WorldWideScience

Sample records for pandemic swine-origin influenza

  1. Pandemic Swine-Origin H1N1 Influenza A Virus Isolates Show Heterogeneous Virulence in Macaques ? ‡

    OpenAIRE

    Safronetz, David; Rockx, Barry; Feldmann, Friederike; Belisle, Sarah E.; Palermo, Robert E.; Brining, Douglas; Gardner, Don; Proll, Sean C.; Marzi, Andrea; Tsuda, Yoshimi; Lacasse, Rachel A.; Kercher, Lisa; York, Anthony; Korth, Marcus J.; Long, Dan

    2010-01-01

    The first influenza pandemic of the new millennium was caused by a newly emerged swine-origin influenza virus (SOIV) (H1N1). This new virus is characterized by a previously unknown constellation of gene segments derived from North American and Eurasian swine lineages and the absence of common markers predictive of human adaptation. Overall, human infections appeared to be mild, but an alarming number of young individuals presented with symptoms atypical for seasonal influenza. The new SOIV al...

  2. Variant (Swine Origin) Influenza Viruses in Humans

    Science.gov (United States)

    ... Submit What's this? Submit Button Past Newsletters Variant (Swine Origin) Influenza Viruses in Humans Language: English Español Recommend ... States since 2005 Background On Variant Influenza Viruses Swine flu viruses do not normally infect humans. However, sporadic ...

  3. Influenza pandemics: a historical retrospect

    OpenAIRE

    Tognotti, Eugenia

    2009-01-01

    The recent global outbreak of human cases of swine origin influenza A (H1N1) has spread fear that this virus will be of pandemic proportions causing high morbidity and mortality. While it is too early to determine the pandemic nature of swine origin influenza A (H1N1), it may be useful to look at the history of influenza pandemics described since recorded history.

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

    OpenAIRE

    Wu Wei; Cui Dawei; Ye Bo; Yang Shigui; Kong Haishen; Li Xuefen; Chen Yu; Guo Xichao; Li Lanjuan

    2011-01-01

    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 ...

  5. Insights into the increasing virulence of the swine-origin pandemic H1N1/2009 influenza virus

    OpenAIRE

    Zou, Wei; Chen, Dijun; Xiong, Min; Zhu, Jiping; Lin, Xian; Wang, Lun; Zhang, Jun; Chen, Lingling; Zhang, Hongyu; Chen, Huanchun; Chen, Ming; Jin, Meilin

    2013-01-01

    Pandemic H1N1/2009 viruses have been stabilized in swine herds, and some strains display higher pathogenicity than the human-origin isolates. In this study, high-throughput RNA sequencing (RNA-seq) is applied to explore the systemic transcriptome responses of the mouse lungs infected by swine (Jia6/10) and human (LN/09) H1N1/2009 viruses. The transcriptome data show that Jia6/10 activates stronger virus-sensing signals, such as the toll-like receptor, RIG-I like receptor and NOD-like receptor...

  6. Development of Two Types of Rapid Diagnostic Test Kits To Detect the Hemagglutinin or Nucleoprotein of the Swine-Origin Pandemic Influenza A Virus H1N1?

    OpenAIRE

    Mizuike, Rika; Sasaki, Tadahiro; Baba, Koichi; Iwamoto, Hisahiko; Shibai, Yusuke; Kosaka, Mieko; Kubota-koketsu, Ritsuko; Yang, Cheng-song; Du, Anariwa; Sakudo, Akikazu; Tsujikawa, Muneo; Yunoki, Mikihiro; Ikuta, Kazuyoshi

    2011-01-01

    Since its emergence in April 2009, pandemic influenza A virus H1N1 (H1N1 pdm), a new type of influenza A virus with a triple-reassortant genome, has spread throughout the world. Initial attempts to diagnose the infection in patients using immunochromatography (IC) relied on test kits developed for seasonal influenza A and B viruses, many of which proved significantly less sensitive to H1N1 pdm. Here, we prepared monoclonal antibodies that react with H1N1 pdm but not seasonal influenza A (H1N1...

  7. Constrictive Pericarditis Accompanied by Swine-Origin Influenza A (H1N1) Infection

    OpenAIRE

    Jang, Ji-yong; Chang, Hyuk-jae; Jang, Yangsoo; Han, Sang-hoon; Bang, Woo-dae; Cho, Sung Soo; Oh, Chang-myung; Yu, Hee Tae; Shim, Chi Young; Ha, Jong Won; Chung, Namsik

    2010-01-01

    Swine-origin influenza A (H1N1) is caused by a new strain of the influenza virus. The disease has spread rapidly and was declared a pandemic in April, 2009. So far, however, there is a scarcity of information regarding the complications of swine influenza. A report of the disease in the winter of 2009 in the Southern Hemisphere found that the most common manifestations of influenza A virus infection are upper respiratory tract infection and pneumonia. Although there may be an association betw...

  8. Pandemic Influenza in Two Newborns

    Directory of Open Access Journals (Sweden)

    Medine Ay?in Ta?ar

    2010-09-01

    Full Text Available The new influenza A (H1N1 virus of swine origin was first described from Mexico in April 2009. Subsequently spreading all over the world, it was considered to be the first pandemic of the 21st century. According to data from the World Health Organization (WHO, the highest disease rates in American and European regions were reported among children and young adults. Despite the highly contagious nature of pandemic influenza, most cases displayed a mild course. WHO declared the risk factors for severe disease in children as ongoing chronic disease, intake of aspirin and age below two-years.The youngest patient reported in the literature is 21 days old. We would like to present two neonatal cases with verified pandemic influenza, who recovered without any complications.

  9. Pandemic Influenza Planning, United States, 1978–2008

    OpenAIRE

    Iskander, John; Strikas, Raymond A.; Gensheimer, Kathleen F.; Cox, Nancy J.; Redd, Stephen C.

    2013-01-01

    During the past century, 4 influenza pandemics occurred. After the emergence of a novel influenza virus of swine origin in 1976, national, state, and local US public health authorities began planning efforts to respond to future pandemics. Several events have since stimulated progress in public health emergency planning: the 1997 avian influenza A(H5N1) outbreak in Hong Kong, China; the 2001 anthrax attacks in the United States; the 2003 outbreak of severe acute respiratory syndrome; and the ...

  10. Optimal Pandemic Influenza Vaccine Allocation Strategies for the Canadian Population

    OpenAIRE

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

    2010-01-01

    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...

  11. From where did the 2009 'swine-origin' influenza A virus (H1N1 emerge?

    Directory of Open Access Journals (Sweden)

    Armstrong John S

    2009-11-01

    Full Text Available Abstract The swine-origin influenza A (H1N1 virus that appeared in 2009 and was first found in human beings in Mexico, is a reassortant with at least three parents. Six of the genes are closest in sequence to those of H1N2 'triple-reassortant' influenza viruses isolated from pigs in North America around 1999-2000. Its other two genes are from different Eurasian 'avian-like' viruses of pigs; the NA gene is closest to H1N1 viruses isolated in Europe in 1991-1993, and the MP gene is closest to H3N2 viruses isolated in Asia in 1999-2000. The sequences of these genes do not directly reveal the immediate source of the virus as the closest were from isolates collected more than a decade before the human pandemic started. The three parents of the virus may have been assembled in one place by natural means, such as by migrating birds, however the consistent link with pig viruses suggests that human activity was involved. We discuss a published suggestion that unsampled pig herds, the intercontinental live pig trade, together with porous quarantine barriers, generated the reassortant. We contrast that suggestion with the possibility that laboratory errors involving the sharing of virus isolates and cultured cells, or perhaps vaccine production, may have been involved. Gene sequences from isolates that bridge the time and phylogenetic gap between the new virus and its parents will distinguish between these possibilities, and we suggest where they should be sought. It is important that the source of the new virus be found if we wish to avoid future pandemics rather than just trying to minimize the consequences after they have emerged. Influenza virus is a very significant zoonotic pathogen. Public confidence in influenza research, and the agribusinesses that are based on influenza's many hosts, has been eroded by several recent events involving the virus. Measures that might restore confidence include establishing a unified international administrative framework coordinating surveillance, research and commercial work with this virus, and maintaining a registry of all influenza isolates.

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

    Science.gov (United States)

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

    2011-03-01

    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.

  13. From where did the 2009 'swine-origin' influenza A virus (H1N1) emerge?

    OpenAIRE

    Armstrong John S; Gibbs Adrian J; Downie Jean C

    2009-01-01

    Abstract The swine-origin influenza A (H1N1) virus that appeared in 2009 and was first found in human beings in Mexico, is a reassortant with at least three parents. Six of the genes are closest in sequence to those of H1N2 'triple-reassortant' influenza viruses isolated from pigs in North America around 1999-2000. Its other two genes are from different Eurasian 'avian-like' viruses of pigs; the NA gene is closest to H1N1 viruses isolated in Europe in 1991-1993, and the MP gene is closest to ...

  14. In vitro and in vivo characterization of new swine-origin H1N1 influenza viruses

    Science.gov (United States)

    Itoh, Yasushi; Shinya, Kyoko; Kiso, Maki; Watanabe, Tokiko; Sakoda, Yoshihiro; Hatta, Masato; Muramoto, Yukiko; Tamura, Daisuke; Sakai-Tagawa, Yuko; Noda, Takeshi; Sakabe, Saori; Imai, Masaki; Hatta, Yasuko; Watanabe, Shinji; Li, Chengjun; Yamada, Shinya; Fujii, Ken; Murakami, Shin; Imai, Hirotaka; Kakugawa, Satoshi; Ito, Mutsumi; Takano, Ryo; Iwatsuki-Horimoto, Kiyoko; Shimojima, Masayuki; Horimoto, Taisuke; Goto, Hideo; Takahashi, Kei; Makino, Akiko; Ishigaki, Hirohito; Nakayama, Misako; Okamatsu, Masatoshi; Takahashi, Kazuo; Warshauer, David; Shult, Peter A.; Saito, Reiko; Suzuki, Hiroshi; Furuta, Yousuke; Yamashita, Makoto; Mitamura, Keiko; Nakano, Kunio; Nakamura, Morio; Brockman-Schneider, Rebecca; Mitamura, Hiroshi; Yamazaki, Masahiko; Sugaya, Norio; Suresh, M.; Ozawa, Makoto; Neumann, Gabriele; Gern, James; Kida, Hiroshi; Ogasawara, Kazumasa; Kawaoka, Yoshihiro

    2009-01-01

    Influenza A viruses cause recurrent outbreaks of local or global scale with potentially severe consequences for human health and the global economy. Recently, a new strain of influenza A virus was detected that causes disease in and transmits among humans, probably owing to little or no pre-existing immunity to the new strain. On June 11, 2009, the WHO declared that the infections caused by the new strain had reached pandemic proportion. Characterized as an influenza A virus of the H1N1 subtype, the genomic segments of the new strain were most closely related to swine viruses1. Most human infections with swine-origin H1N1 influenza viruses (S-OIVs) appear to be mild; however, more than 50% of hospitalized individuals do not have underlying health issues, attesting to the pathogenic potential of S-OIVs. To better assess the risk posed by the new virus, we characterized one of the first US S-OIV isolates, A/California/04/09 (H1N1; CA04), as well as several other S-OIV isolates, in vitro and in vivo. In mice and ferrets, CA04 and other S-OIV isolates tested replicate more efficiently than a currently circulating human H1N1 virus. In addition, CA04 replicates efficiently in nonhuman primates, causes more severe pathologic lesions in the lungs of infected mice, ferrets, and nonhuman primates than a currently circulating human H1N1 virus, and transmits among ferrets. In specific-pathogen free miniature pigs, CA04 replicates without clinical symptoms. The assessment of human sera from different age groups suggests that infection with human H1N1 viruses antigenically closely related to viruses circulating in 1918 confers neutralizing antibody activity to CA04. Finally, we show that CA04 is sensitive to approved and experimental antiviral drugs, suggesting these compounds as a first line of defence against the recently declared S-OIV pandemic. PMID:19672242

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

    OpenAIRE

    Swati Kumar; Chusid, Michael J.; Willoughby, Rodney E.; Havens, Peter L.; Kehl, Sue C.; Ledeboer, Nathan A.; Shun-Hwa Li; Henrickson, Kelly J.

    2009-01-01

    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...

  16. Improving pandemic influenza risk assessment

    OpenAIRE

    Russell, Colin A.; Kasson, Peter M.; Donis, Ruben O.; Riley, Steven; Dunbar, John; Rambaut, Andrew; Asher, Jason; Burke, Stephen; Davis, C. Todd; Garten, Rebecca J.; Gnanakaran, Sandrasegaram; Hay, Simon I.; Herfst, Sander; Lewis, Nicola S.; Lloyd-smith, James O.

    2014-01-01

    Assessing the pandemic risk posed by specific non-human influenza A viruses is an important goal in public health research. As influenza virus genome sequencing becomes cheaper, faster, and more readily available, the ability to predict pandemic potential from sequence data could transform pandemic influenza risk assessment capabilities. However, the complexities of the relationships between virus genotype and phenotype make such predictions extremely difficult. The integration of experimenta...

  17. Influenza pandemics and avian flu

    OpenAIRE

    2005-01-01

    Douglas Fleming is general practitioner in a large suburban practice in Birmingham. In this article he seeks to clarify clinical issues relating to potential pandemics of influenza, including avian influenza

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

    OpenAIRE

    Shukla Jyoti; Parida Manmohan; Sharma Shashi; Pvl, Rao

    2011-01-01

    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 di...

  19. Human vs. Animal Outbreaks of the 2009 swine-origin H1N1 influenza A epidemic

    OpenAIRE

    Scotch, Matthew; Brownstein, John S.; Vegso, Sally; Galusha, Deron; Rabinowitz, Peter

    2011-01-01

    The majority of emerging infectious diseases are zoonotic in origin, including recently emerging influenza viruses such as the 2009 swine-origin H1N1 influenza A epidemic. The epidemic that year affected both human and animal populations as it spread globally. In fact, before the end of 2009, 14 different countries reported H1N1 infected swine. In order to better understand the zoonotic nature of the epidemic and the relationship between human and animal disease surveillance data streams, we ...

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

    OpenAIRE

    Washizuka Shinsuke; Kaneko Minoru; Tsukahara Teruomi; Uchida Mitsuo; Kawa Shigeyuki

    2011-01-01

    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 swi...

  1. Pandemic Influenza and Mathematical Modelling

    OpenAIRE

    Lande, Asgeir

    2007-01-01

    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...

  2. Impact of information on intentions to vaccinate in a potential epidemic: swine-origin Influenza A (H1N1)

    OpenAIRE

    Chanel, Olivier; Luchini, Stephane; Massoni, Se?bastien; Vergnaud, Jean-christophe

    2010-01-01

    Vaccination campaigns to prevent the spread of epidemics are successful only if the targeted populations subscribe to the recommendations of health authorities. However, because compulsory vaccination is hardly conceivable in modern democracies, governments need to convince their populations through efficient and persuasive information campaigns. In the context of the swine-origin A (H1N1) 2009 pandemic, we use an interactive study among the general public in the South of France, with 175 par...

  3. CT manifestations of patients with swine-origin influenza A H1N1

    International Nuclear Information System (INIS)

    Objective: To explore the manifestations of chest multi-slice spiral CT in patients with initial infection of swine-origin influenza A (H1N1) virus (S-OIV). Methods: The chest multi-slices spirals CT images of 19 firstly diagnosed patients with swine-origin influenza A (H1N1) in our institution were retrospectively studied. CT manifestations were evaluated by three experienced radiologists. Location, appearance of lung abnormalities, abnormal distribution, pleural effusion and others (pericadiaum, lymphadenopathy and pleural thickening) were observed and quantitatively analyzed. The correlation of ground-glass and consolidation CT scores with the fever time was studied. Results: The abnormal CT findings were observed bilaterally in 18 of 19 subjects including ground-glass (n=3), consolidation (n=3), consolidation accompanied with ground-glass (n=12). Most of these lesions were distributed diffusively (n=14) while the others located in the middle and low lobes (n=4). Unilateral (n=3) or bilateral (n=2) pleural effusion were observed. Lymphadenopathy (n=2), effusion of pericadium (n=1), pleural thickening (n=1) and cardiac enlargement (n=2) were also found in patients with H1N1. CT scores of ground-glass were 4.25 (n=2), 3.75 (n=1), 2.25 (n=1), 1.75 (n=1), 1.00 (n=6), 0.75 (n=2), 0.50 (n=2), 0 (n=4). CT scores of consolidation were 4.25 (n=1), 4.00 (n=1), 3.75 (n=1), 2.75 (n=1), 1.25 (n=3), 1.00 (n=2), 0.75 (n=2), 0.50 (n=1), 0.25 (n=3), 0 (n=4). CT scores of ground-gla25 (n=3), 0 (n=4). CT scores of ground-glass were significantly correlated with the fever time (r=0.776, P0.01). Conclusions: The most common CT findings in patients with S-OIV infection are diffuse distribution of bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. The increasing of ground-glass's range could be the marker of progression of H1N1 pulmonary infection at initial stage. (authors)

  4. The evolutionary emergence of pandemic influenza

    OpenAIRE

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

    2006-01-01

    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...

  5. Pandemic H1N1 2009 Influenza A Virus Induces Weak Cytokine Responses in Human Macrophages and Dendritic Cells and Is Highly Sensitive to the Antiviral Actions of Interferons ?

    OpenAIRE

    O?sterlund, Pamela; Pirhonen, Jaana; Ikonen, Niina; Ro?nkko?, Esa; Strengell, Mari; Ma?kela?, Sanna M.; Broman, Mia; Hamming, Ole J.; Hartmann, Rune; Ziegler, Thedi; Julkunen, Ilkka

    2009-01-01

    In less than 3 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 ...

  6. Detection of swine-origin influenza A (H1N1) viruses using a paired surface plasma waves biosensor

    Science.gov (United States)

    Su, Li-Chen; Chang, Ying-Feng; Li, Ying-Chang; Hsieh, Jo-Ping; Lee, Cheng-Chung; Chou, Chien

    2010-08-01

    In order to enhance the sensitivity of conventional rapid test technique for the detection of swine-origin influenza A (H1N1) viruses (S-OIVs), we used a paired surface plasma waves biosensor (PSPWB) based on SPR in conjunction with an optical heterodyne technique. Experimentally, PSPWB showed a 125-fold improvement at least in the S-OIV detection as compared to conventional enzyme linked immunosorbent assay. Moreover, the detection limit of the PSPWB for the S-OIV detection was enhanced 250-fold in buffer at least in comparison with that of conventional rapid influenza diagnostic test.

  7. Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population

    OpenAIRE

    Greenbaum, Jason A.; Kotturi, Maya F.; Kim, Yohan; Oseroff, Carla; Vaughan, Kerrie; Salimi, Nima; Vita, Randi; Ponomarenko, Julia; Scheuermann, Richard H.; Sette, Alessandro; Peters, Bjoern

    2009-01-01

    A major concern about the ongoing swine-origin H1N1 influenza virus (S-OIV) outbreak is that the virus may be so different from seasonal H1N1 that little immune protection exists in the human population. In this study, we examined the molecular basis for pre-existing immunity against S-OIV, namely the recognition of viral immune epitopes by T cells or B cells/antibodies that have been previously primed by circulating influenza strains. Using data from the Immune Epitope Database, we found tha...

  8. Seasonal Influenza: Waiting for the Next Pandemic

    OpenAIRE

    Clem, Angela; Galwankar, Sagar

    2009-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Shukla Jyoti

    2011-06-01

    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.

  10. Impact of information on intentions to vaccinate in a potential epidemic: Swine-origin Influenza A (H1N1).

    Science.gov (United States)

    Chanel, Olivier; Luchini, Stéphane; Massoni, Sébastien; Vergnaud, Jean-Christophe

    2011-01-01

    Vaccination campaigns to prevent the spread of epidemics are successful only if the targeted populations subscribe to the recommendations of health authorities. However, because compulsory vaccination is hardly conceivable in modern democracies, governments need to convince their populations through efficient and persuasive information campaigns. In the context of the swine-origin A (H1N1) 2009 pandemic, we use an interactive study among the general public in the South of France, with 175 participants, to explore what type of information can induce change in vaccination intentions at both aggregate and individual levels. We find that individual attitudes to vaccination are based on rational appraisal of the situation, and that it is information of a purely scientific nature that has the only significant positive effect on intention to vaccinate. PMID:21163566

  11. Dating the emergence of pandemic influenza viruses

    OpenAIRE

    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

    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 ...

  12. The 2009 Pandemic Influenza A (H1N1) Infection: Renal Histopathology Findings in Two Infected Patients

    OpenAIRE

    Fernandes, V.; Ferreira, Ac; Viana, H.; Carvalho, F.; Vila Lobos, A.; Nolasco, F.

    2011-01-01

    Background: Acute kidney injury in the pandemic swine origin influenza A virus (H1N1) infection has been reported as coursing with severe illness, although renal pathogenic mechanisms and histologic features are still being characterised. Case Report: We present two patients admitted with H1N1 pneumonia, sepsis, acute respiratory distress syndrome and need for invasive mechanical ventilation who developed acute kidney injury and became dialysis-dependent. In both cases a kidney bi...

  13. Pandemic Influenza Pediatric Office Plan Template

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    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.

  14. Economic and policy implications of pandemic influenza.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Braeton J.; Starks, Shirley J.; Loose, Verne W.; Brown, Theresa Jean; Warren, Drake E.; Vargas, Vanessa N.

    2010-03-01

    Pandemic influenza has become a serious global health concern; in response, governments around the world have allocated increasing funds to containment of public health threats from this disease. Pandemic influenza is also recognized to have serious economic implications, causing illness and absence that reduces worker productivity and economic output and, through mortality, robs nations of their most valuable assets - human resources. This paper reports two studies that investigate both the short- and long-term economic implications of a pandemic flu outbreak. Policy makers can use the growing number of economic impact estimates to decide how much to spend to combat the pandemic influenza outbreaks. Experts recognize that pandemic influenza has serious global economic implications. The illness causes absenteeism, reduced worker productivity, and therefore reduced economic output. This, combined with the associated mortality rate, robs nations of valuable human resources. Policy makers can use economic impact estimates to decide how much to spend to combat the pandemic influenza outbreaks. In this paper economists examine two studies which investigate both the short- and long-term economic implications of a pandemic influenza outbreak. Resulting policy implications are also discussed. The research uses the Regional Economic Modeling, Inc. (REMI) Policy Insight + Model. This model provides a dynamic, regional, North America Industrial Classification System (NAICS) industry-structured framework for forecasting. It is supported by a population dynamics model that is well-adapted to investigating macro-economic implications of pandemic influenza, including possible demand side effects. The studies reported in this paper exercise all of these capabilities.

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

    Directory of Open Access Journals (Sweden)

    Swati Kumar

    2009-06-01

    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.

  16. Infecção pelo vírus Influenza A (H1N1 de origem suína: como reconhecer, diagnosticar e prevenir How to prevent, recognize and diagnose infection with the swine-origin Influenza A (H1N1 virus in humans

    Directory of Open Access Journals (Sweden)

    Alcyone Artioli Machado

    2009-05-01

    Full Text Available Em março de 2009, houve o início de uma epidemia de gripe no México que, em pouco tempo, levou ao surgimento de casos semelhantes em outros países, alertando as autoridades sanitárias para o risco de uma pandemia. Neste artigo, descrevemos os principais sinais e sintomas da infecção pelo vírus Influenza A (H1N1 de origem suína, as medidas a serem tomadas para os casos suspeitos ou confirmados e como proceder em relação aos contactantes. Comentamos também quais drogas são utilizadas para o tratamento e profilaxia.In March of 2009, a flu epidemic began in Mexico. Shortly thereafter, similar cases appeared in other countries, alerting authorities to the risk of a pandemic. This article details the principal signs and symptoms of infection with the swine-origin Influenza A (H1N1 virus. In addition, the measures to be taken in suspected or confirmed cases are addressed, as are the procedures to follow in relation to contacts. Furthermore, the drugs used in the prophylaxis against and the treatment of infection with the H1N1 virus are described.

  17. Single-Reaction Genomic Amplification Accelerates Sequencing and Vaccine Production for Classical and Swine Origin Human Influenza A Viruses ?

    OpenAIRE

    Zhou, Bin; Donnelly, Matthew E.; Scholes, Derek T.; St George, Kirsten; Hatta, Masato; Kawaoka, Yoshihiro; Wentworth, David E.

    2009-01-01

    Pandemic influenza A viruses that emerge from animal reservoirs are inevitable. Therefore, rapid genomic analysis and creation of vaccines are vital. We developed a multisegment reverse transcription-PCR (M-RTPCR) approach that simultaneously amplifies eight genomic RNA segments, irrespective of virus subtype. M-RTPCR amplicons can be used for high-throughput sequencing and/or cloned into modified reverse-genetics plasmids via regions of sequence identity. We used these procedures to rescue a...

  18. Absolute humidity and pandemic versus epidemic influenza.

    Science.gov (United States)

    Shaman, Jeffrey; Goldstein, Edward; Lipsitch, Marc

    2011-01-15

    Experimental and epidemiologic evidence indicates that variations of absolute humidity account for the onset and seasonal cycle of epidemic influenza in temperate regions. A role for absolute humidity in the transmission of pandemic influenza, such as 2009 A/H1N1, has yet to be demonstrated and, indeed, outbreaks of pandemic influenza during more humid spring, summer, and autumn months might appear to constitute evidence against an effect of humidity. However, here the authors show that variations of the basic and effective reproductive numbers for influenza, caused by seasonal changes in absolute humidity, are consistent with the general timing of pandemic influenza outbreaks observed for 2009 A/H1N1 in temperate regions, as well as wintertime transmission of epidemic influenza. Indeed, absolute humidity conditions correctly identify the region of the United States vulnerable to a third, wintertime wave of pandemic influenza. These findings suggest that the timing of pandemic influenza outbreaks is controlled by a combination of absolute humidity conditions, levels of susceptibility, and changes in population-mixing and contact rates. PMID:21081646

  19. Pneumonia induced by swine-origin influenza A (H1N1) infection. Chest computed tomography findings in children

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the features of chest computed tomography (CT) in children with swine-origin influenza A (H1N1) virus (S-OIV). The study population consisted of 16 children with laboratory-confirmed S-OIV infection (12 boys, 4 girls), with an age range of 5-10 years (mean 6.3 years). Pneumonia was suspected in these patients based on clinical features or confirmed by radiography. All subjects underwent CT for close evaluation of pneumonia, including characteristics, distribution, extent, and other findings such as pleural effusion, pneumothorax, and pneumomediastinum. The predominant CT finding was consolidation plus ground-grass opacity (GGO) (11/16, 69%). The consolidation-dominant pattern was found in 10 of 16 (66%) patients, and 1 (6%) was GGO-dominant. One (6%) had only GGO. In all, 7 of the 16 patients had segmental or lobar consolidation. Abnormal opacities were primarily distributed in the central lung zone (8/16, 50%) and were multifocal (15/16, 94%). Four showed atelectasis (4/16, 25%). Pneumomediastinum was observed in 4 of 16 (25%). One patient had negative radiographic findings but was positive on CT. Multifocal consolidation with central distribution is a common CT finding in children with S-OIV, but there are few GGO-dominant cases. Widespread consolidation (segmental or lobar) is also common. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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

  1. The elusive definition of pandemic influenza

    OpenAIRE

    Doshi, Peter

    2011-01-01

    There has been considerable controversy over the past year, particularly in Europe, over whether the World Health Organization (WHO) changed its definition of pandemic influenza in 2009, after novel H1N1 influenza was identified. Some have argued that not only was the definition changed, but that it was done to pave the way for declaring a pandemic. Others claim that the definition was never changed and that this allegation is completely unfounded. Such polarized views have hampered our abili...

  2. Influenza pandemics: past, present and future challenges

    OpenAIRE

    Zylberman Patrick; Flahault Antoine

    2010-01-01

    Influenza epidemics occur regularly and prediction of their conversion to pandemics and their impact is difficult. Coordination of efforts on a global scale to control or reduce the impact is fraught with potential for under and overreaction. In light of the 1956 pandemic and more recently the SARS and H1N1 pandemics, the public health community took steps toward strengthening global surveillance and a coordinated response in keeping with the continuing memory of the tragedy seen in 1918. The...

  3. Avian influenza and pandemic influenza preparedness in Hong Kong.

    Science.gov (United States)

    Lam, Ping Yan

    2008-06-01

    Avian influenza A H5N1 continues to be a major threat to global public health as it is a likely candidate for the next influenza pandemic. To protect public health and avert potential disruption to the economy, the Hong Kong Special Administrative Region Government has committed substantial effort in preparedness for avian and pandemic influenza. Public health infrastructures for emerging infectious diseases have been developed to enhance command, control and coordination of emergency response. Strategies against avian and pandemic influenza are formulated to reduce opportunities for human infection, detect pandemic influenza timely, and enhance emergency preparedness and response capacity. Key components of the pandemic response include strengthening disease surveillance systems, updating legislation on infectious disease prevention and control, enhancing traveller health measures, building surge capacity, maintaining adequate pharmaceutical stockpiles, and ensuring business continuity during crisis. Challenges from avian and pandemic influenza are not to be underestimated. Implementing quarantine and social distancing measures to contain or mitigate the spread of pandemic influenza is problematic in a highly urbanised city like Hong Kong as they involved complex operational and ethical issues. Sustaining effective risk communication campaigns during interpandemic times is another challenge. Being a member of the global village, Hong Kong is committed to contributing its share of efforts and collaborating with health authorities internationally in combating our common public health enemy. PMID:18618061

  4. 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)

    OpenAIRE

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

    2009-01-01

    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. Therefore the prospects for the ...

  5. Preparing for an influenza pandemic in Singapore.

    Science.gov (United States)

    Cutter, Jeffery

    2008-06-01

    The national strategy against pandemic influenza essentially consists of 3 prongs: (i) effective surveillance, (ii) mitigation of the pandemic's impact, and (iii) render the population immune through vaccination. When the pandemic hits Singapore, the response plan aims to achieve the following 3 outcomes: (i) maintenance of essential services to limit social and economic disruption, (ii) reduction of morbidity and mortality through antiviral treatment, and (iii) slow and limit the spread of influenza to reduce the surge on healthcare services. The biggest challenge will come from managing the surge of demand on healthcare services. A high level of preparedness will help healthcare services better cope with the surge. PMID:18618062

  6. Infecção pelo vírus Influenza A (H1N1) de origem suína: como reconhecer, diagnosticar e prevenir / How to prevent, recognize and diagnose infection with the swine-origin Influenza A (H1N1) virus in humans

    Scientific Electronic Library Online (English)

    Alcyone Artioli, Machado.

    2009-05-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese Em março de 2009, houve o início de uma epidemia de gripe no México que, em pouco tempo, levou ao surgimento de casos semelhantes em outros países, alertando as autoridades sanitárias para o risco de uma pandemia. Neste artigo, descrevemos os principais sinais e sintomas da infecção pelo vírus Influ [...] enza A (H1N1) de origem suína, as medidas a serem tomadas para os casos suspeitos ou confirmados e como proceder em relação aos contactantes. Comentamos também quais drogas são utilizadas para o tratamento e profilaxia. Abstract in english In March of 2009, a flu epidemic began in Mexico. Shortly thereafter, similar cases appeared in other countries, alerting authorities to the risk of a pandemic. This article details the principal signs and symptoms of infection with the swine-origin Influenza A (H1N1) virus. In addition, the measure [...] s to be taken in suspected or confirmed cases are addressed, as are the procedures to follow in relation to contacts. Furthermore, the drugs used in the prophylaxis against and the treatment of infection with the H1N1 virus are described.

  7. Modifications in the Polymerase Genes of a Swine-Like Triple-Reassortant Influenza Virus To Generate Live Attenuated Vaccines against 2009 Pandemic H1N1 Viruses? †

    OpenAIRE

    Pena, Lindomar; Vincent, Amy L.; Ye, Jianqiang; Ciacci-zanella, Janice R.; Angel, Matthew; Lorusso, Alessio; Gauger, Philip C.; Janke, Bruce H.; Loving, Crystal L.; Perez, Daniel R.

    2010-01-01

    On 11 June 2009, the World Health Organization (WHO) declared that the outbreaks caused by novel swine-origin influenza A (H1N1) virus had reached pandemic proportions. The pandemic H1N1 (H1N1pdm) virus is the predominant influenza virus strain in the human population. It has also crossed the species barriers and infected turkeys and swine in several countries. Thus, the development of a vaccine that is effective in multiple animal species is urgently needed. We have previously demonstrated t...

  8. Reassortment Patterns in Swine Influenza Viruses

    OpenAIRE

    Khiabanian, Hossein; Trifonov, Vladimir; Rabadan, Raul

    2009-01-01

    Three human influenza pandemics occurred in the twentieth century, in 1918, 1957, and 1968. Influenza pandemic strains are the results of emerging viruses from non-human reservoirs to which humans have little or no immunity. At least two of these pandemic strains, in 1957 and in 1968, were the results of reassortments between human and avian viruses. Also, many cases of swine influenza viruses have reportedly infected humans, in particular, the recent H1N1 influenza virus of swine origin, iso...

  9. Avian influenza pandemic preparedness: developing prepandemic and pandemic vaccines against a moving target

    OpenAIRE

    Singh, Neetu; Pandey, Aseem; Mittal, Suresh K.

    2010-01-01

    The unprecedented global spread of highly pathogenic avian H5N1 influenza viruses within the past ten years and their extreme lethality to poultry and humans has underscored their potential to cause an influenza pandemic. Combating the threat of an impending H5N1 influenza pandemic will require a combination of pharmaceutical and nonpharmaceutical intervention strategies. The emergence of the H1N1 pandemic in 2009 emphasised the unpredictable nature of a pandemic influenza. Undoubtedly, vacci...

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

    International Nuclear Information System (INIS)

    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, hyperinflncluded peribronchial opacities, hyperinflation, lower lung zonal distribution, and central predominance

  11. 75 FR 10268 - Pandemic Influenza Vaccines-Amendment

    Science.gov (United States)

    2010-03-05

    ...the pandemic countermeasures influenza A H5N1, H2, H6, H7, H9...vaccines against pandemic influenza A viruses with pandemic potential...delete ``the virus with (1) highly pathogenic avian influenza A (H5N1, H2, H6, H7,...

  12. The novel influenza A (H1N1 virus pandemic: An update

    Directory of Open Access Journals (Sweden)

    Petrosillo N

    2009-01-01

    Full Text Available In the 4 months since it was first recognized, the pandemic strain of a novel influenza A (H1N1 virus has spread to all continents and, after documentation of human-to-human transmission of the virus in at least three countries in two separate World Health Organization (WHO regions, the pandemic alert was raised to level 6. The agent responsible for this pandemic, a swine-origin influenza A (H1N1 virus (S-OIV, is characterized by a unique combination of gene segments that has not previously been identified among human or swine influenza A viruses. As of 31th July 2009, 168 countries and overseas territories/communities have each reported at least one laboratory-confirmed case of pandemic H1N1 infection. There have been a total of 162,380 reported cases and 1154 associated deaths. Influenza epidemics usually take off in autumn, and it is important to prepare for an earlier start this season. Estimates from Europe indicate that 230 millions Europe inhabitants will have clinical signs and symptoms of S-OIV this autumn, and 7– 35% of the clinical cases will have a fatal outcome, which means that there will be 160,000– 750,000 H1N1-related deaths. A vaccine against H1N1 is expected to be the most effective tool for controlling influenza A (H1N1 infection in terms of reducing morbidity and mortality and limiting diffusion. However, there are several issues with regard to vaccine manufacture and approval, as well as production capacity, that remain unsettled. We searched the literature indexed in PubMed as well as the websites of major international health agencies to obtain the material presented in this update on the current S-OIV pandemic.

  13. Isolation and complete genomic characterization of H1N1 subtype swine influenza viruses in southern China through the 2009 pandemic

    OpenAIRE

    Xue Chunyi; Chen Feng; Chen Cuiying; Shang Huiqin; Wang Jing; Xie Qingmei; Ji Jun; Liu Yizhi; Cao Yongchang; Ma Jingyun; Bi Yingzuo

    2011-01-01

    Abstract Background The swine influenza (SI) is an infectious disease of swine and human. The novel swine-origin influenza A (H1N1) that emerged from April 2009 in Mexico spread rapidly and caused a human pandemic globally. To determine whether the tremendous virus had existed in or transmitted to pigs in southern China, eight H1N1 influenza strains were identified from pigs of Guangdong province during 2008-2009. Results Based on the homology and phylogenetic analyses of the nucleotide seque...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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).

  15. Pandemic Threat Posed by Avian Influenza A Viruses

    OpenAIRE

    Horimoto, Taisuke; Kawaoka, Yoshihiro

    2001-01-01

    Influenza pandemics, defined as global outbreaks of the disease due to viruses with new antigenic subtypes, have exacted high death tolls from human populations. The last two pandemics were caused by hybrid viruses, or reassortants, that harbored a combination of avian and human viral genes. Avian influenza viruses are therefore key contributors to the emergence of human influenza pandemics. In 1997, an H5N1 influenza virus was directly transmitted from birds in live poultry markets in Hong K...

  16. IL-17 response mediates acute lung injury induced by the 2009 Pandemic Influenza A (H1N1) Virus

    OpenAIRE

    Li, Chenggang; Yang, Penghui; Sun, Yang; Li, Taisheng; Wang, Zhong; Zou, Zhen; Yan, Yiwu; Wang, Wei; Wang, Chen; Chen, Zhongwei; Xing, Li; Tang, Chong; Ju, Xiangwu; Guo, Feng; Deng, Jiejie

    2011-01-01

    The 2009 flu pandemic involved the emergence of a new strain of a swine-origin H1N1 influenza virus (S-OIV H1N1) that infected almost every country in the world. Most infections resulted in respiratory illness and some severe cases resulted in acute lung injury. In this report, we are the first to describe a mouse model of S-OIV virus infection with acute lung injury and immune responses that reflect human clinical disease. The clinical efficacy of the antiviral oseltamivir (Tamiflu) administ...

  17. Toward a method for tracking virus evolutionary trajectory applied to the pandemic H1N1 2009 influenza virus.

    Science.gov (United States)

    Squires, R Burke; Pickett, Brett E; Das, Sajal; Scheuermann, Richard H

    2014-12-01

    In 2009 a novel pandemic H1N1 influenza virus (H1N1pdm09) emerged as the first official influenza pandemic of the 21st century. Early genomic sequence analysis pointed to the swine origin of the virus. Here we report a novel computational approach to determine the evolutionary trajectory of viral sequences that uses data-driven estimations of nucleotide substitution rates to track the gradual accumulation of observed sequence alterations over time. Phylogenetic analysis and multiple sequence alignments show that sequences belonging to the resulting evolutionary trajectory of the H1N1pdm09 lineage exhibit a gradual accumulation of sequence variations and tight temporal correlations in the topological structure of the phylogenetic trees. These results suggest that our evolutionary trajectory analysis (ETA) can more effectively pinpoint the evolutionary history of viruses, including the host and geographical location traversed by each segment, when compared against either BLAST or traditional phylogenetic analysis alone. PMID:25064525

  18. Quantifying the transmission potential of pandemic influenza

    Science.gov (United States)

    Chowell, Gerardo; Nishiura, Hiroshi

    2008-03-01

    This article reviews quantitative methods to estimate the basic reproduction number of pandemic influenza, a key threshold quantity to help determine the intensity of interventions required to control the disease. Although it is difficult to assess the transmission potential of a probable future pandemic, historical epidemiologic data is readily available from previous pandemics, and as a reference quantity for future pandemic planning, mathematical and statistical analyses of historical data are crucial. In particular, because many historical records tend to document only the temporal distribution of cases or deaths (i.e. epidemic curve), our review focuses on methods to maximize the utility of time-evolution data and to clarify the detailed mechanisms of the spread of influenza. First, we highlight structured epidemic models and their parameter estimation method which can quantify the detailed disease dynamics including those we cannot observe directly. Duration-structured epidemic systems are subsequently presented, offering firm understanding of the definition of the basic and effective reproduction numbers. When the initial growth phase of an epidemic is investigated, the distribution of the generation time is key statistical information to appropriately estimate the transmission potential using the intrinsic growth rate. Applications of stochastic processes are also highlighted to estimate the transmission potential using similar data. Critically important characteristics of influenza data are subsequently summarized, followed by our conclusions to suggest potential future methodological improvements.

  19. Developing Vaccines to Combat Pandemic Influenza

    Directory of Open Access Journals (Sweden)

    Othmar G. Engelhardt

    2010-02-01

    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.

  20. 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)

    Balabanis Kara

    2010-07-01

    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.

  1. Pathogenesis and Transmission of Triple-Reassortant Swine H1N1 Influenza Viruses Isolated before the 2009 H1N1 Pandemic?

    OpenAIRE

    Belser, Jessica A.; Gustin, Kortney M.; Maines, Taronna R.; Blau, Dianna M.; Zaki, Sherif R.; Katz, Jacqueline M.; Tumpey, Terrence M.

    2010-01-01

    The 2009 H1N1 pandemic influenza virus represents the greatest incidence of human infection with an influenza virus of swine origin to date. Moreover, triple-reassortant swine (TRS) H1N1 viruses, which share similar host and lineage origins with 2009 H1N1 viruses, have been responsible for sporadic human cases since 2005. Similar to 2009 H1N1 viruses, TRS viruses are capable of causing severe disease in previously healthy individuals and frequently manifest with gastrointestinal symptoms; how...

  2. Pandemic H1N1 influenza infections in 2009

    Directory of Open Access Journals (Sweden)

    Mustafa Hac?mustafao?lu

    2010-05-01

    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

  3. 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)

    Shatizadeh Malekshahi S

    2010-12-01

    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.

  4. The Australian response: pandemic influenza preparedness.

    Science.gov (United States)

    Horvath, John S; McKinnon, Moira; Roberts, Leslee

    2006-11-20

    Australia's preparedness for a potential influenza pandemic involves many players, from individual health carers to interdepartmental government committees. It embraces a wide number of strategies from the management of the disease to facilitating business continuity. The key strategy underlying Australia's planned response is an intensive effort to reduce transmission of the virus. This includes actions to reduce the likelihood of entry of the virus into the country and to contain outbreaks when they occur. Containment will provide time to allow production of a matched vaccine. The health strategies are outlined in the Australian health management plan for pandemic influenza. The plan is accompanied by technical annexes setting out key considerations and guidelines in the areas of clinical management and infection control. National plans present overall strategies and guidance, but the operational details can only be determined by individual states and territories, regions, and the services themselves. Primary health care practices will be on the frontline of an influenza pandemic. Every practice needs a plan that defines the roles of staff, incorporates infection control and staff protection measures, and considers business continuity. Most importantly, a practice needs to know how to implement that plan. PMID:17115949

  5. Avian Influenza Virus: The Threat of A Pandemic

    OpenAIRE

    Shih-Cheng Chang; Yi-Ying Cheng; Shin-Ru Shih

    2006-01-01

    The 1918 influenza A virus pandemic caused a death toll of 40~50 million. Currently,because of the widespread dissemination of the avian influenza virus (H5N1), there is a highrisk of another pandemic. Avian species are the natural hosts for numerous subtypes ofinfluenza A viruses; however, the highly pathogenic avian influenza virus (HPAI) is not onlyextremely lethal to domestic avian species but also can infect humans and cause death. Thisreview discusses why the avian influenza virus is co...

  6. Influenza pandemics: past, present and future challenges

    Directory of Open Access Journals (Sweden)

    Zylberman Patrick

    2010-07-01

    Full Text Available Influenza epidemics occur regularly and prediction of their conversion to pandemics and their impact is difficult. Coordination of efforts on a global scale to control or reduce the impact is fraught with potential for under and overreaction. In light of the 1956 pandemic and more recently the SARS and H1N1 pandemics, the public health community took steps toward strengthening global surveillance and a coordinated response in keeping with the continuing memory of the tragedy seen in 1918. The scientific, professional, and technical resources of the 21st century are now advanced far beyond those then available. The H1N1 pandemic which commenced in 2009 progressed differently than predicted; its course was difficult to predict with any degree of certainty. Public responses to national immunization programs against the H1N1 virus have been weak. International movement of diseases can lead to creation of new endemic areas and continuous spread such as that which happened with West Nile Fever and Chikungunya. The lessons learned and the public and political responses to each actual or threatened pandemic will serve public health well in dealing with future challenges.

  7. Experimental Infection of Pigs with the 1918 Pandemic Influenza Virus

    Science.gov (United States)

    Swine influenza was first recognized as a disease during the 1918 "Spanish flu" pandemic suggesting the Spanish flu virus caused swine influenza. The objective of this study was to determine the susceptibility of swine to the Spanish flu virus. A plasmid-derived 1918 pandemic H1N1 (1918/rec) influe...

  8. 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

    Directory of Open Access Journals (Sweden)

    Schoop Roland

    2009-11-01

    Full Text Available 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. Therefore the prospects for the control of IV by existing anti-viral drugs are limited. As an alternative approach to the common anti-virals we studied in more detail a commercial standardized extract of the widely used herb Echinacea purpurea (Echinaforce®, EF in order to elucidate the nature of its anti-IV activity. Results Human H1N1-type IV, highly pathogenic avian IV (HPAIV of the H5- and H7-types, as well as swine origin IV (S-OIV, H1N1, were all inactivated in cell culture assays by the EF preparation at concentrations ranging from the recommended dose for oral consumption to several orders of magnitude lower. Detailed studies with the H5N1 HPAIV strain indicated that direct contact between EF and virus was required, prior to infection, in order to obtain maximum inhibition in virus replication. Hemagglutination assays showed that the extract inhibited the receptor binding activity of the virus, suggesting that the extract interferes with the viral entry into cells. In sequential passage studies under treatment in cell culture with the H5N1 virus no EF-resistant variants emerged, in contrast to Tamiflu®, which produced resistant viruses upon passaging. Furthermore, the Tamiflu®-resistant virus was just as susceptible to EF as the wild type virus. Conclusion As a result of these investigations, we believe that this standard Echinacea preparation, used at the recommended dose for oral consumption, could be a useful, readily available and affordable addition to existing control options for IV replication and dissemination.

  9. Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza

    OpenAIRE

    Selim Kilic; Gray, Gregory C.

    2007-01-01

    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...

  10. Avian Influenza Virus: The Threat of A Pandemic

    Directory of Open Access Journals (Sweden)

    Shih-Cheng Chang

    2006-04-01

    Full Text Available The 1918 influenza A virus pandemic caused a death toll of 40~50 million. Currently,because of the widespread dissemination of the avian influenza virus (H5N1, there is a highrisk of another pandemic. Avian species are the natural hosts for numerous subtypes ofinfluenza A viruses; however, the highly pathogenic avian influenza virus (HPAI is not onlyextremely lethal to domestic avian species but also can infect humans and cause death. Thisreview discusses why the avian influenza virus is considered the most likely candidate forthe first flu pandemic of the 21st century

  11. Updated preparedness and response framework for influenza pandemics.

    Science.gov (United States)

    Holloway, Rachel; Rasmussen, Sonja A; Zaza, Stephanie; Cox, Nancy J; Jernigan, Daniel B

    2014-09-26

    The complexities of planning for and responding to the emergence of novel influenza viruses emphasize the need for systematic frameworks to describe the progression of the event; weigh the risk of emergence and potential public health impact; evaluate transmissibility, antiviral resistance, and severity; and make decisions about interventions. On the basis of experience from recent influenza responses, CDC has updated its framework to describe influenza pandemic progression using six intervals (two prepandemic and four pandemic intervals) and eight domains. This updated framework can be used for influenza pandemic planning and serves as recommendations for risk assessment, decision-making, and action in the United States. The updated framework replaces the U.S. federal government stages from the 2006 implementation plan for the National Strategy for Pandemic Influenza (US Homeland Security Council. National strategy for pandemic influenza: implementation plan. Washington, DC: US Homeland Security Council; 2006. Available at http://www.flu.gov/planning-preparedness/federal/pandemic-influenza-implementation.pdf). The six intervals of the updated framework are as follows: 1) investigation of cases of novel influenza, 2) recognition of increased potential for ongoing transmission, 3) initiation of a pandemic wave, 4) acceleration of a pandemic wave, 5) deceleration of a pandemic wave, and 6) preparation for future pandemic waves. The following eight domains are used to organize response efforts within each interval: incident management, surveillance and epidemiology, laboratory, community mitigation, medical care and countermeasures, vaccine, risk communications, and state/local coordination. Compared with the previous U.S. government stages, this updated framework provides greater detail and clarity regarding the potential timing of key decisions and actions aimed at slowing the spread and mitigating the impact of an emerging pandemic. Use of this updated framework is anticipated to improve pandemic preparedness and response in the United States. Activities and decisions during a response are event-specific. These intervals serve as a reference for public health decision-making by federal, state, and local health authorities in the United States during an influenza pandemic and are not meant to be prescriptive or comprehensive. This framework incorporates information from newly developed tools for pandemic planning and response, including the Influenza Risk Assessment Tool and the Pandemic Severity Assessment Framework, and has been aligned with the pandemic phases restructured in 2013 by the World Health Organization. PMID:25254666

  12. Developing Vaccines to Combat Pandemic Influenza

    OpenAIRE

    Engelhardt, Othmar G.; Robertson, James S.

    2010-01-01

    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 al...

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

    OpenAIRE

    Trebbien, Ramona; Larsen, Lars Erik; Viuff, Birgitte M.

    2011-01-01

    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 ...

  14. Distribution of sialic acid receptors and influenza A virus of avian and swine origin in experimentally infected pigs

    DEFF Research Database (Denmark)

    Trebbien, Ramona; Larsen, Lars Erik

    2011-01-01

    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 (SA-alpha-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.

  15. Abbreviated Pandemic Influenza Planning Template for Primary Care Offices

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    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.

  16. Genome Sequence of a Circulating Human-Like Swine-Origin Influenza A Virus H3N2 Strain

    OpenAIRE

    Li, Xinsheng; Wang, Junya; Chen, Hong-ying; Yan, Ruoqian; Du, Xiangdang

    2013-01-01

    The full-genome sequence of A/swine/Henan/1/2010, a strain of influenza A virus isolated in central China, was determined. Phylogenetic analyses show that its eight genomic segments are human-like, and some of its segments have appeared in swine H1N2, swine H1N1, and human H1N2 influenza viruses.

  17. Killing of Avian and Swine Influenza Virus by Natural Killer Cells?

    OpenAIRE

    Achdout, Hagit; Meningher, Tal; Hirsh, Shira; Glasner, Ariella; Bar-on, Yotam; Gur, Chamutal; Porgador, Angel; Mendelson, Michal; Mandelboim, Michal; Mandelboim, Ofer

    2010-01-01

    Today, global attention is focused on two influenza virus strains: the current pandemic strain, swine origin influenza virus (H1N1-2009), and the highly pathogenic avian influenza virus, H5N1. At present, the infection caused by the H1N1-2009 is moderate, with mortality rates of less

  18. Distribution of sialic acid receptors and influenza A virus of avian and swine origin in experimentally infected pigs

    OpenAIRE

    Viuff Birgitte M; Larsen Lars E; Trebbien Ramona

    2011-01-01

    Abstract 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 (SA-alpha-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 rece...

  19. Achieving clinical equality in an influenza pandemic: patent realities.

    Science.gov (United States)

    Kane, Eileen M

    2009-01-01

    A twenty-first century novel influenza A (H1N1) pandemic is currently unfolding, and the eventual scope of this public health crisis is not clear. In addition, ongoing surveillance of the avian influenza A (H5N1) virus reveals outbreaks of human-to-human transmission of the virus, with significant mortality. Effective pandemic management depends on pharmaceutical intervention with two different clinical objectives: the generation of an immune response to specific viral strains (vaccination) and the reduction of viral replication in an infected individual (antiviral administration). The ability to offer pharmaceutical interventions for a public health crisis depends on three factors: development, capacity, and access. Pharmaceutical measures must be developed, capacity must be established, and access must be ensured. The article discusses the three nodes of patenting that influence the availability of pharmaceutical countermeasures in an influenza pandemic. Identification of the causative influenza virus is the first step in pandemic management and precedes vaccine design, and the virus and its RNA sequence are both knowledge assets and inputs for vaccine design. Vaccine development, therefore, will be influenced by any patents on the genetic sequences or proteins of the pandemic virus, as well as on novel methods for vaccine production, the actual vaccine or adjuvant technology, all of which are relevant to the assembly of a working vaccine on short notice. Pharmaceutical treatment of influenza infection during a pandemic could also rely on use of patented antiviral drugs, whose efficacy may be revealed as the pandemic unfolds. Unlike vaccines, these are not generally developed de novo for a pandemic, but their availability could be dependent on the exercise of patent rights by market incumbents. Patent rights could control capacity, which may determine access. Pandemic planning must consider how patenting can influence development, capacity and access to pharmaceutical interventions. The national and international public health authorities are slowly integrating intellectual property considerations into pandemic planning. Further integration will anticipate the emergence of patent claims, identify any relevant patents, encourage access norms, and consider the use of legal mechanisms that could alleviate patent-mediated obstacles to the availability of critical products and methods that may be patented. Pandemic management must also co-exist with existing efforts to control seasonal influenza outbreaks. The article analyzes the intersection of patent nodes relevant to vaccine development and to antiviral distribution during a global influenza pandemic, identifying where such patents may facilitate or inhibit the availability of pharmaceutical countermeasures, and offers preliminary observations on the emerging novel H1N1 pandemic. The goal of international clinical equality is essential for the eradication of an influenza pandemic, and strategies for its achievement can also be applied to other diseases. PMID:20718133

  20. Distribution of sialic acid receptors and influenza A virus of avian and swine origin in experimentally infected pigs

    Directory of Open Access Journals (Sweden)

    Viuff Birgitte M

    2011-09-01

    Full Text Available Abstract 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 (SA-alpha-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.

