seen in 2009 when the pandemic H1N1 influenza virus strain emerged from reassortment events among avian, swine, and human influenza viruses within pigs. As classic and pandemic H1N1 strains now circulate in swine, an effective vaccine may be the best strategy to protect the pork industry and public health. Current inactivated-virus vaccines available for swine influenza protect only against viral strains closely related to the vaccine strain, and egg-based production of these vaccines is insufficient to respond to large outbreaks. DNA vaccines are a promising alternative since they can potentially induce broad-based protection with more efficient production methods. In this study we evaluated the potentials of monovalent and trivalent DNA vaccine constructs to (i) elicit both humoral and gamma interferon (IFN-?) responses and (ii) protect pigs against viral shedding and lung disease after challenge with pandemic H1N1 or classic swine H1N1 influenza virus. We also compared the efficiency of a needle-free vaccine delivery method to that of a conventional needle/syringe injection. We report that DNA vaccination elicits robust serum antibody and cellular responses after three immunizations and confers significant protection against influenza virus challenge. Needle-free delivery elicited improved antibody responses with the same efficiency as conventional injection and should be considered for development as a practical alternative for vaccine administration.

Gorres, J. Patrick; Lager, Kelly M.; Kong, Wing-Pui; Royals, Michael; Todd, John-Paul; Vincent, Amy L.; Wei, Chih-Jen; Loving, Crystal L.; Zanella, Eraldo L.; Janke, Bruce; Kehrli, Marcus E.; Nabel, Gary J.; Rao, Srinivas S.

2011-01-01

187

Direct association between pharyngeal viral secretion and host cytokine response in severe pandemic influenza  

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Full Text Available Abstract Background Severe disease caused by 2009 pandemic influenza A/H1N1virus is characterized by the presence of hypercytokinemia. The origin of the exacerbated cytokine response is unclear. As observed previously, uncontrolled influenza virus replication could strongly influence cytokine production. The objective of the present study was to evaluate the relationship between host cytokine responses and viral levels in pandemic influenza critically ill patients. Methods Twenty three patients admitted to the ICU with primary viral pneumonia were included in this study. A quantitative PCR based method targeting the M1 influenza gene was developed to quantify pharyngeal viral load. In addition, by using a multiplex based assay, we systematically evaluated host cytokine responses to the viral infection at admission to the ICU. Correlation studies between cytokine levels and viral load were done by calculating the Spearman correlation coefficient. Results Fifteen patients needed of intubation and ventilation, while eight did not need of mechanical ventilation during ICU hospitalization. Viral load in pharyngeal swabs was 300 fold higher in the group of patients with the worst respiratory condition at admission to the ICU. Pharyngeal viral load directly correlated with plasma levels of the pro-inflammatory cytokines IL-6, IL-12p70, IFN-?, the chemotactic factors MIP-1?, GM-CSF, the angiogenic mediator VEGF and also of the immuno-modulatory cytokine IL-1ra (p Conclusions Severe respiratory disease caused by the 2009 pandemic influenza virus is characterized by the existence of a direct association between viral replication and host cytokine response, revealing a potential pathogenic link with the severe disease caused by other influenza subtypes such as H5N1.

Castro Carmen

2011-08-01

188

Clinical characteristics and outcomes among pediatric patients hospitalized with pandemic influenza A/H1N1 2009 infection  

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Full Text Available Purpose : The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. Methods : We retrospectively reviewed the charts of hospitalized pediatric patients (&lt;18 years diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. Results : A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years. A total of 40% had at least 1 underlying medical condition, including asthma (17%, malignancies (19%, and heart diseases (17%. Of the 72 patients, 54 (76% children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/ H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02, higher platelet count (P=0.02, and higher level of serum glucose (P=0.003, and more commonly presented with dyspnea than did those without pneumonia (P=0.04. Conclusion : No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.

Eun Lee

2011-08-01

189

Early Introduction and Delayed Dissemination of Pandemic Influenza, Gabon  

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Active surveillance in health care centers in Gabon during 2009–2011 detected 72 clinical cases of pandemic (H1N1) 2009 (pH1N1). We found that pH1N1 virus was introduced in mid-2009 but spread throughout the country in 2010. Thus, Gabon was also affected by pH1N1.

Lekana-douki, Sonia Etenna; Mouinga-onde?me?, Augustin; Nkoghe, Dieudonne?; Drosten, Christian; Drexler, Jan Felix; Kazanji, Mirdad; Leroy, Eric M.

2013-01-01

190

The politics of medicine and the global governance of pandemic influenza.  

Science.gov (United States)

While still significant, the 2009 H1N1 (A) influenza pandemic was generally viewed as comparatively mild in contrast to past influenza pandemics. Even so, the conventional response of many governments to protect their populations against the threat from the H1N1 virus was to ensure adequate vaccine production and/or access to supplies of vaccines and antiviral medications. In this article, I examine the influence of biomedical knowledge (and the professionals that wield it) in determining the acceptable and rational limits of influenza public policy from 1918 to today. Particular attention is given to the role that medical practitioners have played in shaping post-World War II influenza policy and governance structures, together with the development, deployment, and political effect of more recent biomedical techniques-such as evidence-based medicine-in reinforcing the importance attached to influenza vaccines and antivirals. The article concludes by discussing how the intense focus on pharmaceutical-based solutions reflects a particular view of biomedicine that has had serious political implications in distorting global health governance arrangements, and I argue that only by unpacking these structures and revealing the political authority in play can alternative policy responses more appropriate to a wider proportion of humanity be considered. PMID:23527457

Kamradt-Scott, Adam

2013-01-01

191

Protecting home health care workers: a challenge to pandemic influenza preparedness planning.  

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The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities. Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care. We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process. PMID:19461108

Baron, Sherry; McPhaul, Kathleen; Phillips, Sally; Gershon, Robyn; Lipscomb, Jane

2009-10-01

192

"Destroyer and teacher": Managing the masses during the 1918-1919 influenza pandemic.  

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The Spanish influenza arrived in the United States at a time when new forms of mass transportation, mass media, mass consumption, and mass warfare had vastly expanded the public places in which communicable diseases could spread. Faced with a deadly "crowd" disease, public health authorities tried to implement social-distancing measures at an unprecedented level of intensity. Recent historical work suggests that the early and sustained imposition of gathering bans, school closures, and other social-distancing measures significantly reduced mortality rates during the 1918-1919 epidemics. This finding makes it all the more important to understand the sources of resistance to such measures, especially since social-distancing measures remain a vital tool in managing the current H1N1 influenza pandemic. To that end, this historical analysis revisits the public health lessons learned during the 1918-1919 pandemic and reflects on their relevance for the present. PMID:20568568

Tomes, Nancy

2010-04-01

193

[The influenza pandemic 1968-1970: crisis management in separated Germany - "Vodka and Raspberry Tea"].  

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The Hong Kong Flu in the years 1968-1970 challenged both German health care systems. This article intends to analyse the patterns of reaction to the pandemic. Both German states faced the threat according to their respective ideological orientation. This applied to the two parts of Berlin - West and East - as well. In the GDR the control of influenza was centrally organized. When the pandemic passed away an influenza guiding document ("Führungsdokument") was made obligatory for the fight against the plague. In the FRG hospital treatment maintained predominance while the outpatient sector was administrated by physicians in private practice. In West- Berlin outpatient clinics were declined by the Association of Physicians ("Kassenärztliche Vereinigung"). In 1970 a first concept of surveillance was presented on the level of the state in West Germany. In the years 1968-1970 vaccinations were not common in both German states. The essay is based on the analysis of archival sources, monographs, scientific and newspaper articles. PMID:22169920

Witte, W

2011-12-01

194

Pandemic influenza A virus codon usage revisited: biases, adaptation and implications for vaccine strain development  

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Abstract Background Influenza A virus (IAV) is a member of the family Orthomyxoviridae and contains eight segments of a single-stranded RNA genome with negative polarity. The first influenza pandemic of this century was declared in April of 2009, with the emergence of a novel H1N1 IAV strain (H1N1pdm) in Mexico and USA. Understanding the extent and causes of biases in codon usage is essential to the understanding of viral evolution. A comprehensive study to investiga...

Goñi Natalia; Iriarte Andrés; Comas Victoria; Soñora Martín; Moreno Pilar; Moratorio Gonzalo; Musto Héctor; Cristina Juan

2012-01-01

195

Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus  

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The 1918 influenza pandemic caused more than 20 million deaths worldwide. Thus, the potential impact of a re-emergent 1918 or 1918-like influenza virus, whether through natural means or as a result of bioterrorism, is of significant concern. The genetic determinants of the virulence of the 1918 virus have not been defined yet, nor have specific clinical prophylaxis and/or treatment interventions that would be effective against a re-emergent 1918 or 1918-like virus been identified. Based on th...

2002-01-01

196

Antibody response of healthy children to pandemic A/H1N1/2009 influenza virus  

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Full Text Available Abstract Background Little is known about the proportion of pediatric pandemic A/H1N1/2009 influenza cases who showed seroconversion, the magnitude of this seroconversion, or the factors that can affect the antibody level evoked by the pandemic A/H1N1/2009 influenza. Aims of this study were to analyse antibody responses and the factors associated with high antibody titres in a cohort of children with naturally acquired A/H1N1/2009 influenza infection confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR. Results Demographic, clinical and virologic data were collected from 69 otherwise healthy children with pandemic A/H1N1/2009 influenza (27 females, mean age ± SD: 5.01 ± 4.55 years. Their antibody levels against pandemic A/H1N1/2009 and seasonal A/H1N1 influenza viruses were evaluated by measuring hemagglutination-inhibiting antibodies using standard assays. Sixty-four patients (92.8% with pandemic A/H1N1/2009 influenza had A/H1N1/2009 antibody levels of ?40, whereas only 28/69 (40.6% were seroprotected against seasonal A/H1N1 influenza virus. Those who were seroprotected against seasonal A/H1N1 virus were significantly older, significantly more often hospitalised, had a diagnosis of pneumonia significantly more frequently, and were significantly more often treated with oseltamivir than those who were not seroprotected (p Conclusions Otherwise healthy children seem to show seroprotective antibody titres after natural infection with pandemic A/H1N1/2009 influenza virus. The strength of the immune response seems to be related to the severity of the disease, but not to previous seasonal A/H1N1 influenza immunity.

Esposito Susanna

2011-12-01

197

Key transmission parameters of an institutional outbreak during the 1918 influenza pandemic estimated by mathematical modelling  

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Abstract Aim To estimate the key transmission parameters associated with an outbreak of pandemic influenza in an institutional setting (New Zealand 1918). Methods Historical morbidity and mortality data were obtained from the report of the medical officer for a large military camp. A susceptible-exposed-infectious-recovered epidemiological model was solved numerically to find a range of best-fit estimates for key epidemic parameters and an incidence curve. Morta...

Sertsou Gabriel; Wilson Nick; Baker Michael; Nelson Peter; Roberts Mick G

2006-01-01

198

Can Photoperiod Predict Mortality in the 1918-1920 Influenza Pandemic?  

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Amplitude of the seasonal change in day length increases with distance from the equator, and changes in day length markedly alter immune function in diverse nonhuman animal models of infection. Historical records of mortality data, ambient temperature, population density, geography, and economic indicators from 42 countries during 1918-1920 were analyzed to determine relative contributions toward human mortality during the “Spanish” influenza pandemic of 1918-1920. The data identify a str...

Prendergast, Brian J.

2011-01-01

199

Discovery and characterization of the 1918 pandemic influenza virus in historical context  

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The 2005 completion of the entire genome sequence of the 1918 H1N1 pandemic influenza virus represents both a beginning and an end. Investigators have already begun to study the virus in vitro and in vivo to better understand its properties, pathogenicity, transmissibility and elicitation of host responses. Although this is an exciting new beginning, characterization of the 1918 virus also represents the culmination of over a century of scientific research aiming to understand the causes of p...

Taubenberger, Jeffery K.; Hultin, Johan V.; Morens, David M.

2007-01-01

200

Distribution and Risk Factors of 2009 Pandemic Influenza A (H1N1) in Mainland China  

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Data from all reported cases of 2009 pandemic influenza A (H1N1) were obtained from the China Information System for Disease Control and Prevention. The spatiotemporal distribution patterns of cases were characterized through spatial analysis. The impact of travel-related risk factors on invasion of the disease was analyzed using survival analysis, and climatic factors related to local transmission were identified using multilevel Poisson regression, both at the county level. The results show...

Fang, Li-qun; Wang, Li-ping; Vlas, Sake J.; Liang, Song; Tong, Shi-lu; Li, Yan-li; Li, Ya-pin; Qian, Quan; Yang, Hong; Zhou, Mai-geng; Wang, Xiao-feng; Richardus, Jan Hendrik; Ma, Jia-qi; Cao, Wu-chun

2012-01-01

 
 
 
 
201

Epidemiology of fatal cases associated with pandemic influenza reported in Yemen  

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Objectives: This study describes the incidence of all fatal cases associated with Pandemic Influenza A (H1N1) in Yemen. It sets out to highlight the factors associated with poor prognosis *The authors declare that they have no competing interests. to enhance the implementation of prevention and control programs. Methods: The study is based on retrospective analysis of available data until 14 March 2010, as compiled by the disease control and surveillance team in Yemen. Results: Between 16 Jun...

Thabet, Ahmed A. K.; Moulhee, Najeeb M.; Abdulhakeem Al-kohlani; Mohammed Jahaf

2012-01-01

202

Severe impact of the 1918-19 pandemic influenza in a national military force.  

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The impact of pandemic influenza on the New Zealand Expeditionary Force (NZEF) in 1918-19 has never been studied using modern epidemiological methods. Therefore we analysed mortality and descriptive data from various sources for these military personnel. An estimated 930 NZEF personnel deaths from pandemic influenza occurred in 1918-19, making it the main cause of disease deaths, and representing 5.1% of all NZEF deaths from World War One (WW1). The epidemic curve was much more drawn out in the Northern Hemisphere compared with the Southern Hemisphere. Mortality rates varied markedly by setting (e.g. in military camps, by country and by hemisphere). Significantly higher mortality rates were found amongst NZEF personnel: aged 30-34 years, those of Maori ethnicity, those with a rural background, and those who left New Zealand for Europe in 1918. In conclusion, this work documents the heavy mortality burden from pandemic influenza amongst this national military force and highlights the large variations in mortality rates through host and environmental factors. PMID:24045314

Summers, Jennifer A; Shanks, G Dennis; Baker, Michael G; Wilson, Nick

2013-07-12

203

The pandemic influenza policy model: a planning tool for military public health officials.  

Science.gov (United States)

The Pandemic Influenza Policy Model (PIPM) is a collaborative computer modeling effort between the U.S. Department of Defense (DoD) and the Johns Hopkins University Applied Physics Laboratory. Many helpful computer simulations exist for examining the propagation of pandemic influenza in civilian populations. We believe the mission-oriented nature and structured social composition of military installations may result in pandemic influenza intervention strategies that differ from those recommended for civilian populations. Intervention strategies may differ between military bases because of differences in mission, location, or composition of the population at risk. The PIPM is a web-accessible, user-configurable, installation-specific disease model allowing military planners to evaluate various intervention strategies. Innovations in the PIPM include expanding on the mathematics of prior stochastic models, using military-specific social network epidemiology, utilization of DoD personnel databases to more accurately characterize the population at risk, and the incorporation of possible interventions, e.g., pneumococcal vaccine, not examined in previous models. PMID:19585765

Feighner, Brian H; Chrétien, Jean-Paul; Murphy, Sean P; Skora, Joseph F; Coberly, Jacqueline S; Dietz, Jerrold E; Chaffee, Jennifer L; Sikes, Marvin L; Mabee, Mimms J; Russell, Bruce P; Gaydos, Joel C

2009-06-01

204

The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know.  

Science.gov (United States)

As the world prepares for the next influenza pandemic, governments have made significant funding commitments to vaccine development and antiviral stockpiling. While these are essential components to pandemic response, rapid and accurate diagnostic testing remains an often neglected cornerstone of pandemic influenza preparedness. Clinicians and Public Health Practitioners need to understand the benefits and drawbacks of different influenza tests in both seasonal and pandemic settings. Culture has been the traditional gold standard for influenza diagnosis but requires from 1-10 days to generate a positive result, compared to nucleic acid detection methods such as real time reverse transcriptase polymerase chain reaction (RT-PCR). Although the currently available rapid antigen detection kits can generate results in less than 30 minutes, their sensitivity is suboptimal and they are not recommended for the detection of novel influenza viruses. Until point-of-care (POC) tests are improved, PILPN recommends that the best option for pandemic influenza preparation is the enhancement of nucleic acid-based testing capabilities across Canada. PMID:19507723

Hatchette, Todd F; Bastien, Nathalie; Berry, Jody; Booth, Tim F; Chernesky, Max; Couillard, Michel; Drews, Steven; Ebsworth, Anthony; Fearon, Margaret; Fonseca, Kevin; Fox, Julie; Gagnon, Jean-Nicolas; Guercio, Steven; Horsman, Greg; Jorowski, Cathy; Kuschak, Theodore; Li, Yan; Majury, Anna; Petric, Martin; Ratnam, Sam; Smieja, Marek; Van Caeseele, Paul

2009-01-01

205

Pandemic H1N1 2009 virus in Danish pigs: Diagnosis and lack of surveillance  

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In March-April 2009, a novel pandemic H1N1 virus (H1N1v) of likely swine origin emerged in the human population globally. The first case in pigs was reported from Canada in May 2009 and presently almost all countries with pig production have reported cases. The emergence of a new influenza subtype in swine with a genetic profile similar to older circulating strains implied a challenge for the veterinary diagnostic laboratories. We report the development, validation and implemen...

Larsen, Lars Erik; Nielsen, L. P.; Breum, Solvej Østergaard; Trebbien, Ramona; Hjulsager, Charlotte Kristiane

2011-01-01

206

Virulence and Genetic Compatibility of Polymerase Reassortant Viruses Derived from the Pandemic (H1N1) 2009 Influenza Virus and Circulating Influenza A Viruses?†  

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Gene mutations and reassortment are key mechanisms by which influenza A virus acquires virulence factors. To evaluate the role of the viral polymerase replication machinery in producing virulent pandemic (H1N1) 2009 influenza viruses, we generated various polymerase point mutants (PB2, 627K/701N; PB1, expression of PB1-F2 protein; and PA, 97I) and reassortant viruses with various sources of influenza viruses by reverse genetics. Although the point mutations produced no significant change in p...

Song, Min-suk; Pascua, Philippe Noriel Q.; Lee, Jun Han; Baek, Yun Hee; Park, Kuk Jin; Kwon, Hyeok-il; Park, Su-jin; Kim, Chul-joong; Kim, Hyunggee; Webby, Richard J.; Webster, Robert G.; Choi, Young Ki

2011-01-01

207

An analysis of national target groups for monovalent 2009 pandemic influenza vaccine and trivalent seasonal influenza vaccines in 2009-10 and 2010-11  

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Abstract Background Vaccination is generally considered to be the best primary prevention measure against influenza virus infection. Many countries encourage specific target groups of people to undertake vaccination, often with financial subsidies or a priority list. To understand differential patterns of national target groups for influenza vaccination before, during and after the 2009 influenza pandemic, we reviewed and analyzed the country-specific policies in the correspo...

Ng Sophia; Wu Peng; Nishiura Hiroshi; Km, Ip Dennis; St, Lee Esther; Cowling Benjamin J

2011-01-01

208

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives  

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Full Text Available Abstract Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

Silva Diego S

2012-03-01

209

Combination strategies for pandemic influenza response - a systematic review of mathematical modeling studies  

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Full Text Available Abstract Background Individual strategies in pandemic preparedness plans may not reduce the impact of an influenza pandemic. Methods We searched modeling publications through PubMed and associated references from 1990 to 30 September 2009. Inclusion criteria were modeling papers quantifying the effectiveness of combination strategies, both pharmaceutical and non-pharmaceutical. Results Nineteen modeling papers on combination strategies were selected. Four studies examined combination strategies on a global scale, 14 on single countries, and one on a small community. Stochastic individual-based modeling was used in nine studies, stochastic meta-population modeling in five, and deterministic compartmental modeling in another five. As part of combination strategies, vaccination was explored in eight studies, antiviral prophylaxis and/or treatment in 16, area or household quarantine in eight, case isolation in six, social distancing measures in 10 and air travel restriction in six studies. Two studies suggested a high probability of successful influenza epicenter containment with combination strategies under favorable conditions. During a pandemic, combination strategies delayed spread, reduced overall number of cases, and delayed and reduced peak attack rate more than individual strategies. Combination strategies remained effective at high reproductive numbers compared with single strategy. Global cooperative strategies, including redistribution of antiviral drugs, were effective in reducing the global impact and attack rates of pandemic influenza. Conclusion Combination strategies increase the effectiveness of individual strategies. They include pharmaceutical (antiviral agents, antibiotics and vaccines and non-pharmaceutical interventions (case isolation, quarantine, personal hygiene measures, social distancing and travel restriction. Local epidemiological and modeling studies are needed to validate efficacy and feasibility.

Lee Vernon J

2009-12-01

210

Viral shedding in children infected by pandemic A/H1N1/2009 influenza virus  

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Full Text Available Abstract Background The aim of this study was to investigate viral shedding in otherwise healthy children with pandemic A/H1N1/2009 influenza in order to define how long children with pandemic A/H1N1/2009 influenza shed the virus, and also plan adequate measures to control the spread of the disease within households. Findings In 74 otherwise healthy children with pandemic A/H1N1/2009 influenza, nasopharyngeal swabs were taken for virus detection upon hospital admission and every two days until negative. The nasopharyngeal swabs of all of the children were positive for pandemic A/H1N1/2009 influenza virus in the first three days after the onset of infection, and only 21.6% and 13.5% remained positive after respectively 11 and 15 days. No child was positive after more than 15 days. Viral load also decreased over time, and was not associated with patient age or the risk of pneumonia. Those who shed the virus for ? 9 days were not at any increased risk of suffering from more severe disease in comparison with those who shed the virus for a shorter time, but their households experienced a significantly higher number of influenza-like illness during the two weeks after the onset of the initial disease (72.3% vs 41.4%; p Conclusions Regardless of their age, healthy children can shed pandemic A/H1N1/2009 influenza virus for up to two weeks after illness onset, and the households of the children who shed the virus for ? 9 days suffered a higher number of influenza-like illness in the two weeks following the onset of the first disease. This could suggest that when a completely unknown influenza virus is circulating, isolation period of infected children has to be longer than the 7 days recommended for the infections due to seasonal influenza viruses.

Fossali Emilio

2011-07-01

211

Examining the knowledge, attitudes and practices of domestic and international university students towards seasonal and pandemic influenza  

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Full Text Available Abstract Background Prior to the availability of the specific pandemic vaccine, strategies to mitigate the impact of the disease typically involved antiviral treatment and “non-pharmaceutical” community interventions. However, compliance with these strategies is linked to risk perceptions, perceived severity and perceived effectiveness of the strategies. In 2010, we undertook a study to examine the knowledge, attitudes, risk perceptions, practices and barriers towards influenza and infection control strategies amongst domestic and international university students. Methods A study using qualitative methods that incorporated 20 semi-structured interviews was undertaken with domestic and international undergraduate and postgraduate university students based at one university in Sydney, Australia. Participants were invited to discuss their perceptions of influenza (seasonal vs. pandemic in terms of perceived severity and impact, and attitudes towards infection control measures including hand-washing and the use of social distancing, isolation or cough etiquette. Results While participants were generally knowledgeable about influenza transmission, they were unable to accurately define what ‘pandemic influenza’ meant. While avian flu or SARS were mistaken as examples of past pandemics, almost all participants were able to associate the recent “swine flu” situation as an example of a pandemic event. Not surprisingly, it was uncommon for participants to identify university students as being at risk of catching pandemic influenza. Amongst those interviewed, it was felt that ‘students’ were capable of fighting off any illness. The participant’s nominated hand washing as the most feasible and acceptable compared with social distancing and mask use. Conclusions Given the high levels of interaction that occurs in a university setting, it is really important that students are informed about disease transmission and about risk of infection. It may be necessary to emphasize that pandemic influenza could pose a real threat to them, that it is important to protect oneself from infection and that infection control measures can be effective.

Seale Holly

2012-04-01

212

Does Glycosylation as a modifier of Original Antigenic Sin explain the case age distribution and unusual toxicity in pandemic novel H1N1 influenza?  

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Full Text Available Abstract Background A pandemic novel H1N1 swine-origin influenza virus has emerged. Most recently the World Health Organization has announced that in a country-dependent fashion, up to 15% of cases may require hospitalization, often including respiratory support. It is now clear that healthy children and young adults are disproportionately affected, most unusually among those with severe respiratory disease without underlying conditions. One possible explanation for this case age distribution is the doctrine of Original Antigenic Sin, i.e., novel H1N1 may be antigenically similar to H1N1 viruses that circulated at an earlier time. Persons whose first exposure to influenza viruses was to such similar viruses would be relatively immune. However, this principle is not sufficient to explain the graded susceptibility between ages 20 and 60, the reduced susceptibility in children below age 10, and the unusual toxicity observed. Methods We collected case data from 11 countries, about 60% of all cases reported through mid-July 2009. We compared sequence data for the hemagglutinin of novel H1N1 with sequences of H1N1 viruses from 1918 to the present. We searched for sequence differences that imply loss of antigenicity either directly through amino acid substitution or by the appearance of sites for potential glycosylation proximal to sites known to be antigenic in humans. We also considered T-cell epitopes. Results In our composite, over 75% of confirmed cases of novel H1N1 occurred in persons ? 30 years old, with peak incidence in the age range 10-19 years. Less than 3% of cases occurred in persons over 65, with a gradation in incidence between ages 20 and 60 years. The sequence data indicates that novel H1N1 is most similar to H1N1 viruses that circulated before 1943. Novel H1N1 lacks glycosylation sites on the globular head of hemagglutinin (HA1 near antigenic regions, a pattern shared with the 1918 pandemic strain and H1N1 viruses that circulated until the early 1940s. Later H1N1 viruses progressively added new glycosylation sites likely to shield antigenic epitopes, while T-cell epitopes were relatively unchanged. Conclusions In this evolutionary context, Original Antigenic Sin exposure should produce an immune response increasingly mismatched to novel H1N1 in progressively younger persons. We suggest that it is this mismatch that produces both the gradation in susceptibility and the unusual toxicity. Several murine studies suggest specific cell types as a likely basis of the unusual toxicity. These studies also point to widely available pharmaceutical agents as plausible candidates for mitigating the toxic effects. The principle of Original Antigenic Sin modified by glycosylation appears to explain both the case age distribution and the unusual toxicity pattern of the novel H1N1 pandemic. In addition, it suggests pharmaceutical agents for immediate investigation for mitigation potential, and provides strategic guidance for the distribution of pandemic mitigation resources of all types.

Nishiura Hiroshi

2010-01-01

213

Simplifying influenza vaccination during pandemics: sublingual priming and intramuscular boosting of immune responses with heterologous whole inactivated influenza vaccine.  

