WorldWideScience

Sample records for ah1n1 pandemic vaccine

  1. Monitoring pandemic influenza A(H1N1) vaccination coverage in Germany 2009/10

    OpenAIRE

    Walter, Dietmar; Böhmer, Merle; An der Heiden, Matthias; Reiter, Sabine; Krause, Gérard; Wichmann, Ole

    2011-01-01

    To monitor pandemic influenza A(H1N1) vaccine uptake during the vaccination campaign in Germany 2009/10, thirteen consecutive cross-sectional telephone-surveys were performed between November 2009 and April 2010. In total 13,010 household-interviews were conducted. Vaccination coverage in persons >14 years of age remained low, both in the general population (8.1%; 95%CI: 7.4–8.8) and in specific target groups such as healthcare workers and individuals with underlying chronic diseases (12.8%; ...

  2. Canadian family physicians' and paediatricians' knowledge, attitudes and practices regarding A(H1N1 pandemic vaccine

    Directory of Open Access Journals (Sweden)

    Bettinger Julie A

    2010-04-01

    Full Text Available Abstract Background One of the main determinants of public immunization success is health professionals' support and recommendations. Little is known about the physicians' level of support and intentions regarding A(H1N1 pandemic influenza vaccination. The aim of this survey was to document Canadian family physicians' and paediatricians' knowledge, attitudes and practices (KAP as well as their intentions regarding A(H1N1 pandemic influenza vaccines right before the beginning of the largest immunization campaign in Canadian history. Findings A self-administered, anonymous, mail-based questionnaire was sent to a random sample of family physicians and to all paediatricians practicing in Canada. All 921 questionnaires received by October 29 2009 were included in the analysis. Between 72% and 92% of respondents agreed with the statements regarding vaccine safety, effectiveness and acceptability. More than 75% of respondents intended to recommend the A(H1N1 pandemic influenza vaccine to their patients and to get vaccinated themselves. The most significant factors associated with the intention to recommend A(H1N1 pandemic vaccines were physicians' intention to be vaccinated against influenza themselves and the perceived acceptability of the vaccine by the vaccinators. Conclusions Most Canadian family physicians and paediatricians surveyed were supportive of the A(H1N1 pandemic influenza vaccination before its implementation and large media coverage.

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

    OpenAIRE

    Torun Fuat; Torun Sebahat D; Catak Binali

    2010-01-01

    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 De...

  4. 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

  5. Effectiveness of pandemic and seasonal influenza vaccine in preventing pandemic influenza A(H1N1)2009 infection in England and Scotland 2009-2010.

    Science.gov (United States)

    Hardelid, P; Fleming, D M; McMenamin, J; Andrews, N; Robertson, C; SebastianPillai, P; Ellis, J; Carman, W; Wreghitt, T; Watson, J M; Pebody, R G

    2011-01-01

    Following the global spread of pandemic influenza A(H1N1)2009, several pandemic vaccines have been rapidly developed. The United Kingdom and many other countries in the northern hemisphere implemented seasonal and pandemic influenza vaccine programmes in October 2009. We present the results of a case–control study to estimate effectiveness of such vaccines in preventing confirmed pandemic influenza infection. Some 5,982 individuals with influenza-like illness seen in general practices between November 2009 and January 2010 were enrolled. Those testing positive on PCR for pandemic influenza were assigned as cases and those testing negative as controls. Vaccine effectiveness was estimated as the relative reduction in odds of confirmed infection between vaccinated and unvaccinated individuals. Fourteen or more days after immunisation with the pandemic vaccine, adjusted vaccine effectiveness (VE) was 72% (95% confidence interval (CI): 21% to 90%). If protection was assumed to start after seven or more days, the adjusted VE was 71% (95% CI: 37% to 87%). Pandemic influenza vaccine was highly effective in preventing confirmed infection with pandemic influenza A(H1N1)2009 from one week after vaccination. No evidence of effectiveness against pandemic influenza A(H1N1)2009 was found for the 2009/10 trivalent seasonal influenza vaccine (adjusted VE of -30% (95% CI: -89% to 11%)). PMID:21251487

  6. Influenza vaccination in the Americas: Progress and challenges after the 2009 A(H1N1) influenza pandemic

    Science.gov (United States)

    Ropero-Álvarez, Alba María; El Omeiri, Nathalie; Kurtis, Hannah Jane; Danovaro-Holliday, M. Carolina; Ruiz-Matus, Cuauhtémoc

    2016-01-01

    ABSTRACT Background: There has been considerable uptake of seasonal influenza vaccines in the Americas compared to other regions. We describe the current influenza vaccination target groups, recent progress in vaccine uptake and in generating evidence on influenza seasonality and vaccine effectiveness for immunization programs. We also discuss persistent challenges, 5 years after the A(H1N1) 2009 influenza pandemic. Methods: We compiled and summarized data annually reported by countries to the Pan American Health Organization/World Health Organization (PAHO/WHO) through the WHO/UNICEF joint report form on immunization, information obtained through PAHO's Revolving Fund for Vaccine Procurement and communications with managers of national Expanded Programs on Immunization (EPI). Results: Since 2008, 25 countries/territories in the Americas have introduced new target groups for vaccination or expanded the age ranges of existing target groups. As of 2014, 40 (89%) out of 45 countries/territories have policies established for seasonal influenza vaccination. Currently, 29 (64%) countries/territories target pregnant women for vaccination, the highest priority group according to WHO´s Stategic Advisory Group of Experts and PAHO/WHO's Technical Advisory Group on Vaccine-preventable Diseases, compared to only 7 (16%) in 2008. Among 23 countries reporting coverage data, on average, 75% of adults ≥60 years, 45% of children aged 6–23 months, 32% of children aged 5–2 years, 59% of pregnant women, 78% of healthcare workers, and 90% of individuals with chronic conditions were vaccinated during the 2013–14 Northern Hemisphere or 2014 Southern Hemisphere influenza vaccination activities. Difficulties however persist in the estimation of vaccination coverage, especially for pregnant women and persons with chronic conditions. Since 2007, 6 tropical countries have changed their vaccine formulation from the Northern to the Southern Hemisphere formulation and the timing of

  7. Determinants of refusal of A/H1N1 pandemic vaccination in a high risk population: a qualitative approach.

    Directory of Open Access Journals (Sweden)

    Eugenie d'Alessandro

    Full Text Available BACKGROUND: Our study analyses the main determinants of refusal or acceptance of the 2009 A/H1N1 vaccine in patients with cystic fibrosis, a high-risk population for severe flu infection, usually very compliant for seasonal flu vaccine. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a qualitative study based on semi-structured interviews in 3 cystic fibrosis referral centres in Paris, France. The study included 42 patients with cystic fibrosis: 24 who refused the vaccine and 18 who were vaccinated. The two groups differed quite substantially in their perceptions of vaccine- and disease-related risks. Those who refused the vaccine were motivated mainly by the fears it aroused and did not explicitly consider the 2009 A/H1N1 flu a potentially severe disease. People who were vaccinated explained their choice, first and foremost, as intended to prevent the flu's potential consequences on respiratory cystic fibrosis disease. Moreover, they considered vaccination to be an indirect collective prevention tool. Patients who refused the vaccine mentioned multiple, contradictory information sources and did not appear to consider the recommendation of their local health care provider as predominant. On the contrary, those who were vaccinated stated that they had based their decision solely on the clear and unequivocal advice of their health care provider. CONCLUSIONS/SIGNIFICANCE: These results of our survey led us to formulate three main recommendations for improving adhesion to new pandemic vaccines. (1 it appears necessary to reinforce patient education about the disease and its specific risks, but also general population information about community immunity. (2 it is essential to disseminate a clear and effective message about the safety of novel vaccines. (3 this message should be conveyed by local health care providers, who should be involved in implementing immunization.

  8. Determinants of Refusal of A/H1N1 Pandemic Vaccination in a High Risk Population: A Qualitative Approach

    OpenAIRE

    d'Alessandro, Eugenie; Hubert, Dominique; Launay, Odile; Bassinet, Laurence; Lortholary, Olivier; Jaffre, Yannick; Sermet-Gaudelus, Isabelle

    2012-01-01

    Background Our study analyses the main determinants of refusal or acceptance of the 2009 A/H1N1 vaccine in patients with cystic fibrosis, a high-risk population for severe flu infection, usually very compliant for seasonal flu vaccine. Methodology/Principal Findings We conducted a qualitative study based on semi-structured interviews in 3 cystic fibrosis referral centres in Paris, France. The study included 42 patients with cystic fibrosis: 24 who refused the vaccine and 18 who were vaccinate...

  9. 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

  10. Comparison of Immune Response by Virus Infection and Vaccination to 2009 Pandemic Influenza A/H1N1 in Children

    OpenAIRE

    Kang, Eun Kyeong; Lim, Jung Sub; Lee, Jun Ah; KIM, DONG HO

    2013-01-01

    We aimed to compare the immune response induced by natural infection with 2009 pandemic influenza A/H1N1 (pH1N1) virus and by monovalent pH1N1 vaccination in children and adolescents. This cross-sectional clinical study was conducted at 3 hospitals in Korea from February to May 2010. A total of 266 healthy subjects aged from 6 months to 18 yr were tested for the presence of the antibody against pH1N1 using hemagglutination inhibition (HI) test. Information about pH1N1 vaccination and laborato...

  11. Pandemic vaccination strategies and influenza severe outcomes during the influenza A(H1N1)pdm09 pandemic and the post-pandemic influenza season: the Nordic experience.

    Science.gov (United States)

    Cuesta, Julita Gil; Aavitsland, Preben; Englund, Hélène; Gudlaugsson, Ólafur; Hauge, Siri Helene; Lyytikäinen, Outi; Sigmundsdóttir, Guðrún; Tegnell, Anders; Virtanen, Mikko; Krause, Tyra Grove

    2016-04-21

    During the 2009/10 influenza A(H1N1)pdm09 pandemic, the five Nordic countries adopted different approaches to pandemic vaccination. We compared pandemic vaccination strategies and severe influenza outcomes, in seasons 2009/10 and 2010/11 in these countries with similar influenza surveillance systems. We calculated the cumulative pandemic vaccination coverage in 2009/10 and cumulative incidence rates of laboratory confirmed A(H1N1)pdm09 infections, intensive care unit (ICU) admissions and deaths in 2009/10 and 2010/11. We estimated incidence risk ratios (IRR) in a Poisson regression model to compare those indicators between Denmark and the other countries. The vaccination coverage was lower in Denmark (6.1%) compared with Finland (48.2%), Iceland (44.1%), Norway (41.3%) and Sweden (60.0%). In 2009/10 Denmark had a similar cumulative incidence of A(H1N1)pdm09 ICU admissions and deaths compared with the other countries. In 2010/11 Denmark had a significantly higher cumulative incidence of A(H1N1)pdm09 ICU admissions (IRR: 2.4; 95% confidence interval (CI): 1.9-3.0) and deaths (IRR: 8.3; 95% CI: 5.1-13.5). Compared with Denmark, the other countries had higher pandemic vaccination coverage and experienced less A(H1N1)pdm09-related severe outcomes in 2010/11. Pandemic vaccination may have had an impact on severe influenza outcomes in the post-pandemic season. Surveillance of severe outcomes may be used to compare the impact of influenza between seasons and support different vaccination strategies. PMID:27123691

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

    Science.gov (United States)

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

    2014-05-01

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

  13. The Lao Experience in Deploying Influenza A(H1N1pdm09 Vaccine: Lessons Made Relevant in Preparing for Present Day Pandemic Threats.

    Directory of Open Access Journals (Sweden)

    Anonh Xeuatvongsa

    Full Text Available The Lao PDR, as did most countries of the Mekong Region, embarked on a pandemic vaccine initiative to counter the threat posed by influenza A(H1N1pdm09. Overall, estimated vaccine coverage of the Lao population was 14%, with uptake in targeted health care workers and pregnant women 99% and 41%, respectively. Adverse Events Following Immunization accounted for only 6% of survey driven, reported vaccination experiences, with no severe consequences or deaths. Public acceptability of the vaccine campaign was high (98%. Challenges to vaccine deployment included: 1 no previous experience in fielding a seasonal influenza vaccine, 2 safety and efficacy concerns, and 3 late arrival of vaccine 10 months into the pandemic. The Lao success in surmounting these hurdles was in large measure attributed to the oversight assigned the National Immunization Program, and national sensitivities in responding to the avian influenza A(H5N1 crisis in the years leading up to the pandemic. The Lao "lessons learned" from pandemic vaccine deployment are made even more relevant four years on, given the many avian influenza strains circulating in the region, all with pandemic potential.

  14. Age-specific vaccine effectiveness of seasonal 2010/2011 and pandemic influenza A(H1N1) 2009 vaccines in preventing influenza in the United Kingdom.

    Science.gov (United States)

    Pebody, R G; Andrews, N; Fleming, D M; McMenamin, J; Cottrell, S; Smyth, B; Durnall, H; Robertson, C; Carman, W; Ellis, J; Sebastian-Pillai, P; Zambon, M; Kearns, C; Moore, C; Thomas, D Rh; Watson, J M

    2013-03-01

    An analysis was undertaken to measure age-specific vaccine effectiveness (VE) of 2010/11 trivalent seasonal influenza vaccine (TIV) and monovalent 2009 pandemic influenza vaccine (PIV) administered in 2009/2010. The test-negative case-control study design was employed based on patients consulting primary care. Overall TIV effectiveness, adjusted for age and month, against confirmed influenza A(H1N1)pdm 2009 infection was 56% (95% CI 42-66); age-specific adjusted VE was 87% (95% CI 45-97) in <5-year-olds and 84% (95% CI 27-97) in 5- to 14-year-olds. Adjusted VE for PIV was only 28% (95% CI -6 to 51) overall and 72% (95% CI 15-91) in <5-year-olds. For confirmed influenza B infection, TIV effectiveness was 57% (95% CI 42-68) and in 5- to 14-year-olds 75% (95% CI 32-91). TIV provided moderate protection against the main circulating strains in 2010/2011, with higher protection in children. PIV administered during the previous season provided residual protection after 1 year, particularly in the <5 years age group. PMID:22691710

  15. Personal decision-making criteria related to seasonal and pandemic A(H1N1 influenza-vaccination acceptance among French healthcare workers.

    Directory of Open Access Journals (Sweden)

    Lila Bouadma

    Full Text Available BACKGROUND: Influenza-vaccination rates among healthcare workers (HCW remain low worldwide, even during the 2009 A(H1N1 pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination. METHODS: In June-July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV and pandemic (PIV influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression-tree method. RESULTS: Of the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations. Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV. CONCLUSIONS: Both vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model.

  16. Kinetics of lung lesion development and pro-inflammatory cytokine response in pigs with vaccine-associated enhanced respiratory disease induced by challenge with pandemic (2009) A/H1N1 influenza virus

    Science.gov (United States)

    The objective of this report was to characterize the enhanced clinical disease and lung lesions observed in pigs vaccinated with inactivated H1N2 swine delta-cluster influenza A virus and challenged with pandemic 2009 A/H1N1 human influenza virus. Eighty-four, six-week-old, crossbred pigs were rand...

  17. Detection of Extensive Cross-Neutralization between Pandemic and Seasonal A/H1N1 Influenza Viruses Using a Pseudotype Neutralization Assay

    OpenAIRE

    Labrosse, Béatrice; Tourdjman, Mathieu; Porcher, Raphaël; LeGoff, Jérôme; de Lamballerie, Xavier; Simon, François; Molina, Jean-Michel; Clavel, François

    2010-01-01

    Background Cross-immunity between seasonal and pandemic A/H1N1 influenza viruses remains uncertain. In particular, the extent that previous infection or vaccination by seasonal A/H1N1 viruses can elicit protective immunity against pandemic A/H1N1 is unclear. Methodology/Principal Findings Neutralizing titers against seasonal A/H1N1 (A/Brisbane/59/2007) and against pandemic A/H1N1 (A/California/04/2009) were measured using an HIV-1-based pseudovirus neutralization assay. Using this highly sens...

  18. Decreased serologic response in vaccinated military recruits during 2011 correspond to genetic drift in concurrent circulating pandemic A/H1N1 viruses.

    Directory of Open Access Journals (Sweden)

    Dennis J Faix

    Full Text Available BACKGROUND: Population-based febrile respiratory illness surveillance conducted by the Department of Defense contributes to an estimate of vaccine effectiveness. Between January and March 2011, 64 cases of 2009 A/H1N1 (pH1N1, including one fatality, were confirmed in immunized recruits at Fort Jackson, South Carolina, suggesting insufficient efficacy for the pH1N1 component of the live attenuated influenza vaccine (LAIV. METHODOLOGY/PRINCIPAL FINDINGS: To test serologic protection, serum samples were collected at least 30 days post-vaccination from recruits at Fort Jackson (LAIV, Parris Island (LAIV and trivalent inactivated vaccine [TIV] at Cape May, New Jersey (TIV and responses measured against pre-vaccination sera. A subset of 78 LAIV and 64 TIV sera pairs from recruits who reported neither influenza vaccination in the prior year nor fever during training were tested by microneutralization (MN and hemagglutination inhibition (HI assays. MN results demonstrated that seroconversion in paired sera was greater in those who received TIV versus LAIV (74% and 37%. Additionally, the fold change associated with TIV vaccination was significantly different between circulating (2011 versus the vaccine strain (2009 of pH1N1 viruses (ANOVA p value = 0.0006. HI analyses revealed similar trends. Surface plasmon resonance (SPR analysis revealed that the quantity, IgG/IgM ratios, and affinity of anti-HA antibodies were significantly greater in TIV vaccinees. Finally, sequence analysis of the HA1 gene in concurrent circulating 2011 pH1N1 isolates from Fort Jackson exhibited modest amino acid divergence from the vaccine strain. CONCLUSIONS/SIGNIFICANCE: Among military recruits in 2011, serum antibody response differed by vaccine type (LAIV vs. TIV and pH1N1 virus year (2009 vs. 2011. We hypothesize that antigen drift in circulating pH1N1 viruses contributed to reduce vaccine effectiveness at Fort Jackson. Our findings have wider implications regarding

  19. Infant Respiratory Outcomes Associated with Prenatal Exposure to Maternal 2009 A/H1N1 Influenza Vaccination

    Science.gov (United States)

    Fell, Deshayne B.; Wilson, Kumanan; Ducharme, Robin; Hawken, Steven; Sprague, Ann E.; Kwong, Jeffrey C.; Smith, Graeme; Wen, Shi Wu; Walker, Mark C.

    2016-01-01

    Background Infants are at high risk for influenza illness, but are ineligible for vaccination before 6 months. Transfer of maternal antibodies to the fetus has been demonstrated for 2009 A/H1N1 pandemic vaccines; however, clinical effectiveness is unknown. Our objective was to evaluate the association between 2009 A/H1N1 pandemic vaccination during pregnancy and rates of infant influenza and pneumonia. Methods We linked a population-based birth cohort to administrative databases to measure rates of influenza and pneumonia diagnosed during ambulatory physician visits, hospitalizations and emergency department visits during one year of follow-up. We estimated incidence rate ratios and 95% confidence intervals (95% CI) using Poisson regression, comparing infants born to A/H1N1-vaccinated women (vaccine-exposed infants) with unexposed infants, adjusted for confounding using high-dimensional propensity scores. Results Among 117,335 infants in the study, 36,033 (31%) were born to A/H1N1-vaccinated women. Crude rates of influenza during the pandemic (per 100,000 infant-days) for vaccine-exposed and unexposed infants were similar (2.19, 95% CI: 1.27–3.76 and 3.60, 95% CI: 2.51–5.14, respectively), as were crude rates of influenza and pneumonia combined. We did not observe any significant differences in rates of study outcomes between study groups during the second wave of the 2009 A/H1N1 pandemic, nor during any post-pandemic time period. Conclusion We observed no difference in rates of study outcomes among infants born to A/H1N1-vaccinated mothers relative to unexposed infants born during the second A/H1N1 pandemic wave; however, due to late availability of the pandemic vaccine, the available follow-up time during the pandemic time period was very limited. PMID:27486858

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

    DEFF Research Database (Denmark)

    Bragstad, Karoline; Vinner, Lasse; Hansen, Mette Sif;

    2013-01-01

    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....... 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....... 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...

  1. Effectiveness of seasonal 2010/11 and pandemic influenza A(H1N1)2009 vaccines in preventing influenza infection in the United Kingdom: mid-season analysis 2010/11.