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

    DEFF Research Database (Denmark)

    Trebbien, Ramona; Larsen, Lars Erik

    2011-01-01

    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.

  2. Swine influenza test results from animal health laboratories in Canada

    OpenAIRE

    Kloeze, Harold; Mukhi, Shamir N.; Alexandersen, Soren

    2013-01-01

    Due to its infrastructure and partnerships the Canadian Animal Health Surveillance Network was able to rapidly collect test results from 9 Canadian laboratories that were conducting primary testing for influenza on swine-origin samples, in response to the threat posed by the pandemic H1N1 influenza virus in 2009.

  3. Seasonal and pandemic influenza preparedness: a global threat.

    Science.gov (United States)

    Whitley, Richard J; Monto, Arnold S

    2006-11-01

    The increase in the incidence of avian influenza worldwide in both poultry and humans introduces the potential for another influenza A pandemic that could pose a significant threat to both human health and the global economy. The impact of the next influenza pandemic will be influenced, in part, by how well the medical, government, business, and lay communities are prepared. Despite the additional tools and resources that have become available since prior epidemics, there are limits to the quantity of antiviral drugs that can be manufactured and concerns over the current vaccine production systems. Despite these challenges, there is an opportunity to take action before the emergence of a pandemic influenza strain and, possibly, to prevent its spread or at least mitigate its impact on the world. In February 2006, a group of representatives from federal, state, and local governments; professional bodies; academia; and the pharmaceutical industry met to review the current state of preparedness in the United States for a potential influenza pandemic and its relationship to seasonal influenza. The goal of the meeting was to examine the recently revised US Department of Health and Human Services plan for preparedness and response to an influenza pandemic and to make recommendations to actualize this plan at the state and local levels. PMID:17163390

  4. Sensitivity and Specificity of Serologic Assays for Detection of Human Infection with 2009 Pandemic H1N1 Virus in U.S. Populations?

    OpenAIRE

    Veguilla, Vic; Hancock, Kathy; Schiffer, Jarad; Gargiullo, Paul; Lu, Xiuhua; Aranio, Darbi; Branch, Alicia; Dong, Libo; Holiday, Crystal; Liu, Feng; Steward-clark, Evelene; Sun, Hong; Tsang, Byron; Wang, David; Whaley, Melissa

    2011-01-01

    Swine origin 2009 H1N1 influenza virus has spread globally to cause the first influenza pandemic of the 21st century. Serological studies can improve our understanding of the extent of human infection and risk factors associated with the transmission of this pandemic virus. The “gold standard” for serodiagnosis of human influenza virus infection is the detection of seroconversion between acute- and convalescent-stage samples. However, the timing of seroepidemiological investigations often...

  5. Conserved amino acid markers from past influenza pandemic strains

    Directory of Open Access Journals (Sweden)

    Vitalis Elizabeth A

    2009-04-01

    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.

  6. 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)

    Osterlund, Pamela; Pirhonen, Jaana

    2010-01-01

    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.

  7. Crossing the species barrier: the threat of an avian influenza pandemic

    OpenAIRE

    Riedel, Stefan

    2006-01-01

    Avian influenza (H5N1) has recently been recognized as a new emerging infectious disease that may pose a threat to international public health. Most recent developments lead to the belief that H5N1 could become the cause of the next influenza pandemic. This review discusses the characteristics of H5N1 avian influenza virus as an emerging infectious disease with the potential for pandemic development. In addition, the current pandemic influenza alert status and guidelines for pandemic prepared...

  8. 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)

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

    2011-04-01

    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)

  9. Estimation of seroprevalence of the pandemic H1N1 2009 influenza virus using a novel virus-free ELISA assay for the detection of specific antibodies.

    Science.gov (United States)

    Mavrouli, Maria D; Routsias, John G; Maltezou, Helena C; Spanakis, Nicholas; Tsakris, Athanassios

    2011-06-01

    The pandemic H1N1 2009 influenza A emerged in April 2009 and spread rapidly all over the world. In Greece, the first case of the pandemic H1N1 was reported on May 18, 2009, while a considerable increase in the number of cases was noticed at the beginning of July 2009. The need for surveillance of the immune status of the Greek population led us to develop a virus-free ELISA that specifically recognizes pandemic H1N1 2009 influenza virus antibodies in human sera. The method is based on the use of synthetic peptides (H1-pep and N1-pep) that are derived from the hemagglutinin and neuraminidase of the 2009 pandemic strain, respectively, and differentiate the swine-origin influenza A/California/14/2009 (H1N1) from the seasonal influenza A viruses. Serum samples were obtained from 271 healthy blood donors during May, November, and December 2009. Among sera collected during May, November, and December, IgG antibodies against the peptide H1-pep were detected in 7.4, 13.8, and 19.3% of the donors, respectively, while IgG antibodies against the peptide N1-pep were detected in 5.3, 9.6, and 16.9% of the donors, respectively. The application of the immunoassay indicated a time-dependent increase of the prevalence of anti-H1-pep and anti-N1-pep IgG antibodies during the pandemic H1N1 outbreak in Greece. The method could be also indicative for the discrimination of immune persons from those susceptible to infection with the pandemic H1N1 strain, as well as for the establishment of effective vaccination programs. PMID:21668363

  10. Australian general practice and pandemic influenza: models of clinical practice in an established pandemic.

    Science.gov (United States)

    Phillips, Christine B; Patel, Mahomed S; Glasgow, Nicholas; Pearce, Christopher; Dugdale, Paul; Davies, Alison; Hall, Sally; Kljakovic, Marjan

    2007-04-01

    To minimise the health impact of pandemic influenza, general practice will need to provide influenza-related and non-influenza primary health care, as well as contribute to the public health goal of disease control. Through interviews and workshops with general practitioners, nurses and policy leaders between March and July 2006, and literature analysis, we identified potential models of general practice in an established pandemic, and assessed their strengths and weaknesses. Three possible clinical models were identified: a default model of no change to service delivery; a streamed services model, where general practices reorganise themselves to take on either influenza-specific care or other clinical services; and a staff-determined mixed model, where staff move between different types of services. No single model or set of strategies meets the needs of all general practices to deliver and sustain the essential functions of primary health care during an established pandemic. Governments, general practice and the relevant peak professional bodies should decide before a pandemic on the suite of measures needed to support the models most suitable in their regions. Effective participation by general practice in a pandemic requires supplementary infrastructure support, changes to financial and staffing patterns, a review of legislation on medicolegal implications during an emergency, and intensive collaboration between general practices. PMID:17407432

  11. Low adherence to influenza vaccination campaigns: is the H1N1 virus pandemic to be blamed?

    Directory of Open Access Journals (Sweden)

    Trivellin Valeria

    2011-11-01

    Full Text Available Abstract Background Over the last few months, debates about the handling of the influenza virus A (H1N1 pandemic took place, in particular regarding the change of the WHO pandemic definition, economic interests, the dramatic communication style of mass media. The activation of plans to reduce the virus diffusion resulted in an important investment of resources. Were those investments proportionate to the risk? Was the pandemic overrated? The workload of the Pediatric Emergency Room (P.E.R. at a teaching hospital in Varese (Northern Italy was investigated in order to evaluate the local diffusion and severity of the new H1N1 influenza epidemic. Discussion A 100% increase of the number of P.E.R. visits, particularly for influenza-like illness, was recorded during weeks 42-46 of 2009 (October, 17 to November, 2; the low rate of hospitalization and the mild presentation of the infection gave rise to the conclusion that the pandemic risk was overrated. Mass media communications concerning the new virus created a disproportionate fear in the population that significantly enhanced the burden of cares at the hospital. In the absence of generally implemented measures for etiological diagnosis, the actual incidence of the H1N1 infection could not be estimated. Virus identification, in fact, was limited to children showing severe symptoms after consultancy with an infectious disease specialist. The alarming nature of the communication campaign and the choice to limit etiologic diagnosis to severe cases created a climate of uncertainty which significantly contributed to the massive admissions to the P.E.R.. Summary The communication strategy adopted by the mass media was an important element during the pandemic: the absence of clarity contributed to the spread of a pandemic phobia that appeared to result more from the sensationalism of the campaign than from infection with the novel influenza A variant of human, avian, swine origin virus. One relevant effect of the media coverage was the extremely low adherence rate to the vaccination campaign for the 2009-2010 and 2010-2011, especially among the high- risk population and health care workers. One positive consequence was, however, the spread of preventive hygiene measures, such as hand washing.

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

    International Nuclear Information System (INIS)

    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 = 0ular 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  14. Confronting an influenza pandemic: ethical and scientific issues.

    Science.gov (United States)

    Schuklenk, U; Gartland, K M A

    2006-12-01

    The prolonged concern over the potential for a global influenza pandemic to cause perhaps many millions of fatalities is a chilling one. After the SARS (severe acute respiratory syndrome) scares [1], attention has turned towards the possibility of an avian influenza virus hybridizing with a human influenza virus to create a highly virulent, as yet unknown, killer, on a scale unseen since the Spanish flu outbreak of 1918, which produced more fatalities than the Great War. In deciding how countries should react to this potential pandemic, individually and collectively, a reasonable and practical balance must be struck between the rights and obligations of individual citizens and protection of the wider community and, indeed, society as a whole. In this communication, ethical issues are discussed in the context of some of the scientific questions relating to a potential influenza pandemic. Among these issues are the rights and obligations of healthcare professionals, difficulties surrounding resource allocation, policies that have an impact on liberty and trade, when and how to introduce any vaccine or other form of mass treatment, global governance questions and the role of health policies in contemporary society. By considering these issues and questions in advance of an influenza, or indeed any other, pandemic commencing, countries can be better prepared to deal with the inevitably difficult decisions required during such events, rather than dusting down outdated previous plans, or making and implementing policy in an ad hoc manner with a resultant higher risk of adverse consequences. PMID:17073773

  15. Production of live attenuated influenza vaccines against seasonal and potential pandemic influenza viruses.

    Science.gov (United States)

    Jin, Hong; Chen, Zhongying

    2014-06-01

    Vaccination remains the most effective means to prevent morbidity and mortality caused by influenza epidemics and pandemics. Live attenuated influenza vaccine (LAIV) has been proven to be effective in preventing influenza with broad cross reactivity to drifted strains. Owing to the sophisticated nature of the influenza vaccine production process, the time needed to develop high yield LAIV strains for vaccine production and product release remains a constant challenge. This review summarizes LAIV production process with highlights on the experiences gained during the past decade generating seasonal and pandemic LAIV seeds by reverse genetics strategy. PMID:24705137

  16. A neighborhood susceptibility index for planning of local physical interventions in response to pandemic influenza outbreaks

    OpenAIRE

    Timpka, Toomas; Eriksson, Henrik; Stro?mgren, Magnus; Eriksson, Olle; Ekberg, Joakim; Grimvall, Anders; Nyce, James; Gursky, Elin; Holm, Einar

    2010-01-01

    The global spread of a novel A (H1N1) influenza virus in 2009 has highlighted the possibility of a devastating pandemic similar to the ‘Spanish flu’ of 1917–1918. Responding to such pandemics requires careful planning for the early phases where there is no availability of pandemic vaccine. We set out to compute a Neighborhood Influenza Susceptibility Index (NISI) describing the vulnerability of local communities of different geo-socio-physical structure to a pandemic influenza outbreak....

  17. Experimental vaccines against potentially pandemic and highly pathogenic avian influenza viruses

    OpenAIRE

    Mooney, Alaina J.; Tompkins, S. Mark

    2013-01-01

    Influenza A viruses continue to emerge and re-emerge, causing outbreaks, epidemics and occasionally pandemics. While the influenza vaccines licensed for public use are generally effective against seasonal influenza, issues arise with production, immunogenicity, and efficacy in the case of vaccines against pandemic and emerging influenza viruses, and highly pathogenic avian influenza virus in particular. Thus, there is need of improved influenza vaccines and vaccination strategies. This review...

  18. 2009 Pandemic Influenza A (H1N1)

    Science.gov (United States)

    Shieh, Wun-Ju; Blau, Dianna M.; Denison, Amy M.; DeLeon-Carnes, Marlene; Adem, Patricia; Bhatnagar, Julu; Sumner, John; Liu, Lindy; Patel, Mitesh; Batten, Brigid; Greer, Patricia; Jones, Tara; Smith, Chalanda; Bartlett, Jeanine; Montague, Jeltley; White, Elizabeth; Rollin, Dominique; Gao, Rongbao; Seales, Cynthia; Jost, Heather; Metcalfe, Maureen; Goldsmith, Cynthia S.; Humphrey, Charles; Schmitz, Ann; Drew, Clifton; Paddock, Christopher; Uyeki, Timothy M.; Zaki, Sherif R.

    2010-01-01

    In the spring of 2009, a novel influenza A (H1N1) virus emerged in North America and spread worldwide to cause the first influenza pandemic since 1968. During the first 4 months, over 500 deaths in the United States had been associated with confirmed 2009 pandemic influenza A (H1N1) [2009 H1N1] virus infection. Pathological evaluation of respiratory specimens from initial influenza-associated deaths suggested marked differences in viral tropism and tissue damage compared with seasonal influenza and prompted further investigation. Available autopsy tissue samples were obtained from 100 US deaths with laboratory-confirmed 2009 H1N1 virus infection. Demographic and clinical data of these case-patients were collected, and the tissues were evaluated by multiple laboratory methods, including histopathological evaluation, special stains, molecular and immunohistochemical assays, viral culture, and electron microscopy. The most prominent histopathological feature observed was diffuse alveolar damage in the lung in all case-patients examined. Alveolar lining cells, including type I and type II pneumocytes, were the primary infected cells. Bacterial co-infections were identified in >25% of the case-patients. Viral pneumonia and immunolocalization of viral antigen in association with diffuse alveolar damage are prominent features of infection with 2009 pandemic influenza A (H1N1) virus. Underlying medical conditions and bacterial co-infections contributed to the fatal outcome of this infection. More studies are needed to understand the multifactorial pathogenesis of this infection. PMID:20508031

  19. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    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.

  20. A novel strategy for exploring the reassortment origins of newly emerging influenza virus

    OpenAIRE

    Tian, Deqiao; Wang, Yumin; Zheng, Tao

    2011-01-01

    In early 2009, new swine-origin influenza A (H1N1) virus emerged in Mexico and the United States. The emerging influenza virus had made global influenza pandemic for nearly one year. To every emerging pathogen, exploring the origin sources is vital for viral control and clearance. Influenza virus is different from other virus in that it has 8 segments, making the segment reassortment a main drive in virus evolution. In exploring reassortment evolution origins of a newly emerging infl...

  1. Spatial Transmission of 2009 Pandemic Influenza in the US.

    Science.gov (United States)

    Gog, Julia R; Ballesteros, Sébastien; Viboud, Cécile; Simonsen, Lone; Bjornstad, Ottar N; Shaman, Jeffrey; Chao, Dennis L; Khan, Farid; Grenfell, Bryan T

    2014-06-01

    The 2009 H1N1 influenza pandemic provides a unique opportunity for detailed examination of the spatial dynamics of an emerging pathogen. In the US, the pandemic was characterized by substantial geographical heterogeneity: the 2009 spring wave was limited mainly to northeastern cities while the larger fall wave affected the whole country. Here we use finely resolved spatial and temporal influenza disease data based on electronic medical claims to explore the spread of the fall pandemic wave across 271 US cities and associated suburban areas. We document a clear spatial pattern in the timing of onset of the fall wave, starting in southeastern cities and spreading outwards over a period of three months. We use mechanistic models to tease apart the external factors associated with the timing of the fall wave arrival: differential seeding events linked to demographic factors, school opening dates, absolute humidity, prior immunity from the spring wave, spatial diffusion, and their interactions. Although the onset of the fall wave was correlated with school openings as previously reported, models including spatial spread alone resulted in better fit. The best model had a combination of the two. Absolute humidity or prior exposure during the spring wave did not improve the fit and population size only played a weak role. In conclusion, the protracted spread of pandemic influenza in fall 2009 in the US was dominated by short-distance spatial spread partially catalysed by school openings rather than long-distance transmission events. This is in contrast to the rapid hierarchical transmission patterns previously described for seasonal influenza. The findings underline the critical role that school-age children play in facilitating the geographic spread of pandemic influenza and highlight the need for further information on the movement and mixing patterns of this age group. PMID:24921923

  2. Genetic diversity among pandemic 2009 influenza viruses isolated from a transmission chain

    DEFF Research Database (Denmark)

    Fordyce, Sarah L; Bragstad, Karoline

    2013-01-01

    Influenza viruses such as swine-origin influenza A(H1N1) virus (A(H1N1)pdm09) generate genetic diversity due to the high error rate of their RNA polymerase, often resulting in mixed genotype populations (intra-host variants) within a single infection. This variation helps influenza to rapidly respond to selection pressures, such as those imposed by the immunological host response and antiviral therapy. We have applied deep sequencing to characterize influenza intra-host variation in a transmission chain consisting of three cases due to oseltamivir-sensitive viruses, and one derived oseltamivir-resistant case.

  3. Pandemic controllability: a concept to guide a proportionate and flexible operational response to future influenza pandemics.

    Science.gov (United States)

    McCaw, J M; Glass, K; Mercer, G N; McVernon, J

    2014-03-01

    The 2009 H1N1 influenza pandemic posed challenges for governments worldwide. Strategies designed to limit community transmission, such as antiviral deployment, were largely ineffective due to both feasibility constraints and the generally mild nature of disease, resulting in incomplete case ascertainment. Reviews of national pandemic plans have identified pandemic impact, primarily linked to measures of transmissibility and severity, as a key concept to incorporate into the next generation of plans. While an assessment of impact provides the rationale under which interventions may be warranted, it does not directly provide an assessment on whether particular interventions may be effective. Such considerations motivate our introduction of the concept of pandemic controllability. For case-targeted interventions, such as antiviral treatment and post-exposure prophylaxis, we identify the visibility and transmissibility of a pandemic as the key drivers of controllability. Taking a case-study approach, we suggest that high-impact pandemics, for which control is most desirable, are likely uncontrollable with case-targeted interventions. Strategies that do not rely on the identification of cases may prove relatively more effective. By introducing a pragmatic framework for relating the assessment of impact to the ability to mitigate an epidemic (controllability), we hope to address a present omission identified in pandemic response plans. PMID:23735960

  4. Pandemic Influenza (H1N1) and Mycobacterium tuberculosis Co-infection

    OpenAIRE

    Park, Yehyun; Chin, Bum Sik; Han, Sang Hoon; Yun, Yujung; Kim, Young Ju; Choi, Jun Yong; Kim, Chang Oh; Song, Young Goo; Kim, June Myung

    2014-01-01

    We hereby observe four co-infection cases of pandemic influenza H1N1 and Mycobacterium tuberculosis with various clinical presentations. It may be prudent to consider M. tuberculosis co-infections when patients with pandemic influenza reveal unusual clinical features that do not improve despite appropriate treatments against the influenza, especially in Korea, in the endemic areas of M. tuberculosis.

  5. Understanding pandemic influenza behaviour: An exploratory biopsychosocial study.

    Science.gov (United States)

    Flowers, Paul; Davis, Mark; Lohm, Davina; Waller, Emily; Stephenson, Niamh

    2014-06-23

    Pandemic influenza represents an ongoing public health threat. Understanding the associated behavioural domain is vital for future intervention development. Cross-sectional qualitative research employing purposive sampling employed a combination of one-to-one semi-structured interviews (n = 57) and focus groups (n = 59). Data were analysed using (1) inductive thematic analysis and (2) theoretical thematic analysis focusing upon resonance with psychosocial and sociocultural constructs. Two broad themes highlighted an important duality regarding the determinants of pandemic behaviour: (1) psychosocial determinants (e.g. agency, cognitions and identity) and (2) sociocultural determinants (e.g. social context and capacity). These findings suggest this duality should shape future intervention development. PMID:24957318

  6. Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza

    Directory of Open Access Journals (Sweden)

    Selim Kilic

    2007-08-01

    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

  7. Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza

    Directory of Open Access Journals (Sweden)

    Selim Kilic

    2007-08-01

    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

  8. Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients

    OpenAIRE

    Martin-loeches, Ignacio

    2011-01-01

    Background: There is a vast amount of information published regarding the impact of 2009 pandemic Influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-2011 post-pandemic period has not been described. Methods: A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained ...

  9. Characterization of Oseltamivir-Resistant 2009 H1N1 Pandemic Influenza A Viruses

    OpenAIRE

    Kiso, Maki; Shinya, Kyoko; Shimojima, Masayuki; Takano, Ryo; Takahashi, Kei; Katsura, Hiroaki; Kakugawa, Satoshi; Le, Mai Thi Quynh; Yamashita, Makoto; Furuta, Yousuke; Ozawa, Makoto; Kawaoka, Yoshihiro

    2010-01-01

    Influenza viruses resistant to antiviral drugs emerge frequently. Not surprisingly, the widespread treatment in many countries of patients infected with 2009 pandemic influenza A (H1N1) viruses with the neuraminidase (NA) inhibitors oseltamivir and zanamivir has led to the emergence of pandemic strains resistant to these drugs. Sporadic cases of pandemic influenza have been associated with mutant viruses possessing a histidine-to-tyrosine substitution at position 274 (H274Y) in the NA, a muta...

  10. The pandemic (H1N1) 2009 influenza virus is resistant to mannose-binding lectin

    OpenAIRE

    Ushirogawa Hiroshi; Tokunaga Hirotoshi; Ohuchi Masanobu

    2011-01-01

    Abstract Background Mannose-binding lectin (MBL) is an important component of innate immunity because it promotes bacterial clearance and neutralization of human influenza A viruses. Since a majority of humans have no neutralizing antibody against the pandemic (H1N1) 2009 influenza (pandemic 2009) virus, innate immunity may be crucial and MBL susceptibility may therefore influence viral pathogenesis. Results We examined MBL susceptibility of influenza A viruses and observed that the pandemic ...

  11. Disease mongering and the fear of pandemic influenza.

    Science.gov (United States)

    Vance, Michael A

    2011-01-01

    The catastrophic H1N1 pandemic of 1918, which killed tens of millions, is now legendary, and influenza policy has centered on preventing another such disaster. There is reason for concern about influenza A. It can rapidly alter its genetic makeup to increase virulence and can jump from other species to humans. Nonetheless, ignorance about influenza in 1918, the lack of effective vaccines or antibacterial and antiviral drugs, and the social disruption caused by World War I also contributed heavily to the lethality, and it is unlikely that influenza of similar destructiveness will recur. The stupefying publicity over the threat of influenza has been generated partly by those, such as the pharmaceutical industry and influenza researchers, who benefit from the increased expenditures the publicity provokes. It is, in effect, disease mongering, the promotion of disease or dread of disease for one's own gain. Huge expenditures on influenza preparedness have produced little demonstrable benefit and some harm, independent of the wasted resources. Disease mongering, including spreading fear of influenza, is widespread and unhealthy and should be vigorously opposed. PMID:21319723

  12. INFLUENZA A H1N1 DE ORIGEN PORCINO: Métodos diagnósticos Influenza A H1N1 swine origin: diagnostic methods

    Directory of Open Access Journals (Sweden)

    Manuel Antonio Vargas-Córdoba

    2010-01-01

    Full Text Available El diagnóstico de la infección por virus influenza reposa sobre técnicas virológicas directas e indirectas. Las diferentes pruebas diagnósticas poseen niveles de sensibilidad y especificidad variables que dependen en gran parte de las características genéticas y antigénicas del virus circulante. En el caso de la aparición de una nueva variante viral las pruebas disponibles en el mercado deben ser validadas para comprobar su eficiencia de detección para el nuevo virus. En caso de baja sensibilidad y especificidad, las pruebas deben ajustarse con el fin de mejorar su poder de detección del nuevo agente. Existen múltiples pruebas diagnósticas que presentan cada una sus ventajas y limitaciones y su selección dependerá de las condiciones específicas de cada laboratorio diagnóstico.The diagnosis of infection by influenza viruses relays on direct and indirect virologic techniques. Different diagnostic tests have variable sensitivities and specificities depending to a large extent on the genetic and antigenic features of the circulating virus. When a new viral variant appears, commercially available tests must be validated in order to verify their performance at detecting the new virus. If a low sensitivity or specificity is found, tests must be adjusted in order to improve their detection power for the new agent. There are multiple diagnostic tests, each one with its own advantages and limitations; so the selection of a test will depend on the specific conditions of a particular diagnostic laboratory.

  13. INFLUENZA A H1N1 DE ORIGEN PORCINO: Métodos diagnósticos / Influenza A H1N1 swine origin: diagnostic methods

    Scientific Electronic Library Online (English)

    Manuel Antonio, Vargas-Córdoba.

    2010-01-01

    Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish El diagnóstico de la infección por virus influenza reposa sobre técnicas virológicas directas e indirectas. Las diferentes pruebas diagnósticas poseen niveles de sensibilidad y especificidad variables que dependen en gran parte de las características genéticas y antigénicas del virus circulante. En [...] el caso de la aparición de una nueva variante viral las pruebas disponibles en el mercado deben ser validadas para comprobar su eficiencia de detección para el nuevo virus. En caso de baja sensibilidad y especificidad, las pruebas deben ajustarse con el fin de mejorar su poder de detección del nuevo agente. Existen múltiples pruebas diagnósticas que presentan cada una sus ventajas y limitaciones y su selección dependerá de las condiciones específicas de cada laboratorio diagnóstico. Abstract in english The diagnosis of infection by influenza viruses relays on direct and indirect virologic techniques. Different diagnostic tests have variable sensitivities and specificities depending to a large extent on the genetic and antigenic features of the circulating virus. When a new viral variant appears, c [...] ommercially available tests must be validated in order to verify their performance at detecting the new virus. If a low sensitivity or specificity is found, tests must be adjusted in order to improve their detection power for the new agent. There are multiple diagnostic tests, each one with its own advantages and limitations; so the selection of a test will depend on the specific conditions of a particular diagnostic laboratory.

  14. Phylogenetic analysis of H1N1 sequences from pandemic infections during 2009 in India

    OpenAIRE

    Flavia, Guntupally Balaswamy Arti; Natarajaseenivasan, Kalimuthusamy

    2011-01-01

    Since April 2009, a serious pandemic infection has been rapidly spread across the world. These infections are caused due to the novel swine origin influenza A (H1N1) virus and hence these are commonly called as “Swine Flu”. This new virus is the reassortment of avian, human and swine influenza viruses and thus it has a unique genome composition. There are 16 different types of hemagglutinin (HA) and 9 different types of neuraminidase (NA) that can be genetically and antigeneti...

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

    OpenAIRE

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

    2007-01-01

    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...

  16. Pediatric Healthcare Response to Pandemic (H1N1) 2009 Influenza Stakeholder Meeting - Summary of Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    The goal of the meeting was to bring together subject matter experts to develop tools and resources for use by the pediatric healthcare community in response to 2009 (H1N1) pandemic influenza activity during the 2009 influenza season.

  17. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-14

    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.

  18. The ENSO-pandemic influenza connection: coincident or causal?

    Science.gov (United States)

    Shaman, J. L.; Lipsitch, M.

    2011-12-01

    The El Niño-Southern Oscillation (ENSO) is a coupled ocean-atmosphere system in the tropical Pacific, which affects weather conditions, including temperatures, precipitation, winds and storm activity, across the planet. ENSO has two extreme phases marked by either warmer (El Niño) or cooler (La Niña) than average sea surface temperatures in the central equatorial Pacific. We find that the 4 most recent human influenza pandemics (1918, 1957, 1968, 2009), all of which were first identified in boreal spring or summer, were preceded by La Niña conditions in the equatorial Pacific. Changes in ENSO have been shown to alter the migration, stopover time, fitness and interspecies mixing of migratory birds, and consequently likely affect their mixing with domestic animals. We hypothesize that La Niña conditions bring divergent influenza subtypes together in some parts of the world and favor the reassortment of influenza through simultaneous multiple infection of individual hosts and the generation of novel pandemic strains. We propose approaches to test this hypothesis using influenza population genetics, virus prevalence in various host species, and avian migration patterns.

  19. The Highly Pathogenic Avian Influenza H5N1 – Initial Molecular Signals for the Next Influenza Pandemic

    Directory of Open Access Journals (Sweden)

    Yasuo Suzuki

    2009-06-01

    Full Text Available A new pandemic influenza in the human world may originate from avian reservoirs.Influenza is one of the most widely spread zoonotic infectious diseases. All avian influenzaviruses are type A, and they have often caused pandemics throughout human history. Thehighly pathogenic H5N1 influenza A viruses have now been spreading to many countries inAsia, Europe and Africa. They have infected an increasing number of humans in at least 15countries in the world. This paper describes recent advances in the mechanism of transmissionof highly pathogenic avian influenza to humans and measures for control of a new pandemic.

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

    OpenAIRE

    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

    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...

  1. Cases of Swine Influenza in Humans: A Review of the Literature

    OpenAIRE

    Myers, Kendall P.; Olsen, Christopher W.; Gray, Gregory C.

    2007-01-01

    As the threat of a pandemic looms, improvement in our understanding of interspecies transmission of influenza is necessary. Using the search terms “swine,” “influenza,” and “human,” we searched the PubMed database in April 2006 to identify publications describing symptomatic infections of humans with influenza viruses of swine origin. From these reports, we extracted data regarding demographic characteristics, epidemiological investigations, and laboratory results. We found 50 cas...

  2. PATHOGENICITY AND TRANSMISSION OF THE RECONSTRUCTED 1918 SPANISH INFLUENZA PANDEMIC VIRUS IN FERRETS

    Science.gov (United States)

    The pandemic influenza virus of 1918-1919 killed an estimated 20-50 million people worldwide. Through the use of reverse genetics, we recently generated an influenza virus bearing all eight gene segments of the pandemic virus. Here we evaluate the relative virulence and transmission of the 1918 pan...

  3. Protective Effect of Maritime Quarantine in South Pacific Jurisdictions, 1918–19 Influenza Pandemic

    OpenAIRE

    Mcleod, Melissa A.; Baker, Michael; Wilson, Nick; Kelly, Heath; Kiedrzynski, Tom; Kool, Jacob L.

    2008-01-01

    We reviewed mortality data of the 1918–19 influenza pandemic for 11 South Pacific Island jurisdictions. Four of these appear to have successfully delayed or excluded the arrival of pandemic influenza by imposing strict maritime quarantine. They also experienced lower excess death rates than the other jurisdictions that did not apply quarantine measures.

  4. Seasonal Influenza Vaccine Allocation in the Canadian Population during a Pandemic

    OpenAIRE

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

    2009-01-01

    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.

  5. [Pandemic and prepandemic H5N1 influenza vaccines: a 2009 update].

    Science.gov (United States)

    Loulergue, Pierre; Launay, Odile

    2009-01-01

    Since 2003, hundreds of infections with H5N1 avian influenza virus have been reported in humans with a mortality rate of ca. 60 %, which makes us fear a pandemic influenza in a population without pre-existing immunity. Currently, the inter-human transmission is limited to persons in close contact with poultry. In anticipation of this pandemic threat, a global plan was established in which immunization represents a major issue. However, the development of a vaccine is related to many specific problems as the manipulation of strains or evaluation of immunogenicity. In addition, production delays after identification of the pandemic virus are incompressible and the pandemic is likely to develop before a vaccine is available. Specific approaches have been developed to produce prepandemic vaccines that can induce cross-immunity, partially effective on the pandemic strain. In 2009, several prepandemic and pandemic vaccines have obtained their licensure authorization and strategies are being developed in case of pandemic influenza. PMID:19765386

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

    OpenAIRE

    Tandale Babasaheb V; Pawar Shailesh D; Gurav Yogesh K; Chadha Mandeep S; Koratkar Santosh S; Shelke Vijay N; Mishra Akhilesh C

    2010-01-01

    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, gener...

  7. Pandemic A/H1N1/2009 influenza virus in Swine, Cameroon, 2010

    OpenAIRE

    Njabo, Kevin Y.; Fuller, Trevon L.; Chasar, Anthony; Pollinger, John P.; Cattoli, Giovanni; Terregino, Calogero; Monne, Isabella; Reynes, Jean-marc; Njouom, Richard; Smith, Thomas B.

    2011-01-01

    Although swine origin A/H1N1/2009 influenza virus (hereafter “pH1N1”) has been detected in swine in 20 countries, there has been no published surveillance of the virus in African livestock. The objective of this study was to assess the circulation of influenza A viruses, including pH1N1 in swine in Cameroon, Central Africa. We collected 108 nasal swabs and 98 sera samples from domestic pigs randomly sampled at 11 herds in villages and farms in Cameroon. pH1N1 was isolated from two swine s...

  8. Molecular basis of a pandemic of avian-type influenza virus.

    Science.gov (United States)

    Sriwilaijaroen, Nongluk; Suzuki, Yasuo

    2014-01-01

    Despite heroic efforts to prevent the emergence of an influenza pandemic, avian influenza A virus has prevailed by crossing the species barriers to infect humans worldwide, occasionally with morbidity and mortality at unprecedented levels, and the virus later usually continues circulation in humans as a seasonal influenza virus, resulting in health-social-economic problems each year. Here, we review current knowledge of influenza viruses, their life cycle, interspecies transmission, and past pandemics and discuss the molecular basis of pandemic acquisition, notably of hemagglutinin (lectin) acting as a key contributor to change in host specificity in viral infection. PMID:25117257

  9. The first influenza pandemic of the 21st century

    Directory of Open Access Journals (Sweden)

    Al Hajjar Sami

    2010-01-01

    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?

  10. Influenza pandemic preparedness: motivation for protection among small and medium businesses in Australia

    Directory of Open Access Journals (Sweden)

    MacIntyre C Raina

    2007-07-01

    Full Text Available Abstract Background Community-wide preparedness for pandemic influenza is an issue that has featured prominently in the recent news media, and is currently a priority for health authorities in many countries. The small and medium business sector is a major provider of private sector employment in Australia, yet we have little information about the preparedness of this sector for pandemic influenza. This study aimed to investigate the association between individual perceptions and preparedness for pandemic influenza among small and medium business owners and managers. Methods Semi-structured face-to-face interviews were conducted with 201 small and medium business owners or managers in New South Wales and Western Australia. Eligible small or medium businesses were defined as those that had less than 200 employees. Binomial logistic regression analysis was used to identify the predictors of having considered the impact of, having a plan for, and needing help to prepare for pandemic influenza. Results Approximately 6 per cent of participants reported that their business had a plan for pandemic influenza, 39 per cent reported that they had not thought at all about the impact of pandemic influenza on their business, and over 60 per cent stated that they required help to prepare for a pandemic. Beliefs about the severity of pandemic influenza and the ability to respond were significant independent predictors of having a plan for pandemic influenza, and the perception of the risk of pandemic influenza was the most important predictor of both having considered the impact of, and needing help to prepare for a pandemic. Conclusion Our findings suggest that small and medium businesses in Australia are not currently well prepared for pandemic influenza. We found that beliefs about the risk, severity, and the ability to respond effectively to the threat of pandemic influenza are important predictors of preparedness. Campaigns targeting small and medium businesses should emphasise the severity of the consequences to their businesses if a pandemic were to occur, and, at the same time, reassure them that there are effective strategies capable of being implemented by small and medium businesses to deal with a pandemic.

  11. 2009 Pandemic H1N1 influenza: Risk factors for severe and fatal manifestations.

    OpenAIRE

    Pawitan, Jeanne Adiwinata

    2011-01-01

    Introduction: Most of the confirmed 2009 H1N1 pandemic cases showed mild influenza like illness similar to seasonal influenza. However, there were also severe and fatal cases. Knowledge of the risk factors associated with severe and fatal cases is important. This study assessed the risk factors for severe and fatal manifestations. Materials and Methods: Search of Medline/PubMed (search period unrestricted) using keywords ‘Pandemic’, ‘H1N1 influenza’, ‘risk factor’, ‘severe and/o...

  12. Inference of seasonal and pandemic influenza transmission dynamics.

    Science.gov (United States)

    Yang, Wan; Lipsitch, Marc; Shaman, Jeffrey

    2015-03-01

    The inference of key infectious disease epidemiological parameters is critical for characterizing disease spread and devising prevention and containment measures. The recent emergence of surveillance records mined from big data such as health-related online queries and social media, as well as model inference methods, permits the development of new methodologies for more comprehensive estimation of these parameters. We use such data in conjunction with Bayesian inference methods to study the transmission dynamics of influenza. We simultaneously estimate key epidemiological parameters, including population susceptibility, the basic reproductive number, attack rate, and infectious period, for 115 cities during the 2003-2004 through 2012-2013 seasons, including the 2009 pandemic. These estimates discriminate key differences in the epidemiological characteristics of these outbreaks across 10 y, as well as spatial variations of influenza transmission dynamics among subpopulations in the United States. In addition, the inference methods appear to compensate for observational biases and underreporting inherent in the surveillance data. PMID:25730851

  13. Rol de la Nefrología en la pandemia por Influenza A (H1N1): Puesta al día / The role of nephrology in the influenza A (H1N1) pandemic update

    Scientific Electronic Library Online (English)

    A., Vallejos.

    Full Text Available SciELO Spain | Language: Spanish Abstract in spanish En junio de 2009, la OMS declaró la pandemia por virus de la influenza A de origen porcino (H1N1). Desde entonces, los nefrólogos fuimos afectados en varias de nuestras actividades. Disminuyó la asistencia al trabajo del personal de salud al cuidado de pacientes renales crónicos. Aparecieron nuevos [...] casos de fallo renal agudo asociados a la infección viral, la mayoría en adultos jóvenes, con alta tasa de mortalidad. Hubo contagios en pacientes trasplantados renales y se retrajo transitoriamente la procuración de órganos en la semanas de mayor contagio. Entidades científicas se movilizaron para consensuar protocolos de evaluación y tratamiento con el fin de disminuir el impacto de la pandemia en pacientes renales. Abstract in english In June 2009, WHO declared pandemic swine origin influenza A virus (H1N1). Since then, nephrologists were involved in several of our activities. Decreased work attendance of healthcare for chronic renal patients. Appeared new cases of acute renal failure associated with viral infection, mostly in yo [...] ung adults, with high mortality rate. There were infections in renal transplant patients and temporarily decreased the organs procurement in the weeks of further spread. Scientific institutions were mobilized to agree on protocols for assessment and treatment in order to lessen the impact of the pandemic in renal patients.

  14. Small molecule inhibitors of the c-Jun N-terminal kinase (JNK) possess antiviral activity against highly pathogenic avian and human pandemic influenza A viruses.

    Science.gov (United States)

    Nacken, Wolfgang; Ehrhardt, Christina; Ludwig, Stephan

    2012-05-01

    C-Jun N-terminal kinases (JNK) are activated in course of many viral infections. Here we analyzed the activity of JNK inhibitors on influenza A virus (IAV) amplification. Human lung epithelial cells were infected with either the highly pathogenic avian virus strain A/FPV/Bratislava/79 (H7N7) or the pandemic swine-origin influenza virus A/Hamburg/4/09 (H1N1v). The application of the JNK inhibitors SP600125 and AS601245 reduced IAV amplification by suppressing viral protein and RNA synthesis. Although AS601245 appeared to generally block the transcription of newly introduced genes, SP600125 specifically affected viral RNA synthesis. Overexpression of a dominant negative mutant of SEK/MKK4 and siRNA-mediated suppression of JNK2 expression confirmed that specific manipulation of the JNK pathway attenuates virus propagation. An IAV minigenome replication assay revealed that SP600125 did not directly affect the activity of the viral RNA polymerase complex but seems to suppress an anti-influenza nonstructural protein 1-mediated virus supportive function. Finally, when H7N7- or H1N1v-infected mice were treated with SP600125, the viral load is reduced in lungs of treated compared with untreated mice. Our data suggest that this class of ATP competitive inhibitors once optimized for antiviral action potentially represent novel drugs for antiviral intervention. PMID:22628315

  15. Pandemic influenza preparedness: the critical role of the syringe.

    Science.gov (United States)

    Strauss, Kenneth; van Zundert, André; Frid, Anders; Costigliola, Vincenzo

    2006-05-29

    In the face of an almost unprecedented threat of a global pandemic of influenza it is imperative that stockpiling of appropriate drugs and devices begin now. One vital device is an appropriate syringe for delivering vaccine. With the potential for millions to be infected and the vaccine supply severely stretched it is imperative that the syringe used to vaccinate waste as little vaccine as possible and thus allow for a maximum number of persons to be vaccinated. Our study tested seven leading candidate vaccine syringes for dosing accuracy, dose-capacity per vial, medication wastage and a battery of ergonomic features. One device, the Flu+trade mark syringe, proved superior to the others in all important categories, possibly due to its low dead-space volume and its dosing accuracy. The data suggest that switching to this device from any of the others tested would provide between 2 and 19% additional vaccine doses per vial if the current 10-dose vials are used. Extrapolations from this data suggest that many thousands to millions of additional persons could be vaccinated in mass campaigns. Use of a syringe of this type, and the vaccine savings that would accrue, would likely be important in reducing morbidity and mortality in the event of a pandemic of influenza. PMID:16647790

  16. Behavioural intentions in response to an influenza pandemic

    Directory of Open Access Journals (Sweden)

    Schaalma Herman

    2010-03-01

    Full Text Available Abstract Background Little is known regarding which behavioural responses can be expected if an influenza pandemic were to occur. Methods A survey comprising questions based on risk perception theories, in particular PMT, was conducted with a Dutch sample. Results Although fear that an influenza pandemic may occur was high, participants do not feel well informed. General practitioners and local health authorities were considered trustworthy sources of information and the information considered most urgent pertained to which protective measures should be taken. Participants reported an intention to comply with recommendations regarding protective measures. However, response and self efficacy were low. Maladaptive behaviours can be expected. Increasing numbers of ill individuals and school closures are also expected to lead to a decreased work force. Participants indicated wanting antiviral drugs even if the supply were to be insufficient. Conclusions Messages regarding health protective behaviours from local health authorities should anticipate the balance between overreacting and underreacting. Also, when protective recommendations from health professionals conflict with company policies, it is unclear how employees will react.

  17. Diversity of Influenza Viruses in Swine and the Emergence of a Novel Human Pandemic Influenza A (H1N1)

    OpenAIRE

    Brockwell-staats, Christy; Webster, Robert G.; Webby, Richard J.

    2009-01-01

    The novel H1N1 influenza virus that emerged in humans in Mexico in early 2009 and transmitted efficiently in the human population with global spread has been declared a pandemic strain. Here we review influenza infections in swine since 1918 and the introduction of different avian and human influenza virus genes into swine influenza viruses of North America and Eurasia. These introductions often result in viruses of increased fitness for pigs that occasionally transmit to humans. The novel vi...

  18. Existing health inequalities in India: informing preparedness planning for an influenza pandemic

    OpenAIRE

    Kumar, Supriya; Quinn, Sandra C.

    2011-01-01

    On 11 June 2009, the World Health Organization (WHO) declared that the world was in phase 6 of an influenza pandemic. In India, the first case of 2009 H1N1 influenza was reported on 16 May 2009 and by August 2010 (when the pandemic was declared over), 38?730 cases of 2009 H1N1 had been confirmed of which there were 2024 deaths. Here, we propose a conceptual model of the sources of health disparities in an influenza pandemic in India. Guided by a published model of the plausible sources of s...

  19. Analytical and clinical validation of novel real-time reverse transcriptase-polymerase chain reaction assays for the clinical detection of swine-origin H1N1 influenza viruses.

    Science.gov (United States)

    Duncan, Carla; Guthrie, Jennifer L; Tijet, Nathalie; Elgngihy, Naglaa; Turenne, Christine; Seah, Christine; Lau, Rachel; McTaggart, Lisa; Mallo, Gustavo; Perusini, Stephen; Rebbapragada, Anu; Melano, Roberto; Low, Donald E; Farrell, David; Guyard, Cyril

    2011-02-01

    During the early stages of the 2009/2010 swine-origin H1N1 influenza A (S-OIV H1N1 FluA) outbreak, the development and validation of sensitive and specific detection methods were a priority for rapid and accurate diagnosis. Between May and June 2009, 2 real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) assays targeting the hemagglutinin and neuraminidase genes of the S-OIV H1N1 FluA virus were developed. These assays are highly specific, showing no cross-reactivity against a panel of respiratory viruses and can differentiate S-OIV H1N1 from seasonal FluA viruses. Analytical sensitivities of the 2 assays were found to be 10(-1) tissue culture infectious dose, 50%/ml. Clinical testing showed 99.2% sensitivity and 94.6-98.1% specificity. A large prospective analysis showed that 94.8-95.5% of S-OIV positive specimens were negative by seasonal H1/H3 subtyping. The large-scale validation data presented in this report indicate that these novel assays provide an accurate and efficient method for the rapid detection of S-OIV H1N1 FluA viruses. PMID:21251560

  20. Simulating the Spread of Influenza Pandemic of 1918-1919 Considering the Effect of the First World War

    OpenAIRE

    Yoneyama, Teruhiko; Krishnamoorthy, Mukkai S.

    2010-01-01

    The Influenza Pandemic of 1918-1919, also called Spanish Flu Pandemic, was one of the severest pandemics in history. It is thought that the First World War much influenced the spread of the pandemic. In this paper, we model the pandemic considering both civil and military traffic. We propose a hybrid model to determine how the pandemic spread through the world. Our approach considers both the SEIR-based model for local areas and the network model for global connection betwee...

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

    Directory of Open Access Journals (Sweden)

    Pablo Kuri-Morales

    2006-02-01

    Full Text Available 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.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.

  2. Evaluation of Three Live Attenuated H2 Pandemic Influenza Vaccine Candidates in Mice and Ferrets

    OpenAIRE

    Chen, Grace L.; Lamirande, Elaine W.; Cheng, Xing; Torres-velez, Fernando; Orandle, Marlene; Jin, Hong; Kemble, George; Subbarao, Kanta

    2014-01-01

    H2 influenza viruses have not circulated in humans since 1968, and therefore a significant portion of the population would be susceptible to infection should H2 influenza viruses reemerge. H2 influenza viruses continue to circulate in avian reservoirs worldwide, and these reservoirs are a potential source from which these viruses could emerge. Three reassortant cold-adapted (ca) H2 pandemic influenza vaccine candidates with hemagglutinin (HA) and neuraminidase (NA) genes derived from the wild...

  3. Pathogenicity of swine influenza viruses possessing an avian or swine-origin PB2 polymerase gene evaluated in mouse and pig models

    Science.gov (United States)

    Influenza A viruses isolated from birds normally contain a PB2 polymerase gene with the avian-signature glutamic acid (E) at position 627, while those isolated from humans contain the mammalian-signature lysine (K) at this position. This residue has been shown to be a determinant of host range and c...

  4. Absence of 2009 Pandemic H1N1 Influenza A Virus in Fresh Pork

    OpenAIRE

    Vincent, Amy L.; Lager, Kelly M.; Harland, Michelle; Lorusso, Alessio; Zanella, Eraldo; Ciacci-zanella, Janice R.; Kehrli, Marcus E.; Klimov, Alexander

    2009-01-01

    The emergence of the pandemic 2009 H1N1 influenza A virus in humans and subsequent discovery that it was of swine influenza virus lineages raised concern over the safety of pork. Pigs experimentally infected with pandemic 2009 H1N1 influenza A virus developed respiratory disease; however, there was no evidence for systemic disease to suggest that pork from pigs infected with H1N1 influenza would contain infectious virus. These findings support the WHO recommendation that pork harvested from p...

  5. A Coordinated Approach to Communicating Pediatric-Related Information on Pandemic Influenza at the Community Level

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2009-12-16

    The purpose of this document is to provide a suggested approach, based on input from pediatric stakeholders, to communicating pediatric-related information on pandemic influenza at the community level in a step-by-step manner.

  6. Simulation to assess the efficacy of US airport entry scrreening of passengers for pandemic influenza

    Energy Technology Data Exchange (ETDEWEB)

    Mcmahon, Benjamin [Los Alamos National Laboratory

    2009-01-01

    We present our methodology and stochastic discrete-event simulation developed to model the screening of passengers for pandemic influenza at the US port-of-entry airports. Our model uniquely combines epidemiology modelling, evolving infected states and conditions of passengers over time, and operational considerations of screening in a single simulation. The simulation begins with international aircraft arrivals to the US. Passengers are then randomly assigned to one of three states -- not infected, infected with pandemic influenza and infected with other respiratory illness. Passengers then pass through various screening layers (i.e. pre-departure screening, en route screening, primary screening and secondary screening) and ultimately exit the system. We track the status of each passenger over time, with a special emphasis on false negatives (i.e. passengers infected with pandemic influenza, but are not identified as such) as these passengers pose a significant threat as they could unknowingly spread the pandemic influenza virus throughout our nation.

  7. A monoclonal antibody-based ELISA for differential diagnosis of 2009 pandemic H1N1

    Science.gov (United States)

    The swine-origin 2009 pandemic H1N1 virus (pdmH1N1) is genetically related to North American swine H1 influenza viruses and unrelated to human seasonal H1 viruses. Currently, specific diagnosis of pdmH1N1 relies on RT-PCR. In order to develop an assay that does not rely in amplification of the viral...

  8. Estrategia cubana de caracterización molecular del virus influenza A/H1N1pdm Cuban strategy for the molecular characterization of the pandemic influenza A virus (H1N1

    Directory of Open Access Journals (Sweden)

    Alexander Piñón Ramos

    2011-04-01

    Full Text Available INTRODUCCIÓN: en Abril de 2009 se identificó una variante del virus influenza A/H1N1 de origen porcino, lo cual determinó que fuese declarada rápidamente la primera pandemia del siglo XXI. OBJETIVO: establecer una estrategia de secuenciación nucleotídica que permitiera diagnosticar diferencialmente los virus influenza A estacionales del nuevo virus pandémico, así como obtener la mayor cantidad de información posible desde el punto de vista molecular de los genes hemaglutinina y neuraminidasa, tanto de pacientes que sufrieron una enfermedad tipo influenza como los que padecieron de una infección respiratoria aguda grave y los que fallecieron. MÉTODOS: se diseñaron e implementaron tres estrategias de secuenciación que brindaron información importante acerca del nuevo virus en Cuba. RESULTADOS: a través de la tercera estrategia se obtuvieron los resultados más completos: diagnóstico diferencial, vigilancia de las mutaciones D222G/E en la hemaglutinina y las variantes virales H275Y resistentes al Tamiflu. A pesar de no haber detectado las mutaciones mencionadas, no se puede descartar su presencia en población cubana, debido a que estas estrategias no fueron diseñadas con ese fin. Se impone diseñar un estudio para cumplir con ese objetivo. CONCLUSIONES: las estrategias de secuenciación aplicadas en nuestro algoritmo permitieron realizar el diagnóstico diferencial de los virus influenza estacional del pandémico y su caracterización molecular.INTRODUCTION: in April 2009, there was identified a variant of the A/H1N1 influenza virus of swine origin, and shortly after the first pandemic in XXI century was declared. OBJECTIVES: to establish a nucleotide sequencing strategy for the differential diagnosis of the seasonal and pandemic influenza A viruses, and to obtain as much molecular information as possible about hemagglutinin and neuraminidase genes in patients with influenza-like illnesses, in those with severe respiratory infection and in patients who died. METHODS: three sequencing strategies were designed and implemented, which also offered important information about the new virus in Cuba. RESULTS: the third strategy provided the most comprehensive results such as differential diagnosis, the surveillance of the D222G/E mutation in hemagglutinin and Tamiflu-resistant H275Y viral variants. In spite of the fact that the mentioned mutations were not detected, their presence in the Cuban population can not be ignored since these strategies were not designed for this end. It is imperative to design a study to fulfill this objective. CONCLUSIONS: the sequencing strategies in our algorithm allowed the differential diagnosis of the seasonal and the pandemic viruses, and their molecular characterization.

  9. Estrategia cubana de caracterización molecular del virus influenza A/H1N1pdm / Cuban strategy for the molecular characterization of the pandemic influenza A virus (H1N1)

    Scientific Electronic Library Online (English)

    Alexander, Piñón Ramos; Belsy, Acosta Herrera; Odalys, Valdés Ramírez; Amely, Arencibia García; Clara Estela, Savón Valdés; Grehete, González Muñoz; Suset Isabel, Oropesa Fernández; Elías, Quilarte García; Guelsys, González Baez; Bárbara, Hernández Espinosa; Ángel, Goyenechea Hernández; María Guadalupe, Guzmán Tirado; Alina, Llop Hernández; Vivian, Kourí Cardellá.

    2011-04-01

    Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: en Abril de 2009 se identificó una variante del virus influenza A/H1N1 de origen porcino, lo cual determinó que fuese declarada rápidamente la primera pandemia del siglo XXI. OBJETIVO: establecer una estrategia de secuenciación nucleotídica que permitiera diagnosticar diferencialmente [...] los virus influenza A estacionales del nuevo virus pandémico, así como obtener la mayor cantidad de información posible desde el punto de vista molecular de los genes hemaglutinina y neuraminidasa, tanto de pacientes que sufrieron una enfermedad tipo influenza como los que padecieron de una infección respiratoria aguda grave y los que fallecieron. MÉTODOS: se diseñaron e implementaron tres estrategias de secuenciación que brindaron información importante acerca del nuevo virus en Cuba. RESULTADOS: a través de la tercera estrategia se obtuvieron los resultados más completos: diagnóstico diferencial, vigilancia de las mutaciones D222G/E en la hemaglutinina y las variantes virales H275Y resistentes al Tamiflu. A pesar de no haber detectado las mutaciones mencionadas, no se puede descartar su presencia en población cubana, debido a que estas estrategias no fueron diseñadas con ese fin. Se impone diseñar un estudio para cumplir con ese objetivo. CONCLUSIONES: las estrategias de secuenciación aplicadas en nuestro algoritmo permitieron realizar el diagnóstico diferencial de los virus influenza estacional del pandémico y su caracterización molecular. Abstract in english INTRODUCTION: in April 2009, there was identified a variant of the A/H1N1 influenza virus of swine origin, and shortly after the first pandemic in XXI century was declared. OBJECTIVES: to establish a nucleotide sequencing strategy for the differential diagnosis of the seasonal and pandemic influenza [...] A viruses, and to obtain as much molecular information as possible about hemagglutinin and neuraminidase genes in patients with influenza-like illnesses, in those with severe respiratory infection and in patients who died. METHODS: three sequencing strategies were designed and implemented, which also offered important information about the new virus in Cuba. RESULTS: the third strategy provided the most comprehensive results such as differential diagnosis, the surveillance of the D222G/E mutation in hemagglutinin and Tamiflu-resistant H275Y viral variants. In spite of the fact that the mentioned mutations were not detected, their presence in the Cuban population can not be ignored since these strategies were not designed for this end. It is imperative to design a study to fulfill this objective. CONCLUSIONS: the sequencing strategies in our algorithm allowed the differential diagnosis of the seasonal and the pandemic viruses, and their molecular characterization.