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The best approach to control the spread of influenza virus during a pandemic is vaccination. Yet, an appropriate vaccine is not available early in the pandemic since vaccine production is time consuming. For influenza strains with a high pandemic potential like H5N1, stockpiling of vaccines has been considered but is hampered by rapid antigenic drift of the virus. It has, however, been shown that immunization with a given H5N1 strain can prime the immune system for a later booster with a drifted variant. Here, we investigated whether whole inactivated virus (WIV) vaccine can be processed to tablets suitable for sublingual (s.l.) use and whether s.l. vaccine administration can prime the immune system for a later intramuscular (i.m.) boost with a heterologous vaccine. In vitro results demonstrate that freeze-drying and tableting of WIV did not affect the integrity of the viral proteins or the hemagglutinating properties of the viral particles. Immunization experiments revealed that s.l. priming with WIV (prepared from the H5N1 vaccine strain NIBRG-14) 4 weeks prior to i.m. booster immunization with the same virus strongly enhanced hemagglutination-inhibition (HI) titers against NIBRG-14 and the drifted variant NIBRG-23. Moreover, s.l. (and i.m.) immunization with NIBRG-14 also primed for a subsequent heterologous i.m. booster immunization with NIBRG-23 vaccine. In addition to HI serum antibodies, s.l. priming enhanced lung and nose IgA responses, while i.m. priming enhanced lung IgA but not nose IgA levels. Our results identify s.l. vaccination as a user-friendly method to prime for influenza-specific immune responses toward homologous and drifted variants. PMID:24482005

Murugappan, Senthil; Patil, Harshad P; Frijlink, Henderik W; Huckriede, Anke; Hinrichs, Wouter L J

2014-03-01

214

Influenza pandémica A (H1N1 2009: epidemiología, características clínicas y diferencias con influenza estacional en Chile Pandemic influenza A (H1N1 2009: epidemiology, clinical features and differences with seasonal influenza in Chile  

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Full Text Available La pandemia de inluenza A (H1N1 2009 generó preguntas sobre sus diferencias con influenza estacional. Objetivos: Describir las características de influenza pandémica y comparar con influenza estacional. Pacientes y Métodos: Estudio descriptivo de casos confirmados de influenza pandémica en adultos internados en el Hospital Clínico de la Pontificia Universidad Católica entre mayo y julio de 2009, comparado con 95 casos históricos de influenza estacional. Resultados: 54 pacientes con influenza pandémica, 51,9% género masculino, edad 52,8 ± 19,5 años; 79,6% presentaban co-morbilidades; 16,7% inmunocomprometidos, 7,4% mujeres embarazadas, 25,9% de adquisición nosocomial, 31,5% requirió cuidados intensivos/intermedios. Se diagnosticó neumonía en 37% y la mortalidad global fue 3,7%. En la comparación con inluenza estacional, la pandémica afectó menos pacientes > de 65 años (31,5 vs 68%, p Pandemic influenza A (H1N1 2009 raised questions regarding differences with seasonal influenza. Objectives: To describe the clinical features of pandemic influenza and compare them to seasonal influenza. Patients y Methods: A descriptive study that compared hospitalized adults was done between patients with confirmed pandemic inluenza in the Hospital Clínico Universidad Católica in Santiago, Chile, from May to July 2009 and 95 confirmed historic cases of seasonal influenza. Results: 54 patients with pandemic influenza were included, 51.9% were male, age of 52.8 ± 19.5 years old; 79.6% had chronic diseases; 16.7% were immunocompromised patients and 7.4% of pregnant women. 25.9% of the patients acquired the infection during the hospitalization. 31.5% were admitted to intermediate/intensive care units. Pneumonia was diagnosed in 37%, and the mortality rate was 3.7%. The comparison between pandemic and seasonal influenza showed less proportion of patient > 65 years of age (31.5% vs. 68%; p < 0.0001; double number of nosocomial acquisition and more cases of pneumonia and death. Conclusions: The pandemic inluenza infection affected younger people and was related with more nosocomial cases, pneumonia and mortality rates than seasonal inluenza.

Ricardo Rabagliati B

2011-12-01

215

Comparative analysis of clinical characteristics of pandemic influenza a/h1n1 and seasonal influenza a infections in hospitalized children.  

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Pandemic influenza A/H1N1 (piA) caused significant morbidity and mortality worldwide. We compared characteristics of piA (2009/2010) to those of seasonal influenza A (2007/2008/2009) in 134 (piA/seasonal influenza A: N = 55/79) hospitalized patients Croup syndrome (15%/3%), conjunctivitis (31%/10%) and febrile seizures (26%/13%) were more frequent in piA; 64%/53% patients had ?1 complication, and 5 (3/2) were admitted to intensive care unit. Oseltamivir use was 20%/0%. Severity of pandemic influenza disease was not different compared with seasonal influenza A in preceding years. PMID:23190773

Heininger, Ulrich; Baer, Gurli; Ryser, Anna-Julia; Li, Yulin

2013-03-01

216

Synthetic generation of influenza vaccine viruses for rapid response to pandemics.  

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During the 2009 H1N1 influenza pandemic, vaccines for the virus became available in large quantities only after human infections peaked. To accelerate vaccine availability for future pandemics, we developed a synthetic approach that very rapidly generated vaccine viruses from sequence data. Beginning with hemagglutinin (HA) and neuraminidase (NA) gene sequences, we combined an enzymatic, cell-free gene assembly technique with enzymatic error correction to allow rapid, accurate gene synthesis. We then used these synthetic HA and NA genes to transfect Madin-Darby canine kidney (MDCK) cells that were qualified for vaccine manufacture with viral RNA expression constructs encoding HA and NA and plasmid DNAs encoding viral backbone genes. Viruses for use in vaccines were rescued from these MDCK cells. We performed this rescue with improved vaccine virus backbones, increasing the yield of the essential vaccine antigen, HA. Generation of synthetic vaccine seeds, together with more efficient vaccine release assays, would accelerate responses to influenza pandemics through a system of instantaneous electronic data exchange followed by real-time, geographically dispersed vaccine production. PMID:23677594

Dormitzer, Philip R; Suphaphiphat, Pirada; Gibson, Daniel G; Wentworth, David E; Stockwell, Timothy B; Algire, Mikkel A; Alperovich, Nina; Barro, Mario; Brown, David M; Craig, Stewart; Dattilo, Brian M; Denisova, Evgeniya A; De Souza, Ivna; Eickmann, Markus; Dugan, Vivien G; Ferrari, Annette; Gomila, Raul C; Han, Liqun; Judge, Casey; Mane, Sarthak; Matrosovich, Mikhail; Merryman, Chuck; Palladino, Giuseppe; Palmer, Gene A; Spencer, Terika; Strecker, Thomas; Trusheim, Heidi; Uhlendorff, Jennifer; Wen, Yingxia; Yee, Anthony C; Zaveri, Jayshree; Zhou, Bin; Becker, Stephan; Donabedian, Armen; Mason, Peter W; Glass, John I; Rappuoli, Rino; Venter, J Craig

2013-05-15

217

Skip the Trip: Air Travelers' Behavioral Responses to Pandemic Influenza  

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Theory suggests that human behavior has implications for disease spread. We examine the hypothesis that individuals engage in voluntary defensive behavior during an epidemic. We estimate the number of passengers missing previously purchased flights as a function of concern for swine flu or A/H1N1 influenza using 1.7 million detailed flight records, Google Trends, and the World Health Organization's FluNet data. We estimate that concern over “swine flu,” as measured by Google Trends, accou...

Fenichel, Eli P.; Kuminoff, Nicolai V.; Chowell, Gerardo

2013-01-01

218

Pandemic (H1N1) 2009 and Seasonal Influenza A (H1N1) Co-infection, New Zealand, 2009  

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Co-infection with seasonal influenza A (H1N1) and pandemic (H1N1) 2009 could result in reassortant viruses that may acquire new characteristics of transmission, virulence, and oseltamivir susceptibility. Results from oseltamivir-sensitivity testing on viral culture suggested the possibility of co-infections with oseltamivir-resistant (seasonal A [H1N1]) and -susceptible (pandemic [H1N1] 2009) viruses.

Peacey, Matthew; Hall, Richard J.; Sonnberg, Stephanie; Ducatez, Mariette; Paine, Shevaun; Nicol, Mackenzie; Ralston, Jacqui C.; Bandaranayake, Don; Hope, Virginia; Webby, Richard J.; Huang, Sue

2010-01-01

219

Evidence of Human-to-Swine Transmission of the Pandemic (H1N1) 2009 Influenza Virus in South Korea?  

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As the pandemic (H1N1) 2009 influenza virus continues to infect human populations globally, reports on epidemiologically linked animal infections are also on the rise. Since December 2009, pandemic (H1N1) 2009-like viruses have been isolated in pigs from different swine farms of South Korea. Genetic and phylogenetic analyses of viral segments demonstrated several events of human-to-swine transmission with no apparent signs of reassortment. These events were also supported by serological surve...

Song, Min-suk; Lee, Jun Han; Pascua, Philippe Noriel Q.; Baek, Yun Hee; Kwon, Hyeok-il; Park, Kuk Jin; Choi, Hwan-woon; Shin, Yeun-kyung; Song, Jae-young; Kim, Chul-joong; Choi, Young-ki

2010-01-01

220

Key transmission parameters of an institutional outbreak during the 1918 influenza pandemic estimated by mathematical modelling  

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Full Text Available Abstract Aim To estimate the key transmission parameters associated with an outbreak of pandemic influenza in an institutional setting (New Zealand 1918. Methods Historical morbidity and mortality data were obtained from the report of the medical officer for a large military camp. A susceptible-exposed-infectious-recovered epidemiological model was solved numerically to find a range of best-fit estimates for key epidemic parameters and an incidence curve. Mortality data were subsequently modelled by performing a convolution of incidence distribution with a best-fit incidence-mortality lag distribution. Results Basic reproduction number (R0 values for three possible scenarios ranged between 1.3, and 3.1, and corresponding average latent period and infectious period estimates ranged between 0.7 and 1.3 days, and 0.2 and 0.3 days respectively. The mean and median best-estimate incidence-mortality lag periods were 6.9 and 6.6 days respectively. This delay is consistent with secondary bacterial pneumonia being a relatively important cause of death in this predominantly young male population. Conclusion These R0 estimates are broadly consistent with others made for the 1918 influenza pandemic and are not particularly large relative to some other infectious diseases. This finding suggests that if a novel influenza strain of similar virulence emerged then it could potentially be controlled through the prompt use of major public health measures.

Nelson Peter

2006-11-01

 
 
 
 
221

Low Level of Cross-Reactive Antibodies to Pandemic Influenza (H1N1) 2009 Virus in Humans in Pre-Pandemic Period in Maharashtra, India  

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In India, the first outbreak of pandemic influenza (H1N1) 2009 (H1N1pdm) was reported from Panchgani, Maharashtra, in June 2009. Studies from several countries have revealed different levels of pre-existing immunity to H1N1pdm 2009 in various age groups. This study was undertaken using age-stratified pre-pandemic human sera to understand baseline cross-reactivity of antibodies against H1N1pdm. Using cut off antibody titers 20 and 40, overall cross-reactivity was 2.1 and 0.9% respectively by m...

Kode, Sadhana S.; Pawar, Shailesh D.; Tandale, Babasaheb V.; Parkhi, Saurabh S.; Barde, Tanaji D.; Mishra, Akhilesh C.

2012-01-01

222

Current status of live attenuated influenza vaccine in the United States for seasonal and pandemic influenza  

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A live attenuated influenza vaccine (LAIV) is currently approved in the United States for the prevention of influenza in individuals 2–49 years of age. This article summarizes the available data describing the safety and efficacy of LAIV for the prevention of influenza in both children and adults. LAIV is administered as an intranasal spray and has been shown to provide high levels of efficacy against influenza illness caused by both matched and mismatched strains in children and adults. In...

Ambrose, Christopher S.; Luke, Catherine; Coelingh, Kathleen

2008-01-01

223

An SIR Estimation for Pandemic by influenza A During the Haj  

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Full Text Available In this study, a system of SIR models depended on effective contact rate of the disease and potential size of the community is developed for simulating patterns of pandemic by influenza A during the Haj. Indeed, we consider three different SIR models such that each of them is calibrated to simulate a separate part of the ceremony and then we link these models together to obtain system simulating whole the Haj ceremony. Considering different numerical values of effective contact rate and potential size of the community, we estimate the portion of susceptible hosts in the community and also the portion of total infection during the ceremony and portion of infective individuals at any time of the ceremony. Our goal is to suggest doable optimal situations keeping the pandemic under the control and the number of infected people as low as possible.

O. Rabiei Motlagh

2010-01-01

224

Epidemiological characteristics of the influenza A(H1N1 2009 pandemic in the Western Pacific Region  

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Full Text Available The first laboratory-confirmed cases of infection with pandemic influenza A(H1N1 2009 in the Western Pacific Region were reported on 28 April 2009. By 11 June 2009, the day the pandemic was declared by the World Health Organization, nine Western Pacific Region countries and areas had reported laboratory-confirmed pandemic influenza A(H1N1 2009 cases. From April 2009 to July 2010, more than 250 000 cases and 1800 deaths from laboratory-confirmed pandemic influenza A(H1N1 2009 were reported from 34 countries and areas in the Region. By age group region-wide, 8.6%, 41.9%, 48.3%, and 1.2% of cases were in the < 5 years, 5–14 years, 15–64 years, and 65+ years age groups, respectively; the overall crude case fatality ratio in the Western Pacific Region was 0.5%. The pandemic demonstrated that region-wide disease reporting was possible. Countries and areas of the Western Pacific Region should take this opportunity to strengthen the systems established during the pandemic to develop routine disease reporting.

Lisa McCallum

2010-12-01

225

Healthcare workers as parents: attitudes toward vaccinating their children against pandemic influenza A/H1N1  

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Full Text Available Abstract Background Both the health care workers (HCWs and children are target groups for pandemic influenza vaccination. The coverage of the target populations is an important determinant for impact of mass vaccination. The objective of this study is to determine the attitudes of HCWs as parents, toward vaccinating their children with pandemic influenza A/H1N1 vaccine. Methods A cross-sectional questionnaire survey was conducted with health care workers (HCWs in a public hospital during December 2009 in Istanbul. All persons employed in the hospital with or without a health-care occupation are accepted as HCW. The HCWs who are parents of children 6 months to 18 years of age were included in the study. Pearson's chi-square test and logistic regression analysis was applied for the statistical analyses. Results A total of 389 HCWs who were parents of children aged 6 months-18 years participated study. Among all participants 27.0% (n = 105 reported that themselves had been vaccinated against pandemic influenza A/H1N1. Two third (66.1% of the parents answered that they will not vaccinate their children, 21.1% already vaccinated and 12.9% were still undecided. Concern about side effect was most reported reason among who had been not vaccinated their children and among undecided parents. The second reason for refusing the pandemic vaccine was concerns efficacy of the vaccine. Media was the only source of information about pandemic influenza in nearly one third of HCWs. Agreement with vaccine safety, self receipt of pandemic influenza A/H1N1 vaccine, and trust in Ministry of Health were found to be associated with the positive attitude toward vaccinating their children against pandemic influenza A/H1N1. Conclusions Persuading parents to accept a new vaccine seems not be easy even if they are HCWs. In order to overcome the barriers among HCWs related to pandemic vaccines, determination of their misinformation, attitudes and behaviors regarding the pandemic influenza vaccination is necessary. Efforts for orienting the HCWs to use evidence based scientific sources, rather than the media for information should be considered by the authorities.

Torun Fuat

2010-10-01

226

Bovine and human-derived passive immunization could help slow a future avian influenza pandemic.  

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An epidemic of human transmitted avian influenza could have casualties on a scale seen in the great Spanish influenza pandemic of 1918. This paper proposes that should such occur before effective vaccines and antiviral drugs are available, the outbreak could be significantly slowed by consumption of raw milk produced by herds of pathogen-free lactating cows intranasally inoculated with heat-sterilized sputa pooled from avian influenza patients, supplemented by parenteral serum immune globulin from the same cows. Efficiency of bovine antibody production could be enhanced using cholera toxin subunit b, and milk production could be rapidly accelerated using recombinant bovine somatotropin hormone. In this way, it would be possible to quickly create and distribute large quantities of milk-based and serum-based passive immune globulin active against the strains of avian influenza present in a particular geographic area and gain time for production of human convalescent plasma and other public health measures. This novel approach might also have utility for other serious respiratory infectious diseases, including non-avian influenza, SARS, hantavirus, respiratory syncytial virus, antibiotic-resistant Streptococcus pneumoniae and pneumonia-causing Staphylococcus aureus. PMID:18824305

Alisky, Joseph

2009-01-01

227

Pandemic influenza A virus codon usage revisited: biases, adaptation and implications for vaccine strain development  

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Full Text Available Abstract Background Influenza A virus (IAV is a member of the family Orthomyxoviridae and contains eight segments of a single-stranded RNA genome with negative polarity. The first influenza pandemic of this century was declared in April of 2009, with the emergence of a novel H1N1 IAV strain (H1N1pdm in Mexico and USA. Understanding the extent and causes of biases in codon usage is essential to the understanding of viral evolution. A comprehensive study to investigate the effect of selection pressure imposed by the human host on the codon usage of an emerging, pandemic IAV strain and the trends in viral codon usage involved over the pandemic time period is much needed. Results We performed a comprehensive codon usage analysis of 310 IAV strains from the pandemic of 2009. Highly biased codon usage for Ala, Arg, Pro, Thr and Ser were found. Codon usage is strongly influenced by underlying biases in base composition. When correspondence analysis (COA on relative synonymous codon usage (RSCU is applied, the distribution of IAV ORFs in the plane defined by the first two major dimensional factors showed that different strains are located at different places, suggesting that IAV codon usage also reflects an evolutionary process. Conclusions A general association between codon usage bias, base composition and poor adaptation of the virus to the respective host tRNA pool, suggests that mutational pressure is the main force shaping H1N1 pdm IAV codon usage. A dynamic process is observed in the variation of codon usage of the strains enrolled in these studies. These results suggest a balance of mutational bias and natural selection, which allow the virus to explore and re-adapt its codon usage to different environments. Recoding of IAV taking into account codon bias, base composition and adaptation to host tRNA may provide important clues to develop new and appropriate vaccines.

Goñi Natalia

2012-11-01

228

Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak  

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Full Text Available Abstract Background Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Methods Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. Results The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs, and the possibility of loss due to disclosing health information (risk beliefs. We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. Conclusions The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks.

Grava-Gubins Inese

2011-06-01

229

Influenza pandemic intervention planning using InfluSim: pharmaceutical and non- pharmaceutical interventions  

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Full Text Available Abstract Background Influenza pandemic preparedness plans are currently developed and refined on national and international levels. Much attention has been given to the administration of antiviral drugs, but contact reduction can also be an effective part of mitigation strategies and has the advantage to be not limited per se. The effectiveness of these interventions depends on various factors which must be explored by sensitivity analyses, based on mathematical models. Methods We use the freely available planning tool InfluSim to investigate how pharmaceutical and non-pharmaceutical interventions can mitigate an influenza pandemic. In particular, we examine how intervention schedules, restricted stockpiles and contact reduction (social distancing measures and isolation of cases determine the course of a pandemic wave and the success of interventions. Results A timely application of antiviral drugs combined with a quick implementation of contact reduction measures is required to substantially protract the peak of the epidemic and reduce its height. Delays in the initiation of antiviral treatment (e.g. because of parsimonious use of a limited stockpile result in much more pessimistic outcomes and can even lead to the paradoxical effect that the stockpile is depleted earlier compared to early distribution of antiviral drugs. Conclusion Pharmaceutical and non-pharmaceutical measures should not be used exclusively. The protraction of the pandemic wave is essential to win time while waiting for vaccine development and production. However, it is the height of the peak of an epidemic which can easily overtax general practitioners, hospitals or even whole public health systems, causing bottlenecks in basic and emergency medical care.

Schwehm Markus

2007-07-01

230

Pandemic Influenza A (H1N1) in Non-vaccinated, Pregnant Women in Spain (2009-2010).  

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The aim of this study was to investigate the main characteristics of non-vaccinated pregnant women who were hospitalised for influenza A (H1N1) pdm09 pandemic versus pregnant women hospitalised for non-influenza-related reasons in Spain, and to characterise the clinical presentation of the disease in this population to facilitate early diagnosis and future action programmes. Understanding influenza infection during pregnancy is important as pregnant women are a high-risk population for increased morbidity from influenza infection. We investigated the socio-demographic and clinical features of 51 non-vaccinated, pregnant women infected with the pandemic influenza A (H1N1) virus in Spain (cases) and compared them to 114 controls (non-vaccinated and non-infected pregnant women) aged 15-44 years. Substantial and significant odd ratios (ORs) for pandemic influenza A (H1N1) were found for the pregnant women who were obese compared with controls (body mass index > 30) (OR 3.03; 95 % confidence intervals 1.13-8.11). The more prevalent symptoms observed in pandemic influenza-infected pregnant women were high temperature, cough (82.4 %), malaise (80.5 %), myalgia (56.1 %), and headaches (54.9 %). Our results suggest that the initial symptoms and risk factors for infection of pregnant women with the influenza A (H1N1) pdm09 virus are similar to the symptoms and risk factors for seasonal influenza, which make early diagnosis difficult, and reinforces the need to identify and protect high-risk groups. PMID:24162551

Morales-Suárez-Varela, María; González-Candelas, Fernando; Astray, Jenaro; Alonso, Jordi; Castro, Ady; Cantón, Rafael; Galán, Juan Carlos; Garin, Olatz; Soldevila, Núria; Baricot, Maretva; Castilla, Jesús; Godoy, Pere; Delgado-Rodríguez, Miguel; Martín, Vicente; Mayoral, José María; Pumarola, Tomás; Quintana, José Maria; Tamames, Sonia; Llopis-González, Agustín; Domínguez, Angela

2014-08-01

231

Seasonal influenza infection and live vaccine prime for a response to the 2009 pandemic H1N1 vaccine  

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The robust immune response to a single dose of pandemic 2009 H1N1 vaccine suggests that a large segment of the population has been previously primed. We evaluated the effect of seasonal (s) H1N1 infection, s-trivalent inactivated vaccine (s-TIV), and trivalent s-live attenuated influenza vaccine (s-LAIV) before immunization with a pandemic live attenuated influenza vaccine (p-LAIV) in mice. We compared serum and mucosal antibody and pulmonary CD8 and CD4 responses and the virologic response t...

2011-01-01

232

Influenza A(H1N1)pdm09 antibodies after pandemic and trivalent seasonal influenza vaccination as well as natural infection in November 2010 in Hamburg, Germany.  

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The 2009 influenza pandemic has introduced the new re-assorted influenza A(H1N1)pdm09 virus which recirculated during the 2010/11 influenza season. Before that season, it was possible to acquire protective immunity either by pandemic or seasonal influenza vaccination against influenza A(H1N1)pdm09 or by natural infection. To obtain data on vaccination coverage and antibody levels in a reference population and to calculate whether or not the herd immunity threshold (HIT, calculated as 33% given an R0 of 1.5) was reached at the beginning of the 2010/11 season we performed a seroprevalence study in November 2010 in Hamburg, Germany. Antibody titres were assessed applying a haemagglutination inhibition test. Vaccination coverage was very low: 14% for pandemic and 11% for seasonal 2010/11 vaccinations. Even in those with underlying risk factors, vaccination coverage was not much higher: 17% for both vaccines. Serological analysis revealed antibody titres of ?1:10 in 135 of 352 (38%) and of ?1:40 in 61 of 352 study participants (17%). Specific antibodies were measurable in 26% of those without history of vaccination or natural infection, indicating a high proportion of subclinical and mild influenza disease. Nevertheless, the HIT was not reached, leaving the majority of the population susceptible to influenza A(H1N1)pdm09 and its potential complications. PMID:22264864

Cramer, Jp; Mac, T; Hogan, B; Stauga, S; Eberhardt, S; Wichmann, O; Mertens, T; Burchard, Gd

2012-01-01

233

Evolution and adaptation of the pandemic A/H1N1 2009 influenza virus  

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Full Text Available Mariette F Ducatez, Thomas P Fabrizio, Richard J WebbyDepartment of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN, USAAbstract: The emergence of the 2009 H1N1 pandemic influenza virus [A(H1N1pdm09] has provided the public health community with many challenges, but also the scientific community with an opportunity to monitor closely its evolution through the processes of drift and shift. To date, and despite having circulated in humans for nearly two years, little antigenic variation has been observed in the A(H1N1pdm09 viruses. However, as the A(H1N1pdm09 virus continues to circulate and the immunologic pressure within the human population increases, future antigenic change is almost a certainty. Several coinfections of A(H1N1pdm09 and seasonal A(H1N1 or A(H3N2 viruses have been observed, but no reassortant viruses have been described in humans, suggesting a lack of fitness of reassortant viruses or a lack of opportunities for interaction of different viral lineages. In contrast, multiple reassortment events have been detected in swine populations between A(H1N1 pdm09 and other endemic swine viruses. Somewhat surprisingly, many of the well characterized influenza virus virulence markers appear to have limited impact on the phenotype of the A(H1N1pdm09 viruses when they have been introduced into mutant viruses in laboratory settings. As such, it is unclear what the evolutionary path of the pandemic virus will be, but the monitoring of any changes in the circulating viruses will remain a global public and animal health priority.Keywords: influenza, pandemic, evolution, adaptation

Ducatez MF

2011-07-01

234

Time variations in the transmissibility of pandemic influenza in Prussia, Germany, from 1918–19  

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Full Text Available Abstract Background Time variations in transmission potential have rarely been examined with regard to pandemic influenza. This paper reanalyzes the temporal distribution of pandemic influenza in Prussia, Germany, from 1918–19 using the daily numbers of deaths, which totaled 8911 from 29 September 1918 to 1 February 1919, and the distribution of the time delay from onset to death in order to estimate the effective reproduction number, Rt, defined as the actual average number of secondary cases per primary case at a given time. Results A discrete-time branching process was applied to back-calculated incidence data, assuming three different serial intervals (i.e. 1, 3 and 5 days. The estimated reproduction numbers exhibited a clear association between the estimates and choice of serial interval; i.e. the longer the assumed serial interval, the higher the reproduction number. Moreover, the estimated reproduction numbers did not decline monotonically with time, indicating that the patterns of secondary transmission varied with time. These tendencies are consistent with the differences in estimates of the reproduction number of pandemic influenza in recent studies; high estimates probably originate from a long serial interval and a model assumption about transmission rate that takes no account of time variation and is applied to the entire epidemic curve. Conclusion The present findings suggest that in order to offer robust assessments it is critically important to clarify in detail the natural history of a disease (e.g. including the serial interval as well as heterogeneous patterns of transmission. In addition, given that human contact behavior probably influences transmissibility, individual countermeasures (e.g. household quarantine and mask-wearing need to be explored to construct effective non-pharmaceutical interventions.

Nishiura Hiroshi

2007-06-01

235

Dendritic Cell Activation by Recombinant Hemagglutinin Proteins of H1N1 and H5N1 Influenza A Viruses?  

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Since dendritic cells may play a key role in defense against influenza virus infection, we examined the effects of recombinant hemagglutinin (HA) proteins derived from mouse-adapted H1N1 (A/WSN/1933), swine-origin 2009 pandemic H1N1 (A/Texas/05/2009), and highly pathogenic avian influenza H5N1 (A/Thailand/KAN-1/2004) viruses on mouse myeloid dendritic cells (mDCs). The results reveal that tumor necrosis factor alpha (TNF-?), interleukin-12 (IL-12) p70, and major histocompatibility complex cl...

2010-01-01

236

[Chile between pandemic: the influenza of 1918, globalization and the new medicine].  

Science.gov (United States)

In 1918 Chile met the deadly presence of the Spanish influenza pandemic twentieth century's most important. For many historians, this event is an important milestone in the historical process of the unification of the world through sickness and in which our country has been involved. In this context, this paper aims to examine how the flu broke into Chilean society and how that situation helped give new impetus to the modernization of the Chilean public health and the establishment in the 1920s to model new medicine or preventive medicine. PMID:23677160

López, Marcelo; Beltrán, Miriam

2013-04-01

237

Pandemic H1N1 2009 virus in Norwegian pigs naïve to influenza A viruses  

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In March-April 2009, a novel pandemic influenza A (H1N1) virus (pH1N1-09v) emerged in the human population. The first case of pH1N1v infection in pigs was reported from Canada in May 2009. In Norway, pH1N1v infection was recorded in a swine herd on the 10th of October of 2009. Here, we report results from the investigation performed during the outbreak and the follow up surveillance performed in the Norwegian pig population.

Germundsson, A.; Gjerset, B.; Hjulsager, Charlotte Kristiane; Larsen, Lars Erik; Er, C.; Hungnes, O.; Lium, B.

2011-01-01

238

Antibody recognition of the pandemic H1N1 Influenza virus hemagglutinin receptor binding site.  

Science.gov (United States)

Influenza virus is a global health concern due to its unpredictable pandemic potential. This potential threat was realized in 2009 when an H1N1 virus emerged that resembled the 1918 virus in antigenicity but fortunately was not nearly as deadly. 5J8 is a human antibody that potently neutralizes a broad spectrum of H1N1 viruses, including the 1918 and 2009 pandemic viruses. Here, we present the crystal structure of 5J8 Fab in complex with a bacterially expressed and refolded globular head domain from the hemagglutinin (HA) of the A/California/07/2009 (H1N1) pandemic virus. 5J8 recognizes a conserved epitope in and around the receptor binding site (RBS), and its HCDR3 closely mimics interactions of the sialic acid receptor. Electron microscopy (EM) reconstructions of 5J8 Fab in complex with an HA trimer from a 1986 H1 strain and with an engineered stabilized HA trimer from the 2009 H1 pandemic virus showed a similar mode of binding. As for other characterized RBS-targeted antibodies, 5J8 uses avidity to extend its breadth and affinity against divergent H1 strains. 5J8 selectively interacts with HA insertion residue 133a, which is conserved in pandemic H1 strains and has precluded binding of other RBS-targeted antibodies. Thus, the RBS of divergent HAs is targeted by 5J8 and adds to the growing arsenal of common recognition motifs for design of therapeutics and vaccines. Moreover, consistent with previous studies, the bacterially expressed H1 HA properly refolds, retaining its antigenic structure, and presents a low-cost and rapid alternative for engineering and manufacturing candidate flu vaccines. PMID:24027321

Hong, Minsun; Lee, Peter S; Hoffman, Ryan M B; Zhu, Xueyong; Krause, Jens C; Laursen, Nick S; Yoon, Sung-Il; Song, Langzhou; Tussey, Lynda; Crowe, James E; Ward, Andrew B; Wilson, Ian A

2013-11-01

239

Will the community nurse continue to function during H1N1 influenza pandemic: a cross-sectional study of Hong Kong community nurses?  