    Science.gov (United States)

    Pebody, R; Hardelid, P; Fleming, Dm; McMenamin, J; Andrews, N; Robertson, C; Thomas, Dr; Sebastianpillai, P; Ellis, J; Carman, W; Wreghitt, T; Zambon, M; Watson, Jm

    2011-01-01

    This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 - 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 - 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 - 78%) if vaccinated in both seasons. PMID:21329644

  2. Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España: Influencia de las fuentes de información Factors associated with willingness to be vaccinated against pandemic flu A/H1N1 in the adult population of the Health Department of Elche (Spain: The influence of sources of information

    Directory of Open Access Journals (Sweden)

    J. Tuells

    2012-08-01

    Full Text Available Fundamento. Evaluar en población general las fuentes de información, actitudes y predisposición hacia la vacunación contra la gripe pandémica A/H1N1 de 2009. Métodos. Estudio descriptivo de carácter transversal realizado entre el 25 de noviembre y 30 de diciembre de 2009 mediante entrevista personal cara a cara a una muestra aleatoria (826 de adultos residentes en el Departamento de Salud de Elche (España. Resultados. Los encuestados manifestaron que la televisión (57% y el médico de familia (47,9% eran su fuente principal de información sobre vacunas. El 82,2% tenía una buena opinión sobre las vacunas, un 30,5% percibía la gripe A/H1N1 como más grave que la estacional, siendo esta percepción creciente entre los de mayor edad y con menos estudios. Un 25,4% de encuestados sentía preocupación por padecerla, sobre todo los de menor nivel educativo. Un 42,1% manifiesta su buena predisposición para vacunarse contra la gripe estacional, disminuyendo hasta un 18,4% la intención hacia la gripe A/H1N1. La predisposición hacia la vacunación crece con la edad y en el caso de la gripe A/H1N1 decrece a mayor nivel educativo. El médico de familia es la fuente de información más determinante para inmunizarse frente a gripe estacional (OR 1,43 y gripe A/H1N1 (OR 2,47. Conclusiones. Existe baja aceptabilidad de la vacuna pandémica y baja percepción de gravedad sobre la gripe A/H1N1. La experiencia previa de vacunación ante gripe estacional predispone hacia la inmunización contra gripe A/H1N1. Aunque los medios de comunicación encabezan la fuente de información más usual durante este episodio, la influencia del médico de familia en la decisión de vacunarse resulta significativa.Background. To assess, in the general population, the information sources, attitudes and willingness to be vaccinated against pandemic influenza A/H1N1 in 2009. Methods. We carried out a cross sectional study between 25th November and 30th December 2009

  3. Influenza A(H1N1) pandemic: 2 years after

    OpenAIRE

    ALLAM, M.F.

    2012-01-01

    In 2009, the emergence of the new H1N1 influenza virus saw the world brace itself for the first influenza pandemic since 1968. Two years after, it is time to evaluate the situation of that Influenza A(H1N1) pandemic and its combat measures.

  4. 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

  5. Influenza A(H1N1)pdm09 vaccination policies and coverage in Europe.

    LENUS (Irish Health Repository)

    Mereckiene, J

    2012-06-01

    In August 2010 the Vaccine European New Integrated Collaboration Effort (VENICE) project conducted a survey to collect information on influenza A(H1N1)pdm09 vaccination policies and vaccination coverage in the European Union (EU), Norway and Iceland. Of 29 responding countries, 26 organised national pandemic influenza vaccination and one country had recommendations for vaccination but did not have a specific programme. Of the 27 countries with vaccine recommendations, all recommended it for healthcare workers and pregnant women. Twelve countries recommended vaccine for all ages. Six and three countries had recommendations for specific age groups in children and in adults, countries for specific adult age groups. Most countries recommended vaccine for those in new risk groups identified early in the pandemic such as morbid obese and people with neurologic diseases. Two thirds of countries started their vaccination campaigns within a four week period after week 40\\/2009. The reported vaccination coverage varied between countries from 0.4% to 59% for the entire population (22 countries); 3% to 68% for healthcare workers (13 countries); 0% to 58% for pregnant women (12 countries); 0.2% to 74% for children (12 countries). Most countries identified similar target groups for pandemic vaccine, but substantial variability in vaccination coverage was seen. The recommendations were in accordance with policy advice from the EU Health Security Committee and the World Health Organization.

  6. Vaccine-associated enhanced respiratory disease does not interfere with the adaptive immune response following challenge with pandemic A/H1N1 2009

    Science.gov (United States)

    Background. The implications of sequential prime and challenge with mismatched influenza A viruses is a concern in mammals including humans. We evaluated the ability of pigs affected with vaccine associated enhanced respiratory disease (VAERD) to generate a humoral immune response against the hetero...

  7. 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.

  8. Hospitalization in two waves of pandemic influenza A(H1N1) in England.

    Science.gov (United States)

    Campbell, C N J; Mytton, O T; McLean, E M; Rutter, P D; Pebody, R G; Sachedina, N; White, P J; Hawkins, C; Evans, B; Waight, P A; Ellis, J; Bermingham, A; Donaldson, L J; Catchpole, M

    2011-10-01

    Uncertainties exist regarding the population risks of hospitalization due to pandemic influenza A(H1N1). Understanding these risks is important for patients, clinicians and policy makers. This study aimed to clarify these uncertainties. A national surveillance system was established for patients hospitalized with laboratory-confirmed pandemic influenza A(H1N1) in England. Information was captured on demographics, pre-existing conditions, treatment and outcomes. The relative risks of hospitalization associated with pre-existing conditions were estimated by combining the captured data with population prevalence estimates. A total of 2416 hospitalizations were reported up to 6 January 2010. Within the population, 4·7 people/100,000 were hospitalized with pandemic influenza A(H1N1). The estimated hospitalization rate of cases showed a U-shaped distribution with age. Chronic kidney disease, chronic neurological disease, chronic respiratory disease and immunosuppression were each associated with a 10- to 20-fold increased risk of hospitalization. Patients who received antiviral medication within 48 h of symptom onset were less likely to be admitted to critical care than those who received them after this time (adjusted odds ratio 0·64, 95% confidence interval 0·44-0·94, P=0·024). In England the risk of hospitalization with pandemic influenza A(H1N1) has been concentrated in the young and those with pre-existing conditions. By quantifying these risks, this study will prove useful in planning for the next winter in the northern and southern hemispheres, and for future pandemics. PMID:21108872

  9. PANDEMIC FLU A/H1N1V: VIROLOGICAL SURVEILLANCE IN SOUTH TUSCANY

    Directory of Open Access Journals (Sweden)

    I. Manini

    2012-05-01

    conclusion, the data demonstrates that the age group mainly affected is that between ages 0-24. Presumably such data is justified by considering that the immune system of younger people has never come in contact previously with the variants similar to the A/H1N1, whereas older adults would seem to be less sus- ceptible, probably because they have already come in contact with similar viruses. The obtained data illustrates an elevated level of contagiousness among individuals, since the new influenza virus A/H1N1 of 2009, represents a variant of completely different from other H1N1 viruses that had previously circulated in the human species. It should be pointed out that the hemagglutinin differs by 27.2% and the neuraminidase by 18.2% compared to the amino acid sequence of the 2008 H1N1 influenza virus and by the variant of the viral strain used for the production of the vaccine, this lent to a sig- nificant pandemic potential. The trend of positivity in local cases from the 29th week was kept at medium-low levels until the 38th week with a great increase, probably due to the reopening of schools and offices after the summer break.

  10. Transmission parameters of the A/H1N1 (2009) influenza virus pandemic: a review

    Science.gov (United States)

    Boëlle, Pierre‐Yves; Ansart, Séverine; Cori, Anne; Valleron, Alain‐Jacques

    2011-01-01

    Please cite this paper as: Boëlle P‐Y et al. (2011) Transmission parameters of the A/H1N1 (2009) influenza virus pandemic: a review. Influenza and Other Respiratory Viruses 5(5), 306–316. Background  The new influenza virus A/H1N1 (2009), identified in mid‐2009, rapidly spread over the world. Estimating the transmissibility of this new virus was a public health priority. Methods  We reviewed all studies presenting estimates of the serial interval or generation time and the reproduction number of the A/H1N1 (2009) virus infection. Results  Thirteen studies documented the serial interval from household or close‐contact studies, with overall mean 3 days (95% CI: 2·4, 3·6); taking into account tertiary transmission reduced this estimate to 2·6 days. Model‐based estimates were more variable, from 1·9 to 6 days. Twenty‐four studies reported reproduction numbers for community‐based epidemics at the town or country level. The range was 1·2–3·1, with larger estimates reported at the beginning of the pandemic. Accounting for under‐reporting in the early period of the pandemic and limiting variation because of the choice of the generation time interval, the reproduction number was between 1·2 and 2·3 with median 1·5. Discussion  The serial interval of A/H1N1 (2009) flu was typically short, with mean value similar to the seasonal flu. The estimates of the reproduction number were more variable. Compared with past influenza pandemics, the median reproduction number was similar (1968) or slightly smaller (1889, 1918, 1957). PMID:21668690

  11. Outbreak of pandemic influenza A/H1N1 2009 in Nepal

    OpenAIRE

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

    2011-01-01

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

  12. 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...

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

    OpenAIRE

    Esposito Susanna; Daleno Cristina; Tagliabue Claudia; Scala Alessia; Picciolli Irene; Taroni Francesca; Galeone Carlotta; Baldanti Fausto; Principi Nicola

    2011-01-01

    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 polymer...

  14. Characterizing the epidemiology of the 2009 influenza A/H1N1 pandemic in Mexico.

    Directory of Open Access Journals (Sweden)

    Gerardo Chowell

    2011-05-01

    Full Text Available BACKGROUND: Mexico's local and national authorities initiated an intense public health response during the early stages of the 2009 A/H1N1 pandemic. In this study we analyzed the epidemiological patterns of the pandemic during April-December 2009 in Mexico and evaluated the impact of nonmedical interventions, school cycles, and demographic factors on influenza transmission. METHODS AND FINDINGS: We used influenza surveillance data compiled by the Mexican Institute for Social Security, representing 40% of the population, to study patterns in influenza-like illness (ILIs hospitalizations, deaths, and case-fatality rate by pandemic wave and geographical region. We also estimated the reproduction number (R on the basis of the growth rate of daily cases, and used a transmission model to evaluate the effectiveness of mitigation strategies initiated during the spring pandemic wave. A total of 117,626 ILI cases were identified during April-December 2009, of which 30.6% were tested for influenza, and 23.3% were positive for the influenza A/H1N1 pandemic virus. A three-wave pandemic profile was identified, with an initial wave in April-May (Mexico City area, a second wave in June-July (southeastern states, and a geographically widespread third wave in August-December. The median age of laboratory confirmed ILI cases was ∼ 18 years overall and increased to ∼ 31 years during autumn (p<0.0001. The case-fatality ratio among ILI cases was 1.2% overall, and highest (5.5% among people over 60 years. The regional R estimates were 1.8-2.1, 1.6-1.9, and 1.2-1.3 for the spring, summer, and fall waves, respectively. We estimate that the 18-day period of mandatory school closures and other social distancing measures implemented in the greater Mexico City area was associated with a 29%-37% reduction in influenza transmission in spring 2009. In addition, an increase in R was observed in late May and early June in the southeast states, after mandatory school

  15. Student behavior during a school closure caused by pandemic influenza A/H1N1.

    Directory of Open Access Journals (Sweden)

    Joel C Miller

    Full Text Available 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 week long closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students-though less interaction with other students than during school-with the level of interaction increasing with grade. CONCLUSIONS: Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact.

  16. 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, Marc; Angelis, D. 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. Design: A Bayesian evidence synthesis of all available relevant surveillance data in England to estimate severity of the pandemic. Data sources: All available surveillance systems relevant to the pandemic 2009 A/H1N1 influenza outbreak in Engl...

  17. Generation and Characterization of Recombinant Pandemic Influenza A(H1N1) Viruses Resistant to Neuraminidase Inhibitors

    OpenAIRE

    Pizzorno, Andrés; Bouhy, Xavier; Abed, Yacine; Boivin, Guy

    2011-01-01

    Background. Neuraminidase inhibitors (NAIs) play a key role in the management of influenza epidemics and pandemics. Given the novel pandemic influenza A(H1N1) (pH1N1) virus and the restricted number of approved anti-influenza drugs, evaluation of potential drug-resistant variants is of high priority.

  18. [Advances in the structure and function of pandemic A/H1N1/2009 influenza virus HA protein].

    Science.gov (United States)

    Zhang, Wen-Qiang; Song, Shao-Xia; Wang, Tong-Zhan

    2012-06-01

    Since March 2009, pandemic A/H1N1/2009 influenza virus has been spreading throughout many countries including China. The emerged virus caused great harm to human health and social economy. Hemagglutinin (HA) is the most important viral surface glycoprotein, mainly possessing three kinds of functions: (1) binding to host cell receptor, (2) triggering the fusion between viral envelop and target cell membrane, (3) stimulating the body to generate the neutralizing antibody. Advances in the structure, primary function, evolution and antigenicity of pandemic A/H1N1/2009 influenza virus HA protein are reviewed in this paper. PMID:22978172

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

    Directory of Open Access Journals (Sweden)

    Lisa McCallum

    2010-12-01

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

  20. Effectiveness of the influenza a(H1N1)PDM09 vaccine in adults recommended for annual influenza vaccination : A case-control study

    NARCIS (Netherlands)

    Gefenaite, Giedre; Tacken, Margot; Bos, Jens; Stirbu-Wagner, Irina; Korevaar, Joke C.; Stolk, Ronald P.; Wolters, Bert; Bijl, Marc; Postma, Maarten J.; Wilschut, Jan; Nichol, Kristin L.; Hak, Eelko

    2012-01-01

    Background: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we aimed to assess the effectiveness of MF59-adjuvanted A(H1N1)pdm09 vaccine in a matched case-control study. Objectives: We aimed to assess the effectiveness of MF59- adjuvanted A(H1N1)pdm09 infl

  1. 'Rhyme or reason?' Saying no to mass vaccination: subjective re-interpretation in the context of the A(H1N1) influenza pandemic in Sweden 2009-2010.

    Science.gov (United States)

    Lundgren, Britta

    2015-12-01

    During the swine flu pandemic of 2009-2010, all Swedish citizens were recommended to be vaccinated with the influenza vaccine Pandemrix. However, a very serious and unexpected side effect emerged during the summer of 2010: more than 200 children and young adults were diagnosed with narcolepsy after vaccination. Besides the tragic outcome for these children and their families, this adverse side effect suggests future difficulties in obtaining trust in vaccination in cases of emerging pandemics, and thus there is a growing need to find ways to understand the complexities of vaccination decision processes. This article explores written responses to a questionnaire from a Swedish folk life archive as an unconventional source for analysing vaccine decisions. The aim is to investigate how laypersons responded to and re-interpreted the message about the recommended vaccination in their answers. The answers show the confusion and complex circumstances and influences in everyday life that people reflect on when making such important decisions. The issue of confusion is traced back to the initial communications about the vaccination intervention in which both autonomy and solidarity were expected from the population. Common narratives and stories about the media or 'big pharma capitalism' are entangled with private memories, accidental coincidences and serendipitous associations. It is obvious that vaccination interventions that require compliance from large groups of people need to take into account the kind of personal experience narratives that are produced by the complex interplay of the factors described by the informants. PMID:26077985

  2. Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. A randomized, controlled non-inferiority trial comparing A(H1N1pmd09 vaccine antigen, with and without AS03 adjuvant system, co-administered or sequentially administered with an inactivated trivalent seasonal influenza vaccine

    Directory of Open Access Journals (Sweden)

    Langley Joanne M

    2012-10-01

    Full Text Available Abstract Background At the time of the influenza A(H1N1pmd09 pandemic it was not known if concurrent or sequential administration of seasonal trivalent influenza vaccine (TIV with pandemic vaccine was preferred. Methods Immunogenicity and safety were assessed in 871 healthy subjects aged 19–40 years who were randomised into six groups to receive co-administration or sequential administration of TIV and two doses of A(H1N1pmd09 vaccine (either unadjuvanted or adjuvanted with AS03, an α-tocopherol and squalene-based oil-in-water emulsion. Results Safety and immunogenicity data (by haemagglutination inhibition [HI] assay after each dose and six months post-Dose 1 are reported here. Co-administration of A(H1N1pmd09 vaccine with TIV reduced the HI immune responses to A(H1N1pmd09 vaccine. However, serologic responses with both co-administration and sequential schedules met the European and US regulatory criteria for pandemic and seasonal influenza vaccines up to six months following the first vaccine dose. The AS03-adjuvanted formulation elicited higher immune responses at all time points. Prior administration or co-administration of A(H1N1pmd09 vaccine did not affect immune responses to TIV. Conclusions Co-administration of TIV and A(H1N1pmd09 vaccine negatively influenced A(H1N1pmd09 vaccine immunogenicity but had no effect on TIV responses. The non-adjuvanted and adjuvanted vaccines demonstrated strong immune responses against all vaccine strains for up to six months following the first vaccine dose. Trial registration NCT00985673

  5. 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.

  6. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1 disease.

    Directory of Open Access Journals (Sweden)

    Oliver W Morgan

    Full Text Available BACKGROUND: Severe illness due to 2009 pandemic A(H1N1 infection has been reported among persons who are obese or morbidly obese. We assessed whether obesity is a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1, independent of chronic medical conditions considered by the Advisory Committee on Immunization Practices (ACIP to increase the risk of influenza-related complications. METHODOLOGY/PRINCIPAL FINDINGS: We used a case-cohort design to compare cases of hospitalizations and deaths from 2009 pandemic A(H1N1 influenza occurring between April-July, 2009, with a cohort of the U.S. population estimated from the 2003-2006 National Health and Nutrition Examination Survey (NHANES; pregnant women and children or=20 year olds, hospitalization was associated with being morbidly obese (BMI>or=40 for individuals with ACIP-recognized chronic conditions (OR = 4.9, 95% CI 2.4-9.9 and without ACIP-recognized chronic conditions (OR = 4.7, 95%CI 1.3-17.2. Among 2-19 year olds, hospitalization was associated with being underweight (BMIor=20 years without ACIP-recognized chronic medical conditions death was associated with obesity (OR = 3.1, 95%CI: 1.5-6.6 and morbid obesity (OR = 7.6, 95%CI 2.1-27.9. CONCLUSIONS/SIGNIFICANCE: Our findings support observations that morbid obesity may be associated with hospitalization and possibly death due to 2009 pandemic H1N1 infection. These complications could be prevented by early antiviral therapy and vaccination.

  7. Coverage and side effects of influenza A(H1N1) 2009 monovalent vaccine among primary health care workers.

    Science.gov (United States)

    Ortiz Arjona, Miguel Angel; Abd Elaziz, Khaled Mahmoud; Caballero Lanzas, Jose Maria; Allam, Mohamed Farouk

    2011-08-26

    In June 2009, WHO declared the maximum phase alert against H1N1 pandemic flu. Health care workers (HCWs) are considered a strategic target for prevention of the occurrence of H1N1 influenza since they had the greatest risk of acquiring infection. The objectives of our study were (1) identifying the uptake of influenza A(H1N1) 2009 monovalent vaccine by primary health care workers in the southern part of Cordoba, and (2) reporting of the adverse events occurred after vaccination. We followed 240 HCWs in 12 primary health care centres at southern part of Cordoba for vaccine uptake and the occurrence of adverse events. The coverage rate with H1N1 vaccine was 20.5% which was lower compared to seasonal influenza vaccination rate 44.2% in 2009. Males had higher H1N1 vaccination rate compared to females with no significant difference. Senior HCWs complied more with seasonal influenza vaccine while this finding was not consistent with H1N1 vaccination. Multivariate analysis showed that the only independent variable that affected H1N1 vaccine was the compliance to the seasonal flu vaccine in the past three years with OR 5.1 and 95% CI (2.4-10.8). Adverse events occurred among 26.5% of those who complied with H1N1 vaccination. Those were local pain, irritation and induration at site of injection (38.5%), fever (15.4%), fever cough and rhinorrhea (15.4%) generalized pain and lumber pains (23.1%). The low vaccination rate in this study is consistent with previous studies done in many parts of the world and in Spain. Further studies should be done to explore the factors that hindered the uptake and resistance of HCWs to vaccination to H1N1 vaccine. PMID:21840463

  8. Productive infection of human skeletal muscle cells by pandemic and seasonal influenza A(H1N1 viruses.

    Directory of Open Access Journals (Sweden)

    Marion Desdouits

    Full Text Available Besides the classical respiratory and systemic symptoms, unusual complications of influenza A infection in humans involve the skeletal muscles. Numerous cases of acute myopathy and/or rhabdomyolysis have been reported, particularly following the outbreak of pandemic influenza A(H1N1 in 2009. The pathogenesis of these influenza-associated myopathies (IAM remains unkown, although the direct infection of muscle cells is suspected. Here, we studied the susceptibility of cultured human primary muscle cells to a 2009 pandemic and a 2008 seasonal influenza A(H1N1 isolate. Using cells from different donors, we found that differentiated muscle cells (i. e. myotubes were highly susceptible to infection by both influenza A(H1N1 isolates, whereas undifferentiated cells (i. e. myoblasts were partially resistant. The receptors for influenza viruses, α2-6 and α2-3 linked sialic acids, were detected on the surface of myotubes and myoblasts. Time line of viral nucleoprotein (NP expression and nuclear export showed that the first steps of the viral replication cycle could take place in muscle cells. Infected myotubes and myoblasts exhibited budding virions and nuclear inclusions as observed by transmission electron microscopy and correlative light and electron microscopy. Myotubes, but not myoblasts, yielded infectious virus progeny that could further infect naive muscle cells after proteolytic treatment. Infection led to a cytopathic effect with the lysis of muscle cells, as characterized by the release of lactate dehydrogenase. The secretion of proinflammatory cytokines by muscle cells was not affected following infection. Our results are compatible with the hypothesis of a direct muscle infection causing rhabdomyolysis in IAM patients.