  10. Adaptation of Pandemic H2N2 Influenza A Viruses in Humans.

    Science.gov (United States)

    Joseph, Udayan; Linster, Martin; Suzuki, Yuka; Krauss, Scott; Halpin, Rebecca A; Vijaykrishna, Dhanasekaran; Fabrizio, Thomas P; Bestebroer, Theo M; Maurer-Stroh, Sebastian; Webby, Richard J; Wentworth, David E; Fouchier, Ron A M; Bahl, Justin; Smith, Gavin J D

    2015-02-15

    The 1957 A/H2N2 influenza virus caused an estimated 2 million fatalities during the pandemic. Since viruses of the H2 subtype continue to infect avian species and pigs, the threat of reintroduction into humans remains. To determine factors involved in the zoonotic origin of the 1957 pandemic, we performed analyses on genetic sequences of 175 newly sequenced human and avian H2N2 virus isolates and all publicly available influenza virus genomes. PMID:25505070

  11. Seroprevalence Following the Second Wave of Pandemic 2009 H1N1 Influenza

    OpenAIRE

    Ross, Ted; Zimmer, Shanta; Burke, Don; Crevar, Corey; Carter, Donald; Stark, James; Giles, Brendan; Zimmerman, Richard; Ostroff, Stephen; Lee, Bruce

    2010-01-01

    BACKGROUND: In April 2009, a new pandemic strain of influenza infected thousands of persons in Mexico and the United States and spread rapidly worldwide. During the ensuing summer months, cases ebbed in the Northern Hemisphere while the Southern Hemisphere experienced a typical influenza season dominated by the novel strain. In the fall, a second wave of pandemic H1N1 swept through the United States, peaking in most parts of the country by mid October and returning to baseline levels by early...

  12. Influenza pandemic and professional duty: family or patients first? A survey of hospital employees

    OpenAIRE

    Hanses Frank; Ehrenstein Boris P; Salzberger Bernd

    2006-01-01

    Abstract Background Conflicts between professional duties and fear of influenza transmission to family members may arise among health care professionals (HCP). Methods We surveyed employees at our university hospital regarding ethical issues arising during the management of an influenza pandemic. Results Of 644 respondents, 182 (28%) agreed that it would be professionally acceptable for HCP to abandon their workplace during a pandemic in order to protect themselves and their families, 337 (52...

  13. Quarantine for pandemic influenza control at the borders of small island nations.

    OpenAIRE

    Wilson Nick; Nishiura Hiroshi; Baker Michael G

    2009-01-01

    Background: Although border quarantine is included in many influenza pandemic plans, detailed guidelines have yet to be formulated, including considerations for the optimal quarantine length. Motivated by the situation of small island nations, which will probably experience the introduction of pandemic influenza via just one airport, we examined the potential effectiveness of quarantine as a border control measure. Methods: Analysing the detailed epidemiologic characteristics o...

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

    OpenAIRE

    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

    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...

  15. The Highly Pathogenic Avian Influenza H5N1 – Initial Molecular Signals for the Next Influenza Pandemic

    OpenAIRE

    Yasuo Suzuki

    2009-01-01

    A new pandemic influenza in the human world may originate from avian reservoirs.Influenza is one of the most widely spread zoonotic infectious diseases. All avian influenzaviruses are type A, and they have often caused pandemics throughout human history. Thehighly pathogenic H5N1 influenza A viruses have now been spreading to many countries inAsia, Europe and Africa. They have infected an increasing number of humans in at least 15countries in the world. This paper describes recent advances in...

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

    OpenAIRE

    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

    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...

  17. Searching of Main Cause Leading to Severe Influenza A Virus Mutations and Consequently to Influenza Pandemics/Epidemics

    OpenAIRE

    Guang Wu; Shaomin Yan

    2005-01-01

    The unpredictable mutations in the proteins from influenza A virus lead to the great difficulty in prevention of possible outbreak of bird flu and pandemic/epidemic of influenza. This unpredictability is due to the fact that we know little about the causes that lead to the mutations. In three of our recent studies on the hemagglutinins from influenza A virus, we unintentionally noticed the periodicity of mutations in hemagglutinins similar to the periodicity of sunspot. We calculated the amin...

  18. Influenza vaccination coverage against seasonal and pandemic influenza and their determinants in France: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    de Valk Henriette

    2011-01-01

    Full Text Available Abstract Background Following the emergence of the influenza A(H1N12009 virus, the French ministry of health decided to offer free vaccination against pandemic influenza to the entire French population. Groups of people were defined and prioritised for vaccination. Methods We took a random sample of the population of mainland France and conducted a retrospective cross-sectional telephone survey to estimate vaccination coverage against seasonal and pandemic influenza and to identify determinants of these vaccinations. Results 10,091 people were included in the survey. Overall seasonal influenza vaccination coverage (IVC remained stable in the population from the 2008-2009 season to the 2009-2010 season reaching 20.6% and 20.8% respectively. Overall pandemic IVC in the French population is estimated to be 11.1% (CI95%: 9.8 - 12.4. The highest pandemic IVC was observed in the 0-4 years age group. For individuals with health conditions associated with higher risk of influenza, pandemic IVC was estimated to be 12.2% (CI95%: 9.8 - 15.1. The main determinants associated with pandemic influenza vaccine uptake were: living in a household with a child adj: 2.0 (CI95%: 1.3 - 3.1 or with two children adj: 2.7 (CI95%: 1.4 - 5.1, living in a household where the head of the family is university graduate (>2 years, ORadj: 2.5 (CI95%: 1.5 - 4.1, or has a higher professional and managerial occupation, ORadj: 3.0 (CI95%: 1.5 - 5.5 and being vaccinated against seasonal influenza, ORadj: 7.1 (CI95%: 5.1 - 10.0. Being an individual with higher risk for influenza was not a determinant for pandemic influenza vaccine uptake. These determinants are not the same as those for seasonal influenza vaccination. Conclusions Overall A(H1N12009 influenza vaccine uptake remained low, particularly among individuals with higher risk for influenza and was lower than that observed for seasonal influenza. The reasons behind people's reluctance to be vaccinated need to be investigated further.

  19. The relationship between tuberculosis and influenza death during the influenza (H1N1) pandemic from 1918-19.

    Science.gov (United States)

    Oei, Welling; Nishiura, Hiroshi

    2012-01-01

    The epidemiological mechanisms behind the W-shaped age-specific influenza mortality during the Spanish influenza (H1N1) pandemic 1918-19 have yet to be fully clarified. The present study aimed to develop a formal hypothesis: tuberculosis (TB) was associated with the W-shaped influenza mortality from 1918-19. Three pieces of epidemiological information were assessed: (i) the epidemic records containing the age-specific numbers of cases and deaths of influenza from 1918-19, (ii) an outbreak record of influenza in a Swiss TB sanatorium during the pandemic, and (iii) the age-dependent TB mortality over time in the early 20th century. Analyzing the data (i), we found that the W-shaped pattern was not only seen in mortality but also in the age-specific case fatality ratio, suggesting the presence of underlying age-specific risk factor(s) of influenza death among young adults. From the data (ii), TB was shown to be associated with influenza death (P = 0.09), and there was no influenza death among non-TB controls. The data (iii) were analyzed by employing the age-period-cohort model, revealing harvesting effect in the period function of TB mortality shortly after the 1918-19 pandemic. These findings suggest that it is worthwhile to further explore the role of TB in characterizing the age-specific risk of influenza death. PMID:22848231

  20. Pandemic influenza preparedness: an ethical framework to guide decision-making

    Directory of Open Access Journals (Sweden)

    Gibson Jennifer L

    2006-12-01

    Full Text Available Abstract Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.

  1. Pandemic H1N1 influenza: zoonoses are a two-way street

    Science.gov (United States)

    Influenza is a zoonotic viral disease representing a worldwide health and economic threat to humans and animals. Swine influenza was first recognized clinically in pigs in the Midwestern United States in 1918 concurrent with the Spanish flu human pandemic. Since the first report that flu was caused ...

  2. Reassortment of pandemic H1N1/2009 influenza A virus in swine

    OpenAIRE

    Vijaykrishna, D.; Poon, L. L. M.; Ma, S. K.; Li, O. T. W.; Cheung, C. L.; Smith, G. J. D.; Peiris, J. S. M.; Guan, Y.

    2010-01-01

    The emergence of pandemic H1N1/2009 influenza demonstrated that pandemic viruses could be generated in swine. Subsequent re-introduction of H1N1/2009 to swine has occurred in multiple countries. Through systematic surveillance of influenza viruses in swine from a Hong Kong abattoir, we characterize a reassortant progeny of H1N1/2009 with swine viruses. Continued reassortment of H1N1/2009 with swine influenza viruses could produce variants with transmissibility and altered virulence for humans...

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

    OpenAIRE

    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

    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...

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

    Science.gov (United States)

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

    2013-11-01

    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

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

    OpenAIRE

    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

    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...

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

    Directory of Open Access Journals (Sweden)

    Martin Robyn

    2010-09-01

    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.

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

    OpenAIRE

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

    2010-01-01

    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...

  8. The ability of seasonal and pandemic influenza to disrupt military operations

    OpenAIRE

    Jon Hodge; Dennis Shanks

    2011-01-01

    Influenza is one of the few infectious diseases that is able to disrupt military operations quickly. Although the extreme mortality rates seen during the pandemic of 1918-19 when tens of thousands of soldiers died has never been repeated (for as yet unclear reasons), illness rates alone make influenza of great military importance. Seasonal influenza infection rates from 2-30% of a partially immunized force can still limit military activity and challenge the ability of medical facilities to...

  9. Functional significance of the hemadsorption activity of influenza virus neuraminidase and its alteration in pandemic viruses

    OpenAIRE

    Uhlendorff, Jennifer; Matrosovich, Tatyana; Klenk, Hans-dieter; Matrosovich, Mikhail

    2009-01-01

    Human influenza viruses derive their genes from avian viruses. The neuraminidase (NA) of the avian viruses has, in addition to the catalytic site, a separate sialic acid binding site (hemadsorption site) that is not present in human viruses. The biological significance of the NA hemadsorption activity in avian influenza viruses remained elusive. A sequence database analysis revealed that the NAs of the majority of human H2N2 viruses isolated during the influenza pandemic of 1957 differ from t...

  10. Oseltamivir in seasonal, pandemic, and avian influenza: a comprehensive review of 10-years clinical experience.

    Science.gov (United States)

    Smith, James R; Rayner, Craig R; Donner, Barbara; Wollenhaupt, Martina; Klumpp, Klaus; Dutkowski, Regina

    2011-11-01

    Oseltamivir (Tamiflu®; F. Hoffmann-La Roche Ltd, Basel, Switzerland) is an orally administered antiviral for the treatment and prevention of influenza A and B infections that is registered in more than 100 countries worldwide. More than 83 million patients have been exposed to the product since its introduction. Oseltamivir is recommended by the World Health Organization (WHO) for use in the clinical management of pandemic and seasonal influenza of varying severity, and as the primary antiviral agent for treatment of avian H5N1 influenza infection in humans. This article is a nonsystematic review of the experience gained from the first 10 years of using oseltamivir for influenza infections since its launch in early 2000, emphasizing recent advances in our understanding of the product and its clinical utility in five main areas. The article reviews the pharmacokinetics of oseltamivir and its active metabolite, oseltamivir carboxylate, including information on special populations such as children and elderly adults, and the co-administration of oseltamivir with other agents. This is followed by a summary of data on the effectiveness of oseltamivir treatment and prophylaxis in patients with all types of influenza, including pandemic (H1N1) 2009 and avian H5N1 influenza. The implications of changes in susceptibility of circulating influenza viruses to oseltamivir and other antiviral agents are also described, as is the emergence of antiviral resistance during and after the 2009 pandemic. The fourth main section deals with the safety profile of oseltamivir in standard and special patient populations, and reviews spontaneously reported adverse event data from the pandemic and pre-pandemic periods and the topical issue of neuropsychiatric adverse events. Finally, the article considers the pharmacoeconomics of oseltamivir in comparison with vaccination and usual care regimens, and as a component of pandemic influenza mitigation strategies. PMID:22057727

  11. Analysis of suspected adverse reactions following immunization against pandemic influenza

    Directory of Open Access Journals (Sweden)

    Petrovi? Vladimir

    2011-01-01

    Full Text Available Introduction. The surveillance on adverse reaction following immunization was aimed at recording all adverse events possibly related with vaccines. During the implementation of immunization strategy against pandemic influenza A(H1N1 in 2009, the post-marketing comprehensive surveillance was suggested to be conducted due to limited clinical experience in applying this particular vaccine and because of the fact that some vaccines had been licensed only on the basis of the data regarding their quality. Material and Methods. The passive surveillance on adverse events following immunization was conducted simultaneously with immunization campaign against pandemic influenza in the Autonomous Province of Vojvodina. Reporting of adverse events was conducted by health care service through a specially designed questionnaire Results. In the period from December 17th 2009 to February 7th 2010, of the total number of 55720 people who were vaccinated, 50433 received one dose and 5287 received two doses of vaccine. The total number of doses administered was 61007. During the observed period, some adverse reactions were recorded in 37 people, the rate of occurrence of adverse reactions being 6.6 per 10.000 vaccinated. Since the majority of patients had several symptoms and signs, the number of recorded clinical manifestations was much higher (140 than the number of patients with reactions. The dominant symptoms and signs were fever (51.4%, weakness/fatigue (48.6%, headache (40.5% and myalgia (31.5%. The reactions in the majority of patients were mild and transient. Only two patients sought medical care and one was hospitalized. Since the immunization coverage was very small, it was not possible to record rare adverse events, whose expected incidence is, anyway, very low. Conclusion. Surveillance on adverse reaction following immunization represents an important component of immunization program, especially when new vaccines are introduced. Therefore, this form of surveillance in our country needs further improvement in order to provide more complete information on occurrence and characteristics of adverse reactions following immunization.

  12. Deciphering the Swine-Flu Pandemics of 1918 and 2009

    Science.gov (United States)

    Goldstein, Richard; Dos Reis, Mario; Tamuri, Asif; Hay, Alan

    The devastating "Spanish flu" of 1918 killed an estimated 50 million people worldwide, ranking it as the deadliest pandemic in recorded human history. It is generally believed that the virus transferred from birds directly to humans shortly before the start of the pandemic, subsequently jumping from humans to swine. By developing 'non-homogeneous' substitution models that consider that substitution patterns may be different in human, avian, and swine hosts, we can determine the timing of the host shift to mammals. We find it likely that the Spanish flu of 1918, like the current 2009 pandemic, was a 'swine-origin' influenza virus. Now that we are faced with a new pandemic, can we understand how influenza is able to change hosts? Again by modelling the evolutionary process, considering the different selective constraints for viruses in the different hosts, we can identify locations that seem to be under different selective constraints in humans and avian hosts. This allows us to identify changes that may have facilitated the establishment of the 2009 swine-origin flu in humans.

  13. Negotiating Equitable Access to Influenza Vaccines: Global Health Diplomacy and the Controversies Surrounding Avian Influenza H5N1 and Pandemic Influenza H1N1

    OpenAIRE

    Fidler, David P.

    2010-01-01

    As part of the PLoS Medicine series on Global Health Diplomacy, David Fidler provides a case study of the difficult negotiations to increase equitable access to vaccines for highly pathogenic avian influenza A (H5N1) and pandemic 2009 influenza A (H1N1).

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

    OpenAIRE

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

    2010-01-01

    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 ...

  15. Emerging Influenza Strains in the Last Two Decades: A Threat of a New Pandemic?

    Directory of Open Access Journals (Sweden)

    Claudia Trombetta

    2015-03-01

    Full Text Available In the last 20 years, novel non-seasonal influenza viruses have emerged, most of which have originated from birds. Despite their apparent inability to cause pandemics, with the exception of H1N1 swine influenza virus, these viruses still constitute a constant threat to public health. While general concern has decreased after the peak of the H5N1 virus, in recent years several novel reassorted influenza viruses (e.g., H7N9, H9N2, H10N8 have jumped the host-species barrier and are under surveillance by the scientific community and public health systems. It is still unclear whether these viruses can actually cause pandemics or just isolated episodes. The purpose of this review is to provide an overview of old and novel potential pandemic strains of recent decades.

  16. Uptake of pandemic influenza (H1N1)-2009 vaccines in Brazil, 2010.

    Science.gov (United States)

    Domingues, Carla Magda Allan S; de Oliveira, Wanderson Kleber

    2012-07-01

    In 2010, the Brazilian Ministry of Health organized a mass vaccination campaign of selected priority groups in response to the 2009 H1N1 influenza pandemic. The campaign was conducted in six phases from March to July, 2010. Priority groups included healthcare professionals, indigenous persons, pregnant women, young children, persons with chronic illnesses and otherwise healthy adults 20-39 years of age. Over 89 million doses of pandemic influenza vaccines were administered, surpassing immunization targets among several priority groups, including healthcare professionals. We reviewed strategies used in Brazil to promote vaccination against pandemic influenza as well as factors external to the campaign that may have contributed to vaccine uptake among priority groups. PMID:22609010

  17. Development and Evaluation of a Rapid Influenza Diagnostic Test for the Pandemic (H1N1) 2009 Influenza Virus?

    OpenAIRE

    Kwon, Donghyok; Shin, Kyeongcheol; Kwon, Mihwa; Oh, Hee-bok; Kang, Chun; Lee, Joo-yeon

    2010-01-01

    We evaluated a new rapid influenza diagnostic test for the pandemic (H1N1) 2009 influenza virus by using real-time reverse transcription-PCR (rRT-PCR) and viral culture. The sensitivities were 68.5% and 64.5%, and the specificities were 98.4% and 97.6%, respectively. This kit should be used with caution, and negative results should be verified by a confirmative test.

  18. Influenza Pandemic: Gaps in Pandemic Planning and Preparedness Need to Be Addressed. Testimony before the Committee on Homeland Security, House of Representatives. GAO-09-909T

    Science.gov (United States)

    Steinhardt, Bernice

    2009-01-01

    As the current H1N1 outbreak underscores, an influenza pandemic remains a real threat to our nation. Over the past 3 years, the US Government Accountability Office (GAO) conducted a body of work, consisting of 12 reports and 4 testimonies, to help the nation better prepare for a possible pandemic. In February 2009, GAO synthesized the results of…

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

    OpenAIRE

    Lee Vernon J; Lye David C; Wilder-Smith Annelies

    2009-01-01

    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 strategi...

  20. Oseltamivir compounding in the hospital pharmacy during the (H1N1) influenza pandemic

    OpenAIRE

    Márcia Lúcia de Mário Marin; Bruno Barbosa do Carmo Oliveira; Sonia Lucena Cipriano; Carlos Alberto Suslik; Joel Faintuch

    2010-01-01

    AIMS: Pandemics impose large demands on the health care system. The supply of appropriate chemotherapeutic agents, namely oseltamivir solution, presented a serious challenge in the recent influenza pandemic. This study reports on the rational series of pharmacotechnical steps that were followed to appropriately handle bulk oseltamivir powder to meet the increased demand. METHODS: During a six-week period in August and September of 2009, a task force was created in the Central Pharmacy of Hosp...

  1. Epidemiological evidence of an early wave of the 1918 influenza pandemic in New York City

    OpenAIRE

    Olson, Donald R.; Simonsen, Lone; Edelson, Paul J.; Morse, Stephen S.

    2005-01-01

    The 1918 “Spanish flu” was the fastest spreading and most deadly influenza pandemic in recorded history. Hypotheses of its origin have been based on a limited collection of case and outbreak reports from before its recognized European emergence in the summer of 1918. These anecdotal accounts, however, remain insufficient for determining the early diffusion and impact of the pandemic virus. Using routinely collected monthly age-stratified mortality data, we show that an unmistakable shift ...

  2. Receptor Characterization and Susceptibility of Cotton Rats to Avian and 2009 Pandemic Influenza Virus Strains

    OpenAIRE

    Blanco, Jorge C. G.; Pletneva, Lioubov M.; Wan, Hongquan; Araya, Yonas; Angel, Matthew; Oue, Raymonde O.; Sutton, Troy C.; Perez, Daniel R.

    2013-01-01

    Animal influenza viruses (AIVs) are a major threat to human health and the source of pandemic influenza. A reliable small-mammal model to study the pathogenesis of infection and for testing vaccines and therapeutics against multiple strains of influenza virus is highly desirable. We show that cotton rats (Sigmodon hispidus) are susceptible to avian and swine influenza viruses. Cotton rats express ?2,3-linked sialic acid (SA) and ?2,6-linked SA residues in the trachea and ?2,6-linked SA res...

  3. Influenza pandemic: perception of risk and individual precautions in a general population. Cross sectional study

    Directory of Open Access Journals (Sweden)

    Halvorsen Peder A

    2007-04-01

    Full Text Available Abstract Background An influenza pandemic may have considerable impact on health and societal functioning. The aim of this study was to explore people's reflections on the consequences of a pandemic. Methods Cross-sectional web-based survey of 1,168 Norwegians aged 16–82 years. The main outcome measures were answers to questions about a potential pandemic ("serious influenza epidemic": statements about personal precautions including stockpiling Tamiflu®, the perceived number of fatalities, the perceived effects of Tamiflu®, the sources of information about influenza and trust in public information. Results While 80% of the respondents stated that they would be "careful about personal hygiene", only a few would stay away from work (2%, or move to an isolated place (4%. While 27% of respondents were uncertain about the number of fatalities during an influenza pandemic, 48% thought it would be lower than the estimate of Norwegian health authorities (0.05%–1% and only 3% higher. At least half of the respondents thought that Tamiflu® might reduce the mortality risk, but less than 1% had personally purchased the drug. The great majority had received their information from the mass media, and only 9% directly from health authorities. Still the majority (65% trusted information from the authorities, and only 9% reported overt distrust. Conclusion In Norway, considerable proportions of people seem to consider the mortality risk during a pandemic less than health authorities do. Most people seem to be prepared to take some, but not especially disruptive, precautions.

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

    International Nuclear Information System (INIS)

    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

  5. School closures during the 2009 influenza pandemic: national and local experiences

    OpenAIRE

    Cauchemez, Simon; Kerkhove, Maria; Archer, Brett; Cetron, Martin; Cowling, Benjamin; Grove, Peter; Hunt, Darren; Kojouharova, Mira; Kon, Predrag; Ungchusak, Kumnuan; Oshitani, Hitoshi; Pugliese, Andrea; Rizzo, Caterina; Saour, Guillaume; Sunagawa, Tomimase

    2014-01-01

    BACKGROUND: School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diver...

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

    International Nuclear Information System (INIS)

    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)

  7. Targets for the Induction of Protective Immunity Against Influenza A Viruses

    OpenAIRE

    Rimmelzwaan, Guus F.; Osterhaus, Albert D. M. E.; Rogier Bodewes

    2010-01-01

    The current pandemic caused by the new influenza A(H1N1) virus of swine origin and the current pandemic threat caused by the highly pathogenic avian influenza A viruses of the H5N1 subtype have renewed the interest in the development of vaccines that can induce broad protective immunity. Preferably, vaccines not only provide protection against the homologous strains, but also against heterologous strains, even of another subtype. Here we describe viral targets and the arms of the immune respo...

  8. An Avian Connection as a Catalyst to the 1918-1919 Influenza Pandemic

    Directory of Open Access Journals (Sweden)

    2005-05-01

    Full Text Available The 1918 Influenza pandemic was one of the most virulent strains of influenza in history. This strain quickly dispatched previously held theories on influenza. World War One introduced new environmental stresses and speed of dissemination logistics never experienced by humans. In light of new phylogenic evidence the cause of this influenza outbreak is now being considered to have linkage to the avian influenza. Animals act as reservoirs for this influenza virus and research indicates the influenza virus often originates in the intestines of aquatic wildfowl. The virus is shed into the environment, which in turns infects domestic poultry, which in turn infects mammalian hosts. These animals, usually pigs, act as a transformer or converters; creating a strain that can more readily infect humans. Therefore swine can be infected with both avian and human influenza A viruses and serve as a source for infection for a number of species as the incidents of direct infection from birds to humans have been rare. Increased human habitation near poultry and swine raising facilities pose greater influenza outbreak risk. It was this combination of environmental factors that may have contributed to the greatest pandemic of recent times, and, moreover, similar conditions exist throughout Southeast Asia today.

  9. Modeling the effects of drug resistant influenza virus in a pandemic

    Directory of Open Access Journals (Sweden)

    Koch Daniel

    2008-10-01

    Full Text Available Abstract 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 with the fully drug sensitive strain leads to a cumulative number of 19,500 outpatients and 258 hospitalizations, respectively, per 100,000 inhabitants. Development of de novo resistance alone increases the total number of outpatients by about 6% and hospitalizations by about 21%. If a resistant infection is introduced into the population after three weeks, the outcome dramatically deteriorates. Wide-spread use of NI treatment makes it highly likely that the resistant strain will spread if its fitness is high. This situation is further aggravated if a resistant virus is imported into a country in the early phase of an outbreak. As NI-resistant influenza infections with high fitness and pathogenicity have just been observed, the emergence of drug resistance in treated populations and the transmission of drug resistant strains is an important public health concern for seasonal and pandemic influenza.

  10. Regional differences in mortality associated with pandemic influenza A H1N1 in Brazil.

    Science.gov (United States)

    Cerbino Neto, José; Penna, Gerson Oliveira; Werneck, Guilherme Loureiro

    2013-01-01

    The aim of this article is to examine regional differences in mortality associated with influenza from 2006 to 2010 in Brazil. Syndromic surveillance, which includes deaths from pneumonia and influenza recorded in the Mortality Information System, only showed an increase in mortality during the pandemic in the South, Southeast, and Central, regions. In these regions, especially in the South, this increase occurred from July to September 2009. A review of deaths from confirmed influenza cases reported to the Information System for Notifiable Diseases showed different temporal patterns in the South/Southeast and the North/Northeast, with an increase from July to November 2009 for all regions and another peak, only for the latter, in March 2010, before the vaccination campaign. The results show regional differences in the intensity and temporal distribution of pandemic influenza and highlight the need for specific surveillance tools and control strategies for regions of the country. PMID:23370038

  11. The ability of seasonal and pandemic influenza to disrupt military operations

    Directory of Open Access Journals (Sweden)

    Jon Hodge

    2011-10-01

    Full Text Available Influenza is one of the few infectious diseases that is able to disrupt military operations quickly. Although the extreme mortality rates seen during the pandemic of 1918-19 when tens of thousands of soldiers died has never been repeated (for as yet unclear reasons, illness rates alone make influenza of great military importance. Seasonal influenza infection rates from 2-30% of a partially immunized force can still limit military activity and challenge the ability of medical facilities to cope with a sudden number of sick soldiers. Although social distancing and antiviral medications may have some role, in military practice the main preventive measure against seasonal and pandemic influenza is annual immunization with a current vaccine chosen to match the viruses then circulating.

  12. The El Nino-Southern Oscillation (ENSO)-pandemic influenza connection: coincident or causal?

    Science.gov (United States)

    Shaman, Jeffrey; Lipsitch, Marc

    2013-02-26

    We find that the four most recent human influenza pandemics (1918, 1957, 1968, and 2009), all of which were first identified in boreal spring or summer, were preceded by La Niña conditions in the equatorial Pacific. Changes in the phase of the El Niño-Southern Oscillation have been shown to alter the migration, stopover time, fitness, and interspecies mixing of migratory birds, and consequently, likely affect their mixing with domestic animals. We hypothesize that La Niña conditions bring divergent influenza subtypes together in some parts of the world and favor the reassortment of influenza through simultaneous multiple infection of individual hosts and the generation of novel pandemic strains. We propose approaches to test this hypothesis using influenza population genetics, virus prevalence in various host species, and avian migration patterns. PMID:22308322

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

    Directory of Open Access Journals (Sweden)

    Wasserman Jeffrey

    2007-08-01

    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.

  14. Age Distribution of Cases of 2009 (H1N1) Pandemic Influenza in Comparison with Seasonal Influenza

    Science.gov (United States)

    Karageorgopoulos, Drosos E.; Vouloumanou, Evridiki K.; Korbila, Ioanna P.; Kapaskelis, Anastasios; Falagas, Matthew E.

    2011-01-01

    Introduction Several aspects of the epidemiology of 2009 (H1N1) pandemic influenza have not been accurately determined. We sought to study whether the age distribution of cases differs in comparison with seasonal influenza. Methods We searched for official, publicly available data through the internet from different countries worldwide on the age distribution of cases of influenza during the 2009 (H1N1) pandemic influenza period and most recent seasonal influenza periods. Data had to be recorded through the same surveillance system for both compared periods. Results For 2009 pandemic influenza versus recent influenza seasons, in USA, visits for influenza-like illness to sentinel providers were more likely to involve the age groups of 5–24, 25–64 and 0–4 years compared with the reference group of >64 years [odds ratio (OR) (95% confidence interval (CI)): 2.43 (2.39–2.47), 1.66 (1.64–1.69), and 1.51 (1.48–1.54), respectively]. Pediatric deaths were less likely in the age groups of 2–4 and 65 years [OR (95% CI): 7.19 (6.67–7.75), 5.33 (4.90–5.79), 5.04 (4.70–5.41), 3.12 (2.89–3.36) and 1.89 (1.75–2.05), respectively]. In New Zealand, consultations for influenza-like illness by sentinel providers were more likely in the age groups of 65 years [OR (95% CI): 2.38 (1.74–3.26), 1.99 (1.62–2.45), 1.57 (1.30–1.89), 1.57 (1.30–1.88), 1.40 (1.17–1.69) and 1.39 (1.14–1.70), respectively]. Conclusions The greatest increase in influenza cases during 2009 (H1N1) pandemic influenza period, in comparison with most recent seasonal influenza periods, was seen for school-aged children, adolescents, and younger adults. PMID:21747947

  15. Lessons from the swine flu: pandemic, panic and/or pandemonium?

    Science.gov (United States)

    Isaacs, David

    2010-11-01

    The 2009 pandemic of swine-origin A/H1N1 influenza (swine flu) spread rapidly in Australia and there was a prolonged winter outbreak lasting 18 weeks. For Australian children, the case fatality rate of swine flu was no higher than for severe seasonal influenza. Because of the high number of children infected with swine flu, however, there were more children admitted to hospital than usual and more children died. Health-care services (emergency departments, medical wards and intensive care units) were stretched. The introduction of special influenza clinics helped services cope. Pregnant women were at high risk of severe swine flu and seven pregnant women and seven of their babies died. Future pandemic planning should consider severity of influenza, in addition to rapidity of spread, as a criterion for escalating interventions. PMID:21121084

  16. Qualification of the Hemagglutination Inhibition Assay in Support of Pandemic Influenza Vaccine Licensure?

    OpenAIRE

    Noah, Diana L.; Hill, Heather; Hines, David; White, E. Lucile; Wolff, Mark C.

    2009-01-01

    Continued outbreaks of highly pathogenic avian influenza over the past decade have spurred global efforts to develop antivirals and vaccines. As part of vaccine development, standard methods are needed for determining serum antibody titers in response to vaccination. Hemagglutination inhibition (HAI) assays are appropriate for assessing the immunogenicity of pandemic influenza vaccines in support of license approval. We demonstrate that a rigorous qualification of the HAI assay for H5N1 influ...

  17. Molecular Basis for the Generation in Pigs of Influenza A Viruses with Pandemic Potential

    OpenAIRE

    Ito, Toshihiro; Couceiro, J. Nelson S. S.; Kelm, Sørge; Baum, Linda G.; Krauss, Scott; Castrucci, Maria R.; Donatelli, Isabella; Kida, Hiroshi; Paulson, James C.; Webster, Robert G.; Kawaoka, Yoshihiro

    1998-01-01

    Genetic and biologic observations suggest that pigs may serve as “mixing vessels” for the generation of human-avian influenza A virus reassortants, similar to those responsible for the 1957 and 1968 pandemics. Here we demonstrate a structural basis for this hypothesis. Cell surface receptors for both human and avian influenza viruses were identified in the pig trachea, providing a milieu conducive to viral replication and genetic reassortment. Surprisingly, with continued replication, som...

  18. An avian live attenuated master backbone for potential use in epidemic and pandemic influenza vaccines

    OpenAIRE

    Hickman, Danielle; Hossain, Md Jaber; Song, Haichen; Araya, Yonas; Solo?rzano, Alicia; Perez, Daniel R.

    2008-01-01

    The unprecedented emergence in Asia of multiple avian influenza virus (AIV) subtypes with a broad host range poses a major challenge in the design of vaccination strategies that are both effective and available in a timely manner. The present study focused on the protective effects of a genetically modified AIV as a source for the preparation of vaccines for epidemic and pandemic influenza. It has previously been demonstrated that a live attenuated AIV based on the internal backbone of influe...

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

    Directory of Open Access Journals (Sweden)

    Tandale Babasaheb V

    2010-08-01

    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.

  20. Seasoned adaptive antibody immunity for highly pathogenic pandemic influenza in humans.

    Science.gov (United States)

    Lynch, Garry W; Selleck, Paul; Church, W Bret; Sullivan, John S

    2012-02-01

    Fundamentally new approaches are required for the development of vaccines to pre-empt and protect against emerging and pandemic influenzas. Current strategies involve post-emergent homotypic vaccines that are modelled upon select circulating 'seasonal' influenzas, but cannot induce cross-strain protection against newly evolved or zoonotically introduced highly pathogenic influenza (HPI). Avian H5N1 and the less-lethal 2009 H1N1 and their reassortants loom as candidates to seed a future HPI pandemic. Therefore, more universal 'seasoned' vaccine approaches are urgently needed for heterotypic protection ahead of time. Pivotal to this is the need to understand mechanisms that can deliver broad strain protection. Heterotypic and heterosubtypic humoral immunities have largely been overlooked for influenza cross-protection, with most 'seasoned' vaccine efforts for humans focussed on heterotypic cellular immunity. However, 5 years ago we began to identify direct and indirect indicators of humoral-herd immunity to protein sites preserved among H1N1, H3N2 and H5N1 influenzas. Since then the evidence for cross-protective antibodies in humans has been accumulating. Now proposed is a rationale to stimulate and enhance pre-existing heterotypic humoral responses that, together with cell-mediated initiatives, will deliver pre-emptive and universal human protection against emerging epidemic and pandemic influenzas. PMID:21647170

  1. Confronting the avian influenza threat: vaccine development for a potential pandemic.

    Science.gov (United States)

    Stephenson, Iain; Nicholson, Karl G; Wood, John M; Zambon, Maria C; Katz, Jacqueline M

    2004-08-01

    Sporadic human infection with avian influenza viruses has raised concern that reassortment between human and avian subtypes could generate viruses of pandemic potential. Vaccination is the principal means to combat the impact of influenza. During an influenza pandemic the immune status of the population would differ from that which exists during interpandemic periods. An emerging pandemic virus will create a surge in worldwide vaccine demand and new approaches in immunisation strategies may be needed to ensure optimum protection of unprimed individuals when vaccine antigen may be limited. The manufacture of vaccines from pathogenic avian influenza viruses by traditional methods is not feasible for safety reasons as well as technical issues. Strategies adopted to overcome these issues include the use of reverse genetic systems to generate reassortant strains, the use of baculovirus-expressed haemagglutinin or related non-pathogenic avian influenza strains, and the use of adjuvants to enhance immunogenicity. In clinical trials, conventional surface-antigen influenza virus vaccines produced from avian viruses have proved poorly immunogenic in immunologically naive populations. Adjuvanted or whole-virus preparations may improve immunogenicity and allow sparing of antigen. PMID:15288823

  2. 76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework

    Science.gov (United States)

    2011-09-21

    ...Organization Pandemic Influenza Preparedness Framework (http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_8-en...October 21, 2011. Comments should be no more than 15 pages. Business-confidential information should be clearly identified as...

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

    Science.gov (United States)

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

    2012-01-01

    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…

  4. Pathogenesis Studies of the 2009 Pandemic Influenza Virus and Pseudorabies Virus From Wild Pigs In Swine

    Science.gov (United States)

    Over the last ten years in the United States the epidemiology and ecology of swine flu and pseudorabies has been dynamic. Swine flu is caused by influenza A virus and the disease was first recognized in pigs concurrent with the 1918 Spanish flu pandemic in humans. Pigs displayed clinical signs simil...

  5. Healthcare workers' attitudes to working during pandemic influenza: a qualitative study

    Directory of Open Access Journals (Sweden)

    Petts Judith I

    2009-02-01

    Full Text Available Abstract Background Healthcare workers (HCWs will play a key role in any response to pandemic influenza, and the UK healthcare system's ability to cope during an influenza pandemic will depend, to a large extent, on the number of HCWs who are able and willing to work through the crisis. UK emergency planning will be improved if planners have a better understanding of the reasons UK HCWs may have for their absenteeism, and what might motivate them to work during an influenza pandemic. This paper reports the results of a qualitative study that explored UK HCWs' views (n = 64 about working during an influenza pandemic, in order to identify factors that might influence their willingness and ability to work and to identify potential sources of any perceived duty on HCWs to work. Methods A qualitative study, using focus groups (n = 9 and interviews (n = 5. Results HCWs across a range of roles and grades tended to feel motivated by a sense of obligation to work through an influenza pandemic. A number of significant barriers that may prevent them from doing so were also identified. Perceived barriers to the ability to work included being ill oneself, transport difficulties, and childcare responsibilities. Perceived barriers to the willingness to work included: prioritising the wellbeing of family members; a lack of trust in, and goodwill towards, the NHS; a lack of information about the risks and what is expected of them during the crisis; fear of litigation; and the feeling that employers do not take the needs of staff seriously. Barriers to ability and barriers to willingness, however, are difficult to separate out. Conclusion Although our participants tended to feel a general obligation to work during an influenza pandemic, there are barriers to working, which, if generalisable, may significantly reduce the NHS workforce during a pandemic. The barriers identified are both barriers to willingness and to ability. This suggests that pandemic planning needs to take into account the possibility that staff may be absent for reasons beyond those currently anticipated in UK planning documents. In particular, staff who are physically able to attend work may nonetheless be unwilling to do so. Although there are some barriers that cannot be mitigated by employers (such as illness, transport infrastructure etc., there are a number of remedial steps that can be taken to lesson the impact of others (providing accommodation, building reciprocity, provision of information and guidance etc. We suggest that barriers to working lie along an ability/willingness continuum, and that absenteeism may be reduced by taking steps to prevent barriers to willingness becoming perceived barriers to ability.

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

    OpenAIRE

    Fossali Emilio; Taroni Francesca; Campanini Giulia; Scala Alessia; Baldanti Fausto; Daleno Cristina; Esposito Susanna; Pelucchi Claudio; Principi Nicola

    2011-01-01

    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 unti...

  7. The influenza pandemic and Europe: the social impact and public health response

    Directory of Open Access Journals (Sweden)

    John Paget

    2009-09-01

    Full Text Available Influenza is unpredictable. It is a virus that
    spreads globally and each season viruses emerge
    with different virological, clinical and epidemiological characteristics. Usually influenza affects 5-20% [1] of the population but sometimes a pandemic virus emerges which spreads on a worldwide scale and infects a larger proportion of the human population.
    On 11 June 2009 WHO announced that the world was confronted with a pandemic virus – pandemic (H1N1 2009 virus. This virus was first detected in two children in the United States in March 2009 but had its epidemiological origins in Mexico City in January-March 2009 [2]. The virus
    quickly spread to the US and Canada, and then further afield. In the European Union and EEA countries, there are currently 9453 cases and four deaths and globally there are now over 79,000 cases and 332 deaths (3 July 2009 [3].

  8. Structural Basis of Preexisting Immunity to the 2009 H1N1 Pandemic Influenza Virus

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Rui; Ekiert, Damian C.; Krause, Jens C.; Hai, Rong; Crowe, Jr., James E.; Wilson, Ian A. (Sinai); (Scripps); (Vanderbilt)

    2010-05-25

    The 2009 H1N1 swine flu is the first influenza pandemic in decades. The crystal structure of the hemagglutinin from the A/California/04/2009 H1N1 virus shows that its antigenic structure, particularly within the Sa antigenic site, is extremely similar to those of human H1N1 viruses circulating early in the 20th century. The cocrystal structure of the 1918 hemagglutinin with 2D1, an antibody from a survivor of the 1918 Spanish flu that neutralizes both 1918 and 2009 H1N1 viruses, reveals an epitope that is conserved in both pandemic viruses. Thus, antigenic similarity between the 2009 and 1918-like viruses provides an explanation for the age-related immunity to the current influenza pandemic.

  9. Influenza-associated encephalopathy with elevated antibody titers to pandemic (H1N1) 2009 influenza.

    Science.gov (United States)

    Thampi, Nisha; Bitnun, Ari; Banner, David; Rowe, Thomas; Kelvin, David J; Richardson, Susan E; Parkin, Patricia; Tran, Dat

    2011-04-01

    Pandemic H1N1 influenza (pH1N1) has been associated with encephalopathy, but the role of adaptive immunity in disease pathogenesis remains unclear. A child presented with seizures 5 days after onset of respiratory symptoms with pH1N1, with no detectable virus in cerebrospinal fluid. The authors compared her serum cytokines and pH1N1 antibody titers to those of 22 children with pH1N1, seasonal influenza, or other respiratory viral infections. They also compared her cerebrospinal fluid biomarkers to those of 20 children with confirmed or probable central nervous system infection or viral infection without central nervous system involvement. Her serum antibody titers were several-fold higher, and levels of proinflammatory cytokines in cerebrospinal fluid and serum were lower than those of controls. Antibody titers in cerebrospinal fluid were undetectable. The delayed onset of neurologic manifestations, normal cytokine levels in serum and cerebrospinal fluid, markedly elevated hemagglutinating and neutralizing antibody titers, and absence of virus and antibodies in cerebrospinal fluid raise the possibility of a post-infectious autoimmune-mediated process. PMID:21270466

  10. Connecting the study of wild influenza with the potential for pandemic disease

    OpenAIRE

    Runstadler, Jonathan; Hill, Nichola; Hussein, Islam T. M.; Puryear, Wendy; Keogh, Mandy

    2013-01-01

    Continuing outbreaks of pathogenic (H5N1) and pandemic (SOIVH1N1) influenza have underscored the need to understand the origin, characteristics, and evolution of novel influenza A virus (IAV) variants that pose a threat to human health. In the last 4–5 years, focus has been placed on the organization of large-scale surveillance programs to examine the phylogenetics of avian influenza virus (AIV) and host-virus relationships in domestic and wild animals. Here we review the current gaps in wi...

  11. The response of the Liguria Region (Italy) to the pandemic influenza virus A/H1N1sv.

    Science.gov (United States)

    Amicizia, D; Cremonesi, I; Carloni, R; Schiaffino, S

    2011-09-01

    Influenza is a cause of acute respiratory disease. It has a typical epidemic nature during the winter season, but may also assume a pandemic pattern when a completely new virus spreads among humans. Influenza places a heavy economic and healthcare burden on both the National Health Service and society. During the 2009/2010 influenza pandemic season, the Liguria Region drew upon the specific skills of the various sectors of the Department of Health and Social Services. In collaboration with the Department of Health Sciences of the University of Genova, the Regional Health Agency (RHA) and other public organizations, steps were taken to address the issues of technical and scientific updating and the coordination of all the departments of Local Healthcare Units in Liguria. The main activities conducted at the regional level provided an adequate response to the influenza pandemic. These activities focused on Local and National Influenza Surveillance Systems, the regional Pandemic Plan, vaccination strategies for seasonal and pandemic influenza, and the communication of data from monitoring programs (sentinel physicians--syndromic surveillance). The prevention of influenza transmission and containment of epidemics and pandemics require effective communication strategies that should target the whole population. PMID:22010539

  12. Influenza A(H1N1)pdm09 virus and asthma

    OpenAIRE

    MasatsuguObuchi; YuichiAdachi

    2013-01-01

    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(H1N1)pdm09, emerged in the spring of 2009 and caused the first influenza pandemic in the 21st century. With the emergence of the novel A(H1N1)pdm09 virus, numerous epidemiologic studies detected ast...

  13. The American Red Cross and Local Response to the 1918 Influenza Pandemic: A Four-City Case Study

    OpenAIRE

    Jones, Marian Moser

    2010-01-01

    The role of the American Red Cross in the U.S. response to the 1918–1919 influenza pandemic holds important lessons for current-day pandemic response. This article, which examines local ARC responses in Boston, Pittsburgh, St. Louis, and Richmond, Virginia, demonstrates how the ARC coordinated nursing for military and civilian cases; produced and procured medical supplies and food; transported patients, health workers, and bodies; and aided influenza victims' families. But the organization'...

  14. Seroconversion to Pandemic (H1N1) 2009 Virus and Cross-Reactive Immunity to Other Swine Influenza Viruses

    OpenAIRE

    Perera, Ranawaka A. P. M.; Riley, Steven; Ma, Siu K.; Zhu, Hua-chen; Guan, Yi; Peiris, Joseph S. M.

    2011-01-01

    To assess herd immunity to swine influenza viruses, we determined antibodies in 28 paired serum samples from participants in a prospective serologic cohort study in Hong Kong who had seroconverted to pandemic (H1N1) 2009 virus. Results indicated that infection with pandemic (H1N1) 2009 broadens cross-reactive immunity to other recent subtype H1 swine viruses.

  15. Transmission of pandemic A/H1N1 2009 influenza on passenger aircraft: retrospective cohort study

    OpenAIRE

    Baker, Michael G.; Thornley, Craig N.; Mills, Clair; Roberts, Sally; Perera, Shanika; Peters, Julia; Kelso, Anne; Barr, Ian; Wilson, Nick

    2010-01-01

    Objectives To assess the risk of transmission of pandemic A/H1N1 2009 influenza (pandemic A/H1N1) from an infected high school group to other passengers on an airline flight and the effectiveness of screening and follow-up of exposed passengers.

  16. Prior Population Immunity Reduces the Expected Impact of CTL-Inducing Vaccines for Pandemic Influenza Control.

    Science.gov (United States)

    Bolton, Kirsty J; McCaw, James M; Brown, Lorena; Jackson, David; Kedzierska, Katherine; McVernon, Jodie

    2015-01-01

    Vaccines that trigger an influenza-specific cytotoxic T cell (CTL) response may aid pandemic control by limiting the transmission of novel influenza A viruses (IAV). We consider interventions with hypothetical CTL-inducing vaccines in a range of epidemiologically plausible pandemic scenarios. We estimate the achievable reduction in the attack rate, and, by adopting a model linking epidemic progression to the emergence of IAV variants, the opportunity for antigenic drift. We demonstrate that CTL-inducing vaccines have limited utility for modifying population-level outcomes if influenza-specific T cells found widely in adults already suppress transmission and prove difficult to enhance. Administration of CTL-inducing vaccines that are efficacious in "influenza-experienced" and "influenza-naive" hosts can likely slow transmission sufficiently to mitigate a moderate IAV pandemic. However if neutralising cross-reactive antibody to an emerging IAV are common in influenza-experienced hosts, as for the swine-variant H3N2v, boosting CTL immunity may be ineffective at reducing population spread, indicating that CTL-inducing vaccines are best used against novel subtypes such as H7N9. Unless vaccines cannot readily suppress transmission from infected hosts with naive T cell pools, targeting influenza-naive hosts is preferable. Such strategies are of enhanced benefit if naive hosts are typically intensively mixing children and when a subset of experienced hosts have pre-existing neutralising cross-reactive antibody. We show that CTL-inducing vaccination campaigns may have greater power to suppress antigenic drift than previously suggested, and targeting adults may be the optimal strategy to achieve this when the vaccination campaign does not have the power to curtail the attack rate. Our results highlight the need to design interventions based on pre-existing cellular immunity and knowledge of the host determinants of vaccine efficacy, and provide a framework for assessing the performance requirements of high-impact CTL-inducing vaccines. PMID:25811654

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

    OpenAIRE

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

    2010-01-01

    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...

  18. 2009 pandemic H1N1 influenza virus replicates in human lung tissues

    OpenAIRE

    Zhang, Jinxia; Zhang, Zengfeng; Fan, Xiaohui; Liu, Yuansheng; Wang, Jia; Zheng, Zuoyi; Chen, Rirong; Wang, Pui; Song, Wenjun; Chen, Honglin; Guan, Yi

    2010-01-01

    Replication activity of 2009 pandemic H1N1 influenza virus in human lung cells was evaluated in this study. Twenty-two surgically removed human lung tissue samples were infected ex vivo with pandemic H1N1, A/California/04/2009, seasonal human H1N1 virus, A/ST/92/2009, or a highly pathogenic H5N1 virus, A/Vietnam/1194/04. Examination of nucleoprotein (NP) protein expression and vRNA replication in infected human lung tissues showed that while CA/04 replication varied between tissue samples, ov...

  19. Economics of employer-sponsored workplace vaccination to prevent pandemic and seasonal influenza.

    Science.gov (United States)

    Lee, Bruce Y; Bailey, Rachel R; Wiringa, Ann E; Afriyie, Abena; Wateska, Angela R; Smith, Kenneth J; Zimmerman, Richard K

    2010-08-23

    Employers may be loath to fund vaccination programs without understanding the economic consequences. We developed a decision analytic computational simulation model including dynamic transmission elements that estimated the cost-benefit of employer-sponsored workplace vaccination from the employer's perspective. Implementing such programs was relatively inexpensive (<$35/vaccinated employee) and, in many cases, cost saving across diverse occupational groups in all seasonal influenza scenarios. Such programs were cost-saving for a 20% serologic attack rate pandemic scenario (range: -$15 to -$995) per vaccinated employee) and a 30% serologic attack rate pandemic scenario (range: -$39 to -$1,494 per vaccinated employee) across all age and major occupational groups. PMID:20620168

  20. Heterogeneous virulence of pandemic 2009 influenza H1N1 virus in mice

    Directory of Open Access Journals (Sweden)

    Farooqui Amber

    2012-06-01

    Full Text Available Abstract Background Understanding the pathogenesis of influenza infection is a key factor leading to the prevention and control of future outbreaks. Pandemic 2009 Influenza H1N1 infection, although frequently mild, led to a severe and fatal form of disease in certain cases that make its virulence nature debatable. Much effort has been made toward explaining the determinants of disease severity; however, no absolute reason has been established. Results This study presents the heterogeneous virulence of clinically similar strains of pandemic 2009 influenza virus in human alveolar adenocarcinoma cells and mice. The viruses were obtained from patients who were admitted in a local hospital in China with a similar course of infection and recovered. The A/Nanchang/8002/2009 and A/Nanchang/8011/2009 viruses showed efficient replication and high lethality in mice while infection with A/Nanchang/8008/2009 was not lethal with impaired viral replication, minimal pathology and modest proinflammatory activity in lungs. Sequence analysis displayed prominent differences between polymerase subunits (PB2 and PA of viral genomes that might correlate with their different phenotypic behavior. Conclusions The study confirms that biological heterogeneity, linked with the extent of viral replication, exists among pandemic H1N1 strains that may serve as a benchmark for future investigations on influenza pathogenesis.

  1. Seroprevalence study in Vojvodina (Serbia following 2009 pandemic influenza A(H1N1v

    Directory of Open Access Journals (Sweden)

    Petrovi? Vladimir

    2012-01-01

    Full Text Available Introduction. The seroprevalence study was performed in Vojvodina during May and June 2010 in order to asses the effects of the 2009 pandemic influenza A(H1N1v epidemic on herd immunity. It was a part of the Serbian Ministry of Health funded nationwide study. Objective. Prevalence of antibodies against 2009 pandemic influenza A(H1N1v was determined in a 1% sample of the population monitored for influenza-like illness and acute respiratory infections in Vojvodina through sentinel surveillance system. Methods. The study sample involved a total of 1004 inhabitants of Vojvodina. The control group consisted of randomly selected and age-adjusted 1054 sera collected in the pre-pandemic period. Sera were tested by the reaction of hemagglutination inhibition using influenza A/California/7/2009 (H1N1 antigen in dilution from 1:8 to 1:256. Antibody titers ?1:32 and ?1:8 were considered protective and diagnostic, respectively. Results. The differences between control and study sera in all age groups were significant for both diagnostic ?1/8 and protective titres ?1/32 of hemagglutination inhibition antibodies (chi square test, p<0.001. The highest percentage of seropositive subjects was registered in the age group 15-19 years followed by children aged 5-14 years. Both diagnostic and protective titres were about twice higher in the vaccinated as compared to the non-vaccinated group. There were no statistically significant differences in seroprevalence between seven districts of Vojvodina. Conclusion. The 2009 pandemic influenza A(H1N1v epidemic significantly influenced the herd immunity in our population regardless of low immunization coverage with highest immunity levels in adolescents aged 15-19 years and with similar herd immunity levels in all the regions in the province six months after the outbreak.