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Full Text Available Abstract Background Healthcare workers have been identified as one of the high risk groups for being infected with influenza during influenza pandemic. Potential levels of absenteeism among healthcare workers in hospital settings are high. However, there was no study to explore the attitudes of healthcare workers in community setting towards the preparedness to the novel H1N1 influenza pandemic. The aim of this study was to explore the willingness of community nurses in Hong Kong to work during H1N1 influenza pandemic. Methods A cross-sectional survey was conducted among all 401 community nurses employed by the Hospital Authority in Hong Kong when the WHO pandemic alert level was 6. Results The response rate of this study was 66.6%. 76.9% participants reported being "not willing" (33.3% or "not sure" (43.6% to take care of patients during H1N1 influenza pandemic. The self-reported reasons for being unwilling to report to duty during H1N1 influenza pandemic were psychological stress (55.0% and fear of being infected H1N1 influenza (29.2%. The reported unwillingness to report to duty was marginally significantly associated with the request for further training of using infection control clinical guideline (OR: 0.057; CI: 0.25-1.02. Those who reported unwillingness or not being sure about taking care of the patients during H1N1 influenza pandemic were more depressed (p Conclusions Interventions to provide infection control training and address community nurses' psychological needs might increase their willingness to provide care to patients in the community during H1N1 influenza pandemic. This would help to ensure an effective and appropriate health system response during the H1N1 influenza pandemic.

Gao Tiffany T

2010-04-01

240

A model for the spread and control of pandemic influenza in an isolated geographical region.  

Science.gov (United States)

In the event of an influenza pandemic, the most probable way in which the virus would be introduced to an isolated geographical area is by an infected traveller. We use a mathematical model, structured on the location at which infection occurs and based on published parameters for influenza, to describe an epidemic in a community of one million people. The model is then modified to reflect a variety of control strategies based on social distancing measures, targeted antiviral treatment and antiviral prophylaxis and home quarantine, and the effectiveness of the strategies is compared. The results suggest that the only single strategy that would be successful in preventing an epidemic (with R0=2.0) is targeted antiviral treatment and prophylaxis, and that closing schools combined with either closing work places or home quarantine would only prevent such an epidemic if these strategies were combined with a modest level of antiviral coverage. PMID:17251145

Roberts, M G; Baker, M; Jennings, L C; Sertsou, G; Wilson, N

2007-04-22

 
 
 
 
241

Clinical manifestations, therapy and outcome of pandemic influenza a (H1N1) 2009 in hospitalized patients  

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Background/Aim. Increasing number of epidemiological and clinical studies to date showed that the pandemic influenza A (H1N1) 2009, by its characteristics, significantly differs from infection caused by seasonal influenza. Therefore, the information about clinical spectrum of manifestations, risk factors for severe form of the disease, treatment and outcome in patients with novel flu are still collected. Methods. A total of 98 patients (mean age 32 ± 15 years, range 14-88 years) with t...

2011-01-01

242

Cerebral edema and a transtentorial brain herniation syndrome associated with pandemic swine influenza A (H1N1) virus infection  

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Acute encephalitis, encephalopathy, and seizures are known rare neurologic sequelae of respiratory tract infection with seasonal influenza A and B virus, but the neurological complications of the pandemic 2009 swine influenza A (H1N1) virus, particularly in adults, are ill-defined. We document two young adults suffering from H1N1-associated acute respiratory distress syndrome and renal failure who developed cerebral edema. The patients acutely developed a transtentorial brain herniation syndr...

Kahle, Kristopher T.; Walcott, Brian P.; Nahed, Brian V.; Barnard, Zachary R.; Lo, Eng H.; Buonanno, Ferdinando S.; Venna, Nagagopal; Ning, Mingming

2011-01-01

243

Identification of Oseltamivir Resistance among Pandemic and Seasonal Influenza A (H1N1) Viruses by an His275Tyr Genotyping Assay Using the Cycling Probe Method?  

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Neuraminidase inhibitors are agents used against influenza viruses; however, the emergence of drug-resistant strains is a major concern. Recently, the prevalence of oseltamivir-resistant seasonal influenza A (H1N1) virus increased globally and the emergence of oseltamivir-resistant pandemic influenza A (H1N1) 2009 viruses was reported. In this study, we developed a cycling probe real-time PCR method for the detection of oseltamivir-resistant seasonal influenza A (H1N1) and pandemic influenza ...

Suzuki, Yasushi; Saito, Reiko; Sato, Isamu; Zaraket, Hassan; Nishikawa, Makoto; Tamura, Tsutomu; Dapat, Clyde; Caperig-dapat, Isolde; Baranovich, Tatiana; Suzuki, Takako; Suzuki, Hiroshi

2011-01-01

244

Pandemic clinical case definitions are non-specific: multiple respiratory viruses circulating in the early phases of the 2009 influenza pandemic in New South Wales, Australia  

Science.gov (United States)

Background During the early phases of the 2009 pandemic, subjects with influenza-like illness only had laboratory testing specific for the new A(H1N1)pdm09 virus. Findings Between 25th May and 7th June 2009, during the pandemic CONTAIN phase, A(H1N1)pdm09 virus was detected using nucleic acid tests in only 56 of 1466 (3.8%) samples meeting the clinical case definition required for A(H1N1)pdm09 testing. Two hundred and fifty-five randomly selected A(H1N1)pdm09 virus-negative samples were tested for other respiratory viruses using a real-time multiplex PCR assay. Of the 255 samples tested, 113 (44.3%) had other respiratory viruses detected: rhinoviruses 63.7%, seasonal influenza A 17.6%, respiratory syncytial virus 7.9%, human metapneumovirus 5.3%, parainfluenzaviruses 4.4%, influenza B virus 4.4%, and enteroviruses 0.8%. Viral co-infections were present in 4.3% of samples. Conclusions In the very early stages of a new pandemic, limiting testing to only the novel virus will miss other clinically important co-circulating respiratory pathogens.

2014-01-01

245

Early observational research and registries during the 2009-2010 influenza A pandemic.  

Science.gov (United States)

As a critical care community, we have an obligation to provide not only clinical care but also the research that guides initial and subsequent clinical responses during a pandemic. There are many challenges to conducting such research. The first is speed of response. However, given the near inevitability of certain events, for example, viral respiratory illness such as the 2009 pandemic, geographically circumscribed natural disasters, or acts of terror, many study and trial designs should be preplanned and modified quickly when specific events occur. Template case report forms should be available for modification and web entry; centralized research ethics boards and funders should have the opportunity to preview and advise on such research beforehand; and national and international research groups should be prepared to work together on common studies and trials for common challenges. We describe the early international critical care research response to the influenza A 2009 (H1N1) pandemic, including specifics of observational study case report form, registry, and clinical trial design, cooperation of international critical care research organizations, and the early results of these collaborations. PMID:20101176

Fowler, Robert A; Webb, Steven A R; Rowan, Kathy M; Sprung, Charles L; Thompson, B Taylor; Randolph, Adrienne G; Jouvet, Philippe; Lapinsky, Stephen; Rubinson, Lewis; Rello, Jordi; Cobb, J Perren; Rice, Todd W; Uyeki, Tim; Marshall, John C

2010-04-01

246

Toward unbiased assessment of treatment and prevention: modeling household transmission of pandemic influenza  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Providing valid and reliable estimates of the transmissibility and severity of pandemic influenza in real time is key to guide public health policymaking. In particular, early estimates of the transmissibility are indispensable for determining the type and intensity of interventions. A recent study by House and colleagues in BMC Medicine devised a stochastic transmission model to estimate the unbiased risk of transmission within households, applying the method to datasets of the 2009 A/H1N1 influenza pandemic. Here, we discuss future challenges in household transmission studies and underscore the need to systematically collect epidemiological data to decipher the household transmission dynamics. We emphasize the need to consider three critical issues for future improvements: (i capturing age-dependent heterogeneity within households calls for intensive modeling efforts, (ii the timeline of observation during the course of an epidemic and the length of follow-up should be aligned with study objectives, and (iii the use of laboratory methods, especially molecular techniques, is encouraged to distinguish household transmissions from those arising in the community. See related article: http://www.biomedcentral.com/1741-7015/10/117

Chowell Gerardo

2012-10-01

247

Pandemic influenza A H1N1 vaccines and narcolepsy: vaccine safety surveillance in action.  

Science.gov (United States)

The 2009 influenza A H1N1 pandemic placed unprecedented demand on public health authorities and the vaccine industry. Efforts were coordinated internationally to maximise the speed of vaccine development, distribution, and delivery, and the European Union's novel fast-track authorisation procedures mandated increased postmarketing surveillance to monitor vaccine safety. Clinicians in Finland and Sweden later identified an apparent increase in the incidence of narcolepsy associated with a specific adjuvanted pandemic influenza vaccine. After extensive review, the European Medicines Agency confirmed the existence of this association, which has since been detected in England, Ireland, France, and Norway. Assessments of the causal mechanisms continue. In this Review, we discuss how the narcolepsy association was detected, and we present the evidence according to the causality assessment criteria for adverse events following immunisation. The lessons learnt emphasise the central role of alert clinicians in reporting of suspected adverse reactions, and the importance of internationally robust postmarketing surveillance strategies as crucial components in future mass immunisation programmes. PMID:24360892

Barker, Charlotte I S; Snape, Matthew D

2014-03-01

248

Biopiracy and vaccines: Indonesia and the World Health Organization’s new Pandemic Influenza Plan  

Directory of Open Access Journals (Sweden)

Full Text Available Viral samples of avian influenza are essential to preparing pre-pandemic vaccines. In 2007, the conflicting interests of the developed and developing nations led Indonesia to briefly stop sharing viral samples. The result was a struggle in which the two blocs argued for different paradigms for viral sample sharing. The first paradigm, articulated by the developed world, depicted the issue as one of health security, in which international law mandated the sharing of viral samples. The second paradigm, advanced by the developing world, depicted viral sample sharing as a form of biopiracy, which violated countries’ sovereign control of their biological resources. Ultimately, the second paradigm proved more politically effective, enabling developing nations to achieve many of their goals through the WHO’s 2011 pandemic influenza plan. This paper examines how this plan was shaped by Indonesia’s argument that the global public good required a new approach to global health governance, in order to eliminate neocolonial power relationships.

Shawn Smallman

2013-05-01

249

Contemporary Seasonal Influenza A (H1N1) Virus Infection Primes for a More Robust Response To Split Inactivated Pandemic Influenza A (H1N1) Virus Vaccination in Ferrets ?  

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Human influenza pandemics occur when influenza viruses to which the population has little or no immunity emerge and acquire the ability to achieve human-to-human transmission. In April 2009, cases of a novel H1N1 influenza virus in children in the southwestern United States were reported. It was retrospectively shown that these cases represented the spread of this virus from an ongoing outbreak in Mexico. The emergence of the pandemic led to a number of national vaccination programs. Surprisi...

Ellebedy, Ali H.; Fabrizio, Thomas P.; Kayali, Ghazi; Oguin, Thomas H.; Brown, Scott A.; Rehg, Jerold; Thomas, Paul G.; Webby, Richard J.

2010-01-01

250

A cross-sectional study of pandemic influenza health literacy and the effect of a public health campaign  

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Full Text Available Abstract Background To ascertain the understanding of 2009 pandemic (H1N1 influenza and relevant infection control measures in an emergency department population and to assess the effectiveness of education campaigns in informing the public about the pandemic. Methods Questionnaires were administered to patients, visitors, non-clinical staff and volunteers. Data were collected on knowledge, preventative measures, information sources, attitudes to government and media reporting, perceived seriousness, behaviour change and intended compliance with future measures. Results were used to construct an overall knowledge score. Results There were 252 participants. Traditional forms of mass media (138 [55%] remained the principal information source. Approximately 70% (176 accurately described mode of transmission and recommended precautions and 68% (175 reported behaviour change because of the pandemic. Gaps in knowledge included failure to identify certain high risk groups. Recall of government campaigns was significantly associated with a higher knowledge score. 60% (151 thought that authorities and media had exaggerated the threat; only 40% (101 would comply with recommended measures in a future pandemic. Conclusions The knowledge regarding pandemic influenza was high in this population and positively affected by official campaigns. Pandemic planning should address knowledge gaps and the impression that authorities had exaggerated the public-health threat.

Jhummon-Mahadnac Namrata

2012-07-01

251

What infection control measures will people carry out to reduce transmission of pandemic influenza? A focus group study  

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Full Text Available Abstract Background Pandemic influenza poses a future health threat against which infection control behaviours may be an important defence. However, there is little qualitative research examining perceptions of infection control measures in the context of pandemic influenza. Methods Eight focus groups and one interview were conducted with a purposive sample of 31 participants. Participants were invited to discuss their perceptions of infection transmission and likely adherence to infection control measures in both non-pandemic and pandemic contexts. Infection control measures discussed included handwashing, social distancing and cough hygiene (e.g. covering mouth, disposing of tissues immediately etc.. Results Thematic analysis revealed that although participants were knowledgeable about infection transmission, most expressed unfavourable attitudes toward control behaviours in non-pandemic situations. However, with the provision of adequate education about control measures and appropriate practical support (e.g. memory aids, access to facilities, most individuals report that they are likely to adhere to infection control protocols in the event of a pandemic. Of the behaviours likely to influence infection transmission, handwashing was regarded by our participants as more feasible than cough and sneeze hygiene and more acceptable than social distancing. Conclusion Handwashing could prove a useful target for health promotion, but interventions to promote infection control may need to address a number of factors identified within this study as potential barriers to carrying out infection control behaviours.

Yardley Lucy

2009-07-01

252

Evaluation of New Rapid Antigen Test for Detection of Pandemic Influenza A/H1N1 2009 Virus ?  

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We evaluated the SD Bioline Influenza Ag A/B/A(H1N1) Pandemic test kit and compared it with real-time reverse transcriptase PCR (RT-PCR) for its ability to detect H1N1 2009. The sensitivity and specificity of the test kit for H1N1 2009 were 77% and 100%, respectively.

2010-01-01

253

Computer Simulation as a Tool for Assessing Decision-Making in Pandemic Influenza Response Training  

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Full Text Available Introduction: We sought to develop and test a computer-based, interactive simulation of a hypothetical pandemic influenza outbreak. Fidelity was enhanced with integrated video and branching decision trees, built upon the 2007 federal planning assumptions. We conducted a before-and-after study of the simulation effectiveness to assess the simulations’ ability to assess participants’ beliefs regarding their own hospitals’ mass casualty incident preparedness.Methods: Development: Using a Delphi process, we finalized a simulation that serves up a minimum of over 50 key decisions to 6 role-players on networked laptops in a conference area. The simulation played out an 8-week scenario, beginning with pre-incident decisions. Testing: Role-players and trainees (N=155 were facilitated to make decisions during the pandemic. Because decision responses vary, the simulation plays out differently, and a casualty counter quantifies hypothetical losses. The facilitator reviews and critiques key factors for casualty control, including effective communications, working with external organizations, development of internal policies and procedures, maintaining supplies and services, technical infrastructure support, public relations and training. Pre- and post-survey data were compared on trainees.Results: Post-simulation trainees indicated a greater likelihood of needing to improve their organization in terms of communications, mass casualty incident planning, public information and training. Participants also recognized which key factors required immediate attention at their own home facilities.Conclusion: The use of a computer-simulation was effective in providing a facilitated environment for determining the perception of preparedness, evaluating general preparedness concepts and introduced participants to critical decisions involved in handling a regional pandemic influenza surge. [West J Emerg Med. 2013;14(3:236–242.

James M Leaming

2013-05-01

254

Antibody and inflammatory response-mediated severity of pandemic 2009 (pH1N1) influenza virus.  

Science.gov (United States)

Influenza A virus causes significant morbidity and mortality each year worldwide due to antigenic drift, punctuated by infrequent pandemics following antigenic shift. H1N1 subtype of pandemic 2009 (pH1N1) influenza virus lineages has continued to circulate in humans and raised severe concerns about its pandemic developments. The pathogenesis of the disease and its progression as post-infectious sequelae is not well understood. Moderate inflammatory response protects against the ill effects and hyper-inflammatory response promotes the pathogenesis in disease progression. Samples were screened by RT-PCR and classified in pandemic 2009 (pH1N1), Influenza A virus infected patient. Further antibody titer was analyzed by hemagglutination inhibition assay and cytokine/chemokine response by Cytometric bead array assy. Screening of 216 patients shows 63 were belongs to pH1N1 influenza virus infection and 47 were Influenza A virus infected and 106 samples were negative for these viruses, were used as a disease control. Apart from that 100 samples were taken for healthy control. Lower antibody titer was found in patient infected with pH1N1/Influenza A virus and expression of cytokines (IL-6, IL-8, and IL-10) and chemokine MCP-1 was higher in patient infected with pH1N1 compare to healthy/disease control however there was no significant difference observed in the expression of pro-inflammatory cytokines TNF-? and antiviral cytokine IFN-? in pH1N1 influenza virus infected patients. PMID:24615905

Tiwari, Nivedita; Kapoor, Prerna; Dhole, Tapan N

2014-06-01

255

A 'small-world-like' model for comparing interventions aimed at preventing and controlling influenza pandemics  

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Full Text Available Abstract Background With an influenza pandemic seemingly imminent, we constructed a model simulating the spread of influenza within the community, in order to test the impact of various interventions. Methods The model includes an individual level, in which the risk of influenza virus infection and the dynamics of viral shedding are simulated according to age, treatment, and vaccination status; and a community level, in which meetings between individuals are simulated on randomly generated graphs. We used data on real pandemics to calibrate some parameters of the model. The reference scenario assumes no vaccination, no use of antiviral drugs, and no preexisting herd immunity. We explored the impact of interventions such as vaccination, treatment/prophylaxis with neuraminidase inhibitors, quarantine, and closure of schools or workplaces. Results In the reference scenario, 57% of realizations lead to an explosive outbreak, lasting a mean of 82 days (standard deviation (SD 12 days and affecting 46.8% of the population on average. Interventions aimed at reducing the number of meetings, combined with measures reducing individual transmissibility, would be partly effective: coverage of 70% of affected households, with treatment of the index patient, prophylaxis of household contacts, and confinement to home of all household members, would reduce the probability of an outbreak by 52%, and the remaining outbreaks would be limited to 17% of the population (range 0.8%–25%. Reactive vaccination of 70% of the susceptible population would significantly reduce the frequency, size, and mean duration of outbreaks, but the benefit would depend markedly on the interval between identification of the first case and the beginning of mass vaccination. The epidemic would affect 4% of the population if vaccination started immediately, 17% if there was a 14-day delay, and 36% if there was a 28-day delay. Closing schools when the number of infections in the community exceeded 50 would be very effective, limiting the size of outbreaks to 10% of the population (range 0.9%–22%. Conclusion This flexible tool can help to determine the interventions most likely to contain an influenza pandemic. These results support the stockpiling of antiviral drugs and accelerated vaccine development.

Sallé Anne-Violaine

2006-10-01

256

Influenza A(H1N1pdm09 virus and asthma  

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Full Text Available Respiratory viral infection is a major cause of asthma exacerbations in both children and adults. Among the respiratory viruses, influenza virus is a particularly important pathogen due to its enormous morbidity and mortality in annual epidemics. The swine-origin influenza A virus, designated as A(H1N1pdm09, emerged in the spring of 2009 and caused the first influenza pandemic in the 21st century. With the emergence of the novel A(H1N1pdm09 virus, numerous epidemiologic studies detected asthma as a frequent comorbid condition in patients infected with this virus. Here we review recent reports regarding asthma in patients infected with influenza A(H1N1pdm09 virus, and we discuss the utility of influenza vaccines and antivirals.

MasatsuguObuchi

2013-10-01

257

Influenza Aviar y Riesgo de Pandemia / Pandemic risk of Avian Influenza  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Influenza es una enfermedad común que se presenta en Chile en forma estacional. Ocasionalmente ocurren pandemias las que se generan cuando aparece un nuevo subtipo de virus influenza A en la humanidad producto de la recombinación de genomas de virus de influenza humano con virus de influenza de otra [...] s especies. En los últimos años la humanidad se encuentra en una situación de alerta de una nueva pandemia dada la existencia de la más grande epizootia por influenza A, subtipo H5N1 en aves que se extiende desde el Sudeste Asiático a Europa Oriental, Occidental y África. Se han documentado casos esporádicos en humanos por contacto cercano con aves infectadas. El presente artículo revisa las características virológicas del virus de influenza A, la situación actual de la epizootia por H5N1, las características de esta infección en humanos y el estado de preparación que se encuentra Chile frente a una eventual pandemia Abstract in english Influenza is a common season pathology that occasionally presents pandemia, caused by a new Influenza A virus subtype that results from the genomic recombination of human virus with virus from other species. During the last years, there is a worldwide alert situation in terms of a new pandemia, due [...] to the existence of Influenza A virus subtype H5N1 in birds from Southeast Asia, Europe and Africa. There are some sporadic cases in humans produced by close exposure with infected birds. The present article reviews the virologic characteristics of Influenza A H5N1 virus in humans and the chilean guidelines for a potential pandemia. Influenza is a respiratory disease produced by Influenza virus A,B,C, being the A type the most important due to its capacity to change structure and cause epidemia or pandemia. The last pandemias were classified as Spamsh flu in 1918-1919 (H1N1), Asian flu in 1957 (H2N2) and the Hong-Kong flu in 1967 (H3N2), with the biggest death population in 1918. In template countries, Influenza presents in epidemia affecting the winter months; in tropical countries, the virus circulation occurs during the whole year

PERRET P, CECILIA; DABANCH P, JEANNETTE.

258

Influenza A/H1N1 2009 Pandemic and Respiratory Virus Infections, Beijing, 2009–2010  

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To determine the role of the pandemic influenza A/H1N1 2009 (A/H1N1 2009pdm) in acute respiratory tract infections (ARTIs) and its impact on the epidemic of seasonal influenza viruses and other common respiratory viruses, nasal and throat swabs taken from 7,776 patients with suspected viral ARTIs from 2006 through 2010 in Beijing, China were screened by real-time PCR for influenza virus typing and subtyping and by multiplex or single PCR tests for other common respiratory viruses. We observed...

Yang, Yaowu; Wang, Zhong; Ren, Lili; Wang, Wei; Vernet, Guy; Paranhos-baccala?, Gla?ucia; Jin, Qi; Wang, Jianwei

2012-01-01

259

[In vivo efficacy of Ingavirin against pandemic A (H1N1/09)v influenza virus].  

Science.gov (United States)

Ingavirin was shown to be efficient in inhibition of the pandemic influenza virus strains A/California/04/2009 (H1N1)v, A/California/07/2009 (H1N1)v, A/Moscow/225/2009 (H1N1)v and A/Moscow/226/2009 (H1N1)v. as well as the influenza virus strain A/Aichi/2/68 (H3N2) in the lungs of the infected mice. After oral administration of Ingavirin the titers of the influenza virus strains in the lung homogenates lowered. PMID:21033472

Shishkina, L N; Nebol'sin, V E; Skarnovich, M O; Kabanov, A S; Sergeev, A A; Erdyneeva, U B; Serova, O A; Demina, O K; Agafonov, A P; Stavski?, E A; Drozdov, I G

2010-01-01

260

Gradual changes in the age distribution of excess deaths in the years following the 1918 influenza pandemic in Copenhagen : Using epidemiological evidence to detect antigenic drift  

DEFF Research Database (Denmark)

Background: The 1918 influenza pandemic was associated with an unusual age pattern of mortality, with most deaths occurring among young adults. Few studies have addressed changes in the age distribution for influenza-related mortality in the pre-pandemic and post-pandemic period, which has implications for pandemic preparedness. In the present paper, we analyse the age patterns of influenza-related excess mortality in the decades before and after the 1918 pandemic, using detailed historic surveillance data from Copenhagen. Methods: Weekly age-specific rates of respiratory mortality and influenza-like-illnesses were compiled for 1904â??1937. Seasonal excess rates of morbidity and mortality attributable to influenza were calculated using a seasonal regression approach. To characterize the age patterns of influenza-related deaths in individual seasons, we used two rate ratio (RR) measures representing ratios of excess mortality rates between age groups and influenza seasons. Results: Individuals aged 15â??64 years experienced sharply elevated excess respiratory mortality rates in the 1918â??1919 and 1919â??1920 pandemic periods, compared to pre-pandemic seasons (RR for excess mortality in the fall of 1918 = 67 relative to inter-pandemic seasons). Of all excess respiratory deaths occurring during 1918â??1919, 84% were reported in individuals 15â??64 years. By contrast, seniors over 65 years of age experienced no measurable excess mortality during 1918â??1919 and moderate excess mortality in the recrudescent pandemic wave of 1919â??1920. The first post-pandemic season associated with high excess mortality rates in individuals over 65 years was 1928â??1929, with 73% of excess deaths occurring among seniors. We estimate that the age patterns of influenza-related mortality returned to pre-pandemic levels after 1925, based on trends in the rate ratio of excess respiratory mortality in people under and over 65 years. Conclusions: The unusual elevation of excess respiratory mortality rates in young and middle-aged adults wasconfined to the first three years of A/H1N1 virus circulation 1918â??1920; the rapid return to â??epidemicâ? mortality pattern in this age group was probably due to high attack rates and build-up of immunity. In contrast, seniors were completely spared from pandemic mortality during 1918â??1919, likely due to childhood exposure to an A/H1-like influenza virus. The rise in excess mortality rates in seniors in the recrudescent pandemic wave of 1919â??1920 may suggest the emergence of an early influenza A/H1N1 drift variant. Subsequent drift events may have been associated with the particularly severe 1928â??1929 epidemic in Denmark and elsewhere.

Saglanmak, Neslihan; Andreasen, Viggo

2011-01-01

 
 
 
 
261

Factors associated with 2009 pandemic influenza A (H1N1 vaccination acceptance among university students from India during the post-pandemic phase  

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Full Text Available Abstract Background There was a low adherence to influenza A (H1N1 vaccination program among university students and health care workers during the pandemic influenza in many parts of the world. Vaccination of high risk individuals is one of the recommendations of World Health Organization during the post-pandemic period. It is not documented about the student's knowledge, attitude and willingness to accept H1N1 vaccination during the post-pandemic period. We aimed to analyze the student's knowledge, attitude and willingness to accept H1N1 vaccination during the post-pandemic period in India. Methods Vaccine against H1N1 was made available to the students of Vellore Institute of Technology, India from September 2010. The data are based on a cross-sectional study conducted during October 2010 to January 2011 using a self-administered questionnaire with a representative sample of the student population (N = 802. Results Of the 802 respondents, only 102/802 (12.7% had been vaccinated and 105/802 (13% planned to do so in the future, while 595/802 (74% would probably or definitely not get vaccinated in the future. The highest coverage was among the female (65/102, 63.7% and non-compliance was higher among men in the group (384/595; 64.5% (p Conclusions Our study shows that the vaccination coverage among university students remains very low in the post-pandemic period and doubts about the safety and effectiveness of the vaccine are key elements in their rejection. Our results indicate a need to provide accessible information about the vaccine safety by scientific authorities and fill gaps and confusions in this regard.

Thejaswini Venkatesh

2011-07-01

262

Mortality Risk Factors for Pandemic Influenza on New Zealand Troop Ship, 1918  

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We describe the epidemiology and risk factors for death in an outbreak of pandemic influenza on a troop ship. Mortality and descriptive data for military personnel on His Majesty’s New Zealand Transport troop ship Tahiti in July 1918 were analyzed, along with archival information. Mortality risk was increased among persons 25–34 years of age. Accommodations in cabins rather than sleeping in hammocks in other areas were also associated with increased mortality risk (rate ratio 4.28, 95% confidence interval 2.69–6.81). Assignment to a particular military unit, the field artillery (probably housed in cabins), also made a significant difference (adjusted odds ratio in logistic regression 3.04, 95% confidence interval 1.59–5.82). There were no significant differences by assigned rurality (rural residence) or socioeconomic status. Results suggest that the virulent nature of the 1918 influenza strain, a crowded environment, and inadequate isolation measures contributed to the high influenza mortality rate onboard this ship.

Wilson, Nick; Baker, Michael G.; Shanks, G. Dennis

2010-01-01

263

Pandemic influenza: a note on international planning to reduce the risk from air transport.  