  9. Excess mortality monitoring in England and Wales during the influenza A(H1N1) 2009 pandemic.

    Science.gov (United States)

    Hardelid, P; Andrews, N; Pebody, R

    2011-09-01

    We present the results from a novel surveillance system for detecting excess all-cause mortality by age group in England and Wales developed during the pandemic influenza A(H1N1) 2009 period from April 2009 to March 2010. A Poisson regression model was fitted to age-specific mortality data from 1999 to 2008 and used to predict the expected number of weekly deaths in the absence of extreme health events. The system included adjustment for reporting delays. During the pandemic, excess all-cause mortality was seen in the 5-14 years age group, where mortality was flagged as being in excess for 1 week after the second peak in pandemic influenza activity; and in age groups >45 years during a period of very cold weather. This new system has utility for rapidly estimating excess mortality for other acute public health events such as extreme heat or cold weather. PMID:21439100

  10. A/H1N1 Vaccine Intentions in College Students: An Application of the Theory of Planned Behavior

    Science.gov (United States)

    Agarwal, Vinita

    2014-01-01

    Objective: To test the applicability of the Theory of Planned Behavior (TPB) in college students who have not previously received the A/H1N1 vaccine. Participants: Undergraduate communication students at a metropolitan southern university. Methods: In January-March 2010, students from voluntarily participating communication classes completed a…

  11. Learning to trust flu shots: quasi-experimental evidence on the role of learning in influenza vaccination decisions from the 2009 influenza A/H1N1 (swine flu) pandemic

    OpenAIRE

    Maurer, J.; Harris, K M

    2015-01-01

    This paper studies consumer learning in influenza vaccination decisions, i.e., potential causal effects of past experiences of being vaccinated on current use of influenza vaccine. Existing structural models of demand usually identify consumer learning parametrically based on functional form assumptions within dynamic forward-looking Bayesian demand models. To the best of our knowledge, we are the first to explore the potential role of consumer learning in pharmaceutical demand within a reduc...

  12. Risk factors and immunity in a nationally representative population following the 2009 influenza A(H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Don Bandaranayake

    Full Text Available BACKGROUND: Understanding immunity, incidence and risk factors of the 2009 influenza A(H1N1 pandemic (2009 H1N1 through a national seroprevalence study is necessary for informing public health interventions and disease modelling. METHODS AND FINDINGS: We collected 1687 serum samples and individual risk factor data between November-2009 to March-2010, three months after the end of the 2009 H1N1 wave in New Zealand. Participants were randomly sampled from selected general practices countrywide and hospitals in the Auckland region. Baseline immunity was measured from 521 sera collected during 2004 to April-2009. Haemagglutination inhibition (HI antibody titres of ≥1:40 against 2009 H1N1 were considered seroprotective as well as seropositive. The overall community seroprevalence was 26.7% (CI:22.6-29.4. The seroprevalence varied across age and ethnicity. Children aged 5-19 years had the highest seroprevalence (46.7%;CI:38.3-55.0, a significant increase from the baseline (14%;CI:7.2-20.8. Older adults aged ≥60 had no significant difference in seroprevalence between the serosurvey (24.8%;CI:18.7-30.9 and baseline (22.6%;CI:15.3-30.0. Pacific peoples had the highest seroprevalence (49.5%;CI:35.1-64.0. There was no significant difference in seroprevalence between both primary (29.6%;CI:22.6-36.5 and secondary healthcare workers (25.3%;CI:20.8-29.8 and community participants. No significant regional variation was observed. Multivariate analysis indicated age as the most important risk factor followed by ethnicity. Previous seasonal influenza vaccination was associated with higher HI titres. Approximately 45.2% of seropositive individuals reported no symptoms. CONCLUSIONS: Based on age and ethnicity standardisation to the New Zealand Population, about 29.5% of New Zealanders had antibody titers at a level consistent with immunity to 2009 H1N1. Around 18.3% of New Zealanders were infected with the virus during the first wave including about one child

  13. Prospective hospital-based case–control study to assess the effectiveness of pandemic influenza A(H1N1pdm09 vaccination and risk factors for hospitalization in 2009–2010 using matched hospital and test-negative controls

    Directory of Open Access Journals (Sweden)

    Hellenbrand Wiebke

    2012-05-01

    Full Text Available Abstract Background We performed a case–control study to estimate vaccine effectiveness (VE for prevention of hospitalization due to pandemic influenza A(H1N1pdm09 (pH1N1 and to identify risk factors for pH1N1 and acute respiratory infection (ARI in 10 hospitals in Berlin from December 2009 to April 2010. Methods Cases were patients aged 18–65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1 matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2 ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis. Results Of 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%. The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100% in the matched multivariate analysis and 46% (95%CI: -376-100% in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI. Conclusions Though limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted

  14. Evidence of person-to-person transmission of oseltamivir-resistant pandemic influenza A(H1N1) 2009 virus in a hematology unit.

    Science.gov (United States)

    Moore, Catherine; Galiano, Monica; Lackenby, Angie; Abdelrahman, Tamer; Barnes, Rosemary; Evans, Meirion R; Fegan, Christopher; Froude, Susannah; Hastings, Mark; Knapper, Steven; Litt, Emma; Price, Nicola; Salmon, Roland; Temple, Mark; Davies, Eleri

    2011-01-01

    We describe the first confirmed person-to-person transmission of oseltamivir-resistant pandemic influenza A(H1N1) 2009 virus that occurred in a hematology unit in the United Kingdom. Eleven cases of (H1N1) 2009 virus infection were identified, of which, ten were related as shown by sequence analysis of the hemagglutinin and neuraminidase genes. H275Y analysis demonstrated that 8 of 10 case patients had oseltamivir-resistant virus, with 4 of 8 case patients infected by direct transmission of resistant virus. Zanamivir should be considered as first-line therapy for influenza in patients with lymphopenic hematological conditions and uptake of influenza vaccination encouraged to further reduce the number of susceptible individuals. PMID:21148492

  15. PD-L1 Expression Induced by the 2009 Pandemic Influenza A(H1N1 Virus Impairs the Human T Cell Response

    Directory of Open Access Journals (Sweden)

    Nuriban Valero-Pacheco

    2013-01-01

    Full Text Available PD-L1 expression plays a critical role in the impairment of T cell responses during chronic infections; however, the expression of PD-L1 on T cells during acute viral infections, particularly during the pandemic influenza virus (A(H1N1pdm09, and its effects on the T cell response have not been widely explored. We found that A(H1N1pdm09 virus induced PD-L1 expression on human dendritic cells (DCs and T cells, as well as PD-1 expression on T cells. PD-L1 expression impaired the T cell response against A(H1N1pdm09 by promoting CD8+ T cell death and reducing cytokine production. Furthermore, we found increased PD-L1 expression on DCs and T cells from influenza-infected patients from the first and second 2009 pandemic waves in Mexico City. PD-L1 expression on CD8+ T cells correlated inversely with T cell proportions in patients infected with A(H1N1pdm09. Therefore, PD-L1 expression on DCs and T cells could be associated with an impaired T cell response during acute infection with A(H1N1pdm09 virus.

  16. Effect of human rhinovirus infection in pediatric patients with influenza-like illness on the 2009 pandemic influenza A(H1N1) virus

    Institute of Scientific and Technical Information of China (English)

    Sun Yu; Zhu Ru'nan; Zhao Linqing; Deng Jie; Wang Fang; Ding Yaxin; Yuan Yi

    2014-01-01

    Background Some research groups have hypothesized that human rhinoviruses (HRVs) delayed the circulation of the 2009 pandemic influenza A(H1N1) virus (A(H1N1)pdm09) at the beginning of Autumn 2009 in France.This study aimed to evaluate the relationship between HRV and A(H1N1)pdm09 in pediatric patients with influenza-like illness in Beijing,China.Methods A systematic analysis to detect A(H1N1)pdm09 and seasonal influenza A virus (FLU A) was performed on 4 349 clinical samples from pediatric patients with influenza-like illness during the period June 1,2009 to February 28,2010,while a one-step real-time RT-PCR (rRT-PCR) assay was used to detect HRV in 1 146 clinical specimens selected from those 4 349 specimens.Results During the survey period,only one wave of A(H1N1)pdm09 was observed.The percentage of positive cases for A(H1N1)pdm09 increased sharply in September with a peak in November 2009 and then declined in February 2010.Data on the monthly distribution of HRVs indicated that more HRV-positive samples were detected in September (2.2%) and October (3.3%),revealing that the peak of HRV infection in 2009 was similar to that of other years.Among the 1 146 specimens examined for HRVs,21 (1.8%) were HRV-positive,which was significantly lower than that reported previously in Beijing (15.4% to 19.2%) (P <0.01).Overall,6 samples were positive for both A(H1N1)pdm09 and HRV,which represented a positive relative frequency of 1.60% and 2.08% HRV,considering the A(H1N1)pdm09-positive and-negative specimens,respectively.The odds ratio was 0.87 (95% CI 0.32; 2.44,P=0.80).Conclusions HRVs and A (H1N1)pdm09 co-circulated in this Chinese population during September and October 2009,and the HRV epidemic in 2009 did not affect A(H1N1)pdm09 infection rates in Beijing,China as suggested by other studies.However,the presence of A(H1N1)pdm09 might explain the unexpected reduction in the percentage of HRV positive cases during the period studied.

  17. 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

  18. 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

  19. Revealing the True Incidence of Pandemic A(H1N1)pdm09 Influenza in Finland during the First Two Seasons — An Analysis Based on a Dynamic Transmission Model

    Science.gov (United States)

    Shubin, Mikhail; Lebedev, Artem; Lyytikäinen, Outi; Auranen, Kari

    2016-01-01

    The threat of the new pandemic influenza A(H1N1)pdm09 imposed a heavy burden on the public health system in Finland in 2009-2010. An extensive vaccination campaign was set up in the middle of the first pandemic season. However, the true number of infected individuals remains uncertain as the surveillance missed a large portion of mild infections. We constructed a transmission model to simulate the spread of influenza in the Finnish population. We used the model to analyse the two first years (2009-2011) of A(H1N1)pdm09 in Finland. Using data from the national surveillance of influenza and data on close person-to-person (social) contacts in the population, we estimated that 6% (90% credible interval 5.1 – 6.7%) of the population was infected with A(H1N1)pdm09 in the first pandemic season (2009/2010) and an additional 3% (2.5 – 3.5%) in the second season (2010/2011). Vaccination had a substantial impact in mitigating the second season. The dynamic approach allowed us to discover how the proportion of detected cases changed over the course of the epidemic. The role of time-varying reproduction number, capturing the effects of weather and changes in behaviour, was important in shaping the epidemic. PMID:27010206

  20. Whole genome characterization of human influenza A(H1N1)pdm09 viruses isolated from Kenya during the 2009 pandemic.

    Science.gov (United States)

    Gachara, George; Symekher, Samuel; Otieno, Michael; Magana, Japheth; Opot, Benjamin; Bulimo, Wallace

    2016-06-01

    An influenza pandemic caused by a novel influenza virus A(H1N1)pdm09 spread worldwide in 2009 and is estimated to have caused between 151,700 and 575,400 deaths globally. While whole genome data on new virus enables a deeper insight in the pathogenesis, epidemiology, and drug sensitivities of the circulating viruses, there are relatively limited complete genetic sequences available for this virus from African countries. We describe herein the full genome analysis of influenza A(H1N1)pdm09 viruses isolated in Kenya between June 2009 and August 2010. A total of 40 influenza A(H1N1)pdm09 viruses isolated during the pandemic were selected. The segments from each isolate were amplified and directly sequenced. The resulting sequences of individual gene segments were concatenated and used for subsequent analysis. These were used to infer phylogenetic relationships and also to reconstruct the time of most recent ancestor, time of introduction into the country, rates of substitution and to estimate a time-resolved phylogeny. The Kenyan complete genome sequences clustered with globally distributed clade 2 and clade 7 sequences but local clade 2 viruses did not circulate beyond the introductory foci while clade 7 viruses disseminated country wide. The time of the most recent common ancestor was estimated between April and June 2009, and distinct clusters circulated during the pandemic. The complete genome had an estimated rate of nucleotide substitution of 4.9×10(-3) substitutions/site/year and greater diversity in surface expressed proteins was observed. We show that two clades of influenza A(H1N1)pdm09 virus were introduced into Kenya from the UK and the pandemic was sustained as a result of importations. Several closely related but distinct clusters co-circulated locally during the peak pandemic phase but only one cluster dominated in the late phase of the pandemic suggesting that it possessed greater adaptability. PMID:26921801

  1. Live attenuated influenza A virus vaccine protects against A(H1N1)pdm09 heterologous challenge without vaccine associated enhanced respiratory disease.

    Science.gov (United States)

    Gauger, Phillip C; Loving, Crystal L; Khurana, Surender; Lorusso, Alessio; Perez, Daniel R; Kehrli, Marcus E; Roth, James A; Golding, Hana; Vincent, Amy L

    2014-12-01

    Live-attenuated influenza virus (LAIV) vaccines may provide cross-protection against contemporary influenza A virus (IAV) in swine. Conversely, whole inactivated virus (WIV) vaccines have the potential risk of vaccine-associated enhanced respiratory disease (VAERD) when challenged with IAV of substantial antigenic drift. A temperature sensitive, intranasal H1N2 LAIV was compared to wild type exposure (WT) and an intramuscular WIV vaccine in a model shown to induce VAERD. WIV vaccinated swine challenged with pandemic A/H1N1 (H1N1pdm09) were not protected from infection and demonstrated severe respiratory disease consistent with VAERD. Lung lesions were mild and challenge virus was not detected in the respiratory tract of LAIV vaccinates. High levels of post-vaccination IgG serum antibodies targeting the H1N1pdm09 HA2 stalk domain were exclusively detected in the WIV group and associated with increased H1N1pdm09 virus infectivity in MDCK cells. In contrast, infection-enhancing antibodies were not detected in the serum of LAIV vaccinates and VAERD was not observed. PMID:25461535

  2. Toll-like receptor 3 gene polymorphisms and severity of pandemic A/H1N1/2009 influenza in otherwise healthy children

    Directory of Open Access Journals (Sweden)

    Esposito Susanna

    2012-11-01

    Full Text Available Abstract Background Toll-like receptors (TLRs form an essential part of the innate immune system, which plays a fundamental role in rapidly and effectively controlling infections and initiating adaptive immunity. There are no published data concerning the importance of polymorphisms of TLRs in conditioning susceptibility to influenza or the severity of the disease. The aim of this study was to evaluate whether selected polymorphisms of TLR2, TLR3 and TLR4 influence the incidence and clinical picture of pandemic A/H1N1/2009 influenza. Results The study involved 272 healthy children attending our Emergency Room for influenza-like illness (ILI, including 51 (18.8% with pandemic A/H1N1/2009 influenza as revealed by real-time polymerase chain reaction, and 164 healthy controls examined after minor surgery. Genomic DNA was extracted from whole blood samples and five single-nucleotide polymorphisms (SNPs were studied: TLR2 rs5743708, TLR3 rs5743313, TLR3 rs5743315, TLR4 rs4986790 and TLR4 rs4986791. The TLR3 rs5743313/CT polymorphism was found in all of the children with pneumonia and influenza infection, but in a significantly smaller number of those with A/H1N1/2009 influenza without pneumonia ( Conclusions There is a close relationship between the presence of TLR3 rs5743313/CT and an increased risk of pneumonia in children infected by the pandemic A/H1N1/2009 influenza virus.

  3. Altered response to A(H1N1)pnd09 vaccination in pregnant women

    DEFF Research Database (Denmark)

    Bischoff, Anne Louise; Følsgaard, Nilofar Vahman; Carson, Charlotte Giwercman;

    2013-01-01

    were to compare influences of dose and adjuvant on the immune response. METHODS: The study was nested in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010) pregnancy cohort in 2009-2010 and conducted as a single-blinded block-randomised [1∶1∶1] controlled clinical trial in pregnant......-pregnant (NPa7.5 µg) groups (OR = 0.49 [0.13-1.85], p = 0.29). CONCLUSION: Our study suggests the immune response to the 7.5 µg MF59-adjuvanted Focetria® H1N1pnd09 vaccine in pregnant women may be diminished compared with non-pregnant women. TRIAL REGISTRATION: ClinicalTrials.gov NCT01012557....

  4. Immunogenicity and Efficacy of A/H1N1pdm Vaccine Among Subjects With Severe Motor and Intellectual Disability in the 2010/11 Influenza Season

    Science.gov (United States)

    Hara, Megumi; Hanaoka, Tomoyuki; Maeda, Kazuhiro; Kase, Tetsuo; Ohfuji, Satoko; Fukushima, Wakaba; Hirota, Yoshio

    2016-01-01

    Background While the immunogenicity and effectiveness of seasonal influenza vaccines among subjects with severe motor and intellectual disability (SMID) are known to be diminished, the efficacy of the A/H1N1pdm vaccine has not been evaluated. Methods We prospectively evaluated 103 subjects with SMID (mean age, 41.7 years) who received trivalent inactivated influenza vaccine during the 2010/11 influenza season. The hemagglutination inhibition (HI) antibody titer was measured in serum samples collected pre-vaccination (S0), post-vaccination (S1), and end-of-season (S2) to evaluate subjects’ immunogenicity capacity. Vaccine efficacy was assessed based on antibody efficacy and achievement proportion. Results The proportions of seroprotection and seroconversion, and the geometric mean titer (GMT) ratio (GMT at S1/GMT at S0) for A/H1N1pdm were 46.0%, 16.0%, and 1.8, respectively—values which did not meet the European Medicines Evaluation Agency criteria. The achievement proportion was 26%. During follow-up, 11 of 43 subjects with acute respiratory illness were diagnosed with type A influenza according to a rapid influenza diagnostic test (RIDT), and A/H1N1pdm strains were isolated from the throat swabs of 5 of those 11 subjects. When either or both RIDT-diagnosed influenza or serologically diagnosed influenza (HI titer at S2/HI titer at S1 ≥2) were defined as probable influenza, subjects with A/H1N1pdm seroprotection were found to have a lower incidence of probable influenza (odds ratio, 0.31; antibody efficacy, 69%; vaccine efficacy, 18%). Conclusions In the present seasonal assessment, antibody efficacy was moderate against A/H1N1pdm among SMID subjects, but vaccine efficacy was low due to the reduced immunogenicity of SMID subjects. PMID:26780860

  5. Molecular findings from influenza A(H1N1pdm09 detected in patients from a Brazilian equatorial region during the pandemic period

    Directory of Open Access Journals (Sweden)

    Maria José Couto Oliveira

    2014-11-01

    Full Text Available After the World Health Organization officially declared the end of the first pandemic of the XXI century in August 2010, the influenza A(H1N1pdm09 virus has been disseminated in the human population. In spite of its sustained circulation, very little on phylogenetic data or oseltamivir (OST resistance is available for the virus in equatorial regions of South America. In order to shed more light on this topic, we analysed the haemagglutinin (HA and neuraminidase (NA genes of influenza A(H1N1pdm09 positive samples collected during the pandemic period in the Pernambuco (PE, a northeastern Brazilian state. Complete HA sequences were compared and amino acid changes were related to clinical outcome. In addition, the H275Y substitution in NA, associated with OST resistance, was investigated by pyrosequencing. Samples from PE were grouped in phylogenetic clades 6 and 7, being clustered together with sequences from South and Southeast Brazil. The D222N/G HA gene mutation, associated with severity, was found in one deceased patient that was pregnant. Additionally, the HA mutation K308E, which appeared in Brazil in 2010 and was only detected worldwide the following year, was identified in samples from hospitalised cases. The resistance marker H275Y was not identified in samples tested. However, broader studies are needed to establish the real frequency of resistance in this Brazilian region.