  2. Experience of Triage During an A/H1N1 Influenza Pandemic in After-Hours Emergency Centers.

    Science.gov (United States)

    Nakagawa, Hiroshi; Onuma, Takehide

    2012-07-01

    During the 2009 A/H1N1 influenza pandemic in Sendai, two primary emergency clinics, which are after-hours emergency centers managed by the Sendai Emergency Medical Service Foundation, were inundated with many influenza patients. In the course of the pandemic, from August 1, 2009 to March 31, 2010, a total of 47,831 internal medicine and pediatric patients visited the two clinics and rapid influenza tests were performed in 17,167 of patients, in which 6,697 patients tested A-positive. Consequently, 10,743 patients were diagnosed with influenza, which included 1,447 patients that tested negative, and 2,599 patients that were not tested. Prior to the physicians check up, nurses performed triage and divided the patients into two groups, isolated and non-isolated. We examined the effect of triage, using the results of the rapid influenza test and antiviral drug administration, in each of the early, middle and maximum pandemic phases. Triage was considered effective in the early and middle phases, where the average number of influenza patients that visited the clinic per day were 21.4 and 50.6, respectively. But in the maximum phase where the average number of influenza patients soared to 275.3 per day, one out of three patients in the non-isolated group was clinically diagnosed as influenza. We were unable to separate influenza patients effectively in the maximum phase of pandemic. PMID:25237239

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

    Directory of Open Access Journals (Sweden)

    Castro Carmen

    2011-08-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Eun Lee

    2011-08-01

    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.

  5. The first identified case of pandemic H1N1 influenza in pigs in Australia.

    Science.gov (United States)

    Holyoake, P K; Kirkland, P D; Davis, R J; Arzey, K E; Watson, J; Lunt, R A; Wang, J; Wong, F; Moloney, B J; Dunn, S E

    2011-11-01

    A 300-sow farrow-to-finish herd in New South Wales was infected with influenza pandemic (H1N1) 2009 (H1N1/09) virus in July 2009 and became the first recorded case of influenza in pigs in Australia. The outbreak resulted from human-to-pig transmission. Clinical signs in affected pigs were mild compared with overseas reports of 'classical' swine influenza virus and included coughing and decreased appetite in a small proportion of non-lactating breeding stock, weaners, growers and finishers. A diagnosis of H1N1/09 influenza virus infection was confirmed using a combination of serology (haemagglutination inhibition, blocking enzyme-linked immunosorbent assay) and real-time reverse transcription polymerase chain reaction. Attempts at virus isolation were unsuccessful. Results of a longitudinal study of pigs on this farm suggested that the virus continued to circulate for 9 weeks after the onset of infection, but was not present 6 months later. This report highlights the difficulties in preventing transmission of H1N1/09 influenza virus from infected humans to pigs during a human pandemic. PMID:22008120

  6. Adenovirus-Vectored Vaccine as a Rapid-Response Tool Against Avian Influenza Pandemic

    International Nuclear Information System (INIS)

    Influenza viruses in nature undergo genetic mutation and reassortment. Three pandemics of avian influenza in man were recorded in the twentieth century. Highly pathogenic avian influenza (HPAI) viruses currently in circulation pose a threat for another world-wide pandemic, if they become transmissible from man to man. Manufacturing protective vaccines using current egg-based technology is often difficult due to the virulence of the virus and its adverse effects on the embryonating egg substrate. New technologies allow the creation of safe and protective pandemic influenza vaccines without the need for egg based substrates. These technologies allow new vaccines to be created in less than one month. Manufacturing is in tissue culture, not eggs. Vaccine can be administered to man non-invasively, without adjuvants, eliciting a rapid and protective immune response. Protective immunity against avian influenza (AI) virus was elicited in chickens by single-dose in ovo vaccination with a replication-competent adenovirus (RCA)-free human adenovirus serotype 5 (Ad5)-derived vector encoding an H5N9 avian influenza virus hemagglutinin. Vaccinated chickens were protected against both H5N1 and H5N2 HPAI virus challenges. Mass-administration of this bird flu vaccine can be streamlined with available robotic in ovo injectors. Vaccination using this vaccine could protect the the largest host reservoir (chickens) and greatly reduce the exposure of man to avian influenza. In addition, Ad5-vectored vaccines can be produced rapidly and the safety margin of a non-replicating vector is superior to that of a replicating counterpart. Furthermore, this mode of vaccination is compatible with epidemiological surveys of natural AI virus infections. In addition to mass immunization of poultry, both animals and humans have been effectively immunized by intranasal administration of Ad5-vectored influenza vaccines without any appreciable side effects, even in mice and human volunteers with preexisting immunity to Ad5. RCA-free Ad5-vectored AI vaccines may thus provide a critical tool for mitigating an AI pandemic in a simple, rapid, and safe manner. (author)

  7. Fatal Cases of 2009 Pandemic Influenza A (H1N1) in Korea

    OpenAIRE

    Kim, Hyun Su; Kim, Joon Hyung; Shin, Soo Youn; Kang, Young A.; Lee, Ha Gyung; Kim, Jin Seok; Lee, Jong Koo; Cho, Belong

    2010-01-01

    The aim of this study was to describe the features of deaths associated with the 2009 pandemic influenza A (H1N1) by 26 November 2009 in Korea. We collected standardized case reports on 115 confirmed deaths through a nationwide enhanced influenza surveillance system. The median age was 61 yr (interquartile range [IQR], 0.2-97 yr) and 58 (50.4%) were females. The case fatality rate was estimated as 16 per 100,000 cases. The age-related mortality rate had a J-shaped curve. Eighty-three patients...

  8. Performance of the Directigen EZ Flu A+B rapid influenza diagnostic test to detect pandemic influenza A/H1N1 2009.

    Science.gov (United States)

    Boyanton, Bobby L; Almradi, Amro; Mehta, Tejal; Robinson-Dunn, Barbara

    2014-04-01

    The Directigen EZ Flu A+B rapid influenza diagnostic test, as compared to real-time reverse transcriptase polymerase chain reaction, demonstrated suboptimal performance to detect pandemic influenza A/H1N1 2009. Age- and viral load-stratified test sensitivity ranged from 33.3 to 84.6% and 0 to 100%, respectively. PMID:24582319

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

    Directory of Open Access Journals (Sweden)

    Esposito Susanna

    2011-12-01

    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.

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

    OpenAIRE

    Leaming, James M.; Spencer Adoff; Terndrup, Thomas E.

    2013-01-01

    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 D...

  11. Factors Affecting Medical Students' Uptake of the 2009 Pandemic Influenza A (H1N1) Vaccine

    OpenAIRE

    Lee, Siang I.; Aung, Ei M.; Chin, Ik S.; Hing, Jeremy W.; Mummadi, Sanghamitra; Palaniandy, Ghunavadee D.; Jordan, Rachel

    2012-01-01

    Background. Pandemic influenza vaccination rate amongst healthcare workers in England 2009/2010 was suboptimal (40.3%). Targeting medical students before they enter the healthcare workforce is an attractive future option. This study assessed the H1N1 vaccine uptake rate amongst medical students and factors that influenced this. Methods. Anonymised, self-administered questionnaire at a medical school. Results. The uptake rate amongst 126 medical students offered the vaccine was 49.2% and inten...

  12. The El Niño–Southern Oscillation (ENSO)–pandemic Influenza connection: Coincident or causal?

    OpenAIRE

    Shaman, Jeffrey; Lipsitch, Marc

    2012-01-01

    We find that the four most recent human influenza pandemics (1918, 1957, 1968, and 2009), all of which were first identified in boreal spring or summer, were preceded by La Niña conditions in the equatorial Pacific. Changes in the phase of the El Niño–Southern Oscillation have been shown to alter the migration, stopover time, fitness, and interspecies mixing of migratory birds, and consequently, likely affect their mixing with domestic animals. We hypothesize that La Niña conditions brin...

  13. Student Behavior during a School Closure Caused by Pandemic Influenza A/H1N1

    OpenAIRE

    Lajous, Martin; Miller, Joel C.; Danon, Leon; O Hagan, Justin John; Goldstein, Edward; Lipsitch, Marc

    2010-01-01

    Background: Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors. Methodology/Principal Findings: To characterize this behavior, we surveyed students in grades 9–12 and parents of students in grades 5–8 about student activities during a weeklong ...

  14. Antiviral treatment for the control of pandemic influenza: some logistical constraints.

    OpenAIRE

    Arinaminpathy, N.; Mclean, Ar

    2008-01-01

    Disease control programmes for an influenza pandemic will rely initially on the deployment of antiviral drugs such as Tamiflu, until a vaccine becomes available. However, such control programmes may be severely hampered by logistical constraints such as a finite stockpile of drugs and a limit on the distribution rate. We study the effects of such constraints using a compartmental modelling approach. We find that the most aggressive possible antiviral programme minimizes the final epidemic siz...

  15. Pandemic influenza A/H1N1: comparative analysis of microscopic lung histopathological findings

    OpenAIRE

    Roberta Marchiori; Carla Sakuma de Oliveira Bredt; Marcos Menezes Freitas de Campos; Fábio Negretti; Péricles Almeida Delfino Duarte

    2012-01-01

    Objective: To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics. Methods: descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009. Nasopharyngeal aspirate specimens were collected from the patients and were analyzed by real-time polymerase chain reaction. Lung biopsy was performed post mortem; a score of i...

  16. Next Generation Syndromic Surveillance: Molecular Epidemiology, Electronic Health Records and the Pandemic Influenza A (H1N1) Virus

    OpenAIRE

    Rabadan, Raul; Calman Md, Neil; Hripcsak, George

    2009-01-01

    In the early phase of the 2009 A (H1N1) pandemic a marked increase in severity and a shift in the age distribution toward younger persons was found, with higher severity reported in patients with pre-existing medical conditions and pregnant women. Consistent with previous pandemics, the age and clinical history of the patients play a critical role in the morbidity and mortality associated with the pandemic virus. This is the first influenza pandemic in the information era, where enormous amou...

  17. Characteristics of Outpatients with Pandemic H1N1/09 Influenza in a Tertiary Care University Hospital in Korea

    OpenAIRE

    Park, Kyung Sun; Park, Tae Sung; Suh, Jin Tae; Nam, You Sun; Lee, Mi Suk; Lee, Hee Joo

    2011-01-01

    The pandemic H1N1/09 emerged rapidly in Korea. Here, we describe the clinical characteristics of outpatients in Seoul, Korea who were infected in the 2009 H1N1 pandemic. We reviewed the cases of outpatients with pandemic H1N1/09 who visited a tertiary care teaching hospital between September 1 and December 31, 2009. Infection with pandemic H1N1/09 was confirmed by molecular tests. Of a total of 7,182 tests, 3,020 (42.0%) were positive. Compared with 473 cases of influenza-like illness (ILI), ...

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

    Science.gov (United States)

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

    2013-07-12

    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

  19. Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality

    OpenAIRE

    Gagnon, Alain; Miller, Matthew S.; Hallman, Stacey A.; Bourbeau, Robert; Herring, D. Ann; Earn, David Jd; Madrenas, Joaqui?n

    2013-01-01

    The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza dur...

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

    OpenAIRE

    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

    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...

  1. A Cloud-Based Simulation Architecture for Pandemic Influenza Simulation

    OpenAIRE

    Eriksson, Henrik; Raciti, Massimiliano; Basile, Maurizio; Cunsolo, Alessandro; Fro?berg, Anders; Leifler, Ola; Ekberg, Joakim; Timpka, Toomas

    2011-01-01

    High-fidelity simulations of pandemic outbreaks are resource consuming. Cluster-based solutions have been suggested for executing such complex computations. We present a cloud-based simulation architecture that utilizes computing resources both locally available and dynamically rented online. The approach uses the Condor framework for job distribution and management of the Amazon Elastic Computing Cloud (EC2) as well as local resources. The architecture has a web-based user interface that all...

  2. Trend of emergency department presentations for influenza like illness: Differences between pandemic (2009-2010 and post-pandemic (2010-2011 season

    Directory of Open Access Journals (Sweden)

    Elena Di Tondo

    2012-12-01

    Full Text Available The aim of this paper is to analyze differences between incidence, characteristics and out-comes of patients with Influenza Like Illness (ILI presenting to a teaching public hospital in Central Italy during pandemic influenza season (2009-2010 and during the post-pandemic outbreak (2010-2011. We performed a retrospective descriptive study, and we identified Emergency Department (ED presentations for ILI, relying on hospital discharge data administrative database. Bivariate analyses for the outcome of hospital admission were performed for both seasons and a multiple logistic regression model has been developed to evaluate which factors were independently associated with hospital admission. Among all the ED presentations (51,757, visits for ILI were respectively 821 (3.1% during the pandemic season, and 704 (2.8% during the post-pandemic one. The pandemic cohort differs significantly from the post-pandemic cohort for every characteristic investigated, with the exception of the length of stay in the ED. Overall in 2009-2010 there were more ED presentations compared to the following season, but hospital admission rates were less than in 2010-2011. Further studies are needed to assess if other variables may affect the use of the ED for ILI in order to try to plan staff and hospital organization.

  3. Pandemic 2009 Influenza A (H1N1 Infection in Children

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    Taner Özgür

    2011-08-01

    Full Text Available Introduction: The aim of this study is to share our experience of sixty-eight pediatric hospitalizations associated with influenza-like illness and pneumonia between November, 2009 and December, 2009.Materials and Methods: Clinical signs and symptoms, laboratory and radiological results, length of stay in hospital and intensive care unit, treatments and complications were compared in laboratory confirmed pandemic influenza A positive and negative cases.Results: There was no significant difference in gender distribution between the two groups. The number of positive cases in patients over 5 years of age were significantly higher than the same age group in negative patients (p=0.004. There were underlying health conditions in 78.8% of the positive cases and in 68.8% of the negative cases (p=0.57. The incidence of diarrhea in positive group was significantly higher than in the negative group (p=0.02. Low immunization rates of the seasonal influenza vaccine were remarkable in each group. There was no significant difference in vaccination rates between the two groups (p=0.99.Conclusions: The severity of the disease remained similar in patients with positive and negative groups. In both groups, the high ratio of those having an underlying disease was noteworthy. (Journal of Current Pediatrics 2011; 9: 53-9Key words: Pandemic 2009 influenza A, childhood, pneumonia

  4. One-way trip: influenza virus' adaptation to gallinaceous poultry may limit its pandemic potential.

    Science.gov (United States)

    Long, Jason S; Benfield, Camilla T; Barclay, Wendy S

    2015-02-01

    We hypothesise that some influenza virus adaptations to poultry may explain why the barrier for human-to-human transmission is not easily overcome once the virus has crossed from wild birds to chickens. Since the cluster of human infections with H5N1 influenza in Hong Kong in 1997, chickens have been recognized as the major source of avian influenza virus infection in humans. Although often severe, these infections have been limited in their subsequent human-to-human transmission, and the feared H5N1 pandemic has not yet occurred. Here we examine virus adaptations selected for during replication in chickens and other gallinaceous poultry. These include altered receptor binding and increased pH of fusion of the haemagglutinin as well as stalk deletions of the neuraminidase protein. This knowledge could aid the delivery of vaccines and increase our ability to prioritize research efforts on those viruses from the diverse array of avian influenza viruses that have greatest human pandemic potential. Also watch the Video Abstract. PMID:25546511

  5. PATHOGENICITY OF INFLUENZA VIRUSES WITH GENES FROM THE 1918 PANDEMIC VIRUS: FUNCTIONAL ROLES OF ALVEOLAR MACROPHAGES AND NEUTROPHILS IN LIMITING VIRUS REPLICATION AND MORTALITY IN MICE

    Science.gov (United States)

    The Spanish influenza pandemic of 1918-1919 swept the globe and resulted in the deaths of at least 20 million people. The basis of the pulmonary damage and high lethality caused by the 1918 H1N1 influenza virus remains largely unknown. Recombinant influenza viruses bearing the 1918 influenza virus h...

  6. Humanized antibody neutralizing 2009 pandemic H1N1 virus.

    Science.gov (United States)

    Shembekar, Nachiket; Mallajosyula, Vamsee V Aditya; Chaudhary, Piyush; Upadhyay, Vaibhav; Varadarajan, Raghavan; Gupta, Satish Kumar

    2014-12-01

    The 2009 pandemic H1N1 S-OIV (swine origin influenza A virus) caused noticeable morbidity and mortality worldwide. In addition to vaccine and antiviral drug therapy, the use of influenza virus neutralizing monoclonal antibodies (MAbs) for treatment purposes is a viable alternative. We previously reported the isolation of a high affinity, potently neutralizing murine MAb MA2077 against 2009 pandemic H1N1 virus. We describe here the humanization of MA2077 and its expression in a mammalian cell line. Six complementarity-determining regions (CDRs) of MA2077 were grafted onto the human germline variable regions; along with six and eight back mutations in the framework of heavy and light chains, respectively, pertaining to the vernier zone and interchain packing residues to promote favorable CDR conformation and facilitate antigen binding. The full length humanized antibody, 2077Hu2, expressed in CHO-K1 cells, showed high affinity to hemagglutinin protein (KD = 0.75 ± 0.32 nM) and potent neutralization of pandemic H1N1 virus (IC50 = 0.17 ?g/mL), with marginally higher IC50 as compared to MA2077 (0.08 ?g/mL). In addition, 2077Hu2 also retained the epitope specificity for the "Sa" antigenic site on pandemic HA. To the best of our knowledge, this is the first report of a humanized neutralizing antibody against pandemic H1N1 virus. PMID:25044602

  7. Influenza H5N1 and H1N1 virus replication and innate immune responses in bronchial epithelial cells are influenced by the state of differentiation.

    OpenAIRE

    Chan, Renee W. Y.; Yuen, Kit M.; Yu, Wendy C. L.; Ho, Carol C. C.; Nicholls, John M.; Peiris, J. S. Malik; Chan, Michael C. W.

    2010-01-01

    Influenza H5N1 virus continues to be enzootic in poultry and transmits zoonotically to humans. Although a swine-origin H1N1 virus has emerged to become pandemic, its virulence for humans remains modest in comparison to that seen in zoonotic H5N1 disease. As human respiratory epithelium is the primary target cells for influenza viruses, elucidating the viral tropism and host innate immune responses of influenza H5N1 virus in human bronchial epithelium may help to understand the pathogenesis. H...

  8. Evaluation of the seroprevalence of influenza A(H1N1) 2009 on a university campus: a cross-sectional study

    OpenAIRE

    Shafir Shira C; O'Keefe Kaitlin A; Shoaf Kimberley I

    2011-01-01

    Abstract Background Human infection with influenza A(H1N1) 2009 was first identified in the United States on 15 April 2009 and on 11 June 2009, WHO declared that the rapidly spreading swine-origin influenza virus constituted a global pandemic. We evaluated the seroprevalence of influenza A(H1N1) 2009 virus on a large public University campus, as well as disparities in demographic, symptomatic and vaccination characteristics of participants. Methods Using a cross-sectional study design, sera w...

  9. Estimates of the demand for mechanical ventilation in the United States during an influenza pandemic.

    Science.gov (United States)

    Meltzer, Martin I; Patel, Anita; Ajao, Adebola; Nystrom, Scott V; Koonin, Lisa M

    2015-05-01

    An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9) virus provided reason for US public health officials to revisit existing national pandemic response plans. We built a spreadsheet model to examine the potential demand for invasive mechanical ventilation (excluding "rescue therapy" ventilation). We considered scenarios of either 20% or 30% gross influenza clinical attack rate (CAR), with a "low severity" scenario with case fatality rates (CFR) of 0.05%-0.1%, or a "high severity" scenario (CFR: 0.25%-0.5%). We used rates-of-influenza-related illness to calculate the numbers of potential clinical cases, hospitalizations, admissions to intensive care units, and need for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13% of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000 to 11 000 ventilators will be needed, averting a pandemic total of 35 000 to 55 000 deaths. A 30% CAR, high severity scenario, will need approximately 35 000 to 60 500 additional ventilators, averting a pandemic total 178 000 to 308 000 deaths. Estimates of deaths averted may not be realized because successful ventilation also depends on sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen sources, suction apparatus, circuits, and monitoring equipment) and timely ability to match access to ventilators with critically ill cases. There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic. PMID:25878301

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

    Directory of Open Access Journals (Sweden)

    Lee Vernon J

    2009-12-01

    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.

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

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    Fossali Emilio

    2011-07-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Seale Holly

    2012-04-01

    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.

  13. VIROLOGY: Enhanced: The Origin and Control of Pandemic Influenza

    Science.gov (United States)

    Graeme Laver (Australian National University; )

    2001-09-07

    Access to the article is free, however registration and sign-in are required:What would happen if a flu pandemic as devastating as the 1918 Spanish flu arrived tomorrow. As Laver explains in a Perspective, preparation of the appropriate subunit vaccine (which depends on accurate identification of the flu virus strain) would take too long. He suggests that stockpiling antiviral drugs such as Relenza and Tamiflu, which block the action of the flu neuraminidase enzyme preventing spread of the virus throughout the host's body, would be a good place to start.

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

    Directory of Open Access Journals (Sweden)

    Wilson Nick

    2009-09-01

    Full Text Available 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 of the 17 PICTs with travel data, only six would be likely to escape a major pandemic with a viral strain of relatively low contagiousness (i.e., for R0 = 1.5 even when imposing very tight travel volume reductions of 99% throughout the course of the pandemic. For a more contagious viral strain (R0 = 2.25 only five PICTs would have a probability of over 50% to escape. The total number of travellers during the pandemic must not exceed 115 (for R0 = 3.0 or 380 (for R0 = 1.5 if a PICT aims to keep the probability of pandemic arrival below 50%. Conclusion These results suggest that relatively few island nations could successfully rely on intensive travel volume restrictions alone to avoid the arrival of pandemic influenza (or subsequent waves. Therefore most island nations may need to plan for multiple additional interventions (e.g., screening and quarantine to raise the probability of remaining pandemic free or achieving substantial delay in pandemic arrival.

  15. Influenza epidemiology in Italy two years after the 2009–2010 pandemic

    Science.gov (United States)

    Gasparini, Roberto; Bonanni, Paolo; Amicizia, Daniela; Bella, Antonino; Donatelli, Isabella; Cristina, Maria Luisa; Panatto, Donatella; Lai, Piero Luigi

    2013-01-01

    Since 2000, a sentinel surveillance of influenza, INFLUNET, exists in Italy. It is coordinated by the Ministry of Health and is divided into two parts; one of these is coordinated by the National Institute of Health (NIH), the other by the Inter-University Centre for Research on Influenza and other Transmissible Infections (CIRI-IT). The influenza surveillance system performs its activity from the 42nd week of each year (mid-October) to the 17th week of the following year (late April). Only during the pandemic season (2009/2010) did surveillance continue uninterruptedly. Sentinel physicians – about 1,200 general practitioners and independent pediatricians – send in weekly reports of cases of influenza-like illness (ILI) among their patients (over 2% of the population of Italy) to these centers. In order to estimate the burden of pandemic and seasonal influenza, we examined the epidemiological data collected over the last 3 seasons (2009–2012). On the basis of the incidences of ILIs at different ages, we estimated that: 4,882,415; 5,519,917; and 4,660,601 cases occurred in Italy in 2009–2010, 2010–2011 and 2011–2012, respectively. Considering the ILIs, the most part of cases occurred in < 14 y old subjects and especially in 5–14 y old individuals, about 30% and 21% of cases respectively during 2009–2010 and 2010–2011 influenza seasons. In 2011–2012, our evaluation was of about 4.7 million of cases, and as in the previous season, the peak of cases regarded subjects < 14 y (about 29%). A/California/07/09 predominated in 2009–2010 and continued to circulate in 2010–2011. During 2010–2011 B/Brisbane/60/08 like viruses circulated and A/H3N2 influenza type was sporadically present. H3N2 (A/Perth/16/2009 and A/Victoria/361/2011) was the predominant influenza type-A virus that caused illness in the 2011–2012 season. Many strains of influenza viruses were present in the epidemiological scenario in 2009–2012. In the period 2009–2012, overall vaccination coverage was low, never exceeding 20% of the Italian population. Among the elderly, coverage rates grew from 40% in 1999 to almost 70% in 2005–2006, but subsequently decreased, in spite of the pandemic; this trend reveals a slight, though constant, decline in compliance with vaccination. Our data confirm that 2009 pandemics had had a spread particularly important in infants and schoolchildren, and this fact supports the strategy to vaccinate schoolchildren at least until 14 y of age. Furthermore, the low levels of vaccination coverage in Italy reveal the need to improve the catch-up of at-risk subjects during annual influenza vaccination campaigns, and, if possible, to extend free vaccination to at least all 50–64-y-old subjects. Virologic and epidemiological surveillance remains critical for detection of evolving influenza viruses and to monitor the health and economic burden in all age class annually. PMID:23292210

  16. Planning for the next influenza pandemic: using the science and art of logistics.

    Science.gov (United States)

    Cupp, O Shawn; Predmore, Brad G

    2011-01-01

    The complexities and challenges for healthcare providers and their efforts to provide fundamental basic items to meet the logistical demands of an influenza pandemic are discussed in this article. The supply chain, planning, and alternatives for inevitable shortages are some of the considerations associated with this emergency mass critical care situation. The planning process and support for such events are discussed in detail with several recommendations obtained from the literature and the experience from recent mass casualty incidents (MCIs). The first step in this planning process is the development of specific triage requirements during an influenza pandemic. The second step is identification of logistical resources required during such a pandemic, which are then analyzed within the proposed logistics science and art model for planning purposes. Resources highlighted within the model include allocation and use of work force, bed space, intensive care unit assets, ventilators, personal protective equipment, and oxygen. The third step is using the model to discuss in detail possible workarounds, suitable substitutes, and resource allocation. An examination is also made of the ethics surrounding palliative care within the construction of an MCI and the factors that will inevitably determine rationing and prioritizing of these critical assets to palliative care patients. PMID:22010601

  17. Structural Characterization of the Hemagglutinin Receptor Specificity from the 2009 H1N1 Influenza Pandemic

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Rui; McBride, Ryan; Nycholat, Corwin M.; Paulson, James C.; Wilson, Ian A. (Scripps)

    2012-02-13

    Influenza virus hemagglutinin (HA) is the viral envelope protein that mediates viral attachment to host cells and elicits membrane fusion. The HA receptor-binding specificity is a key determinant for the host range and transmissibility of influenza viruses. In human pandemics of the 20th century, the HA normally has acquired specificity for human-like receptors before widespread infection. Crystal structures of the H1 HA from the 2009 human pandemic (A/California/04/2009 [CA04]) in complex with human and avian receptor analogs reveal conserved recognition of the terminal sialic acid of the glycan ligands. However, favorable interactions beyond the sialic acid are found only for {alpha}2-6-linked glycans and are mediated by Asp190 and Asp225, which hydrogen bond with Gal-2 and GlcNAc-3. For {alpha}2-3-linked glycan receptors, no specific interactions beyond the terminal sialic acid are observed. Our structural and glycan microarray analyses, in the context of other high-resolution HA structures with {alpha}2-6- and {alpha}2-3-linked glycans, now elucidate the structural basis of receptor-binding specificity for H1 HAs in human and avian viruses and provide a structural explanation for the preference for {alpha}2-6 siaylated glycan receptors for the 2009 pandemic swine flu virus.

  18. Development of a Quick Look Pandemic Influenza Modeling and Visualization Tool

    Energy Technology Data Exchange (ETDEWEB)

    Brigantic, Robert T.; Ebert, David S.; Corley, Courtney D.; Maciejewski, Ross; Muller, George; Taylor, Aimee E.

    2010-05-30

    Federal, State, and local decision makers and public health officials must prepare and exercise complex plans to contend with a variety of possible mass casualty events, such as pandemic influenza. Through the provision of quick look tools (QLTs) focused on mass casualty events, such planning can be done with higher accuracy and more realism through the combination of interactive simulation and visualization in these tools. If an event happens, the QLTs can then be employed to rapidly assess and execute alternative mitigation strategies, and thereby minimize casualties. This can be achieved by conducting numerous 'what-if' assessments prior to any event in order to assess potential health impacts (e.g., number of sick individuals), required community resources (e.g., vaccinations and hospital beds), and optimal mitigative decision strategies (e.g., school closures) during the course of a pandemic. In this presentation, we overview and demonstrate a pandemic influenza QLT, discuss some of the modeling methods and construct and visual analytic components and interface, and outline additional development concepts. These include the incorporation of a user selectable infectious disease palette, simultaneous visualization of decision alternatives, additional resource elements associated with emergency response (e.g., first responders and medical professionals), and provisions for other potential disaster events.

  19. Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality.

    Science.gov (United States)

    Gagnon, Alain; Miller, Matthew S; Hallman, Stacey A; Bourbeau, Robert; Herring, D Ann; Earn, David J D; Madrenas, Joaquín

    2013-01-01

    The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889-90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics. PMID:23940526

  20. Differences in pandemic influenza vaccination policies for pregnant women in Europe

    Directory of Open Access Journals (Sweden)

    Marnoch Gordon J

    2011-10-01

    Full Text Available Abstract Background An important component of the policy to deal with the H1N1 pandemic in 2009 was to develop and implement vaccination. Since pregnant women were found to be at particular risk of severe morbidity and mortality, the World Health Organization and the European Centers for Disease Control advised vaccinating pregnant women, regardless of trimester of pregnancy. This study reports a survey of vaccination policies for pregnant women in European countries. Methods Questionnaires were sent to European competent authorities of 27 countries via the European Medicines Agency and to leaders of registries of European Surveillance of Congenital Anomalies in 21 countries. Results Replies were received for 24 out of 32 European countries of which 20 had an official pandemic vaccination policy. These 20 countries all had a policy targeting pregnant women. For two of the four countries without official pandemic vaccination policies, some vaccination of pregnant women took place. In 12 out of 20 countries the policy was to vaccinate only second and third trimester pregnant women and in 8 out of 20 countries the policy was to vaccinate pregnant women regardless of trimester of pregnancy. Seven different vaccines were used for pregnant women, of which four contained adjuvants. Few countries had mechanisms to monitor the number of vaccinations given specifically to pregnant women over time. Vaccination uptake varied. Conclusions Differences in pandemic vaccination policy and practice might relate to variation in perception of vaccine efficacy and safety, operational issues related to vaccine manufacturing and procurement, and vaccination campaign systems. Increased monitoring of pandemic influenza vaccine coverage of pregnant women is recommended to enable evaluation of the vaccine safety in pregnancy and pandemic vaccination campaign effectiveness.

  1. A Computational-Experimental Approach Identifies Mutations That Enhance Surface Expression of an Oseltamivir-Resistant Influenza Neuraminidase

    OpenAIRE

    Bloom, Jesse D.; Nayak, Jagannath S.; Baltimore, David

    2011-01-01

    The His274Tyr (H274Y) oseltamivir (Tamiflu) resistance mutation causes a substantial decrease in the total levels of surface-expressed neuraminidase protein and activity in early isolates of human seasonal H1N1 influenza, and in the swine-origin pandemic H1N1. In seasonal H1N1, H274Y only became widespread after the occurrence of secondary mutations that counteracted this decrease. H274Y is currently rare in pandemic H1N1, and it remains unclear whether secondary mutations exist that might si...

  2. Pandemic preparedness with live attenuated influenza vaccines based on A/Leningrad/134/17/57 master donor virus.

    Science.gov (United States)

    Rudenko, Larisa; Isakova-Sivak, Irina

    2015-03-01

    Continuously evolving avian influenza viruses pose a constant threat to the human public health. In response to this threat, a number of pandemic vaccine candidates have been prepared and evaluated in animal models and clinical trials. This review summarizes the data from the development and preclinical and clinical evaluation of pandemic live attenuated influenza vaccines (LAIV) based on Russian master donor virus A/Leningrad/134/17/57. LAIV candidates of H5N1, H5N2, H7N3, H1N1 and H2N2 subtypes were safe, immunogenic and protected animals from challenge with homologous and heterologous viruses. Clinical trials of the pandemic LAIVs demonstrated their safety and immunogenicity for healthy adult volunteers. The vaccine viruses were infectious, genetically stable and did not transmit to unvaccinated contacts. In addition, here we discuss criteria for the assessment of pandemic LAIV immunogenicity and efficacy necessary for their licensure. PMID:25555687

  3. Clinical characteristics of 2009 pandemic influenza A (H1N1) infection in children and the performance of rapid antigen test

    OpenAIRE

    Yong-Jae Park; Jang-Yong Jin; Hyeon-Jong Yang; Woo-Ryung Lee; Dong-Hwan Lee; Bok-Yang Pyun; Eun-Sook Suh

    2011-01-01

    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, bet...

  4. Continued dominance of pandemic A(H1N1 2009 influenza in Victoria, Australia in 2010

    Directory of Open Access Journals (Sweden)

    James E. Fielding

    2011-08-01

    Full Text Available The 2010 Victorian influenza season was characterized by normal seasonal influenza activity and the dominance of the pandemic A(H1N1 2009 strain. General Practice Sentinel Surveillance rates peaked at 9.4 ILI cases per 1000 consultations in week 36 for metropolitan practices, and at 10.5 ILI cases per 1000 in the following week for rural practices. Of the 678 ILI cases, 23% were vaccinated, a significantly higher percentage than in previous years. A significantly higher percentage of ILI patients were swabbed in 2010 compared to 2003–2008, but similar to 2009, with a similar percentage being positive for influenza as in previous years. Vaccination rates increased with patient age. Melbourne Medical Deputising Service rates peaked in week 35 at 19.1 ILI cases per 1000 consultations. Of the 1914 cases of influenza notified to the Department of Health, Victoria, 1812 (95% were influenza A infections - 1001 (55% pandemic A(H1N1 2009, 4 (<1% A(H3N2 and 807 (45% not subtyped; 88 (5% were influenza B; and 14 (< 1% were influenza A and B co-infections. The World Health Organization Collaborating Centre for Reference and Research on Influenza tested 403 isolates of which 261 were positive for influenza, 250 of which were influenza A and 11 were influenza B. Ninety-two per cent of the influenza A viruses were pandemic A(H1N1 2009, and following antigenic analysis all of these were found to be similar to the current vaccine strain. Three viruses (0.9% were found to be oseltamivir resistant due to an H275Y mutation in the neuraminidase gene.

  5. Determinants of Non-Vaccination against Pandemic 2009 H1N1 Influenza in Pregnant Women: A Prospective Cohort Study

    OpenAIRE

    Freund, Romain; Le Ray, Camille; Charlier, Caroline; Avenell, Carolyn; Truster, Van; Tre?luyer, Jean-marc; Skalli, Dounia; Ville, Yves; Goffinet, Franc?ois; Launay, Odile

    2011-01-01

    BACKGROUND: In October 2009, the French government organized a national-wide, free of charge vaccination campaign against pandemic H1N1 influenza virus, especially targeting pregnant women, a high risk group for severe illness. The study objective was to evaluate pandemic flu vaccine uptake and factors associated with non-vaccination in a population of pregnant women. METHODOLOGY/PRINCIPAL FINDINGS: In a prospective cohort conducted in 3 maternity hospitals in Paris, 882 pregnant women were r...

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

    OpenAIRE

    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

    ? We compared the ability of DI RNA and Tamiflu to protect ferrets from influenza. ? We treated ferrets with one 2 ?g intranasal dose of DI RNA delivered as DI virus. ? Or we treated ferrets with 10 oral doses of Tamiflu totalling 25 mg over 5 days. ? Pandemic A/California/04/09 amplified the DI RNA by >25,000-fold. ? DI virus was more effective than Tamiflu in combatting pandemic A/California/04/09.

  7. Pandemic influenza vaccination: lessons learned from Latin America and the Caribbean.

    Science.gov (United States)

    Ropero-Álvarez, Alba María; Whittembury, Alvaro; Kurtis, Hannah Jane; dos Santos, Thais; Danovaro-Holliday, M Carolina; Ruiz-Matus, Cuauhtémoc

    2012-01-20

    In April 2009, the World Health Organization (WHO) reported the emergence of a new influenza (H1N1) virus which led to the first pandemic declaration of the 21st century. Most countries in Latin America and the Caribbean (LAC) had a national preparedness plan in place at this time; however, the vaccination component of such plans was largely undeveloped. Nevertheless, countries were able to capitalize on the infrastructure of their immunization programs and widespread experience utilizing the seasonal influenza vaccine to prepare rapidly, developing H1N1 vaccination plans targeting individuals with chronic disease, pregnant women and health care workers, among others. In LAC vaccine was acquired through three mechanisms: the Pan American Health Organization's Revolving Fund, direct manufacturer purchase, and WHO donations. Vaccine access was not equitable both in quantity of vaccine available and timeless of vaccine availability. As of December 2010, an estimated 145 million doses had been administered in LAC. Despite high regional coverage, there were large variations in coverage at the national level; pregnant women had the lowest coverage, despite their high risk for morbidity and mortality. The number of severe adverse events reported in LAC was similar to those expected with the seasonal influenza vaccine. Risk communication was one of the key challenges countries faced, mainly due to concerns and misinformation spread regarding vaccine safety. Countries and the international community need to learn from the experiences gained during H1N1 vaccination in order to be better prepared for the next pandemic. PMID:22155136

  8. Pandemic influenza A/H1N1: comparative analysis of microscopic lung histopathological findings

    Directory of Open Access Journals (Sweden)

    Roberta Marchiori

    2012-09-01

    Full Text Available Objective: To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics. Methods: descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009. Nasopharyngeal aspirate specimens were collected from the patients and were analyzed by real-time polymerase chain reaction. Lung biopsy was performed post mortem; a score of intensity for pathological changes was applied. Results: Three patients had positive real-time polymerase chain reaction (although all of them had a clinical diagnose of influenza H1N1. The main histopathological changes were: exudative diffuse alveolar damage with atelectasis; varying degrees of alveolar hemorrhage and edema, necrosis and sloughing of the respiratory epithelium in several bronchioli; and thrombus formation. One of the patients (the pregnant one presented histopathological findings of cytomegalic inclusion. Conclusion: The pulmonary histopathological findings in patients with fatal 2009 H1N1 influenza pandemic disclosed intense alveolar damage and hemorrhage and severebronchiolitis. A co-infection with cytomegalovirus was described inthe pregnant patient.

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

    Directory of Open Access Journals (Sweden)

    Nelson Peter

    2006-11-01

    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.

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

    OpenAIRE

    Busquets, Nu?ria; Segale?s, Joaquim; Co?rdoba, Lorena; Mussa?, Tufaria; Crisci, Elisa; Marti?n-valls, Gerard E.; Simon-grife?, Meritxell; Pe?rez-simo?, Marta; Pe?rez-mai?llo, Monica; Nu?n?ez, Jose I.; Abad, Francesc X.; Fraile, Lorenzo; Pina, Sonia; Majo?, Natalia; Bensaid, Albert

    2010-01-01

    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 curren...

  11. Cold-Adapted Pandemic 2009 H1N1 Influenza Virus Live Vaccine Elicits Cross-Reactive Immune Responses against Seasonal and H5 Influenza A Viruses

    OpenAIRE

    Jang, Yo Han; Byun, Young Ho; Lee, Yoon Jae; Lee, Yun Ha; Lee, Kwang-hee; Seong, Baik Lin

    2012-01-01

    The rapid transmission of the pandemic 2009 H1N1 influenza virus (pH1N1) among humans has raised the concern of a potential emergence of reassortment between pH1N1 and highly pathogenic influenza strains, especially the avian H5N1 influenza virus. Here, we report that the cold-adapted pH1N1 live attenuated vaccine (CApH1N1) elicits cross-reactive immunity to seasonal and H5 influenza A viruses in the mouse model. Immunization with CApH1N1 induced both systemic and mucosal antibodies with broa...

  12. Review: influenza virus in pigs.

    Science.gov (United States)

    Crisci, Elisa; Mussá, Tufária; Fraile, Lorenzo; Montoya, Maria

    2013-10-01

    Influenza virus disease still remains one of the major threats to human health, involving a wide range of animal species and pigs play an important role in influenza ecology. Pigs were labeled as "mixing vessels" since they are susceptible to infection with avian, human and swine influenza viruses and genetic reassortment between these viruses can occur. After the H1N1 influenza pandemic of 2009 with a swine origin virus, the most recent research in "influenzology" is directed at improving knowledge of porcine influenza virus infection. This tendency is probably due to the fact that domestic pigs are closely related to humans and represent an excellent animal model to study various microbial infectious diseases. In spite of the role of the pig in influenza virus ecology, swine immune responses against influenza viruses are not fully understood. Considering these premises, the aim of this review is to focus on the in vitro studies performed with porcine cells and influenza virus and on the immune responses of pigs against human, avian and swine influenza viruses in vivo. The increased acceptance of pigs as suitable and valuable models in the scientific community may stimulate the development of new tools to assess porcine immune responses, paving the way for their consideration as the future "gold standard" large-animal model in immunology. PMID:23523121

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

    Directory of Open Access Journals (Sweden)

    Torun Fuat

    2010-10-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Goñi Natalia

    2012-11-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Schwehm Markus

    2007-07-01

    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.

  16. 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

    Scientific Electronic Library Online (English)

    Ricardo, Rabagliati B; Leonardo, Siri Z; Carlos M, Pérez C; Jaime, Labarca L; Marcela, Ferrés G.

    2011-12-01

    Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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 Abstract in english 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 pati [...] ents 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

  17. Influenza activity in Saint Joseph, Missouri 1910-1923: Evidence for an early wave of the 1918 pandemic

    OpenAIRE

    Hoffman, Brian L.

    2011-01-01

    While the 1918/1919 H1N1 influenza pandemic is widely recognized as a “worst-case scenario” for the emergence of a new influenza strain, relatively little is known about the origin of the responsible virus and its pattern of spread. Most studies of this virus in the United States rely on temporally and spatially aggregated data. Location-specific studies of the impact of the 1918 pandemic strain in the United States have been confined primarily to large cities on the East Coast or West...

  18. Restored PB1-F2 in the 2009 Pandemic H1N1 Influenza Virus Has Minimal Effects in Swine

    OpenAIRE

    Pena, Lindomar; Vincent, Amy L.; Loving, Crystal L.; Henningson, Jamie N.; Lager, Kelly M.; Lorusso, Alessio; Perez, Daniel R.

    2012-01-01

    PB1-F2 is an 87- to 90-amino-acid-long protein expressed by certain influenza A viruses. Previous studies have shown that PB1-F2 contributes to virulence in the mouse model; however, its role in natural hosts—pigs, humans, or birds—remains largely unknown. Outbreaks of domestic pigs infected with the 2009 pandemic H1N1 influenza virus (pH1N1) have been detected worldwide. Unlike previous pandemic strains, pH1N1 viruses do not encode a functional PB1-F2 due to the presence of three stop co...

  19. Hemagglutination inhibiting antibodies and protection against seasonal and pandemic influenza infection

    Science.gov (United States)

    Fox, Annette; Mai, Le Quynh; Thanh, Le Thi; Wolbers, Marcel; Le Khanh Hang, Nguyen; Thai, Pham Quang; Thu Yen, Nguyen Thi; Minh Hoa, Le Nguyen; Bryant, Juliet E.; Duong, Tran Nhu; Thoang, Dang Dinh; Barr, Ian G.; Wertheim, Heiman; Farrar, Jeremy; Hien, Nguyen Tran; Horby, Peter

    2015-01-01

    Summary Objectives Hemagglutination inhibiting (HI) antibodies correlate with influenza vaccine protection but their association with protection induced by natural infection has received less attention and was studied here. Methods 940 people from 270 unvaccinated households participated in active ILI surveillance spanning 3 influenza seasons. At least 494 provided paired blood samples spanning each season. Influenza infection was confirmed by RT-PCR on nose/throat swabs or serum HI assay conversion. Results Pre-season homologous HI titer was associated with a significantly reduced risk of infection for H3N2 (OR 0.61, 95%CI 0.44–0.84) and B (0.65, 95%CI 0.54–0.80) strains, but not H1N1 strains, whether re-circulated (OR 0.90, 95%CI 0.71–1.15), new seasonal (OR 0.86, 95%CI 0.54–1.36) or pandemic H1N1-2009 (OR 0.77, 95%CI 0.40–1.49). The risk of seasonal and pandemic H1N1 decreased with increasing age (both p < 0.0001), and the risk of pandemic H1N1 decreased with prior seasonal H1N1 (OR 0.23, 95%CI 0.08–0.62) without inducing measurable A/California/04/2009-like titers. Conclusions While H1N1 immunity was apparent with increasing age and prior infection, the effect of pre-season HI titer was at best small, and weak for H1N1 compared to H3N2 and B. Antibodies targeting non-HI epitopes may have been more important mediators of infection-neutralizing immunity for H1N1 compared to other subtypes in this setting. PMID:25224643

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

    Directory of Open Access Journals (Sweden)

    Ducatez MF

    2011-07-01

    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

  1. Eurasian-Origin Gene Segments Contribute to the Transmissibility, Aerosol Release, and Morphology of the 2009 Pandemic H1N1 Influenza Virus

    OpenAIRE

    Lakdawala, Seema S.; Lamirande, Elaine W.; Suguitan, Amorsolo L.; Wang, Weijia; Santos, Celia P.; Vogel, Leatrice; Matsuoka, Yumiko; Lindsley, William G.; Jin, Hong; Subbarao, Kanta

    2011-01-01

    The epidemiological success of pandemic and epidemic influenza A viruses relies on the ability to transmit efficiently from person-to-person via respiratory droplets. Respiratory droplet (RD) transmission of influenza viruses requires efficient replication and release of infectious influenza particles into the air. The 2009 pandemic H1N1 (pH1N1) virus originated by reassortment of a North American triple reassortant swine (TRS) virus with a Eurasian swine virus that contributed the neuraminid...

  2. Developing cell culture-derived pandemic vaccines.

    Science.gov (United States)

    Barrett, P Noel; Portsmouth, Daniel; Ehrlich, Hartmut J

    2010-02-01

    The growing prospect of avian influenza viruses achieving sustained interhuman transmission, combined with the recent emergence of a novel swine-origin A/H1N1 influenza strain, has brought the issue of influenza vaccine production capacity into sharp focus. It is becoming increasingly clear that traditional egg-based manufacturing processes may be insufficient to meet global vaccine demands in a pandemic situation that is caused by a highly pathogenic influenza virus. This review introduces the concepts of modern, cell culture-derived influenza vaccines and their manufacture, and explains the advantages of these vaccines in terms of both speed and efficiency of production as well as immunogenic efficacy. Vaccine production technologies using the mammalian cell lines Vero, MDCK and PER.C6, as well as the baculovirus/insect cell platform, are described in detail. Clinical data are provided from cell culture-derived vaccines that are at an advanced stage of development, and insights are provided into recent developments in the preclinical evaluation of more experimental technologies. PMID:20140813

  3. Outbreaks of pandemic (H1N1) 2009 and seasonal influenza A (H3N2) on cruise ship.

    Science.gov (United States)

    Ward, Kate A; Armstrong, Paul; McAnulty, Jeremy M; Iwasenko, Jenna M; Dwyer, Dominic E

    2010-11-01

    To determine the extent and pattern of influenza transmission and effectiveness of containment measures, we investigated dual outbreaks of pandemic (H1N1) 2009 and influenza A (H3N2) that had occurred on a cruise ship in May 2009. Of 1,970 passengers and 734 crew members, 82 (3.0%) were infected with pandemic (H1N1) 2009 virus, 98 (3.6%) with influenza A (H3N2) virus, and 2 (0.1%) with both. Among 45 children who visited the ship's childcare center, infection rate for pandemic (H1N1) 2009 was higher than that for influenza A (H3N2) viruses. Disembarked passengers reported a high level of compliance with isolation and quarantine recommendations. We found 4 subsequent cases epidemiologically linked to passengers but no evidence of sustained transmission to the community or passengers on the next cruise. Among this population of generally healthy passengers, children seemed more susceptible to pandemic (H1N1) 2009 than to influenza (H3N2) viruses. Intensive disease control measures successfully contained these outbreaks. PMID:21029531

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

    OpenAIRE

    Mf, Ducatez; Tp, Fabrizio; Rj, Webby

    2011-01-01

    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(H1N1)pdm09] 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, li...

  5. Did the pandemic have an impact on influenza vaccination attitude? a survey among health care workers

    OpenAIRE

    Pullukçu Hüsnü; Ta?bakan Meltem; Sipahi O?uz; Yamazhan Tansu; Durusoy Raika; Arda Bilgin; Erdem Esra; Ulusoy Sercan

    2011-01-01

    Abstract Background Health care workers' (HCWs) influenza vaccination attitude is known to be negative. The H1N1 epidemic had started in mid 2009 and made a peak in October-November in Turkey. A national vaccination campaign began on November 2nd, 2009. Despite the diligent efforts of the Ministry of Health and NGOs, the attitudes of the media and politicians were mostly negative. The aim of this study was to evaluate whether HCWs' vaccination attitudes improved during the pandemic and to ass...

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

    OpenAIRE

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

    2011-01-01

    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. Nasal swabs were collected from herds i) where pigs had been exp...

  7. Persistence of the 2009 Pandemic Influenza A (H1N1) Virus on N95 Respirators

    OpenAIRE

    Coulliette, A. D.; Perry, K. A.; Edwards, J. R.; Noble-wang, J. A.

    2013-01-01

    In the United States, the 2009 pandemic influenza A (H1N1) virus (pH1N1) infected almost 20% of the population and caused >200,000 hospitalizations and >10,000 deaths from April 2009 to April 2010. On 24 April 2009, the CDC posted interim guidance on infection control measures in health care settings explicitly for pH1N1 and recommended using filtering face respirators (FFRs) when in close contact with a suspected- or confirmed-to-be-infected individual, particularly when performing aerosol-g...

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

    Science.gov (United States)

    López, Marcelo; Beltrán, Miriam

    2013-04-01

    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

  9. The effect of population structure on the emergence of drug resistance during influenza pandemics

    OpenAIRE

    De?barre, Florence; Bonhoeffer, Sebastian; Regoes, Roland R.

    2007-01-01

    The spread of H5N1 avian influenza and the recent high numbers of confirmed human cases have raised international concern about the possibility of a new pandemic. Therefore, antiviral drugs are now being stockpiled to be used as a first line of defence. The large-scale use of antivirals will however exert a strong selection pressure on the virus, and may lead to the emergence of drug-resistant strains. A few mathematical models have been developed to assess the emergence of drug resistance du...

  10. Syndromic surveillance for influenza in two hospital emergency departments. Relationships between ICD-10 codes and notified cases, before and during a pandemic

    OpenAIRE

    Rowe Stacey; Black James; Moore Karen; Franklin Lucinda

    2011-01-01

    Abstract Background Interest in the use of emergency department (ED) data by syndromic surveillance systems to detect influenza outbreaks has been growing. Evaluations of these systems generally focus on events during influenza seasons. The aims of this study were to identify which emergency department disease codes best correlated with confirmed influenza cases and to determine if these same codes would be useful in the non-influenza season. The 2009 influenza pandemic in Victoria, Australia...

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

    Directory of Open Access Journals (Sweden)

    Bowman Christopher S

    2009-01-01

    Full Text Available 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 for treatment of clinical infections. Using estimated parameters in the published literature, the model was simulated for various sizes of stockpiles to evaluate the outcome of different antiviral strategies. Results We demonstrated that the emergence of highly transmissible resistant strains has no significant impact on the use of available stockpiles if treatment is maintained at low levels or the reproduction number of the sensitive strain is sufficiently high. However, moderate to high treatment levels can result in a more rapid depletion of stockpiles, leading to run-out, by promoting wide-spread drug resistance. We applied an antiviral strategy that delays the onset of aggressive treatment for a certain amount of time after the onset of the outbreak. Our results show that if high treatment levels are enforced too early during the outbreak, a second wave of infections can potentially occur with a substantially larger magnitude. However, a timely implementation of wide-scale treatment can prevent resistance spread in the population, and minimize the final size of the pandemic. Conclusion Our results reveal that conservative treatment levels during the early stages of the outbreak, followed by a timely increase in the scale of drug-use, will offer an effective strategy to manage drug resistance in the population and avoid run-out. For a 1918-like strain, the findings suggest that pandemic plans should consider stockpiling antiviral drugs to cover at least 20% of the population.

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

    Directory of Open Access Journals (Sweden)

    Gao Tiffany T

    2010-04-01

    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.

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

    OpenAIRE

    Liu, Wen-chun; Lin, Shih-chang; Yu, Yen-ling; Chu, Ching-liang; Wu, Suh-chin

    2010-01-01

    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...

  14. "Will they just pack up and leave?" – attitudes and intended behaviour of hospital health care workers during an influenza pandemic

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    Po Kieren

    2009-02-01

    Full Text Available Abstract Background There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. Methods Cross-sectional investigation of a convenience sample of clinical and non-clinical HCWs from two tertiary-referral teaching hospitals in Sydney, Australia was conducted between June 4 and October 19, 2007. The self-administered questionnaire was distributed to hospital personal from 40 different wards and departments. The main outcome measures were intentions regarding work attendance and quarantine, antiviral use and perceived preparation. Results Respondents were categorized into four main groups by occupation: Nursing (47.5%, Medical (26.0%, Allied (15.3% and Ancillary (11.2%. Our study found that most HCWs perceived pandemic influenza to be very serious (80.9%, n = 873 but less than half were able to correctly define it (43.9%, n = 473. Only 24.8% of respondents believed their department to be prepared for a pandemic, but nonetheless most were willing to work during a pandemic if a patient or colleague had influenza. The main determinants of variation in our study were occupational factors, demographics and health beliefs. Non-clinical staff were significantly most likely to be unsure of their intentions (OR 1.43, p Conclusion We identified two issues that could undermine the best of pandemic plans – the first, a low level of confidence in antivirals as an effective measure; secondly, that non-clinical workers are an overlooked group whose lack of knowledge and awareness could undermine pandemic plans. Other issues included a high level of confidence in dietary measures to protect against influenza, and a belief among ancillary workers that antibiotics would be protective. All health care worker strategies should include non clinical and ancillary staff to ensure adequate business continuity for hospitals. HCW education, psychosocial support and staff communication could improve knowledge of appropriate pandemic interventions and confidence in antivirals.