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The rapid and intercontinental spread of avian influenza in 2005 and the potential for human pandemic influenza caused preparedness plans for such an event to be highlighted. The World Health Organization (WHO) has developed a global influenza preparedness plan, but this document does not address in detail the contribution necessary by the aviation community. The International Civil Aviation Organization, with assistance from WHO, the Airports Council International, and the International Air Transport Association, and others, has developed preparedness guidelines that are in accord with those of WHO but which are focused on the aviation aspects. Effective communication between stakeholders is the single most important issue that is addressed in the preparedness guidelines. States are recommended to appoint a clear contact point at the national aviation level that has responsibility for ensuring that all stakeholders are adequately consulted in the development of an aviation preparedness plan and that the relevant communication links are established. It is also important that the aviation preparedness plan is incorporated into the State's general preparedness plan, which demands efficient collaboration between the departments of health and transport at the government level. Communication with passengers, and those considering traveling, is important so that individuals are made aware of the risks associated with travel to particular parts of the globe and of the risk-reduction measures they may experience, or can take themselves, at airports and on aircraft. The guidelines will be web-based and will evolve as more knowledge becomes available. PMID:16964750

Evans, Anthony; Finkelstein, Silvio; Singh, Jarnail; Thibeault, Claude

2006-09-01

264

Report of two rare complications of pandemic influenza A (H1N1).  

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Novel influenza A (H1N1) has created a major worldwide health problem within a short time after its emergence. This infection is often self-limited, but sometimes can cause severe and fatal complications. In this study, we present two rare complications of pandemic influenza A, who were referred to Razi University Affiliated Hospital in northern Iran. The first case was a 30-year-old man with severe headache and high fever accompanied with chills, generalized myalgia, and arthralgia. Cerebrospinal fluid analysis was consistent with aseptic meningitis. The second case, a 25-year-old pregnant woman with high fever, chills and severe fatigue and malaise, developed tachypnea, tachycardia, respiratory distress, cyanosis and loss of consciousness a few hours after admission. Echocardiography reported myopericarditis. The patient was transferred to the intensive care unit and mechanical ventilation was begun. The next day, the patient started vaginal bleeding which progressed to spontaneous abortion three days later. Diagnosis of novel influenza A (H1N1) was confirmed using real-time reverse-transcriptase PCR of a pharyngeal swab. PMID:22337853

Babamahmoodi, Farhang; Davoodi, Ali Reza; Ghasemian, Roya; Delavarian, Leila

2012-02-01

265

Safety monitoring of Influenza A/H1N1 pandemic vaccines in EudraVigilance.  

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The 14,543 spontaneous reports of suspected adverse reactions received in EudraVigilance from 1 November 2009 to 30 April 2010 for three centrally authorized Influenza A/H1N1 vaccines marketed in the European Economic Area (Celvapan, Focetria and Pandemrix) were extracted to evaluate the effectiveness of recommendations to strengthen pharmacovigilance systems during the pandemic and illustrate methods of signal detection used by the European Medicines Agency in this context. The number of vaccinees on 30 April 2010 was estimated to be at least 37,166,000 with a reporting rate of 391 per million vaccinees. 81.4% of reports were received in a period of 2 months ending 31 December 2009. Reports for A/H1N1 vaccines had fewer missing values for date of birth, age, case narrative, vaccination date and reaction onset date than reports involving human papilloma virus vaccines in a pre-pandemic period but more missing batch numbers (46.6%), with earlier notification by health care professionals to national authorities (median of 7 days since reaction onset date) and by national authorities to EudraVigilance (4 days). The network of European pharmacovigilance centers and the Agency was effective for monitoring the safety of A/H1N1 vaccines during the 2009-2010 influenza pandemic and coped with a sudden increase of the number of reports. Areas to be reinforced in order to improve the response to a future pandemic and to strengthen vaccine pharmacovigilance systems in general are highlighted. Observed-to-expected analyses were affected by uncertainties regarding the numbers of vaccinated individuals and age-specific background incidence rates. Imbalance analysis used by the Agency may overcome some of these limitations but needs further development. A multinational vaccine health outcome resource is needed to assess the burden of vaccine preventable diseases and the epidemiology of potential adverse outcomes, and to quickly evaluate safety signals, estimate the utilization, benefits and risks of vaccines and evaluate the effectiveness of public health measures. PMID:21501644

Kurz, Xavier; Domergue, François; Slattery, Jim; Segec, Andrej; Szmigiel, Agnieszka; Hidalgo-Simon, Ana

2011-06-10

266

Pandemic H1N1 Influenza Isolated from Free-Ranging Northern Elephant Seals in 2010 off the Central California Coast  

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Interspecies transmission of influenza A is an important factor in the evolution and ecology of influenza viruses. Marine mammals are in contact with a number of influenza reservoirs, including aquatic birds and humans, and this may facilitate transmission among avian and mammalian hosts. Virus isolation, whole genome sequencing, and hemagluttination inhibition assay confirmed that exposure to pandemic H1N1 influenza virus occurred among free-ranging Northern Elephant Seals (Mirounga angustir...

Goldstein, Tracey; Mena, Ignacio; Anthony, Simon J.; Medina, Rafael; Robinson, Patrick W.; Greig, Denise J.; Costa, Daniel P.; Lipkin, W. Ian; Garcia-sastre, Adolfo; Boyce, Walter M.

2013-01-01

267

In vitro and in vivo efficacy of fluorodeoxycytidine analogs against highly pathogenic avian influenza H5N1, seasonal, and pandemic H1N1 virus infections  

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Various fluorodeoxyribonucleosides were evaluated for their antiviral activities against influenza virus infections in vitro and in vivo. Among the most potent inhibitors was 2'-deoxy-2'-fluorocytidine (2'-FdC). It inhibited various strains of low and highly pathogenic avian influenza H5N1 viruses, pandemic H1N1 viruses, an oseltamivir-resistant pandemic H1N1 virus, and seasonal influenza viruses (H3N2, H1N1, influenza B) in MDCK cells, with the 90% inhibitory concentrations ranging from 0.13...

Kumaki, Yohichi; Day, Craig W.; Smee, Donald F.; Morrey, John D.; Barnard, Dale L.

2011-01-01

268

Narcolepsy, 2009 A(H1N1) pandemic influenza, and pandemic influenza vaccinations: what is known and unknown about the neurological disorder, the role for autoimmunity, and vaccine adjuvants.  

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The vaccine safety surveillance system effectively detected a very rare adverse event, narcolepsy, in subjects receiving AS03-adjuvanted A(H1N1) pandemic vaccine made using the European inactivation/purification protocol. The reports of increased cases of narcolepsy in non-vaccinated subjects infected with wild A(H1N1) pandemic influenza virus suggest a role for the viral antigen(s) in disease development. However, additional investigations are needed to better understand what factor(s) in wild influenza infection trigger(s) narcolepsy in susceptible hosts. An estimated 31 million doses of European AS03-adjuvanted A(H1N1) pandemic vaccine were used in more than 47 countries. The Canadian AS03-adjuvanted A(H1N1) pandemic vaccine was used with high coverage in Canada where an estimated 12 million doses were administered. As no similar narcolepsy association has been reported to date with the AS03-adjuvanted A(H1N1) pandemic vaccine made using the Canadian inactivation/purification protocol, this suggests that the AS03 adjuvant alone may not be responsible for the narcolepsy association. To date, no narcolepsy association has been reported with the MF59®-adjuvanted A(H1N1) pandemic vaccine. This review article provides a brief background on narcolepsy, outlines the different types of vaccine preparations including the ones for influenza, reviews the accumulated evidence for the safety of adjuvants, and explores the association between autoimmune diseases and natural infections. It concludes by assimilating the historical observations and recent clinical studies to formulate a feasible hypothesis on why vaccine-associated narcolepsy may not be solely linked to the AS03 adjuvant but more likely be linked to how the specific influenza antigen component of the European AS03-adjuvanted pandemic vaccine was prepared. Careful and long-term epidemiological studies of subjects who developed narcolepsy in association with AS03-adjuvanted A(H1N1) pandemic vaccine prepared with the European inactivation/purification protocol are needed. PMID:24559657

Ahmed, S Sohail; Schur, Peter H; MacDonald, Noni E; Steinman, Lawrence

2014-05-01

269

Usefulness of health registries when estimating vaccine effectiveness during the influenza A(H1N1)pdm09 pandemic in Norway  

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Abstract Background During the 2009-2010 pandemic in Norway, 12 513 laboratory-confirmed cases of pandemic influenza A(H1N1)pdm09, were reported to the Norwegian Surveillance System for Communicable Diseases (MSIS). 2.2 million persons (45% of the population) were vaccinated with an AS03-adjuvanted monovalent vaccine during the pandemic. Most of them were registered in the Norwegian Immunisation Registry (SYSVAK). Based on these registries, we aimed at estimating the vaccine ...

Guzmán Herrador Bernardo; Aavitsland Preben; Feiring Berit; Riise Bergsaker Marianne A; Borgen Katrine

2012-01-01

270

The Impact of the H1N1 Influenza pandemic on Clinical Presentations and Viral Epidemiology of Acute Respiratory Infection in Pre-school Children in Brazil  

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We assessed the impact of the H1N1 influenza pandemic on acute respiratory infection (ARI) in young children from low-income families in Brazil. Influenza (specifically H1N1) detection in ARI quintupled during the pandemic and, during its peak, it was associated with 30% of all ARI visits to the emergency department. H1N1 was also associated with increased risk of hospitalisation and co-infection.

Fawkner-Corbett, David W.; Duarte, Maria doCarmo MB; Rose, Katie; Fonceca, Angela; Britto, Murilo; Bezerra, Patricia; Cuevas, Luis E.; Hopkins, Mark; Correia, Jailson B.; McNamara, Paul Stephen

2012-01-01

271

Clinical review: mass casualty triage--pandemic influenza and critical care.  

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Worst case scenarios for pandemic influenza planning in the US involve over 700,000 patients requiring mechanical ventilation. UK planning predicts a 231% occupancy of current level 3 (intensive care unit) bed capacity. Critical care planners need to recognise that mortality is likely to be high and the risk to healthcare workers significant. Contingency planning should, therefore, be multi-faceted, involving a robust health command structure, the facility to expand critical care provision in terms of space, equipment and staff and cohorting of affected patients in the early stages. It should also be recognised that despite this expansion of critical care, demand will exceed supply and a process for triage needs to be developed that is valid, reproducible, transparent and consistent with distributive justice. We advocate the development and validation of physiological scores for use as a triage tool, coupled with candid public discussion of the process. PMID:17490495

Challen, Kirsty; Bentley, Andrew; Bright, John; Walter, Darren

2007-01-01

272

An analysis of national target groups for monovalent 2009 pandemic influenza vaccine and trivalent seasonal influenza vaccines in 2009-10 and 2010-11  

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Full Text Available Abstract Background Vaccination is generally considered to be the best primary prevention measure against influenza virus infection. Many countries encourage specific target groups of people to undertake vaccination, often with financial subsidies or a priority list. To understand differential patterns of national target groups for influenza vaccination before, during and after the 2009 influenza pandemic, we reviewed and analyzed the country-specific policies in the corresponding time periods. Methods Information on prioritized groups targeted to receive seasonal and pandemic influenza vaccines was derived from a multi-step internet search of official health department websites, press releases, media sources and academic journal articles. We assessed the frequency and consistency of targeting 20 different groups within populations which are associated with age, underlying medical conditions, role or occupations among different countries and vaccines. Information on subsidies provided to specific target groups was also extracted. Results We analyzed target groups for 33 (seasonal 2009 and 2009-10 vaccines, 72 (monovalent pandemic 2009-10 vaccine and 34 (seasonal 2010 and 2010-11 vaccines countries. In 2009-10, the elderly, those with chronic illness and health care workers were common targets for the seasonal vaccine. Comparatively, the elderly, care home residents and workers, animal contacts and close contacts were less frequently targeted to receive the pandemic vaccine. Pregnant women, obese persons, essential community workers and health care workers, however, were more commonly targeted. After the pandemic, pregnant women, obese persons, health care and care home workers, and close contacts were more commonly targeted to receive the seasonal vaccine compared to 2009-10, showing continued influence from the pandemic. Many of the countries provided free vaccines, partial subsidies, reimbursements or national health insurance coverage to specific target groups and over one-third of the countries offered universal subsidy regarding the pandemic vaccine. There was also some inconsistency between countries in target groups. Conclusions Differences in target groups between countries may reflect variable objectives as well as uncertainties regarding the transmission dynamics, severity and age-specific immunity against influenza viruses before and after vaccination. Clarification on these points is essential to elucidate optimal and object-oriented vaccination strategies.

Lee Esther ST

2011-08-01

273

How integration of global omics-data could help preparing for pandemics - a scent of influenza  

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Pandemics caused by novel emerging or re-emerging infectious diseases could lead to high mortality and morbidity world-wide when left uncontrolled. In this perspective, we evaluate the possibility of integration of global omics-data in order to timely prepare for pandemics. Such an approach requires two major innovations. First, data that is obtained should be shared with the global community instantly. The strength of rapid integration of simple signals is exemplified by Google’sTM Flu Trend, which could predict the incidence of influenza-like illness based on online search engine queries. Second, omics technologies need to be fast and high-throughput. We postulate that analysis of the exhaled breath would be a simple, rapid and non-invasive alternative. Breath contains hundreds of volatile organic compounds that are altered by infection and inflammation. The molecular fingerprint of breath (breathprint) can be obtained using an electronic nose, which relies on sensor technology. These breathprints can be stored in an online database (a “breathcloud”) and coupled to clinical data. Comparison of the breathprint of a suspected subject to the breathcloud allows for a rapid decision on the presence or absence of a pathogen.

Bos, Lieuwe D. J.; de Jong, Menno D.; Sterk, Peter J.; Schultz, Marcus J.

2014-01-01

274

How integration of global omics-data could help preparing for pandemics - a scent of influenza.  

Science.gov (United States)

Pandemics caused by novel emerging or re-emerging infectious diseases could lead to high mortality and morbidity world-wide when left uncontrolled. In this perspective, we evaluate the possibility of integration of global omics-data in order to timely prepare for pandemics. Such an approach requires two major innovations. First, data that is obtained should be shared with the global community instantly. The strength of rapid integration of simple signals is exemplified by Google's(TM) Flu Trend, which could predict the incidence of influenza-like illness based on online search engine queries. Second, omics technologies need to be fast and high-throughput. We postulate that analysis of the exhaled breath would be a simple, rapid and non-invasive alternative. Breath contains hundreds of volatile organic compounds that are altered by infection and inflammation. The molecular fingerprint of breath (breathprint) can be obtained using an electronic nose, which relies on sensor technology. These breathprints can be stored in an online database (a "breathcloud") and coupled to clinical data. Comparison of the breathprint of a suspected subject to the breathcloud allows for a rapid decision on the presence or absence of a pathogen. PMID:24795745

Bos, Lieuwe D J; de Jong, Menno D; Sterk, Peter J; Schultz, Marcus J

2014-01-01

275

Nosocomial outbreak of the pandemic Influenza A (H1N1) 2009 in critical hematologic patients during seasonal influenza 2010-2011: detection of oseltamivir resistant variant viruses  

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Background The pandemic influenza A (H1N1) 2009 (H1N1pdm09) virus infection caused illness and death among people worldwide, particularly in hematologic/oncologic patients because influenza infected individuals can shed virus for prolonged periods, thus increasing the chances for the development of drug-resistant strains such as oseltamivir-resistant (OST-r) variant. Methods The aim of our study was to retrospectively evaluate the clinical importance of OST-r variant in circulating strains of the pandemic H1N1pdm09 virus. By means of RT-PCR and Sanger sequencing we analysed the presence of OST-r variant in 76 H1N1pdm09 laboratory-confirmed cases, hospitalized at the hematologic/oncologic ward at Spedali Civili of Brescia –Italy. Results Out of 76 hospitalized hematologic/oncologic patients, 23 patients (30.2%) were infected by H1N1pdm09 virus. Further investigation revealed that 3 patients were positive for the OST-r variant carrying the H275Y mutation. All the 23 infected patients were immuno-compromised, and were under treatment or had been treated previously with oseltamivir. Three patients died (13%) after admission to intensive care unit and only one of them developed H275Y mutation. Conclusions Our retrospective observational study shows that pandemic influenza A (H1N1) 2009 virus can cause significant morbidity and even mortality in hematologic/oncologic patients and confirms the high rate of nosocomial transmission of pandemic H1N1pdm09 virus in these critical subjects. Indeed, the reduction in host defences in these hospitalized patients favoured the prolonged use of antiviral therapy and permitted the development of OST-r strain. Strategies as diagnostic vigilance, early isolation of patients and seasonal influenza A(H1N1) vaccination may prevent transmission of influenza in high risk individuals.

2013-01-01

276

Phylogenetic analysis of influenza A(H1N1pdm viruses isolated in Ukraine during the 2009–2010 pandemic season  

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Full Text Available Aim. To perform the phylogenetic analysis of segments, encoding hemagglutinin and neuraminidase of A(H1N1 pdm influenza viruses, isolated in Ukraine. Methods. In this study the real-time polymerase chain reaction (RT-PCR, sequencing and phylogenetic analysis methods were used. Results. Key mutations in amino acid sequences of proteins of Ukrainian pandemic influenza isolates were analyzed. High genetic similarity of Ukrainian and foreign pandemic isolates (99 % was observed. Conclusions. The stability of Ukrainian isolates genes during 2009–2010 pandemic season was shown.

Mironenko A. P.

2013-03-01

277

Transmission of pandemic (H1N1) 2009 influenza to healthcare personnel in the United States.  

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After identification of pandemic 2009 influenza (pH1N1) in the United States, the Centers for Disease Control and Prevention (CDC) worked with state and local health officials to characterize infections among healthcare personnel (HCP). Detailed information, including likely routes of exposure, was reported for 70 HCP from 22 states. Thirty-five cases (50%) were classified as being infected in healthcare settings, 18 cases (26%) were considered to have been infected in community settings, and no definitive source was identified for 17 cases (24%). Of the 23 HCP infected by ill patients, only 20% reported using an N95 respirator or surgical mask during all encounters and more than half worked in outpatient clinics. In addition to community transmission, likely patient-to-HCP and HCP-to-HCP transmission were identified in healthcare settings, highlighting the need for comprehensive infection control strategies including administration of influenza vaccine, appropriate management of ill HCP, and adherence to infection control precautions. PMID:21342895

Wise, Matthew E; De Perio, Marie; Halpin, John; Jhung, Michael; Magill, Shelley; Black, Stephanie R; Gerber, Susan I; Harriman, Kathleen; Rosenberg, Jon; Borlaug, Gwen; Finelli, Lyn; Olsen, Sonja J; Swerdlow, David L; Kallen, Alexander J

2011-01-01

278

Tropism of pandemic 2009 H1N1 influenza A virus  

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Full Text Available Substitutions at the receptor binding site of the pandemic H1N1 2009 influenza A virus (H1N1pdm hemagglutinin (HA gene may be critical in determining whether a virus binds to human or avian receptors. Previous reports suggest that HA Gly222 and/or Arg223 allow viruses to bind preferentially to the ?2,3-linked sialic acid found in avian species. We also demonstrated that serial passaging of influenza A virus in embryonated chicken eggs increased viral growth 32-64-fold, coincident with the increased prevalence of Gly222 or Arg223 in HA protein. In this study, we showed that the minor genotype of ?2,3 linkage-tropic viruses in upper airways became dominant after passaging through chicken eggs. Viruses possessing HA containing N125D-Q223R, N125D-D187E-Q223R, K119N-D222G and K119N-N129S-D222G, were detected in both clinical specimens and egg-passaged samples. These results might suggest that egg-adapted viruses, likely represented by ?2,3 linkage-tropic virus, were also present in human upper airways as a minor population and transmitted in humans during the outbreak of H1N1pdm.

TakaakiNakaya

2012-04-01

279

Serums and vaccines to fight the 1918-1919 influenza pandemic in Spain  

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Full Text Available Against the background of the renewed interest aroused in recent years by the influenza pandemic of 1918-1919, and the leading role now played by research analysing the process of innovation in medicine, this paper assesses the role played by serums and vaccines —the new resources of the medical science of the time— in the fight against the influenza outbreak of 1918-1919. The paper highlights the dependence on combined scientific, social, economic and professional factors, and also shows the main consequences arising from the fine-tuning and implementation of these therapeutic and prophylactic resources.

En el marco de la renovada actualidad alcanzada por la pandemia de gripe de 1918-1919 en los últimos años y del protagonismo logrado por los estudios que analizan el proceso de innovación en Medicina, el presente trabajo analiza el papel representado por sueros y vacunas —los nuevos recursos de la ciencia médica del momento— en la lucha contra la gripe de 1918-1919. El estudio pone de relieve su dependencia de los factores científicos, sociales, económicos y profesionales que concurrieron, y muestra también las principales consecuencias derivadas de la puesta a punto y uso de los citados recursos terapéuticos y profilácticos.

Porras Gallo, María Isabel

2008-12-01

280

Inicio del brote de Influenza A (H1N1) pandémica en Chile: caracterización genética de los primeros casos detectados Genetic characterization of the virus causing H1N1 influenza pandemic in Chile: Analysis of the first detected cases  

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Background: Following the announcement of the Influenza A(H1N1) pandemic by the World Health Organization in April 2009, a surveillance program was carried out in Chile to detect the introduction of the virus in the country and to monitor its propagation and impact. Aim: To describe the onset of the outbreak and the genetic characterization of the pandemic H1N1 influenza virus in the first detected cases in Chile. Material and Methods: Analysis of18 clinical s...

2011-01-01

 
 
 
 
281

Characterization In Vitro and In Vivo of a Pandemic H1N1 Influenza Virus from a Fatal Case  

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Pandemic 2009 H1N1 (pH1N1) influenza viruses caused mild symptoms in most infected patients. However, a greater rate of severe disease was observed in healthy young adults and children without co-morbid conditions. Here we tested whether influenza strains displaying differential virulence could be present among circulating pH1N1 viruses. The biological properties and the genotype of viruses isolated from a patient showing mild disease (M) or from a fatal case (F), both without known co-morbid...

Rodriguez, Ariel; Falcon, Ana; Cuevas, Maria Teresa; Pozo, Francisco; Guerra, Susana; Garci?a-barreno, Blanca; Martinez-orellana, Pamela; Pe?rez-bren?a, Pilar; Montoya, Maria; Melero, Jose Antonio; Pizarro, Manuel; Ortin, Juan; Casas, Inmaculada; Nieto, Amelia

2013-01-01

282

Delayed emergence of oseltamivir-resistant seasonal influenza A (H1N1) and pandemic influenza A(H1N1)pdm09 viruses in Myanmar.  

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The prevalence and timing of emergence of oseltamivir-resistant seasonal and pandemic influenza A (H1N1) viruses in Myanmar in 2008 and 2009 are described in this report. In 2008, the oseltamivir-resistant seasonal H1N1 virus was detected at a lower rate (6%) and emerged at least 2 months later when compared with neighboring countries. Similarly, the prevalence of pandemic H1N1 virus was low (3%) and the timing of emergence was late (August 2009) in Myanmar. Interestingly, we detected three isolates that were resistant to both amantadine and oseltamivir. Limited movement of people into the country is attributed to the delayed emergence of drug-resistant seasonal and pandemic A(H1N1) viruses. PMID:23122276

Dapat, Clyde; Saito, Reiko; Kyaw, Yadanar; Myint, Yi Yi; Oo, Htun Naing; Oo, Khin Yi; Naito, Makoto; Hasegawa, Go; Dapat, Isolde C; Suzuki, Hiroshi

2013-09-01

283

Response to 2009 pandemic influenza a (H1N1) vaccine in HIV-infected patients and the influence of prior seasonal influenza vaccination  

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Background: The immunogenicity of 2009 pandemic influenza A(H1N1) (pH1N1) vaccines and the effect of previous influenza vaccination is a matter of current interest and debate. We measured the immune response to pH1N1 vaccine in HIV-infected patients and in healthy controls. In addition we tested whether recent vaccination with seasonal trivalent inactivated vaccine (TIV) induced cross-reactive antibodies to pH1N1. (clinicaltrials.gov Identifier:NCT01066169) Methods and Findings: In this singl...

2011-01-01

284

Immunogenicity of a Monovalent Pandemic Influenza A H1N1 Virus Vaccine with or without Prior Seasonal Influenza Vaccine Administration  

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The immunogenicity of pandemic influenza A H1N1 virus (A/H1pdm) vaccine might be modified by prior seasonal trivalent influenza vaccine (sTIV) administration. We conducted a retrospective analysis of immunogenicity of 243 health care workers (number of sTIV-positive [sTIV+] subjects, 216; number of sTIV? subjects, 27) by hemagglutination inhibition. There was no significant difference in the ratios of antibody titers of ?40 (41.2% versus 48.1%; P = 0.49) and fold increases in geometric me...

2012-01-01

285

Comparison of the protection of ferrets against pandemic 2009 influenza A virus (H1N1) by 244 DI influenza virus and oseltamivir  

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The main antivirals employed to combat seasonal and pandemic influenza are oseltamivir and zanamivir which act by inhibiting the virus-encoded neuraminidase. These have to be deployed close to the time of infection and antiviral resistance to the more widely used oseltamivir has arisen relatively rapidly. Defective interfering (DI) influenza virus is a natural antiviral that works in a different way to oseltamivir and zanamivir, and a cloned version (segment 1 244 DI RNA in a cloned A/PR/8/34...

Dimmock, Nigel J.; Dove, Brian K.; Meng, Bo; Scott, Paul D.; Taylor, Irene; Cheung, Linda; Hallis, Bassam; Marriott, Anthony C.; Carroll, Miles W.; Easton, Andrew J.

2012-01-01

286

Modeling control strategies for concurrent epidemics of seasonal and pandemic H1N1 influenza.  

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The lessons learned from the 2009-2010 H1N1 influenza pandemic, as it moves out of the limelight, should not be under-estimated, particularly since the probability of novel influenza epidemics in the near future is not negligible and the potential consequences might be huge. Hence, as the world, particularly the industrialized world, responded to the potentially devastating effects of this novel A-H1N1 strain with substantial resources, reminders of the recurrent loss of life from a well established foe, seasonal influenza, could not be ignored. The uncertainties associated with the reported and expected levels of morbidity and mortality with this novel A-H1N1 live in a backdrop of deaths, over 200,000 hospitalizations, and millions of infections (20% of the population) attributed to seasonal influenza in the USA alone, each year. So, as the Northern Hemisphere braced for the possibility of a potentially "lethal" second wave of the novel A-H1N1 without a vaccine ready to mitigate its impact, questions of who should be vaccinated first if a vaccine became available, came to the forefront of the discussion. Uncertainty grew as we learned that the vaccine, once available, would be unevenly distributed around the world. Nations capable of acquiring large vaccine supplies soon became aware that those who could pay would have to compete for a limited vaccine stockpile. The challenges faced by nations dealing jointly with seasonal and novel A-H1N1 co-circulating strains under limited resources, that is, those with no access to novel A-H1N1 vaccine supplies, limited access to the seasonal influenza vaccine, and limited access to antivirals (like Tamiflu) are explored in this study. One- and two-strain models are introduced to mimic the influenza dynamics of a single and co-circulating strains, in the context of a single epidemic outbreak. Optimal control theory is used to identify and evaluate the "best" control policies. The controls account for the cost associated with social distancing and antiviral treatment policies. The optimal policies identified might have, if implemented, a substantial impact on the novel H1N1 and seasonal influenza co-circulating dynamics. Specifically, the implementation of antiviral treatment might reduce the number of influenza cases by up to 60% under a reasonable seasonal vaccination strategy, but only by up to 37% when the seasonal vaccine is not available. Optimal social distancing policies alone can be as effective as the combination of multiple policies, reducing the total number of influenza cases by more than 99% within a single outbreak, an unrealistic but theoretically possible outcome for isolated populations with limited resources. PMID:21361405

Prosper, Olivia; Saucedo, Omar; Thompson, Doria; Torres-Garcia, Griselle; Wang, Xiaohong; Castillo-Chavez, Carlos

2011-01-01

287

A review of the dynamics and severity of the pandemic A(H1N1) influenza virus on Réunion island, 2009.  