  6. Viral Etiology of Chronic Obstructive Pulmonary Disease Exacerbations during the A/H1N1pdm09 Pandemic and Postpandemic Period

    Directory of Open Access Journals (Sweden)

    Ivan Sanz

    2015-01-01

    Full Text Available Viral infections are one of the main causes of acute exacerbations of chronic obstructive pulmonary disease (AE-COPD. Emergence of A/H1N1pdm influenza virus in the 2009 pandemic changed the viral etiology of exacerbations that were reported before the pandemic. The aim of this study was to describe the etiology of respiratory viruses in 195 Spanish patients affected by AE-COPD from the pandemic until the 2011-12 influenza epidemic. During the study period (2009–2012, respiratory viruses were identified in 48.7% of samples, and the proportion of viral detections in AE-COPD was higher in patients aged 30–64 years than ≥65 years. Influenza A viruses were the pathogens most often detected during the pandemic and the following two influenza epidemics in contradistinction to human rhino/enteroviruses that were the main viruses causing AE-COPD before the pandemic. The probability of influenza virus detection was 2.78-fold higher in patients who are 30–64 years old than those ≥65. Most respiratory samples were obtained during the pandemic, but the influenza detection rate was higher during the 2011-12 epidemic. There is a need for more accurate AE-COPD diagnosis, emphasizing the role of respiratory viruses. Furthermore, diagnosis requires increased attention to patient age and the characteristics of each influenza epidemic.

  7. National surveillance of pandemic influenza A(H1N1) infection-related admissions to intensive care units during the 2009-10 winter peak in Denmark: two complementary approaches

    DEFF Research Database (Denmark)

    Gubbels, S; Perner, A; Valentiner-Branth, Palle; Molbak, K

    2010-01-01

    Surveillance of 2009 pandemic influenza A(H1N1) in Denmark was enhanced during the 2009–10 winter season with a system monitoring the burden of the pandemic on intensive care units (ICUs), in order to inform policymakers and detect shortages in ICUs in a timely manner. Between week 46 of 2009 and...... week 11 of 2010, all 36 relevant Danish ICUs reported in two ways: aggregate data were reported online and case-based data on paper. Cases to be reported were defined as patients admitted to an ICU with laboratory-confirmed 2009 pandemic influenza A(H1N1) infection or clinically suspected illness after...

  8. 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

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

    Institute of Scientific and Technical Information of China (English)

    Chenggang Li; Chen Wang; Zhongwei Chen; Li Xing; Chong Tang; Xiangwu Ju; Feng Guo; Jiejie Deng; Yan Zhao; Peng Yang; Jun Tang; Penghui Yang; Huanling Wang; Zhongpeng Zhao; Zhinan Yin; Bin Cao; Xiliang Wang; Chengyu Jiang; Yang Sun; Taisheng Li; Chen Wang; Zhong Wang; Zhen Zou; Yiwu Yan; Wei Wang

    2012-01-01

    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)administered in the early stages of S-OIV H1N1 infection was confirmed in the mouse model.Moreover,elevated levels of IL-17,Th-17 mediators and IL-17-responsive cytokines were found in serum samples of S-OIV-infected patients in Beijing.IL-17 deficiency or treatment with monoclonal antibodies against IL-17-ameliorated acute lung injury induced by the S-OIV H1N1 virus in mice.These results suggest that IL-17 plays an important role in S-OIV-induced acute lung injury and that monoclonal antibodies against IL-17 could be useful as a potential therapeutic remedy for future S-OIV H1N1 pandemics.

  10. Using high-throughput sequencing to leverage surveillance of genetic diversity and oseltamivir resistance: a pilot study during the 2009 influenza A(H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Juan Téllez-Sosa

    Full Text Available BACKGROUND: Influenza viruses display a high mutation rate and complex evolutionary patterns. Next-generation sequencing (NGS has been widely used for qualitative and semi-quantitative assessment of genetic diversity in complex biological samples. The "deep sequencing" approach, enabled by the enormous throughput of current NGS platforms, allows the identification of rare genetic viral variants in targeted genetic regions, but is usually limited to a small number of samples. METHODOLOGY AND PRINCIPAL FINDINGS: We designed a proof-of-principle study to test whether redistributing sequencing throughput from a high depth-small sample number towards a low depth-large sample number approach is feasible and contributes to influenza epidemiological surveillance. Using 454-Roche sequencing, we sequenced at a rather low depth, a 307 bp amplicon of the neuraminidase gene of the Influenza A(H1N1 pandemic (A(H1N1pdm virus from cDNA amplicons pooled in 48 barcoded libraries obtained from nasal swab samples of infected patients (n  =  299 taken from May to November, 2009 pandemic period in Mexico. This approach revealed that during the transition from the first (May-July to second wave (September-November of the pandemic, the initial genetic variants were replaced by the N248D mutation in the NA gene, and enabled the establishment of temporal and geographic associations with genetic diversity and the identification of mutations associated with oseltamivir resistance. CONCLUSIONS: NGS sequencing of a short amplicon from the NA gene at low sequencing depth allowed genetic screening of a large number of samples, providing insights to viral genetic diversity dynamics and the identification of genetic variants associated with oseltamivir resistance. Further research is needed to explain the observed replacement of the genetic variants seen during the second wave. As sequencing throughput rises and library multiplexing and automation improves, we foresee that

  11. The impact of immunosenescence on humoral immune response variation after influenza A/H1N1 vaccination in older subjects.

    Directory of Open Access Journals (Sweden)

    Iana H Haralambieva

    Full Text Available Although influenza causes significant morbidity and mortality in the elderly, the factors underlying the reduced vaccine immunogenicity and efficacy in this age group are not completely understood. Age and immunosenescence factors, and their impact on humoral immunity after influenza vaccination, are of growing interest for the development of better vaccines for the elderly.We assessed associations between age and immunosenescence markers (T cell receptor rearrangement excision circles - TREC content, peripheral white blood cell telomerase - TERT expression and CD28 expression on T cells and influenza A/H1N1 vaccine-induced measures of humoral immunity in 106 older subjects at baseline and three timepoints post-vaccination.TERT activity (TERT mRNA expression was significantly positively correlated with the observed increase in the influenza-specific memory B cell ELISPOT response at Day 28 compared to baseline (p-value=0.025. TREC levels were positively correlated with the baseline and early (Day 3 influenza A/H1N1-specific memory B cell ELISPOT response (p-value=0.042 and p-value=0.035, respectively. The expression and/or expression change of CD28 on CD4+ and/or CD8+ T cells at baseline and Day 3 was positively correlated with the influenza A/H1N1-specific memory B cell ELISPOT response at baseline, Day 28 and Day 75 post-vaccination. In a multivariable analysis, the peak antibody response (HAI and/or VNA at Day 28 was negatively associated with age, the percentage of CD8+CD28 low T cells, IgD+CD27- naïve B cells, and percentage overall CD20- B cells and plasmablasts, measured at Day 3 post-vaccination. The early change in influenza-specific memory B cell ELISPOT response was positively correlated with the observed increase in influenza A/H1N1-specific HAI antibodies at Day 28 and Day 75 relative to baseline (p-value=0.007 and p-value=0.005, respectively.Our data suggest that influenza-specific humoral immunity is significantly influenced by

  12. National surveillance of pandemic influenza A(H1N1) infection-related admissions to intensive care units during the 2009-10 winter peak in Denmark: two complementary approaches

    DEFF Research Database (Denmark)

    Gubbels, S; Perner, A; Valentiner-Branth, Palle; Molbak, K

    2010-01-01

    Surveillance of 2009 pandemic influenza A(H1N1) in Denmark was enhanced during the 2009–10 winter season with a system monitoring the burden of the pandemic on intensive care units (ICUs), in order to inform policymakers and detect shortages in ICUs in a timely manner. Between week 46 of 2009 and...... useful for monitoring the burden of the pandemic on ICUs....

  13. Oseltamivir-resistant pandemic A/H1N1 virus is as virulent as its wild-type counterpart in mice and ferrets.

    Directory of Open Access Journals (Sweden)

    Marie-Eve Hamelin

    Full Text Available The neuraminidase inhibitor oseltamivir is currently used for treatment of patients infected with the pandemic A/H1N1 (pH1N1 influenza virus, although drug-resistant mutants can emerge rapidly and possibly be transmitted. We describe the characteristics of a pair of oseltamivir-resistant and oseltamivir-susceptible pH1N1 clinical isolates that differed by a single change (H274Y in the neuraminidase protein. Viral fitness of pH1N1 isolates was assessed in vitro by determining replication kinetics in MDCK alpha2,6 cells and in vivo by performing experimental infections of BALB/c mice and ferrets. Despite slightly reduced propagation of the mutant isolate in vitro during the first 24 h, the wild-type (WT and mutant resistant viruses induced similar maximum weight loss in mice and ferrets with an identical pyrexic response in ferrets (AUC of 233.9 and 233.2, P = 0.5156. Similarly, comparable titers were obtained for the WT and the mutant strains on days 1, 3, 6 and 9 post-infection in mouse lungs and on days 1-7 in ferret nasal washes. A more important perivascular (day 6 and pleural (days 6 and 12 inflammation was noted in the lungs of mice infected with the H274Y mutant, which correlated with increased pulmonary levels of IL-6 and KC. Such increased levels of IL-6 were also observed in lymph nodes of ferrets infected with the mutant strain. Furthermore, the H274Y mutant strain was transmitted to ferrets. In conclusion, viral fitness of the H274Y pH1N1 isolate is not substantially altered and has the potential to induce severe disease and to disseminate.

  14. No Evidence for Disease History as a Risk Factor for Narcolepsy after A(H1N1)pdm09 Vaccination

    Science.gov (United States)

    Lamb, Favelle; Ploner, Alexander; Fink, Katharina; Maeurer, Markus; Bergman, Peter; Piehl, Fredrik; Weibel, Daniel; Sparén, Pär; Dahlström, Lisen Arnheim

    2016-01-01

    Objectives To investigate disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. Methods Case-control study in Sweden. Cases included persons referred for a Multiple Sleep Latency Test between 2009 and 2010, identified through diagnostic sleep centres and confirmed through independent review of medical charts. Controls, selected from the total population register, were matched to cases on age, gender, MSLT-referral date and county of residence. Disease history (prescriptions and diagnoses) and vaccination history was collected through telephone interviews and population-based healthcare registers. Conditional logistic regression was used to investigate disease history before A(H1N1)pdm09 vaccination as a risk-factor for narcolepsy. Results In total, 72 narcolepsy cases and 251 controls were included (range 3–69 years mean19-years). Risk of narcolepsy was increased in individuals with a disease history of nervous system disorders (OR range = 3.6–8.8) and mental and behavioural disorders (OR = 3.8, 95% CI 1.6–8.8) before referral. In a second analysis of vaccinated individuals only, nearly all initial associations were no longer statistically significant and effect sizes were smaller (OR range = 1.3–2.6). A significant effect for antibiotics (OR = 0.4, 95% CI 0.2–0.8) and a marginally significant effect for nervous system disorders was observed. In a third case-only analysis, comparing cases referred before vaccination to those referred after; prescriptions for nervous system disorders (OR = 26.0 95% CI 4.0–170.2) and ADHD (OR = 35.3 95% CI 3.4–369.9) were statistically significant during the vaccination period, suggesting initial associations were due to confounding by indication. Conclusion The findings of this study do not support disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. PMID:27120092

  15. Ethnicity, deprivation and mortality due to 2009 pandemic influenza A(H1N1) in England during the 2009/2010 pandemic and the first post-pandemic season.

    Science.gov (United States)

    Zhao, H; Harris, R J; Ellis, J; Pebody, R G

    2015-12-01

    The relationship between risk of death following influenza A(H1N1)pdm09 infection and ethnicity and deprivation during the 2009/2010 pandemic period and the first post-pandemic season of 2010/2011 in England was examined. Poisson regression models were used to estimate the mortality risk, adjusted for age, gender, and place of residence. Those of non-White ethnicity experienced an increased mortality risk compared to White populations during the 2009/2010 pandemic [10·5/1000 vs. 6·0/1000 general population; adjusted risk ratio (RR) 1·84, 95% confidence interval (CI) 1·39-2·54] with the highest risk in those of Pakistani ethnicity. However, no significant difference between ethnicities was observed during the following 2010/2011 season. Persons living in areas with the highest level of deprivation had a significantly higher risk of death (RR 2·08, 95% CI 1·49-2·91) compared to the lowest level for both periods. These results highlight the importance of rapid identification of groups at higher risk of severe disease in the early stages of future pandemics to enable the implementation of optimal prevention and control measures for vulnerable populations. PMID:25850904

  16. Narcolepsy with cataplexy after A/H1N1 vaccination – A case reported from Cuba

    OpenAIRE

    Mesa, Yaimi Rosales; Meira e Cruz, Miguel Gonçalves

    2014-01-01

    Narcolepsy with cataplexy is a rare sleep disorder with a neurological basis which has been recently linked to H1N1 vaccination either in children or adults. Cases from Europe, United States and Brasil were registered. Authors describe a case report of a 15 years old boy who developed narcolepsy with cataplexy after H1N1 vaccination in Havana. As far as it is concerned this is the first case reported from Cuba.

  17. A(H1N1) vaccination recruits T lymphocytes to the choroid plexus for the promotion of hippocampal neurogenesis and working memory in pregnant mice.

    Science.gov (United States)

    Qi, Fangfang; Yang, Junhua; Xia, Yucen; Yuan, Qunfang; Guo, Kaihua; Zou, Juntao; Yao, Zhibin

    2016-03-01

    We previously demonstrated that A(H1N1) influenza vaccine (AIV) promoted hippocampal neurogenesis and working memory in pregnant mice. However, the underlying mechanism of flu vaccination in neurogenesis and memory has remained unclear. In this study, we found that T lymphocytes were recruited from the periphery to the choroid plexus (CP) of the lateral and third (3rd) ventricles in pregnant mice vaccinated with AIV (Pre+AIV). Intracerebroventricular delivery of anti-TCR antibodies markedly decreased neurogenesis and the working memory of the Pre+AIV mice. Similarly, intravenous delivery of anti-CD4 antibodies to the periphery also down-regulated neurogenesis. Furthermore, AIV vaccination caused microglia to skew toward an M2-like phenotype (increased Arginase-1 and Ym1 mRNA levels), and elevated levels of brain-derived growth factor (BDNF) and insulin-like growth factor-1 (IGF-1) were found in the hippocampus, whereas these effects were offset by anti-TCR antibody treatment. Additionally, in the CP, the expression level of adhesion molecules and chemokines, which assist leukocytes in permeating into the brain, were also elevated after AIV vaccination of pregnant mice. Collectively, the results suggested that the infiltrative T lymphocytes in the CP contribute to the increase in hippocampal neurogenesis and working memory caused by flu vaccination, involving activation of the brain's CP, M2 microglial polarization and neurotrophic factor expression. PMID:26576725

  18. Punctuated evolution of influenza virus neuraminidase (A/H1N1) under opposing migration and vaccination pressures.

    Science.gov (United States)

    Phillips, J C

    2014-01-01

    Influenza virus contains two highly variable envelope glycoproteins, hemagglutinin (HA) and neuraminidase (NA). The structure and properties of HA, which is responsible for binding the virus to the cell that is being infected, change significantly when the virus is transmitted from avian or swine species to humans. Here we focus first on the simpler problem of the much smaller human individual evolutionary amino acid mutational changes in NA, which cleaves sialic acid groups and is required for influenza virus replication. Our thermodynamic panorama shows that very small amino acid changes can be monitored very accurately across many historic (1945-2011) Uniprot and NCBI strains using hydropathicity scales to quantify the roughness of water film packages. Quantitative sequential analysis is most effective with the fractal differential hydropathicity scale based on protein self-organized criticality (SOC). Our analysis shows that large-scale vaccination programs have been responsible for a very large convergent reduction in common influenza severity in the last century. Hydropathic analysis is capable of interpreting and even predicting trends of functional changes in mutation prolific viruses directly from amino acid sequences alone. An engineered strain of NA1 is described which could well be significantly less virulent than current circulating strains. PMID:25143953

  19. Punctuated Evolution of Influenza Virus Neuraminidase (A/H1N1 under Opposing Migration and Vaccination Pressures

    Directory of Open Access Journals (Sweden)

    J. C. Phillips

    2014-01-01

    Full Text Available Influenza virus contains two highly variable envelope glycoproteins, hemagglutinin (HA and neuraminidase (NA. The structure and properties of HA, which is responsible for binding the virus to the cell that is being infected, change significantly when the virus is transmitted from avian or swine species to humans. Here we focus first on the simpler problem of the much smaller human individual evolutionary amino acid mutational changes in NA, which cleaves sialic acid groups and is required for influenza virus replication. Our thermodynamic panorama shows that very small amino acid changes can be monitored very accurately across many historic (1945–2011 Uniprot and NCBI strains using hydropathicity scales to quantify the roughness of water film packages. Quantitative sequential analysis is most effective with the fractal differential hydropathicity scale based on protein self-organized criticality (SOC. Our analysis shows that large-scale vaccination programs have been responsible for a very large convergent reduction in common influenza severity in the last century. Hydropathic analysis is capable of interpreting and even predicting trends of functional changes in mutation prolific viruses directly from amino acid sequences alone. An engineered strain of NA1 is described which could well be significantly less virulent than current circulating strains.

  20. Severe acute respiratory infections during the influenza A(H1N1)2009 pandemic in Belgium: first experience of hospital-based flu surveillance

    Science.gov (United States)

    2010-01-01

    Introduction In September 2009, as part of the surveillance during the Influenza A(2009) pandemic, Bel-gium introduced a web-based surveillance system aimed at recording hospitalisations and deaths attributable to Influenza in real time. Methods We present the web-based application developed for the pandemic as well as a descriptive analysis of Severe Acute Respiratory Infection (SARI) cases reported through this system. Results From 1 September to 31 December 2009, 1723 SARI-related hospitalisations potentially due to influenza were reported in Belgium. The median age of the patients was 29 years (range: < 1 year-99 years). Among SARI-hospitalised patients 68% were aged less than 45 years, 10.6% were vaccinated with the seasonal influenza vaccine and 7.5% with the pandemic influenza vaccine. No deaths were recorded. Conclusions This first experience showed the feasibility of getting real-time information from hospitals during a public health crisis. However, the absence of death detected through the system highlighted the importance of better defining the severity of the hospital cases.

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

    Directory of Open Access Journals (Sweden)

    Ristić 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.

  2. Early spread of the 2009 influenza A(H1N1) pandemic in the United Kingdom--use of local syndromic data, May-August 2009.

    Science.gov (United States)

    Smith, S; Smith, G E; Olowokure, B; Ibbotson, S; Foord, D; Maguire, H; Pebody, R; Charlett, A; Hippisley-Cox, J; Elliot, A J

    2011-01-01

    Following the confirmation of the first two cases of pandemic influenza on 27 April 2009 in the United Kingdom (UK), syndromic surveillance data from the Health Protection Agency (HPA)/QSurveillance and HPA/NHS Direct systems were used to monitor the possible spread of pandemic influenza at local level during the first phase of the outbreak. During the early weeks, syndromic indicators sensitive to influenza activity monitored through the two schemes remained low and the majority of cases were travel-related. The first evidence of community spread was seen in the West Midlands region following a school-based outbreak in central Birmingham. During the first phase several Primary Care Trusts had periods of exceptional influenza activity two to three weeks ahead of the rest of the region. Community transmission in London began slightly later than in the West Midlands but the rates of influenza-like illness recorded by general practitioners (GPs) were ultimately higher. Influenza activity in the West Midlands and London regions peaked a week before the remainder of the UK. Data from the HPA/NHS Direct and HPA/QSurveillance systems were mapped at local level and used alongside laboratory data and local intelligence to assist in the identification of hotspots, to direct limited public health resources and to monitor the progression of the outbreak. This work has demonstrated the utility of local syndromic surveillance data in the detection of increased transmission and in the epidemiological investigation of the pandemic and has prompted future spatio-temporal work. PMID:21262185

  3. Management of the 2009 A/H1N1 influenza pandemic in patients with hematologic diseases: a prospective experience at an Italian center.

    Science.gov (United States)

    Girmenia, Corrado; Mercanti, Caterina; Federico, Vincenzo; Rea, Massimiliano; De Vellis, Annalisa; Valle, Veronica; Micozzi, Alessandra; Latagliata, Roberto; Breccia, Massimo; Morano, Salvatore Giacomo; Brunetti, Gregorio Antonio; Sali, Michela; Delogu, Giovanni; Foà, Robin; Alimena, Giuliana; Gentile, Giuseppe

    2011-01-01

    Data derived from epidemiologic surveillance adopted at our center in hematologic and stem cell transplant patients during the 2009 influenza A (H1N1)v pandemic are reported. Of the 52 patients with influenza-like disease we observed, 37 underwent a real-time PCR evaluation and 21 had a confirmed diagnosis. Of the RT-PCR-confirmed cases, 23.8% were children (age 65 years; 47.6% presented with a pulmonary infiltrate and 33.3% with respiratory failure. Pulmonary involvement was observed more frequently in patients with comorbidities. All patients received a course of oseltamivir therapy starting an average of 1 day (range <1-2) after the onset of symptoms. No patient was transferred to the intensive care unit. The viral disease had a generally favorable outcome despite the high frequency of pulmonary involvement. A prompt clinical evaluation with an early antiviral and supportive therapy may have played a beneficial role in the outcome. PMID:21411983

  4. The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2).

    LENUS (Irish Health Repository)

    Valenciano, Marta

    2015-06-04

    In the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013-2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013-2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season.