  15. The so-called Great Spanish Influenza Pandemic of 1918 may have originated in France in 1916.

    OpenAIRE

    Oxford, J. S.

    2001-01-01

    This discussion piece examines the likely epicentre of the influenza pandemic of 1918-1919. Contrary to previous studies that have proposed a Chinese origin, there is documentation that suggests that, in this instance, the virus spread eastwards to China from Europe. Although more recent oubreaks of influenza have undoubtedly had an Oriental origin, the evidence indicates that future outbreaks could conceivably arise anywhere in the world.

  16. Experiences after Twenty Months with Pandemic Influenza A (H1N1) 2009 Infection in the Naïve Norwegian Pig Population

    OpenAIRE

    Gjerset, B.; Er, C.; Løtvedt, S.; Jørgensen, A.; Hungnes, O.; Lium, B.; Germundsson, A.

    2011-01-01

    Pandemic (H1N1) 2009 influenza A virus was detected in Norwegian pigs in October 2009. Until then, Norway was regarded free of swine influenza. Intensified screening revealed 91 positive herds within three months. The virus was rapidly transmitted to the susceptible population, including closed breeding herds with high biosecurity. Humans were important for the introduction as well as spread of the virus to pigs. Mild or no clinical signs were observed in infected pigs. Surveillance of SIV in...

  17. The community impact of the 2009 influenza pandemic in the WHO European Region: a comparison with historical seasonal data from 28 countries

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    Martirosyan Liana

    2012-02-01

    Full Text Available Abstract Background The world has recently experienced the first influenza pandemic of the 21st century that lasted 14 months from June 2009 to August 2010. This study aimed to compare the timing, geographic spread and community impact during the winter wave of influenza pandemic A (H1N1 2009 to historical influenza seasons in countries of the WHO European region. Methods We assessed the timing of pandemic by comparing the median peak of influenza activity in countries of the region during the last seven influenza seasons. The peaks of influenza activity were selected by two independent researchers using predefined rules. The geographic spread was assessed by correlating the peak week of influenza activity in included countries against the longitude and latitude of the central point in each country. To assess the community impact of pandemic influenza, we constructed linear regression models to compare the total and age-specific influenza-like-illness (ILI or acute respiratory infection (ARI rates reported by the countries in the pandemic season to those observed in the previous six influenza seasons. Results We found that the influenza activity reached its peak during the pandemic, on average, 10.5 weeks (95% CI 6.4-14.2 earlier than during the previous 6 seasons in the Region, and there was a west to east spread of pandemic A(H1N1 influenza virus in the western part of the Region. A regression analysis showed that the total ILI or ARI rates were not higher than historical rates in 19 of the 28 countries. However, in countries with age-specific data, there were significantly higher consultation rates in the 0-4 and/or 5-14 age groups in 11 of the 20 countries. Conclusions Using routine influenza surveillance data, we found that pandemic influenza had several differential features compared to historical seasons in the region. It arrived earlier, caused significantly higher number of outpatient consultations in children in most countries and followed west to east spread that was previously observed during some influenza seasons with dominant A (H3N2 ifluenza viruses. The results of this study help to understand the epidemiology of 2009 influenza pandemic and can be used for pandemic preparedness planning.

  18. Simulating the Spread of Influenza Pandemic of 1918-1919 Considering the Effect of the First World War

    CERN Document Server

    Yoneyama, Teruhiko

    2010-01-01

    The Influenza Pandemic of 1918-1919, also called Spanish Flu Pandemic, was one of the severest pandemics in history. It is thought that the First World War much influenced the spread of the pandemic. In this paper, we model the pandemic considering both civil and military traffic. We propose a hybrid model to determine how the pandemic spread through the world. Our approach considers both the SEIR-based model for local areas and the network model for global connection between countries. First, we reproduce the situation in 12 countries. Then, we simulate another scenario: there was no military traffic during the pandemic, to determine the influence of the influenced of the war on the pandemic. By considering the simulation results, we find that the influence of the war varies in countries; in countries which were deeply involved in the war, the infections were much influenced by the war, while in countries which were not much engaged in the war, the infections were not influenced by the war.

  19. Pandemic influenza A (H1N1 in Saudi Arabia: Description of the first one hundred cases

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    AlMazroa Mohammad

    2010-01-01

    Full Text Available Background and Objectives : In April 2009, the World Health Organization (WHO declared pandemic influenza A (H1N1 "public health emergency of international concern". On June 11, 2009, WHO raised the pandemic alert level to phase 6, indicating a global pandemic. By December 2009, more than 208 countries and territories had reported swine flu cases. The descriptive epidemiology of the first reported 100 cases of this virus in Saudi Arabia are summarized in this report. Methods : Data were collected from 1 June to 3 July, 2009 using a predesigned questionnaire. Questionnaires were filled by Field Epidemiology Training Program residents. Data for the first 100 complete cases of confirmed pandemic influenza A (H1N1 were compiled and analyzed. Results : The age of reported cases was in the range of 1 to 56 years. The highest percentage of cases was in the age group of 20 to 30 years followed by the age group of 1 to 10 years. Females represented 55% of the cases; imported cases represented 47%, 58% of whom had come via the King Khaled Airport. The most common nationalities most were from Saudi Arabia and the Philippines. The main symptoms were fever (56%, cough (54%, and sore throat and the number of cases was seen to peak from the 27 to 29 June. Conclusion : Pandemic influenza A (H1N1 is still a threat to Saudi Arabia. Thus, comprehensive and effective measures for surveillance and prevention of the disease are needed to control its spread.

  20. A qualitative study of pandemic influenza preparedness among small and medium-sized businesses in New York City.

    Science.gov (United States)

    Burton, Deron C; Confield, Evan; Gasner, Mary Rose; Weisfuse, Isaac

    2011-10-01

    Small businesses need to engage in continuity planning to assure delivery of goods and services and to sustain the economy during an influenza pandemic. This is especially true in New York City, where 98 per cent of businesses have fewer than 100 employees. It was an objective therefore, to determine pandemic influenza business continuity practices and strategies suitable for small and medium-sized NYC businesses. The study design used focus groups, and the participants were owners and managers of businesses with fewer than 500 employees in New York City. The main outcome measures looked for were the degree of pandemic preparedness, and the feasibility of currently proposed business continuity strategies. Most participants reported that their businesses had no pandemic influenza plan. Agreement with feasibility of specific business continuity strategies was influenced by the type of business represented, cost of the strategy, and business size. It was concluded that recommendations for pandemic-related business continuity plans for small and medium-sized businesses should be tailored to the type and size of business and should highlight the broad utility of the proposed strategies to address a range of business stressors. PMID:22308579

  1. A community-based participatory approach and engagement process creates culturally appropriate and community informed pandemic plans after the 2009 H1N1 influenza pandemic: remote and isolated First Nations communities of sub-arctic Ontario, Canada

    OpenAIRE

    Charania Nadia A; Js, Tsuji Leonard

    2012-01-01

    Abstract Background Public health emergencies have the potential to disproportionately impact disadvantaged populations due to pre-established social and economic inequalities. Internationally, prior to the 2009 H1N1 influenza pandemic, existing pandemic plans were created with limited public consultation; therefore, the unique needs and characteristics of some First Nations communities may not be ethically and adequately addressed. Engaging the public in pandemic planning can provide vital i...

  2. Effectiveness and harms of seasonal and pandemic influenza vaccines in children, adults and elderly

    Science.gov (United States)

    Manzoli, Lamberto; Ioannidis, John P.A.; Flacco, Maria Elena; De Vito, Corrado; Villari, Paolo

    2012-01-01

    Fifteen meta-analyses have been published between 1995 and 2011 to evaluate the efficacy/effectiveness and harms of diverse influenza vaccines—seasonal, H5N1 and 2009(H1N1) —in various age-classes (healthy children, adults or elderly). These meta-analyses have often adopted different analyses and study selection criteria. Because it is difficult to have a clear picture of vaccine benefits and harms examining single systematic reviews, we compiled the main findings and evaluated which could be the most reasonable explanations for some differences in findings (or their interpretation) across previously published meta-analyses. For each age group, we performed analyses that included all trials that had been included in at least one relevant meta-analysis, also exploring whether effect sizes changed over time. Although we identified several discrepancies among the meta-analyses on seasonal vaccines for children and elderly, overall most seasonal influenza vaccines showed statistically significant efficacy/effectiveness, which was acceptable or high for laboratory-confirmed cases and of modest magnitude for clinically-confirmed cases. The available evidence on parenteral inactivated vaccines for children aged < 2 y remains scarce. Pre-pandemic “avian” H5N1 and pandemic 2009 (H1N1) vaccines can achieve satisfactory immunogenicity, but no meta-analysis has addressed H1N1 vaccination impact on clinical outcomes. Data on harms are overall reassuring, but their value is diminished by inconsistent reporting. PMID:22777099

  3. Developing guidelines for school closure interventions to be used during a future influenza pandemic

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    Milne George J

    2010-07-01

    Full Text Available Abstract Background The A/H1N1 2009 influenza pandemic revealed that operational issues of school closure interventions, such as when school closure should be initiated (activation trigger, how long schools should be closed (duration and what type of school closure should be adopted, varied greatly between and within countries. Computer simulation can be used to examine school closure intervention strategies in order to inform public health authorities as they refine school closure guidelines in light of experience with the A/H1N1 2009 pandemic. Methods An individual-based simulation model was used to investigate the effectiveness of school closure interventions for influenza pandemics with R0 of 1.5, 2.0 and 2.5. The effectiveness of individual school closure and simultaneous school closure were analyzed for 2, 4 and 8 weeks closure duration, with a daily diagnosed case based intervention activation trigger scheme. The effectiveness of combining antiviral drug treatment and household prophyaxis with school closure was also investigated. Results Illness attack rate was reduced from 33% to 19% (14% reduction in overall attack rate by 8 weeks school closure activating at 30 daily diagnosed cases in the community for an influenza pandemic with R0 = 1.5; when combined with antivirals a 19% (from 33% to 14% reduction in attack rate was obtained. For R0 >= 2.0, school closure would be less effective. An 8 weeks school closure strategy gives 9% (from 50% to 41% and 4% (from 59% to 55% reduction in attack rate for R0 = 2.0 and 2.5 respectively; however, school closure plus antivirals would give a significant reduction (~15% in over all attack rate. The results also suggest that an individual school closure strategy would be more effective than simultaneous school closure. Conclusions Our results indicate that the particular school closure strategy to be adopted depends both on the disease severity, which will determine the duration of school closure deemed acceptable, and its transmissibility. For epidemics with a low transmissibility (R0 mild severity, individual school closures should begin once a daily community case count is exceeded. For a severe, highly transmissible epidemic (R0 >= 2.0, long duration school closure should begin as soon as possible and be combined with other interventions.

  4. Importation and spread of pandemic influenza virus a(H1N1 in Autonomous Province of vojvodina in preepidemic period

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    Risti? Mioljub

    2010-01-01

    Full Text Available Introduction. Influenza is the most frequently reported communicable disease, having epidemic and pandemic potential. The first influenza pandemic in this century started in Mexico and spread quickly throughout the world. This paper analyses importation of pandemic influenza cases and local transmission among population in the Autonomous Province of Vojvodina. Material and methods. According to the WHO guidelines and national recommendations, the influenza surveillance activities were conducted in Vojvodina in order to detect, isolate and treat affected international travelers and their close contacts. Patients whose pandemic influenza infection was laboratory confirmed were classified as confirmed cases, while those with symptoms who were epidemiologically linked with confirmed cases were classified as probable cases. Results. During the period from the 24th of June to 17th of August 2009, 123 pandemic influenza cases were recorded in Vojvodina. Infection was imported through international travelers and our citizens coming from countries affected by influenza outbreaks. Majority of cases had mild clinical picture. Most frequently reported symptoms were high fever (above 38oC (85.6%, and cough (61.6%. Difficulty in breathing was recorded in 20 (16.0% cases, while pneumonia developed in 4 (3.2% cases but none of the cases required mechanical ventilation. Conclusion. The imported cases of pandemic influenza in the pre-epidemic period led to limited local transmission in general population and caused a small outbreak among visitors of International music festival called EXIT.

  5. The Scourge of Asian Flu: In Utero Exposure to Pandemic Influenza and the Development of a Cohort of British Children

    Science.gov (United States)

    Kelly, Elaine

    2011-01-01

    This paper examines the impact of in utero exposure to the Asian influenza pandemic of 1957 upon childhood development. Outcome data are provided by the National Child Development Study (NCDS), a panel study where all members were potentially exposed in the womb. Epidemic effects are identified using geographic variation in a surrogate measure of…

  6. Antibody persistence after Pandemic H1N1 2009 influenza vaccination among healthcare workers in Pune, India

    OpenAIRE

    Tandale, Babasaheb V.; Pawar, Shailesh D.; Gurav, Yogesh K.; Parkhi, Saurabh S.; Mishra, Akhilesh C.

    2012-01-01

    The healthcare workers having seroprotection at 3 weeks (n = 127) following Pandemic H1N1 2009 influenza vaccination were followed up for antibody persistence. Seroprotection at 12 mo (60.2%) was significantly lower as compared with 3 weeks (74.7%), 3 mo (77.8%) and 6 mo (75.4%). The vaccine provided seroprotection up to one year.

  7. Antibody persistence after Pandemic H1N1 2009 influenza vaccination among healthcare workers in Pune, India.

    Science.gov (United States)

    Tandale, Babasaheb V; Pawar, Shailesh D; Gurav, Yogesh K; Parkhi, Saurabh S; Mishra, Akhilesh C

    2013-01-01

    The healthcare workers having seroprotection at 3 weeks (n = 127) following Pandemic H1N1 2009 influenza vaccination were followed up for antibody persistence. Seroprotection at 12 mo (60.2%) was significantly lower as compared with 3 weeks (74.7%), 3 mo (77.8%) and 6 mo (75.4%). The vaccine provided seroprotection up to one year. PMID:23047369

  8. Changes in severity of 2009 pandemic A/H1N1 influenza in England: a Bayesian evidence synthesis

    OpenAIRE

    Presanis, A. M.; Pebody, R. G.; Paterson, B. J.; Tom, B. D. M.; Birrell, P. J.; Charlett, A.; Lipsitch, M.; Angelis, D.

    2011-01-01

    Objective To assess the impact of the 2009 A/H1N1 influenza pandemic in England during the two waves of activity up to end of February 2010 by estimating the probabilities of cases leading to severe events and the proportion of the population infected.

  9. Why did many more diamond miners than gold miners die in South Africa during the 1918 influenza pandemic?

    Science.gov (United States)

    Shanks, G Dennis; Brundage, John; Frean, John

    2010-03-01

    The very large difference in mortality rates between Kimberley diamond miners and Witwatersrand gold miners during the 1918 influenza pandemic has never been explained. We examined extant epidemiological records from South African mining operations and other related activities to determine if mortality risk factors could be measured. During October 1918 when pandemic influenza struck in South Africa, the mortality rates in Kimberley diamond miners (22.4%, n = 11 445) were >35 times that of Rand gold miners (0.6%, n = 200 000). There were no differences discernable between diamond and gold miners regarding their recruitment, working conditions, housing or medical care that would explain the great variance in mortality rates. Reports of influenza-like illness in Natal Province some weeks prior to the main pandemic suggest infection from a mild version of influenza and thus protection of the gold miners from mortality whereas the more isolated diamond miners only experienced the second, more lethal, wave. The huge mortality difference between South African diamond and gold miners in 1918 is most likely explained by the circulation of a related but not identical virus to the A/H1N1 pandemic strain which reached Johannesburg prior to October 1918 because of its better transportation connections. PMID:24037050

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

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    Yardley Lucy

    2009-07-01

    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.

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

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    James M Leaming

    2013-05-01

    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.

  12. Infectious disease modeling methods as tools for informing response to novel influenza viruses of unknown pandemic potential.

    Science.gov (United States)

    Gambhir, Manoj; Bozio, Catherine; O'Hagan, Justin J; Uzicanin, Amra; Johnson, Lucinda E; Biggerstaff, Matthew; Swerdlow, David L

    2015-05-01

    The rising importance of infectious disease modeling makes this an appropriate time for a guide for public health practitioners tasked with preparing for, and responding to, an influenza pandemic. We list several questions that public health practitioners commonly ask about pandemic influenza and match these with analytical methods, giving details on when during a pandemic the methods can be used, how long it might take to implement them, and what data are required. Although software to perform these tasks is available, care needs to be taken to understand: (1) the type of data needed, (2) the implementation of the methods, and (3) the interpretation of results in terms of model uncertainty and sensitivity. Public health leaders can use this article to evaluate the modeling literature, determine which methods can provide appropriate evidence for decision-making, and to help them request modeling work from in-house teams or academic groups. PMID:25878297

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

    Scientific Electronic Library Online (English)

    CECILIA, PERRET P; JEANNETTE, DABANCH P.

    2008-08-01

    Full Text Available 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

  14. Influenza Aviar y Riesgo de Pandemia Pandemic risk of Avian Influenza

    Directory of Open Access Journals (Sweden)

    CECILIA PERRET P

    2008-08-01

    Full Text Available 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 otras 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 pandemiaInfluenza 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

  15. Social contact networks for the spread of pandemic influenza in children and teenagers

    Directory of Open Access Journals (Sweden)

    Glass Robert J

    2008-02-01

    Full Text Available Abstract Background Influenza is a viral infection that primarily spreads via fluid droplets from an infected person's coughs and sneezes to others nearby. Social contact networks and the way people interact within them are thus important to its spread. We developed a method to characterize the social contact network for the potential transmission of influenza and then applied the method to school aged children and teenagers. Methods Surveys were administered to students in an elementary, middle and high-school in the United States. The social contact network of a person was conceptualized as a set of groups to which they belong (e.g., households, classes, clubs each composed of a sub-network of primary links representing the individuals within each group that they contact. The size of the group, number of primary links, time spent in the group, and level of contact along each primary link (near, talking, touching, or kissing were characterized. Public activities done by groups venturing into the community where random contacts occur (e.g., friends viewing a movie also were characterized. Results Students, groups and public activities were highly heterogeneous. Groups with high potential for the transmission of influenza were households, school classes, friends, and sports; households decreased and friends and sports increased in importance with grade level. Individual public activity events (such as dances were also important but lost their importance when averaged over time. Random contacts, primarily in school passing periods, were numerous but had much lower transmission potential compared to those with primary links within groups. Students are highly assortative, interacting mainly within age class. A small number of individual students are identified as likely "super-spreaders". Conclusion High-school students may form the local transmission backbone of the next pandemic. Closing schools and keeping students at home during a pandemic would remove the transmission potential within these ages and could be effective at thwarting its spread within a community. Social contact networks characterized as groups and public activities with the time, level of contact and primary links within each, yields a comprehensive view, which if extended to all ages, would allow design of effective community containment for pandemic influenza.

  16. Targets for the Induction of Protective Immunity Against Influenza A Viruses

    Directory of Open Access Journals (Sweden)

    Guus F. Rimmelzwaan

    2010-01-01

    Full Text Available The current pandemic caused by the new influenza A(H1N1 virus of swine origin and the current pandemic threat caused by the highly pathogenic avian influenza A viruses of the H5N1 subtype have renewed the interest in the development of vaccines that can induce broad protective immunity. Preferably, vaccines not only provide protection against the homologous strains, but also against heterologous strains, even of another subtype. Here we describe viral targets and the arms of the immune response involved in protection against influenza virus infections such as antibodies directed against the hemagglutinin, neuraminidase and the M2 protein and cellular immune responses directed against the internal viral proteins.

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

    OpenAIRE

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

    2012-01-01

    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...

  18. Cultural epidemiology of pandemic influenza in urban and rural Pune, India: a cross-sectional, mixed-methods study

    Science.gov (United States)

    Sundaram, Neisha; Schaetti, Christian; Purohit, Vidula; Kudale, Abhay; Weiss, Mitchell G

    2014-01-01

    Objective To identify and compare sociocultural features of pandemic influenza with reference to illness-related experience, meaning and behaviour in urban and rural areas of India. Design Cross-sectional, mixed-methods, cultural epidemiological survey with vignette-based interviews. Semistructured explanatory model interviews were used to study community ideas of the 2009 influenza pandemic. In-depth interviews elaborated respondents’ experience during the pandemic. Setting Urban and rural communities, Pune district, western India. Participants Survey of urban (n=215) and rural (n=221) residents aged between 18 and 65?years. In-depth interviews of respondents with a history of 2009 pandemic influenza (n=6). Results More urban (36.7%) than rural respondents (16.3%, pperson’–were more prominent in the urban group. Among rural respondents, climatic conditions, drinking contaminated water, tension and cultural ideas on humoral imbalance from heat-producing or cold-producing foods were more prominent. The most widely reported home treatment was herbal remedies; more rural respondents suggested reliance on prayer, and symptom relief was more of a priority for urban respondents. Government health services were preferred in the urban communities, and rural residents relied more than urban residents on private facilities. The important preventive measures emphasised were cleanliness, wholesome lifestyle and vaccines, and more urban respondents reported the use of masks. In-depth interviews indicated treatment delays during the 2009 pandemic, especially among rural patients. Conclusions Although the term was well known, better recognition of pandemic influenza cases is needed, especially in rural areas. Improved awareness, access to treatment and timely referrals by private practitioners are also required to reduce treatment delays. PMID:25492273

  19. Epidemiology of fatal cases associated with pandemic influenza reported in Yemen

    Directory of Open Access Journals (Sweden)

    Ahmed A. K. Thabet

    2012-11-01

    Full Text Available 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 June 2009 and 14 March 2010, a total of 33 laboratory-confirmed death cases associated with pandemic influenza A (H1N1 were reported to the Diseases Control and Surveillance in the Ministry of Public Health and Population. During this period, a total of 6049 suspected influenza A (H1N1 cases were recorded. With this denominator, the case fatality rate (CFR was 0.54%. During June through August, H1N1 confirmed cases were infrequently detected, including only 30; however, from September through December, over 200 confirmed cases were reported each month. Of the 33 cases recorded, 25 were male (76% and 8 were female (24%, male to female ratio being 3:1. Overall median age of the death cases was 30.8 years (range 1 - 55. The most common diagnosis upon admission was pneumonia. Out of the deaths, twenty five (75.8% had no documented underlying diseases. Chronic cardiovascular disease (9.1% was the most commonly reported disease and 2 deaths (6.1% were recorded as pregnant women. Conclusions: The most common diagnosis upon admission was pneumonia. Chronic cardiovascular diseases were the most commonly reported underlying conditions, while the most identified risk factor was pregnancy. These findings should be taken into consideration, when vaccination strategies are employed.

  20. 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)

    Saglanmak, Neslihan; Andreasen, Viggo

    2011-01-01

    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 1904–1937. 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 15–64 years experienced sharply elevated excess respiratory mortality rates in the 1918–1919 and 1919–1920 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 1918–1919, 84% were reported in individuals 15–64 years. By contrast, seniors over 65 years of age experienced no measurable excess mortality during 1918–1919 and moderate excess mortality in the recrudescent pandemic wave of 1919–1920. The first post-pandemic season associated with high excess mortality rates in individuals over 65 years was 1928–1929, 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 1918–1920; the rapid return to “epidemic” 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 1918–1919, 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 1919–1920 may suggest the emergence of an early influenza A/H1N1 drift variant. Subsequent drift events may have been associated with the particularly severe 1928–1929 epidemic in Denmark and elsewhere.

  1. Influenza A(H1N1pdm09 virus and asthma

    Directory of Open Access Journals (Sweden)

    MasatsuguObuchi

    2013-10-01

    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.

  2. Fully human broadly neutralizing monoclonal antibodies against influenza A viruses generated from the memory B cells of a 2009 pandemic H1N1 influenza vaccine recipient

    International Nuclear Information System (INIS)

    Whether the 2009 pandemic H1N1 influenza vaccine can induce heterosubtypic cross-protective anti-hemagglutinin (HA) neutralizing antibodies is an important issue. We obtained a panel of fully human monoclonal antibodies from the memory B cells of a 2009 pandemic H1N1 influenza vaccine recipient. Most of the monoclonal antibodies targeted the HA protein but not the HA1 fragment. Among the analyzed antibodies, seven mAbs exhibited neutralizing activity against several influenza A viruses of different subtypes. The conserved linear epitope targeted by the neutralizing mAbs (FIEGGWTGMVDGWYGYHH) is part of the fusion peptide on HA2. Our work suggests that a heterosubtypic neutralizing antibody response primarily targeting the HA stem region exists in recipients of the 2009 pandemic H1N1 influenza vaccine. The HA stem region contains various conserved neutralizing epitopes with the fusion peptide as an important one. This work may aid in the design of a universal influenza A virus vaccine.

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

    Directory of Open Access Journals (Sweden)

    Lee Gyu-Cheol

    2010-09-01

    Full Text Available 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 1,023 specimens. In addition, the kit was able to detect two strains of novel influenza viruses, Influenza A/California/12/2009(H1N1 and clinically isolated wild-type novel influenza A/H1N1, both of which are spreading epidemically throughout the world. In addition, the correlation between NanoSign® Influenza A/B test and conventional RT-PCR was approximately 94%, indicating a high concordance rate. Analytical sensitivity of the kit was approximately 73 ± 3.65 ng/mL of the purified viral proteins and 1.13 ± 0.11 hemagglutination units for the cultured virus. Conclusions As the NanoSign® Influenza A/B kit showed relatively high sensitivity and specificity and the good correlation with RT-PCR, it will be very useful in the early control of influenza infection and in helping physicians in making early treatment decisions.

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

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    Thejaswini Venkatesh

    2011-07-01

    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.

  5. Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

    Directory of Open Access Journals (Sweden)

    Putthasri Weerasak

    2010-06-01

    Full Text Available Abstract Background Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. Methods The study relied on the Systemic Rapid Assessment (SYSRA toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. Results The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission while preparation for later pandemic stages was limited. The interfaces and linkages between health system contexts and pandemic preparedness programmes in these countries were explored. Conclusion Health system context influences how the six countries have been preparing themselves for a pandemic. At the same time, investment in pandemic preparation in the six Asian countries has contributed to improvement in health system surveillance, laboratory capacity, monitoring and evaluation and public communications. A number of suggestions for improvement were presented to strengthen the pandemic preparation and mitigation as well as to overcome some of the underlying health system constraints.

  6. An H5N1 M2e-based multiple antigenic peptide vaccine confers heterosubtypic protection from lethal infection with pandemic 2009 H1N1 virus

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    Yu Hong

    2010-07-01

    Full Text Available Abstract Background A 2009 global influenza pandemic caused by a novel swine-origin H1N1 influenza A virus has posted an increasing threat of a potential pandemic by the highly pathogenic avian influenza (HPAI H5N1 virus, driving us to develop an influenza vaccine which confers cross-protection against both H5N1 and H1N1 viruses. Previously, we have shown that a tetra-branched multiple antigenic peptide (MAP vaccine based on the extracellular domain of M2 protein (M2e from H5N1 virus (H5N1-M2e-MAP induced strong immune responses and cross-protection against different clades of HPAI H5N1 viruses. In this report, we investigated whether such M2e-MAP presenting the H5N1-M2e consensus sequence can afford heterosubtypic protection from lethal challenge with the pandemic 2009 H1N1 virus. Results Our results demonstrated that H5N1-M2e-MAP plus Freund's or aluminum adjuvant induced strong cross-reactive IgG antibody responses against M2e of the pandemic H1N1 virus which contains one amino acid variation with M2e of H5N1 at position 13. These cross-reactive antibodies may maintain for 6 months and bounced back quickly to the previous high level after the 2nd boost administered 2 weeks before virus challenge. H5N1-M2e-MAP could afford heterosubtypic protection against lethal challenge with pandemic H1N1 virus, showing significant decrease of viral replications and obvious alleviation of histopathological damages in the challenged mouse lungs. 100% and 80% of the H5N1-M2e-MAP-vaccinated mice with Freund's and aluminum adjuvant, respectively, survived the lethal challenge with pandemic H1N1 virus. Conclusions Our results suggest that H5N1-M2e-MAP has a great potential to prevent the threat from re-emergence of pandemic H1N1 influenza and possible novel influenza pandemic due to the reassortment of HPAI H5N1 virus with the 2009 swine-origin H1N1 influenza virus.

  7. Dynamic modelling of costs and health consequences of school closure during an influenza pandemic

    Directory of Open Access Journals (Sweden)

    Xue Yiting

    2012-11-01

    Full Text Available Abstract Background The purpose of this article is to evaluate the cost-effectiveness of school closure during a potential influenza pandemic and to examine the trade-off between costs and health benefits for school closure involving different target groups and different closure durations. Methods We developed two models: a dynamic disease model capturing the spread of influenza and an economic model capturing the costs and benefits of school closure. Decisions were based on quality-adjusted life years gained using incremental cost-effectiveness ratios. The disease model is an age-structured SEIR compartmental model based on the population of Oslo. We studied the costs and benefits of school closure by varying the age targets (kindergarten, primary school, secondary school and closure durations (1–10 weeks, given pandemics with basic reproductive number of 1.5, 2.0 or 2.5. Results The cost-effectiveness of school closure varies depending on the target group, duration and whether indirect costs are considered. Using a case fatality rate (CFR of 0.1-0.2% and with current cost-effectiveness threshold for Norway, closing secondary school is the only cost-effective strategy, when indirect costs are included. The most cost-effective strategies would be closing secondary schools for 8 weeks if R0=1.5, 6 weeks if R0=2.0, and 4 weeks if R0= 2.5. For severe pandemics with case fatality rates of 1-2%, similar to the Spanish flu, or when indirect costs are disregarded, the optimal strategy is closing kindergarten, primary and secondary school for extended periods of time. For a pandemic with 2009 H1N1 characteristics (mild severity and low transmissibility, closing schools would not be cost-effective, regardless of the age target of school children. Conclusions School closure has moderate impact on the epidemic’s scope, but the resulting disruption to society imposes a potentially great cost in terms of lost productivity from parents’ work absenteeism.

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

    Science.gov (United States)

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

    2010-01-01

    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 pandemic, and seasonal human H1N1 viruses has been lacking. By homology modeling of the HA structure, here we show that HAs of 2009 H1N1 and the 1918 pandemic virus share a significant number of amino acid residues in known antigenic sites, suggesting the existence of common epitopes for neutralizing antibodies cross-reactive to both HAs. It was noted that the early human H1N1 viruses isolated in the 1930s–1940s still harbored some of the original epitopes that are also found in 2009 H1N1. Interestingly, while 2009 H1N1 HA lacks the multiple N-glycosylations that have been found to be associated with an antigenic change of the human H1N1 virus during the early epidemic of this virus, 2009 H1N1 HA still retains unique three-codon motifs, some of which became N-glycosylation sites via a single nucleotide mutation in the human H1N1 virus. We thus hypothesize that the 2009 H1N1 HA antigenic sites involving the conserved amino acids will soon be targeted by antibody-mediated selection pressure in humans. Indeed, amino acid substitutions predicted here are occurring in the recent 2009 H1N1 variants. The present study suggests that antibodies elicited by natural infection with the 1918 pandemic or its early descendant viruses play a role in specific immunity against 2009 H1N1, and provides an insight into future likely antigenic changes in the evolutionary process of 2009 H1N1 in the human population. PMID:20049332

  9. Analysis of 2009 pandemic influenza A/H1N1 outcomes in 19 European countries: association with completeness of national strategic plans

    OpenAIRE

    Meeyai, A.; Cooper, Bs; Coker, R.

    2013-01-01

    Objective: To describe changes in reported influenza activity associated with the 2009 H1N1 pandemic in European countries and determine whether there is a correlation between these changes and completeness of national strategic pandemic preparedness. Design: A retrospective correlational study. Setting: Countries were included if their national strategic plans had previously been analysed and if weekly influenza-like illness (ILI) data from sentinel networks between week 21, 2006 and week 20...

  10. Reassortment between Seasonal H1N1 and Pandemic (H1N1) 2009 Influenza Viruses Is Restricted by Limited Compatibility among Polymerase Subunits ?

    OpenAIRE

    Octaviani, Ca?ssio Pontes; Goto, Hideo; Kawaoka, Yoshihiro

    2011-01-01

    Reassortment is important for influenza virus evolution and the generation of novel viruses with pandemic potential; however, the factors influencing reassortment are still poorly understood. Here, using reverse genetics and a replicon assay, we demonstrated that a mixed polymerase complex containing a pandemic (H1N1) 2009 influenza virus PB2 on a seasonal H1N1 virus background has reduced polymerase activity, leading to impaired virus viability. Adaptation of viruses containing the mixed pol...

  11. Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus

    OpenAIRE

    Chong Ka Chun; Ying Zee Benny Chung

    2012-01-01

    Abstract Background During the early stages of a new influenza pandemic, travel restriction is an immediate and non-pharmaceutical means of retarding incidence growth. It extends the time frame of effective mitigation, especially when the characteristics of the emerging virus are unknown. In the present study, we used the 2009 influenza A pandemic as a case study to evaluate the impact of regulating air, sea, and land transport. Other government strategies, namely, antivirals and hospitalizat...

  12. C-reactive protein serum levels as an early predictor of outcome in patients with pandemic H1N1 influenza A virus infection

    OpenAIRE

    Tarabeia Jalal; Tau Luba; Touvia Oholi; Arad Roy; Dahan Esther; Justo Dan; Zeltser David; Mizrahi Michal; Aviram Galit; Rogowski Ori; Zimmerman Ofer; Berliner Shlomo; Paran Yael

    2010-01-01

    Abstract Background Data for predicting which patients with pandemic influenza A (H1N1) infection are likely to run a complicated course are sparse. We retrospectively studied whether the admission serum C-reactive protein (CRP) levels can serve as a predictor of illness severity. Methods Included were all consecutive adult patients who presented to the emergency department (ED) between May-December, 2009 with a flu-like illness, a confirmed diagnosis of pandemic influenza A (H1N1) infection ...

  13. Estimating the value of containment strategies in delaying the arrival time of an influenza pandemic: A case study of travel restriction and patient isolation

    OpenAIRE

    Wang, Lin; Zhang, Yan; Huang, Tianyi; Li, Xiang

    2012-01-01

    With a simple phenomenological metapopulation model, which characterizes the invasion process of an influenza pandemic from a source to a subpopulation at risk, we compare the efficiency of inter- and intra-population interventions in delaying the arrival of an influenza pandemic. We take travel restriction and patient isolation as examples, since in reality they are typical control measures implemented at the inter- and intra-population levels, respectively. We find that th...

  14. Absenteeism in schools during the 2009 influenza A(H1N1) pandemic: a useful tool for early detection of influenza activity in the community?

    Science.gov (United States)

    Kara, E O; Elliot, A J; Bagnall, H; Foord, D G F; Pnaiser, R; Osman, H; Smith, G E; Olowokure, B

    2012-07-01

    Certain influenza outbreaks, including the 2009 influenza A(H1N1) pandemic, can predominantly affect school-age children. Therefore the use of school absenteeism data has been considered as a potential tool for providing early warning of increasing influenza activity in the community. This study retrospectively evaluates the usefulness of these data by comparing them with existing syndromic surveillance systems and laboratory data. Weekly mean percentages of absenteeism in 373 state schools (children aged 4-18 years) in Birmingham, UK, from September 2006 to September 2009, were compared with established syndromic surveillance systems including a telephone health helpline, a general practitioner sentinel network and laboratory data for influenza. Correlation coefficients were used to examine the relationship between each syndromic system. In June 2009, school absenteeism generally peaked concomitantly with the existing influenza surveillance systems in England. Weekly school absenteeism surveillance would not have detected pandemic influenza A(H1N1) earlier but daily absenteeism data and the development of baselines could improve the timeliness of the system. PMID:22014106

  15. Pathogenesis of Pandemic Influenza A (H1N1) and Triple-Reassortant Swine Influenza A (H1) Viruses in Mice ?

    OpenAIRE

    Belser, Jessica A.; Wadford, Debra A.; Pappas, Claudia; Gustin, Kortney M.; Maines, Taronna R.; Pearce, Melissa B.; Zeng, Hui; Swayne, David E.; Pantin-jackwood, Mary; Katz, Jacqueline M.; Tumpey, Terrence M.

    2010-01-01

    The pandemic H1N1 virus of 2009 (2009 H1N1) continues to cause illness worldwide, primarily in younger age groups. To better understand the pathogenesis of these viruses in mammals, we used a mouse model to evaluate the relative virulence of selected 2009 H1N1 viruses and compared them to a representative human triple-reassortant swine influenza virus that has circulated in pigs in the United States for over a decade preceding the current pandemic. Additional comparisons were made with the re...

  16. A duplex real-time RT-PCR assay for detecting H5N1 avian influenza virus and pandemic H1N1 influenza virus

    Directory of Open Access Journals (Sweden)

    Qin E-de

    2010-06-01

    Full Text Available Abstract A duplex real-time reverse transcriptase polymerase chain reaction (RT-PCR assay was improved for simultaneous detection of highly pathogenic H5N1 avian influenza virus and pandemic H1N1 (2009 influenza virus, which is suitable for early diagnosis of influenza-like patients and for epidemiological surveillance. The sensitivity of this duplex real-time RT-PCR assay was 0.02 TCID50 (50% tissue culture infective dose for H5N1 and 0.2 TCID50 for the pandemic H1N1, which was the same as that of each single-target RT-PCR for pandemic H1N1 and even more sensitive for H5N1 with the same primers and probes. No cross reactivity of detecting other subtype influenza viruses or respiratory tract viruses was observed. Two hundred and thirty-six clinical specimens were tested by comparing with single real-time RT-PCR and result from the duplex assay was 100% consistent with the results of single real-time RT-PCR and sequence analysis.

  17. Knowledge and anticipated behavior of health care workers in response to an outbreak of pandemic influenza in Georgia

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    Maia Butsashvili,1 Wayne Triner,2 George Kamkamidze,1 Maia Kajaia,1 Louise-Anne McNutt.2

    2007-12-01

    Full Text Available Background: Avian influenza has been documented in over 331 humans since 2003 with 203 associated deaths. Health Care Workers (HCWs have been shown to be at personal risk during other highly virulent outbreaks with a high attack rate. This study aimed to determine the magnitude and factors associated with absenteeism of hospital based health care workers (HCWs in Georgia associated with a potential highly virulent influenza pandemic.Methodology: This was a cross-sectional study of how HCWs responded to a potentially highly virulent influenza pandemic in two urban hospitals in Georgia. Hospital based physicians and nurses were studied. Data was collected utilizing a survey instrument. The survey was either self-administered or interviewer administered based upon the preference of the respondent.Results: There were 288 HCWs surveyed. The study suggested a 23% rate of worker absenteeism, predominately among women and nurses. The majority of the respondents (58.1%, mostly HCWs less than age 35, were opposed to forced isolation or quarantine of staff during a highly virulent influenza pandemic. Seventy-six percent of respondents correctly reported that the strain of virus that was responsible for the outbreaks in the neighboring countries was H5N1. Only 15.5% of respondents, however, correctly identified influenza as the culprit virus.Conclusions: The rate of work absenteeism suggested by this study represents a significant workforce reduction. There are specific groups who would choose not to attend work in the face of a flu pandemic. This information may allow planners to target these specific groups for education and social support services to encourage greater inclination to attend to clinical duties.

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

    Science.gov (United States)

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

    2014-01-01

    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

  19. Human H-ficolin inhibits replication of seasonal and pandemic influenza A viruses

    DEFF Research Database (Denmark)

    Verma, Anamika; White, Mitchell

    2012-01-01

    The collectins have been shown to have a role in host defense against influenza A virus (IAV) and other significant viral pathogens (e.g., HIV). The ficolins are a related group of innate immune proteins that are present at relatively high concentrations in serum, but also in respiratory secretions; however, there has been little study of the role of ficolins in viral infection. In this study, we demonstrate that purified recombinant human H-ficolin and H-ficolin in human serum and bronchoalveolar lavage fluid bind to IAV and inhibit viral infectivity and hemagglutination activity in vitro. Removal of ficolins from human serum or bronchoalveolar lavage fluid reduces their antiviral activity. Inhibition of IAV did not involve the calcium-dependent lectin activity of H-ficolin. We demonstrate that H-ficolin is sialylated and that removal of sialic acid abrogates IAV inhibition, while addition of the neuraminidase inhibitor oseltamivir potentiates neutralization, hemagglutinin inhibition, and viral aggregation caused by H-ficolin. Pandemic and mouse-adapted strains of IAV are generally not inhibited by the collectins surfactant protein D or mannose binding lectin because of a paucity of glycan attachments on the hemagglutinin of these strains. In contrast, H-ficolin inhibited both the mouse-adapted PR-8 H1N1 strain and a pandemic H1N1 strain from 2009. H-ficolin also fixed complement to a surface coated with IAV. These findings suggest that H-ficolin contributes to host defense against IAV.

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

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    Mironenko A. P.

    2013-03-01

    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.

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

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    Porras Gallo, María Isabel

    2008-12-01

    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.

  2. The role of different social contexts in shaping influenza transmission during the 2009 pandemic

    Science.gov (United States)

    Ajelli, Marco; Poletti, Piero; Melegaro, Alessia; Merler, Stefano

    2014-11-01

    Evaluating the relative importance of different social contexts in which infection transmission occurs is critical for identifying optimal intervention strategies. Nonetheless, an overall picture of influenza transmission in different social contexts has yet to emerge. Here we provide estimates of the fraction of infections generated in different social contexts during the 2009 H1N1 pandemic in Italy by making use of a highly detailed individual-based model accounting for time use data and parametrized on the basis of observed age-specific seroprevalence. We found that 41.6% (95%CI: 39-43.7%) of infections occurred in households, 26.7% (95%CI: 21-33.2) in schools, 3.3% (95%CI: 1.7-5%) in workplaces, and 28.4% (95%CI: 24.6-31.9%) in the general community. The above estimates strongly depend on the lower susceptibility to infection of individuals 19+ years old compared to younger ones, estimated to be 0.2 (95%CI 0.12-0.28). We also found that school closure over the weekends contributed to decrease the effective reproduction number of about 8% and significantly affected the pattern of transmission. These results highlight the pivotal role played by schools in the transmission of the 2009 H1N1 influenza. They may be relevant in the evaluation of intervention options and, hence, for informing policy decisions.

  3. Experience with the clinical development of influenza vaccines for potential pandemics.

    Science.gov (United States)

    Wood, J M; Nicholson, K G; Stephenson, I; Zambon, M; Newman, R W; Major, D L; Podda, A

    2002-12-01

    During normal interpandemic influenza seasons, immune responses to vaccines are quite predictable and meet the licensing criteria of the European Union (EU) Committee for Proprietary Medicinal Products (CPMP). In a pandemic situation, large sections, if not all of the community will be immunologically naïve and therefore new immunisation strategies will be needed. In 1976 and 1977 H1N1 vaccines were prepared and tested clinically. To stimulate 'protective' antibody responses, two doses of vaccine were needed in people below the age of 24 years (no previous experience of H1N1 virus), whereas one conventional dose was adequate in older people. In 1997, the highly pathogenic avian influenza H5N1 virus caused widespread concern when it infected man, with lethal effects. Due to safety concerns it was necessary to adopt new strategies for vaccine development and one such strategy was to produce vaccine from an avirulent H5N3 virus, A/Duck/Singapore-Q/F119-2/97. Clinical trials of a subunit vaccine prepared from A/Duck/Sing/97 virus revealed that even two doses of twice the normal vaccine concentration (i.e. 30 micro g haemagglutinin) were poorly immunogenic, whereas an H5N3 vaccine adjuvanted with microfluidised emulsion (MF) 59 stimulated antibody levels that complied with CPMP criteria after two half strength doses (i.e. 7.5 micro g haemagglutinin). PMID:12458360

  4. Immunogenicity and Efficacy of Flagellin-Fused Vaccine Candidates Targeting 2009 Pandemic H1N1 Influenza in Mice

    OpenAIRE

    Liu, Ge; Tarbet, Bart; Song, Langzhou; Reiserova, Lucia; Weaver, Bruce; Chen, Yan; Li, Hong; Hou, Fu; Liu, Xiangyu; Parent, Jason; Umlauf, Scott; Shaw, Alan; Tussey, Lynda

    2011-01-01

    We have previously demonstrated that the globular head of the hemagglutinin (HA) antigen fused to flagellin of Salmonella typhimurium fljB (STF2, a TLR5 ligand) elicits protective immunity to H1N1 and H5N1 lethal influenza infections in mice (Song et al., 2008, PLoS ONE 3, e2257; Song et al., 2009, Vaccine 27, 5875–5888). These fusion proteins can be efficiently and economically manufactured in E. coli fermentation systems as next generation pandemic and seasonal influenza vaccines. Here we...

  5. Response to 2009 Pandemic Influenza A (H1N1) Vaccine in HIV-Infected Patients and the Influence of Prior Seasonal Influenza Vaccination

    OpenAIRE

    Soonawala, D.; Rimmelzwaan, G. F.; Gelinck, L. B. S.; Visser, L. G.; Kroon, F. P.

    2011-01-01

    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...

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

    DEFF Research Database (Denmark)

    Germundsson, A.; Gjerset, B.

    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. Nasal swabs were collected from herds i) where pigs had been exposed to persons with verified pH1N1-09v infection or with influenza-like illness (ILI); ii) where pigs showed clinical signs or iii) with a history of close contact with or close proximity to infected herds. In addition, blood samples were collected from nucleus and multiplier breeding herds. Detection of pH1N1-09v was initially performed using a real-time RT-PCR targeted to detect influenza A virus. Positive samples were tested by a pH1N1-09v specific real-time RT-PCR. Blood samples were tested for presence of antibodies against influenza A virus by ELISA (IDVET) and positive samples in the ELISA were tested by haemagglutinin inhibition test using A/California/07/09 as antigen. From the onset of the outbreak and until 31st of December 2009, the pH1N1-09v was detected in nasal swabs from 54 of 114 herds investigated tested, while 55 of 140 herds tested positive for antibodies against pH1N1-09v. No herd has been tested positive for pH1N1-09v since early January 2010, however, results of the Norwegian surveillance and control programme for specific swine herds for 2010 so far indicates that 40 % of the swine herds (154 herds) are positive for antibodies against pH1N1-09. Serological evaluation of swine herds and detailed back tracking of the outbreak indicated that the virus was introduced in September 2009. The Norwegian swine population has, until the outbreak of pH1N1-09v, been considered free from influenza A virus infection as documented through serological surveillance program running since 1997. Virus isolated from one of the herds positive for pH1N1-09v was fully identical across the full genome to virus isolated from a confirmed human case at the farm. The majority of the positive herds had a history of contact with humans that were diagnosed with pandemic influenza or with ILI. This suggests that infected humans are the most likely source for introduction of pH1N1-09v to the Norwegian pig herds, especially in the early phase of the outbreak.

  7. Evolutionary characterization of the pandemic H1N1/2009 influenza virus in humans based on non-structural genes.

    Science.gov (United States)

    Wang, Chengmin; Zhang, Yanyu; Wu, Bin; Liu, Shelan; Xu, Ping; Lu, Yanmin; Luo, Jing; Nolte, Dale Louis; Deliberto, Thomas Jude; Duan, Mingxing; Zhang, Hong; He, Hongxuan

    2013-01-01

    The 2009 influenza pandemic had a tremendous social and economic impact. To study the genetic diversity and evolution of the 2009 H1N1 virus, a mutation network for the non-structural (NS) gene of the virus was constructed. Strains of the 2009 H1N1 pandemic influenza A virus could be divided into two categories based on the V123I mutation in the NS1 gene: G1 (characterized as 123 Val) and G2 (characterized as 123 Ile). Sequence homology analysis indicated that one type of NS sequence, primarily isolated from Mexico, was likely the original type in this pandemic. The two genotypes of the virus presented distinctive clustering features in their geographic distributions. These results provide additional insight into the genetics and evolution of human pandemic influenza H1N1. PMID:23418535

  8. Seasonal influenza vaccination predicts pandemic H1N1 vaccination uptake among healthcare workers in three countries.

    Science.gov (United States)

    Chor, Josette S Y; Pada, Surinder K; Stephenson, Iain; Goggins, William B; Tambyah, Paul A; Clarke, Tristan William; Medina, Mariejo; Lee, Nelson; Leung, Ting Fun; Ngai, Karry L K; Law, Shu Kei; Rainer, Timothy H; Griffiths, Sian; Chan, Paul K S

    2011-10-01

    The aim of this study was to identify the common barriers and facilitators for acceptance of pandemic influenza vaccination across different countries. This study utilized a standardized, anonymous, self-completed questionnaire-based survey recording the demographics and professional practice, previous experience and perceived risk and severity of influenza, infection control practices, information of H1N1 vaccination, acceptance of the H1N1 vaccination and reasons of their choices and opinions on mandatory vaccination. Hospital-based doctors, nurses and allied healthcare workers in Hong Kong (HK), Singapore (SG) and Leicester, United Kingdom (UK) were recruited. A total of 6318 (HK: 5743, SG: 300, UK: 275) questionnaires were distributed, with response rates of 27.1% (HK), 94.7% (SG) and 94.5% (UK). The uptake rates for monovalent 2009 pandemic H1N1 vaccine were 13.5% (HK), 36.2% (SG) and 41.3% (UK). The single common factor associated with vaccine acceptance across all sites was having seasonal influenza vaccination in 2009. In UK and HK, overestimation of side effect reduced vaccination acceptance; and fear of side effect was a significant barrier in all sites. In HK, healthcare workers with more patient contact were more reluctant to accept vaccination. Drivers for vaccination in UK and HK were concern about catching the infection and following advice from health authority. Only a small proportion of respondents agreed with mandatory pandemic influenza vaccination (HK: 25% and UK: 42%), except in Singapore where 75.3% were in agreement. Few respondents (Mandatory vaccination even during pandemic is likely to arouse substantial discontent. PMID:21807048

  9. Deterministic model for the role of antivirals in controlling the spread of the H1N1 influenza pandemic

    OpenAIRE

    Mudassar Imran; Malik, Mohammad T.; Garba, Salisu M.

    2011-01-01

    A deterministic model is designed and used to theoretically assess the impact of antiviral drugs in controlling the spread of the 2009 swine influenza pandemic. In particular, the model considers the administration of the antivirals both as a preventive as well as a therapeutic agent. Rigorous analysis of the model reveals that its disease-free equilibrium is globally-asymptotically stable under certain conditions involving having the associated reproduction number less than unity. Fu...

  10. Cross-protection against lethal H5N1 challenge ferrets with an adjuvanted pandemic influenza vaccine

    OpenAIRE

    Baras, B.; Stittelaar, K. J.; Simon, J. H.; Thoolen, R. J. M. M.; Mossman, S. P.; Pistoor, F. H.; Amerongen, G.; Wettendorff, M. A.; Hanon, E.; Osterhaus, A. D. M. E.

    2008-01-01

    Background. Unprecedented spread between birds and mammals of highly pathogenic avian influenza viruses (HPAI) of the H5N1 subtype has resulted in hundreds of human infections with a high fatality rate. This has highlighted the urgent need for the development of H5N1 vaccines that can be produced rapidly and in sufficient quantities. Potential pandemic inactivated vaccines will ideally induce substantial intra-subtypic cross-protection in humans to warrant the option of use, either prior to o...

  11. Lessons from the past: Familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918

    OpenAIRE

    Gottfredsson, Magnu?s; Halldo?rsson, Bjarni V.; Jo?nsson, Stefa?n; Kristja?nsson, Ma?r; Kristja?nsson, Kristleifur; Kristinsson, Karl G.; Lo?ve, Arthur; Blo?ndal, Thorsteinn; Viboud, Ce?cile; Thorvaldsson, Sverrir; Helgason, Agnar; Gulcher, Jeffrey R.; Stefa?nsson, Ka?ri; Jo?nsdo?ttir, Ingileif

    2008-01-01

    The pandemic influenza of 1918 (Spanish flu) killed 21–50 million people globally, including in Iceland, where the characteristics and spread of the epidemic were well documented. It has been postulated that genetic host factors may have contributed to this high mortality. We identified 455 individuals who died of the Spanish flu in Iceland during a 6-week period during the winter of 1918, representing >92% of all fatal domestic cases mentioned by historical accounts. The highest case fatal...

  12. Age-related sensitivity and pathological differences in infections by 2009 pandemic influenza A (H1N1) virus

    OpenAIRE

    Wu Xiaohong; Yu Hong; Guo Yan; Hu Jingya; Xiao Wenjun; Zhao Guangyu; Sun Shihui; Tan Yadi; Zhou Yusen

    2011-01-01

    Abstract Background The highly pandemic 2009 influenza A H1N1 virus infection showed distinguished skewed age distribution with majority of infection and death in children and young adults. Although previous exposure to related antigen has been proposed as an explanation, the mechanism of age protection is still unknown. Methods In this study, murine model of different ages were inoculated intranasally with H1N1 (A/Beijing/501/09) virus and the susceptibility and pathological response to 2009...