Science.gov (United States)

On Reunion Island, in response to the threat of emergence of the pandemic influenza A(H1N1)2009 virus, we implemented enhanced influenza surveillance from May 2009 onwards in order to detect the introduction of pandemic H1N1 influenza and to monitor its spread and impact on public health. The first 2009 pandemic influenza A(H1N1) virus was identified in Réunion on July 5, 2009, in a traveller returning from Australia; seasonal influenza B virus activity had already been detected. By the end of July, a sustained community pandemic virus transmission had been established. Pandemic H1N1 influenza activity peaked during week 35 (24-30 August 2009), 4 weeks after the beginning of the epidemic. The epidemic ended on week 38 and had lasted 9 weeks. During these 9 weeks, an estimated 66 915 persons who consulted a physician could have been infected by the influenza A(H1N1)2009 virus, giving a cumulative attack rate for consultants of 8.26%. Taking into account the people who did not consult, the total number of infected persons reached 104 067, giving a cumulative attack rate for symptomatics of 12.85%. The crude fatality rate (CFR) for influenza A(H1N1)2009 and the CFR for acute respiratory infection was 0.7/10 000 cases. Our data show that influenza pandemic did not have a health impact on overall mortality on Réunion Island. These findings demonstrate the value of an integrated epidemiological, virological and hospital surveillance programme to monitor the scope of an epidemic, identify circulating strains and provide some guidance to public health control measures. PMID:20121825

D'Ortenzio, E; Renault, P; Jaffar-Bandjee, M C; Gaüzère, B A; Lagrange-Xélot, M; Fouillet, A; Poubeau, P; Winer, A; Bourde, A; Staikowsky, F; Morbidelli, P; Rachou, E; Thouillot, F; Michault, A; Filleul, L

2010-04-01

288

Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus.  

Science.gov (United States)

The 1918 influenza pandemic caused more than 20 million deaths worldwide. Thus, the potential impact of a re-emergent 1918 or 1918-like influenza virus, whether through natural means or as a result of bioterrorism, is of significant concern. The genetic determinants of the virulence of the 1918 virus have not been defined yet, nor have specific clinical prophylaxis and/or treatment interventions that would be effective against a re-emergent 1918 or 1918-like virus been identified. Based on the reported nucleotide sequences, we have reconstructed the hemagglutinin (HA), neuraminidase (NA), and matrix (M) genes of the 1918 virus. Under biosafety level 3 (agricultural) conditions, we have generated recombinant influenza viruses bearing the 1918 HA, NA, or M segments. Strikingly, recombinant viruses possessing both the 1918 HA and 1918 NA were virulent in mice. In contrast, a control virus with the HA and NA from a more recent human isolate was unable to kill mice at any dose tested. The recombinant viruses were also tested for their sensitivity to U.S. Food and Drug Administration-approved antiinfluenza virus drugs in vitro and in vivo. Recombinant viruses possessing the 1918 NA or both the 1918 HA and 1918 NA were inhibited effectively in both tissue culture and mice by the NA inhibitors, zanamivir and oseltamivir. A recombinant virus possessing the 1918 M segment was inhibited effectively both in tissue culture and in vivo by the M2 ion-channel inhibitors amantadine and rimantadine. These data suggest that current antiviral strategies would be effective in curbing the dangers of a re-emergent 1918 or 1918-like virus. PMID:12368467

Tumpey, Terrence M; García-Sastre, Adolfo; Mikulasova, Andrea; Taubenberger, Jeffery K; Swayne, David E; Palese, Peter; Basler, Christopher F

2002-10-15

289

Factors associated with death or intensive care unit admission due to pandemic 2009 influenza A (H1N1) infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background : In preparation for pandemic HINI or H1N1 influenza (H1N1) it is necessary to identify factors associated with mortality of patients with HINI and hospital admissions to intensive care unit (ICU) of patients diagnosed in 2009 with HINI. Objectives : To describe the clinical and epidemiological features associated with 2009 HIN1 mortality and ICU patient admissions to Masih Daneshvari Teaching Hospital, Iran. Methods : A retrospective cross-sectional study w...

Tabarsi Payam; Moradi Ahmadreza; Marjani Majid; Baghaei Parvaneh; Hashemian Seyed; Nadji Seyed; Fakharian Atefeh; Mansouri Davood; Masjedi Mohammadreza; Velayati Aliakbar

2011-01-01

290

Transmission Characteristics of the 2009 H1N1 Influenza Pandemic: Comparison of 8 Southern Hemisphere Countries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

While in Northern hemisphere countries, the pandemic H1N1 virus (H1N1pdm) was introduced outside of the typical influenza season, Southern hemisphere countries experienced a single wave of transmission during their 2009 winter season. This provides a unique opportunity to compare the spread of a single virus in different countries and study the factors influencing its transmission. Here, we estimate and compare transmission characteristics of H1N1pdm for eight Southern hemisphere countries/st...

2011-01-01

291

Epidemiological Characteristics of 2009 (H1N1) Pandemic Influenza Based on Paired Sera from a Longitudinal Community Cohort Study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: While patterns of incidence of clinical influenza have been well described, much uncertainty remains over patterns of incidence of infection. The 2009 pandemic provided both the motivation and opportunity to investigate patterns of mild and asymptomatic infection using serological techniques. However, to date, only broad epidemiological patterns have been defined, based on largely cross-sectional study designs with convenience sampling frameworks. Methods and Findings: We conducte...

Riley, Steven; Kwok, Kin O.; Wu, Kendra M.; Ning, Danny Y.; Cowling, Benjamin J.; Wu, Joseph T.; Ho, Lai-ming; Tsang, Thomas; Lo, Su-vui; Chu, Daniel K. W.; Ma, Edward S. K.; Peiris, J. S. Malik

2011-01-01

292

Knowledge and attitudes of healthcare workers in Chinese intensive care units regarding 2009 H1N1 influenza pandemic  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background To describe the knowledge and attitudes of critical care clinicians during the 2009 H1N1 influenza pandemic. Methods A survey conducted in 21 intensive care units in 17 provinces in China. Results Out of 733 questionnaires distributed, 695 were completed. Three hundred and fifty-six respondents (51.2%) reported their experience of caring for H1N1 patients. Despite the fact that 88.5% of all respondents ultimately finished an H1N...

Ma Xiaochun; He Zhenyang; Wang Yushan; Jiang Li; Xu Yuan; Qian Chuanyun; Sun Rongqing; Chen Erzhen; Hu Zhenjie; Zhou Lihua; Zhou Fachun; Qin Tiehe; Cao Xiangyuan; An Youzhong; Sun Renhua

2011-01-01

293

An Academic/Government Partnership to Provide Technical Assistance with Pandemic Influenza Planning to Local Health Departments in North Carolina  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In 2006, the North Carolina Division of Public Health (NC DPH) required all 85 local health departments (LHDs) in North Carolina to develop a pandemic influenza plan. Because few LHDs had experience in developing such plans, NC DPH engaged in a unique partnership with an academic center, the North Carolina Center for Public Health Preparedness (NCCPHP), to provide technical assistance to local planners. This article describes the technical assistance program implemented by NCCPHP, the use of ...

Rosselli, Richard T.; Davis, Meredith K.; Simeonsson, Kristina; Johnson, Morgan; Goode, Brant; Casani, Julie; Macdonald, Pia D. M.

2010-01-01

294

Small islands and pandemic influenza: Potential benefits and limitations of travel volume reduction as a border control measure  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Some island nations have explicit components of their influenza pandemic plans for providing travel warnings and restricting incoming travellers. But the potential value of such restrictions has not been quantified. Methods We developed a probabilistic model and used parameters from a published model (i.e., InfluSim) and travel data from Pacific Island Countries and Territories (PICTs). Results The results indicate that...

Eichner Martin; Schwehm Markus; Wilson Nick; Baker Michael G

2009-01-01

295

Potency of a vaccine prepared from A/swine/Hokkaido/2/1981 (H1N1) against A/Narita/1/2009 (H1N1) pandemic influenza virus strain  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background The pandemic 2009 (H1N1) influenza virus has spread throughout the world and is now causing seasonal influenza. To prepare for the emergence of pandemic influenza, we have established a library of virus strains isolated from birds, pigs, and humans in global surveillance studies. Methods Inactivated whole virus particle (WV) and ether-split (ES) vaccines were prepared from an influenza virus strain, A/swine/Hokkaido/2/1981 (H1N1), from the li...

Okamatsu Masatoshi; Sakoda Yoshihiro; Hiono Takahiro; Yamamoto Naoki; Kida Hiroshi

2013-01-01

296

Oseltamivir for treatment and prevention of pandemic influenza A/H1N1 virus infection in households, Milwaukee, 2009  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background During an influenza pandemic, a substantial proportion of transmission is thought to occur in households. We used data on influenza progression in individuals and their contacts collected by the City of Milwaukee Health Department (MHD to study the transmission of pandemic influenza A/H1N1 virus in 362 households in Milwaukee, WI, and the effects of oseltamivir treatment and chemoprophylaxis. Methods 135 households had chronological information on symptoms and oseltamivir usage for all household members. The effect of oseltamivir treatment and other factors on the household secondary attack rate was estimated using univariate and multivariate logistic regression with households as the unit of analysis. The effect of oseltamivir treatment and other factors on the individual secondary attack rate was estimated using univariate and multivariate logistic regression with individual household contacts as the unit of analysis, and a generalized estimating equations approach was used to fit the model to allow for clustering within households. Results Oseltamivir index treatment on onset day or the following day (early treatment was associated with a 42% reduction (OR: 0.58, 95% CI: 0.19, 1.73 in the odds of one or more secondary infections in a household and a 50% reduction (OR: 0.5, 95% CI: 0.17, 1.46 in the odds of a secondary infection in individual contacts. The confidence bounds are wide due to a small sample of households with early oseltamivir index usage - in 29 such households, 5 had a secondary attack. Younger household contacts were at higher risk of infection (OR: 2.79, 95% CI: 1.50-5.20. Conclusions Early oseltamivir treatment may be beneficial in preventing H1N1pdm influenza transmission; this may have relevance to future control measures for influenza pandemics. Larger randomized trials are needed to confirm this finding statistically.

Miller Joel C

2010-07-01

297

Triple-Combination Antiviral Drug for Pandemic H1N1 Influenza Virus Infection in Critically Ill Patients on Mechanical Ventilation ? §  

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A recent in vitro study showed that the three compounds of antiviral drugs with different mechanisms of action (amantadine, ribavirin, and oseltamivir) could result in synergistic antiviral activity against influenza virus. However, no clinical studies have evaluated the efficacy and safety of combination antiviral therapy in patients with severe influenza illness. A total of 245 adult patients who were critically ill with confirmed pandemic influenza A/H1N1 2009 (pH1N1) virus infection and w...

2011-01-01

298

Lung histopathological findings in fatal pandemic influenza A (H1N1) Resultados histopatológicos pulmonares en la gripe a (H1N1) pandémica letal  

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Objective: To describe the lung pathological changes in influenza A (H1N1) viral pneumonia. We studied morphological changes, nitro-oxidative stress and the presence of viral proteins in lung tissue. Methods and patients: Light microscopy was used to examine lung tissue from 6 fatal cases of pandemic influenza A (H1N1) viral pneumonia. Fluorescence for oxidized dihydroethydium, nitrotyrosine, inducible NO synthase (NOS2) and human influenza A nucleoprotein (NP) (for analysis under confocal mi...

Nin, N.; Sa?nchez-rodri?guez, C.; Ver, L. S.; Cardinal, P.; Ferruelo, A.; Soto, L.; Deicas, A.; Campos, N.; Rocha, O.; Ceraso, D. H.; El-assar, M.; Orti?n, J.; Ferna?ndez-segoviano, P.; Esteban, A.; Lorente, J. A.

2012-01-01

299

Reassortment ability of the 2009 pandemic H1N1 influenza virus with circulating human and avian influenza viruses: public health risk implications.  

Science.gov (United States)

Exploring the reassortment ability of the 2009 pandemic H1N1 (A/H1N1pdm09) influenza virus with other circulating human or avian influenza viruses is the main concern related to the generation of more virulent or new variants having implications for public health. After different coinfection experiments in human A549 cells, by using the A/H1N1pdm09 virus plus one of human seasonal influenza viruses of H1N1 and H3N2 subtype or one of H11, H10, H9, H7 and H1 avian influenza viruses, several reassortant viruses were obtained. Among these, the HA of H1N1 was the main segment of human seasonal influenza virus reassorted in the A/H1N1pdm09 virus backbone. Conversely, HA and each of the three polymerase segments, alone or in combination, of the avian influenza viruses mainly reassorted in the A/H1N1pdm09 virus backbone. Of note, A/H1N1pdm09 viruses that reassorted with HA of H1N1 seasonal human or H11N6 avian viruses or carried different combination of avian origin polymerase segments, exerted a higher replication effectiveness than that of the parental viruses. These results confirm that reassortment of the A/H1N1pdm09 with circulating low pathogenic avian influenza viruses should not be misjudged in the prediction of the next pandemic. PMID:23639426

Stincarelli, Maria; Arvia, Rosaria; De Marco, Maria Alessandra; Clausi, Valeria; Corcioli, Fabiana; Cotti, Claudia; Delogu, Mauro; Donatelli, Isabella; Azzi, Alberta; Giannecchini, Simone

2013-08-01

300

U.S. airport entry screening in response to pandemic influenza: Modeling and analysis  

Energy Technology Data Exchange (ETDEWEB)

A stochastic discrete event simulation model was developed to assess the effectiveness of passenger screening for Pandemic Influenza (PI) at U.S. airport foreign entry. Methods: International passengers arriving at 18 U.S. airports from Asia, Europe, South America, and Canada were assigned to one of three states: not infected, infected with PI, infected with other respiratory illness. Passengers passed through layered screening then exited the model. 80% screening effectiveness was assumed for symptomatic passengers; 6% asymptomatic passengers. Results: In the first 100 days of a global pandemic, U.S. airport screening would evaluate over 17 M passengers with 800 K secondary screenings. 11,570 PI infected passengers (majority asymptomatic) would enter the U.S. undetected from all 18 airports. Foreign airport departure screening significantly decreased the false negative (infected/undetected) passengers. U.S. attack rates: no screening (26.9%-30.9%); screening (26.4%-30.6%); however airport screening results in 800 K-1.8 M less U.S. PI cases; 16 K-35 K less deaths (2% fatality rate). Antiviral medications for travel contact prophylaxis (10 contacts/PI passenger) were high - 8.8 M. False positives from all 18 airports: 100-200/day. Conclusions: Foreign shore exit screening greatly reduces numbers of PI infected passengers. U.S. airport screening identifies 50% infected individuals; efficacy is limited by the asymptomatic PI infected. Screening will not significantly delay arrival of PI via international air transport, but will reduce the rate of new US cases and subsequent deaths. (C) 2009 Elsevier Ltd. All rights reserved.

Malone, John D. [Uniformed Services University of the Health Sciences (USUHS); Brigantic, Robert [Pacific Northwest National Laboratory (PNNL); Muller, G. [Pacific Northwest National Laboratory (PNNL); Gadgil, Ashok [Lawrence Berkeley National Laboratory (LBNL); Delp, Woody [Lawrence Berkeley National Laboratory (LBNL); McMahon, Benjamin H. [Los Alamos National Laboratory (LANL); Lee, Russell [ORNL; Kulesz, Jim [Oak Ridge National Laboratory (ORNL); Mihelic, F. Matthew [Oak Ridge National Laboratory (ORNL)

2009-01-01

 
 
 
 
301

Determinants of Receiving the Pandemic (H1N1) 2009 Vaccine and Intention to Receive the Seasonal Influenza Vaccine in Taiwan  

Science.gov (United States)

Objectives The paper examines the factors associated with both receiving pandemic (H1N1) 2009 vaccines and individuals’ intentions to get the next seasonal influenza vaccine in Taiwan. Methods We conducted a representative nationwide survey with in-person household interviews during April–July 2010. Multivariate logistic regression incorporated socio-demographic background, household characteristics, health status, behaviors, and perceptions of influenza and vaccination. Results We completed interviews with 1,954 respondents. Among those, 548 (28.0%) received the pandemic (H1N1) 2009 vaccination, and 469 (24.0%) intended to get the next seasonal influenza vaccine. Receipt of the H1N1 vaccine was more prevalent among schoolchildren, the elderly, those who had contact with more people in their daily lives, and those who had received influenza vaccinations in previous years. In comparison, the intention to receive the next seasonal influenza vaccine tended to be stronger among children, the elderly, and those who reported less healthy status or lived with children, who received a seasonal influenza vaccination before, and who worried more about a possible new pandemic. Conclusions Children, the elderly, and those who had gotten seasonal flu shots before in Taiwan were more likely to both receive a pandemic H1N1 vaccination and intend to receive a seasonal influenza vaccine.

Chan, Ta-Chien; Fu, Yang-chih; Wang, Da-Wei; Chuang, Jen-Hsiang

2014-01-01

302

Facilitating access to antiviral medications and information during an influenza pandemic: engaging with the public on possible new strategies.  

Science.gov (United States)

Antiviral medications can decrease the severity and duration of influenza, but they are most effective if started within 48 hours of the onset of symptoms. In a severe influenza pandemic, normal channels of obtaining prescriptions and medications could become overwhelmed. To assess public perception of the acceptability and feasibility of alternative strategies for prescribing, distributing, and dispensing antivirals and disseminating information about influenza and its treatment, the Institute of Medicine, with technical assistance from the Centers for Disease Control and Prevention (CDC), convened public engagement events in 3 demographically and geographically diverse communities: Fort Benton, MT; Chattanooga, TN; and Los Angeles, CA. Participants were introduced to the issues associated with pandemic influenza and the challenges of ensuring timely public access to information and medications. They then discussed the advantages and disadvantages of 5 alternative strategies currently being considered by the CDC and its partners. Participants at all 3 venues expressed high levels of acceptance for each of the proposed strategies and contributed useful ideas to support their implementation. This article discusses the key findings from these sessions. PMID:24552360

Fain, Barbara A; Koonin, Lisa M; Stoto, Michael A; Shah, Umair A; Cooper, Susan R; Piltch-Loeb, Rachael N; Kellermann, Arthur L

2014-01-01

303

Los virus Influenza y la nueva pandemia A/H1N1 / Influenza virus and the new Influenza A/H1N1 pandemics  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Los virus Influenza pertenecen a la familia Orthomyxoviridae, virus con genoma RNA de sentido negativo segmentado. Los virus influenza tipo A infectan a humanos y otros organismos, y son los agentes causantes de influenza en humanos. Resaltan entre sus principales proteínas la Hemaglutinina y la Neu [...] raminidasa, que son utilizadas en la clasificación de los miembros de este grupo. Estos virus mutan continuamente, exhibiendo patrones muy estudiados, como el cambio y la deriva antigénica, siendo uno de los principales eventos de recombinación el reordenamiento. Todos los subtipos se encuentran en aves acuáticas silvestres, aunque se han encontrado otros hospederos, como equinos, visones, ballenas, focas, cerdos, gallinas y pavos, entre otros. Tanto las aves salvajes, las aves domésticas y el cerdo juegan un rol fundamental en la adaptación progresiva del virus al hospedero humano. Aunque los subtipos H2N2 y H3N2 han sido muy comunes, el subtipo H1N1 ha reemergido con mutaciones que le han permitido alcanzar el estado de pandemia en 2009. Este nuevo virus surge de un virus generado por triple reordenamiento con el virus humano, porcino norteamericano y aviar, conteniendo a su vez segmentos génicos de virus influenza porcina euroasiática. Esto ha hecho que el virus presente una enfermedad humana moderada y solamente severa y hasta letal en casos de individuos con condiciones médicas previas. A nivel mundial ha causado más de 134,510 casos y en el Perú alcanza cerca de 3,700 casos. El estado actual indica que la pandemia está por llegar a su pico máximo en el Perú, debido a la alta morbilidad del virus coincidente con la estación más fría del año. Es importante contener al máximo la dispersión del virus, ya que cuanto mayor sea el número de personas que infecte, el mismo estará sometido a un mayor número de eventos de recombinación genética por reordenamiento con virus influenza humanos previos y esto puede condicionar a la aparición todavía de nuevas cepas, para las que el sistema inmune podría no estar preparado a nivel poblacional. Abstract in english The Influenza virus belongs to the Orthomyxoviridae family, viruses with a negative sense segmented RNA genome. The influenza virus type A infects humans and other organisms, and is the causative agent of human influenza. Hemagglutinin and Neuraminidase stand out among other proteins, and are used i [...] n the classification of the members of this group. These viruses mutate continuously, with patterns long studied, the antigenic shift and the antigenic drift, with one major event of recombination called reassortment. All subtypes exist in wild aquatic birds, although other hosts can be found, such as horses, minks, whales, seals, pigs, hens and turkeys, among others. As part of its progressive adaptation to the human host, wild birds and poultry play a fundamental role as well as swine. Although H2N2 and H3N2 subtypes have been very common among the human population, H1N1 subtype has re-emerged with mutations that have allowed it to reach the pandemics state in 2009. This new virus has a close ancestor in a triple reassortant virus from a human influenza virus, a classic influenza swine virus and an avian influenza virus, and contains as well genetic segments from a Euroasian swine influenza virus. This has caused that the virus displays a mild disease, only severe or lethal in individuals with previous medical history. At worldwide level it has caused more than 134.510 cases and in Peru they are close to 3.700. The current state indicates that in Peru the pandemics is about to reach its peak due to the high morbidity of the virus and coldest season of the year. The containment of this virus is important, since the greater the number of people infected, the greater the number of reassortment events the virus will be subjected to, with previous human influenza viruses, and may determine the appearance of new strains, for which the immune system might not be prepared at t

Miguel, Talledo; Kattya, Zumaeta.

304

Experimental infection with H1N1 European swine influenza virus protects pigs from an infection with the 2009 pandemic H1N1 human influenza virus  

Science.gov (United States)

The recent pandemic caused by human influenza virus A(H1N1) 2009 contains ancestral gene segments from North American and Eurasian swine lineages as well as from avian and human influenza lineages. The emergence of this A(H1N1) 2009 poses a potential global threat for human health and the fact that it can infect other species, like pigs, favours a possible encounter with other influenza viruses circulating in swine herds. In Europe, H1N1, H1N2 and H3N2 subtypes of swine influenza virus currently have a high prevalence in commercial farms. To better assess the risk posed by the A(H1N1) 2009 in the actual situation of swine farms, we sought to analyze whether a previous infection with a circulating European avian-like swine A/Swine/Spain/53207/2004 (H1N1) influenza virus (hereafter referred to as SwH1N1) generated or not cross-protective immunity against a subsequent infection with the new human pandemic A/Catalonia/63/2009 (H1N1) influenza virus (hereafter referred to as pH1N1) 21 days apart. Pigs infected only with pH1N1 had mild to moderate pathological findings, consisting on broncho-interstitial pneumonia. However, pigs inoculated with SwH1N1 virus and subsequently infected with pH1N1 had very mild lung lesions, apparently attributed to the remaining lesions caused by SwH1N1 infection. These later pigs also exhibited boosted levels of specific antibodies. Finally, animals firstly infected with SwH1N1 virus and latter infected with pH1N1 exhibited undetectable viral RNA load in nasal swabs and lungs after challenge with pH1N1, indicating a cross-protective effect between both strains.

Busquets, Nuria; Segales, Joaquim; Cordoba, Lorena; Mussa, Tufaria; Crisci, Elisa; Martin-Valls, Gerard E.; Simon-Grife, Meritxell; Perez-Simo, Marta; Perez-Maillo, Monica; Nunez, Jose I.; Abad, Francesc X.; Fraile, Lorenzo; Pina, Sonia; Majo, Natalia; Bensaid, Albert; Domingo, Mariano; Montoya, Maria

2010-01-01

305

Analysis of the effectiveness of interventions used during the 2009 A/H1N1 influenza pandemic  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Following the emergence of the A/H1N1 2009 influenza pandemic, public health interventions were activated to lessen its potential impact. Computer modelling and simulation can be used to determine the potential effectiveness of the social distancing and antiviral drug therapy interventions that were used at the early stages of the pandemic, providing guidance to public health policy makers as to intervention strategies in future pandemics involving a highly pathogenic influenza strain. Methods An individual-based model of a real community with a population of approximately 30,000 was used to determine the impact of alternative interventions strategies, including those used in the initial stages of the 2009 pandemic. Different interventions, namely school closure and antiviral strategies, were simulated in isolation and in combination to form different plausible scenarios. We simulated epidemics with reproduction numbers R0of 1.5, which aligns with estimates in the range 1.4-1.6 determined from the initial outbreak in Mexico. Results School closure of 1 week was determined to have minimal effect on reducing overall illness attack rate. Antiviral drug treatment of 50% of symptomatic cases reduced the attack rate by 6.5%, from an unmitigated rate of 32.5% to 26%. Treatment of diagnosed individuals combined with additional household prophylaxis reduced the final attack rate to 19%. Further extension of prophylaxis to close contacts (in schools and workplaces further reduced the overall attack rate to 13% and reduced the peak daily illness rate from 120 to 22 per 10,000 individuals. We determined the size of antiviral stockpile required; the ratio of the required number of antiviral courses to population was 13% for the treatment-only strategy, 25% for treatment and household prophylaxis and 40% for treatment, household and extended prophylaxis. Additional simulations suggest that coupling school closure with the antiviral strategies further reduces epidemic impact. Conclusions These results suggest that the aggressive use of antiviral drugs together with extended school closure may substantially slow the rate of influenza epidemic development. These strategies are more rigorous than those actually used during the early stages of the relatively mild 2009 pandemic, and are appropriate for future pandemics that have high morbidity and mortality rates.

Milne George J

2010-03-01

306

Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff. Methods We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4%, approximately one third of whom were health professionals. Results Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28% hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10% were willing if required. One-third (32% of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic. Conclusions Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The findings point to certain hospital-based communication and training strategies to boost employees' response willingness, including promoting pre-event plans for home-based dependents; ensuring adequate supplies of personal protective equipment, vaccines and antiviral drugs for all hospital employees; and establishing a subjective norm of awareness and preparedness.

Catlett Christina L

2010-07-01

307

Nursing students’ experiences of exposure to pandemic influenza A (H1N1  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The purpose of this study was to examine the experiences of nursing students with exposure of influenza A (H1N1. Methods: A qualitative descriptive study design was used. A total of 24 nursing students participated in six focus groups. Results: The six themes that emerged from the data are as follows: (1 worrying about becoming infected; (2 protectingoneself and others; (3 relying on the nurses in the school health center; (4 being hurt by others’ negative reactions; (5being ambivalent, and (6 being concerned over the high price. Conclusions: Nursing students who come in contact with patients in a clinical setting must also be considered as candidatesfor early vaccination. Healthcare professionals, as well as family and friends, should keep in mind that their verbal ornonverbal expressions can hurt others’ feelings at a time when special care and support are needed the most. Stigma couldbe serious barriers of people's access to health services and preventive behaviors. Therefore, education on stigma reductionassociated with pandemic infection is essential to enhance public health preparedness.

Hee Sun Kang

2012-03-01

308

Stochastic Modelling: An Approach to Quantify the Transmission Intensity of Pandemic Influenza (H1N1 in Maharashtra  

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Full Text Available In India, Maharashtra was one of the badly affected states during the influenza A/H1N1 2009 pandemic. We undertook the study to identify the disease dynamics and real time varying intensity of the strain in Maharashtra and to evaluate the internal heterogeneity under different epidemiological contours. Reproduction Number, the key epidemiological parameter, defined as average number of secondary infected individuals generated by a typical primary case in his/her entire infectious period, which being used to quantify the characteristic of the transmission intensity of pandemic. The aim of the paper is to estimate instantaneous reproduction number from daily case reported data considering the stochastic nature of generation time. We used the Kermack McKendrick transmission model (Time-Since-Infection model applied to stochastic renewal process of disease outbreak. Our reliable estimate of reproduction number is 1.44 for the Influenza A/H1N1 pandemic in Maharashtra, comparatively higher than other part of India. Moreover, we examine that the effectiveness of interventions at the initial stage, and is found to have a significant role in reducing the contact rate, consequently the transmissibility.

Sheikh Taslim Ali

2013-05-01

309

Pandemic influenza A (H1N1) vaccination among libyan health care personnel: A cross-sectional retrospective study  

Science.gov (United States)

Context: Vaccination rate among health-care personnel's (HCPs) are not promising notwithstanding the World Health Organization campaigns over three decades resulting in compromising patient safety. The H1N1 virus, which caused a world-wide pandemic earlier has now transformed into a seasonal flu virus. Aims: The aim of this study was to analyze the incidence of 2009-10 pandemic influenza A (H1N1) vaccination among Libyan HCPs in four hospitals of Al-Zawia, Libya. Materials and Methods: A questionnaire, which listed eight sections of parameters distributed among 310 HCPs to assess the vaccination rate and resulting adverse effects. Statistical Analysis: The data were analyzed using descriptive statistics, Pearson's ?2-test and Student's t-test where appropriate. Results: The overall pandemic A (H1N1) vaccination among all HCPs was only 107 (39.9%) out of 268 respondents. The distribution of respondents based on physicians, other staff and sex were found significant (P influenza in recent times, vaccination campaigns should be promoted immediately to address the knowledge gap of HCPs for intervention by regulatory and health organizations in Libya. The health belief model could be applied to improve vaccination among HCPs.