  5. Perceptions populaires du risque et savoirs experts en contexte de pandémie : le cas du A(H1N1 au Québec. Public perceptions of risk and expert knowledge in times of pandemic disease: the cases of A (H1N1 in Quebec.

    Directory of Open Access Journals (Sweden)

    Michel Désy

    2011-11-01

    Full Text Available La pandémie A(H1N1 de 2009 a mis en évidence les limites des stratégies de communication du risque tout en ravivant l’intérêt pour une analyse des perceptions populaires du risque. Au Québec, la campagne de vaccination de l’automne 2009 fut le théâtre de la circulation d’informations perçues souvent comme contradictoires sur le risque épidémique. Dans le cadre de dix focus groups organisés à Montréal et à Québec dans les mois qui ont suivi la fin de la campagne de vaccination, 100 Québécois francophones ont été invités à débattre de leur perception tant du risque associé au virus et au vaccin que de la gestion qui en fut faite par les autorités de santé publique. L’article analyse ces perceptions, en illustre la diversité et montre que diverses logiques cohabitent dans un savoir populaire marqué d’une certaine réflexivité. L’article conclut sur certaines leçons à tirer pour les stratégies de communication du risque épidémique.The A(H1N1 pandemic of 2009 illustrated the limitations of communication strategies on risk and revived interest in the analysis of public perception of risk. In Quebec, during the vaccination campaign carried out in the fall of 2009, the spread of information on epidemiological risk was often perceived as contradictory. In the months following the vaccination campaign, 10 focus groups were organized in Montréal and Québec City and 100 French-speaking Quebecers were invited to discuss their perception of the risk associated with the virus and vaccination, the management of the situation by public health authorities and the pertinence of holding a public consultation in the context of a pandemic disease. The article presents the different opinions of the general public tempered, however, by a measure of reflexivity. The article concludes with lessons to be learned regarding communication strategies on epidemiological risk.

  6. Potentially-toxic and essential elements profile of AH1N1 patients in Mexico City

    OpenAIRE

    Mireya Moya; Edgar G. Bautista; Antonio Velázquez-González; Felipe Vázquez-Gutiérrez; Guadalupe Tzintzun; María Elena García-Arreola; Manuel Castillejos; Andrés Hernández

    2013-01-01

    During spring of 2009, a new influenza virus AH1N1 spread in the world causing acute respiratory illness and death, resulting in the first influenza pandemic since 1968. Blood levels of potentially-toxic and essential elements of 40 pneumonia and confirmed AH1N1 were evaluated against two different groups of controls, both not infected with the pandemic strain. Significant concentrations of potentially-toxic elements (lead, mercury, cadmium, chromium, arsenic) along with deficiency of seleniu...

  7. Maternal and neonatal outcomes among pregnant women with 2009 pandemic influenza A(H1N1 illness in Florida, 2009-2010: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Timothy J Doyle

    Full Text Available INTRODUCTION: Pregnant women have been identified as a high risk group for severe illness with 2009 pandemic influenza A(H1N1 virus infection (pH1N1. Obesity has also been identified as a risk factor for severe illness, though this has not been thoroughly assessed among pregnant women. The objectives of this study were to provide risk estimates for adverse maternal and neonatal outcomes associated with pH1N1 illness during pregnancy and to assess the role of obesity in these outcomes. METHODS: We established a retrospective population-based cohort of all live births occurring in Florida during the first 15 months of the pandemic. Illness with pH1N1 during pregnancy was ascertained through record linkage with the Florida state notifiable disease surveillance database. Data from the birth record, including pre-pregnancy body mass index, were analyzed to assess risk of adverse outcomes associated with pH1N1 illness. RESULTS: A total of 194 women were identified through surveillance with pH1N1 illness during pregnancy. Children born to women with pH1N1 illness during pregnancy were at increased risk for low birth weight [OR (95%CI: 1.78 (1.11-2.860], premature birth [2.21 (1.47-3.330], and infant death [4.46 (1.80-11.00], after adjusting for other factors. Women with pH1N1 illness during pregnancy were at increased risk for severe outcomes including admission to an intensive care unit. Obesity was an observed risk factor, both for the more severe pH1N1 illness detected through surveillance, and for severe maternal outcomes. CONCLUSIONS: Case-patients in this analysis likely represent the most severely ill subset of all women infected with pH1N1 during pregnancy, limiting the generalizability of these findings to more severely ill patients rather than influenza infection in general. Nevertheless, these results suggest that more severe pH1N1 illness during pregnancy is associated with adverse neonatal outcomes and that pregnant women should continue

  8. DEVELOPMENT OF RECOMBINANT VACCINE AGAINST A(H1N1) 2009 INFLUENZA BASED ON VIRUS-LIKE NANOPARTICLES CARRYING THE EXTRACELLULAR DOMAIN OF M2 PROTEIN

    OpenAIRE

    Kotlyarov, R.; Kuprianov, V.; Migunov, A.; Stepanova, L.; Tsybalova, L.; Kiselev, O.; Ravin, N.; Skryabin, K.

    2010-01-01

    The conventional vaccines currently being used to deal with influenza are based on a virus obtained in chicken embryos or its components. The high variability of the major immunogenic surface proteins – hemagglutinin and neuraminidase–require the development of strain–specific vaccines that match the antigenic specificity of a newly emerging virus. Recombinant vaccines based on single viral proteins that could be easily produced in standard expression systems are attractive alternatives to tr...

  9. Airway Mucosal Immune-suppression in Neonates of Mothers Receiving A(H1N1)pnd09 Vaccination During Pregnancy

    DEFF Research Database (Denmark)

    Pedersen, Susanne Brix; Bischoff, Anne L.; Folsgaard, Nilofar V.;

    2015-01-01

    Background: It is recommended to vaccinate pregnant women against influenza. A possible impact on the immune expression of the fetus has never been studied. We aim to study the immune signature in the upper airways and the incidence of infections in neonates born to mothers receiving Influenza A(...

  10. International flight-related transmission of pandemic influenza A(H1N1)pdm09: an historical cohort study of the first identified cases in the United Kingdom

    OpenAIRE

    Young, Nicholas; Pebody, Richard; Smith, Gillian; Olowokure, Babatunde; Shankar, Giri; Hoschler, Katja; Galiano, Monica; Green, Helen; Wallensten, Anders; Hogan, Angela; Oliver, Isabel

    2013-01-01

    Background Transporting over two billion passengers per year, global airline travel has the potential to spread emerging infectious diseases, both via transportation of infectious cases and through in-flight transmission. Current World Health Organization (WHO) guidance recommends contact tracing of passengers seated within two rows of a case of influenza during air travel. Objectives The objectives of this study were to describe flight-related transmission of influenza A(H1N1)pdm09 during a ...

  11. Epidemiological effects of the A(H1N1)influenza vaccine immunization program on students%中学生接种甲型H1N1流感疫苗保护效果的评价

    Institute of Scientific and Technical Information of China (English)

    何寒青; 李倩; 何奔; 高雯洁; 姚凤燕; 蒋雪峰; 沈月根; 周建红; 陈恩富

    2011-01-01

    Objective To evaluate the epidemiological effects of vaccine immunization program related to A(H1N1)influenza in the middle school students.Methods Non-randomized clinical trial was designed to assess the A(H1N1)influenza vaccine on its efficacy.14883 students from 8 middle schools in Zhejiang province were recruited and classified into vaccinated or control groups,based on the status of immunization with A(H1N1)influenza vaccine.All subjects were followed up through one epidemic period(6 months)and the incidence rates of influenza-like illnesses,A(H1N1)influenza,and seasonal influenza in these two groups were compared to evaluate the efficacy of the vaccine.Results There were 6334 subjects in the vaccinated group and 8549 in the control group.7441.75 person-years were followed from these two groups.The incidence rate of A (H1N1)influenza in vaccinated group was 1.64‰ per person-year,lower than that of the control group.The rate difference(RD)was-1.64‰ per person-year(95% confidence interval value from-3.04‰ to-0.23‰ per person-year),and the difference was significant(P=0.010).The incidence rate of influenza-like illnesses in vaccinated group was 21.47‰ per person-year,lower than that of the control group(22.69‰ per person-year)and the diffefence was not significant(P>0.05).The incidence rate of B influenza in vaccinated group was 6.63‰ per person-year,higher than that of control group(7.02‰ per person-year)but the difference was not significant(P>0.05).Conclusion This vaccine demonstrated a good epidemiological effect against the A(H1N1)influenza virus infection,observed through a student-immunization program.The cross-protection effect against the influenza-like illnesses and other seasonal influenzas was not noticed in this study.%目的 了解中学生接种甲型H1NI流感疫苗的保护效果.方法 采用非随机对照临床试验方法,选择8所中学14 883名学生,分甲型H1N1流感疫苗接种组6334人,对照组(未接种)8549人,

  12. The Possible Impact of Vaccination for Seasonal Influenza on Emergence of Pandemic Influenza via Reassortment

    OpenAIRE

    Xu-Sheng Zhang; Richard Pebody; Daniela De Angelis; Peter J White; Andre Charlett; McCauley, John W.

    2014-01-01

    Background One pathway through which pandemic influenza strains might emerge is reassortment from coinfection of different influenza A viruses. Seasonal influenza vaccines are designed to target the circulating strains, which intuitively decreases the prevalence of coinfection and the chance of pandemic emergence due to reassortment. However, individual-based analyses on 2009 pandemic influenza show that the previous seasonal vaccination may increase the risk of pandemic A(H1N1) pdm09 infecti...

  13. An outbreak of influenza A(H1N1)pdm09 virus in a primary school in Vietnam

    OpenAIRE

    Duong, Tran Nhu; Tho, Nguyen Thi Thi; Hien, Nguyen Tran; Olowokure, Babatunde

    2015-01-01

    Background Despite school pupils being at greatest risk during the 2009 influenza pandemic there are limited data on outbreaks of influenza A(H1N1)pdm09 in primary schools in South-East Asia. This prospective cohort study describes an outbreak of influenza A(H1N1)pdm09 in a primary school in rural Vietnam. Findings In total 103 cases of influenza-like illness were found among the 407 pupils in the primary school. Ten of these were laboratory confirmed cases of influenza A(H1N1)pdm09 virus. Th...

  14. Global Variability in Reported Mortality for Critical Illness during the 2009-10 Influenza A(H1N1) Pandemic: A Systematic Review and Meta-Regression to Guide Reporting of Outcomes during Disease Outbreaks

    Science.gov (United States)

    Pinto, Ruxandra; Rubenfeld, Gordon; Fowler, Robert A.

    2016-01-01

    Purpose To determine how patient, healthcare system and study-specific factors influence reported mortality associated with critical illness during the 2009–2010 Influenza A (H1N1) pandemic. Methods Systematic review with meta-regression of studies reporting on mortality associated with critical illness during the 2009–2010 Influenza A (H1N1) pandemic. Data Sources Medline, Embase, LiLACs and African Index Medicus to June 2009-March 2016. Results 226 studies from 50 countries met our inclusion criteria. Mortality associated with H1N1-related critical illness was 31% (95% CI 28–34). Reported mortality was highest in South Asia (61% [95% CI 50–71]) and Sub-Saharan Africa (53% [95% CI 29–75]), in comparison to Western Europe (25% [95% CI 22–30]), North America (25% [95% CI 22–27]) and Australia (15% [95% CI 13–18]) (Peconomic status of the outbreak location. Outcomes from a relatively small number of patients from specific regions may lead to biased estimates of outcomes on a global scale. PMID:27170999

  15. Surveillance of influenza viruses attacking children in Beijing during 2009 pandemic influenza A(H1N1)%2009甲型H1N1流感大流行期间北京儿童的流感监测

    Institute of Scientific and Technical Information of China (English)

    朱汝南; 沙莉; 袁艺; 王菲; 胡凤华; 李杰; 胡岚; 张宝元; 曹玲; 金丽敏; 李娟娟; 钱渊; 王晓颖; 孙宇; 王芳; 邓洁; 赵林清; 曲东; 李颖; 任晓旭

    2010-01-01

    目的 了解2009年甲型H1N1流感大流行期间北京地区儿童中流感流行的情况.方法 采用WHO推荐的实时荧光定量RT-PCR和国家流感中心推荐的分型方法,对2009年甲型H1N1流感大流行期间因流感样症状来首都儿科研究所附属儿童医院就诊患儿的咽拭子标本进行流感病毒核酸检测.结果 2009年6月1日至2010年2月28日期间共检测了4363份咽拭子标本,其中623例为甲型H1N1阳性,阳性率为14.3%,657例为其他甲型流感病毒阳性(15.1%),所有甲型流感病毒的总阳性率为29.3%.623例中有23例为危重症病例(占阳性患者的3.7%),其中5例死亡.618例信息完整的甲型H1N1病例中,患儿年龄为14天~16岁,性别比例为男比女为1.3:1.1~3岁儿童占25.2%,3~6岁学龄前儿童和6~12岁学龄儿童所占比例相近,各约占30%.在监测期间,仅呈现了一个甲型H1N1的流行波.2009年11月达到最高峰,随后减弱,2010年2月快速下降至2.7%.对监测期间每周20~30份临床标本同时进行季节性流感的监测显示,季节性H3N2、甲型H1N1和乙型流感交替流行.呼吸道合胞病毒(RSV)在甲型H1N1流行趋势减缓后逐渐流行成为流行优势株.结论 2009年6月至2010年2月北京地区儿童中出现甲型H1N1的流行,主要累及学龄前和学龄儿童.季节性流感和RSV与甲型H1N1交替流行.%Objective To investigate the prevalence of influenza virus infections in infants and young children during the pandemic period of 2009 influenza A(H1N1)in Beijing.Methods Throat swabs were collected from children visited the affiliated Children's Hospital to Capital Institute of Pediatrics for influenza-like illness from June 1,2009 to February 28,2010.The specific gene segments of 2009 pandemic influenza H1N1 and seasonal influenza viruses were amplified from samples by real-time RT-PCR recommended by WHO and National Influenza Reference Center of China.Results Out of 4363 clinical samples tested by real

  16. Bayesian modeling to unmask and predict influenza A/H1N1pdm dynamics in London

    OpenAIRE

    Birrell, Paul J.; Ketsetzis, Georgios; Gay, Nigel J.; Cooper, Ben S.; Presanis, Anne M.; Harris, Ross J.; Charlett, André; Zhang, Xu-Sheng; Peter J White; Pebody, Richard G.; De Angelis, Daniela

    2011-01-01

    The tracking and projection of emerging epidemics is hindered by the disconnect between apparent epidemic dynamics, discernible from noisy and incomplete surveillance data, and the underlying, imperfectly observed, system. Behavior changes compound this, altering both true dynamics and reporting patterns, particularly for diseases with nonspecific symptoms, such as influenza. We disentangle these effects to unravel the hidden dynamics of the 2009 influenza A/H1N1pdm pandemic in London, where ...

  17. Antigenic and genomic characterization of human influenza A and B viruses circulating in Argentina after the introduction of influenza A(H1N1)pdm09.

    Science.gov (United States)

    Russo, Mara L; Pontoriero, Andrea V; Benedetti, Estefania; Czech, Andrea; Avaro, Martin; Periolo, Natalia; Campos, Ana M; Savy, Vilma L; Baumeister, Elsa G

    2014-12-01

    This study was conducted as part of the Argentinean Influenza and other Respiratory Viruses Surveillance Network, in the context of the Global Influenza Surveillance carried out by the World Health Organization (WHO). The objective was to study the activity and the antigenic and genomic characteristics of circulating viruses for three consecutive seasons (2010, 2011 and 2012) in order to investigate the emergence of influenza viral variants. During the study period, influenza virus circulation was detected from January to December. Influenza A and B, and all current subtypes of human influenza viruses, were present each year. Throughout the 2010 post-pandemic season, influenza A(H1N1)pdm09, unexpectedly, almost disappeared. The haemagglutinin (HA) of the A(H1N1)pdm09 viruses studied were segregated in a different genetic group to those identified during the 2009 pandemic, although they were still antigenically closely related to the vaccine strain A/California/07/2009. Influenza A(H3N2) viruses were the predominant strains circulating during the 2011 season, accounting for nearly 76 % of influenza viruses identified. That year, all HA sequences of the A(H3N2) viruses tested fell into the A/Victoria/208/2009 genetic clade, but remained antigenically related to A/Perth/16/2009 (reference vaccine recommended for this three-year period). A(H3N2) viruses isolated in 2012 were antigenically closely related to A/Victoria/361/2011, recommended by the WHO as the H3 component for the 2013 Southern Hemisphere formulation. B viruses belonging to the B/Victoria lineage circulated in 2010. A mixed circulation of viral variants of both B/Victoria and B/Yamagata lineages was detected in 2012, with the former being predominant. A(H1N1)pdm09 viruses remained antigenically closely related to the vaccine virus A/California/7/2009; A(H3N2) viruses continually evolved into new antigenic clusters and both B lineages, B/Victoria/2/87-like and B/Yamagata/16/88-like viruses, were observed

  18. Niños hospitalizados con neumonía por influenza AH1N11/2009 pandémico en un hospital de referencia de Perú Children hospitalized with influenza pneumonia AH1N1/2009 pandemic in the INSN

    OpenAIRE

    Edwin Miranda-Choque; Carlos Ramírez; Jorge Candela-Herrera; Javier Díaz; Ana Fernández; Lenka Kolevic; Segura, Eddy R; Sonia Farfán-Ramos

    2011-01-01

    Objetivos. Determinar las características clínicas y demográficas de la neumonía por el virus de influenza AH1N1/2009 pandémico en un hospital de referencia de Perú. Materiales y métodos. Se realizó un estudio serie de casos en niños hospitalizados por neumonía por influenza AH1N1/2009 pandémico en un hospital de referencia. Revisamos las historias clínicas entre los meses de junio a septiembre 2009. Todos los casos tuvieron confirmación virológica. Resultados. Se encontró 74 casos de neumoní...

  19. Natural A(H1N1)pdm09 influenza virus infection case in a pet ferret in Taiwan.

    Science.gov (United States)

    Lin, Hui-Ting; Wang, Ching-Ho; Wu, Wen-Ling; Chi, Chau-Hwa; Wang, Lih Chiann

    2014-11-01

    Ferrets have demonstrated high susceptibility to the influenza virus. This study discusses a natural 2009 pandemic influenza A (H1N1) (A(H1N1)pdm09) virus infection in a pet ferret (Mustela putorius furo) identified in Taiwan in 2013. The ferret was in close contact with family members who had recently experienced an influenza-like illness (ILI). The ferret nasal swab showed positive results for influenza A virus using one-step RT-PCR. The virus was isolated and the phylogenetic analysis indicated that all of the eight segmented genes were closely related to the human A(H1N1)pdm09 virus linage isolated in Taiwan. This study may provide a perspective view on natural influenza A virus transmission from the local human population into pet ferrets. PMID:25597188

  20. Influenza A/H1N1 2009 pneumonia in kidney transplant recipients: characteristics and outcomes following high-dose oseltamivir exposure.