  13. Radiological and Clinical Characteristics of a Military Outbreak of Pandemic H1N1 2009 Influenza Virus Infection

    International Nuclear Information System (INIS)

    To describe detailed clinical and radiological features of the pandemic H1N1 2009 influenza viral infection among healthy young males in a semiclosed institutionalized setting. A total of 18 patients confirmed with the pandemic H1N1 2009 influenza virus infection from July 18 to July 30, 2009 were enrolled in this study. Each patient underwent an evaluation to determine detailed clinical and radiological features. All patients presented with high fever (> 38.0..C), with accompanying symptoms of cough, rhinorrhea, sore throat, myalgia and diarrhea, and increased C-reactive protein (CRP) values with no leukocytosis nor elevated erythrocyte sedimentation rate (ESR). All patients, including one patient who progressed into acute respiratory distress syndrome, were treated with oseltamivir phosphate and quickly recovered from their symptoms. Chest radiographs showed abnormalities of small nodules and lobar consolidation in only two out of 18 patients. However, six of 12 patients who underwent thin-section CT examinations showed abnormal findings for small ground-glass opacities (GGOs) in addition to poorly-defined nodules with upper lobe predominance. In a population of healthy young adults, elevated CRP with normal ESR and white blood cell levels combined with GGOs and nodules on thin section CT scans may indicate early signs of infection by the pandemic H1N1 2009 influenza virus

  14. Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008

    Directory of Open Access Journals (Sweden)

    Liese Johannes G

    2011-08-01

    Full Text Available Abstract Background Data on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU with severe seasonal influenza. Methods From October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED including all paediatric hospitals in Germany. Cases to be reported were hospitalized children Results Twenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008. The median age of the patients (12 males/8 females was 7.5 years (range 0.1-15 years. None had received vaccination against influenza. In 14 (70% patients, the infection had been caused by influenza A and in five (25% by influenza B; in one child (5% the influenza type was not reported. Patients spent a median of 19 (IQR 12-38 days in the hospital and a median of 11 days (IQR 6-18 days in the PICU; 10 (50% needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%, bronchitis/bronchiolitis (30%, encephalitis/encephalopathy (25%, secondary bacterial pneumonia (25%, and ARDS (25%. Eleven (55% children had chronic underlying medical conditions, including 8 (40% with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45% patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae. Conclusions Influenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of risk groups in Germany.

  15. Compatibility of H9N2 avian influenza surface genes and 2009 pandemic H1N1 internal genes for transmission in the ferret model

    OpenAIRE

    Kimble, J. Brian; Sorrell, Erin; Shao, Hongxia; Martin, Philip L.; Perez, Daniel Roberto

    2011-01-01

    In 2009, a novel H1N1 influenza (pH1N1) virus caused the first influenza pandemic in 40 y. The virus was identified as a triple reassortant between avian, swine, and human influenza viruses, highlighting the importance of reassortment in the generation of viruses with pandemic potential. Previously, we showed that a reassortant virus composed of wild-type avian H9N2 surface genes in a seasonal human H3N2 backbone could gain efficient respiratory droplet transmission in the ferret model. Here ...

  16. Use of a large general practice syndromic surveillance system to monitor the progress of the influenza A(H1N1) pandemic 2009 in the UK.

    Science.gov (United States)

    Harcourt, S E; Smith, G E; Elliot, A J; Pebody, R; Charlett, A; Ibbotson, S; Regan, M; Hippisley-Cox, J

    2012-01-01

    The Health Protection Agency/QSurveillance national surveillance system utilizes QSurveillance®, a recently developed general practitioner database covering over 23 million people in the UK. We describe the spread of the first wave of the influenza A(H1N1) pandemic 2009 using data on consultations for influenza-like illness (ILI), respiratory illness and prescribing for influenza from 3400 contributing general practices. Daily data, provided from 27 April 2009 to 28 January 2010, were used to give a timely overview for those managing the pandemic nationally and locally. The first wave particularly affected London and the West Midlands with a peak in ILI in week 30. Children aged between 1 and 15 years had consistently high consultation rates for ILI. Daily ILI rates were used for modelling national weekly case estimates. The system enabled the 'real-time' monitoring of the pandemic to a small geographical area, linking morbidity and prescribing for influenza and other respiratory illnesses. PMID:21473803

  17. Visual detection of pandemic influenza A H1N1 Virus 2009 by reverse-transcription loop-mediated isothermal amplification with hydroxynaphthol blue dye.

    Science.gov (United States)

    Ma, Xue-Jun; Shu, Yue-Long; Nie, Kai; Qin, Meng; Wang, Da-Yan; Gao, Rong-Bao; Wang, Miao; Wen, Le-Ying; Han, Feng; Zhou, Shu-Mei; Zhao, Xiang; Cheng, Yan-Hui; Li, De-Xin; Dong, Xiao-Ping

    2010-08-01

    A sensitive reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assay was developed for rapid visual detection of pandemic influenza A H1N1 virus infection. The reaction was performed in one step in a single tube at 65 degrees C for 60 min with the addition of hydroxynaphthol blue (HNB) dye prior to amplification. The detection limit of the RT-LAMP assay was approximately 60 copies, and no cross-detection was observed. The assay was evaluated further with 50 clinical specimens diagnosed clinically with seasonal influenza or pandemic influenza A H1N1 virus infection. RT-LAMP with HNB dye was demonstrated to be a sensitive and easy assay for rapid detection of pandemic influenza A H1N1 virus. PMID:20381535

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

    Directory of Open Access Journals (Sweden)

    Miller Joel C

    2010-07-01

    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.

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

    OpenAIRE

    Kim, Won-young; Young Suh, Gee; Huh, Jin Won; Kim, Sung-han; Kim, Min-ju; Kim, Yun Seong; Kim, Hye-ryoun; Ryu, Yon Ju; Han, Min Soo; Ko, Young Gwan; Chon, Gyu Rak; Lee, Kwan Ho; Choi, Sang-ho; Hong, Sang-bum

    2011-01-01

    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...

  20. Synergistic Adaptive Mutations in the Hemagglutinin and Polymerase Acidic Protein Lead to Increased Virulence of Pandemic 2009 H1N1 Influenza A Virus in Mice

    OpenAIRE

    Seyer, Roman; Hrincius, Eike R.; Ritzel, Dorothea; Abt, Marion; Mellmann, Alexander; Marjuki, Henju; Ku?hn, Joachim; Wolff, Thorsten; Ludwig, Stephan; Ehrhardt, Christina

    2011-01-01

    Influenza impressively reflects the paradigm of a viral disease in which continued evolution of the virus is of paramount importance for annual epidemics and occasional pandemics in humans. Because of the continuous threat of novel influenza outbreaks, it is essential to gather further knowledge about viral pathogenicity determinants. Here, we explored the adaptive potential of the influenza A virus subtype H1N1 variant isolate A/Hamburg/04/09 (HH/04) by sequential passaging in mice lungs. Th...

  1. Ultrasensitive Detection of Drug-Resistant Pandemic 2009 (H1N1) Influenza A Virus by Rare-Variant-Sensitive High-Resolution Melting-Curve Analysis?‡

    OpenAIRE

    Chen, Neng; Pinsky, Benjamin A.; Lee, Betty P.; Lin, Min; Schrijver, Iris

    2011-01-01

    Oseltamivir (Tamiflu), an oral neuraminidase inhibitor, has been widely used to treat pandemic 2009 (H1N1) influenza A. Although a majority of 2009 (H1N1) influenza A virus remains oseltamivir susceptible, the threat of resistance due to the His275Tyr mutation is highlighted by the limitations of alternative therapies and the potential for rapid, global fixation of this mutation in the circulating influenza A virus population. In order to better understand the emergence of resistance, we deve...

  2. A community-based participatory approach and engagement process creates culturally appropriate and community informed pandemic plans after the 2009 H1N1 influenza pandemic: remote and isolated First Nations communities of sub-arctic Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Charania Nadia A

    2012-04-01

    Full Text Available Abstract Background Public health emergencies have the potential to disproportionately impact disadvantaged populations due to pre-established social and economic inequalities. Internationally, prior to the 2009 H1N1 influenza pandemic, existing pandemic plans were created with limited public consultation; therefore, the unique needs and characteristics of some First Nations communities may not be ethically and adequately addressed. Engaging the public in pandemic planning can provide vital information regarding local values and beliefs that may ultimately lead to increased acceptability, feasibility, and implementation of pandemic plans. Thus, the objective of the present study was to elicit and address First Nations community members’ suggested modifications to their community-level pandemic plans after the 2009 H1N1 influenza pandemic. Methods The study area included three remote and isolated First Nations communities located in sub-arctic Ontario, Canada. A community-based participatory approach and community engagement process (i.e., semi-directed interviews (n?=?13, unstructured interviews (n?=?4, and meetings (n?=?27 were employed. Participants were purposively sampled and represented various community stakeholders (e.g., local government, health care, clergy, education, etc. involved in the community’s pandemic response. Collected data were manually transcribed and coded using deductive and inductive thematic analysis. The data subsequently informed the modification of the community-level pandemic plans. Results The primary modifications incorporated in the community-level pandemic plans involved adding community-specific detail. For example, ‘supplies’ emerged as an additional category of pandemic preparedness and response, since including details about supplies and resources was important due to the geographical remoteness of the study communities. Furthermore, it was important to add details of how, when, where, and who was responsible for implementing recommendations outlined in the pandemic plans. Additionally, the roles and responsibilities of the involved organizations were further clarified. Conclusions Our results illustrate the importance of engaging the public, especially First Nations, in pandemic planning to address local perspectives. The community engagement process used was successful in incorporating community-based input to create up-to-date and culturally-appropriate community-level pandemic plans. Since these pandemic plans are dynamic in nature, we recommend that the plans are continuously updated to address the communities’ evolving needs. It is hoped that these modified plans will lead to an improved pandemic response capacity and health outcomes, during the next public health emergency, for these remote and isolated First Nations communities. Furthermore, the suggested modifications presented in this paper may help inform updates to the community-level pandemic plans of other similar communities.

  3. From press release to news: mapping the framing of the 2009 H1N1 A influenza pandemic.

    Science.gov (United States)

    Lee, Seow Ting; Basnyat, Iccha

    2013-01-01

    Pandemics challenge conventional assumptions about health promotion, message development, community engagement, and the role of news media. To understand the use of press releases in news coverage of pandemics, this study traces the development of framing devices from a government public health agency's press releases to news stories about the 2009 H1N1 A influenza pandemic. The communication management of the H1N1 pandemic, an international news event with local implications, by the Singapore government is a rich locus for understanding the dynamics of public relations, health communication, and journalism. A content analysis shows that the evolution of information from press release to news is marked by significant changes in media frames, including the expansion and diversification in dominant frames and emotion appeals, stronger thematic framing, more sources of information, conversion of loss frames into gain frames, and amplification of positive tone favoring the public health agency's position. Contrary to previous research that suggests that government information subsidies passed almost unchanged through media gatekeepers, the news coverage of the pandemic reflects journalists' selectivity in disseminating the government press releases and in mediating the information flow and frames from the press releases. PMID:22439616

  4. Infection dynamics of pandemic 2009 H1N1 influenza virus in a two-site swine herd.

    Science.gov (United States)

    Allerson, M W; Davies, P R; Gramer, M R; Torremorell, M

    2014-12-01

    Influenza A viruses are common causes of respiratory disease in pigs and can be transmitted among multiple host species, including humans. The current lack of published information on infection dynamics of influenza viruses within swine herds hinders the ability to make informed animal health, biosecurity and surveillance programme decisions. The objectives of this serial cross-sectional study were to describe the infection dynamics of influenza virus in a two-site swine system by estimating the prevalence of influenza virus in animal subpopulations at the swine breeding herd and describing the temporal pattern of infection in a selected cohort of growing pigs weaned from the breeding herd. Nasal swab and blood samples were collected at approximately 30-day intervals from the swine breeding herd (Site 1) known to be infected with pandemic 2009 H1N1 influenza virus. Sows, gilts and neonatal pigs were sampled at each sampling event, and samples were tested for influenza virus genome using matrix gene RRT-PCR. Influenza virus was detected in neonatal pigs, but was not detected in sow or gilt populations via RRT-PCR. A virus genetically similar to that detected in the neonatal pig population at Site 1 was also detected at the wean-to-finish site (Site 2), presumably following transportation of infected weaned pigs. Longitudinal sampling of nasal swabs and oral fluids revealed that influenza virus persisted in the growing pigs at Site 2 for at least 69 days. The occurrence of influenza virus in neonatal pigs, but not breeding females, at Site 1 emphasizes the potential for virus maintenance in this dynamic subpopulation, the importance of including this subpopulation in surveillance programmes and the potential transport of influenza virus between sites via the movement of weaned pigs. PMID:23294593

  5. The Spanish flu in Uppsala, clinical and epidemiological impact of the influenza pandemic 1918–1919 on a Swedish county

    Directory of Open Access Journals (Sweden)

    Jonas Holtenius

    2014-01-01

    Full Text Available Introduction and aim: The Spanish flu reached Sweden in June 1918, and at least one-third of the population (then 5.8 million became infected. Some 34,500 persons (5.9 per 1,000 people died from influenza during the first year of the pandemic (when acute pneumonia is included, the number of deaths rose to 7.1 per 1,000 people. In this historical look back at the pandemic, our aim was to review the epidemiological impact on the Swedish county of Uppsala, the clinical outcomes and the economic impact on the regional hospital; a relevant backgound to consider the impact of a future virulent pandemic. We also focused on how the pandemic was perceived by the medical community and by health care authorities. Methods: Health care reports, statistics, daily newspapers, medical journals, and records of patients treated for influenza at the Uppsala Academic Hospital from July 1918 to June 1919 were included in our review. Results: An influenza related mortality rate of 693 persons (5.1 per 1,000 people was reported in the Uppsala region from 1918–1919; from July 1918 to June 1919, 384 patients were treated for influenza at the Uppsala Academic Hospital. The first wave peaked in November 1918 with case fatality rates up to 30%; a second wave peaked in April 1919 with a lower rate of mortality. Of the patients treated, a total of 66 died. Of these, 60% were 20–29 years of age, and 85% were less than 40 years old. Autopsy reports revealed pneumonia in 89% of the cases; among these, 47% were hemorrhagic, 18% were bilateral, and 45% had additional extrapulmonary organ involvement. Signs of severe viral disease were documented, but secondary bacterial disease was the primary cause of death in the majority of cases. Conclusion: The epidemiologic and pathologic results were in accordance with other publications of this time period. The costs of running the hospital doubled from 1917 to 1920 and then reversed by 45%. Today, an influenza pandemic of the same virulence would paralyze health care systems and result in extremely high financial costs and rates of mortality.

  6. Scaling in the Global Spreading Patterns of Pandemic Influenza A and the Role of Control: Empirical Statistics and Modeling

    CERN Document Server

    Han, Xiao-Pu; Zhou, Chang-Song; Zhou, Tao; Zhu, Jun-Fang

    2009-01-01

    The pandemic of influenza A (H1N1) is a serious on-going global public crisis. Understanding its spreading dynamics is of fundamental importance for both public health and scientific researches. In this paper, we investigate the spreading patterns of influenza A and find the Zipf's law of the distributions of confirmed cases in different levels. Similar scaling properties are also observed for severe acute respiratory syndrome (SARS) and bird cases of avian influenza (H5N1). To explore the underlying mechanism, a model considering the control effects on both the local growth and transregional transmission is proposed, which shows that the strong control effects are responsible for the scaling properties. Although strict control measures for interregional travelers are helpful to delay the outbreak in the regions without local cases, our analysis suggests that the focus should be turned to local prevention after the outbreak of local cases. This work provides not only a deeper understanding of the generic mech...

  7. Military and Military Medical Support in Highly Pathogenic Avian Influenza (HPAI/H5N1) Pandemic Scenario

    International Nuclear Information System (INIS)

    Avian influenza (Bird flu) is a highly contagious viral disease affecting mainly chickens, turkeys, ducks, other birds and mammals. Reservoirs for HPAI /H5N1 virus are shore birds and waterfowl (asymptomatic, excrete virus in feces for a long periods of time), live bird markets and commercial swine facilities. Virus tends to cycle between pigs and birds. HPAI (H5N1) virus is on every 'top ten' list available for potential agricultural bio-weapon agents. The threat of a HPAI/H5N1 pandemic is a definitively global phenomenon and the response must be global. A number of National plans led to various measures of preventing and dealing with epidemics/pandemics. Lessons learned form the pandemic history indicated essential role of military and military medical support to civil authorities in a crisis situation. Based on International Military Medical Avian Influenza Pandemic workshop (Vienna 2006), an expected scenario would involve 30-50% outpatients, 20-30% hospital admission, 2-3% deaths, 10-20% complicated cases. Activities of civil hospital may be reduced by 50%. Benefits of military support could be in: Transportation of patients (primarily by air); Mass vaccination and provision of all other preventive measures (masks, Tamiflu); Restriction of movements; Infection control of health care facilities; Field hospitals for triage and quarantine, military barracks to treat milder cases and military hospitals for severe cases; Deal with corpses; Stockpiling (vaccines, antiviral, antibiotics, protective equipment, supplies); Training; Laboratories; Ensure public safety, etc. With the aim of minimizing the risk of a pandemic spread by means of rapid and uncomplicated cooperation, an early warning system has to be established to improve surveillance, improve international contacts (WHO, ECDC, CDC), establish Platform for sharing information, close contacts of national and international military and civilian surveillance networks and databases, cooperation between military and civilian labs (external quality control). (author)

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

    Scientific Electronic Library Online (English)

    Miguel, Talledo; Kattya, Zumaeta.

    2009-12-01

    Full Text Available 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 the population level.

  9. Polymorphisms in the haemagglutinin gene influenced the viral shedding of pandemic 2009 influenza virus in swine.

    Science.gov (United States)

    Lorusso, Alessio; Ciacci-Zanella, Janice R; Zanella, Eraldo L; Pena, Lindomar; Perez, Daniel R; Lager, Kelly M; Rajão, Daniela S; Loving, Crystal L; Kitikoon, Pravina; Vincent, Amy L

    2014-12-01

    Interactions between the viral surface glycoprotein haemagglutinin (HA) and the corresponding receptors on host cells is one important aspect of influenza virus infection. Mutations in HA have been described to affect pathogenicity, antigenicity and the transmission of influenza viruses. Here, we detected polymorphisms present in HA genes of two pandemic 2009 H1N1 (H1N1pdm09) isolates, A/California/04/2009 (Ca/09) and A/Mexico/4108/2009 (Mx/09), that resulted in amino acid changes at positions 186 (S to P) and 194 (L to I) of the mature HA1 protein. Although not reported in the published H1N1pdm09 consensus sequence, the P186 genotype was more readily detected in primary infected and contact-naïve pigs when inoculated with a heterogeneous mixed stock of Ca/09. Using reverse genetics, we engineered Ca/09 and Mx/09 genomes by introducing Ca/09 HA with two naturally occurring variants expressing S186/I194 (HA-S/I) and P186/L194 (HA-P/L), respectively. The Ca/09 HA with the combination of P186/L194 with either the Ca/09 or Mx/09 backbone resulted in higher and prolonged viral shedding in naïve pigs. This efficiency appeared to be more likely through an advantage in cell surface attachment rather than replication efficiency. Although these mutations occurred within the receptor-binding pocket and the Sb antigenic site, they did not affect serological cross-reactivity. Relative increases of P186 in publicly available sequences from swine H1N1pdm09 viruses supported the experimental data, indicating this amino acid substitution conferred an advantage in swine. PMID:25127710

  10. Influenza epidemiology in Italy two years after the 2009-2010 pandemic: need to improve vaccination coverage.

    Science.gov (United States)

    Gasparini, Roberto; Bonanni, Paolo; Amicizia, Daniela; Bella, Antonino; Donatelli, Isabella; Cristina, Maria Luisa; Panatto, Donatella; Lai, Piero Luigi

    2013-03-01

    Since 2000, a sentinel surveillance of influenza, INFLUNET, exists in Italy. It is coordinated by the Ministry of Health and is divided into two parts; one of these is coordinated by the National Institute of Health (NIH), the other by the Inter-University Centre for Research on Influenza and other Transmissible Infections (CIRI-IT). The influenza surveillance system performs its activity from the 42nd week of each year (mid-October) to the 17th week of the following year (late April). Only during the pandemic season (2009/2010) did surveillance continue uninterruptedly. Sentinel physicians - about 1,200 general practitioners and independent pediatricians - send in weekly reports of cases of influenza-like illness (ILI) among their patients (over 2% of the population of Italy) to these centers.   In order to estimate the burden of pandemic and seasonal influenza, we examined the epidemiological data collected over the last 3 seasons (2009-2012). On the basis of the incidences of ILIs at different ages, we estimated that: 4,882,415; 5,519,917; and 4,660,601 cases occurred in Italy in 2009-2010, 2010-2011 and 2011-2012, respectively. Considering the ILIs, the most part of cases occurred in < 14 y old subjects and especially in 5-14 y old individuals, about 30% and 21% of cases respectively during 2009-2010 and 2010-2011 influenza seasons. In 2011-2012, our evaluation was of about 4.7 million of cases, and as in the previous season, the peak of cases regarded subjects < 14 y (about 29%). A/California/07/09 predominated in 2009-2010 and continued to circulate in 2010-2011. During 2010-2011 B/Brisbane/60/08 like viruses circulated and A/H3N2 influenza type was sporadically present. H3N2 (A/Perth/16/2009 and A/Victoria/361/2011) was the predominant influenza type-A virus that caused illness in the 2011-2012 season. Many strains of influenza viruses were present in the epidemiological scenario in 2009-2012. In the period 2009-2012, overall vaccination coverage was low, never exceeding 20% of the Italian population. Among the elderly, coverage rates grew from 40% in 1999 to almost 70% in 2005-2006, but subsequently decreased, in spite of the pandemic; this trend reveals a slight, though constant, decline in compliance with vaccination. Our data confirm that 2009 pandemics had had a spread particularly important in infants and schoolchildren, and this fact supports the strategy to vaccinate schoolchildren at least until 14 y of age. Furthermore, the low levels of vaccination coverage in Italy reveal the need to improve the catch-up of at-risk subjects during annual influenza vaccination campaigns, and, if possible, to extend free vaccination to at least all 50-64-y-old subjects. Virologic and epidemiological surveillance remains critical for detection of evolving influenza viruses and to monitor the health and economic burden in all age class annually. PMID:23292210

  11. Humans and Ferrets with Prior H1N1 Influenza Virus Infections Do Not Exhibit Evidence of Original Antigenic Sin after Infection or Vaccination with the 2009 Pandemic H1N1 Influenza Virus

    OpenAIRE

    O Donnell, Christopher D.; Wright, Amber; Vogel, Leatrice; Boonnak, Kobporn; Treanor, John J.; Subbarao, Kanta

    2014-01-01

    The hypothesis of original antigenic sin (OAS) states that the imprint established by an individual's first influenza virus infection governs the antibody response thereafter. Subsequent influenza virus infection results in an antibody response against the original infecting virus and an impaired immune response against the newer influenza virus. The purpose of our study was to seek evidence of OAS after infection or vaccination with the 2009 pandemic H1N1 (2009 pH1N1) virus in ferrets and hu...

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

    Directory of Open Access Journals (Sweden)

    Milne George J

    2010-03-01

    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.

  13. A cost comparison of electronic and hybrid data collection systems in Ontario during pandemic and seasonal influenza vaccination campaigns

    Directory of Open Access Journals (Sweden)

    Quan Sherman D

    2011-09-01

    Full Text Available Abstract Background During the pandemic (H1N1 2009 influenza vaccination campaign, health regions in Canada collected client-level immunization data using fully electronic or hybrid systems, with the latter comprising both electronic and paper-based elements. The objective of our evaluation was to compare projected five-year costs associated with implementing these systems in Ontario public health units (PHUs during pandemic and seasonal influenza vaccination campaigns. Methods Six PHUs provided equipment and staffing costs during the pandemic (H1N1 2009 influenza vaccination campaign and staffing algorithms for seasonal campaigns. We standardized resources to population sizes 100,000, 500,000 and 1,000,000, assuming equipment lifetime of five years and public health vaccine administration rates of 18% and 2.5% for H1N1 and seasonal campaigns, respectively. Two scenarios were considered: Year 1 pandemic and Year 1 seasonal campaigns, each followed by four regular influenza seasons. Costs were discounted at 5%. Results Assuming a Year 1 pandemic, the five-year costs per capita for the electronic system decrease as PHU population size increases, becoming increasingly less costly than hybrid systems ($4.33 vs. $4.34 [100,000], $4.17 vs. $4.34 [500,000], $4.12 vs. $4.34 [1,000, 000]. The same trend is observed for the scenario reflecting five seasonal campaigns, with the electronic system being less expensive per capita than the hybrid system for all population sizes ($1.93 vs. $1.95 [100,000], $1.91 vs. $1.94 [500,000], $1.87 vs. $1.94 [1,000, 000]. Sensitivity analyses identified factors related to nurse hours as affecting the direction and magnitude of the results. Conclusions Five-year cost projections for electronic systems were comparable or less expensive than for hybrid systems, at all PHU population sizes. An intangible benefit of the electronic system is having data rapidly available for reporting.

  14. Did the pandemic have an impact on influenza vaccination attitude? a survey among health care workers

    Directory of Open Access Journals (Sweden)

    Pullukçu Hüsnü

    2011-04-01

    Full Text Available Abstract Background Health care workers' (HCWs influenza vaccination attitude is known to be negative. The H1N1 epidemic had started in mid 2009 and made a peak in October-November in Turkey. A national vaccination campaign began on November 2nd, 2009. Despite the diligent efforts of the Ministry of Health and NGOs, the attitudes of the media and politicians were mostly negative. The aim of this study was to evaluate whether HCWs' vaccination attitudes improved during the pandemic and to assess the related factors. Methods This cross-sectional survey was carried out at the largest university hospital of the Aegean Region-Turkey. A self-administered questionnaire with 12 structured questions was applied to 807 HCWs (sample coverage 91.3% before the onset of the vaccination programme. Their final vaccination status was tracked one week afterwards, using immunization records. Factors influencing vaccination rates were analyzed using ANOVA, t-test, chi-square test and logistic regression. Results Among 807 participants, 363 (45.3% were doctors and 293 (36.6% nurses. A total of 153 (19.0% had been vaccinated against seasonal influenza in the 2008-2009 season. Regarding H1N1 vaccination, 143 (17.7% were willing to be vaccinated vs. 357 (44.2% unwilling. The number of indecisive HCWs was 307 (38.0% one week prior to vaccination. Only 53 (11.1% stated that they would vaccinate their children. Possible side effects (78%, n = 519 and lack of comprehensive field evaluation before marketing (77%, n = 508 were the most common reasons underlying unwillingness or hesitation. Among the 749 staff whose vaccination status could be tracked, 228 (30.4% actually received the H1N1 vaccine. Some of the 'decided' staff members had changed their mind one week later. Only 82 (60% of those willing, 108 (37% of those indecisive and 38 (12% of those unwilling were vaccinated. Indecisive HCWs were significantly younger (p = 0.017. Females, nurses, and HCWs working in surgical departments were more likely to reject vaccination (p Conclusions Vaccination rates increased substantially in comparison to the previous influenza season. However, vaccination rates could have been even higher since hesitation to be vaccinated increased dramatically within one week (only 60% of those willing and the minority of those indecisive were finally vaccinated. We speculate that this may be connected with negative media at the time.

  15. 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

    Directory of Open Access Journals (Sweden)

    Timen Aura

    2011-10-01

    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.

  16. 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)

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

    2012-06-01

    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. 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.

  17. Why the French did not choose to panic: a dynamic analysis of the public response to the influenza pandemic.

    Science.gov (United States)

    Sherlaw, William; Raude, Jocelyn

    2013-02-01

    To understand the French public's response to the 2009 pandemic A/H1N1 influenza health threat a sequence analysis framework has been employed mobilising different theoretical strands such as innovations diffusion theory, surprise theory and social representation theory. These tend to suggest that disease episodes, public health policy and the public's response should be considered within a larger socio-cognitive frame incorporating representations anchored by prior disease episodes and campaigns. It is suggested in this article that the public's response was greatly influenced by the pervasive anchoring of the social representations of the pandemic threat to the 1918 Spanish flu in the lay and scientific media. These representations were eventually seen not to match the reality of the disease and consequently the French public did not panic during the 2009 pandemic. This hypothesis has been tested empirically by examining retrospective media, bibliographical data and an analysis of risk perception carried out through three cross-sectional studies prior to and during the pandemic episode and one month after the launch of the vaccination campaign. These findings suggest that alarmist framings of health threats may be counterproductive since they may reduce the capacity of public health organisations to mobilise the public in the case of more serious emerging disease. PMID:23030815

  18. General influenza infection control policies and practices during the 2009 H1N1 influenza pandemic: A survey of women’s health, obstetric, and neonatal nurses

    Science.gov (United States)

    Ruch-Ross, Holly S.; Zapata, Lauren B.; Williams, Jennifer L.; Ruhl, Catherine

    2015-01-01

    Background An evaluation of infection control practices was conducted following the release of the Centers for Disease Control and Prevention (CDC) guidance regarding the care of pregnant women during the 2009 H1N1 influenza pandemic. This paper describes 9 general hospital practices. Methods A questionnaire was distributed electronically to 12,612 members of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN). Respondents (N = 2,304) who reported working in obstetric or neonatal settings during the pandemic completed the questionnaire. Results Most (73%) respondents considered the Centers for Disease Control and Prevention’s guidance very useful. Significantly more reported a written hospital policy for each practice during versus before the pandemic. Six of the 9 practices were implemented most of the time by at least 70% of respondents; the practices least often implemented were mandatory vaccination of health care personnel involved (52%) and not involved (34%) in direct patient care and offering vaccination to close contacts of newborns prior to discharge (22%). The most consistent factor associated with implementation was the presence of a written policy supporting the practice at the respondent’s hospital. Conclusion We offer a descriptive account of general hospital infection control policies and practices during the 2009 H1N1 pandemic. Factors associated with reported implementation may be useful to inform planning to protect women and children for future public health emergencies. PMID:24837128

  19. Recommended Mitigation Measures for an Influenza Pandemic in Remote and Isolated First Nations Communities of Ontario, Canada: A Community-Based Participatory Research Approach

    OpenAIRE

    Charania, Nadia A.; Js, Leonard Tsuji

    2014-01-01

    Influenza pandemics disproportionately impact remote and/or isolated Indigenous communities worldwide. The differential risk experienced by such communities warrants the recommendation of specific mitigation measures. Interviewer-administered questionnaires were conducted with adult key health care informants from three remote and isolated Canadian First Nations communities of sub-Arctic Ontario. Forty-eight mitigation measures (including the setting, pandemic period, trigger, and duration) w...

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

    Science.gov (United States)

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

    2014-06-17

    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

  1. Epidemiology, ecology and gene pool of influenza A virus in Egypt: Will Egypt be the epicentre of the next influenza pandemic?

    Science.gov (United States)

    Abdelwhab, Em; Abdel-Moneim, Ahmed S

    2015-01-01

    Outside Asia, Egypt is considered to be an influenza H5N1 epicentre and presents a far greater pandemic risk than other countries. The long-term endemicity of H5N1 and the recent emergence of H9N2 in poultry call attention to the need for unravelling the epidemiology, ecology and highly diverse gene pool of influenza A virus (IAV) in Egypt which is the aim of this review. Isolation of a considerable number of IAV subtypes from several avian and mammalian hosts was described. Co-infections of poultry with H5N1 and H9N2 and subclinical infections of pigs and humans with H1N1 and H5N1 may raise the potential for the reassortment of these viruses. Moreover, the adjustment of IAV genomes, particularly H5N1, to optimize their evolution toward efficient transmission in human is progressing in Egypt. Understanding the present situation of influenza viruses in Egypt will help in the control of the disease and can potentially prevent a possible pandemic. PMID:25635701

  2. Pandemic H1N1 Influenza Infection and Vaccination in Humans Induces Cross-Protective Antibodies that Target the Hemagglutinin Stem

    OpenAIRE

    Thomson, C. A.; Wang, Y.; Jackson, L. M.; Olson, M.; Wang, W.; Liavonchanka, A.; Keleta, L.; Silva, V.; Diederich, S.; Jones, R. B.; Gubbay, J.; Pasick, J.; Petric, M.; Jean, Franc?ois; Allen, V. G.

    2012-01-01

    Most monoclonal antibodies (mAbs) generated from humans infected or vaccinated with the 2009 pandemic H1N1 (pdmH1N1) influenza virus targeted the hemagglutinin (HA) stem. These anti-HA stem mAbs mostly used IGHV1-69 and bound readily to epitopes on the conventional seasonal influenza and pdmH1N1 vaccines. The anti-HA stem mAbs neutralized pdmH1N1, seasonal influenza H1N1 and avian H5N1 influenza viruses by inhibiting HA-mediated fusion of membranes and protected against and treated heterologo...

  3. Molecular epidemiology of influenza A virus infection among hospitalized children in vietnam during post-pandemic period.

    Science.gov (United States)

    Tran, Dinh Nguyen; Pham, Thi Minh Hong; Ha, Manh Tuan; Hayakawa, Satoshi; Mizuguchi, Masashi; Ushijima, Hiroshi

    2015-06-01

    Genetic variability makes influenza virus to escape the immunity and causes yearly epidemics. Monitoring those changes is necessary for vaccine selection. In addition, H3N2 viruses were considered to be seeded from Southeast Asia before spreading globally. This study described the molecular epidemiology of influenza A during the post-pandemic season 2010-2011 in Vietnam. Nasopharyngeal samples were collected from children with respiratory infections at Children's Hospital 2, Ho Chi Minh City. The HA, NA, M genes were amplified, sequenced and analyzed. Thirty-five of 1,082 (3.2%) patients were positive for influenza A, including 14 pandemic H1N1 2009 (H1N1pdm09) and 21 H3N2 infections. H3N2 was dominant in the rainy season (May-October 2010) while H1N1pdm09 was dominant in the dry season (November 2010-April 2011). Phylogenetic analysis showed that Vietnamese H1N1pdm09 sequences in 2010-2011 formed the distinct cluster, with other contemporary Asian and 2012-American sequences, suggesting a possible common ancestor. All were oseltamivir-sensitive except two strains carrying S247N and D199N in NA which reduced the neuraminidase inhibitor susceptibility. The Vietnamese H3N2 viruses in mid-2010 belonged to the emerging subclade Perth10/2010, which then spread worldwide in 2011. The Vietnamese influenza viruses were well matched with the Southern Hemisphere vaccine formulation. Mutations at antigenic sites were also identified in these viruses. Surveillance of influenza viruses in tropical countries is important not only for development of their prevention and control strategies but also for earlier identification of the newly emerged strains that may be selected for future vaccine. J. Med. Virol. 87:904-912, 2015. © 2015 Wiley Periodicals, Inc. PMID:25648607

  4. Concurrent 2009 pandemic influenza A (H1N1) virus infection in ferrets and in a community in Pennsylvania.

    Science.gov (United States)

    Campagnolo, E R; Moll, M E; Tuhacek, K; Simeone, A J; Miller, W S; Waller, K O; Simwale, O; Rankin, J T; Ostroff, S M

    2013-03-01

    We report a fall 2010 cluster of pandemic influenza A/H1N1 (pH1N1) infections in pet ferrets in Lehigh Valley region of Pennsylvania. The ferrets were associated with one pet shop. The influenza cluster occurred during a period when the existing human surveillance systems had identified little to no pH1N1 in humans in the Lehigh Valley, and there were no routine influenza surveillance systems for exotic pets. The index case was a 2.5-month-old neutered male ferret that was presented to a veterinary clinic with severe influenza-like illness (ILI). In response to laboratory notification of a positive influenza test result, and upon request from the Pennsylvania Department of Health (PADOH), the Pennsylvania Department of Agriculture (PDA) conducted an investigation to identify other ill ferrets and to identify the source and extent of infection. PDA notified the PADOH of the pH1N1 infection in the ferrets, leading to enhanced human surveillance and the detection of pH1N1 human infections in the surrounding community. Five additional ferrets with ILI linked to the pet shop were identified. This simultaneous outbreak of ferret and human pH1N1 demonstrates the important link between animal health and public health and highlights the potential use of veterinary clinics for sentinel surveillance of diseases shared between animals and humans. PMID:22697485

  5. Modelling the progression of pandemic influenza A (H1N1 in Vietnam and the opportunities for reassortment with other influenza viruses

    Directory of Open Access Journals (Sweden)

    Farrar Jeremy

    2009-09-01

    Full Text Available Abstract Background A novel variant of influenza A (H1N1 is causing a pandemic and, although the illness is usually mild, there are concerns that its virulence could change through reassortment with other influenza viruses. This is of greater concern in parts of Southeast Asia, where the population density is high, influenza is less seasonal, human-animal contact is common and avian influenza is still endemic. Methods We developed an age- and spatially-structured mathematical model in order to estimate the potential impact of pandemic H1N1 in Vietnam and the opportunities for reassortment with animal influenza viruses. The model tracks human infection among domestic animal owners and non-owners and also estimates the numbers of animals may be exposed to infected humans. Results In the absence of effective interventions, the model predicts that the introduction of pandemic H1N1 will result in an epidemic that spreads to half of Vietnam's provinces within 57 days (interquartile range (IQR: 45-86.5 and peaks 81 days after introduction (IQR: 62.5-121 days. For the current published range of the 2009 H1N1 influenza's basic reproductive number (1.2-3.1, we estimate a median of 410,000 cases among swine owners (IQR: 220,000-670,000 with 460,000 exposed swine (IQR: 260,000-740,000, 350,000 cases among chicken owners (IQR: 170,000-630,000 with 3.7 million exposed chickens (IQR: 1.9 M-6.4 M, and 51,000 cases among duck owners (IQR: 24,000 - 96,000, with 1.2 million exposed ducks (IQR: 0.6 M-2.1 M. The median number of overall human infections in Vietnam for this range of the basic reproductive number is 6.4 million (IQR: 4.4 M-8.0 M. Conclusion It is likely that, in the absence of effective interventions, the introduction of a novel H1N1 into a densely populated country such as Vietnam will result in a widespread epidemic. A large epidemic in a country with intense human-animal interaction and continued co-circulation of other seasonal and avian viruses would provide substantial opportunities for H1N1 to acquire new genes.

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

    Science.gov (United States)

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

    2013-04-26

    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

  7. 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)

    Rebolledo, J

    2013-11-11

    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.

  8. Immunological characterization of monoclonal antibodies used in rapid influenza diagnostic test for detection of the 2009 pandemic influenza A(H1N1)pdm09 infection.

    Science.gov (United States)

    Yi, Hwajung; Lee, Mi-Seon; Lee, Joo-Yeon; Lee, Hae Kyung; Kang, Chun

    2015-02-01

    Since the 2009 pandemic, monoclonal antibodies (mAbs) for rapid influenza diagnostic tests (RIDT) have been developed for specific diagnostics of pandemic viral infection. Most of the mAbs were poorly characterized because of urgency during the pandemic. Further characterization of the mAbs for RIDTs would be beneficial for understanding the immunological properties of the pandemic virus and utilizing the mAbs for other research purposes. In this study, it was confirmed that two mAbs (I38 and D383) in an RIDT for H1N1pdm09 diagnostics were able to detect H1N1pdm09 virus through enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). Also, the two mAbs exhibited reactivity to hemagglutinins (HAs) of both the H1N1pdm09 and 1918 H1N1 viruses; therefore, the RIDT using the mAbs could detect HAs of H1N1pdm09 and also HAs of 1918 H1N1-like strains. In an extension to our previous study, the epitopes (Sa antigenic site and the interface area of F' and vestigial esterase subdomains on the HA1 domain of HA of H1N1pdm09) recognized by the mAbs were corroborated in depth by IFA with escape-mutants from the mAbs and mapping of the epitopes on the crystal structure of human H1N1 viral HAs. Collectively, these results imply that the mAbs for the RIDT may be suitable for use in studying the immunological properties of H1N1pdm09 viruses and that the Sa antigenic site and the interface area between F' and vestigial esterase subdomains on influenza viral HA recognized by the mAbs are immunologically conserved regions between H1N1pdm09 and 1918 H1N1. PMID:25626373

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

    Directory of Open Access Journals (Sweden)

    Dausey David J

    2011-09-01

    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.

  10. Pregnant Women Infected with Pandemic H1N1pdm2009 Influenza Virus Displayed Overproduction of Peripheral Blood CD69+ Lymphocytes and Increased Levels of Serum Cytokines

    OpenAIRE

    Ce?rbulo-va?zquez, Arturo; Figueroa-damia?n, Ricardo; Arriaga-pizano, Lourdes A.; Herna?ndez-andrade, Edgar; Mancilla-herrera, Ismael; Flores-meji?a, Luis Angel; Arteaga-troncoso, Gabriel; Lo?pez-maci?as, Constantino; Isibasi, Armando; Mancilla-rami?rez, Javier

    2014-01-01

    The first pandemic of the 21st century occurred in 2009 and was caused by the H1N1pdm influenza A virus. Severe cases of H1N1pdm infection in adults are characterized by sustained immune activation, whereas pregnant women are prone to more severe forms of influenza, with increased morbi-mortality. During the H1N1pdm09 pandemic, few studies assessed the immune status of infected pregnant women. The objective of this study was to evaluate the behavior of several immune markers in 13 H1N1pdm2009...

  11. The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States

    OpenAIRE

    Grant, William B.; Giovannucci, Edward

    2009-01-01

    Deaths during the 1918–1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918–1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population ...

  12. Immune response after one or two doses of pandemic influenza A (H1N1) monovalent, AS03-adjuvanted vaccine in HIV infected adults

    DEFF Research Database (Denmark)

    Bybeck Nielsen, Allan; Nielsen, Henriette SchjØnning

    2012-01-01

    INTRODUCTION: Continued research is needed to evaluate and improve the immunogenicity of influenza vaccines in HIV infected patients. We aimed to determine the antibody responses after one or two doses of the AS03-adjuvanted pandemic influenza A (H1N1) vaccine in HIV infected patients. METHOD: Following the influenza season 2009/2010, 219 HIV infected patients were included and divided into three groups depending on whether they received none (n=60), one (n=31) or two (n=128) doses of pandemic influenza A (H1N1) vaccine. At inclusion, antibody titers for all patients were analyzed and compared to pre-pandemic antibody titers analyzed from serum samples in a local storage facility. RESULTS: 4-9 months after a single immunization, we found a seroprotection rate of 77.4% and seroconversion rate of 67.7%. After two immunizations the rates increased significantly to seroprotection rate of 97.7% and seroconversion rate of 86.7%. CONCLUSION: A single dose of AS03-adjuvanted pandemic influenza A (H1N1) vaccine created an adequate immune response in HIV infected patients lasting as long as 4-9 months. Two doses improved the immunogenicity further.

  13. Pandemic H1N1 influenza A virus induces a potent innate immune response in human chorionic cells.

    Science.gov (United States)

    Kumar, Sandeep R P; Biswas, Moanaro; Elankumaran, Subbiah

    2014-04-01

    To understand the mechanistic basis for the reported outcomes of influenza A virus (IAV) infection during pregnancy, the effects of mouse adapted and pandemic (pdm) IAV infection in human choriocarcinoma cells were examined. Both viruses were able to infect and replicate in human placental cells, with pdm IAV being more apoptotic. A strong induction of innate signaling molecules, type I interferon and pro-inflammatory cytokine production, were associated with pdm IAV infection of human placental cells, with implications for adverse immediate and late outcomes during pregnancy. PMID:24702460

  14. Persistence of the 2009 Pandemic Influenza A (H1N1) Virus in Water and on Non-Porous Surface

    OpenAIRE

    Dublineau, Ame?lie; Bate?jat, Christophe; Pinon, Anthony; Burguie?re, Ana Maria; Leclercq, India; Manuguerra, Jean-claude

    2011-01-01

    Knowledge of influenza A virus survival in different environmental conditions is a key element for the implementation of hygiene and personal protection measures by health authorities. As it is dependent on virus isolates even within the same subtype, we studied the survival of the 2009 H1N1 pandemic (H1N1pdm) virus in water and on non-porous surface. The H1N1pdm virus was subjected to various environmental parameters over time and tested for infectivity. In water, at low and medium salinity ...

  15. Pathogenicity and transmissibility of reassortant H9 influenza viruses with genes from pandemic H1N1 virus

    OpenAIRE

    Qiao, Chuanling; Liu, Qinfang; Bawa, Bhupinder; Shen, Huigang; Qi, Wenbao; Chen, Ying; Mok, Chris Ka Pun; Garci?a-sastre, Adolfo; Richt, Ju?rgen A.; Ma, Wenjun

    2012-01-01

    Both H9N2 avian influenza and 2009 pandemic H1N1 viruses (pH1N1) are able to infect humans and swine, which has raised concerns that novel reassortant H9 viruses with pH1N1 genes might be generated in these hosts by reassortment. Although previous studies have demonstrated that reassortant H9 viruses with pH1N1 genes show increased virulence in mice and transmissibility in ferrets, the virulence and transmissibility of reassortant H9 viruses in natural hosts such as chickens and swine remain ...

  16. Clinical Presentation and Outcome in Hospitalized Patients of 2009 Pandemic Influenza A (H1N1) viral infection in Oman

    OpenAIRE

    Omaima Abdelaziz; Sayed Mudasser; Chandrashekar Puttaswamy; Akhwand Shakeel Ahmad

    2011-01-01

     Objectives: In 2009, cases of human infection with a novel influenza A (H1N1) virus were detected and soon reached a pandemic level. Presenting clinical features of this disease in Oman were observed and an attempt was made to identify features predicting the high risk of mortality.Methods: The clinical and laboratory features at the time of presentation in adult patients admitted with flu-like illness or pneumonia were studied who were later diagnosed as H1N1 infection by PCR of nasopharyn...

  17. Early Host Responses of Seasonal and Pandemic Influenza A Viruses in Primary Well-Differentiated Human Lung Epithelial Cells

    OpenAIRE

    Gerlach, Rachael L.; Camp, Jeremy V.; Chu, Yong-kyu; Jonsson, Colleen B.

    2013-01-01

    Replication, cell tropism and the magnitude of the host's antiviral immune response each contribute to the resulting pathogenicity of influenza A viruses (IAV) in humans. In contrast to seasonal IAV in human cases, the 2009 H1N1 pandemic IAV (H1N1pdm) shows a greater tropism for infection of the lung similar to H5N1. We hypothesized that host responses during infection of well-differentiated, primary human bronchial epithelial cells (wd-NHBE) may differ between seasonal (H1N1 A/BN/59/07) and ...

  18. Enhanced surveillance of initial cases of pandemic H1N1 2009 influenza in Ireland, April-July 2009.

    LENUS (Irish Health Repository)

    Martin, J

    2009-09-24

    From 28 April to 18 July 2009 there were 156 cases of pandemic H1N1 2009 influenza confirmed in Ireland. During this time, Ireland was in containment phase, and detailed case-based epidemiological information was gathered on all cases presenting in the community and acute health care setting. Active case finding was performed among contacts of cases. Eighty percent of cases were in people less than 35 years of age and 86% were imported. The most frequent symptoms were fever, sore throat, myalgia and dry cough. Nine people were hospitalized, no fatalities occurred.

  19. Structural basis of pre-existing immunity to the 2009 H1N1 pandemic influenza virus

    OpenAIRE

    Xu, Rui; Ekiert, Damian C.; Krause, Jens C.; Hai, Rong; Crowe, James E.; Wilson, Ian A.

    2010-01-01

    The 2009 H1N1 swine flu is the first influenza pandemic in decades. The crystal structure of the hemagglutinin from the A/California/04/2009 H1N1 virus shows that its antigenic structure, particularly within the Sa antigenic site, is extremely similar to human H1N1 viruses circulating early in the 20th century. The co-crystal structure of the 1918 HA with 2D1, an antibody from a survivor of the 1918 Spanish flu that neutralizes both 1918 and 2009 H1N1 viruses, reveals an epitope that is conse...

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

    Scientific Electronic Library Online (English)

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

    2013-12-01

    Full Text Available 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 of patients infected with this virus, an outbreak or pandemi

  1. Influenza A pandemics: clinical and organizational aspects: the experience in Chile.

    Science.gov (United States)

    Ugarte, Sebastián; Arancibia, Francisco; Soto, Rodrigo

    2010-04-01

    Recently, the World Health Organization declared a pandemic mediated by the novel A H1N1 influenza virus. Soon after the first report from Mexico, the disease arrived in Chile, where it spread quickly from south to north, mimicking cold weather progression through the country. Between May and September 2009, 366,624 cases of H1N1 were reported; 12,248 were confirmed by real-time reverse-transcription polymerase chain reaction and 1562 were hospitalized. One hundred thirty-two deaths were attributable to the infection, creating a death rate of 0.78 per 100,000 inhabitants. Common comorbidities were present in 59%, including obesity, chronic obstructive pulmonary disease, hypertension, type II diabetes, and congestive heart failure. Nine percent were pregnant. Severe disease developed early; the median time to admittance was 5 days, and the most common clinical manifestations were cough, fever, dyspnea, and myalgia. Mean acute physiology and chronic health evaluation II and sequential organ failure assessment scores were 14 and 5, respectively. Highlighted laboratory data were lactate dehydrogenase and creatine kinase elevation, leukocytosis in 50%, elevated creatinine in a 25%, and thrombocytopenia in 20%. Severe respiratory failure requiring high-frequency oscillatory ventilation and extracorporeal membrane oxygenation as sophisticated modes of respiratory support was seen in 17%. Acute renal failure occurred in 25% of the intensive care unit patients, with death rates near 50%. Health systems reinforced outpatient guards with extra staff and extension of the duty schedules. Antivirals were supplied free for medically diagnosed cases. Admissions for severe cases were prioritized, reconverting hospital beds into advanced care ones; a central coordination station rationed their assignment. Recommendations for small hospitals include adding ventilators, using videoconferences, providing tutorial activity from experts, developing guidelines for disease management, and outlining criteria for transport. PMID:19935412

  2. Pathological Findings and Distribution of Pandemic Influenza A (H1N1) 2009 Virus in Lungs from Naturally Infected Fattening Pigs in Norway

    OpenAIRE

    Bjørn Lium; Anna Germundsson; Britt Gjerset; Hans Gamlem; Mette Valheim

    2011-01-01

    The Norwegian pig population was considered free from influenza A virus infections until the first case of porcine pandemic influenza A (H1N1) 2009 virus infection in October 2009. Human to pig transmission of virus was suspected. Unusual lung lesions were observed in fattening pigs, with red, lobular, multifocal to coalescing consolidation, most frequently in the cranial, middle, and accessory lobes. The main histopathological findings were epithelial degeneration and necrosis, lymphocyte in...

  3. Deep Sequencing Reveals Mixed Infection with 2009 Pandemic Influenza A (H1N1) Virus Strains and the Emergence of Oseltamivir Resistance

    OpenAIRE

    Ghedin, Elodie; Laplante, Jennifer; Depasse, Jay; Wentworth, David E.; Santos, Roberto P.; Lepow, Martha L.; Porter, Joanne; Stellrecht, Kathleen; Lin, Xudong; Operario, Darwin; Griesemer, Sara; Fitch, Adam; Halpin, Rebecca A.; Stockwell, Timothy B.; Spiro, David J.

    2011-01-01

    Mixed infections with seasonal influenza A virus strains are a common occurrence and an important source of genetic diversity. Prolonged viral shedding, as observed in immunocompromised individuals, can lead to mutational accumulation over extended periods. Recently, drug resistance was reported in immunosuppressed patients infected with the 2009 pandemic influenza A (H1N1) virus within a few days after oseltamivir treatment was initiated. To better understand the evolution and emergence of d...

  4. Cross-reactive CD8+ T-cell immunity between the pandemic H1N1-2009 and H1N1-1918 influenza A viruses

    OpenAIRE

    Gras, Stephanie; Kedzierski, Lukasz; Valkenburg, Sophie A.; Laurie, Karen; Liu, Yu Chih; Denholm, Justin T.; Richards, Michael J.; Rimmelzwaan, Guus F.; Kelso, Anne; Doherty, Peter C.; Turner, Stephen J.; Rossjohn, Jamie; Kedzierska, Katherine

    2010-01-01

    Preexisting T-cell immunity directed at conserved viral regions promotes enhanced recovery from influenza virus infections, with there being some evidence of cross-protection directed at variable peptides. Strikingly, many of the immunogenic peptides derived from the current pandemic A(H1N1)-2009 influenza virus are representative of the catastrophic 1918 “Spanish flu” rather than more recent “seasonal” strains. We present immunological and structural analyses of cross-reactive CD8+ T...

  5. Pandemic influenza A (H1N1) 2009: epidemiological analysis of cases in a tropical/semi-arid region of Brazil

    Scientific Electronic Library Online (English)

    Roberto da Justa, Pires Neto; Daniele Rocha Queiroz, Lemos; Luciano Pamplona de Góes, Cavalcanti; Alberto Novaes, Ramos Junior; Carlos Henrique, Alencar; Mônica Cardoso, Façanha; Madalena Isabel Coelho, Barroso; Dina Cortez Lima Feitosa, Vilar; Manoel Dias da, Fonseca Neto.

    2013-04-01

    Full Text Available SciELO Brazil | Language: English Abstract in english Introduction The year 2009 marked the beginning of a pandemic caused by a new variant of influenza A (H1N1). After spreading through North America, the pandemic influenza virus (H1N1) 2009 spread rapidly throughout the world. The aim of this study was to describe the clinical and epidemio [...] logical characteristics of cases of pandemic influenza in a tropical/semi-arid region of Brazil. Methods A retrospective study analyzed all suspected cases of pandemic influenza (H1N1) 2009 reported in the Ceará State through the National Information System for Notifiable Diseases during the pandemic period between 28 April, 2009 and November 25, 2010. Results A total of 616 suspected cases were notified, 58 (9.4%) in the containment phase and 558 (90.6%) in the mitigation phase. Most cases were of affected young people resident in the City of Fortaleza, the largest urban center in the State of Ceará. The most frequent symptoms presented by the cases with confirmed infection were fever, cough, myalgia, arthralgia, and nasal congestion. Mortality rate was 0.0009/1,000 inhabitants and lethality was 5.6%. Deaths were observed only in the mitigation phase. Mortality rates were similar for both sexes but were higher in the age group under 5 years. Conclusions The study suggests that the influenza A (H1N1) pandemic in this tropical/semi-arid region had a lower magnitude when compared to states in the Southern and Southeastern regions of Brazil.