Hwisa, Nagiat Tayeb; Katakam, Prakash; Chandu, Babu Rao; Ismael, Mraa Hazim; Bader, Abdalwahab

2014-01-01

310

Case-based reported mortality associated with laboratory-confirmed influenza A(H1N1 2009 virus infection in the Netherlands: the 2009-2010 pandemic season versus the 2010-2011 influenza season  

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Full Text Available Abstract Background In contrast to seasonal influenza epidemics, where the majority of deaths occur amongst elderly, a considerable part of the 2009 pandemic influenza related deaths concerned relatively young people. In the Netherlands, all deaths associated with laboratory-confirmed influenza A(H1N1 2009 virus infection had to be notified, both during the 2009-2010 pandemic season and the 2010-2011 influenza season. To assess whether and to what extent pandemic mortality patterns were reverting back to seasonal patterns, a retrospective analyses of all notified fatal cases associated with laboratory-confirmed influenza A(H1N1 2009 virus infection was performed. Methods The notification database, including detailed information about the clinical characteristics of all notified deaths, was used to perform a comprehensive analysis of all deceased patients with a laboratory-confirmed influenza A(H1N1 2009 virus infection. Characteristics of the fatalities with respect to age and underlying medical conditions were analysed, comparing the 2009-2010 pandemic and the 2010-2011 influenza season. Results A total of 65 fatalities with a laboratory-confirmed influenza A(H1N1 2009 virus infection were notified in 2009-2010 and 38 in 2010-2011. During the pandemic season, the population mortality rates peaked in persons aged 0-15 and 55-64 years. In the 2010-2011 influenza season, peaks in mortality were seen in persons aged 0-15 and 75-84 years. During the 2010-2011 influenza season, the height of first peak was lower compared to that during the pandemic season. Underlying immunological disorders were more common in the pandemic season compared to the 2010-2011 season (p = 0.02, and cardiovascular disorders were more common in the 2010-2011 season (p = 0.005. Conclusions The mortality pattern in the 2010-2011 influenza season still resembled the 2009-2010 pandemic season with a peak in relatively young age groups, but concurrently a clear shift toward seasonal patterns was seen, with a peak in mortality in the elderly, i.e. ? 75 years of age.

Timen Aura

2011-10-01

311

Costo-efectividad de la vacunación contra influenza pandémica en mujeres embarazadas en Colombia Cost-effectiveness of vaccinating pregnant women against pandemic influenza in Colombia  

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Full Text Available OBJETIVO: Estimar la relación costo-efectividad de la vacunación contra influenza pandémica A (H1N1 2009 en mujeres embarazadas en Colombia durante la segunda onda de la pandemia. MÉTODOS: Se construyó un árbol de decisiones que simulaba los resultados sanitarios (muertes y años potenciales de vida perdidos, APVP en dos cohortes de mujeres embarazadas, una vacunada y otra sin vacunar. Los parámetros del modelo fueron extraídos de la literatura científica y los costos se estimaron a partir de un estudio previo. Se calcularon razones de costo-efectividad incrementales (RCEI. RESULTADOS: La vacunación de embarazadas contra influenza pandémica habría evitado entre 4 664 y 15 741 consultas ambulatorias y entre 119 y 401 hospitalizaciones. Los costos de atención evitados serían de US$ 249 530 a US$ 842 163. Para el escenario base, vacunar embarazadas sería costo-efectivo (RCEI/APVP evitado US$ 7 657. Esta RCEI fue sensible a la letalidad de la enfermedad; en escenarios de baja letalidad la vacunación no sería costo-efectiva en Colombia. CONCLUSIONES: La vacunación en embarazadas contra influenza pandémica es costo-efectiva en un escenario de alta mortalidad. La evidencia existente de que las mujeres embarazadas tienen mayor riesgo de presentar complicaciones y de que la vacuna es segura justificaría su uso en embarazadas.OBJECTIVE: Estimating the cost-effectiveness ratio of vaccinating pregnant women against the 2009 pandemic influenza A (H1N1 in Colombia during the second wave of the pandemic. METHODS: A decision tree was constructed, which simulated the health results (deaths and years of potential life lost [YPLL] in two cohorts of pregnant women; one vaccinated, the other unvaccinated. The model's parameters were drawn from scientific literature and costs were estimated on the basis of a previous study. Incremental cost-effectiveness ratios (ICER were calculated. RESULTS: Vaccinating pregnant women against pandemic flu would have prevented between 4 664 and 15 741 outpatient visits and between 119 and 401 hospitalizations. Between US$ 249 530 and US$ 842 163 in costs of care would have been avoided. For the base scenario, vaccinating pregnant women would be cost-effective (ICER/YPLL avoided US$ 7 657. This ICER was responsive to the disease's fatality rate; vaccina tion would not be cost-effective in Colombia in scenarios with a lower fatality rate. CONCLUSIONS: Vaccinating pregnant women against pandemic influenza is cost-effective in a scenario with a high mortality rate. The existing evidence that pregnant women are at increased risk of complications and that the vaccine is safe would justify its use in pregnant women.

Luz Angela Chocontá-Piraquive

2012-06-01

312

Costo-efectividad de la vacunación contra influenza pandémica en mujeres embarazadas en Colombia / Cost-effectiveness of vaccinating pregnant women against pandemic influenza in Colombia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish OBJETIVO: Estimar la relación costo-efectividad de la vacunación contra influenza pandémica A (H1N1) 2009 en mujeres embarazadas en Colombia durante la segunda onda de la pandemia. MÉTODOS: Se construyó un árbol de decisiones que simulaba los resultados sanitarios (muertes y años potenciales de vida [...] perdidos, APVP) en dos cohortes de mujeres embarazadas, una vacunada y otra sin vacunar. Los parámetros del modelo fueron extraídos de la literatura científica y los costos se estimaron a partir de un estudio previo. Se calcularon razones de costo-efectividad incrementales (RCEI). RESULTADOS: La vacunación de embarazadas contra influenza pandémica habría evitado entre 4 664 y 15 741 consultas ambulatorias y entre 119 y 401 hospitalizaciones. Los costos de atención evitados serían de US$ 249 530 a US$ 842 163. Para el escenario base, vacunar embarazadas sería costo-efectivo (RCEI/APVP evitado US$ 7 657). Esta RCEI fue sensible a la letalidad de la enfermedad; en escenarios de baja letalidad la vacunación no sería costo-efectiva en Colombia. CONCLUSIONES: La vacunación en embarazadas contra influenza pandémica es costo-efectiva en un escenario de alta mortalidad. La evidencia existente de que las mujeres embarazadas tienen mayor riesgo de presentar complicaciones y de que la vacuna es segura justificaría su uso en embarazadas. Abstract in english OBJECTIVE: Estimating the cost-effectiveness ratio of vaccinating pregnant women against the 2009 pandemic influenza A (H1N1) in Colombia during the second wave of the pandemic. METHODS: A decision tree was constructed, which simulated the health results (deaths and years of potential life lost [YPL [...] L]) in two cohorts of pregnant women; one vaccinated, the other unvaccinated. The model's parameters were drawn from scientific literature and costs were estimated on the basis of a previous study. Incremental cost-effectiveness ratios (ICER) were calculated. RESULTS: Vaccinating pregnant women against pandemic flu would have prevented between 4 664 and 15 741 outpatient visits and between 119 and 401 hospitalizations. Between US$ 249 530 and US$ 842 163 in costs of care would have been avoided. For the base scenario, vaccinating pregnant women would be cost-effective (ICER/YPLL avoided US$ 7 657). This ICER was responsive to the disease's fatality rate; vaccina tion would not be cost-effective in Colombia in scenarios with a lower fatality rate. CONCLUSIONS: Vaccinating pregnant women against pandemic influenza is cost-effective in a scenario with a high mortality rate. The existing evidence that pregnant women are at increased risk of complications and that the vaccine is safe would justify its use in pregnant women.

Luz Angela, Chocontá-Piraquive; Nelson, Alvis Guzmán; Fernando, De la Hoz Restrepo.

313

Cellular and Humoral Immune Responses to Pandemic Influenza Vaccine in Healthy and in Highly Active Antiretroviral Therapy-Treated HIV Patients  

Science.gov (United States)

Abstract Influenza vaccination is recommended for HAART-treated HIV patients to prevent influenza illness and complications. Due to the known ability of T cells to mediate a broadly cross-reactive response, vaccination effectiveness in cell-mediated immune (CMI) response induction is a main objective in new influenza vaccination strategies. Nevertheless, data on CMI responses after pandemic vaccination in HIV subjects are still missing. In the present study, the ability of a single dose of adjuvanted pandemic influenza vaccine to induce humoral and CMI responses was compared in HAART-treated HIV patients and in healthcare workers. Healthcare workers (HCW, n=65) and HAART-treated HIV patients (HIV, n=67) receiving pandemic vaccination were enrolled and analyzed before (t0) and after (t1) vaccination. The analysis of strain-specific humoral response was performed by HAI assay; CMI against pandemic (A/H1N1/Cal/09) and seasonal (A/H1N1/Brisb/07 and A/H3N2/Brisb/07) strains was analyzed by ELISpot and intracellular staining followed by flow cytometry. Pandemic vaccination was effective in inducing both humoral and cell-mediated responses in HAART-treated HIV patients as well as in HCWs. A large fraction of both HCWs and HIV-infected patients showed a T cell response to the pandemic strain before vaccination, suggesting possible previous exposure to A/H1N1/pdm/09 and/or cross-reactive T cells. Notably, pandemic vaccine was also able to boost cross-reactive immune responses to seasonal strains. Finally, a weaker boost of both strain-specific and cross-reactive T cell immunity was found in individuals showing a higher baseline response. These data show the effectiveness of adjuvanted pandemic vaccine to induce both humoral and cellular (strain-specific and cross-reactive) immune responses in HIV patients similar to HCWs.

Gioia, Cristiana; Castilletti, Concetta; Lapa, Daniele; Berno, Giulia; Puro, Vincenzo; Carletti, Fabrizio; Cimini, Eleonora; Nisii, Carla; Castellino, Flora; Martini, Federico; Capobianchi, Maria R.

2012-01-01

314

Development and preclinical testing of HNVAC, a cell culture-based H1N1 pandemic influenza vaccine from India.  

Science.gov (United States)

Several limitations of the use of embryonated eggs and the threat of pandemics have highlighted the need for other platforms for the production of influenza vaccines. We report the indigenous development and pre-clinical testing of an MDCK-based H1N1 pandemic influenza vaccine HNVAC from India. The cell bank and virus seed were characterized extensively. The cells were characterized by PCR, electron microscopy, and karyotyping, and found to be of female canine epithelial origin. The virus was confirmed by neutralization, haemagglutination inhibition, neuraminidase inhibition, and PCR and nucleotide sequencing. Adventitious agent testing was performed by both in vitro and in vivo studies. The in vitro studies included culturing, haemadsorption, haemagglutination, PCR and RT-PCR, whereas in vivo studies included passage in embryonated eggs and in laboratory animals. Both cell bank and virus seed were free of adventitious agents. MDCK cell lysates as well as cellular DNA did not produce tumours in newborn or adult laboratory animals. The bioprocess parameters were standardized to recover antigen with minimal levels of process-related impurities. The vaccine bulk was tested for the presence of specific antigen, and quantified by single radial immunodiffusion. Finally, non-adjuvanted and aluminium hydroxide adjuvanted vaccine formulations were found to be safe in preclinical toxicity studies in mice, rats, guinea pigs and rabbits, and immunogenic in mice and rabbits. This is the first and only cell culture-based influenza vaccine platform developed in any developing country. PMID:24801052

Hegde, Nagendra R; Kumar, Deepak; Rao, P Panduranga; Kumari, P Krishna; Kaushik, Yashpal; Ravikrishnan, R; Prasad, Sai D; Ella, Krishna M

2014-06-17

315

Identification and analysis of the first 2009 pandemic H1N1 influenza virus from U.S. feral swine.  

Science.gov (United States)

The first case of pandemic H1N1 influenza (pH1N1) virus in feral swine in the United States was identified in Texas through the United States Department of Agriculture (USDA) Wildlife Services' surveillance program. Two samples were identified as pandemic influenza by reverse transcriptase quantitative PCR (RT-qPCR). Full-genome Sanger sequencing of all eight influenza segments was performed. In addition, Illumina deep sequencing of the original diagnostic samples and their respective virus isolation cultures were performed to assess the feasibility of using an unbiased whole-genome linear target amplification method and multiple sample sequencing in a single Illumina GAIIx lane. Identical sequences were obtained using both techniques. Phylogenetic analysis indicated that all gene segments belonged to the pH1N1 (2009) lineage. In conclusion, we have identified the first pH1N1 isolate in feral swine in the United States and have demonstrated the use of an easy unbiased linear amplification method for deep sequencing of multiple samples. PMID:22978260

Clavijo, A; Nikooienejad, A; Esfahani, M S; Metz, R P; Schwartz, S; Atashpaz-Gargari, E; Deliberto, T J; Lutman, M W; Pedersen, K; Bazan, L R; Koster, L G; Jenkins-Moore, M; Swenson, S L; Zhang, M; Beckham, T; Johnson, C D; Bounpheng, M

2013-08-01

316

Response to the 2009-H1N1 influenza pandemic in the Mekong Basin: surveys of country health leaders  

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Full Text Available Abstract Background Soon after the 2009-H1N1 virus emerged as the first influenza pandemic in 41 years, countries had an early opportunity to test their preparedness plans, protocols and procedures, including their cooperation with other countries in responding to the global pandemic threat. The Mekong Basin Disease Surveillance cooperation (MBDS comprises six countries - Cambodia, China (Yunnan and Guangxi Provinces, Lao People's Democratic Republic, Myanmar, Thailand and Vietnam - that formally organized themselves in 2001 to cooperate in disease surveillance and control. The pandemic presented an opportunity to assess their responses in light of their individual and joint planning. We conducted two surveys of the MBDS leadership from each country, early during the pandemic and shortly after it ended. Results On average, participants rated their country's pandemic response performance as good in both 2009 and 2010. Post-pandemic (2010, perceived performance quality was best for facility-based interventions (overall mean of 4.2 on a scale from 1 = poor to 5 = excellent, followed by surveillance and information sharing (4.1, risk communications (3.9 and disease prevention and control in communities (3.7. Performance was consistently rated as good or excellent for use of hotlines for case reporting (2010 mean of 4.4 and of selected facility-based interventions (each with a 2010 mean of 4.4: using hospital admission criteria, preparing or using isolation areas, using PPE for healthcare workers and using antiviral drugs for treatment. In at least half the countries, the post-pandemic ratings were lower than initial 2009 assessments for performance related to surveillance, facility-based interventions and risk communications. Conclusions MBDS health leaders perceived their pandemic responses effective in areas previously considered problematic. Most felt that MBDS cooperation helped drive and thus added value to their efforts. Surveillance capacity within countries and surveillance information sharing across countries, longstanding MBDS focus areas, were cited as particular strengths. Several areas needing further improvement are already core strategies in the 2011-2016 MBDS Action Plan. Self-organized sub-regional cooperation in disease surveillance is increasingly recognized as an important new element in global disease prevention and control. Our findings suggest that more research is needed to understand the characteristics of networking that will result in the best shared outcomes.

Dausey David J

2011-09-01

317

A polyvalent influenza A DNA vaccine induces heterologous immunity and protects pigs against pandemic A(H1N1)pdm09 virus infection.  

Science.gov (United States)

The composition of current influenza protein vaccines has to be reconsidered every season to match the circulating influenza viruses, continuously changing antigenicity. Thus, influenza vaccines inducing a broad cross-reactive immune response would be a great advantage for protection against both seasonal and emerging influenza viruses. We have developed an alternative influenza vaccine based on DNA expressing selected influenza proteins of pandemic and seasonal origin. In the current study, we investigated the protection of a polyvalent influenza DNA vaccine approach in pigs. We immunised pigs intradermally with a combination of influenza DNA vaccine components based on the pandemic 1918 H1N1 (M and NP genes), pandemic 2009 H1N1pdm09 (HA and NA genes) and seasonal 2005 H3N2 genes (HA and NA genes) and investigated the protection against infection with virus both homologous and heterologous to the DNA vaccine components. We found that pigs challenged with a virus homologous to the HA and NA DNA vaccine components were well protected from infection. In addition, heterologous challenge virus was cleared rapidly compared to the unvaccinated control pigs. Immunisation by electroporation induced HI antibodies >40 HAU/ml seven days after second vaccination. Heterologous virus challenge as long as ten weeks after last immunisation was able to trigger a vaccine antibody HI response 26 times higher than in the control pigs. The H3N2 DNA vaccine HA and NA genes also triggered an effective vaccine response with protective antibody titres towards heterologous H3N2 virus. The described influenza DNA vaccine is able to induce broadly protective immune responses even in a larger animal, like the pig, against both heterologous and homologous virus challenges despite relatively low HI titres after vaccination. The ability of this DNA vaccine to limit virus shedding may have an impact on virus spread among pigs which could possibly extend to humans as well, thereby diminishing the risk for epidemics and pandemics to evolve. PMID:23499598

Bragstad, Karoline; Vinner, Lasse; Hansen, Mette Sif; Nielsen, Jens; Fomsgaard, Anders

2013-04-26

318

Selection for resistance to oseltamivir in seasonal and pandemic H1N1 influenza and widespread co-circulation of the lineages  

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Abstract Background In Spring 2009, a novel reassortant strain of H1N1 influenza A emerged as a lineage distinct from seasonal H1N1. On June 11, the World Heath Organization declared a pandemic - the first since 1968. There are currently two main branches of H1N1 circulating in humans, a seasonal branch and a pandemic branch. The primary treatment method for pandemic and seasonal H1N1 is the antiviral drug Tamiflu® (oseltamivir). Although many seasonal H1N1 strain...

Janies Daniel A; Voronkin Igor O; Studer Jonathon; Hardman Jori; Alexandrov Boyan B; Treseder Travis W; Valson Chandni

2010-01-01

319

Influenza in hospitalized children in Ireland in the pandemic period and the 2010/2011 season: risk factors for paediatric intensive-care-unit admission.  

Science.gov (United States)

SUMMARY Influenza causes significant morbidity and mortality in children. This study's objectives were to describe influenza A(H1N1)pdm09 during the pandemic, to compare it with circulating influenza in 2010/2011, and to identify risk factors for severe influenza defined as requiring admission to a paediatric intensive care unit (PICU). Children hospitalized with influenza during the pandemic were older, and more likely to have received antiviral therapy than children hospitalized during the 2010/2011 season. In 2010/2011, only one child admitted to a PICU with underlying medical conditions had been vaccinated. The risk of severe illness in the pandemic was higher in females and those with underlying conditions. In 2010/2011, infection with influenza A(H1N1)pdm09 compared to other influenza viruses was a significant risk factor for severe disease. An incremental relationship was found between the number of underlying conditions and PICU admission. These findings highlight the importance of improving low vaccination uptake and increasing the use of antivirals in vulnerable children. PMID:24229618

Rebolledo, J; Igoe, D; O'Donnell, J; Domegan, L; Boland, M; Freyne, B; McNAMARA, A; Molloy, E; Callaghan, M; Ryan, A; O'Flanagan, D

2014-09-01

320

Influenza in hospitalized children in Ireland in the pandemic period and the 2010/2011 season: risk factors for paediatric intensive-care-unit admission.  

LENUS (Irish Health Repository)

SUMMARY Influenza causes significant morbidity and mortality in children. This study\\'s objectives were to describe influenza A(H1N1)pdm09 during the pandemic, to compare it with circulating influenza in 2010\\/2011, and to identify risk factors for severe influenza defined as requiring admission to a paediatric intensive care unit (PICU). Children hospitalized with influenza during the pandemic were older, and more likely to have received antiviral therapy than children hospitalized during the 2010\\/2011 season. In 2010\\/2011, only one child admitted to a PICU with underlying medical conditions had been vaccinated. The risk of severe illness in the pandemic was higher in females and those with underlying conditions. In 2010\\/2011, infection with influenza A(H1N1)pdm09 compared to other influenza viruses was a significant risk factor for severe disease. An incremental relationship was found between the number of underlying conditions and PICU admission. These findings highlight the importance of improving low vaccination uptake and increasing the use of antivirals in vulnerable children.

Rebolledo, J

2013-11-11

 
 
 
 
321

Factors Affecting Acceptance and Intention to Receive Pandemic Influenza A H1N1 Vaccine among Primary School Children: A Cross-Sectional Study in Birmingham, UK  

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UK pandemic influenza strategy focused on vaccination of high risk groups, although evidence shows that school-age children have the highest infection rates. Vaccination of children might be an additional strategy. We undertook a cross-sectional study amongst 149 parents of primary school children aged 4–7 years in Birmingham, UK to quantify intention to accept pandemic influenza vaccine and identify factors affecting uptake. Ninety-one (61.1%, 95% CI 52.8, 68.9) had or would accept vaccine...

2012-01-01

322

Emergency Physicians’ Adherence to Center for Disease Control and Prevention Guidance During the 2009 Influenza A H1N1 Pandemic  

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Full Text Available Introduction: Little is known regarding compliance with management guidelines for epidemicinfluenza in adult emergency department (ED settings during the 2009 novel influenza A(H1N1 epidemic, especially in relation to the Centers for Disease Control and Prevention (CDCguidance.Methods: We investigated all patients with a clinical diagnosis of influenza at an inner-citytertiary academic adult ED with an annual census of approximately 60,000 visits from May 2008to December 2009. We aimed to determine patterns of presentation and management for adultpatients with an ED diagnosis of influenza during the H1N1 pandemic, using seasonal influenza(pre-H1N1 as reference and to determine the ED provider’s adherence to American College ofEmergency Physicians and CDC guidance during the 2009 H1N1 influenza pandemic. Adherenceto key elements of CDC 2009 H1N1 guidance was defined as (1 the proportion of admittedpatients who were recommended to receive testing or treatment who actually received testingfor influenza or treatment with antivirals; and (2 the proportion of high-risk patients who weresupposed to be treated who actually were treated with antivirals.Results: Among 339 patients with clinically diagnosed influenza, 88% occurred during the H1N1pandemic. Patients were similarly managed during both phases. Median length of visit (pre-H1N1:385 min, H1N1: 355 min, P > 0.05 and admission rates (pre-H1N1: 8%, H1N1: 11%, P > 0.05were similar between the 2 groups. 28% of patients in the pre-H1N1 group and 16% of patientsin the H1N1 group were prescribed antibiotics during their ED visits (P > 0.05. There were 34admitted patients during the pandemic;, 30 (88% of them received influenza testing in the ED,and 22 (65% were prescribed antivirals in the ED. Noticeably, 19 (56% of the 34 admittedpatients, including 6 with a positive influenza test, received antibiotic treatment during their ED stay.Conclusion: During the recent H1N1 pandemic, most admitted patients received ED diagnostictesting corresponding to the current recommended guidance. Antibiotic treatment for ED patientsadmitted with suspected influenza is not uncommon. However, less than 70% of admitted patientsand less than 50% of high-risk patients were treated with antivirals during their ED visit, indicatinga specific call for closer adherence to guidelines in future influenza pandemics.

Yu-Hsiang Hsieh

2013-03-01

323

The impact of mass gatherings and holiday traveling on the course of an influenza pandemic: a computational model  

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Full Text Available Abstract Background During the 2009 H1N1 influenza pandemic, concerns arose about the potential negative effects of mass public gatherings and travel on the course of the pandemic. Better understanding the potential effects of temporal changes in social mixing patterns could help public officials determine if and when to cancel large public gatherings or enforce regional travel restrictions, advisories, or surveillance during an epidemic. Methods We develop a computer simulation model using detailed data from the state of Georgia to explore how various changes in social mixing and contact patterns, representing mass gatherings and holiday traveling, may affect the course of an influenza pandemic. Various scenarios with different combinations of the length of the mass gatherings or traveling period (range: 0.5 to 5 days, the proportion of the population attending the mass gathering events or on travel (range: 1% to 50%, and the initial reproduction numbers R0 (1.3, 1.5, 1.8 are explored. Results Mass gatherings that occur within 10 days before the epidemic peak can result in as high as a 10% relative increase in the peak prevalence and the total attack rate, and may have even worse impacts on local communities and travelers' families. Holiday traveling can lead to a second epidemic peak under certain scenarios. Conversely, mass traveling or gatherings may have little effect when occurring much earlier or later than the epidemic peak, e.g., more than 40 days earlier or 20 days later than the peak when the initial R0 = 1.5. Conclusions Our results suggest that monitoring, postponing, or cancelling large public gatherings may be warranted close to the epidemic peak but not earlier or later during the epidemic. Influenza activity should also be closely monitored for a potential second peak if holiday traveling occurs when prevalence is high.

Lee Bruce Y

2010-12-01

324

Mammalian pathogenesis of oseltamivir-resistant pandemic (H1N1) 2009 influenza virus isolated in South Korea.  

Science.gov (United States)

Oseltamivir, a neuraminidase (NA) inhibitor, has been widely used for the treatment of patients infected with the pandemic (H1N1) 2009 influenza virus. With the increasing use of oseltamivir, drug-resistant mutants emerged rapidly and 11 cases of resistant viruses were detected during the 2009 H1N1 pandemic in South Korea. To better understand the differences between oseltamivir-susceptible and oseltamivir-resistant virus, we compared the replication and pathogenesis of the NA H275Y mutant virus, A/Gyeongnam/1820/2009, in ferrets and mice with those of oseltamivir-susceptible A/Korea/01/2009 virus. Oseltamivir-resistant virus infected ferrets showed mild clinical signs and the virus replicated well in the upper respiratory tract and slightly in the lower respiratory tract. No virus was detected in the extrapulmonary organs. Severe bronchopneumonia and thickening of alveolar walls were detected in the lungs. Viral antigens were detected mainly in the bronchiolar epithelial cells, cells present in the interstitial septa, pneumocytes and peribronchial glands with severe peribronchitis. A/Gyeongnam/1820/2009 virus-infected mice showed weight loss and the virus replicated in lungs with high titer. Histopathologically, the mice showed mild to moderate alveolitis, interstitial pneumonia and perivascular lymphoid tissue hyperplasia. In lungs, bronchiolar epithelial cells, pneumocytes and interstitial inflammatory cells were infected by influenza virus and trachea epithelial cells were the sites of infection. When compared with the results of A/Korea/01/2009 oseltamivir-susceptible pandemic influenza virus, an oseltamivir-resistant virus isolated in South Korea showed fewer pathogenic properties in ferrets and similar fitness in mice. PMID:24657788

Kwon, Donghyok; Shin, Kyeongcheol; Kim, Su-Jin; Lee, Joo-Yeon; Kang, Chun

2014-06-24

325

Antigenic and genetic analysis of pandemic influenza A(H1N1) 2009 viruses from Portugal  

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Backround: The influenza AH1N1 2009 pandemic virus (AH1N1pdm) was first detected in Portugal in May 4th 2009. This virus had origin in a reassortment between a North American swine lineage (already a triple reassortant, circulating in pigs since the late 1990’s) and a Eurasian swine lineage. As the HA (North American swine lineage) continues to circulate in the human population, its antigenic sites will continue to be targeted by antibody-mediated selection pressure. Therefore it is importa...

Pechirra, Pedro; Arraiolos, Ana; Conde, Patri?cia; Gonc?alves, Paulo; Cordeiro, Rita; Guiomar, Raquel

2010-01-01

326

Assessment of the efficacy of the neuraminidase inhibitor oseltamivir against 2009 pandemic H1N1 influenza virus in ferrets  

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Pandemic 2009 influenza A (H1N1) virus (H1N1pdm) is different from contemporary seasonal human viruses in that it can cause infection deep in the lungs of critical care patients. Here we establish a mammalian animal model and assessed the efficacy of the neuraminidase (NA) inhibitor oseltamivir treatment against H1N1pdm virus infection. Oseltamivir (25 mg/kg/day twice daily for 5 days) was orally administered to groups of ferrets, starting either 2 or 24 h after inoculation with 106 PFU of A/...

Govorkova, Elena A.; Marathe, Bindumadhav M.; Prevost, Ashley; Rehg, Jerold E.; Webster, Robert G.

2011-01-01

327

Cytokine and chemokine response in children with the 2009 pandemic influenza A (H1N1) virus infection  

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We report the systemic cytokine and chemokine response in children with the 2009 pandemic influenza A (H1N1) virus infection. In patients with pneumonia, the serum levels of IFN-? and IL-5 were significantly higher than those in patients without pneumonia. This tendency was also present for IL-6, IL-8, IL-10, IL-13, and MCP-1 in patients with pneumonia. Among patients with pneumonia, the levels of MCP-1 were significantly higher in the group of patients with pneumonia with severe respiratory...

Takano, T.; Tajiri, H.; Kashiwagi, Y.; Kimura, S.; Kawashima, H.