    Science.gov (United States)

    Watcharananan, S P; Suwatanapongched, T; Wacharawanichkul, P; Chantratitaya, W; Mavichak, V; Mossad, S B

    2010-04-01

    We report 2 cases of severe pneumonia due to the novel pandemic influenza A/H1N1 2009 in kidney transplant recipients. Our patients initially experienced influenza-like illness that rapidly progressed to severe pneumonia within 48 h. The patients became hypoxic and required non-invasive ventilation. The novel influenza A/H1N1 2009 was identified from their nasal swabs. These cases were treated successfully with a relatively high dose of oseltamivir, adjusted for their renal function. Clinical improvement was documented only after a week of antiviral therapy. Despite early antiviral treatment, we showed that morbidity following novel pandemic influenza A/H1N1 2009 infection is high among kidney transplant recipients. PMID:20102550

  1. 2009年新型甲型H1N1流感病毒聚合酶编码基因的遗传特性及重要功能位点变异分析%Genetic characteristics and variations at important functional sites of polymerase coding genes of the novel A/H1N1 influenza pandemic virus in 2009

    Institute of Scientific and Technical Information of China (English)

    韩磊; 谢佳新; 殷建华; 韩一芳; 鹿文英; 曹广文

    2009-01-01

    Objective To elucidate the hereditary characteristics and variations of important functional domains of polymerase PA, PB1 and PB2 gene of the novel A/H1N1 influenza pandemic virus in 2009. Methods The sequences of PA, PB1 and PB2 gene of the novel A/H1N1 strains, and the reference sequences according to the years, locations, hosts and subtypes of influenza virus were retrieved from NCBI database. All the sequences were contrasted with MEGA4.0 software. The phylogenetic tree was constructed with the neighbor-joining method. All the deduced PB2 protein sequences were compared among the influenza strains, the avian influenza virus and the human A/H1N1 influenza virus found in different years. Results The sequence homology exceeded 99. 8% of PA, PB1 and PB2 gene of the novel A/H1N1 influenza virus isolated from different locations and different time. The sequences of PA, PB1 and PB2 gene isolated from different locations and time showed a high homology, clustered in a unique new clade, and close to avain influenza virus. Phylogenesis indicated that all the PA, PB1 and PB2 gene originally evolved from avain influenza virus. Alignments of the deduced protein sequences showed that the 627th amino acid of the PB2 gene of novel A/H1N1 strains was glutamic acid (Glu) , which was the same as that of avian influenza virus, rather than human H1N1 virus. Conclusions The novel A/H1N1 influenza virus from the same origin leads to the outbreak in 2009, and it is of atypical high pathogenicity. The polymerase gene of avian influenza virus might partially reassort with the novel A/H1N1 virus.%目的 分析2009年新型甲型H1N1流感病毒聚合酶PA、PB1和PB2编码基因序列遗传的进化特征及重要功能位点变异.方法 从NCBI流感数据库中获取此次流行株的PA、PB1和PB2聚合酶编码基因序列以及不同年代、不同地区、不同宿主、不同亚型的参考序列,运用MEGA4.0软件比对和修剪此次流行株的代表

  2. Detection of influenza A(H1N1)v virus by real-time RT-PCR.

    Science.gov (United States)

    Panning, M; Eickmann, M; Landt, O; Monazahian, M; Olschläger, S; Baumgarte, S; Reischl, U; Wenzel, J J; Niller, H H; Günther, S; Hollmann, B; Huzly, D; Drexler, J F; Helmer, A; Becker, S; Matz, B; Eis-Hübinger, Am; Drosten, C

    2009-09-10

    Influenza A(H1N1)v virus was first identified in April 2009. A novel real-time RT-PCR for influenza A(H1N1)v virus was set up ad hoc and validated following industry-standard criteria. The lower limit of detection of the assay was 384 copies of viral RNA per ml of viral transport medium (95% confidence interval: 273-876 RNA copies/ml). Specificity was 100% as assessed on a panel of reference samples including seasonal human influenza A virus H1N1 and H3N2, highly pathogenic avian influenza A virus H5N1 and porcine influenza A virus H1N1, H1N2 and H3N2 samples. The real-time RT-PCR assay for the influenza A matrix gene recommended in 2007 by the World Health Organization was modified to work under the same reaction conditions as the influenza A(H1N1)v virus-specific test. Both assays were equally sensitive. Clinical applicability of both assays was demonstrated by screening of almost 2,000 suspected influenza (H1N1)v specimens, which included samples from the first cases of pandemic H1N1 influenza imported to Germany. Measuring influenza A(H1N1)v virus concentrations in 144 laboratory-confirmed samples yielded a median of 4.6 log RNA copies/ml. The new methodology proved its principle and might assist public health laboratories in the upcoming influenza pandemic. PMID:19758541

  3. [Cases of children with influenza AH1N1/2009 in the district of Lodz in two epidemic waves].

    Science.gov (United States)

    Majda-Stanisławska, Ewa; Sobieraj, Iwona

    2011-01-01

    High influenza morbidity due to new antigenic strain AH1N1 was announced in Mexico in spring 2009. Influenza pandemic caused by the virus AH1N1/2009 spread around the world. Two pandemic waves were noted in most European countries: the first one was due to summer months migration, the second wave started in the beginning of common influenza season. We present features of both waves in children from the district of Lodz. We describe mild clinical course in 14 children who came from holiday in Spain with influenza and who were hospitalized and treated with osltamimivir due to unpredictable course of new influenza. We also present 22 influenza cases of the autumn pandemic wave, when children with severe complications of influenza and children from high risk groups were hospitalized and treated with antivirals. Experience that we have gained during 2009 influenza pandemic indicates that International Influenza Control System is very efficient, however more flexibility is required in application of treatment and prophylaxis procedures with new influenza strains. Applied methods of control should mostly depend on the virulence of pandemic strain. PMID:22390048

  4. Multidrug resistant 2009 a/h1n1 influenza clinical isolate with a neuraminidase i223r mutation retains its virulence and transmissibility in ferrets

    OpenAIRE

    Vries, Erhard; Kroeze, E.J.B.V.; Stittelaar, Koert; Linster, Martin; Linden, A; Schrauwen, Eefje; Leijten, Lonneke; Amerongen, Geert; Schutten, Martin; Kuiken, Thijs; Osterhaus, Albert; Fouchier, Ron; Boucher, Charles; Herfst, Sander

    2011-01-01

    textabstractOnly two classes of antiviral drugs, neuraminidase inhibitors and adamantanes, are approved for prophylaxis and therapy against influenza virus infections. A major concern is that influenza virus becomes resistant to these antiviral drugs and spreads in the human population. The 2009 pandemic A/H1N1 influenza virus is naturally resistant to adamantanes. Recently a novel neuraminidase I223R mutation was identified in an A/H1N1 virus showing cross-resistance to the neuraminidase inh...

  5. Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

    OpenAIRE

    Chowell, G.; Ayala, A; Berisha, V.; Viboud, C.; Schumacher, M.

    2012-01-01

    We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR)   =   6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3...

  6. Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

    OpenAIRE

    Chowell, G.; Ayala, A; Berisha, V.; Viboud, C.; Schumacher, M.

    2012-01-01

    We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR)  =  6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9...

  7. Clinical features, complications and mortality in critically ill patients with 2009 influenza A(H1N1) in Sfax,Tunisia

    OpenAIRE

    Damak, Hassen; Chtara, Kamilia; Bahloul, Mabrouk; Kallel, Hatem; Chaari, Anis; Ksibi, Hichem; Chaari, Adel; Chelly, Hedi; Rekik, Noureddine; Ben Hamida, Chokri; Bouaziz, Mounir

    2011-01-01

    Please cite this paper as: Damak et al.(2011) Clinical features, complications and mortality in critically ill patients with 2009 influenza A(H1N1) in Sfax,Tunisia. Influenza and Other Respiratory Viruses 5(4), 230–240 Purpose  Africa, as the rest of the world, was touched by the 2009 pandemic influenza A(H1N1). In the literature, a few publications covering this subject emerged from this continent. We prospectively describe baseline characteristics, treatment and outcomes of consecutive crit...

  8. Vaccines for Pandemic Influenza

    OpenAIRE

    Luke, Catherine J.; Subbarao, Kanta

    2006-01-01

    Recent outbreaks of highly pathogenic avian influenza in Asia and associated human infections have led to a heightened level of awareness and preparation for a possible influenza pandemic. Vaccination is the best option by which spread of a pandemic virus could be prevented and severity of disease reduced. Production of live attenuated and inactivated vaccine seed viruses against avian influenza viruses, which have the potential to cause pandemics, and their testing in preclinical studies and...

  9. Molecular epidemiology of influenza A(H1N1pdm09 viruses from Pakistan in 2009-2010.

    Directory of Open Access Journals (Sweden)

    Uzma Bashir Aamir

    Full Text Available BACKGROUND: In early 2009, a novel influenza A(H1N1 virus that emerged in Mexico and United States rapidly disseminated worldwide. The spread of this virus caused considerable morbidity with over 18000 recorded deaths. The new virus was found to be a reassortant containing gene segments from human, avian and swine influenza viruses. METHODS/RESULTS: The first case of human infection with A(H1N1pdm09 in Pakistan was detected on 18(th June 2009. Since then, 262 laboratory-confirmed cases have been detected during various outbreaks with 29 deaths (as of 31(st August 2010. The peak of the epidemic was observed in December with over 51% of total respiratory cases positive for influenza. Representative isolates from Pakistan viruses were sequenced and analyzed antigenically. Sequence analysis of genes coding for surface glycoproteins HA and NA showed high degree of high levels of sequence identity with corresponding genes of regional viruses circulating South East Asia. All tested viruses were sensitive to Oseltamivir in the Neuraminidase Inhibition assays. CONCLUSIONS: Influenza A(H1N1pdm09 viruses from Pakistan form a homogenous group of viruses. Their HA genes belong to clade 7 and show antigenic profile similar to the vaccine strain A/California/07/2009. These isolates do not show any amino acid changes indicative of high pathogenicity and virulence. It is imperative to continue monitoring of these viruses for identification of potential variants of high virulence or drug resistance.

  10. The Possible Impact of Vaccination for Seasonal Influenza on Emergence of Pandemic Influenza via Reassortment.

    Directory of Open Access Journals (Sweden)

    Xu-Sheng Zhang

    Full Text Available One pathway through which pandemic influenza strains might emerge is reassortment from coinfection of different influenza A viruses. Seasonal influenza vaccines are designed to target the circulating strains, which intuitively decreases the prevalence of coinfection and the chance of pandemic emergence due to reassortment. However, individual-based analyses on 2009 pandemic influenza show that the previous seasonal vaccination may increase the risk of pandemic A(H1N1 pdm09 infection. In view of pandemic influenza preparedness, it is essential to understand the overall effect of seasonal vaccination on pandemic emergence via reassortment.In a previous study we applied a population dynamics approach to investigate the effect of infection-induced cross-immunity on reducing such a pandemic risk. Here the model was extended by incorporating vaccination for seasonal influenza to assess its potential role on the pandemic emergence via reassortment and its effect in protecting humans if a pandemic does emerge. The vaccination is assumed to protect against the target strains but only partially against other strains. We find that a universal seasonal vaccine that provides full-spectrum cross-immunity substantially reduces the opportunity of pandemic emergence. However, our results show that such effectiveness depends on the strength of infection-induced cross-immunity against any novel reassortant strain. If it is weak, the vaccine that induces cross-immunity strongly against non-target resident strains but weakly against novel reassortant strains, can further depress the pandemic emergence; if it is very strong, the same kind of vaccine increases the probability of pandemic emergence.Two types of vaccines are available: inactivated and live attenuated, only live attenuated vaccines can induce heterosubtypic immunity. Current vaccines are effective in controlling circulating strains; they cannot always help restrain pandemic emergence because of the

  11. Comparison of shedding characteristics of seasonal influenza virus (subtypes and influenza A(H1N1pdm09; Germany, 2007-2011.

    Directory of Open Access Journals (Sweden)

    Thorsten Suess

    Full Text Available BACKGROUND: Influenza viral shedding studies provide fundamental information for preventive strategies and modelling exercises. We conducted a prospective household study to investigate viral shedding in seasonal and pandemic influenza between 2007 and 2011 in Berlin and Munich, Germany. METHODS: Study physicians recruited index patients and their household members. Serial nasal specimens were obtained from all household members over at least eight days and tested quantitatively by qRT-PCR for the influenza virus (subtype of the index patient. A subset of samples was also tested by viral culture. Symptoms were recorded daily. RESULTS: We recruited 122 index patients and 320 household contacts, of which 67 became secondary household cases. Among all 189 influenza cases, 12 were infected with seasonal/prepandemic influenza A(H1N1, 19 with A(H3N2, 60 with influenza B, and 98 with A(H1N1pdm09. Nine (14% of 65 non-vaccinated secondary cases were asymptomatic/subclinical (0 (0% of 21 children, 9 (21% of 44 adults; p = 0.03. Viral load among patients with influenza-like illness (ILI peaked on illness days 1, 2 or 3 for all (subtypes and declined steadily until days 7-9. Clinical symptom scores roughly paralleled viral shedding dynamics. On the first day prior to symptom onset 30% (12/40 of specimens were positive. Viral load in 6 asymptomatic/subclinical patients was similar to that in ILI-patients. Duration of infectiousness as measured by viral culture lasted approximately until illness days 4-6. Viral load did not seem to be influenced by antiviral therapy, age or vaccination status. CONCLUSION: Asymptomatic/subclinical infections occur infrequently, but may be associated with substantial amounts of viral shedding. Presymptomatic shedding may arise in one third of cases, and shedding characteristics appear to be independent of (seasonal or pandemic (subtype, age, antiviral therapy or vaccination; however the power to find moderate differences

  12. Top leads for swine influenza A/H1N1 virus revealed by steered molecular dynamics approach.

    Science.gov (United States)

    Mai, Binh Khanh; Viet, Man Hoang; Li, Mai Suan

    2010-12-27

    Since March 2009, the rapid spread of infection during the recent A/H1N1 swine flu pandemic has raised concerns of a far more dangerous outcome should this virus become resistant to current drug therapies. Currently oseltamivir (tamiflu) is intensively used for the treatment of influenza and is reported effective for 2009 A/H1N1 virus. However, as this virus is evolving fast, some drug-resistant strains are emerging. Therefore, it is critical to seek alternative treatments and identify roots of the drug resistance. In this paper, we use the steered molecular dynamics (SMD) approach to estimate the binding affinity of ligands to the glycoprotein neuraminidase. Our idea is based on the hypothesis that the larger is the force needed to unbind a ligand from a receptor the higher its binding affinity. Using all-atom models with Gromos force field 43a1 and explicit water, we have studied the binding ability of 32 ligands to glycoprotein neuraminidase from swine flu virus A/H1N1. The electrostatic interaction is shown to play a more important role in binding affinity than the van der Waals one. We have found that four ligands 141562, 5069, 46080, and 117079 from the NSC set are the most promising candidates to cope with this virus, while peramivir, oseltamivir, and zanamivir are ranked 8, 11, and 20. The observation that these four ligands are better than existing commercial drugs has been also confirmed by our results on the binding free energies obtained by the molecular mechanics-Poisson-Boltzmann surface area (MM-PBSA) method. Our prediction may be useful for the therapeutic application. PMID:21090736

  13. The progress of research on influenza A(H1N1)%甲型H1N1流感的研究进展

    Institute of Scientific and Technical Information of China (English)

    雷晓燕; 孙永红

    2010-01-01

    Influenza A(H1N1)virus is a re-mixed strains of human influenza virus genes,avian influenza virus gene and swine influenza virus gene.Influenza A(H1N1)pandemic influenza has spread around the world,which has drawn worldwide attention.In order to early discovery,early diagnosis,early treatment and effective prevention of Influenza A(H1N1),we describe the characteristics of linfluenza A(H1N1)virus,epidemiology,pathogenesis,clinical manifestations,laboratory examination and effective treatment and preventive measures.%甲型H1N1流感病毒是人流感病毒基因、禽流感病毒基因和猪流感病毒基因混合的重配株,其造成的疫情来势凶猛,引起世界各国的广泛关注.为了早发现、早诊断、早治疗及有效地预防甲型H1N1流感,本文综述了甲型H1N1流感病毒的特点、流行病学、致人发病的机制、甲型H1N1流感患者的临床表现、实验室检查及有效的治疗和预防措施.

  14. Psychological response of family members of patients hospitalised for influenza A/H1N1 in Oaxaca, Mexico

    Directory of Open Access Journals (Sweden)

    Mayoral-García Maurilio

    2010-12-01

    Full Text Available Abstract Background The A/H1N1 pandemic originated in Mexico in April 2009, amid high uncertainty, social and economic disruption, and media reports of panic. The aim of this research project was to evaluate the psychological response of family primary caregivers of patients hospitalised in the Intensive Care Unit (ICU with suspected influenza A/H1N1 to establish whether there was empirical evidence of high adverse psychological response, and to identify risk factors for such a response. If such evidence was found, a secondary aim was to develop a specific early intervention of psychological support for these individuals, to reduce distress and possibly lessen the likelihood of post-traumatic stress disorder (PTSD in the longer term. Methods Psychological assessment questionnaires were administered to the family primary caregivers of patients hospitalised in the ICU in the General Hospital of Zone 1 of the Mexican Institute for Social Security (IMSS, Oaxaca, Mexico with suspected influenza A/H1N1, during the month of November 2009. The main outcome measures were ratings of reported perceived stress (PSS-10, depression (CES-D, and death anxiety (DAQ. Data were subjected to simple and multiple linear regression analysis to identify risk factors for adverse psychological response. Results Elevated levels of perceived stress and depression, compared to population normative data, and moderate levels of death anxiety were noted. Levels of depression were similar to those found in comparable studies of family members of ICU patients admitted for other conditions. Multiple regression analysis indicated that increasing age and non-spousal family relationship were significantly associated with depression and perceived stress. Female gender, increasing age, and higher levels of education were significantly associated with high death anxiety. Comparisons with data collected in previous studies in the same hospital ICU with groups affected by a range of

  15. Estimating time to onset of swine influenza symptoms after initial novel A(H1N1v) viral infection.

    Science.gov (United States)

    Tom, B D M; Van Hoek, A J; Pebody, R; McMenamin, J; Robertson, C; Catchpole, M; De Angelis, D

    2011-09-01

    Characterization of the incubation time from infection to onset is important for understanding the natural history of infectious diseases. Attempts to estimate the incubation time distribution for novel A(H1N1v) have been, up to now, based on limited data or peculiar samples. We characterized this distribution for a generic group of symptomatic cases using laboratory-confirmed swine influenza case-information. Estimates of the incubation distribution for the pandemic influenza were derived through parametric time-to-event analyses of data on onset of symptoms and exposure dates, accounting for interval censoring. We estimated a mean of about 1·6-1·7 days with a standard deviation of 2 days for the incubation time distribution in those who became symptomatic after infection with the A(H1N1v) virus strain. Separate analyses for the <15 years and ≥ 15 years age groups showed a significant (P<0·02) difference with a longer mean incubation time in the older age group. PMID:21087539

  16. In Vitro Antiviral Activity of Favipiravir (T-705) against Drug-Resistant Influenza and 2009 A(H1N1) Viruses▿

    OpenAIRE

    Sleeman, Katrina; Mishin, Vasiliy P.; Deyde, Varough M.; Furuta, Yousuke; Klimov, Alexander I; Larisa V Gubareva

    2010-01-01

    Favipiravir (T-705) has previously been shown to have a potent antiviral effect against influenza virus and some other RNA viruses in both cell culture and in animal models. Currently, favipiravir is undergoing clinical evaluation for the treatment of influenza A and B virus infections. In this study, favipiravir was evaluated in vitro for its ability to inhibit the replication of a representative panel of seasonal influenza viruses, the 2009 A(H1N1) strains, and animal viruses with pandemic ...

  17. Influenza A/H1N1/2009 virus - experience of the clinical microbiology laboratory of the “L. Sacco” University Hospital in Milan

    Directory of Open Access Journals (Sweden)

    Lisa Lucia Chenal

    2011-06-01

    Full Text Available In the spring of 2009, a new variant of influenza A/H1N1 virus that had never been isolated before, was identified. From April 27 to December 31, 2009 the respiratory samples of 974 patients, obtained from suspected cases of pandemic influenza A virus infection, were analyzed at the Clinical Microbiology Laboratory of the “L. Sacco” University Hospital in Milan. The diagnosis of influenza A/H1N1 infection was performed initially through the use of different molecular biological methods: Seeplex® RV12 ACE Detection (Seegene, NUCLISENS® EASYQ® INFLUENZA A/B (bioMérieux, Influenza A/B Q-PCR Alert (Nanogen running in parallel with rRT-PCR (CDC to confirm the positivity to the new influenza virus, then was used a single specific test, Fast set H1N1v (Arrow Diagnostics. Retrospective study of data showed that 293 (30.1% patients were positive for the new strain of influenza A/H1N1 virus and 8 (0.8% for influenza A other than H1N1 virus.The distribution of influenza A/H1N1 cases showed two peaks, one on July (62.9% and the other one on October (36%, moreover we observed that 155 patients (53% out of 293 positive for influenza A/H1N1 virus aged under 20 years old. The first positivity peak was found in travelers and the second one, occurred 2-3 months prior to the classic seasonal epidemic influenza, was attributed to autochthonous cases , by which the virus had spread worldwide. The highest proportion of cases were among subjects aged from 0 to 20 years and, over this age the positivity rate decreased proportionally with increasing age, in agreement with data reported in other countries.

  18. Analysis of fatal outcomes from influenza A(H1N1pdm09 in Mongolia

    Directory of Open Access Journals (Sweden)

    Erdenebaatariin Soyolmaa

    2012-08-01

    Full Text Available Introduction: While influenza A(H1N1pdm09 usually causes mild illness in the majority of people, there have been reports of severe cases and deaths. As there is no documented evidence on fatal outcomes from influenza in Mongolia previously, we aimed to describe the epidemiology of fatal influenza A(H1N1pdm09 cases to provide recommendations to assist the national influenza prevention and control strategy.Methods: We selected influenza A(H1N1pdm09-confirmed deaths in hospitals between 12 October 2009 and 31 January 2010 in Mongolia from the national influenza surveillance system. The mortality rate and case fatality rate (CFR of influenza A(H1N1pdm09-hospitalized deaths were calculated. Using country prevalence of pregnancy and chronic diseases, we calculated the relative risk of death from influenza A(H1N1pdm09.Results: There were 29 deaths with a mortality rate of 1.0 per 100 000 population during the study period, which was highest in children under five and the middle-aged population. Crude CFR was 2.2%. Of all fatal cases, 62% had at least one underlying condition. Most (62% were provided antivirals, although none received these within 48 hours of symptom onset. Prevalence for pregnancy, cardiovascular and chronic liver diseases was five to 50 times higher in fatal cases compared to country prevalence.Discussion: Mortality and crude CFR in our study was higher than in other studies. However, due to the diagnostic policy change during the epidemic, this estimate is likely to have overestimated actual case fatalities. Pregnancy, cardiovascular and chronic liver diseases were suggestive risk factors for death from influenza A(H1N1pdm09. Strengthening hospital-based influenza surveillance is important in predicting severity of an epidemic and responding to influenza epidemics in a timely and appropriate manner.