  6. Oseltamivir-resistant influenza A(H1N1) 2009 virus in Greece during the post-pandemic 2010-2011 season.

    Science.gov (United States)

    Kourti, Afroditi; Spanakos, Gregory; Politi, Leda; Stavropoulou, Anastasia; Spanakis, Nicholas; Tsakris, Athanassios

    2012-07-01

    Information on the drug susceptibility of influenza epidemic strains is important for antiviral resistance monitoring. In Greece, the 2009-2010 pandemic waves were very mild and seroprevalence rates remained low after this influenza season, resulting in exclusive detection of the pandemic strain during the 2010-2011 influenza season. In the present study during the post-pandemic 2010-2011 season, 50 consecutive influenza A(H1N1) 2009 virus-positive samples from patients hospitalised in Greek hospitals were analysed for resistance to the neuraminidase inhibitor oseltamivir. All patients were hospitalised with severe influenza complications and had previously received oseltamivir. Influenza A(H1N1) 2009 virus detection and testing for oseltamivir resistance were performed with real-time PCR amplification assays. The H275Y substitution associated with resistance to oseltamivir was identified in two immunocompetent patients who received oseltamivir treatment for 3 days and 5 days, respectively. In both cases, patients were discharged in good condition despite development of resistance to antiviral treatment. PMID:22591839

  7. Structure, Receptor Binding, and Antigenicity of Influenza Virus Hemagglutinins from the 1957 H2N2 Pandemic

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Rui; McBride, Ryan; Paulson, James C.; Basler, Christopher F.; Wilson, Ian A. (Sinai); (Scripps)

    2010-03-04

    The hemagglutinin (HA) envelope protein of influenza viruses mediates essential viral functions, including receptor binding and membrane fusion, and is the major viral antigen for antibody neutralization. The 1957 H2N2 subtype (Asian flu) was one of the three great influenza pandemics of the last century and caused 1 million deaths globally from 1957 to 1968. Three crystal structures of 1957 H2 HAs have been determined at 1.60 to 1.75 {angstrom} resolutions to investigate the structural basis for their antigenicity and evolution from avian to human binding specificity that contributed to its introduction into the human population. These structures, which represent the highest resolutions yet recorded for a complete ectodomain of a glycosylated viral surface antigen, along with the results of glycan microarray binding analysis, suggest that a hydrophobicity switch at residue 226 and elongation of receptor-binding sites were both critical for avian H2 HA to acquire human receptor specificity. H2 influenza viruses continue to circulate in birds and pigs and, therefore, remain a substantial threat for transmission to humans. The H2 HA structure also reveals a highly conserved epitope that could be harnessed in the design of a broader and more universal influenza A virus vaccine.

  8. Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey

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    Blumental Sophie

    2011-11-01

    Full Text Available Abstract Background During the 2009 influenza A/H1N1v pandemic, children were identified as a specific "at risk" group. We conducted a multicentric study to describe pattern of influenza A/H1N1v infection among hospitalized children in Brussels, Belgium. Methods From July 1, 2009, to January 31, 2010, we collected epidemiological and clinical data of all proven (positive H1N1v PCR and probable (positive influenza A antigen or culture pediatric cases of influenza A/H1N1v infections, hospitalized in four tertiary centers. Results During the epidemic period, an excess of 18% of pediatric outpatients and emergency department visits was registered. 215 children were hospitalized with proven/probable influenza A/H1N1v infection. Median age was 31 months. 47% had ? 1 comorbid conditions. Febrile respiratory illness was the most common presentation. 36% presented with initial gastrointestinal symptoms and 10% with neurological manifestations. 34% had pneumonia. Only 24% of the patients received oseltamivir but 57% received antibiotics. 10% of children were admitted to PICU, seven of whom with ARDS. Case fatality-rate was 5/215 (2%, concerning only children suffering from chronic neurological disorders. Children over 2 years of age showed a higher propensity to be admitted to PICU (16% vs 1%, p = 0.002 and a higher mortality rate (4% vs 0%, p = 0.06. Infants less than 3 months old showed a milder course of infection, with few respiratory and neurological complications. Conclusion Although influenza A/H1N1v infections were generally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.

  9. Pandemic Influenza A (H1N1) and Its Prevention: A Cross Sectional Study on Patients’ Knowledge, Attitude and Practice among l study on Patients’ Knowledge, Attitude and Practice among patients attending Primary Health Care Clinic in Kuala Lumpur, Malaysia

    OpenAIRE

    Latiffah Abdul Latiff; Saadat Parhizkar; Huda Zainuddin; Chun, Goh M.; Rahiman, Mohammad Ali A.; Ramli, Nur Liyana N.; Yun, Kerk L.

    2012-01-01

    The World Health Organization confirmed that the novel influenza A, H1N1 as a pandemic on 11 June 2009. After less than three months, 182 countries were affected by the pandemic accounting for about 150,000 infected cases and 3000 mortality. Successful H1N1 pandemic management strategies’ shaped by making changes in health behavior. The aim of this study was to document patients’ knowledge, attitudes and practices (KAP) regarding the pandemic influenza A (H1N1) and its prevention. We perf...

  10. 'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

    Science.gov (United States)

    Mwacalimba, Kennedy Kapala; Green, Judith

    2015-03-01

    'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centres of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. We highlight the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments. One Health prioritizes disease risk mitigation, sidelining those trade and development narratives which speak to broader public health concerns. We show how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. Our findings are likely to be generalizable to other resource-constrained countries, and suggest that effective disease governance requires alignment with trade and development sectors, as well as integration of veterinary and public health sectors. PMID:24532120

  11. Prioritization strategies for pandemic influenza vaccine in 27 countries of the European Union and the Global Health Security Action Group: a review

    Directory of Open Access Journals (Sweden)

    Haas Walter

    2007-09-01

    Full Text Available Abstract Background Although there is rapid progress in vaccine research regarding influenza pandemic vaccines it is expected that pandemic influenza vaccine production can only start once the pandemic virus has been recognized. Therefore, pandemic vaccine capacity will be limited at least during the first phase of an influenza pandemic, requiring vaccine prioritization strategies. WHO recommends developing preliminary priorities for pandemic vaccine use. The goal of this review is to provide a thorough overview of pandemic vaccine prioritization concepts in the 27 European Union (EU member states and the four non-EU countries of the Global Health Security Action Group. Methods Between September and December 2006 data was collected for each country through two data sources: (i the national influenza pandemic plan; (ii contacting key persons involved in pandemic planning by email and/or phone and/or fax Results Twenty-six (84% countries had established at least one vaccine priority group. Most common reported vaccine priority groups were health care workers (HCW (100%, essential service providers (ESP (92% and high risk individuals (HRI (92%. Ranking of at least one vaccine priority group was done by 17 (65% of 26 countries. Fifteen (88% of these 17 countries including a ranking strategy, decided that HCW with close contact to influenza patients should be vaccinated first; in most countries followed and/or ranked equally by ESP and subsequently HRI. Rationales for prioritization were provided by 22 (85% of 26 countries that established vaccine priority groups. There was large variation in the phrasing and level of detailed specification of rationales. Seven (32% of 22 countries providing rationales clearly associated each vaccine priority group with the specific rationale. Ten (32% of the 31 countries studied countries have consulted and involved ethical experts to guide decisions related to vaccine prioritization. Conclusion In the majority of the countries the establishment of vaccine priority groups, ranking and underlying rationales are in line with WHO recommendations. In most public plans the criteria by which prioritized groups are identified are not easily recognizable. Clarity however, may be necessary to assure public acceptability of the prioritization. Ethical experts, results of modelling exercises could play an increasing role in the future decision making process.

  12. 5'PPP-RNA induced RIG-I activation inhibits drug-resistant avian H5N1 as well as 1918 and 2009 pandemic influenza virus replication

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    García-Sastre Adolfo

    2010-05-01

    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.

  13. Cross-Reactive T Cells Are Involved in Rapid Clearance of 2009 Pandemic H1N1 Influenza Virus in Nonhuman Primates

    OpenAIRE

    Weinfurter, Jason T.; Brunner, Kevin; Capuano, Saverio V.; Li, Chengjun; Broman, Karl W.; Kawaoka, Yoshihiro; Friedrich, Thomas C.

    2011-01-01

    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...

  14. Comparative study of pandemic (H1N1) 2009, swine H1N1, and avian H3N2 influenza viral infections in quails

    OpenAIRE

    Thontiravong, Aunyaratana; Wannaratana, Suwarak; Tantilertcharoen, Rachod; Prakairungnamthip, Duangduean; Tuanudom, Ranida; Sasipreeyajan, Jiroj; Pakpinyo, Somsak; Amonsin, Alongkorn; Kitikoon, Pravina; Oraveerakul, Kanisak

    2012-01-01

    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...

  15. Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India

    OpenAIRE

    Rajesh K Chudasama,; Umed V Patel,; Pramod B Verma,; Chikitsa D Amin,; Hitesh M Shah,; Anupam Banerjee,; Ravikant R Patel,

    2011-01-01

    Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (...

  16. Seasonal influenza immunisation in Europe. Overview of recommendations and vaccination coverage for three seasons: pre-pandemic (2008/09), pandemic (2009/10) and post-pandemic (2010/11).

    Science.gov (United States)

    Mereckiene, J; Cotter, S; Nicoll, A; Lopalco, P; Noori, T; Weber, Jt; D'Ancona, F; Levy-Bruhl, D; Dematte, L; Giambi, C; Valentiner-Branth, P; Stankiewicz, I; Appelgren, E; O Flanagan, D

    2014-01-01

    Since 2008, annual surveys of influenza vaccination policies, practices and coverage have been undertaken in 29 European Union (EU)/ European Economic Area (EEA) countries. After 2009, this monitored the impact of European Council recommendation to increase vaccination coverage to 75% among risk groups. This paper summarises the results of three seasonal influenza seasons: 2008/09, 2009/10 and 2010/11. In 2008/09, 27/29 countries completed the survey; in 2009/10 and 2010/11, 28/29 completed it. All or almost all countries recommended vaccination of older people (defined as those aged ?50, ?55, ?59, ?60 or ?65 years), and people aged ?6 months with clinical risk and healthcare workers. A total of 23 countries provided vaccination coverage data for older people, but only 7 and 10 had data for the clinical risk groups and healthcare workers, respectively. The number of countries recommending vaccination for some or all pregnant women increased from 10 in 2008/09 to 22 in 2010/11. Only three countries could report coverage among pregnant women. Seasonal influenza vaccination coverage during and after the pandemic season in older people and clinical groups remained unchanged in countries with higher coverage. However, small decreases were seen in most countries during this period. The results of the surveys indicate that most EU/EEA countries recommend influenza vaccination for the main target groups; however, only a few countries have achieved the target of 75% coverage among risk groups. Coverage among healthcare workers remained low. PMID:24786262

  17. Seroepidemiological study of pandemic influenza H1N1 following the 2009-2010 wave in Greece.

    Science.gov (United States)

    Maltezou, Helena C; Katerelos, Panagiotis; Mavrouli, Maria; Lourida, Athanasia; Routsias, John G; Spanakis, Nicholas; Maragos, Antonios; Tedoma, Anastasia; Bassiakos, Yiannis; Koratzanis, Georgios; Mantagos, Stephanos; Metallidis, Simeon; Katragkou, Aspasia; Nikolaidis, Pavlos; Roilides, Emmanuel; Theodoridou, Maria; Tsakris, Athanassios

    2011-09-01

    Knowledge of seroprevalence rates against 2009 pandemic H1N1 virus will assist vaccination recommendations and the preparation of the health-care system during subsequent years. This study was conducted in Greece during June-August 2010 to estimate the seroprevalence rate against pandemic H1N1 virus. Persons presenting in 29 health-care facilities across the country were studied. Seroprevalence was estimated employing a virus-free ELISA that specifically recognizes 2009 H1N1 virus antibodies in human sera. Sera collected from 2005 to April 2009 were also used to estimate pre-pandemic seroprevalence rates. A total of 954 persons were studied. The overall seroprevalence rate was 28.5% (95% confidence interval=25.6-31.3%). Age-specific rates were 34.2% in persons 0-4 years, 36.3% in persons 5-19 years, 25.0% in persons 20-39 years, 23.4% in persons 40-59 years, and 31.8% in persons ? 60 years. The highest rates were recorded in the Regions of Ionian Islands (67%) and Epirus (42.9%), while the lowest (8.4%) in the Region of Thessaly. Age-specific attack rates of infection during 2009-2010 were 28.8% in persons 0-4 years, 32.5% in persons 5-19 years, 14.3% in persons 20-39 years, 19.1% in persons 40-59 years, and 14.4% in persons ? 60 years. Multivariate analysis revealed that Region of residence and caring for children <5 years were associated with increased risk for seropositivity. Urbanity, personal and family characteristics, working in a health-care facility or in a school, history of pandemic H1N1 vaccination or history of influenza-like illness during 2009-2010 were not associated with increased risk for seropositivity. PMID:21762749

  18. Using clinical criteria on seasonal and pandemic influenza: what to look for?

    OpenAIRE

    Gonc?alves, Paulo; Paixa?o, Eleonora; Machado, Ausenda; Cordeiro, Rita; Nunes, Baltazar; Pechirra, Pedro; Guiomar, Raquel

    2010-01-01

    The reliability of clinical criteria on the diagnosis of influenza has been a question which has generated much debate in the scientific community. In Portugal, Influenza-like illness (ILI) cases have been notified by two sentinel networks, one of general practitioners (“Médicos-Sentinela”) and another of emergency rooms of hospitals and health centres, to the National Influenza Reference Laboratory in the context of the National Influenza Surveillance Programme, using clinical criteria ...

  19. Pandemic Influenza Planning: Shouldn’t Swine and Poultry Workers Be Included?

    OpenAIRE

    Gray, Gregory C.; Trampel, Darrell W.; Roth, James A.

    2007-01-01

    Recent research has demonstrated that swine and poultry professionals, especially those who work in large confinement facilities, are at markedly increased risk of zoonotic influenza virus infections. In serving as a bridging population for influenza virus spread between animals and man, these workers may introduce zoonotic influenza virus into their homes and communities as well as expose domestic swine and poultry to human influenza viruses. Prolonged and intense occupational exposures of h...

  20. Mortality Attributable to Influenza in England and Wales Prior to, during and after the 2009 Pandemic

    OpenAIRE

    Green, Helen K.; Andrews, Nick; Fleming, Douglas; Zambon, Maria; Pebody, Richard

    2013-01-01

    Very different influenza seasons have been observed from 2008/09–2011/12 in England and Wales, with the reported burden varying overall and by age group. The objective of this study was to estimate the impact of influenza on all-cause and cause-specific mortality during this period. Age-specific generalised linear regression models fitted with an identity link were developed, modelling weekly influenza activity through multiplying clinical influenza-like illness consultation rates with prop...

  1. Fever screening during the influenza (H1N1-2009 pandemic at Narita International Airport, Japan

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    Nishiura Hiroshi

    2011-05-01

    Full Text Available Abstract Background Entry screening tends to start with a search for febrile international passengers, and infrared thermoscanners have been employed for fever screening in Japan. We aimed to retrospectively assess the feasibility of detecting influenza cases based on fever screening as a sole measure. Methods Two datasets were collected at Narita International Airport during the 2009 pandemic. The first contained confirmed influenza cases (n = 16 whose diagnosis took place at the airport during the early stages of the pandemic, and the second contained a selected and suspected fraction of passengers (self-reported or detected by an infrared thermoscanner; n = 1,049 screened from September 2009 to January 2010. The sensitivity of fever (38.0°C for detecting H1N1-2009 was estimated, and the diagnostic performances of the infrared thermoscanners in detecting hyperthermia at cut-off levels of 37.5°C, 38.0°C and 38.5°C were also estimated. Results The sensitivity of fever for detecting H1N1-2009 cases upon arrival was estimated to be 22.2% (95% confidence interval: 0, 55.6 among nine confirmed H1N1-2009 cases, and 55.6% of the H1N1-2009 cases were under antipyretic medications upon arrival. The sensitivity and specificity of the infrared thermoscanners in detecting hyperthermia ranged from 50.8-70.4% and 63.6-81.7%, respectively. The positive predictive value appeared to be as low as 37.3-68.0%. Conclusions The sensitivity of entry screening is a product of the sensitivity of fever for detecting influenza cases and the sensitivity of the infrared thermoscanners in detecting fever. Given the additional presence of confounding factors and unrestricted medications among passengers, reliance on fever alone is unlikely to be feasible as an entry screening measure.

  2. Two waves of pandemic influenza A(H1N1) 2009 in Wales--the possible impact of media coverage on consultation rates, April-December 2009.

    Science.gov (United States)

    Keramarou, M; Cottrell, S; Evans, M R; Moore, C; Stiff, R E; Elliott, C; Thomas, D R; Lyons, M; Salmon, R L

    2011-01-01

    In the United Kingdom, the influenza A(H1N1) 2009 pandemic had a distinct two-wave pattern of general practice consultations for influenza-like illness (ILI). We describe the epidemiology of the influenza pandemic in Wales between April and December 2009 using integrated data from a number of independent sources: GP surveillance, community virology surveillance, hospital admissions and deaths, and media enquiries monitoring. The first wave peaked in late July at 100 consultations per 100,000 general practice population and attracted intensive media coverage. The positivity rate for the A(H1N1)2009 influenza did not exceed 25% and only 44 hospitalisations and one death were recorded. By contrast, the second wave peaked in late October and although characterised by lower ILI consultation rates (65 consultations per 100,000 general practice population) and low profile media activity, was associated with much higher positivity rates for pandemic influenza A(H1N1)2009 (60%) and substantially more hospital admissions (n=379) and deaths (n=26). The large number of ILI-related consultations during the first wave in Wales probably reflected the intensive media activity rather than influenza virus circulating in the community. Data from community surveillance schemes may therefore have considerably overestimated the true incidence of influenza. This has implications for the future interpretation of ILI surveillance data and their use in policy making, and underlines the importance of using integrated epidemiological, virological and hospital surveillance data to monitor influenza activity. PMID:21262184

  3. Clinical characteristics of 2009 pandemic influenza A (H1N1 infection in children and the performance of rapid antigen test

    Directory of Open Access Journals (Sweden)

    Yong-Jae Park

    2011-10-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Treseder Travis W

    2010-02-01

    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.

  5. Atypical clinic presentation of pandemic influenza A successfully rescued by extracorporeal membrane oxygenation – Our experience and review of the literature

    Science.gov (United States)

    Ciapetti, Marco; Di Lascio, Gabriella; Harmelin, Guy; Sani, Guido; Peris, Adriano

    2013-01-01

    The novel pandemic influenza A (H1N1) caused an epidemic of critical illness, and some patients developed severe acute respiratory distress syndrome (ARDS) or severe cardiopulmonary failure despite the use of conventional management. Extracorporeal membrane oxygenation (ECMO) support may successfully rescue these severely ill patients. We demonstrate the causative role of H1N1 in refractory ARDS of a previously healthy 15-year-old man who presented to the intensive care unit with a hypoxic and persistent cardiogenic shock refractory to conventional management as the leading symptom of influenza A. Because of compromised cardiopulmonary function, venovenous ECMO was applied 24 h after admission. Despite that the patient was manifesting heart failure, we decided the placement of venovenous ECMO because we believed that the real problem was the uncontrollable hypoxia and hypercapnia. A normal left ventricular ejection fraction was documented on a 2D echocardiography on day 2. The patient, after 6 days of ECMO, recovered completely and was successfully weaned from the mechanical ventilator on the 9th day after admission. The patient was discharged from the hospital on the 15th day. This experience showed that ECMO can be lifesaving for severe H1N1 infection also in patients with atypical clinical presentation of influenza. PMID:24381738

  6. The characteristics, clinical manifestations and outcomes of pandemic influenza A (H1N1) 2009 in the elderly

    Scientific Electronic Library Online (English)

    Luana, Lenzi; Astrid, Wiens; Roberto, Pontarolo.

    2013-04-01

    Full Text Available Introduction The objetctive of this study was to evaluate the 2009 Pandemic Influenza A (H1N1) in the elderly and identify the clinical characteristics, mortality and prognostic factors of the infection in these patients. Methods This was an observational, retrospectiv [...] e study. Data were collected from the National Notifiable Diseases (SINAN), from the Brazilian Ministry of Health. Only patients 60 years old or more that had laboratory confirmed infections were included. The socio-demographic and clinical variables and outcomes were evaluated to compare mortality rates in the presence or absence of these factors. Results We included 93 patients in the study, 16.1% of whom died. The symptoms of cough and dyspnea, the use of the antiviral oseltamivir, influenza vaccine and comorbidities influenced the outcomes of cure or death. Chest radiography can aid in diagnosis. Conclusions Although relatively few elderly people were infected, this population presented high lethality that can be justified by the sum of clinical, physical and immunological factors in this population. Treatment with oseltamivir and vaccination against seasonal influenza have significantly reduced rates of hospitalization and mortality.

  7. In vitro antiviral activity of hypothiocyanite against A/H1N1/2009 pandemic influenza virus.

    Science.gov (United States)

    Cegolon, L; Salata, C; Piccoli, E; Juarez, V; Palu', G; Mastrangelo, G; Calistri, A

    2014-01-01

    Influenza virus spreads via small particle aerosols, droplets and fomites, and since it can survive for a short time on surfaces, can be introduced into the nasal mucosa before it loses infectivity. The hypothiocyanite ion (OSCN-), product of the lactoperoxidase/H2O2/SCN- system of central airways, is emerging as an important molecule for innate defense mechanism against bacteria, fungi and viruses. Here we demonstrated that OSCN(-) displays virucidal activity in vitro against the A/H1N1 2009 pandemic influenza virus. The concentration required to inhibit viral replication by 50% was 2 ?M when virus were challenged directly with OSCN- before cell inoculation. These values were even lower when inoculated cells were maintained in contact with enzyme free-OSCN- in the culture medium. The last experimental conditions better reflect those of tracheobronchial mucosa, where HOSCN/OSCN- is retained in the air-liquid interface and inactivates both the viruses approaching the epithelium from outside and those released from the inoculated cells after the replication cycle. Importantly no OSCN- cytotoxicity was observed in the cellular system employed. The lack of toxicity in humans and the absence of damage on surfaces of fomites suggest a potential use of OSCN- to avoid mucosal and environmental transmission of influenza virus. Since hypothiocyanite is normally present in human airways a low risk of viral resistance is envisaged. In vivo confirmatory studies are needed to evaluate the appropriate dose, regimen and formulation. PMID:23540488

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

    OpenAIRE

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

    2014-01-01

    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 Tre...

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

    OpenAIRE

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

    2013-01-01

    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 library and from A/Narita/1/2009 ...

  10. Sensitivity and Specificity of Serologic Assays for Detection of Human Infection with 2009 Pandemic H1N1 Virus in U.S. Populations?

    Science.gov (United States)

    Veguilla, Vic; Hancock, Kathy; Schiffer, Jarad; Gargiullo, Paul; Lu, Xiuhua; Aranio, Darbi; Branch, Alicia; Dong, Libo; Holiday, Crystal; Liu, Feng; Steward-Clark, Evelene; Sun, Hong; Tsang, Byron; Wang, David; Whaley, Melissa; Bai, Yaohui; Cronin, Li; Browning, Peter; Dababneh, Hanan; Noland, Heather; Thomas, Leilani; Foster, Lydia; Quinn, Conrad P.; Soroka, Stephen D.; Katz, Jacqueline M.

    2011-01-01

    Swine origin 2009 H1N1 influenza virus has spread globally to cause the first influenza pandemic of the 21st century. Serological studies can improve our understanding of the extent of human infection and risk factors associated with the transmission of this pandemic virus. The “gold standard” for serodiagnosis of human influenza virus infection is the detection of seroconversion between acute- and convalescent-stage samples. However, the timing of seroepidemiological investigations often precludes the collection of truly acute-phase sera, requiring development of serological criteria for evaluating convalescent-phase sera that optimize detection of true positives and true negatives. To guide seroepidemiological investigations into the spread of the novel 2009 pandemic H1N1 virus, we characterized serum antibody responses to 2009 H1N1 virus in 87 individuals with confirmed viral infection and 227 nonexposed U.S. individuals using microneutralization (MN) and hemagglutination inhibition (HI) assays. Sensitivity and specificity were determined for each assay alone and in combination for detection of 2009 H1N1 virus-specific antibodies in convalescent-phase sera. Although the HI assay was more specific for detecting antibody to 2009 H1N1, the MN assay was more sensitive, particularly for detecting low-titer seroconversions. A combination of titers (MN ? 40 and HI ? 20) provided the highest sensitivity (90%) and specificity (96%) for individuals aged <60 years and 92% specificity for adults aged ?60 years for detection of serologically confirmed 2009 H1N1 infections in U.S. populations during the first pandemic waves. These studies provide an approach to optimize timely serological investigations for future pandemics or outbreaks of novel influenza viruses among humans. PMID:21471339

  11. Sensitivity and specificity of serologic assays for detection of human infection with 2009 pandemic H1N1 virus in U.S. populations.

    Science.gov (United States)

    Veguilla, Vic; Hancock, Kathy; Schiffer, Jarad; Gargiullo, Paul; Lu, Xiuhua; Aranio, Darbi; Branch, Alicia; Dong, Libo; Holiday, Crystal; Liu, Feng; Steward-Clark, Evelene; Sun, Hong; Tsang, Byron; Wang, David; Whaley, Melissa; Bai, Yaohui; Cronin, Li; Browning, Peter; Dababneh, Hanan; Noland, Heather; Thomas, Leilani; Foster, Lydia; Quinn, Conrad P; Soroka, Stephen D; Katz, Jacqueline M

    2011-06-01

    Swine origin 2009 H1N1 influenza virus has spread globally to cause the first influenza pandemic of the 21st century. Serological studies can improve our understanding of the extent of human infection and risk factors associated with the transmission of this pandemic virus. The "gold standard" for serodiagnosis of human influenza virus infection is the detection of seroconversion between acute- and convalescent-stage samples. However, the timing of seroepidemiological investigations often precludes the collection of truly acute-phase sera, requiring development of serological criteria for evaluating convalescent-phase sera that optimize detection of true positives and true negatives. To guide seroepidemiological investigations into the spread of the novel 2009 pandemic H1N1 virus, we characterized serum antibody responses to 2009 H1N1 virus in 87 individuals with confirmed viral infection and 227 nonexposed U.S. individuals using microneutralization (MN) and hemagglutination inhibition (HI) assays. Sensitivity and specificity were determined for each assay alone and in combination for detection of 2009 H1N1 virus-specific antibodies in convalescent-phase sera. Although the HI assay was more specific for detecting antibody to 2009 H1N1, the MN assay was more sensitive, particularly for detecting low-titer seroconversions. A combination of titers (MN ? 40 and HI ? 20) provided the highest sensitivity (90%) and specificity (96%) for individuals aged <60 years and 92% specificity for adults aged ? 60 years for detection of serologically confirmed 2009 H1N1 infections in U.S. populations during the first pandemic waves. These studies provide an approach to optimize timely serological investigations for future pandemics or outbreaks of novel influenza viruses among humans. PMID:21471339

  12. Influenza pandémica a un año de la primera ola: ¿Qué podemos decir ahora? / Pandemic influenza one year after the first wave: What did we learn?

    Scientific Electronic Library Online (English)

    Cecilia, Perret P.

    2010-04-01

    Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Durante el año 2009 nuestro país vivió la primera ola pandémica causada por el nuevo virus de influenza A (H1N1) 2009 aparecido en el hemisferio norte a fines de abril del ese año. La tasa de ataque estimada fue entre 6 a 12% afectando más frecuentemente a los escolares quienes presentaron una enfer [...] medad leve. Los grupos etáreos con mayor riesgo de hospitalización fueron los adultos mayores y los niños bajo 5 años de edad. Tuvieron mayor riesgo de fallecer los adultos mayores y aquellas personas con una co-morbilidad asociada. Aprendimos que el diagnóstico clínico de influenza se confirma por laboratorio en alrededor del 80% pero tiene una baja correlación en los niños bajo 5 años de edad, especialmente en lactantes bajo 1 año de edad, al circular concomitantemente con VRS. Los métodos de diagnóstico como la IFD y los inmunocromatográficos tienen una sensibilidad que no supera el 80% y es muy baja en los adultos mayores cuando se compara con PCR. Dado el impacto clínico de este nuevo virus se justifica el uso de vacunación en los grupos de riesgo previamente descritos y el tratamiento con antivirales en los pacientes que cursan con enfermedad grave o con riesgo de evolucionar a una enfermedad más complicada. Abstract in english During year 2009 our nation experimented the first influenza pandemic wave due to the novel influenza A (H1N1) 2009 virus that emerged in the Northern hemisphere at the end of April, 2009. Estimated attack rate was about 6 to 12% affecting mainly to schoolchildren who presented with a mild disease. [...] Age groups with highest risk of hospitalization were elderly people and children under 5 years old. Elderly patients and patients with co-morbidities had the highest risk to die. We have learnt that clinical diagnosis of influenza has a laboratory confirmation in about 80% of cases but its correlation is lower in kids under 5 years old, especially in infants when RSV co-circulates with influenza virus. Laboratory diagnostic methods like DFA and immuno-cromatography have about 80% of sensitivity but a significantly lower rate in elderly patients compared to PCR. The clinical impact of this new virus justifies the recommendation to vaccinate traditionally established risk groups and to prescribe antiviral treatment to patients that acquire severe influenza or have risk factors to progress to complications.

  13. Influenza pandémica a un año de la primera ola: ¿Qué podemos decir ahora? Pandemic influenza one year after the first wave: What did we learn?

    Directory of Open Access Journals (Sweden)

    Cecilia Perret P

    2010-04-01

    Full Text Available Durante el año 2009 nuestro país vivió la primera ola pandémica causada por el nuevo virus de influenza A (H1N1 2009 aparecido en el hemisferio norte a fines de abril del ese año. La tasa de ataque estimada fue entre 6 a 12% afectando más frecuentemente a los escolares quienes presentaron una enfermedad leve. Los grupos etáreos con mayor riesgo de hospitalización fueron los adultos mayores y los niños bajo 5 años de edad. Tuvieron mayor riesgo de fallecer los adultos mayores y aquellas personas con una co-morbilidad asociada. Aprendimos que el diagnóstico clínico de influenza se confirma por laboratorio en alrededor del 80% pero tiene una baja correlación en los niños bajo 5 años de edad, especialmente en lactantes bajo 1 año de edad, al circular concomitantemente con VRS. Los métodos de diagnóstico como la IFD y los inmunocromatográficos tienen una sensibilidad que no supera el 80% y es muy baja en los adultos mayores cuando se compara con PCR. Dado el impacto clínico de este nuevo virus se justifica el uso de vacunación en los grupos de riesgo previamente descritos y el tratamiento con antivirales en los pacientes que cursan con enfermedad grave o con riesgo de evolucionar a una enfermedad más complicada.During year 2009 our nation experimented the first influenza pandemic wave due to the novel influenza A (H1N1 2009 virus that emerged in the Northern hemisphere at the end of April, 2009. Estimated attack rate was about 6 to 12% affecting mainly to schoolchildren who presented with a mild disease. Age groups with highest risk of hospitalization were elderly people and children under 5 years old. Elderly patients and patients with co-morbidities had the highest risk to die. We have learnt that clinical diagnosis of influenza has a laboratory confirmation in about 80% of cases but its correlation is lower in kids under 5 years old, especially in infants when RSV co-circulates with influenza virus. Laboratory diagnostic methods like DFA and immuno-cromatography have about 80% of sensitivity but a significantly lower rate in elderly patients compared to PCR. The clinical impact of this new virus justifies the recommendation to vaccinate traditionally established risk groups and to prescribe antiviral treatment to patients that acquire severe influenza or have risk factors to progress to complications.

  14. The elusive definition of pandemic influenza / L'insaisissable définition de la grippe pandémique / La evasiva definición de la gripe pandémica

    Scientific Electronic Library Online (English)

    Peter, Doshi.

    2011-07-01

    Full Text Available Durante el pasado año, fundamentalmente en Europa, se generó una considerable polémica sobre si la Organización Mundial de la Salud (OMS) habría cambiado su definición de gripe pandémica en el año 2009, tras la identificación de la nueva gripe H1N1. Algunos argumentan que no solo se cambió la defini [...] ción, sino que se hizo para despejar el camino hacia la declaración de una pandemia. Otros aseguran que la definición nunca se cambió y que esta alegación está completamente infundada. Estos puntos de vista tan opuestos han dificultado nuestra capacidad para extraer conclusiones relevantes. Este callejón sin salida, unido a las preocupaciones sobre los posibles conflictos de intereses y las dudas sobre la proporcionalidad de la respuesta al brote de la gripe H1N1, ha menoscabado la confianza de la población en los responsables de la salud y en nuestra capacidad colectiva para responder con eficacia a futuras amenazas de este tipo. La OMS no cambió su definición de gripe pandémica por el simple motivo de que nunca antes había definido formalmente el concepto de gripe pandémica. Si bien la OMS ha propuesto numerosas descripciones de gripe pandémica, nunca estableció una definición formal y los criterios para la declaración de una pandemia provocada por el virus H1N1 procedían de las definiciones de «fase de alerta pandémica», no de una definición de «gripe pandémica». El hecho de no contar con una definición formal de gripe pandémica, a pesar del bagaje de los diez años de actividades de preparación contra las pandemias, revela importantes suposiciones subyacentes sobre la naturaleza de esta enfermedad infecciosa. En particular, las limitaciones de los enfoques «centrados en el virus» reclaman una mayor atención y se debe informar sobre los esfuerzos que se realicen para «aprender las lecciones» que dirijan nuestra respuesta ante los futuros brotes de nuevas enfermedades infecciosas. Abstract in english There has been considerable controversy over the past year, particularly in Europe, over whether the World Health Organization (WHO) changed its definition of pandemic influenza in 2009, after novel H1N1 influenza was identified. Some have argued that not only was the definition changed, but that it [...] was done to pave the way for declaring a pandemic. Others claim that the definition was never changed and that this allegation is completely unfounded. Such polarized views have hampered our ability to draw important conclusions. This impasse, combined with concerns over potential conflicts of interest and doubts about the proportionality of the response to the H1N1 influenza outbreak, has undermined the public trust in health officials and our collective capacity to effectively respond to future disease threats. WHO did not change its definition of pandemic influenza for the simple reason that it has never formally defined pandemic influenza. While WHO has put forth many descriptions of pandemic influenza, it has never established a formal definition and the criteria for declaring a pandemic caused by the H1N1 virus derived from "pandemic phase" definitions, not from a definition of "pandemic influenza". The fact that despite ten years of pandemic preparedness activities no formal definition of pandemic influenza has been formulated reveals important underlying assumptions about the nature of this infectious disease. In particular, the limitations of "virus-centric" approaches merit further attention and should inform ongoing efforts to "learn lessons" that will guide the response to future outbreaks of novel infectious diseases.

  15. Extension and verification of the SEIR model on the 2009 influenza A (H1N1) pandemic in Japan.

    Science.gov (United States)

    Saito, Masaya M; Imoto, Seiya; Yamaguchi, Rui; Sato, Hiroki; Nakada, Haruka; Kami, Masahiro; Miyano, Satoru; Higuchi, Tomoyuki

    2013-11-01

    In order to understand the evolution of the 2009 influenza A (H1N1) pandemic within local regions of Japan, we studied the significance of regional migration between these regions. For this purpose, we have employed an extended SEIR model to describe the immigration of infected people and the stochastic variation of the infectious efficiency. We then applied a data assimilation technique in order to study how the agreement of the simulation results with the observed data depends on the presence/absence of immigration and the degree of variation of the infectious efficiency. Reproducibility is evaluated by log-likelihood values. The log-likelihood does not indicate the significance of immigration. Although there are multiple waves in the time course of the number of reported infected individuals, these waves could be explained by the stochastic nature of infectious events. PMID:24012502

  16. Burden of influenza, healthcare seeking behaviour and hygiene measures during the A(H1N12009 pandemic in France: a population based study

    Directory of Open Access Journals (Sweden)

    Van Cauteren Dieter

    2012-11-01

    Full Text Available Abstract Background Influenza surveillance systems do not allow the identification of the true burden of illness caused by influenza in the community because they are restricted to consulting cases. A study was conducted to estimate the incidence and the burden of self-defined influenza, and to describe healthcare seeking behavior for self-defined influenza during the A(H1N12009 pandemic in the French population. Methods We conducted a random-based retrospective cross-sectional telephone survey between May 2009 and April 2010 among a random sample of the French population. Results For the 10 076 people included, 107 episodes of self-defined influenza were reported. The annual incidence of self-defined influenza was estimated at 13 942 cases per 100 000 inhabitants (CI95% 10 947 – 16 961, 62.1% (CI95% 50.5 – 72.5 of cases consulted a physician and 11.3% (CI95% 5.5 - 21.7 used a face mask. Following recommendations, 37.5% (CI95% 35.5 – 39.5 of people in the survey reported washing their hands more often during the pandemic season, and there was a positive association with being vaccinated against A(H1N12009 influenza, being a women, being a child ( Conclusions Self-defined influenza causes a significant burden of illness in the French population and is a frequent cause for consultation. These results allow a more accurate interpretation of influenza surveillance data and an opportunity to adapt future health education messages.

  17. Surveillance of hospitalizations with pandemic A(H1N1 2009 influenza infection in Queensland, Australia

    Directory of Open Access Journals (Sweden)

    Frances Birrell

    2011-05-01

    Full Text Available Objective : To describe the demographic and clinical characteristics of patients hospitalized with pandemic A(H1N1 2009 infection in Queensland, Australia between 25 May and 3 October 2009 and to examine the relationship between timing of antiviral treatment and severity of illness.Method: Using data from the Queensland Health EpiLog information system, descriptive analysis and logistic regression modelling were used to describe and model factors which influence patient outcomes (death, admission to intensive care unit and/or special care unit. Data on patients admitted to hospital in Queensland with confirmed pandemic A(H1N1 2009 infection were included in this analysis.Results: 1236 patients with pandemic A(H1N1 2009 infection were admitted to hospitals in Queensland during the study period. Of the total group: 15% were admitted to an intensive care unit or special care unit; 3% died; 34% were under the age of 18 years and 8% were 65 years of age or older; and 55% had at least one underlying medical condition. Among the 842 patients for whom data were available regarding the use of antiviral drugs, antiviral treatment was initiated in 737 (87.5% patients with treatment commencing at a median of one day (range 1–33 days after onset of illness. Admission to an intensive care unit or special care unit (ICU/SCU or death was significantly associated with increased age, lack of timeliness of antiviral treatment, chronic renal disease and morbid obesity.Discussion: Early antiviral treatment was significantly associated with lower likelihood of ICU/SCU admission or death. Early antiviral treatment for influenza cases may therefore have important public health implications.

  18. A proposed non-consequentialist policy for the ethical distribution of scarce vaccination in the face of an influenza pandemic.

    Science.gov (United States)

    McLachlan, Hugh V

    2012-05-01

    The current UK policy for the distribution of scarce vaccination in an influenza pandemic is ethically dubious. It is based on the planned outcome of the maximum health benefit in terms of the saving of lives and the reduction of illness. To that end, the population is classified in terms of particular priority groups. An alternative policy with a non-consequentialist rationale is proposed in the present work. The state should give the vaccination, in the first instance, to those who are at risk of catching the pandemic flu in the line of their duties of public employment. Thereafter, if there is not sufficient vaccine to give all citizens equally an effective dose, the state should give all citizens an equal chance of receiving an effective dose. This would be the just thing to do because the state has a duty to treat each and all of its citizens impartially and they have a corresponding right to such impartial treatment. Although this article specifically refers to the UK, it is considered that the suggested alternative policy would be applicable generally. The duty to act justly is not merely a local one. PMID:22411748

  19. Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010.

    Science.gov (United States)

    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

    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

  20. [Attitudes and side effects related to pandemic influenza A (H1N1) vaccination in healthcare personnel].

    Science.gov (United States)

    Ormen, Bahar; Türker, Nesrin; Vardar, Ilknur; Kaptan, Figen; El, Sibel; Ural, Serap; Kaya, Fatih; Co?kun, Nejat Ali

    2012-01-01

    The aims of this study were to evaluate the attitudes towards H1N1 vaccination and to determine the safety and side effects following 2009 pandemic influenza A (H1N1) vaccination. Pandemic influenza vaccine had been administered to the healthcare personnel in our research and training hospital in December 2009. The rate being vaccinated was established as 40% (800/2000). Four months following vaccination, the opinions about vaccination were asked to the healthcare workers, and also side effects were questioned to the vaccinated group. Two different questionnaires (for vaccinated and unvaccinated subjects) were delivered to the volunteers who agreed to participate in the study. Demographic features, reasons related to being vaccinated or not, were questioned. The vaccinated group was also questioned for the presence of chronic diseases, previous vaccinations (pandemic/seasonal influenza), local or systemic reactions that develop after vaccination. A total of 332 volunteers participated in the questionnaire. Of them 247 (74.4%) were vaccinated and 85 (25.6%) were unvaccinated. Male/female ratio of the participants was 1.2, and 55.7% of them were older than 30-year-old. Most of the participants (82.8%) were highly educated (high school and faculty-graduated). Vaccination rates were found statistically significant in advanced age group compared to young adults (p= 0.042); in male gender compared to females (p= 0.001) and in parents compared to subjects who didn't have children (p= 0.021). Vaccination rates were observed to be higher (57.5%) in non-medical staff (cleaning employers, administrative personnel, etc.) than the physicians (29.1%) and nurses (13.4%), and the rate was also high (54.7%) in personnel who worked in intensive care units, emergency department and administrative units than the personnel who worked in the clinics of internal medicine (22.3%) and surgery (23.1%) (p= 0.001). The most important causes of rejecting vaccination were being afraid of the side effects (69.4%) and not believing the effectiveness of the vaccine (56.4%). The leading causes of accepting vaccination were worries about infecting their family (60.3%) and being in a risk group (54.3%). After vaccination, local reactions (pain, swelling and redness at the vaccination site) were described in 43.3% and systemic reactions (weakness, fatigue, muscle aches, influenza-like symptoms, etc.) were described in 43.7% of the subjects. Severe side effects such as vasculitis, neuritis, encephalomyelitis, Guillian-Barre syndrome and anaphylactic reaction were not observed in any of the vaccinated cases. It was detected that worries about the safety of vaccine had negative impact for vaccination. Since no serious side effects were detected related to vaccination, it was concluded that the vaccine was safe. In spite of the scientific proofs, negative concerns about the safety of the vaccines can unfavorably affect the vaccination campaigns and can jeopardize efforts of influenza control. As a result, data collection systems about the safety and side effects of the vaccine all over the country and regular reports about these data may more efficiently guide vaccination programs in the future. PMID:22399172

  1. Tracking oseltamivir-resistance in New Zealand influenza viruses during a medicine reclassification in 2007, a resistant-virus importation in 2008 and the 2009 pandemic

    Directory of Open Access Journals (Sweden)

    Q Sue Huang

    2012-10-01

    Full Text Available Introduction: Oseltamivir (Tamiflu® is an important pharmaceutical intervention against the influenza virus. The importance of surveillance for resistance to oseltamivir has been highlighted by two global events: the emergence of an oseltamivir-resistant seasonal influenza A(H1N1 virus in 2008, and emergence of the influenza A(H1N1pdm09 virus in 2009. Oseltamivir is a prescription medicine in New Zealand, but more timely access has been provided since 2007 by allowing pharmacies to directly dispense oseltamivir to patients with influenza-like illness.Objective: To determine the frequency of oseltamivir-resistance in the context of a medicine reclassification in 2007, the importation of an oseltamivir-resistant seasonal influenza virus in 2008, and the emergence of a pandemic in 2009.Methods: A total of 1795 influenza viruses were tested for oseltamivir-resistance using a fluorometric neuraminidase inhibition assay. Viruses were collected as part of a sentinel influenza surveillance programme between the years 2006 and 2010.Results: All influenza B, influenza A(H3N2 and influenza A(H1N1pdm09 viruses tested between 2006 and 2010 were shown to be sensitive to oseltamivir. Seasonal influenza A(H1N1 viruses from 2008 and 2009 were resistant to oseltamivir. Sequencing of the neuraminidase gene showed that the resistant viruses contained an H275Y mutation, and S247N was also identified in the neuraminidase gene of one seasonal influenza A(H1N1 virus that exhibited enhanced resistance.Discussion: No evidence was found to suggest that increased access to oseltamivir has promoted resistance. A probable importation event was documented for the global 2008 oseltamivir-resistant seasonal A(H1N1 virus nine months after it was first reported in Europe in January 2008.

  2. A/H1N1 pandemic influenza vaccination: A retrospective evaluation of adverse maternal, fetal and neonatal outcomes in a cohort of pregnant women in Italy.

    Science.gov (United States)

    Fabiani, Massimo; Bella, Antonino; Rota, Maria C; Clagnan, Elena; Gallo, Tolinda; D'Amato, Maurizio; Pezzotti, Patrizio; Ferrara, Lorenza; Demicheli, Vittorio; Martinelli, Domenico; Prato, Rosa; Rizzo, Caterina

    2015-05-01

    Although concerns about safety of influenza vaccination during pregnancy have been raised in the past, vaccination of pregnant women was recommended in many countries during the 2009 A/H1N1 pandemic influenza. A retrospective cohort study was conducted to evaluate the risk of adverse maternal, fetal and neonatal outcomes among pregnant women vaccinated with a MF59-adjuvanted A/H1N1 pandemic influenza vaccine. The study was carried out in four Italian regions (Piemonte, Friuli-Venezia-Giulia, Lazio, and Puglia) among 102,077 pregnant women potentially exposed during the second or third trimester of gestation to the vaccination campaign implemented in 2009/2010. Based on data retrieved from the regional administrative databases, the statistical analysis was performed using the Cox proportional-hazards model, adjusting for the propensity score to account for the potential confounding effect due to the socio-demographic characteristics and the clinical and reproductive history of women. A total of 100,332 pregnant women were eligible for the analysis. Of these, 2003 (2.0%) received the A/H1N1 pandemic influenza vaccination during the second or third trimester of gestation. We did not observe any statistically significant association between the A/H1N1 pandemic influenza vaccination and different maternal outcomes (hospital admissions for influenza, pneumonia, hypertension, eclampsia, diabetes, thyroid disease, and anaemia), fetal outcomes (fetal death after the 22nd gestational week) and neonatal outcomes (pre-term birth, low birth weight, low 5-min Apgar score, and congenital malformations). Pre-existing health-risk conditions (hospital admissions and drug prescriptions for specific diseases before the onset of pregnancy) were observed more frequently among vaccinated women, thus suggesting that concomitant chronic conditions increased vaccination uptake. The results of this study add some evidence on the safety of A/H1N1 pandemic influenza vaccination during pregnancy but, because of the reduced statistical power, meta-analyses and large multi-centres studies are needed in order to obtain more conclusive results, especially for rare outcomes. PMID:25820060

  3. Novel host markers in the 2009 pandemic H1N1 influenza a virus

    Directory of Open Access Journals (Sweden)

    Wei Hu

    2010-06-01

    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.

  4. [Pandemic influenza A (H1N1)v vaccination status and factors affecting vaccination: Ankara and Diyarbak?r 2009 data from Turkey].

    Science.gov (United States)

    Ertek, Mustafa; Sevencan, Funda; Kalayc?o?lu, Handan; Gözalan, Ay?egül; Sim?ek, Ci?dem; Culha, Gönül; Dorman, Vedat; Ozlü, Ahmet; Ar?kan, Füsun; Akta?, Dilber; Ak?n, Levent; Korukluo?lu, Gülay; Sevindi, Demet Furkan

    2011-10-01

    In this study, it was aimed to determine the frequency of the symptoms of influenza-like illness during influenza A (H1N1)v pandemic in two provinces where sentinel influenza surveillance was conducted and also to obtain opinions about H1N1 influenza and vaccination, H1N1 vaccination status and factors affecting vaccination. This cross-sectional study was conducted in the provinces of Ankara (capital city, located at Central Anatolia) and Diyarbak?r (located at southeastern Anatolia). It was planned to include 455 houses in Ankara and 276 houses in Diyarbak?r. The household participation rate in the study was 78.9% and 53.6% for Ankara and Diyarbak?r, respectively. Our study was carried out between January-February 2010, with 1164 participants from Ankara and 804 from Diyarbak?r, including every household subjects except for infants younger than 11 months and patients with primary/secondary immunodeficiency diseases. Data was collected by site teams consisting of a physician and a healthcare staff with informed consent. Of the participants 45.5% from Ankara and 35.3% from Diyarbak?r stated that they had gone through an influenza-like illness. The most frequently indicated clinical symptoms were fatigue/weakness, rhinitis, sore throat and cough. The rates of admission to a physician with influenza like illness complaints were 50.6% and 58.7%; rates of hospitalization due to influenza-like illness were 1% and 1.5%, and rates of antiviral drug use were 3.8% and 1.9%, in Ankara ve Diyarbak?r participants, respectively. The rate of personal precautions taken by the subjects for prevention from pandemic influenza were 59% and 53.3%, in Ankara and Diyarbak?r, respectively. These precautions most frequently were "hand washing" and "avoiding crowded public areas". H1N1 influenza vaccine was applied in 9.3% of the participants in Ankara and in 3.7% of the participants in Diyarbak?r. Vaccination rate was higher in both of the provinces in adults over 25 years old than children and adolescents and in patients with chronic underlying disease. None of the 25 pregnant participants were vaccinated against pandemic influenza. The educational background, employment status and quality of the job have been detected as factors affecting the status of being vaccinated with H1N1 influenza vaccine in both provinces. In addition, the percentage of having H1N1 influenza vaccination was found to be higher in subjects who had seasonal influenza vaccination previously and in 2009, than those who had not, and this difference was statistically significant in both provinces (Ankara pdata emphasized the insufficient awareness of our population about the importance of pandemic influenza and vaccine. It is also believed that possible case definition in H1N1 case management scheme should be revised. In conclusion an important part of pandemic preparation plans is risk communication with the public to increase awareness and to prevent the missed opportunities. PMID:22090299

  5. Chile entre pandemias: la influenza de 1918, globalización y la nueva medicina / Chile between pandemic: the influenza of 1918, globalization and the new medicine

    Scientific Electronic Library Online (English)

    Marcelo, López; Miriam, Beltrán.

    2013-04-01

    Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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. Abstract in english 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.

  6. Early host responses of seasonal and pandemic influenza A viruses in primary well-differentiated human lung epithelial cells.

    Science.gov (United States)

    Gerlach, Rachael L; Camp, Jeremy V; Chu, Yong-Kyu; Jonsson, Colleen B

    2013-01-01

    Replication, cell tropism and the magnitude of the host's antiviral immune response each contribute to the resulting pathogenicity of influenza A viruses (IAV) in humans. In contrast to seasonal IAV in human cases, the 2009 H1N1 pandemic IAV (H1N1pdm) shows a greater tropism for infection of the lung similar to H5N1. We hypothesized that host responses during infection of well-differentiated, primary human bronchial epithelial cells (wd-NHBE) may differ between seasonal (H1N1 A/BN/59/07) and H1N1pdm isolates from a fatal (A/KY/180/10) and nonfatal (A/KY/136/09) case. For each virus, the level of infectious virus and host response to infection (gene expression and apical/basal cytokine/chemokine profiles) were measured in wd-NHBE at 8, 24, 36, 48 and 72 hours post-infection (hpi). At 24 and 36 hpi, KY/180 showed a significant, ten-fold higher titer as compared to the other two isolates. Apical cytokine/chemokine levels of IL-6, IL-8 and GRO were similar in wd-NHBE cells infected by each of these viruses. At 24 and 36 hpi, NHBE cells had greater levels of pro-inflammatory cytokines including IFN-?, CCL2, TNF-?, and CCL5, when infected by pandemic viruses as compared with seasonal. Polarization of IL-6 in wd-NHBE cells was greatest at 36 hpi for all isolates. Differential polarized secretion was suggested for CCL5 across isolates. Despite differences in viral titer across isolates, no significant differences were observed in KY/180 and KY/136 gene expression intensity profiles. Microarray profiles of wd-NHBE cells diverged at 36 hpi with 1647 genes commonly shared by wd-NHBE cells infected by pandemic, but not seasonal isolates. Significant differences were observed in cytokine signaling, apoptosis, and cytoskeletal arrangement pathways. Our studies revealed differences in temporal dynamics and basal levels of cytokine/chemokine responses of wd-NHBE cells infected with each isolate; however, wd-NHBE cell gene intensity profiles were not significantly different between the two pandemic isolates suggesting post-transcriptional or later differences in viral-host interactions. PMID:24244384

  7. Fatal acute myocarditis and fulminant hepatic failure in an infant with pandemic human influenza A, H1N1 (2009 virus infection

    Directory of Open Access Journals (Sweden)

    Mortada H.F. El-Shabrawi

    2011-04-01

    Full Text Available We report the clinical presentation of a 10 month-old infant who succumbed with acute myocarditis and fulminant hepatic failure associated with a virologically confirmed human influenza A, H1N1 (2009 virus infection. To date, this is the first pediatric patient presenting with this fatal combination of complications during the current H1N1 pandemic. Therefore, we recommend meticulous assessment and follow up of the cardiac status, liver enzymes and coagulation profile in all pediatric patients with severe H1N1 influenza infection.