2011-01-01

328

Evolutionary genomics of the pandemic 2009 H1N1 influenza viruses (pH1N 1v)  

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Abstract Background A new strain of human H1N1 influenza A viruses was broken out in the April 2009 and caused worldwide pandemic emergency. The present study is trying to estimate a temporal reassortment history of 2009 H1N1 viruses by phylogenetic analysis based on a total 394 sequences of H1N1viruses isolated from swine, human and avian. Results Phylogenetic trees of eight gene segments showed that viruses sampled from human formed a well-supported clade, whe...

Qu Yanhua; Zhang Ruiying; Cui Peng; Song Gang; Duan Ziyuan; Lei Fumin

2011-01-01

329

Pandemic Influenza A Viruses Escape from Restriction by Human MxA through Adaptive Mutations in the Nucleoprotein  

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The interferon-induced dynamin-like MxA GTPase restricts the replication of influenza A viruses. We identified adaptive mutations in the nucleoprotein (NP) of pandemic strains A/Brevig Mission/1/1918 (1918) and A/Hamburg/4/2009 (pH1N1) that confer MxA resistance. These resistance-associated amino acids in NP differ between the two strains but form a similar discrete surface-exposed cluster in the body domain of NP, indicating that MxA resistance evolved independently. The 1918 cluster was con...

Ma?nz, Benjamin; Dornfeld, Dominik; Go?tz, Veronika; Zell, Roland; Zimmermann, Petra; Haller, Otto; Kochs, Georg; Schwemmle, Martin

2013-01-01

330

Early Pandemic Influenza (2009 H1N1) in Ho Chi Minh City, Vietnam: A Clinical Virological and Epidemiological Analysis  

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"Background: To date, little is known about the initial spread and response to the 2009 pandemic of novel influenza A (""2009 H1N1'') in tropical countries. Here, we analyse the early progression of the epidemic from 26 May 2009 until the establishment of community transmission in the second half of July 2009 in Ho Chi Minh City (HCMC), Vietnam. In addition, we present detailed systematic viral clearance data on 292 isolated and treated patients and the first three ca...

Hien, Tt; Boni, Mf; Bryant, Je; Ngan, Tt; Wolbers, M.; Nguyen, Td; Truong, Nt; Dung, Nt; Ha, Doq; Hien, Vm; Thanh, Tt; Nhu, Lent; Uyen, Lett; Nhien, Pt; Chinh, Nt

2010-01-01

331

Contemporary Seasonal Influenza A (H1N1) Virus Infection Primes for a More Robust Response To Split Inactivated Pandemic Influenza A (H1N1) Virus Vaccination in Ferrets ?  

Science.gov (United States)

Human influenza pandemics occur when influenza viruses to which the population has little or no immunity emerge and acquire the ability to achieve human-to-human transmission. In April 2009, cases of a novel H1N1 influenza virus in children in the southwestern United States were reported. It was retrospectively shown that these cases represented the spread of this virus from an ongoing outbreak in Mexico. The emergence of the pandemic led to a number of national vaccination programs. Surprisingly, early human clinical trial data have shown that a single dose of nonadjuvanted pandemic influenza A (H1N1) 2009 monovalent inactivated vaccine (pMIV) has led to a seroprotective response in a majority of individuals, despite earlier studies showing a lack of cross-reactivity between seasonal and pandemic H1N1 viruses. Here we show that previous exposure to a contemporary seasonal H1N1 influenza virus and to a lesser degree a seasonal influenza virus trivalent inactivated vaccine is able to prime for a higher antibody response after a subsequent dose of pMIV in ferrets. The more protective response was partially dependent on the presence of CD8+ cells. Two doses of pMIV were also able to induce a detectable antibody response that provided protection from subsequent challenge. These data show that previous infection with seasonal H1N1 influenza viruses likely explains the requirement for only a single dose of pMIV in adults and that vaccination campaigns with the current pandemic influenza vaccines should reduce viral burden and disease severity in humans.

Ellebedy, Ali H.; Fabrizio, Thomas P.; Kayali, Ghazi; Oguin, Thomas H.; Brown, Scott A.; Rehg, Jerold; Thomas, Paul G.; Webby, Richard J.

2010-01-01

332

Contemporary seasonal influenza A (H1N1) virus infection primes for a more robust response to split inactivated pandemic influenza A (H1N1) Virus vaccination in ferrets.  

Science.gov (United States)

Human influenza pandemics occur when influenza viruses to which the population has little or no immunity emerge and acquire the ability to achieve human-to-human transmission. In April 2009, cases of a novel H1N1 influenza virus in children in the southwestern United States were reported. It was retrospectively shown that these cases represented the spread of this virus from an ongoing outbreak in Mexico. The emergence of the pandemic led to a number of national vaccination programs. Surprisingly, early human clinical trial data have shown that a single dose of nonadjuvanted pandemic influenza A (H1N1) 2009 monovalent inactivated vaccine (pMIV) has led to a seroprotective response in a majority of individuals, despite earlier studies showing a lack of cross-reactivity between seasonal and pandemic H1N1 viruses. Here we show that previous exposure to a contemporary seasonal H1N1 influenza virus and to a lesser degree a seasonal influenza virus trivalent inactivated vaccine is able to prime for a higher antibody response after a subsequent dose of pMIV in ferrets. The more protective response was partially dependent on the presence of CD8(+) cells. Two doses of pMIV were also able to induce a detectable antibody response that provided protection from subsequent challenge. These data show that previous infection with seasonal H1N1 influenza viruses likely explains the requirement for only a single dose of pMIV in adults and that vaccination campaigns with the current pandemic influenza vaccines should reduce viral burden and disease severity in humans. PMID:20962210

Ellebedy, Ali H; Fabrizio, Thomas P; Kayali, Ghazi; Oguin, Thomas H; Brown, Scott A; Rehg, Jerold; Thomas, Paul G; Webby, Richard J

2010-12-01

333

INFLUENZA H5N1: NEXT PANDEMIC? / INFLUENZA H5N1: PANDEMIA PRÓXIMO? / INFLUENZA H5N1: PRÓXIMA PANDEMIA?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: English Abstract in portuguese Desde 1990 se têm reportado casos de pacientes infectados por influenza causadas por vírus de baixa patogenicidade, porém, desde o ano 1997, vírus altamente patógenos como o A/H5N1 têm provocado um aumento no número de pessoas infectadas por transmissão zoonótica. Os pacientes infectados apresentam [...] sintomas constitucionais e respiratórios, transtornos hematológicos e disfunção hepática. Cerca dametade de casos são pacientes menores de 20 anos, e aproximadamente o 90% são menores de 40 anos. Recentes estudos em mamíferos indicam que são necessárias algumas mutações no genoma viral para que o vírustenha a capacidade de infectar células mamíferas. Em resposta a estes estudos o centro de controle de doenças (por suas siglas em inglês: Centers for Disease Controle), ente regulador na dinâmica epidemiológica mundial propõe continuar com as pesquisassem alertar aos sistemas de saúde, pois em este momento não constituiu maameaça mundial. Porém, este aspecto toma lugar como uma preocupação importante desde o ponto de vista dasaúde pública, já que poderia constituir a próxima pandemia. Devido à alta mortalidade em humanos que se apresenta nos casos de pacientes infectados com este vírus, um surto ou uma pandemia, exigirão por tanto um conhecimento apropriado da biologia do vírus da influenza aviar, os determinantes dasua patogenicidade, a prevenção mediante vacinae os possíveis esquemas de tratamento. Abstract in spanish Desde 1990 se han reportado casos de pacientes infectados por influenza causadas por virus de baja patogenicidad, sin embargo, desde el año 1997, virus altamente patógenos como el A/H5N1 han provocado un aumento en el número de personas infectadas por transmisión zoonotica. Los pacientes infectados [...] presentan síntomas constitucionales y respiratorios, trastornos hematológicos y disfunción hepática. Cerca de la mitad de casos son pacientes menores de 20 años, y aproximadamente el 90% son menores de 40 años. Recientes estudios en mamíferos indican que son necesarias algunas mutaciones en el genoma viral para que el virus tenga la capacidad de infectar células mamíferas. En respuesta a estos estudios el centro de control de enfermedades (por sus siglas en ingles Centers for Disease Control), ente regulador en la dinámica epidemiológica mundial propone continuar con las investigaciones sin alertar a los sistemas de salud, pues en este momento no constituye una amenaza mundial. Sin embargo, este aspecto toma lugar como una preocupación importante desde el punto de vista de la salud pública, por cuanto podría constituir la próxima pandemia. Debido a la alta mortalidad en humanos que se presenta en los casos de pacientes infectados con este virus, un brote o una pandemia exigirán por tanto un conocimiento apropiado de la biología del virus de la influenza aviar, los determinantes de su patogenicidad, la prevención mediante vacuna y los posibles esquemas de tratamiento. Abstract in english Since 1990 there have been cases of patients infected by influenza caused by Low Pathogenic Avian Influenza. However, since 1997, highly pathogenic viruses, such as A/H5N1, have caused an increase in the number of people infected via zoonotic transmission. Infected patients have constitutional and m [...] ainly respiratory symptoms, hematological disorders and liver dysfunction. About half of patients are under 20 years and about 90% under 40 years. In recent studies in mammals it seems that only few mutations in viral genome are necessary to confer the virus the ability to infect mammalian cells. In response to these studies, the Centers for Disease Control (CDC) propose continuous researches without alerting the health care system, because, at present, there is not a global threat. Moreover, in the future, this issue would take place as a major concern from the point of view of public health; it could be the next pandemic. Due to the high human mortality rate occurring in cases o

JEFFERSON, GUERRERO; LINDA, NAVARRETE; DIANA, ROLDÁN; MARÍA PAULA, PEÑA; JEIMY, OVIEDO; IVÁN, MÉNDEZ.

334

Characterization of 2009 pandemic influenza A (H1N1) virus specimens with a positive hemagglutinin 1 signal in the Luminex xTAG respiratory viral panel assay.  

Science.gov (United States)

This retrospective review analyzed Luminex xTAG respiratory viral panel (RVP) results for 2009 pandemic influenza A (H1N1) virus specimens. Comparing median fluorescence intensity (MFI) signals for the influenza A virus and hemagglutinin 1 (H1) reactions for specimens with very low positive (MFI < 1,000) or "no-call" H1 results reliably distinguished 2009 H1N1 from seasonal virus. PMID:21325556

McCloskey, Cindy B; Kraft, Colleen S; Ingersoll, Jessica M; Hill, Charles E; Burd, Eileen M; Caliendo, Angela M

2011-04-01

335

Characterization of 2009 Pandemic Influenza A (H1N1) Virus Specimens with a Positive Hemagglutinin 1 Signal in the Luminex xTAG Respiratory Viral Panel Assay?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This retrospective review analyzed Luminex xTAG respiratory viral panel (RVP) results for 2009 pandemic influenza A (H1N1) virus specimens. Comparing median fluorescence intensity (MFI) signals for the influenza A virus and hemagglutinin 1 (H1) reactions for specimens with very low positive (MFI < 1,000) or “no-call” H1 results reliably distinguished 2009 H1N1 from seasonal virus.

Mccloskey, Cindy B.; Kraft, Colleen S.; Ingersoll, Jessica M.; Hill, Charles E.; Burd, Eileen M.; Caliendo, Angela M.

2011-01-01

336

Evaluation of a rapid diagnostic test, NanoSign® Influenza A/B Antigen, for detection of the 2009 pandemic influenza A/H1N1 viruses  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background This study evaluated the clinical accuracy and analytical sensitivity of the NanoSign® Influenza A/B antigen kit in detecting 2009 pandemic influenza A/H1N1 viruses. The kit is one of the most popular rapid diagnostic tests for detecting influenza in Republic of Korea. Results The NanoSign® Influenza A/B kit resulted in 79.4% sensitivity and 97.2% specificity compared to RT-PCR in the detection of the viruses from 1,02...

Lee Gyu-Cheol; Jeon Eun-Sung; Kim Won-Shik; Le Dung; Yoo Jong-Ha; Chong Chom-Kyu

2010-01-01

337

Healthcare epidemiology: the current status of planning for pandemic influenza and implications for health care planning in the United States.  

Science.gov (United States)

The United States needs to be better prepared for a large-scale medical catastrophe, be it a natural disaster, a bioterrorism act, or a pandemic. There are substantial planning efforts now devoted to responding to an influenza pandemic. Here, we review these efforts and identify some harsh realities: (1) the US health care system is private, competitive, broke, and at capacity, so that any demand for surge cannot be met with existing economic resources, hospital beds, manpower, or supplies; (2) the emphasis placed on the development and rapid production of an effective vaccine is excellent, but the effort is underfunded to meet global demand; (3) and the Centers for Disease Control and Prevention's community mitigation measures, such as the use nonpharmacological and social interventions (e.g., use of face masks or respirators, social distancing, and closure of schools), lack validation and could have substantial indirect and unintended consequences. Finally, international collaborations are essential for disease surveillance and to assure investigator access to influenza strains, equitable vaccine distribution, and availability of critical supplies from offshore sources. PMID:18279045

Bartlett, John G; Borio, Luciana

2008-03-15

338

76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework  

Science.gov (United States)

...Administration Request for Comments on World Health Organization Pandemic...including implementation of the World Health Organization Pandemic...should be no more than 15 pages. Business-confidential information should...light of the approval of the World Health Organization...

2011-09-21

339

Laboratory-confirmed pandemic h1n1 influenza in hospitalized adults: findings from the Canadian Nosocomial Infections Surveillance Program, 2009-2010.  

Science.gov (United States)

Surveillance for pandemic H1N1 influenza was conducted between June 1, 2009, and May 31, 2010, among adults at 40 participating hospitals in the Canadian Nosocomial Infection Surveillance Program. The first wave was characterized by a higher proportion of Aboriginals and pregnant women as well as severe outcomes, compared to the second wave. PMID:22961025

Wilkinson, Krista; Mitchell, Robyn; Taylor, Geoffrey; Amihod, Barbara; Frenette, Charles; Gravel, Denise; McGeer, Allison; Suh, Kathryn N; Wong, Alice

2012-10-01

340

5'PPP-RNA induced RIG-I activation inhibits drug-resistant avian H5N1 as well as 1918 and 2009 pandemic influenza virus replication  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Emergence of drug-resistant strains of influenza viruses, including avian H5N1 with pandemic potential, 1918 and 2009 A/H1N1 pandemic viruses to currently used antiviral agents, neuraminidase inhibitors and M2 Ion channel blockers, underscores the importance of developing novel antiviral strategies. Activation of innate immune pathogen sensor Retinoic Acid Inducible Gene-I (RIG-I has recently been shown to induce antiviral state. Results In the present investigation, using real time RT-PCR, immunofluorescence, immunoblot, and plaque assay we show that 5'PPP-containing single stranded RNA (5'PPP-RNA, a ligand for the intracytoplasmic RNA sensor, RIG-I can be used as a prophylactic agent against known drug-resistant avian H5N1 and pandemic influenza viruses. 5'PPP-RNA treatment of human lung epithelial cells inhibited replication of drug-resistant avian H5N1 as well as 1918 and 2009 pandemic influenza viruses in a RIG-I and type 1 interferon dependant manner. Additionally, 5'PPP-RNA treatment also inhibited 2009 H1N1 viral replication in vivo in mice. Conclusions Our findings suggest that 5'PPP-RNA mediated activation of RIG-I can suppress replication of influenza viruses irrespective of their genetic make-up, pathogenicity, and drug-sensitivity status.

García-Sastre Adolfo

2010-05-01

 
 
 
 
341

Extreme efficiency of airway pressure release ventilation (APRV) in a patient suffering from acute lung injury with pandemic influenza A (H1N1) 2009 and high cytokines.  

Science.gov (United States)

The authors report a Japanese boy with severe pandemic influenza A(H1N1) 2009-associated pneumonia and deteriorating oxygenation. He dramatically recovered after the use of Airway Pressure Release Ventilation (APRV) mode. There was no improvement by using any conventional ventilation, however, APRV immediately led to an improvement of his clinical symptoms and laboratory findings. PMID:20978870

Kawashima, Hisashi; Go, Souken; Nara, Shonosuke; Miura, Taro; Ushio, Masataka; Miyahara, Atsushi; Kashiwagi, Yasuyo; Hoshika, Akinori; Miyata, Kazuto

2011-03-01

342

Characterization of an enhanced antigenic change in the pandemic 2009 H1N1 influenza virus haemagglutinin.  

Science.gov (United States)

Murine hybridomas producing neutralizing mAbs specific to the pandemic influenza virus A/California/07/2009 haemagglutinin (HA) were isolated. These antibodies recognized at least two different but overlapping new epitopes that were conserved in the HA of most Spanish pandemic isolates. However, one of these isolates (A/Extremadura/RR6530/2010) lacked reactivity with the mAbs and carried two unique mutations in the HA head (S88Y and K136N) that were required simultaneously to eliminate reactivity with the murine antibodies. This unusual requirement directly illustrates the phenomenon of enhanced antigenic change proposed previously for the accumulation of simultaneous amino acid substitutions at antigenic sites of the influenza A virus HA during virus evolution (Shih et al., Proc Natl Acad Sci USA, 104?, 6283-6288, 2007). The changes found in the A/Extremadura/RR6530/2010 HA were not found in escape mutants selected in vitro with one of the mAbs, which contained instead nearby single amino acid changes in the HA head. Thus, either single or double point mutations may similarly alter epitopes of the new antigenic site identified in this work in the 2009 H1N1 pandemic virus HA. Moreover, this site is relevant for the human antibody response, as shown by competition of mAbs and human post-infection sera for virus binding. The results are discussed in the context of the HA antigenic structure and challenges posed for identification of sequence changes with possible antigenic impact during virus surveillance. PMID:24531414

García-Barreno, Blanca; Delgado, Teresa; Benito, Sonia; Casas, Inmaculada; Pozo, Francisco; Cuevas, María Teresa; Mas, Vicente; Trento, Alfonsina; Rodriguez-Frandsen, Ariel; Falcón, Ana; Ortín, Juan; Nieto, Amelia; Melero, José A

2014-05-01

343

Secondary Bacterial Infections in Patients with Seasonal Influenza A and Pandemic H1N1  

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The aim of the present study is to analyse the secondary bacterial infections in a large group of patients with seasonal influenza A and influenza A(H1N1) pdm09. Patients diagnosed with seasonal influenza A and influenza A(H1N1) pdm09 between 2005 and 2009 were enrolled in the study. Data was retrieved from medical records and laboratory information systems (LIS). In total, 1094 patients with laboratory confirmed influenza were studied. There were 352 patients with seasonal influenza A and 74...

Liderot, Karin; Ahl, Marcus; O?zenci, Volkan

2013-01-01

344

Cross-Reactive T Cells Are Involved in Rapid Clearance of 2009 Pandemic H1N1 Influenza Virus in Nonhuman Primates  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In mouse models of influenza, T cells can confer broad protection against multiple viral subtypes when antibodies raised against a single subtype fail to do so. However, the role of T cells in protecting humans against influenza remains unclear. Here we employ a translational nonhuman primate model to show that cross-reactive T cell responses play an important role in early clearance of infection with 2009 pandemic H1N1 influenza virus (H1N1pdm). To “prime” cellular immunity, we first inf...

Weinfurter, Jason T.; Brunner, Kevin; Capuano, Saverio V.; Li, Chengjun; Broman, Karl W.; Kawaoka, Yoshihiro; Friedrich, Thomas C.

2011-01-01

345

Comparative study of pandemic (H1N1) 2009, swine H1N1, and avian H3N2 influenza viral infections in quails  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Quail has been proposed to be an intermediate host of influenza A viruses. However, information on the susceptibility and pathogenicity of pandemic H1N1 2009 (pH1N1) and swine influenza viruses in quails is limited. In this study, the pathogenicity, virus shedding, and transmission characteristics of pH1N1, swine H1N1 (swH1N1), and avian H3N2 (dkH3N2) influenza viruses in quails was examined. Three groups of 15 quails were inoculated with each virus and evaluated for clinical signs, virus she...

Thontiravong, Aunyaratana; Wannaratana, Suwarak; Tantilertcharoen, Rachod; Prakairungnamthip, Duangduean; Tuanudom, Ranida; Sasipreeyajan, Jiroj; Pakpinyo, Somsak; Amonsin, Alongkorn; Kitikoon, Pravina; Oraveerakul, Kanisak

2012-01-01

346

[Highly pathogenic avian influenza: a new pandemic threat and possibilities to resist it].  

Science.gov (United States)

The review presents modern data on outbreaks of avian influenza subtype H5N1 and the incidence of the infection in animals, birds, and humans. The authors adduce data on the resistance of influenza A virus to physical and chemical factors. Factors making avian influenza A virus potentially capable of causing human pandemia are considered. The review also deals with public health possibilities in the event of influenza pandemia, and measures directed towards lowering its negative social and economic consequences. PMID:17806201

Onishchenko, G G; Netesov, S V; Agafonov, A P; Safatov, A S; Buriak, G A; Generalov, V M; Sergeev, A N; Drozdov, I G

2006-01-01

347

Influenza pandemic (H1N1) 2009 activity during summer 2009: Effectiveness of the 2008-9 trivalent vaccine against pandemic influenza in Spain / Actividad de la gripe pandémica (H1N1) 2009 durante el verano de 2009: Efectividad de la vacuna trivalente 2008-9 frente a la gripe pandémica en España  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish Introducción: El Sistema de Vigilancia de Gripe en España (SVGE) continuó y reforzó su actividad durante el verano de 2009 con el objetivo de vigilar la evolución de la pandemia en España. Objetivos: Describir la actividad de la gripe pandémica en España de mayo a septiembre de 2009 y estimar la efe [...] ctividad de la vacuna antigripal estacional 2008-2009 frente a casos confirmados de gripe pandémica (H1N1) 2009. Métodos: Se utilizaron datos del SVGE para presentar la evolución de la pandemia por virus (H1N1) 2009 fuera de la temporada de vigilancia 2008-2009. Para el estudio de la efectividad vacunal se comparó el estado vacunal de los casos de gripe pandémica confirmados por laboratorio con el de los casos negativos para el virus de la gripe (controles negativos). Resultados: El primer caso confirmado de virus pandémico se notificó en la semana 20/2009. La incidencia de gripe aumentó paulatinamente durante el periodo estudiado y sobrepasó el umbral basal en la semana 38/2009. La proporción de virus (H1N1) 2009 detectada por el SVGE fue del 14% en la semana 20 y aumentó rápidamente, llegando a alcanzar el 90% en la semana 34. La efectividad ajustada de la vacuna antigripal 2008-2009 frente a casos confirmados de gripe pandémica fue del 12% (-30; 41). Conclusiones: El SVGE se adaptó y mejoró de forma rápida a las exigencias nacionales e internacionales de vigilancia de la pandemia. Esta mejora supone información más precisa y de calidad en futuras ondas epidémicas/pandémicas. Con los datos obtenidos en vigilancia no se pudo demostrar alguna efectividad de la vacuna antigripal 2008-2009 frente a los casos de gripe pandémica confirmados por laboratorio. Abstract in english Introduction: The Spanish influenza surveillance system (SISS) maintained its activity during the summer of 2009 to monitor the influenza pandemic. Objectives: To describe pandemic influenza activity from May to September 2009 and to estimate the effectiveness of the 2008-9 seasonal influenza vaccin [...] e against laboratory-confirmed pandemic (H1N1) 2009 influenza. Methods: Data from the SISS were used to identify the trend of pandemic (H1N1) 2009 influenza outside the influenza season. For the effectiveness study, we compared the vaccination status of notified cases [influenza-like illnesses (ILI) laboratory confirmed as pandemic influenza] with that of the test-negative controls. Results: The first laboratory-confirmed case of the pandemic virus was notified in the system in week 20/2009. The ILI rate increased gradually in the study period, exceeding basic activity in week 38. The proportion of pandemic (H1N1) 2009 influenza viruses detected by the system represented 14% in week 20/2009 and rapidly increased to 90% in week 34. The adjusted vaccine effectiveness of the 2008-9 seasonal vaccine against laboratory-confirmed pandemic influenza was 12% (-30; 41). Conclusions: The SISS became an essential tool for pandemic monitoring in Spain. The improved SISS will provide more accurate information on influenza activity in future seasonal or pandemic waves. Using surveillance data, we could not demonstrate the effectiveness of the seasonal 2008-9 vaccine against laboratory-confirmed pandemic influenza.

Amparo, Larrauri; Camelia, Savulescu; Silvia, Jiménez-Jorge; Pilar, Pérez-Breña; Francisco, Pozo; Inmaculada, Casas; Juan, Ledesma; Salvador de, Mateo.

348

Influenza pandemic (H1N1) 2009 activity during summer 2009: Effectiveness of the 2008-9 trivalent vaccine against pandemic influenza in Spain / Actividad de la gripe pandémica (H1N1) 2009 durante el verano de 2009: Efectividad de la vacuna trivalente 2008-9 frente a la gripe pandémica en España  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Introducción: El Sistema de Vigilancia de Gripe en España (SVGE) continuó y reforzó su actividad durante el verano de 2009 con el objetivo de vigilar la evolución de la pandemia en España. Objetivos: Describir la actividad de la gripe pandémica en España de mayo a septiembre de 2009 y estimar la efe [...] ctividad de la vacuna antigripal estacional 2008-2009 frente a casos confirmados de gripe pandémica (H1N1) 2009. Métodos: Se utilizaron datos del SVGE para presentar la evolución de la pandemia por virus (H1N1) 2009 fuera de la temporada de vigilancia 2008-2009. Para el estudio de la efectividad vacunal se comparó el estado vacunal de los casos de gripe pandémica confirmados por laboratorio con el de los casos negativos para el virus de la gripe (controles negativos). Resultados: El primer caso confirmado de virus pandémico se notificó en la semana 20/2009. La incidencia de gripe aumentó paulatinamente durante el periodo estudiado y sobrepasó el umbral basal en la semana 38/2009. La proporción de virus (H1N1) 2009 detectada por el SVGE fue del 14% en la semana 20 y aumentó rápidamente, llegando a alcanzar el 90% en la semana 34. La efectividad ajustada de la vacuna antigripal 2008-2009 frente a casos confirmados de gripe pandémica fue del 12% (-30; 41). Conclusiones: El SVGE se adaptó y mejoró de forma rápida a las exigencias nacionales e internacionales de vigilancia de la pandemia. Esta mejora supone información más precisa y de calidad en futuras ondas epidémicas/pandémicas. Con los datos obtenidos en vigilancia no se pudo demostrar alguna efectividad de la vacuna antigripal 2008-2009 frente a los casos de gripe pandémica confirmados por laboratorio. Abstract in english Introduction: The Spanish influenza surveillance system (SISS) maintained its activity during the summer of 2009 to monitor the influenza pandemic. Objectives: To describe pandemic influenza activity from May to September 2009 and to estimate the effectiveness of the 2008-9 seasonal influenza vaccin [...] e against laboratory-confirmed pandemic (H1N1) 2009 influenza. Methods: Data from the SISS were used to identify the trend of pandemic (H1N1) 2009 influenza outside the influenza season. For the effectiveness study, we compared the vaccination status of notified cases [influenza-like illnesses (ILI) laboratory confirmed as pandemic influenza] with that of the test-negative controls. Results: The first laboratory-confirmed case of the pandemic virus was notified in the system in week 20/2009. The ILI rate increased gradually in the study period, exceeding basic activity in week 38. The proportion of pandemic (H1N1) 2009 influenza viruses detected by the system represented 14% in week 20/2009 and rapidly increased to 90% in week 34. The adjusted vaccine effectiveness of the 2008-9 seasonal vaccine against laboratory-confirmed pandemic influenza was 12% (-30; 41). Conclusions: The SISS became an essential tool for pandemic monitoring in Spain. The improved SISS will provide more accurate information on influenza activity in future seasonal or pandemic waves. Using surveillance data, we could not demonstrate the effectiveness of the seasonal 2008-9 vaccine against laboratory-confirmed pandemic influenza.

Amparo, Larrauri; Camelia, Savulescu; Silvia, Jiménez-Jorge; Pilar, Pérez-Breña; Francisco, Pozo; Inmaculada, Casas; Juan, Ledesma; Salvador de, Mateo.