  19. Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

    Directory of Open Access Journals (Sweden)

    Paola Faverio

    2014-01-01

    Full Text Available We present the results of bronchoalveolar lavage (BAL performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS. Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage.

  20. Socioeconomic factors influencing hospitalized patients with pneumonia due to influenza A(H1N1pdm09 in Mexico.

    Directory of Open Access Journals (Sweden)

    Toshie Manabe

    Full Text Available BACKGROUND: In addition to clinical aspects and pathogen characteristics, people's health-related behavior and socioeconomic conditions can affect the occurrence and severity of diseases including influenza A(H1N1pdm09. METHODOLOGY AND PRINCIPAL FINDINGS: A face-to-face interview survey was conducted in a hospital in Mexico City at the time of follow-up consultation for hospitalized patients with pneumonia due to influenza virus infection. In all, 302 subjects were enrolled and divided into two groups based on the period of hospitalization. Among them, 211 tested positive for influenza A(H1N1pdm09 virus by real-time reverse-transcriptase-polymerase-chain-reaction during the pandemic period (Group-pdm and 91 tested positive for influenza A virus in the post-pandemic period (Group-post. All subjects were treated with oseltamivir. Data on the demographic characteristics, socioeconomic status, living environment, and information relating to A(H1N1pdm09, and related clinical data were compared between subjects in Group-pdm and those in Group-post. The ability of household income to pay for utilities, food, and health care services as well as housing quality in terms of construction materials and number of rooms revealed a significant difference: Group-post had lower socioeconomic status than Group-pdm. Group-post had lower availability of information regarding H1N1 influenza than Group-pdm. These results indicate that subjects in Group-post had difficulty receiving necessary information relating to influenza and were more likely to be impoverished than those in Group-pdm. Possible factors influencing time to seeking health care were number of household rooms, having received information on the necessity of quick access to health care, and house construction materials. CONCLUSIONS: Health-care-seeking behavior, poverty level, and the distribution of information affect the occurrence and severity of pneumonia due to H1N1 virus from a socioeconomic

  1. Mortality, severe acute respiratory infection, and influenza-like illness associated with influenza A(H1N1pdm09 in Argentina, 2009.

    Directory of Open Access Journals (Sweden)

    Eduardo Azziz-Baumgartner

    Full Text Available INTRODUCTION: While there is much information about the burden of influenza A(H1N1pdm09 in North America, little data exist on its burden in South America. METHODS: During April to December 2009, we actively searched for persons with severe acute respiratory infection and influenza-like illness (ILI in three sentinel cities. A proportion of case-patients provided swabs for influenza testing. We estimated the number of case-patients that would have tested positive for influenza by multiplying the number of untested case-patients by the proportion who tested positive. We estimated rates by dividing the estimated number of case-patients by the census population after adjusting for the proportion of case-patients with missing illness onset information and ILI case-patients who visited physicians multiple times for one illness event. RESULTS: We estimated that the influenza A(H1N1pdm09 mortality rate per 100,000 person-years (py ranged from 1.5 among persons aged 5-44 years to 5.6 among persons aged ≥ 65 years. A(H1N1pdm09 hospitalization rates per 100,000 py ranged between 26.9 among children aged <5 years to 41.8 among persons aged ≥ 65 years. Influenza A(H1N1pdm09 ILI rates per 100 py ranged between 1.6 among children aged <5 to 17.1 among persons aged 45-64 years. While 9 (53% of 17 influenza A(H1N1pdm09 decedents with available data had obesity and 7 (17% of 40 had diabetes, less than 4% of surviving influenza A(H1N1pdm09 case-patients had these pre-existing conditions (p ≤ 0.001. CONCLUSION: Influenza A(H1N1pdm09 caused a similar burden of disease in Argentina as in other countries. Such disease burden suggests the potential value of timely influenza vaccinations.

  2. Guillain-Barre syndrome and adjuvanted pandemic influenza A (H1N1 2009 vaccines: a multinational self-controlled case series in Europe.

    Directory of Open Access Journals (Sweden)

    Silvana Romio

    Full Text Available BACKGROUND: The risk of Guillain-Barré syndrome (GBS following the United States' 1976 swine flu vaccination campaign in the USA led to enhanced active surveillance during the pandemic influenza (A(H1N1pdm09 immunization campaign. This study aimed to estimate the risk of GBS following influenza A(H1N1pdm09 vaccination. METHODS: A self-controlled case series (SCCS analysis was performed in Denmark, Finland, France, Netherlands, Norway, Sweden, and the United Kingdom. Information was collected according to a common protocol and standardised procedures. Cases classified at levels 1-4a of the Brighton Collaboration case definition were included. The risk window was 42 days starting the day after vaccination. Conditional Poisson regression and pooled random effects models estimated adjusted relative incidences (RI. Pseudo likelihood and vaccinated-only methods addressed the potential contraindication for vaccination following GBS. RESULTS: Three hundred and three (303 GBS and Miller Fisher syndrome cases were included. Ninety-nine (99 were exposed to A(H1N1pdm09 vaccination, which was most frequently adjuvanted (Pandemrix and Focetria. The unadjusted pooled RI for A(H1N1pdm09 vaccination and GBS was 3.5 (95% Confidence Interval (CI: 2.2-5.5, based on all countries. This lowered to 2.0 (95% CI: 1.2-3.1 after adjustment for calendartime and to 1.9 (95% CI: 1.1-3.2 when we accounted for contra-indications. In a subset (Netherlands, Norway, and United Kingdom we further adjusted for other confounders and there the RI decreased from 1.7 (adjusted for calendar month to 1.4 (95% CI: 0.7-2.8, which is the main finding. CONCLUSION: This study illustrates the potential of conducting European collaborative vaccine safety studies. The main, fully adjusted analysis, showed that the RI of GBS was not significantly elevated after influenza A(H1N1pdm09 vaccination (RI = 1.4 (95% CI: 0.7-2.8. Based on the upper limits of the pooled estimate we can rule out with

  3. Point of care strategy for rapid diagnosis of novel A/H1N1 influenza virus.

    Directory of Open Access Journals (Sweden)

    Antoine Nougairede

    Full Text Available Within months of the emergence of the novel A/H1N1 pandemic influenza virus (nA/H1N1v, systematic screening for the surveillance of the pandemic was abandoned in France and in some other countries. At the end of June 2009, we implemented, for the public hospitals of Marseille, a Point Of Care (POC strategy for rapid diagnosis of the novel A/H1N1 influenza virus, in order to maintain local surveillance and to evaluate locally the kinetics of the pandemic.Two POC laboratories, located in strategic places, were organized to receive and test samples 24 h/24. POC strategy consisted of receiving and processing naso-pharyngeal specimens in preparation for the rapid influenza diagnostic test (RIDT and real-time RT-PCR assay (rtRT-PCR. This strategy had the theoretical capacity of processing up to 36 samples per 24 h. When the flow of samples was too high, the rtRT-PCR test was abandoned in the POC laboratories and transferred to the core virology laboratory. Confirmatory diagnosis was performed in the core virology laboratory twice a day using two distinct rtRT-PCR techniques that detect either influenza A virus or nA/N1N1v. Over a period of three months, 1974 samples were received in the POC laboratories, of which 111 were positive for nA/H1N1v. Specificity and sensitivity of RIDT were 100%, and 57.7% respectively. Positive results obtained using RIDT were transmitted to clinical practitioners in less than 2 hours. POC processed rtRT-PCR results were available within 7 hours, and rtRT-PCR confirmation within 24 hours.The POC strategy is of benefit, in all cases (with or without rtRT-PCR assay, because it provides continuous reception/processing of samples and reduction of the time to provide consolidated results to the clinical practitioners. We believe that implementation of the POC strategy for the largest number of suspect cases may improve the quality of patient care and our knowledge of the epidemiology of the pandemic.

  4. Adaptive vaccination strategies to mitigate pandemic influenza: Mexico as a case study.

    Directory of Open Access Journals (Sweden)

    Gerardo Chowell

    Full Text Available We explore vaccination strategies against pandemic influenza in Mexico using an age-structured transmission model calibrated against local epidemiological data from the Spring 2009 A(H1N1 pandemic.In the context of limited vaccine supplies, we evaluate age-targeted allocation strategies that either prioritize youngest children and persons over 65 years of age, as for seasonal influenza, or adaptively prioritize age groups based on the age patterns of hospitalization and death monitored in real-time during the early stages of the pandemic. Overall the adaptive vaccination strategy outperformed the seasonal influenza vaccination allocation strategy for a wide range of disease and vaccine coverage parameters.This modeling approach could inform policies for Mexico and other countries with similar demographic features and vaccine resources issues, with regard to the mitigation of the S-OIV pandemic. We also discuss logistical issues associated with the implementation of adaptive vaccination strategies in the context of past and future influenza pandemics.

  5. Sales of oseltamivir in Norway prior to the emergence of oseltamivir resistant influenza A(H1N1 viruses in 2007–08

    Directory of Open Access Journals (Sweden)

    Hungnes Olav

    2009-05-01

    Full Text Available Abstract Background An unprecedented high proportion of oseltamivir resistant influenza A(H1N1 viruses emerged in the 2007–08 influenza season. In Norway, two thirds of all tested A(H1N1 viruses were resistant to the antiviral drug. In order to see if this emergence could be explained by a drug induced selection pressure, we analysed data on the sales of oseltamivir in Norway for the years 2002–07. Methods We used data from two sources; the Norwegian Drug Wholesales Statistics Database and the Norwegian Prescription Database (NorPD, for the years 2002–2007. We calculated courses sold of oseltamivir (Tamiflu® per 1000 inhabitants per year. Results Our data showed that, except for the years 2005 and 2006, sales of oseltamivir were low in Norway; courses sold per 1000 inhabitants varied between 0.17–1.64. The higher sales in 2005 and 2006 we believe were caused by private stockpiling in fear of a pandemic, and do not represent actual usage. Conclusion A drug induced selection pressure was probably not the cause of the emergence of oseltamivir resistant influenza A(H1N1 viruses in 2007–08 in Norway.

  6. Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

    Directory of Open Access Journals (Sweden)

    G. Chowell

    2012-01-01

    Full Text Available We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR  =  6.2; 95% CI: 6.15, 6.21, non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9, and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01 compared to non-Hispanic Whites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P<0.0001. In our best-fit logistic model, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 to March 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03 compared to the spring wave (April 1, 2009 to August 15, 2009. Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4, cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8, immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9, and admission delays (OR = 4.6; 95% CI: 2.2, 9.5 were significantly associated with an increased the risk of death among A/H1N1 inpatients.

  7. Risk factors for mortality among 2009 A/H1N1 influenza hospitalizations in Maricopa County, Arizona, April 2009 to March 2010.

    Science.gov (United States)

    Chowell, G; Ayala, A; Berisha, V; Viboud, C; Schumacher, M

    2012-01-01

    We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR)  =  6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9), and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01) compared to non-Hispanic Whites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P < 0.0001). In our best-fit logistic model, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 to March 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03) compared to the spring wave (April 1, 2009 to August 15, 2009). Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4), cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8), immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9), and admission delays (OR = 4.6; 95% CI: 2.2, 9.5) were significantly associated with an increased the risk of death among A/H1N1 inpatients. PMID:22844347

  8. Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

    Science.gov (United States)

    Chowell, G.; Ayala, A.; Berisha, V.; Viboud, C.; Schumacher, M.

    2012-01-01

    We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR)  =  6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9), and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01) compared to non-Hispanic Whites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P < 0.0001). In our best-fit logistic model, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 to March 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03) compared to the spring wave (April 1, 2009 to August 15, 2009). Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4), cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8), immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9), and admission delays (OR = 4.6; 95% CI: 2.2, 9.5) were significantly associated with an increased the risk of death among A/H1N1 inpatients. PMID:22844347

  9. Enhanced Pneumonia and Proinflammatory Cytokine Response in Pigs Challenged with Pandemic 2009 A/H1N1 Influenza Virus Following Vaccination with an Inactivated delta-Cluster H1N2 Virus

    Science.gov (United States)

    Endemic strains of swine influenza A virus (IAV) in North America consist of the subtypes H1N1, H1N2, and H3N2. These circulating strains contain the triple reassortant internal gene (TRIG) cassette resulting from incorporation of genes from swine, avian, and human IAV’s. Genetic drift and reassortm...

  10. Pandemic influenza vaccine & narcolepsy: simulations on the potential impact of bias.

    Science.gov (United States)

    Wijnans, Leonoor; Dodd, Caitlin; de Ridder, Maria; Romio, Silvana; Weibel, Daniel; Overeem, Sebastiaan; Lammers, Gert Jan; Bonhoeffer, Jan; Black, Steve; Sturkenboom, Miriam

    2016-05-01

    Several studies have identified an association between Pandemrix(TM), an AS03 adjuvanted pandemic influenza A(H1N1) vaccine, and narcolepsy, a rare and under-diagnosed sleep disorder with a median onset-to-diagnosis interval of ten years. This paper reviews potential sources of bias in published studies and aims to provide, through simulation, methodological recommendations for assessment of vaccine safety signals. Our simulation study showed that in the absence of an association between the vaccine and the outcome, presence of detection bias and differential exposure misclassification could account for elevated risk estimates. These may play a major role, particularly in alert situations when observation times are limited and the disease has a long latency period. Estimates from the case-control design were less inflated than those from the cohort design when these biases were present. Overall, these simulations provide useful insights for the design and interpretation of future studies. PMID:26967200

  11. Influenza risk management: lessons learned from an A(H1N1 pdm09 outbreak investigation in an operational military setting.

    Directory of Open Access Journals (Sweden)

    Margaret Farrell

    Full Text Available BACKGROUND: At the onset of an influenza pandemic, when the severity of a novel strain is still undetermined and there is a threat of introduction into a new environment, e.g., via the deployment of military troops, sensitive screening criteria and conservative isolation practices are generally recommended. OBJECTIVES: In response to elevated rates of influenza-like illness among U.S. military base camps in Kuwait, U.S. Naval Medical Research Unit No. 3 partnered with local U.S. Army medical units to conduct an A(H1N1 pdm09 outbreak investigation. PATIENTS/METHODS: Initial clinical data and nasal specimens were collected via the existent passive surveillance system and active surveillance was conducted using a modified version of the World Health Organization/U.S. Centers for Disease Control and Prevention influenza-like illness case definition [fever (T > 100.5˚F/38˚C in addition to cough and/or sore throat in the previous 72 hours] as the screening criteria. Samples were tested via real-time reverse-transcription PCR and sequenced for comparison to global A(H1N1 pdm09 viruses from the same time period. RESULTS: The screening criteria used in Kuwait proved insensitive, capturing only 16% of A(H1N1 pdm09-positive individuals. While still not ideal, using cough as the sole screening criteria would have increased sensitivity to 73%. CONCLUSIONS: The results of and lessons learned from this outbreak investigation suggest that pandemic influenza risk management should be a dynamic process (as information becomes available regarding true attack rates and associated mortality, screening and isolation criteria should be re-evaluated and revised as appropriate, and that military operational environments present unique challenges to influenza surveillance.

  12. A Novel Duplex Real-Time Reverse-Transcription PCR Assay for the Detection of Influenza A and the Novel Influenza A(H1N1 Strain

    Directory of Open Access Journals (Sweden)

    Theo P. Sloots

    2009-12-01

    Full Text Available Timely implementation of antiviral treatment and other public health based responses are dependent on accurate and rapid diagnosis of the novel pandemic influenza A(H1N1 strain. In this study we developed a duplex real-time PCR (RT-PCR (dFLU-TM assay for the simultaneous detection of a broad range of influenza A subtypes and specific detection of the novel H1N1 2009 pandemic strain. The assay was compared to the combined results of two previously described monoplex RT-PCR assays using 183 clinical samples and 10 seasonal influenza A isolates. Overall, the results showed that the dFLU-TM RT-PCR method is suitable for detection of influenza A, including the novel H1N1 pandemic strain, in clinical samples.

  13. Oseltamivir-resistant influenza A(H1N1pdm09 virus in southern Brazil

    Directory of Open Access Journals (Sweden)

    Camila Marx

    2013-05-01

    Full Text Available The neuraminidase (NA genes of A(H1N1pdm09 influenza virus isolates from 306 infected patients were analysed. The circulation of oseltamivir-resistant viruses in Brazil has not been reported previously. Clinical samples were collected in the state of Rio Grande do Sul (RS from 2009-2011 and two NA inhibitor-resistant mutants were identified, one in 2009 (H275Y and the other in 2011 (S247N. This study revealed a low prevalence of resistant viruses (0.8% with no spread of the resistant mutants throughout RS.

  14. Enhanced Pneumonia With Pandemic 2009 A/H1N1 Swine Influenza Virus in Pigs

    Science.gov (United States)

    Introduction. Swine influenza A viruses (SIV) in the major swine producing regions of North America consist of multiple subtypes of endemic H1N1, H1N2, and H3N2 derived from swine, avian and human influenza viruses with a triple reassortant internal gene (TRIG) constellation (1). Genetic drift and r...

  15. Bayesian modeling to unmask and predict influenza A/H1N1pdm dynamics in London.

    Science.gov (United States)

    Birrell, Paul J; Ketsetzis, Georgios; Gay, Nigel J; Cooper, Ben S; Presanis, Anne M; Harris, Ross J; Charlett, André; Zhang, Xu-Sheng; White, Peter J; Pebody, Richard G; De Angelis, Daniela

    2011-11-01

    The tracking and projection of emerging epidemics is hindered by the disconnect between apparent epidemic dynamics, discernible from noisy and incomplete surveillance data, and the underlying, imperfectly observed, system. Behavior changes compound this, altering both true dynamics and reporting patterns, particularly for diseases with nonspecific symptoms, such as influenza. We disentangle these effects to unravel the hidden dynamics of the 2009 influenza A/H1N1pdm pandemic in London, where surveillance suggests an unusual dominant peak in the summer. We embed an age-structured model into a bayesian synthesis of multiple evidence sources to reveal substantial changes in contact patterns and health-seeking behavior throughout the epidemic, uncovering two similar infection waves, despite large differences in the reported levels of disease. We show how this approach, which allows for real-time learning about model parameters as the epidemic progresses, is also able to provide a sequence of nested projections that are capable of accurately reflecting the epidemic evolution. PMID:22042838

  16. Emerging influenza A/H1N1: challenges and development

    Directory of Open Access Journals (Sweden)

    Mishra N

    2011-01-01

    Full Text Available Human population suffered to four major influenza pandemics in the past by influenza virus in the form of either bird flu or swine flu. The virus has immense capability to diverse as it is capable in antigenic shift, antigenic drift and reassortment due to its fragmented RNA genome. The severity of previous pandemics suggests that severity in human population is directly proportional to the degree of divergence in hemagglutinin (HA and neuraminidase (NA genes and so the virus is named as HnNn (H1N1, H5N1, etc. Till date no treatment (vaccines and drugs is available against influenza virus infection. Therefore, evolution of new strains, lack of herd immunity, high divergence rate, resistance against antiviral, co-infection with different influenza strains and replication in multiple hosts might help the present virus to develop in super-virus with a potential health threat to man-kind. To tackle the issue, there is a need for a joint venture among government health department, researchers, clinicians, ecologists and general public for future preparedness to combat future influenza pandemics.

  17. Seasonal transmission potential and activity peaks of the new influenza A(H1N1: a Monte Carlo likelihood analysis based on human mobility

    Directory of Open Access Journals (Sweden)

    Paolotti Daniela

    2009-09-01

    identification of plausible scenarios for the future unfolding of the pandemic and the estimate of pandemic activity peaks in the different hemispheres. We provide estimates for the number of hospitalizations and the attack rate for the next wave as well as an extensive sensitivity analysis on the disease parameter values. We also studied the effect of systematic therapeutic use of antiviral drugs on the epidemic timeline. Conclusion The analysis shows the potential for an early epidemic peak occurring in October/November in the Northern hemisphere, likely before large-scale vaccination campaigns could be carried out. The baseline results refer to a worst-case scenario in which additional mitigation policies are not considered. We suggest that the planning of additional mitigation policies such as systematic antiviral treatments might be the key to delay the activity peak in order to restore the effectiveness of the vaccination programs.