  8. The neuraminidase and matrix genes of the 2009 pandemic influenza H1N1 virus cooperate functionally to facilitate efficient replication and transmissibility in pigs

    OpenAIRE

    Ma, Wenjun; Liu, Qinfang; Bawa, Bhupinder; Qiao, Chuanling; Qi, Wenbao; Shen, Huigang; Chen, Ying; Ma, Jingqun; Li, Xi; Webby, Richard J.; Garci?a-sastre, Adolfo; Richt, Ju?rgen A.

    2012-01-01

    The 2009 pandemic H1N1 virus (pH1N1) contains neuraminidase (NA) and matrix (M) genes from Eurasian avian-like swine influenza viruses (SIVs), with the remaining six genes from North American triple-reassortant SIVs. To characterize the role of the pH1N1 NA and M genes in pathogenesis and transmission, their impact was evaluated in the background of an H1N1 triple-reassortant (tr1930) SIV in which the HA (H3) and NA (N2) of influenza A/swine/Texas/4199-2/98 virus were replaced with those from...

  9. Effect of Priming with H1N1 Influenza Viruses of Variable Antigenic Distances on Challenge with 2009 Pandemic H1N1 Virus

    OpenAIRE

    O Donnell, Christopher D.; Wright, Amber; Vogel, Leatrice N.; Wei, Chih-jen; Nabel, Gary J.; Subbarao, Kanta

    2012-01-01

    Compared to seasonal influenza viruses, the 2009 pandemic H1N1 (pH1N1) virus caused greater morbidity and mortality in children and young adults. People over 60 years of age showed a higher prevalence of cross-reactive pH1N1 antibodies, suggesting that they were previously exposed to an influenza virus or vaccine that was antigenically related to the pH1N1 virus. To define the basis for this cross-reactivity, ferrets were infected with H1N1 viruses of variable antigenic distance that circulat...

  10. PB2 Residue 158 Is a Pathogenic Determinant of Pandemic H1N1 and H5 Influenza A Viruses in Mice ? ‡

    OpenAIRE

    Zhou, Bin; Li, Yan; Halpin, Rebecca; Hine, Erin; Spiro, David J.; Wentworth, David E.

    2010-01-01

    Influenza A viruses are human and animal pathogens that cause morbidity and mortality, which range from mild to severe. The 2009 H1N1 pandemic was caused by the emergence of a reassortant H1N1 subtype (H1N1pdm) influenza A virus containing gene segments that originally circulated in human, avian, and swine virus reservoirs. The molecular determinants of replication and pathogenesis of H1N1pdm viruses in humans and other mammals are poorly understood. Therefore, we set out to elucidate viral d...

  11. Receptor Specificity does not affect Replication or Virulence of the 2009 Pandemic H1N1 Influenza Virus in Mice and Ferrets

    OpenAIRE

    Lakdawala, Seema S.; Shih, Angela R.; Jayaraman, Akila; Lamirande, Elaine W.; Moore, Ian; Paskel, Myeisha; Sasisekharan, Ram; Subbarao, Kanta

    2013-01-01

    Human influenza viruses predominantly bind ?2,6 linked sialic acid (SA) while avian viruses bind ?2,3 SA-containing complex glycans. Virulence and tissue tropism of influenza viruses have been ascribed to this binding preference. We generated 2009 pandemic H1N1 (pH1N1) viruses with either predominant ?2,3 or ?2,6 SA binding and evaluated these viruses in mice and ferrets. The ?2,3 pH1N1 virus had similar virulence in mice and replicated to similar titers in the respiratory tract of mice ...

  12. Age- Matched Comparison of Children Hospitalized for 2009 Pandemic H1N1 Influenza with Those Hospitalized for Seasonal H1N1 and H3N2.

    OpenAIRE

    Chiu, Susan S.; Chan, Kwok-hung; Wong, Wilfred H. S.; Chan, Eunice L. Y.; Peiris, J. S. M.

    2011-01-01

    BACKGROUND: A wide spectrum of clinical manifestation ranging from deaths to a mild course of disease has been reported in children infected with the 2009 pandemic H1N1 (pH1N1) influenza. METHODOLOGY/MAJOR FINDINGS: We conducted an age-matched control study comparing children hospitalized for pH1N1 with historic controls infected with seasonal H1N1 and H3N2 influenza to correct for the effect of age on disease susceptibility and clinical manifestations. We also compared children with pH1N1 to...

  13. Prior infection with classical swine H1N1 influenza viruses is associated with protective immunity to the 2009 pandemic H1N1 virus

    OpenAIRE

    Kash, John C.; Qi, Li; Dugan, Vivien G.; Jagger, Brett W.; Hrabal, Rachel J.; Memoli, Matthew J.; Morens, David M.; Taubenberger, Jeffery K.

    2010-01-01

    In a mouse challenge study with the 2009 pandemic H1N1 virus, we evaluated protective immune responses elicited by prior infection with human and swine influenza A viruses. Mice infected with A/Mexico/4108/2009 (Mex09) showed significant weight loss and 40% mortality. Prior infection with a 1976 classical swine H1N1 virus resulted in complete protection from Mex09 challenge. Prior infection with either a 2009 or a 1940 seasonal H1N1 influenza virus provided partial protection and a >100-fold ...

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

    OpenAIRE

    Blower Sally; Wagner Bradley G; Coburn Brian J

    2009-01-01

    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 e...

  15. Estimating the value of containment strategies in delaying the arrival time of an influenza pandemic: A case study of travel restriction and patient isolation

    CERN Document Server

    Wang, Lin; Huang, Tianyi; Li, Xiang; 10.1103/PhysRevE.86.032901

    2012-01-01

    With a simple phenomenological metapopulation model, which characterizes the invasion process of an influenza pandemic from a source to a subpopulation at risk, we compare the efficiency of inter- and intra-population interventions in delaying the arrival of an influenza pandemic. We take travel restriction and patient isolation as examples, since in reality they are typical control measures implemented at the inter- and intra-population levels, respectively. We find that the intra-population interventions, e.g., patient isolation, perform better than the inter-population strategies such as travel restriction if the response time is small. However, intra-population strategies are sensitive to the increase of the response time, which might be inevitable due to socioeconomic reasons in practice and will largely discount the efficiency.

  16. Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus

    Directory of Open Access Journals (Sweden)

    Chong Ka Chun

    2012-11-01

    Full Text Available Abstract Background During the early stages of a new influenza pandemic, travel restriction is an immediate and non-pharmaceutical means of retarding incidence growth. It extends the time frame of effective mitigation, especially when the characteristics of the emerging virus are unknown. In the present study, we used the 2009 influenza A pandemic as a case study to evaluate the impact of regulating air, sea, and land transport. Other government strategies, namely, antivirals and hospitalizations, were also evaluated. Methods Hong Kong arrivals from 44 countries via air, sea, and land transports were imported into a discrete stochastic Susceptible, Exposed, Infectious and Recovered (SEIR host-flow model. The model allowed a number of latent and infectious cases to pass the border, which constitutes a source of local disease transmission. We also modeled antiviral and hospitalization prevention strategies to compare the effectiveness of these control measures. Baseline reproduction rate was estimated from routine surveillance data. Results Regarding air travel, the main route connected to the influenza source area should be targeted for travel restrictions; imposing a 99% air travel restriction delayed the epidemic peak by up to two weeks. Once the pandemic was established in China, the strong land connection between Hong Kong and China rendered Hong Kong vulnerable. Antivirals and hospitalization were found to be more effective on attack rate reductions than travel restrictions. Combined strategies (with 99% restriction on all transport modes deferred the peak for long enough to establish a vaccination program. Conclusion The findings will assist policy-makers with decisions on handling similar future pandemics. We also suggest regulating the extent of restriction and the transport mode, once restriction has been deemed necessary for pandemic control. Although travel restrictions have yet to gain social acceptance, they allow time for mitigation response when a new and highly intrusive virus emerges.

  17. Influenza. Vacunas clásicas y novedosas a las puertas de otra pandemia / Influenza. Classic and novel vaccines on the verge of another pandemic

    Scientific Electronic Library Online (English)

    Raiza, Martínez; Nevis, Amín; Alicia, Aguilar; Frank, Camacho; Ela María, Pérez.

    2006-08-01

    Full Text Available Los virus de la influenza A, además del hombre, infectan otros mamíferos y una gran variedad de especies de aves. Desde 1997 se sabe que cepas aviares son capaces de infectar al hombre provocando una enfermedad generalmente leve. El brote actual de gripe aviar H5N1 en humanos ha puesto en alerta a l [...] a comunidad científica internacional, no solo por su elevada mortalidad sino por su potencialidad en la generación de una nueva pandemia. Las autoridades sanitarias han puesto en marcha un amplio programa para la preparación ante esta contingencia, que abarca diferentes campos, desde el diagnóstico y la detección precoz de los brotes tanto en animales como en humanos, la caracterización sistemática de las cepas circulantes, el sacrificio de aves infectadas, la producción masiva de antivirales y por supuesto el desarrollo y producción a gran escala de vacunas eficaces. En este último tema se trabaja intensamente tanto en el mejoramiento de las vacunas ya existentes como en la búsqueda de alternativas basadas en tecnologías de nueva generación. Abstract in english Influenza A viruses infect humans and other mammalian and bird species. Since 1997, it has been known that some avian strains were able to infect humans, generally causing a mild disease.The present H5N1 avian influenza outbreak has led to a heightened level of awareness of the scientific and public [...] health officials, not only because of its high mortality, but also because of its potential to trigger a new pandemic. In response to this emerging threat, the international sanitary authorities are developing a wide preparation program, which involving different measures such as the accurate diagnosis of animal and human outbreaks; systematic characterization of circulating strains; elimination of infected birds; mass production of antiviral drugs,and research,development and large scale production of efficacious vaccines. In the last aspect, great effort is being carried out for the improvement of classic vaccines and in the search for alternatives based on new technologies.

  18. Knowledge, attitudes and practices towards pandemic influenza among cases, close contacts, and healthcare workers in tropical Singapore: a cross-sectional survey

    OpenAIRE

    Lee Vernon J; Yap Jonathan; Yau Teng; Ng Tze; Tor Phern-Chern

    2010-01-01

    Abstract Background Effective influenza pandemic management requires understanding of the factors influencing behavioral changes. We aim to determine the differences in knowledge, attitudes and practices in various different cohorts and explore the pertinent factors that influenced behavior in tropical Singapore. Methods We performed a cross-sectional knowledge, attitudes and practices survey in the Singapore military from mid-August to early-October 2009, among 3054 personnel in four exposur...

  19. Disparities among 2009 Pandemic Influenza A (H1N1) Hospital Admissions: A Mixed Methods Analysis – Illinois, April–December 2009

    OpenAIRE

    Soyemi, Kenneth; Medina-marino, Andrew; Sinkowitz-cochran, Ronda; Schneider, Amy; Njai, Rashid; Mcdonald, Marian; Glover, Maleeka; Garcia, Jocelyn; Aiello, Allison E.

    2014-01-01

    During late April 2009, the first cases of 2009 pandemic influenza A (H1N1) (pH1N1) in Illinois were reported. On-going, sustained local transmission resulted in an estimated 500,000 infected persons. We conducted a mixed method analysis using both quantitative (surveillance) and qualitative (interview) data; surveillance data was used to analyze demographic distribution of hospitalized cases and follow-up interview data was used to assess health seeking behavior. Invitations to participate i...

  20. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in an university hospital of Morocco

    OpenAIRE

    Louriz Maha; Mahraoui Chafiq; Azzouzi Abderrahim; El Fassy Fihri Mohamed Taoufiq; Zeggwagh Amine Ali; Abidi Khalid; Ferhati Driss; Echcherif El Kettani Salma; Tachinante Rajae; Belayachi Jihane; Zekraoui Aicha; Sefiani Yasser; Charif Chefchaouni Al Mountacer; Abouqal Redouane

    2010-01-01

    Abstract Background The first case of 2009 pandemic influenza A (H1N1) virus infection in our center was documented on June 15. Subsequently, persons with suspected cases of infection and contacts of those with suspected infection were tested. Persons in whom infection was confirmed were hospitalized and quarantined, and some of them were closely observed for the purpose of investigating the nature and duration of the disease. The aim of the present study was to describe baseline characterist...

  1. Have the public's expectations for antibiotics for acute uncomplicated respiratory tract infections changed since the H1N1 influenza pandemic? A qualitative interview and quantitative questionnaire study.

    OpenAIRE

    Mcnulty, C.; Joshi, P.; Butler, Cc; Atkinson, L.; Nichols, T; Hogan, A.; French, D.

    2012-01-01

    OBJECTIVE: To investigate the effect of the H1N1 influenza pandemic on the public's expectations for a general practice consultation and antibiotic for acute respiratory illness. DESIGN: Mixed methods. PARTICIPANTS: Qualitative interviews: 17 participants with acute respiratory tract infection (RTI) visiting English pharmacies. Face-to-face survey: about 1700 adults aged 15?years and older were recruited from households in England in January 2008, 2009 and 2011. RESULTS: The qualitative dat...

  2. Utility of Pandemic H1N1 2009 Influenza Virus Recombinant Hemagglutinin Protein-Based Enzyme-Linked Immunosorbent Assay for Serosurveillance ?

    OpenAIRE

    Arankalle, V. A.; Virkar, R. G.; Tandale, B. V.; Ingle, N. B.

    2010-01-01

    An enzyme-linked immunosorbent assay (ELISA) for the detection of IgG antibodies against the pandemic H1N1 2009 influenza A virus, employing a recombinant hemagglutinin protein of the virus, was compared to the hemagglutination inhibition (HI) test using 783 serum samples. The results showed a concordance of 98.4%, suggesting the utility of the ELISA in serosurveillance. Two hundred sixty-nine (100%) serum samples with an HI titer of ?20 were ELISA reactive.

  3. Utility of pandemic H1N1 2009 influenza virus recombinant hemagglutinin protein-based enzyme-linked immunosorbent assay for serosurveillance.

    Science.gov (United States)

    Arankalle, V A; Virkar, R G; Tandale, B V; Ingle, N B

    2010-09-01

    An enzyme-linked immunosorbent assay (ELISA) for the detection of IgG antibodies against the pandemic H1N1 2009 influenza A virus, employing a recombinant hemagglutinin protein of the virus, was compared to the hemagglutination inhibition (HI) test using 783 serum samples. The results showed a concordance of 98.4%, suggesting the utility of the ELISA in serosurveillance. Two hundred sixty-nine (100%) serum samples with an HI titer of > or =20 were ELISA reactive. PMID:20631333

  4. The Modes of Evolutionary Emergence of Primal and Late Pandemic Influenza Virus Strains from Viral Reservoir in Animals: An Interdisciplinary Analysis

    OpenAIRE

    Dany Shoham

    2011-01-01

    Based on a wealth of recent findings, in conjunction with earliest chronologies pertaining to evolutionary emergences of ancestral RNA viruses, ducks, Influenzavirus A (assumingly within ducks), and hominids, as well as to the initial domestication of mallard duck (Anas platyrhynchos), jungle fowl (Gallus gallus), wild turkey (Meleagris gallopavo), wild boar (Sus scrofa), and wild horse (Equus ferus), presumed genesis modes of primordial pandemic influenza strains have multidisciplinarily bee...

  5. 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

    Scientific Electronic Library Online (English)

    RODRIGO A, FASCE; JAVIER, TOGNARELLI; JUDITH, MORA; GRACIELA, TORRES; WINSTON, ANDRADE; PATRICIA, BUSTOS; PAMELA, ARAYA; MONSERRAT, BALANDA; CAROLINA, AGUAYO; JORGE, SEIN; EUGENIO, RAMÍREZ; JORGE, FERNÁNDEZ.

    2011-07-01

    Full Text Available [...] Abstract in english 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 samples coming from suspicious patients, received in a National Reference Laboratory. RNA reverse transcription and real time influenza gene DNA amplification was carried out in a 7500 Fast and Step One Real Time PCR Systems of Applied Biosystems and MxPro-Mx3000P thermocycler from Stratagene. Super Script III Platinum One-Step Quantitative RT-PCR was used. Results: The virus was first detected in three persons returning from the Dominican Republic via Panamá and a child from the east zone of Santiago. Genetic characterization of the virus showed that the child was infected by a different variant of the pandemic virus than the three persons returning from the Caribbean. Conclusions: The onset of the Influenza outbreak in Chile apparently carne from two different epidemiological groups. The spread of the virus detected in the voyagers was limited immediately However the virus of the fourth case was found in different regions of Chile.

  6. Factors Affecting the Acceptance of Pandemic Influenza A H1N1 Vaccine amongst Essential Service Providers: A Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Charlotte Roberts

    2012-12-01

    Full Text Available Although mentioned in the UK pandemic plan, essential service providers were not among the priority groups. They may be important targets of future influenza pandemic vaccination campaigns. Therefore, we conducted a cross-sectional survey among 380 employees from West Midlands police headquarters and 15 operational command units in the West Midlands Area during December 2009–February 2010 to identify factors affecting intention to accept the pandemic influenza A (H1N1 vaccine. One hundred and ninety nine (52.4% employees completed the questionnaire. 39.7% were willing to accept the vaccine. The most common reasons for intention to accept were worry about catching Swine Flu (n = 42, 53.2% and about infecting others (n = 40, 50.6%. The most common reason for declination was worry about side effects (n = 45, 57.0%. The most important factor predicting vaccine uptake was previous receipt of seasonal vaccine (OR 7.9 (95% CI 3.4, 18.5. Employees aged <40 years, males, current smokers, and those who perceived a greater threat and severity of swine flu were also more likely to agree to the vaccine. The findings of this study could be used to improve future pandemic immunization strategies. Targeted education programs should be used to address misconceptions; the single most important factor which might lead to a large improvement in uptake is to allay concern about side effects.

  7. Recommended Mitigation Measures for an Influenza Pandemic in Remote and Isolated First Nations Communities of Ontario, Canada: A Community-Based Participatory Research Approach

    Directory of Open Access Journals (Sweden)

    Nadia A. Charania

    2014-06-01

    Full Text Available Influenza pandemics disproportionately impact remote and/or isolated Indigenous communities worldwide. The differential risk experienced by such communities warrants the recommendation of specific mitigation measures. Interviewer-administered questionnaires were conducted with adult key health care informants from three remote and isolated Canadian First Nations communities of sub-Arctic Ontario. Forty-eight mitigation measures (including the setting, pandemic period, trigger, and duration were questioned. Participants’ responses were summarized and collected data were deductively and inductively coded. The participants recommended 41 of the questioned mitigation measures, and often differed from previous literature and national recommendations. Results revealed that barriers, such as overcrowded housing, limited supplies, and health care infrastructure, impacted the feasibility of implementing mitigation measures. These findings suggest that pandemic plans should recommend control strategies for remote and isolated Canadian First Nations communities that may not be supported in other communities. These findings highlight the importance of engaging locally impacted populations using participatory approaches in policy decision-making processes. Other countries with remote and/or isolated Indigenous communities are encouraged to include recommendations for mitigation measures that specifically address the unique needs of such communities in an effort to improve their health outcomes during the next influenza pandemic.

  8. Household transmission of 2009 pandemic influenza A (H1N1) and nonpharmaceutical interventions among households of high school students in San Antonio, Texas.

    Science.gov (United States)

    Loustalot, Fleetwood; Silk, Benjamin J; Gaither, Amber; Shim, Trudi; Lamias, Mark; Dawood, Fatimah; Morgan, Oliver W; Fishbein, Daniel; Guerra, Sandra; Verani, Jennifer R; Carlson, Susan A; Fonseca, Vincent P; Olsen, Sonja J

    2011-01-01

    San Antonio, Texas, was one of the first metropolitan areas where 2009 pandemic influenza A (H1N1) virus (pH1N1) was detected. Identification of laboratory-confirmed pH1N1 in 2 students led to a preemptive 8-day closure of their high school. We assessed transmission of pH1N1 and changes in adoption of nonpharmaceutical interventions (NPIs) within households of students attending the affected school. Household secondary attack rates were 3.7% overall and 9.1% among those 0-4 years of age. Widespread adoption of NPIs was reported among household members. Respondents who viewed pH1N1 as very serious were more likely to adopt certain NPIs than were respondents who viewed pH1N1 as not very serious. NPIs may complement influenza vaccine prevention programs or be the only line of defense when pandemic vaccine is unavailable. The 2009 pandemic provided a unique opportunity to study NPIs, and these real-world experiences provide much-needed data to inform pandemic response policy. PMID:21342887

  9. Diagnostic Testing for Pandemic Influenza in Singapore: A Novel Dual-Gene Quantitative Real-Time RT-PCR for the Detection of Influenza A/H1N1/2009

    OpenAIRE

    Lee, Hong Kai; Lee, Chun Kiat; Loh, Tze Ping; Tang, Julian Wei-tze; Chiu, Lily; Tambyah, Paul A.; Sethi, Sunil K.; Koay, Evelyn Siew-chuan

    2010-01-01

    With the relative global lack of immunity to the pandemic influenza A/H1N1/2009 virus that emerged in April 2009 as well as the sustained susceptibility to infection, rapid and accurate diagnostic assays are essential to detect this novel influenza A variant. Among the molecular diagnostic methods that have been developed to date, most are in tandem monoplex assays targeting either different regions of a single viral gene segment or different viral gene segments. We describe a dual-gene (dupl...

  10. Impacto clínico de la influenza A H1N1 pandémica en el hospital de Puerto Montt, Chile / Clinical impact of pandemic influenza A H1N1 in a Chilean regional hospital

    Scientific Electronic Library Online (English)

    Raúl, Riquelme O; Mauricio, Riquelme O; María Luisa, Rioseco Z; Carlos, Inzunza P; Cristian, Contreras G; Yarella, Gómez V; Javier, Riquelme D.

    2011-03-01

    Full Text Available [...] Abstract in english Background: Pandemic flu (H1N1 ) strongly affected southern Chile during2009. Aim: To report the logistic and organizational changes implemented at a regional hospital to face the pandemic. Material and Methods: All patients with flu like disease that were hospitalized, were prospectively enrolled a [...] t the Puerto Montt hospital. A nasopharyngeal aspirate was obtained in all for influenza virus A and B direct immunofluorescence and polymerase chain reaction (PCR). All epidemiological and clinical data of patients were recorded. Results: Between May 29 and July 7, 2009, 184 adults were admitted to the hospital and in 117patients aged 41 ± 18 years (56% females ), direct immunofluorescence was positive for influenza. In 67 of these patients PCR did not confirm the disease. These unconfirmed patients had a mean age of 49 ± 19 years (p

  11. Human H7N9 avian influenza virus infection: a review and pandemic risk assessment

    OpenAIRE

    Yiu Lai, Kang; Wing Yiu Ng, George; Fai Wong, Kit; Fan Ngai Hung, Ivan; Kam Fai Hong, Jeffrey; Fan Cheng, Fanny; Kwok Cheung Chan, John

    2013-01-01

    China is undergoing a recent outbreak of a novel H7N9 avian influenza virus (nH7N9) infection that has thus far involved 132 human patients, including 37 deaths. The nH7N9 virus is a reassortant virus originating from the H7N3, H7N9 and H9N2 avian influenza viruses. nH7N9 isolated from humans contains features related to adaptation to humans, including a Q226L mutation in the hemagglutinin cleavage site and E627K and D701N mutations in the PB2 protein. Live poultry markets provide an environm...

  12. Outbreaks of influenza A virus in farmed mink (Neovison vison) in Denmark: molecular characterization of the viruses

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Breum, Solvej Østergaard

    2012-01-01

    Influenza in mink (Neovison vison) is assumed to be rare, but several outbreaks have been described during recent years in Europe and the North America. In 2009, influenza A of the subtype H3N2 was detected in several Danish mink farms with respiratory symptoms. Full-genome sequencing showed that the virus was a human/swine reassortant, with the H and N gene most related to human H3N2 viruses circulating in 2005. The remaining 6 genes were most closely related to H1N2 influenza viruses circulating in Danish swine. This virus had not previously been described in swine, mink or humans. PCRs assays specifically targeting the new reassortant were developed and used to screen influenza positive samples from humans and swine in Denmark with negative results. Thus, there was no evidence that this virus had spread to humans or was circulating in Danish pigs. In 2010 and 2011, influenza virus was again diagnosed in diseased mink in a few farms. The genetic typing showed that the virus was similar to the pandemic H1N1 virus circulating in humans and swine. The H3N2 virus was not detected in 2010 and 2011. Taken together, these findings indicate that mink is highly susceptible for influenza A virus of human and swine origin and may therefore act as a potential host/reservoir for influenza A viruses.

  13. Outbreaks of Influenza A Virus in Farmed Mink (Neovison vison) in Denmark: Molecular characterization of the involved viruses

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Breum, Solvej Østergaard

    Influenza in mink (Neovison vison) is assumed to be rare, but outbreaks have previously been reported in farmed mink. The first report was from Swedish mink farms in 1984 and the second was reported from Canadian mink farms. In 2009, influenza A of the subtype H3N2 was detected in several Danish mink farms with respiratory symptoms. Full-genome sequencing showed that the virus was a human/swine reassortant, with the H and N gene most related to human H3N2 viruses circulating in 2005. The remaining 6 genes were most closely related to H1N2 influenza viruses circulating in Danish swine. This virus had not previously been described in swine, mink nor humans. PCRs assays specifically targeting the new reassortant were developed and used to screen influenza positive samples from humans and swine in Denmark with negative results. Thus, there was no evidence that this virus had spread to humans or was circulating in Danish pigs. In 2010 and 2011, influenza virus was again diagnosed in diseased mink in a fewfarms. The genetic typing showed that the virus was similar to the pandemic H1N1 virus circulating in humans and swine. The H3N2 virus was not detected in 2010 and 2011. Taken together, these findings indicate that mink is highly susceptible for influenza A virus of human and swine origin and may therefore act as a potential host/reservoir for influenza A viruses.

  14. Special article: personal protective equipment for care of pandemic influenza patients: a training workshop for the powered air purifying respirator.

    Science.gov (United States)

    Tompkins, Bonnie M; Kerchberger, John P

    2010-10-01

    Virulent respiratory infectious diseases may present a life-threatening risk for health care professionals during aerosol-generating procedures, including endotracheal intubation. The 2009 Pandemic Influenza A (H1N1) brings this concern to the immediate forefront. The Centers for Disease Control and Prevention have stated that, when performing or participating in aerosol-generating procedures on patients with virulent contagious respiratory diseases, health care professionals must wear a minimum of the N95 respirator, and they may wish to consider using the powered air purifying respirator (PAPR). For influenza and other diseases transmitted by both respiratory and contact modes, protective respirators must be combined with contact precautions. The PAPR provides 2.5 to 100 times greater protection than the N95, when used within the context of an Occupational Safety and Health Administration-compliant respiratory protection program. The relative protective capability of a respirator is quantified using the assigned protection factor. The level of protection designated by the APF can only be achieved with appropriate training and correct use of the respirator. Face seal leakage limits the protective capability of the N95 respirator, and fit testing does not assure the ability to maintain a tight face seal. The protective capability of the PAPR will be defeated by improper handling of contaminated equipment, incorrect assembly and maintenance, and improper don (put on) and doff (take off) procedures. Stress, discomfort, and physical encumbrance may impair performance. Acclimatization through training will mitigate these effects. Training in the use of PAPRs in advance of their need is strongly advised. "Just in time" training is unlikely to provide adequate preparation for groups of practitioners requiring specialized personal protective equipment during a pandemic. Employee health departments in hospitals may not presently have a PAPR training program in place. Anesthesia and critical care providers would be well advised to take the lead in working with their hospitals' employee health departments to establish a PAPR training program where none exists. User instructions state that the PAPR should not be used during surgery because it generates positive outward airflow, and may increase the risk of wound infection. Clarification of this prohibition and acceptable solutions are currently lacking and need to be addressed. The surgical hood system is not an acceptable alternative. We provide on line a PAPR training workshop. Supporting information is presented here. Anesthesia and critical care providers may use this workshop to supplement, but not substitute for, the manufacturers' detailed use and maintenance instructions. PMID:20810676

  15. Relative Efficacy of AS03-Adjuvanted Pandemic Influenza A(H1N1) Vaccine in Children: Results of a Controlled, Randomized Efficacy Trial

    Science.gov (United States)

    Nolan, Terry; Roy-Ghanta, Sumita; Montellano, May; Weckx, Lily; Ulloa-Gutierrez, Rolando; Lazcano-Ponce, Eduardo; Kerdpanich, Angkool; Safadi, Marco Aurélio Palazzi; Cruz-Valdez, Aurelio; Litao, Sandra; Lim, Fong Seng; de Los Santos, Abiel Mascareñas; Weber, Miguel Angel Rodriguez; Tinoco, Juan-Carlos; Mezerville, Marcela Hernandez-de; Faingezicht, Idis; Kosuwon, Pensri; Lopez, Pio; Borja-Tabora, Charissa; Li, Ping; Durviaux, Serge; Fries, Louis; Dubin, Gary; Breuer, Thomas; Innis, Bruce L.; Vaughn, David W.

    2014-01-01

    Background.?The vaccine efficacy (VE) of 1 or 2 doses of AS03-adjuvanted influenza A(H1N1) vaccine relative to that of 2 doses of nonadjuvanted influenza A(H1N1) vaccine in children 6 months to <10 years of age in a multinational study conducted during 2010–2011. Methods.?A total of 6145 children were randomly assigned at a ratio of 1:1:1 to receive 2 injections 21 days apart of A/California/7/2009(H1N1)-AS03 vaccine at dose 1 and saline placebo at dose 2, 2 doses 21 days apart of A/California/7/2009(H1N1)-AS03 vaccine (the Ad2 group), or 2 doses 21 days apart of nonadjuvanted A/California/7/2009(H1N1) vaccine (the NAd2 group). Active surveillance for influenza-like illnesses continued from days 14 to 385. Nose and throat samples obtained during influenza-like illnesses were tested for A/California/7/2009(H1N1), using reverse-transcriptase polymerase chain reaction. Immunogenicity, reactogenicity, and safety were assessed. Results.?There were 23 cases of confirmed 2009 pandemic influenza A(H1N1) (A[H1N1]pdm09) infection for the primary relative VE analysis. The VE in the Ad2 group relative to that in the NAd2 group was 76.8% (95% confidence interval, 18.5%–93.4%). The benefit of the AS03 adjuvant was demonstrated in terms of the greater immunogenicity observed in the Ad2 group, compared with the NAd2 group. Conclusion.?The 4–8-fold antigen-sparing adjuvanted pandemic influenza vaccine demonstrated superior and clinically important prevention of A(H1N1)pdm09 infection, compared with nonadjuvanted vaccine, with no observed increase in medically attended or serious adverse events. These data support the use of adjuvanted influenza vaccines during influenza pandemics. Clinical Trials Registration.?NCT01051661. PMID:24652494

  16. Caveolin-1 influences human influenza A virus (H1N1 multiplication in cell culture

    Directory of Open Access Journals (Sweden)

    Hemgård Gun-Viol

    2010-05-01

    Full Text Available Abstract Background The threat of recurring influenza pandemics caused by new viral strains and the occurrence of escape mutants necessitate the search for potent therapeutic targets. The dependence of viruses on cellular factors provides a weak-spot in the viral multiplication strategy and a means to interfere with viral multiplication. Results Using a motif-based search strategy for antiviral targets we identified caveolin-1 (Cav-1 as a putative cellular interaction partner of human influenza A viruses, including the pandemic influenza A virus (H1N1 strains of swine origin circulating from spring 2009 on. The influence of Cav-1 on human influenza A/PR/8/34 (H1N1 virus replication was determined in inhibition and competition experiments. RNAi-mediated Cav-1 knock-down as well as transfection of a dominant-negative Cav-1 mutant results in a decrease in virus titre in infected Madin-Darby canine kidney cells (MDCK, a cell line commonly used in basic influenza research as well as in virus vaccine production. To understand the molecular basis of the phenomenon we focussed on the putative caveolin-1 binding domain (CBD located in the lumenal, juxtamembranal portion of the M2 matrix protein which has been identified in the motif-based search. Pull-down assays and co-immunoprecipitation experiments showed that caveolin-1 binds to M2. The data suggest, that Cav-1 modulates influenza virus A replication presumably based on M2/Cav-1 interaction. Conclusion As Cav-1 is involved in the human influenza A virus life cycle, the multifunctional protein and its interaction with M2 protein of human influenza A viruses represent a promising starting point for the search for antiviral agents.

  17. Isolamento e caracterização do vírus da influenza pandêmico H1N1 em suínos no Brasil Isolation and characterization of a pandemic H1N1 influenza virus in pigs in Brazil

    Directory of Open Access Journals (Sweden)

    Rejane Schaefer

    2011-09-01

    Full Text Available A infecção causada pelo vírus Influenza A (IAV é endêmica em suínos no mundo inteiro. O surgimento da pandemia de influenza humana pelo vírus A/H1N1 (pH1N1 em 2009 levantou dúvidas sobre a ocorrência deste vírus em suínos no Brasil. Durante o desenvolvimento de um projeto de pesquisa do vírus de influenza suína em 2009-2010, na Embrapa Suínos e Aves (CNPSA, foi detectado em um rebanho de suínos em Santa Catarina, Brasil, um surto de influenza altamente transmissível causado pelo subtipo viral H1N1. Este vírus causou uma doença leve em suínos em crescimento e em fêmeas adultas, sem mortalidade. Tres leitões clinicamente afetados foram eutanasiados. As lesões macroscópicas incluiam consolidação leve a moderada das áreas cranioventrais do pulmão. Microscopicamente, as lesões foram caracterizadas por bronquiolite necrosante obliterativa e pneumonia broncointersticial. A imunohistoquímica, utilizando um anticorpo monoclonal contra a nucleoproteína do vírus influenza A, revelou marcação positiva no núcleo das células epiteliais bronquiolares. O tecido pulmonar de três leitões e os suabes nasais de cinco fêmeas e quatro leitões foram positivos para influenza A pela RT-PCR. O vírus influenza foi isolado de um pulmão, mais tarde sendo confirmado pelo teste de hemaglutinação (título HA 1:128 e por RT-PCR. A análise das seqüências de nucleotídeos dos genes da hemaglutinina (HA e proteína da matriz (M revelou que o vírus isolado foi consistente com o vírus pandêmico A/H1N1/2009 que circulou em humanos no mesmo período. Este é o primeiro relato de um surto de influenza causado pelo vírus pandêmico A/H1N1 em suínos no Brasil.Influenza A virus (IAV infections are endemic in pork producing countries around the world. The emergence of the pandemic 2009 human H1N1 influenza A virus (pH1N1 raised questions about the occurrence of this virus in Brazilian swine population. During a 2009-2010 swine influenza virus research project at Embrapa Swine and Poultry (CNPSA, an outbreak of a highly transmissible H1N1 influenza A virus disease was detected in a pig herd in Santa Catarina State, Brazil. The virus caused a mild disease in growing pigs and sows without mortality. Three clinically affected piglets were euthanized. Gross lesions included mild to moderate consolidation of cranioventral areas of the lung. Microscopically, the lesions were characterized by necrotizing obliterative bronchiolitis and bronchointerstitial pneumonia. Immunohistochemistry using a monoclonal antibody against type A influenza virus nucleoprotein revealed positive staining in the nuclei of the bronchiolar epithelial cells. Lung tissue from three piglets and nasal swabs from five sows and four piglets were positive for influenza A by RT-PCR. Influenza virus was isolated from one lung, later confirmed by the hemagglutination test (HA titer 1:128 and RT-PCR. Sequence analyses of Hemmaglutinin (HA and Matrix (M genes revealed that the virus was consistent with the pandemic (A/H1N1 2009 influenza virus strain that circulated in humans. This is the first report of an outbreak of pandemic A/H1N1 influenza virus in pigs in Brazil.

  18. In ovo and in vitro susceptibility of American alligators (Alligator mississippiensis) to avian influenza virus infection.

    Science.gov (United States)

    Temple, Bradley L; Finger, John W; Jones, Cheryl A; Gabbard, Jon D; Jelesijevic, Tomislav; Uhl, Elizabeth W; Hogan, Robert J; Glenn, Travis C; Tompkins, S Mark

    2015-01-01

    Avian influenza has emerged as one of the most ubiquitous viruses within our biosphere. Wild aquatic birds are believed to be the primary reservoir of all influenza viruses; however, the spillover of H5N1 highly pathogenic avian influenza (HPAI) and the recent swine-origin pandemic H1N1 viruses have sparked increased interest in identifying and understanding which and how many species can be infected. Moreover, novel influenza virus sequences were recently isolated from New World bats. Crocodilians have a slow rate of molecular evolution and are the sister group to birds; thus they are a logical reptilian group to explore susceptibility to influenza virus infection and they provide a link between birds and mammals. A primary American alligator (Alligator mississippiensis) cell line, and embryos, were infected with four, low pathogenic avian influenza (LPAI) strains to assess susceptibility to infection. Embryonated alligator eggs supported virus replication, as evidenced by the influenza virus M gene and infectious virus detected in allantoic fluid and by virus antigen staining in embryo tissues. Primary alligator cells were also inoculated with the LPAI viruses and showed susceptibility based upon antigen staining; however, the requirement for trypsin to support replication in cell culture limited replication. To assess influenza virus replication in culture, primary alligator cells were inoculated with H1N1 human influenza or H5N1 HPAI viruses that replicate independent of trypsin. Both viruses replicated efficiently in culture, even at the 30 C temperature preferred by the alligator cells. This research demonstrates the ability of wild-type influenza viruses to infect and replicate within two crocodilian substrates and suggests the need for further research to assess crocodilians as a species potentially susceptible to influenza virus infection. PMID:25380354

  19. Waiting for the Flu: Cognitive Inertia and the Spanish Influenza Pandemic of 1918-19.

    Science.gov (United States)

    Dicke, Tom

    2014-06-22

    This study looks at public awareness and understanding of the Spanish flu in the United States between June 1918, when the flu became "Spanish," and the end of September when the deadly second wave reached the majority of the country. Based on an extensive reading of local newspapers, it finds a near universal lack of preparation or panic or other signs of personal concern among those in the unaffected areas, despite extensive and potentially worrying coverage of the flu's progress. The normal reaction to news of the inexorable approach of a pandemic of uncertain virulence is anxiety and action. The Spanish flu produced neither in the uninfected areas for a month. The most likely reason appears to be cognitive inertia-the tendency of existing beliefs or habits of thought to blind people to changed realities. This inertia grew out of the widespread understanding of flu as a seasonal visitor that while frequently unpleasant almost never killed the strong and otherwise healthy. This view of the flu was powerful enough that it blinded many in the unaffected regions to the threat for weeks even in the face of daily or near daily coverage of the pandemic's spread. PMID:24957069

  20. Validation of Urban Community Survey Regarding Pandemic Flu Influenza A (H1N1 Using Rasch Measurement Tools

    Directory of Open Access Journals (Sweden)

    Izni Syamsina Saari

    2013-05-01

    Full Text Available This has made an attempt to apply the Rasch measurement model in the field of health sciences to validate the response behavioural patterns of local urban community regarding the risk of Pandemic Flu, Influenza A (H1N1. The variables include subjects' response behaviour towards H1N1 treatment effectiveness, knowledge, perceived risk attitude and preventive practices towards HINI. Following this is the investigation of the nature of associations between the binary response patterns (knowledge and the selected explanatory variables in the study (age, education status, effectiveness, perceived risk and preventive practices towards H1N1. The study used secondary survey data provided by the Department of Population Health and Preventive Medicine (PHPM, Faculty of Medicine, UiTM Shah Alam which were collected from communities residing at two different locations in Selangor, Malaysia. Results from the study show that community with different characteristics or background to some extent have provided true responses displaying moderate degree of knowledge and awareness towards the risk of H1N1. Significant association between knowledge and education status has also been detected.

  1. The impact of ethnicity and geographical location of residence on the 2009 influenza H1N1 pandemic vaccination.

    Science.gov (United States)

    Xiao, Y; Moghadas, S M

    2015-03-01

    In Canada, vaccination policies against the 2009 influenza H1N1 pandemic (H1N1pdm09) were modified at different times during the autumn wave. We hypothesized that ethnicity and place of residence influenced the odds of vaccination. To test this hypothesis, we used vaccination databases for the entire province of Manitoba, and obtained the age distribution of vaccination for First Nations (FN) and non-First Nations (non-FN) populations. We used regression analysis to determine the effect of ethnicity and location of residence on odds of vaccination. We found that individuals with FN identity were over 2.8 times [95% confidence interval (CI) 2.79-2.87] more likely to receive vaccination compared to non-FN individuals. For the FN populations, on-reserve residency was associated with 5.15-fold (95% CI 5.00-5.30) higher odds of vaccination compared to off-reserve residency. Our study highlights the importance of demographic and geographical variables in developing strategies for vaccine prioritization. PMID:25703398

  2. Isolamento e caracterização do vírus da influenza pandêmico H1N1 em suínos no Brasil / Isolation and characterization of a pandemic H1N1 influenza virus in pigs in Brazil

    Scientific Electronic Library Online (English)

    Rejane, Schaefer; Janice R.C., Zanella; Liana, Brentano; Amy L., Vincent; Giseli A., Ritterbusch; Simone, Silveira; Luizinho, Caron; Nelson, Mores.

    2011-09-01

    Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A infecção causada pelo vírus Influenza A (IAV) é endêmica em suínos no mundo inteiro. O surgimento da pandemia de influenza humana pelo vírus A/H1N1 (pH1N1) em 2009 levantou dúvidas sobre a ocorrência deste vírus em suínos no Brasil. Durante o desenvolvimento de um projeto de pesquisa do vírus de i [...] nfluenza suína em 2009-2010, na Embrapa Suínos e Aves (CNPSA), foi detectado em um rebanho de suínos em Santa Catarina, Brasil, um surto de influenza altamente transmissível causado pelo subtipo viral H1N1. Este vírus causou uma doença leve em suínos em crescimento e em fêmeas adultas, sem mortalidade. Tres leitões clinicamente afetados foram eutanasiados. As lesões macroscópicas incluiam consolidação leve a moderada das áreas cranioventrais do pulmão. Microscopicamente, as lesões foram caracterizadas por bronquiolite necrosante obliterativa e pneumonia broncointersticial. A imunohistoquímica, utilizando um anticorpo monoclonal contra a nucleoproteína do vírus influenza A, revelou marcação positiva no núcleo das células epiteliais bronquiolares. O tecido pulmonar de três leitões e os suabes nasais de cinco fêmeas e quatro leitões foram positivos para influenza A pela RT-PCR. O vírus influenza foi isolado de um pulmão, mais tarde sendo confirmado pelo teste de hemaglutinação (título HA 1:128) e por RT-PCR. A análise das seqüências de nucleotídeos dos genes da hemaglutinina (HA) e proteína da matriz (M) revelou que o vírus isolado foi consistente com o vírus pandêmico A/H1N1/2009 que circulou em humanos no mesmo período. Este é o primeiro relato de um surto de influenza causado pelo vírus pandêmico A/H1N1 em suínos no Brasil. Abstract in english Influenza A virus (IAV) infections are endemic in pork producing countries around the world. The emergence of the pandemic 2009 human H1N1 influenza A virus (pH1N1) raised questions about the occurrence of this virus in Brazilian swine population. During a 2009-2010 swine influenza virus research pr [...] oject at Embrapa Swine and Poultry (CNPSA), an outbreak of a highly transmissible H1N1 influenza A virus disease was detected in a pig herd in Santa Catarina State, Brazil. The virus caused a mild disease in growing pigs and sows without mortality. Three clinically affected piglets were euthanized. Gross lesions included mild to moderate consolidation of cranioventral areas of the lung. Microscopically, the lesions were characterized by necrotizing obliterative bronchiolitis and bronchointerstitial pneumonia. Immunohistochemistry using a monoclonal antibody against type A influenza virus nucleoprotein revealed positive staining in the nuclei of the bronchiolar epithelial cells. Lung tissue from three piglets and nasal swabs from five sows and four piglets were positive for influenza A by RT-PCR. Influenza virus was isolated from one lung, later confirmed by the hemagglutination test (HA titer 1:128) and RT-PCR. Sequence analyses of Hemmaglutinin (HA) and Matrix (M) genes revealed that the virus was consistent with the pandemic (A/H1N1) 2009 influenza virus strain that circulated in humans. This is the first report of an outbreak of pandemic A/H1N1 influenza virus in pigs in Brazil.

  3. The Ratio of Emergency Department Visits for ILI to Seroprevalence of 2009 Pandemic Influenza A (H1N1) Virus Infection, Florida, 2009

    Science.gov (United States)

    Hopkins, Richard S.; Kite-Powell, Aaron; Goodin, Kate; Hamilton, Janet J.

    2014-01-01

    Background. A seroprevalence survey carried out in four counties in the Tampa Bay area of Florida provided an estimate of cumulative incidence of infection due to the 2009 influenza A (H1N1) as of the end of that year’s pandemic in the four counties from which seroprevalence data were obtained Methods. Excess emergency department (ED) visits for influenza-like illness (ILI) during the pandemic period (compared to four non-pandemic years) were estimated using the ESSENCE-FL syndromic surveillance system for the four-county area. Results. There were an estimated 44 infections for every ILI ED visit. Age-specific ratios rose from 19.7 to 1 for children aged 64 years. Conclusions. These ratios provide a way to estimate cumulative incidence. These estimated ratios can be used in real time for planning and forecasting, when carrying out timely seroprevalence surveys is not practical. Syndromic surveillance data allow age and geographic breakdowns, including for children.

  4. “Alert to the Necessities of the Emergency”: U.S. Nursing During the 1918 Influenza Pandemic

    OpenAIRE

    Keeling, Arlene W.

    2010-01-01

    In 1918, excellent nursing care was the primary treatment for influenza. The disease was not well understood, and there were no antiviral medications to inhibit its progression or antibiotics to treat the complicating pneumonia that often followed. The social, cultural, and scientific context of the times shaped the profession's response. The Great War created a severe civilian nursing shortage: 9,000 trained white nurses were sent overseas and thousands more were assigned to U.S. military ca...

  5. Awareness, attitudes, and practices related to the swine influenza pandemic among the Saudi public

    OpenAIRE

    Al-Jumah Mohammad A; Al-Hathlool Rawabi H; Abolfotouh Mostafa A; Balkhy Hanan H

    2010-01-01

    Abstract Background During an infectious disease outbreak, it is critical to learn as much as possible about the concerns, knowledge, attitudes, and behavior of the public. Such information can be crucial to the improvement of communication efforts by public health officials and clinicians. The aim of this study was to identify awareness, attitudes, and practices related to influenza A (H1N1) among the Saudi public. Methods A cross-sectional study of 1,548 adult subjects recruited from variou...

  6. "Conselhos ao povo": educação contra a influenza de 1918 / "Advice to the people": education against the 1918 influenza pandemic

    Scientific Electronic Library Online (English)

    Liane Maria, Bertucci-Martins.

    2003-04-01

    Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Quando os primeiros casos de gripe espanhola começaram a vitimar os paulistanos em outubro de 1918, o Serviço Sanitário do Estado de São Paulo publicou uma série de prescrições com a intenção de esclarecer e instruir os moradores da capital do estado sobre a doença, suas características e algumas fo [...] rmas de combate de uma moléstia também chamada de influenza ou influenza espanhola. Resumidos e reeditados na imprensa, muitas vezes sob o título de "Conselhos ao Povo", os pareceres elaborados pela diretoria de saúde ganharam diferentes nuanças, mas algo permaneceu constante: o apelo à higiene pessoal e ao cuidado com os contatos sociais, como maneiras de se evitar a enfermidade e sua propagação. O objetivo deste texto é recuperar um pouco dessa história, em que as questões de higiene, educação e saúde se mesclavam. Abstract in english The first residents of São Paulo to catch the Spanish flu became ill in October, 1918. At that time, the Public Health Services of the state of São Paulo designed a series of prescriptions to inform the inhabitants of the state capital about the disease and its symptoms, and provide information abou [...] t how to treat it and avoid contamination. Summarized, printed and reprinted by the press, usually under the title "Advice to the People", such information underwent variations even though one thing remained the same: the recommendations to practice personal hygiene and avoid large social gatherings to prevent contamination and the spread of the disease. The present paper attempts to rescue some of this story, which incorporates issues of personal hygiene, education, and health in general.

  7. "Conselhos ao povo": educação contra a influenza de 1918 "Advice to the people": education against the 1918 influenza pandemic

    Directory of Open Access Journals (Sweden)

    Liane Maria Bertucci-Martins

    2003-04-01

    Full Text Available Quando os primeiros casos de gripe espanhola começaram a vitimar os paulistanos em outubro de 1918, o Serviço Sanitário do Estado de São Paulo publicou uma série de prescrições com a intenção de esclarecer e instruir os moradores da capital do estado sobre a doença, suas características e algumas formas de combate de uma moléstia também chamada de influenza ou influenza espanhola. Resumidos e reeditados na imprensa, muitas vezes sob o título de "Conselhos ao Povo", os pareceres elaborados pela diretoria de saúde ganharam diferentes nuanças, mas algo permaneceu constante: o apelo à higiene pessoal e ao cuidado com os contatos sociais, como maneiras de se evitar a enfermidade e sua propagação. O objetivo deste texto é recuperar um pouco dessa história, em que as questões de higiene, educação e saúde se mesclavam.The first residents of São Paulo to catch the Spanish flu became ill in October, 1918. At that time, the Public Health Services of the state of São Paulo designed a series of prescriptions to inform the inhabitants of the state capital about the disease and its symptoms, and provide information about how to treat it and avoid contamination. Summarized, printed and reprinted by the press, usually under the title "Advice to the People", such information underwent variations even though one thing remained the same: the recommendations to practice personal hygiene and avoid large social gatherings to prevent contamination and the spread of the disease. The present paper attempts to rescue some of this story, which incorporates issues of personal hygiene, education, and health in general.

  8. Pandemic Flu

    Science.gov (United States)

    ... address the pandemic. Characteristics and Challenges of a Flu Pandemic Rapid Worldwide Spread When a pandemic flu ... exposure could result in significant employee absenteeism. Seasonal Flu versus Pandemic Flu Pandemic Flu Seasonal Flu Rarely ...

  9. Reflexiones en torno a la pandemia de influenza de 1918: El caso de la ciudad de Puebla / Reflections about the 1918 influenza pandemic: The case of the city of Puebla

    Scientific Electronic Library Online (English)

    Miguel Ángel, Cuenya Mateos.

    2010-04-01

    Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish El año de 1918 fue fatídico. Marcó el fin de una década en la que las crisis política y económica, los desajustes sociales y diversas enfermedades golpearon duramente a México. Destacaron entre estas últimas la terrible epidemia de tifo (octubre de 1915-marzo de 1916) y la pandemia de influenza en 1 [...] 918. En ese año, con el recuerdo del tifo todavía presente, Puebla sufrió en carne propia la llegada de la influenza, como la mayoría de las ciudades del país. Esta pandemia ocasionó en esa localidad cerca de 2 000 defunciones en poco más de 60 días, con lo cual entró en crisis la política sanitaria y se agudizaron los conflictos sociales existentes. Abstract in english 1918 was a catastrophic year. It marked the end of a decade during which Mexico was harshly struck by political and economical crisis, social upset and several diseases. Among these, the terrible epidemic of typhoid fever (October, 1915-March 1916), and the 1918 influenza pandemic, are outstanding. [...] That year, with the memory of the typhoid fever still present, the city of Puebla suffered in its own flesh the arrival of influenza, as did most cities. In this locality, that pandemic caused nearly 2 000 deaths in 60 days, leading to a sanitary policy crisis and the worsening of existing social conflicts.

  10. Cytokine production by primary human macrophages infected with highly pathogenic H5N1 or pandemic H1N1 2009 influenza viruses

    Science.gov (United States)

    Sakabe, Saori; Iwatsuki-Horimoto, Kiyoko; Takano, Ryo; Nidom, Chairul A.; Le, Mai thi Quynh; Nagamura-Inoue, Tokiko; Horimoto, Taisuke; Yamashita, Naohide

    2011-01-01

    Highly pathogenic H5N1 avian influenza viruses have caused infection in humans, with a high mortality rate, since 1997. While the pathogenesis of this infection is not completely understood, hypercytokinaemia and alveolar macrophages are thought to play a role. To gain further insight into the cytokine-mediated pathogenesis of this infection in humans, we measured various cytokines produced by primary human macrophages infected with H5N1, pandemic H1N1 or seasonal influenza viruses. We found that many cytokines were produced at higher levels on infection with the H5N1 strains tested compared with seasonal influenza viruses. Interestingly, the extent of cytokine induction varied among the H5N1 strains and did not correlate with replicative ability in macrophages. Further, a pandemic H1N1 virus induced higher levels of several cytokines compared with seasonal viruses and some H5N1 strains. Our results demonstrate that high cytokine induction is not a universal feature of all H5N1 viruses. PMID:21367984

  11. Integrated network analysis reveals a novel role for the cell cycle in 2009 pandemic influenza virus-induced inflammation in macaque lungs

    Directory of Open Access Journals (Sweden)

    Shoemaker Jason E

    2012-08-01

    Full Text Available Abstract Background Annually, influenza A viruses circulate the world causing wide-spread sickness, economic loss, and death. One way to better defend against influenza virus-induced disease may be to develop novel host-based therapies, targeted at mitigating viral pathogenesis through the management of virus-dysregulated host functions. However, mechanisms that govern aberrant host responses to influenza virus infection remain incompletely understood. We previously showed that the pandemic H1N1 virus influenza A/California/04/2009 (H1N1; CA04 has enhanced pathogenicity in the lungs of cynomolgus macaques relative to a seasonal influenza virus isolate (A/Kawasaki/UTK-4/2009 (H1N1; KUTK4. Results Here, we used microarrays to identify host gene sequences that were highly differentially expressed (DE in CA04-infected macaque lungs, and we employed a novel strategy – combining functional and pathway enrichment analyses, transcription factor binding site enrichment analysis and protein-protein interaction data – to cre