349

Influenza pandemic (H1N1 2009 activity during summer 2009: Effectiveness of the 2008-9 trivalent vaccine against pandemic influenza in Spain Actividad de la gripe pandémica (H1N1 2009 durante el verano de 2009: Efectividad de la vacuna trivalente 2008-9 frente a la gripe pandémica en España  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: The Spanish influenza surveillance system (SISS maintained its activity during the summer of 2009 to monitor the influenza pandemic. Objectives: To describe pandemic influenza activity from May to September 2009 and to estimate the effectiveness of the 2008-9 seasonal influenza vaccine against laboratory-confirmed pandemic (H1N1 2009 influenza. Methods: Data from the SISS were used to identify the trend of pandemic (H1N1 2009 influenza outside the influenza season. For the effectiveness study, we compared the vaccination status of notified cases [influenza-like illnesses (ILI laboratory confirmed as pandemic influenza] with that of the test-negative controls. Results: The first laboratory-confirmed case of the pandemic virus was notified in the system in week 20/2009. The ILI rate increased gradually in the study period, exceeding basic activity in week 38. The proportion of pandemic (H1N1 2009 influenza viruses detected by the system represented 14% in week 20/2009 and rapidly increased to 90% in week 34. The adjusted vaccine effectiveness of the 2008-9 seasonal vaccine against laboratory-confirmed pandemic influenza was 12% (-30; 41. Conclusions: The SISS became an essential tool for pandemic monitoring in Spain. The improved SISS will provide more accurate information on influenza activity in future seasonal or pandemic waves. Using surveillance data, we could not demonstrate the effectiveness of the seasonal 2008-9 vaccine against laboratory-confirmed pandemic influenza.Introducción: El Sistema de Vigilancia de Gripe en España (SVGE continuó y reforzó su actividad durante el verano de 2009 con el objetivo de vigilar la evolución de la pandemia en España. Objetivos: Describir la actividad de la gripe pandémica en España de mayo a septiembre de 2009 y estimar la efectividad de la vacuna antigripal estacional 2008-2009 frente a casos confirmados de gripe pandémica (H1N1 2009. Métodos: Se utilizaron datos del SVGE para presentar la evolución de la pandemia por virus (H1N1 2009 fuera de la temporada de vigilancia 2008-2009. Para el estudio de la efectividad vacunal se comparó el estado vacunal de los casos de gripe pandémica confirmados por laboratorio con el de los casos negativos para el virus de la gripe (controles negativos. Resultados: El primer caso confirmado de virus pandémico se notificó en la semana 20/2009. La incidencia de gripe aumentó paulatinamente durante el periodo estudiado y sobrepasó el umbral basal en la semana 38/2009. La proporción de virus (H1N1 2009 detectada por el SVGE fue del 14% en la semana 20 y aumentó rápidamente, llegando a alcanzar el 90% en la semana 34. La efectividad ajustada de la vacuna antigripal 2008-2009 frente a casos confirmados de gripe pandémica fue del 12% (-30; 41. Conclusiones: El SVGE se adaptó y mejoró de forma rápida a las exigencias nacionales e internacionales de vigilancia de la pandemia. Esta mejora supone información más precisa y de calidad en futuras ondas epidémicas/pandémicas. Con los datos obtenidos en vigilancia no se pudo demostrar alguna efectividad de la vacuna antigripal 2008-2009 frente a los casos de gripe pandémica confirmados por laboratorio.

Amparo Larrauri

2011-02-01

350

Aptamers that bind to the hemagglutinin of the recent pandemic influenza virus H1N1 and efficiently inhibit agglutination.  

Science.gov (United States)

Influenza virus hemagglutinin (HA) mediates both receptor (glycan) binding and membrane fusion for cell entry and has been the basis for typing influenza A viruses. In this study we have selected RNA aptamers (D-12 and D-26) that specifically target the HA protein of the recent pandemic influenza virus pdmH1N1 (A/California/07/2009). Among the selected aptamers the D-26 aptamer showed higher affinity for the HA of pdmH1N1 and was able to distinguish HA derived from other sub-types of influenza A viruses. The affinity of the D-26 aptamer was further improved upon incorporation of 2'-fluoropyrimidines to a level of 67 fM. Furthermore, the high affinity D-12 and D-26 aptamers were tested for their ability to interfere with HA-glycan interactions using a chicken red blood cell (RBC) agglutination assay. At a concentration of 200 nM the D-26 aptamer completely abolished the agglutination of RBCs, whereas D-12 only did so at 400 nM. These studies suggest that the selected aptamer D-26 not only has a higher affinity and specificity for the HA of pdmH1N1 but also has a better ability to efficiently interfere with HA-glycan interactions compared with the D-12 aptamer. The D-26 aptamer warrants further study regarding its application in developing topical virucidal products against the pdmH1N1 virus and also in surveillance of the pdmH1N1 influenza virus. PMID:23791676

Gopinath, Subash C B; Kumar, Penmetcha K R

2013-11-01

351

Long Term Immune Responses to Pandemic Influenza A/H1N1 Infection in Solid Organ Transplant Recipients  

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In solid organ transplant (SOT) recipients it is unknown if natural infection with influenza confers protection from re-infection with the same strain during the next influenza season. The purpose of this study was to determine if infection with pandemic influenza A/H1N1 (pH1N1) resulted in a long-term immunologic response. Transplant recipients with microbiologically proven pH1N1 infection in 2009/2010 underwent humoral and cell-mediated immunity (CMI) testing for pH1N1 just prior to the next influenza season. Concurrent testing for A/Brisbane/59/2007 was done to rule-out cross-reacting antibody. We enrolled 22 adult transplant patients after pH1N1 infection. Follow up testing was done at a median of 7.4 months (range 5.8–15.4) after infection. After excluding those with cross-reactive antibody, 7/19 (36.8%) patients were seroprotected. Detectable pH1N1-specific CD4+ and CD8+ interferon-? producing T-cells were found in 11/22 (50%) and 8/22 (36.4%) patients respectively. Humoral immunity had a significant correlation with a CD4 response. This is the first study in transplant patients to evaluate long-term humoral and cellular response after natural influenza infection. We show that a substantial proportion of SOT recipients with previous pH1N1 infection lack long-term humoral and cellular immune responses to pH1N1. These patients most likely are at risk for re-infection.

Baluch, Aliyah; Humar, Atul; Egli, Adrian; Gubbay, Jonathan; Lisboa, Luiz; Wilson, Leticia; Kumar, Deepali

2011-01-01

352

2009 Pandemic Influenza A (H1N1) Virus Outbreak and Response - Rwanda, October, 2009-May, 2010  

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Background In October 2009, the first case of pandemic influenza A(H1N1)pdm09 (pH1N1) was confirmed in Kigali, Rwanda and countrywide dissemination occurred within several weeks. We describe clinical and epidemiological characteristics of this epidemic. Methods From October 2009 through May 2010, we undertook epidemiologic investigations and response to pH1N1. Respiratory specimens were collected from all patients meeting the WHO case definition for pH1N1, which were tested using CDC’s real time RT-PCR protocol at the Rwandan National Reference Laboratory (NRL). Following documented viral transmission in the community, testing focused on clinically severe and high-risk group suspect cases. Results From October 9, 2009 through May 31, 2010, NRL tested 2,045 specimens. In total, 26% (n?=?532) of specimens tested influenza positive; of these 96% (n?=?510) were influenza A and 4% (n?=?22) were influenza B. Of cases testing influenza A positive, 96.8% (n?=?494), 3% (n?=?15), and 0.2% (n?=?1) were A(H1N1)pdm09, Seasonal A(H3) and Seasonal A(non-subtyped), respectively. Among laboratory-confirmed cases, 263 (53.2%) were children <15 years and 275 (52%) were female. In total, 58 (12%) cases were hospitalized with mean duration of hospitalization of 5 days (Range: 2–15 days). All cases recovered and there were no deaths. Overall, 339 (68%) confirmed cases received oseltamivir in any setting. Among all positive cases, 26.9% (143/532) were among groups known to be at high risk of influenza-associated complications, including age <5 years 23% (122/532), asthma 0.8% (4/532), cardiac disease 1.5% (8/532), pregnancy 0.6% (3/532), diabetes mellitus 0.4% (2/532), and chronic malnutrition 0.8% (4/532). Conclusions Rwanda experienced a PH1N1 outbreak which was epidemiologically similar to PH1N1 outbreaks in the region. Unlike seasonal influenza, children <15 years were the most affected by pH1N1. Lessons learned from the outbreak response included the need to strengthen integrated disease surveillance, develop laboratory contingency plans, and evaluate the influenza sentinel surveillance system.

Wane, Justin; Nyatanyi, Thierry; Nkunda, Richard; Rukelibuga, Joseph; Ahmed, Zara; Biedron, Caitlin; Kabeja, Adeline; Muhimpundu, Marie Aimee; Kabanda, Alice; Antara, Simon; Briet, Olivier; Koama, Jean Baptiste; Rusanganwa, Andre; Mukabayire, Odette; Karema, Corine; Raghunathan, Pratima; Lowrance, David

2012-01-01

353

Clinical characteristics of 2009 pandemic influenza A (H1N1 infection in children and the performance of rapid antigen test  

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Full Text Available Purpose : In autumn 2009, the swine-origin influenza A (H1N1 virus spread throughout South Korea. The aims of this study were to determine the clinical characteristics of children infected by the 2009 H1N1 influenza A virus, and to compare the rapid antigen and realtime polymerase chain reaction (PCR tests. Methods : We conducted a retrospective review of patients ?#241;8 years of age who presented to Soonchunhyang University Hospital in Seoul with respiratory symptoms, including fever, between September 2009 and January 2010. A real-time PCR test was used to definitively diagnose 2009 H1N1 influenza A infection. Medical records of confirmed cases were reviewed for sex, age, and the time of infection. The decision to perform rapid antigen testing was not influenced by clinical conditions, but by individual factors such as economic conditions. Its sensitivity and specificity were evaluated compared to real-time PCR test results. Results : In total, 934 patients tested positive for H1N1 by real-time PCR. The highest number of patients (48.9% was diagnosed in November. Most patients (48.2% were aged between 6 and 10 years. Compared with the H1N1 real-time PCR test results, the rapid antigen test showed 22% sensitivity and 83% specificity. Seventy-eight patients were hospitalized for H1N1 influenza A virus infection, and fever was the most common symptom (97.4%. Conclusion : For diagnosis of 2009 H1N1 influenza A virus infection, the rapid antigen test was inferior to the real-time PCR test in both sensitivity and specificity. This outcome suggests that the rapid antigen test is inappropriate for screening.

Yong-Jae Park

2011-10-01

354

Selection for resistance to oseltamivir in seasonal and pandemic H1N1 influenza and widespread co-circulation of the lineages  

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Full Text Available Abstract Background In Spring 2009, a novel reassortant strain of H1N1 influenza A emerged as a lineage distinct from seasonal H1N1. On June 11, the World Heath Organization declared a pandemic - the first since 1968. There are currently two main branches of H1N1 circulating in humans, a seasonal branch and a pandemic branch. The primary treatment method for pandemic and seasonal H1N1 is the antiviral drug Tamiflu® (oseltamivir. Although many seasonal H1N1 strains around the world are resistant to oseltamivir, initially, pandemic H1N1 strains have been susceptible to oseltamivir. As of February 3, 2010, there have been reports of resistance to oseltamivir in 225 cases of H1N1 pandemic influenza. The evolution of resistance to oseltamivir in pandemic H1N1 could be due to point mutations in the neuraminidase or a reassortment event between seasonal H1N1 and pandemic H1N1 viruses that provide a neuraminidase carrying an oseltamivir-resistant genotype to pandemic H1N1. Results Using phylogenetic analysis of neuraminidase sequences, we show that both seasonal and pandemic lineages of H1N1 are evolving to direct selective pressure for resistance to oseltamivir. Moreover, seasonal lineages of H1N1 that are resistant to oseltamivir co-circulate with pandemic H1N1 throughout the globe. By combining phylogenetic and geographic data we have thus far identified 53 areas of co-circulation where reassortment can occur. At our website POINTMAP, http://pointmap.osu.edu we make available a visualization and an application for updating these results as more data are released. Conclusions As oseltamivir is a keystone of preparedness and treatment for pandemic H1N1, the potential for resistance to oseltamivir is an ongoing concern. Reassortment and, more likely, point mutation have the potential to create a strain of pandemic H1N1 against which we have a reduced number of treatment options.

Treseder Travis W

2010-02-01

355

Chronic disease and hospitalisation for pandemic (H1N1) 2009 influenza in Indigenous and non-Indigenous Western Australians.  

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Indigenous and non-indigenous Western Australians with pandemic (H1N1) 2009 influenza (pH1N1) infection were compared for risk factors, influenza vaccination history, symptoms, use of antiviral medications, and hospitalisation. Data were collected systematically on 856 notified cases with laboratory confirmed pH1N1 infection during the first 10 weeks of pH1N1 virus transmission in Western Australia in 2009. Indigenous people with pH1N1 were approximately 3 times more likely to be hospitalised and were more likely to have a range of underlying medical conditions and be smokers, compared with non-Indigenous cases. Age (P < 0.001) and the presence of two or more co-morbidities (P < 0.001) were independent predictors of hospitalisation, while Indigenous status was not, indicating that higher pH1N1 hospitalisation rates in Indigenous Australians during the 2009 winter season were attributable to the higher prevalence of underlying chronic disease. These results underscore the need to ensure that influenza vaccination is delivered as widely as possible among those with chronic health conditions. PMID:22010511

Goggin, Leigh S; Carcione, Dale; Mak, Donna B; Dowse, Gary K; Giele, Carolien M; Smith, David W; Effler, Paul V

2011-06-01

356

Lack of group X secreted phospholipase A? increases survival following pandemic H1N1 influenza infection.  

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The role of Group X secreted phospholipase A2 (GX-sPLA2) during influenza infection has not been previously investigated. We examined the role of GX-sPLA2 during H1N1 pandemic influenza infection in a GX-sPLA2 gene targeted mouse (GX(-/-)) model and found that survival after infection was significantly greater in GX(-/-) mice than in GX(+/+) mice. Downstream products of GX-sPLA2 activity, PGD2, PGE2, LTB4, cysteinyl leukotrienes and Lipoxin A4 were significantly lower in GX(-/-) mice BAL fluid. Lung microarray analysis identified an earlier and more robust induction of T and B cell associated genes in GX(-/-) mice. Based on the central role of sPLA2 enzymes as key initiators of inflammatory processes, we propose that activation of GX-sPLA2 during H1N1pdm infection is an early step of pulmonary inflammation and its inhibition increases adaptive immunity and improves survival. Our findings suggest that GX-sPLA2 may be a potential therapeutic target during influenza. PMID:24725934

Kelvin, Alyson A; Degousee, Norbert; Banner, David; Stefanski, Eva; Le?n, Alberto J; Angoulvant, Denis; Paquette, Stéphane G; Huang, Stephen S H; Danesh, Ali; Robbins, Clinton S; Noyan, Hossein; Husain, Mansoor; Lambeau, Gerard; Gelb, Michael; Kelvin, David J; Rubin, Barry B

2014-04-01

357

Can We “Hedge” against the Development of Antiviral Resistance among Pandemic Influenza Viruses?  

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David K. Shay and Benjamin Ridenhour discuss a modeling study predicting that stockpiling a secondary antiviral for use early in a flu pandemic can forestall resistance to the primary stockpiled drug.

Shay, David K.; Ridenhour, Benjamin J.

2009-01-01

358

Early observational research and registries during the 2009–2010 influenza A pandemic  

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As a critical care community, we have an obligation to provide not only clinical care but also the research that guides initial and subsequent clinical responses during a pandemic. There are many challenges to conducting such research. The first is speed of response. However, given the near inevitability of certain events, for example, viral respiratory illness such as the 2009 pandemic, geographically circumscribed natural disasters, or acts of terror, many study and trial designs should be ...

2010-01-01

359

CLINICAL CHARACTERIZATION OF H1N1 INFLUENZA TAQMAN REAL TIME PCR POSITIVE CASES  

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Full Text Available Background: A novel swine origin influenza virus (H1N1 is spreading worldwide and become the first pandemic of the 21st century. The currently circulating strain of swine origin influenza virus of the H1N1 strain has undergone triple reassortment and contains genes from the avian, swine and human viruses. H1N1 critical illness mostly affects young patients and it is often fatal. Aim: The aim of the present study is to evaluate the clinical characteristic of H1N1 infection in a tertiary care institute. Material & Methods: A total of 251 pharyangeal and nasal swabs from suspected cases of swineflu were processed by TaqMan real-time PCR (CDC protocol. Clinical co-relation with presenting sign and symptoms and analysis was done. Results: 36 (14% were confirmed as positive. The clinical picture was characterized by fever (88%, cough (94%, sorethroat (35%, nasal catarrh (51%, chest pain (0.4%. Chest X-ray findings suggested association of consolidation with positive cases (47%. Discussion: Strong clinical association is seen in those who were It was also noted that 2009 H1N1 influenza illness predominantly affects young patients. Conclusion: The knowledge and technology translation previously acquired through courses by health care providers were the key in controlling the first influenza A (H1N1 2009 cases. Hospitalized cases of H1N1 influeza should be monitored carefully and vaccination is a good alternative to control such pandemic. [National J of Med Res 2012; 2(1.000: 12-14

Sangita Revdiwala

2012-02-01

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Morphological changes in lung tissue of victims associated with the 2009 A H1N1/v09 influenza pandemic in Colombia Alteraciones morfológicas en pulmón por la influenza A H1N1/v09 en autopsias, Colombia, 2009  

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Introduction. Influenza is an acute respiratory infection that may be seasonal or pandemic. In 2009 The World Health Organization (WHO) declared an influenza pandemia; 3,876 cases and 239 deaths were reported in Colombia.
Objective. The morphological changes in lung tissues associated with virus infection H1N1/v09 were described from autopsied victims.
Materials and methods. Seventy-five cases were diagnosed by RT-PCR for influenza A H1N1/v09, of which the lungs...

Jorge Rivera; Ladys Sarmiento; Edgar Parra; Gabriel Toro; Marcela Neira; Jairo Méndez; Juliana Barbosa; María Leonor Caldas

2011-01-01

 
 
 
 
361

Asthma in patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection–United States, 2009  

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Abstract Background Asthma was the most common co-morbidity among patients hospitalized with pandemic influenza A(H1N1)pdm09 [pH1N1] infection. The objective was to compare characteristics of hospitalized pH1N1 patients with and without asthma and assess factors associated with severity among asthma patients. Methods Patient data were derived from two 2009 pandemic case-series of U.S. pH1N1 hospitalizations. A case was defined as a person???2 years old hos...

McKenna John J; Bramley Anna M; Skarbinski Jacek; Fry Alicia M; Finelli Lyn; Jain Seema

2013-01-01

362

Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1)  

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Abstract Here we present a review of the literature of influenza modeling studies, and discuss how these models can provide insights into the future of the currently circulating novel strain of influenza A (H1N1), formerly known as swine flu. We discuss how the feasibility of controlling an epidemic critically depends on the value of the Basic Reproduction Number (R0). The R0 for novel influenza A (H1N1) has recently been estimated to be betwe...

Coburn Brian J; Wagner Bradley G; Blower Sally

2009-01-01

363

Effects of Vaccine Program against Pandemic Influenza A(H1N1) Virus, United States, 2009-2010  

Science.gov (United States)

In April 2009, the United States began a response to the emergence of a pandemic influenza virus strain: A(H1N1)pdm09. Vaccination began in October 2009. By using US surveillance data (April 12, 2009–April 10, 2010) and vaccine coverage estimates (October 3, 2009–April 18, 2010), we estimated that the A(H1N1)pdm09 virus vaccination program prevented 700,000–1,500,000 clinical cases, 4,000–10,000 hospitalizations, and 200–500 deaths. We found that the national health effects were greatly influenced by the timing of vaccine administration and the effectiveness of the vaccine. We estimated that recommendations for priority vaccination of targeted priority groups were not inferior to other vaccination prioritization strategies. These results emphasize the need for relevant surveillance data to facilitate a rapid evaluation of vaccine recommendations and effects.

Borse, Rebekah H.; Shrestha, Sundar S.; Fiore, Anthony E.; Atkins, Charisma Y.; Singleton, James A.; Furlow, Carolyn

2013-01-01

364

Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010.  

Science.gov (United States)

In 2011, the Irish Medicines Board received reports of onset of narcolepsy following vaccination against influenza A(H1N1)pdm09 with Pandemrix. A national steering committee was convened to examine the association between narcolepsy and pandemic vaccination. We conducted a retrospective population-based cohort study. Narcolepsy cases with onset from 1 April 2009 to 31 December 2010 were identified through active case finding. Narcolepsy history was gathered from medical records. Pandemic vaccination status was obtained from vaccination databases. Two independent experts classified cases using the Brighton case definition. Date of onset was defined as date of first healthcare contact for narcolepsy symptoms. Incidence of narcolepsy in vaccinated and non-vaccinated individuals was compared. Of 32 narcolepsy cases identified, 28 occurred in children/adolescents and for 24 first healthcare contact was between April 2009 and December 2010. Narcolepsy incidence was 5.7 (95% confidence interval (CI): 3.4–8.9) per 100,000 children/adolescents vaccinated with Pandemrix and 0.4 (95% CI: 0.1–1.0) per 100,000 unvaccinated children/adolescents (relative risk: 13.9; absolute attributable risk: 5.3 cases per 100,000 vaccinated children/adolescents). This study confirms the crude association between Pandemrix vaccination and narcolepsy as observed in Finland and Sweden. The vaccine is no longer in use in Ireland. Further studies are needed to explore the immunogenetic mechanism of narcolepsy. PMID:24821121

O'Flanagan, D; Barret, A S; Foley, M; Cotter, S; Bonner, C; Crowe, C; Lynch, B; Sweeney, B; Johnson, H; McCoy, B; Purcell, E

2014-01-01

365

Novel host markers in the 2009 pandemic H1N1 influenza a virus  

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Full Text Available The winter of 2009 witnessed the concurrent spread of 2009 pandemic H1N1 with 2009 seasonal H1N1. It is clinically important to develop knowledge of the key features of these two different viruses that make them unique. A robust pattern recognition technique, Random Forests, was employed to uncover essential amino acid markers to differentiate the two viruses. Some of these markers were also part of the previously discovered genomic signature that separate avian or swine from human viruses. Much research to date in search of host markers in 2009 pandemic H1N1 has been primarily limited in the context of traditional markers of avian-human or swine-human host shifts. However, many of the molecular markers for adaptation to human hosts or to the emergence of a pandemic virus do not exist in 2009 pandemic H1N1, implying that other previously unrecognized molecular determinants are accountable for its capability to infect humans. The current study aimed to explore novel host markers in the proteins of 2009 pandemic H1N1 that were not present in those classical markers, thus providing fresh and unique insight into the adaptive genetic modifications that could lead to the generation of this new virus. Random Forests were used to find 18 such markers in HA, 15 in NA, 9 in PB2, 11 in PB1, 13 in PA, 10 in NS1, 1 in NS2, 11 in NP, 3 in M1, and 1 in M2. The amino acids at many of these novel sites in 2009 pandemic H1N1 were distinct from those in avian, human, and swine viruses that were identical at these positions, reflecting the uniqueness of these novel sites.

Wei Hu

2010-06-01

366

Pandemic influenza 2009 on Réunion Island: A mild wave linked to a low reproduction number  

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We studied the epidemic trend following the introduction of the pandemic A(H1N1) 2009 in the subtropical Réunion Island. There, the pandemic wave started from week 30 and lasted until week 38, with an estimated attack rate of 12.85 % for symptomatic infections. The best estimate for the initial reproduction number was Ri = 1.26 [1.08; 1.49]. It results that the herd immunity necessary to stop the epidemic growth is of the same magnitude than the attack rate. Thus, a second wave before the 20...

Renault, Philippe; D Ortenzio, Eric; Kermarec, Florence; Filleul, Laurent

2010-01-01

367

The month of July: an early experience with pandemic influenza A (H1N1 in adults with cystic fibrosis  

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Full Text Available Abstract Background Pandemic Influenza A (H1N1 2009 is a novel viral infection that emerged in March 2009. This is the first report addressing the clinical course of patients with cystic fibrosis (CF and H1N1 infection. Methods All patients with an influenza-like illness (ILI attending our adult centre during July 2009 were identified. Baseline respiratory function, nutritional status, approach to management and short-term clinical course were recorded. Results Most patients experienced a mild course and were able to be managed with antiviral agents as an outpatient. Robust infection control policies were implemented to limit transmission of H1N1 infection within our CF centre. Patients with severe lung disease, poor baseline nutritional reserve and presenting with more than 48 hours of ILI experienced a more severe course. Prompt antiviral therapy within the first 48 hours of illness may have been important in improving outcomes. Conclusions This observational study demonstrates that most adults with CF with H1N1 infection had mild clinical courses and recovered rapidly.

McMahon Tracy L

2010-02-01

368

An investigation into human pandemic influenza virus (H1N1) 2009 on an Alberta swine farm.  

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On May 2, 2009 the Canadian Food Inspection Agency notified the World Organization for Animal Health that an emerging novel influenza A virus (pandemic H1N1 2009) had been confirmed on a swine farm in Alberta. Over a 4-week period pigs in this farrow-to-finish operation were clinically affected by respiratory disease consistent with an influenza A virus infection and the presence of active viral infection was confirmed in all production areas by real-time polymerase chain reaction (RT-PCR). Despite clinical recovery of animals, there was reluctance by purchasers to receive animals from this operation due to concerns about the effect on both domestic and international markets. The owner decided to depopulate the entire herd due to impending welfare issues associated with overcrowding and economic concerns resulting from the inability to market these animals. Carcasses were rendered or composted and did not enter the human food or animal feed chain. The source of virus in this herd was determined to be an infected human. Zoonotic transmission to 2 individuals responding to the outbreak was suspected and recommendations to prevent occupational exposure are discussed. PMID:20119537

Howden, Krista J; Brockhoff, Egan J; Caya, Francois D; McLeod, Laura J; Lavoie, Martin; Ing, Joan D; Bystrom, Janet M; Alexandersen, Soren; Pasick, John M; Berhane, Yohannes; Morrison, Margaret E; Keenliside, Julia M; Laurendeau, Sonja; Rohonczy, Elizabeth B

2009-11-01

369

Chile entre pandemias: la influenza de 1918, globalización y la nueva medicina Chile between pandemic: the influenza of 1918, globalization and the new medicine  

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Full Text Available En 1918 Chile conoció la mortífera presencia de la influenza española, la pandemia más importante del siglo XX. Para muchos historiadores, ese evento es un importante hito en el proceso histórico de la unificación del mundo a través de las enfermedades y en el cual nuestro país ha sido partícipe. En ese contexto, el presente artículo pretende examinar la forma en que la gripe irrumpió en la sociedad chilena y cómo esa coyuntura contribuyó a dar un nuevo impulso a la modernización de la salud pública chilena y a la instauración en la década de 1920 al modelo de la nueva medicina o medicina preventiva.In 1918 Chile met the deadly presence of the Spanish influenza pandemic twentieth century's most important. For many historians, this event is an important milestone in the historical process of the unification of the world through sickness and in which our country has been involved. In this context, this paper aims to examine how the flu broke into Chilean society and how that situation helped give new impetus to the modernization of the Chilean public health and the establishment in the 1920s to model new medicine or preventive medicine.

Marcelo López

2013-04-01

370

Factors associated with humoral immune response to pandemic A/H1N1(v) 2009 influenza vaccine in cystic fibrosis.  

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Influenza vaccination is recommended in cystic fibrosis patients. The objective of this study was to assess the immunogenicity of vaccination against 2009 pandemic A/H1N1 influenza and to study the factors associated with the immune response in patients with cystic fibrosis. 122 patients with cystic fibrosis were enrolled in a prospective study and received 1 dose of 2009/H1N1v adjuvanted vaccine, or for children <2 years and lung-transplanted patients, two doses of non-adjuvanted 2009/H1N1v vaccine administered 21 days apart. Hemagglutination inhibition antibodies were assessed before and 21 days after vaccination and at least 6 months after vaccination. After vaccination, 85% of the patients had an influenza antibody titer ?1:40 and 69% seroconverted. 13% of the transplanted patients seroconverted compared with 72% of the non-transplanted patients. In this latter group, non-adjuvanted vaccine and low body mass index were independently associated with lower response to vaccination. 86% of the non-transplanted patients with normal BMI and receiving adjuvanted vaccine seroconverted. Persistence of seroprotection 10 months after vaccination was found in 50% of the patients. In patients with cystic fibrosis, malnutrition and receipt of non-adjuvanted vaccine were associated with lower immune response to pandemic influenza vaccination. Our data also suggest a potential defect in the immune response to influenza vaccination of patients with cystic fibrosis and raise the question of whether a different immunization strategy is needed. PMID:24950362

Launay, O; Boelle, P Y; Krivine, A; Grenet, D; Boussaud, V; Rémus, N; Corvol, H; Chedevergne, F; Hubert, D; Sermet-Gaudelus, I

2014-07-31

371

New mutational trends in the HA protein of 2009 H1N1 pandemic influenza virus from May 2010 to February 2011  

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As we enter the year of 2011, the 2009 H1N1 pandemic influenza virus is in the news again. At least 20 people have died of this virus in China since the beginning of 2011 and it is now the predominant flu strain in the country. Although this novel virus was quite stable during its run in the flu season of 2009-2010, a genetic variant of this virus was found in Singapore in early 2010, and then in Australia and New Zealand during their 2010 winter influenza season. Several critical mutations i...

Wei Hu