  18. Swine flu. Mexico's handling of A/H1N1 in comparative perspective.

    Science.gov (United States)

    Ear, Sophal

    2012-01-01

    Emerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. Despite the scale of this threat, there are inherent limitations in preventing and controlling EIDs, including the scope of current disease surveillance efforts. All of this leads to the following questions in the context of Mexico's recent swine flu experience: What were the cultural, political, and economic challenges to Influenza A/H1N1 virus response in Mexico? By way of comparison, what can we learn from the U.S. experience in 1976 with A/New Jersey/76 (Hsw1N1), later referred to as H1N1? This article explores the comparative political economy of Mexico's handling of influenza virus A/H1N1 outbreak in 2009. Research provides notable observations-based on the strengths and weaknesses of each country's response--that can be used as a starting point of discussion for the design of effective EIDs surveillance programs in developing and middle-income countries. In the U.S., the speed and efficiency of the 1976 U.S. mobilization against H1N1 was laudable. Although the U.S. response to the outbreak is seldom praised, the unity of the scientific and political communities demonstrated the national ability to respond to the situation. Mexico's strongest characteristics were its transparency, as well as the cooperation the country exhibited with other nations, particularly the U.S. and Canada. While Mexico showed savvy in its effective management of public and media relations, as the article details, political, economic, and cultural problems persisted. PMID:23379315

  19. Epidemiological and clinical characteristics of patients who died from Influenza A(H1N1pdm09 in Viet Nam

    Directory of Open Access Journals (Sweden)

    Phan Thanh Tinh

    2012-02-01

    Full Text Available We describe the epidemiological and clinical characteristics of patients who died from influenza A(H1N1pdm09 in hospitals in Viet Nam between August 2009 and March 2010.Of 58 fatal cases, 32 (55% were below 30 years of age and 14 (24% were pregnant females. Forty-five (78% patients had at least one underlying medical condition including chronic heart, kidney or lung diseases or pregnancy. Twelve (21% cases sought medical attention on the day of symptom onset. Only 13 (36% of 36 cases for whom treatment data were available had been given antiviral drugs within the recommended two days of symptom onset.The clinical and epidemiologic characteristics of the patients who died from influenza A(H1N1pdm09 are similar to those reported from other countries. To improve preparedness and response to future pandemics, Viet Nam needs to strengthen the surveillance of influenza; increase laboratory capacity to test for influenza viruses; and develop strategies for promoting the timely attendance of at-risk individuals at health facilities and the early administration of antiviral drugs, particularly for persons with underlying medical conditions and pregnant females.

  20. Measuring the effect of influenza A(H1N1)pdm09: the epidemiological experience in the West Midlands, England during the 'containment' phase.

    Science.gov (United States)

    Inglis, N J; Bagnall, H; Janmohamed, K; Suleman, S; Awofisayo, A; De Souza, V; Smit, E; Pebody, R; Mohamed, H; Ibbotson, S; Smith, G E; House, T; Olowokure, B

    2014-02-01

    The West Midlands was the first English region to report sustained community transmission during the 'containment' phase of the influenza A(H1N1)pdm09 pandemic in England. To describe the epidemiological experience in the region, West Midlands and national datasets containing laboratory-confirmed A(H1N1)pdm09 virus cases in the region during the 'containment' phase were analysed. The region accounts for about 10·5% of England's population, but reported about 42% of all laboratory-confirmed cases. Altogether 3063 cases were reported, with an incidence rate of 56/100 000 population. School-associated cases accounted for 25% of cases. Those aged <20 years, South Asian ethnic groups, and residents of urban and socioeconomically deprived areas were disproportionately affected. Imported cases accounted for 1% of known exposures. Regional R 0 central estimates between 1·41 and 1·43 were obtained. The West Midlands experience suggests that interpretation of transmission rates may be affected by complex interactions within and between sub-populations in the region. PMID:23731730

  1. Department of Defense influenza and other respiratory disease surveillance during the 2009 pandemic.

    Science.gov (United States)

    Burke, Ronald L; Vest, Kelly G; Eick, Angelia A; Sanchez, Jose L; Johns, Matthew C; Pavlin, Julie A; Jarman, Richard G; Mothershead, Jerry L; Quintana, Miguel; Palys, Thomas; Cooper, Michael J; Guan, Jian; Schnabel, David; Waitumbi, John; Wilma, Alisa; Daniels, Candelaria; Brown, Matthew L; Tobias, Steven; Kasper, Matthew R; Williams, Maya; Tjaden, Jeffrey A; Oyofo, Buhari; Styles, Timothy; Blair, Patrick J; Hawksworth, Anthony; Montgomery, Joel M; Razuri, Hugo; Laguna-Torres, Alberto; Schoepp, Randal J; Norwood, David A; Macintosh, Victor H; Gibbons, Thomas; Gray, Gregory C; Blazes, David L; Russell, Kevin L; Rubenstein, Jennifer; Hathaway, Kyle; Gibbons, Robert; Yoon, In-Kyu; Saunders, David; Gaywee, Jariyanart; Stoner, Mikal; Timmermans, Ans; Shrestha, Sanjaya K; Velasco, John Mark S; Alera, Maria T; Tannitisupawong, Darunee; Myint, Khin Saw; Pichyangkul, Sathit; Woods, Ben; Jerke, Kurt H; Koenig, Michael G; Byarugaba, Denis K; Mangen, Fred Wabwire; Assefa, Berhane; Williams, Maya; Brice, Gary; Mansour, Moustafa; Pimentel, Guillermo; Sebeny, Peter; Talaat, Maha; Saeed, Tamer; Espinosa, Ben; Faix, Dennis; Maves, Ryan; Kochel, Tadeusz; Smith, James; Guerrero, Alicia; Maupin, Gen; Sjoberg, Paul; Duffy, Mark; Garner, Jason; Canas, Linda; Macias, Elizabeth; Kuschner, Robert A; Shanks, Dennis; Lewis, Sheri; Nowak, Gosia; Ndip, Lucy M; Wolfe, Nathan; Saylors, Karen

    2011-01-01

    The Armed Forces Health Surveillance Center's Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) supports and oversees surveillance for emerging infectious diseases, including respiratory diseases, of importance to the U.S. Department of Defense (DoD). AFHSC-GEIS accomplishes this mission by providing funding and oversight to a global network of partners for respiratory disease surveillance. This report details the system's surveillance activities during 2009, with a focus on efforts in responding to the novel H1N1 Influenza A (A/H1N1) pandemic and contributions to global public health. Active surveillance networks established by AFHSC-GEIS partners resulted in the initial detection of novel A/H1N1 influenza in the U.S. and several other countries, and viruses isolated from these activities were used as seed strains for the 2009 pandemic influenza vaccine. Partners also provided diagnostic laboratory training and capacity building to host nations to assist with the novel A/H1N1 pandemic global response, adapted a Food and Drug Administration-approved assay for use on a ruggedized polymerase chain reaction platform for diagnosing novel A/H1N1 in remote settings, and provided estimates of seasonal vaccine effectiveness against novel A/H1N1 illness. Regular reporting of the system's worldwide surveillance findings to the global public health community enabled leaders to make informed decisions on disease mitigation measures and controls for the 2009 A/H1N1 influenza pandemic. AFHSC-GEIS's support of a global network contributes to DoD's force health protection, while supporting global public health. PMID:21388566

  2. Timeliness of contact tracing among flight passengers for influenza A/H1N1 2009

    Directory of Open Access Journals (Sweden)

    Swaan Corien M

    2011-12-01

    Full Text Available Abstract Background During the initial containment phase of influenza A/H1N1 2009, close contacts of cases were traced to provide antiviral prophylaxis within 48 h after exposure and to alert them on signs of disease for early diagnosis and treatment. Passengers seated on the same row, two rows in front or behind a patient infectious for influenza, during a flight of ≥ 4 h were considered close contacts. This study evaluates the timeliness of flight-contact tracing (CT as performed following national and international CT requests addressed to the Center of Infectious Disease Control (CIb/RIVM, and implemented by the Municipal Health Services of Schiphol Airport. Methods Elapsed days between date of flight arrival and the date passenger lists became available (contact details identified - CI was used as proxy for timeliness of CT. In a retrospective study, dates of flight arrival, onset of illness, laboratory diagnosis, CT request and identification of contacts details through passenger lists, following CT requests to the RIVM for flights landed at Schiphol Airport were collected and analyzed. Results 24 requests for CT were identified. Three of these were declined as over 4 days had elapsed since flight arrival. In 17 out of 21 requests, contact details were obtained within 7 days after arrival (81%. The average delay between arrival and CI was 3,9 days (range 2-7, mainly caused by delay in diagnosis of the index patient after arrival (2,6 days. In four flights (19%, contacts were not identified or only after > 7 days. CI involving Dutch airlines was faster than non-Dutch airlines (P Conclusion CT for influenza A/H1N1 2009 among flight passengers was not successful for timely provision of prophylaxis. CT had little additional value for alerting passengers for disease symptoms, as this information already was provided during and after the flight. Public health authorities should take into account patient delays in seeking medical advise and laboratory confirmation in relation to maximum time to provide postexposure prophylaxis when deciding to install contact tracing measures. International standardization of CT guidelines is recommended.

  3. Detection of influenza A(H1N1)v virus by real-time RT-PCR.

    OpenAIRE

    Hollmann, B.; Wenzel, J. J.; Eis-hü binger, Am; Olschlä ger, S.; Huzly, D.; Drosten, C.; Panning, M.; Gu; nther, S.; Niller, H H; Becker, S.; Monazahian, M.; Matz, B.

    2009-01-01

    Influenza A(H1N1)v virus was first identified in April 2009. A novel real-time RT-PCR for influenza A(H1N1)v virus was set up ad hoc and validated following industry-standard criteria. The lower limit of detection of the assay was 384 copies of viral RNA per ml of viral transport medium (95% confidence interval: 273-876 RNA copies/ml). Specificity was 100% as assessed on a panel of reference samples including seasonal human influenza A virus H1N1 and H3N2, highly pathogenic avian influenza A ...

  4. 2009 A(H1N1) seroconversion rates and risk factors among the general population in Vientiane Capital, Laos

    OpenAIRE

    Kieffer, Alexia; Paboriboune, Phimpha; Crepey, Pascal; Flaissier, Bruno; Souvong, Vimalay; Steenkeste, Nicolas; Salez, Nicolas; Babin, François-Xavier; LONGUET, Christophe; Carrat, Fabrice; Flahault, Antoine; De Lamballerie, Xavier

    2013-01-01

    Objective To assess 2009 A(H1N1) seroconversion rates and their determinants within an unvaccinated population in Vientiane Capital, Laos. Methods CoPanFlu Laos, a general population cohort of 807 households and 4,072 participants was established in March 2010. Sociodemographic data, epidemiological data, and capillary blood samples were collected from all the household members in March, and again in October 2010, in order to assess the level of antibodies to 2009 A(H1N1) with the haemaggluti...

  5. [Effect of Yinghua Pinggan granule against influenza A/H1N1 virus in vivo].

    Science.gov (United States)

    Peng, Xue-qian; He, Yu; Zhou, Hui-fen; Zhang, Yu-yan; Yang, Jie-hong; Chen, Jun-kui; Lu, Yi-yu; Wan, Hai-tong

    2015-10-01

    To study the effect of Yinghua Pinggan granule (YHPG) against influenza A/H1N1 virus in vivo and on the immunologic function of infected mice. The intranasal influenza virus infection was adopted in ICR mouse to establish the influenza virus pneumonia model. At the 3rd and 7th day after the infection, the lung index and pathologic changes in lung tissues of mice were detected. Realtime PCR and flow cytometry were employed to observe the virus load in lung tissues and the levels of CD4+, CD8+, and CD4+/CD8+ in peripheral blood. The result showed that at the 3rd and 7th day after the infection, YHPG (15, 30 g x kg(-1)) can significant decrease in the lung index and virus load in lung tissues of mice infected with influenza virus, alleviate the pathologic changes in lung tissues, significantly increase the levels of CD4+ and CD4+/CD8+ ratio and reduce the levels of CD8+ in whole blood. This indicated that YHPG can inhibit the influenza virus replication, alleviate pulmonary damage and adjust the weak immunologic function of infected mice, with a certain therapeutic effect on mice infected by H1N1 virus in vivo. PMID:26975112

  6. Measured voluntary avoidance behaviour during the 2009 A/H1N1 epidemic.

    Science.gov (United States)

    Bayham, Jude; Kuminoff, Nicolai V; Gunn, Quentin; Fenichel, Eli P

    2015-11-01

    Managing infectious disease is among the foremost challenges for public health policy. Interpersonal contacts play a critical role in infectious disease transmission, and recent advances in epidemiological theory suggest a central role for adaptive human behaviour with respect to changing contact patterns. However, theoretical studies cannot answer the following question: are individual responses to disease of sufficient magnitude to shape epidemiological dynamics and infectious disease risk? We provide empirical evidence that Americans voluntarily reduced their time spent in public places during the 2009 A/H1N1 swine flu, and that these behavioural shifts were of a magnitude capable of reducing the total number of cases. We simulate 10 years of epidemics (2003-2012) based on mixing patterns derived from individual time-use data to show that the mixing patterns in 2009 yield the lowest number of total infections relative to if the epidemic had occurred in any of the other nine years. The World Health Organization and other public health bodies have emphasized an important role for 'distancing' or non-pharmaceutical interventions. Our empirical results suggest that neglect for voluntary avoidance behaviour in epidemic models may overestimate the public health benefits of public social distancing policies. PMID:26511046

  7. Multidrug resistant 2009 A/H1N1 influenza clinical isolate with a neuraminidase I223R mutation retains its virulence and transmissibility in ferrets.

    Directory of Open Access Journals (Sweden)

    Erhard van der Vries

    2011-09-01

    Full Text Available Only two classes of antiviral drugs, neuraminidase inhibitors and adamantanes, are approved for prophylaxis and therapy against influenza virus infections. A major concern is that influenza virus becomes resistant to these antiviral drugs and spreads in the human population. The 2009 pandemic A/H1N1 influenza virus is naturally resistant to adamantanes. Recently a novel neuraminidase I223R mutation was identified in an A/H1N1 virus showing cross-resistance to the neuraminidase inhibitors oseltamivir, zanamivir and peramivir. However, the ability of this virus to cause disease and spread in the human population is unknown. Therefore, this clinical isolate (NL/2631-R223 was compared with a well-characterized reference virus (NL/602. In vitro experiments showed that NL/2631-I223R replicated as well as NL/602 in MDCK cells. In a ferret pathogenesis model, body weight loss was similar in animals inoculated with NL/2631-R223 or NL/602. In addition, pulmonary lesions were similar at day 4 post inoculation. However, at day 7 post inoculation, NL/2631-R223 caused milder pulmonary lesions and degree of alveolitis than NL/602. This indicated that the mutant virus was less pathogenic. Both NL/2631-R223 and a recombinant virus with a single I223R change (recNL/602-I223R, transmitted among ferrets by aerosols, despite observed attenuation of recNL/602-I223R in vitro. In conclusion, the I223R mutated virus isolate has comparable replicative ability and transmissibility, but lower pathogenicity than the reference virus based on these in vivo studies. This implies that the 2009 pandemic influenza A/H1N1 virus subtype with an isoleucine to arginine change at position 223 in the neuraminidase has the potential to spread in the human population. It is important to be vigilant for this mutation in influenza surveillance and to continue efforts to increase the arsenal of antiviral drugs to combat influenza.

  8. Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: a 2010 survey.

    Science.gov (United States)

    Pulcini, Céline; Massin, Sophie; Launay, Odile; Verger, Pierre

    2013-08-20

    Our objectives were to describe the vaccine coverage (VC(1)) for some occupational vaccines (hepatitis B, pertussis, seasonal and pandemic influenza) among French General Practitioners (GPs(2)) and to study the factors associated with being vaccinated for each of these four diseases. We surveyed a representative national sample of 1431 self-employed GPs in France. Self-reported VC was 76.9% for 2009/10 seasonal influenza, 73.0% for hepatitis B, 63.9% for pertussis and 60.8% for A/H1N1 pandemic influenza. The factors associated with reporting being vaccinated were quite different from one vaccine to another. For some or all four vaccines, we found a significant positive association (pexercise (e.g. homoeopathy), no use of Internet at the practice, Continuing Medical Education sessions, discussing the benefits and risks of vaccination with the patients and performing prevention investigations for oneself (lipid profile). Being vaccinated for one vaccine also increased the VC for some or all three other studied vaccines. All these findings argue for public health campaigns using messages adapted to each vaccine. PMID:23806242

  9. Contact Tracing for Influenza A(H1N1)pdm09 Virus–infected Passenger on International Flight

    OpenAIRE

    Shankar, Ananda G.; Janmohamed, Kulsum; Olowokure, Babatunde; Smith, Gillian E.; Hogan, Angela H.; De Souza, Valerie; Wallensten, Anders; Oliver, Isabel; Blatchford, Oliver; Cleary, Paul; Ibbotson, Sue

    2014-01-01

    In April 2009, influenza A(H1N1)pdm09 virus infection was confirmed in a person who had been symptomatic while traveling on a commercial flight from Mexico to the United Kingdom. Retrospective public health investigation and contact tracing led to the identification of 8 additional confirmed cases among passengers and community contacts of passengers.

  10. The association between serum biomarkers and disease outcome in influenza A(H1N1)pdm09 virus infection

    DEFF Research Database (Denmark)

    Davey, Richard T; Lynfield, Ruth; Dwyer, Dominic E; Losso, Marcello H; Cozzi-Lepri, Alessandro; Wentworth, Deborah; Lane, H Clifford; Dewar, Robin; Rupert, Adam; Metcalf, Julia A; Pett, Sarah L; Uyeki, Timothy M; Bruguera, Jose Maria; Angus, Brian; Cummins, Nathan; Lundgren, Jens; Neaton, James D

    2013-01-01

    Prospective studies establishing the temporal relationship between the degree of inflammation and human influenza disease progression are scarce. To assess predictors of disease progression among patients with influenza A(H1N1)pdm09 infection, 25 inflammatory biomarkers measured at enrollment were...

  11. Seroprevalence of Influenza A(H1N1)pdm09 Virus Antibody, England, 2010 and 2011

    OpenAIRE

    Hoschler, K; C. Thompson; Andrews, N.; Galiano, M; Pebody, R; Ellis, J.; Stanford, E; Baguelin, M.; Miller, E.; Zambon, M

    2012-01-01

    The intense influenza activity in England during the 2010-11 winter resulted from a combination of factors. Population-based seroepidemiology confirms that the third wave of influenza A(H1N1)pdm09 virus circulation was associated with a shift in age groups affected, with the highest rate of infection in young adults.

  12. Seroprevalence of influenza A(H1N1)pdm09 virus antibody, England, 2010 and 2011.

    Science.gov (United States)

    Hoschler, Katja; Thompson, Catherine; Andrews, Nick; Galiano, Monica; Pebody, Richard; Ellis, Joanna; Stanford, Elaine; Baguelin, Marc; Miller, Elizabeth; Zambon, Maria

    2012-11-01

    The intense influenza activity in England during the 2010-11 winter resulted from a combination of factors. Population-based seroepidemiology confirms that the third wave of influenza A(H1N1)pdm09 virus circulation was associated with a shift in age groups affected, with the highest rate of infection in young adults. PMID:23092684

  13. Systemic corticosteroids and early administration of antiviral agents for pneumonia with acute wheezing due to influenza A(H1N1pdm09 in Japan.

    Directory of Open Access Journals (Sweden)

    Koichiro Kudo

    Full Text Available BACKGROUND: Pneumonia patients with wheezing due to influenza A(H1N1pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1pdm09 has been controversial. Applicability of systemic corticosteroid treatment needs to be evaluated. METHODS/PRINCIPAL FINDINGS: We retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males was 8 years (range, 0-71. All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0-7. Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6% and pneumonia with wheezing (43.3% groups than in the other two groups (p = 0.017. Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group than in subjects not receiving corticosteroids (no-steroid group (p<0.001. The steroid group required greater oxygen supply than the no-steroid group (p<0.001. No significant difference was found by the Kaplan-Meier method between the steroid and the no-steroid groups in hours to fever alleviation from the initiation of antiviral agents and hospitalization days. In logistic regression analysis, wheezing, pneumonia and oxygen saturation were independent factors associated with using systemic corticosteroids. CONCLUSION: Patients with wheezing and a history of asthma were frequently found in the study subjects. Systemic corticosteroids together with early administration of antiviral agents to pneumonia with wheezing and

  14. Epidemiological characteristics and underlying risk factors for mortality during the autumn 2009 pandemic wave in Mexico.

    Directory of Open Access Journals (Sweden)

    Gerardo Chowell

    Full Text Available BACKGROUND: Elucidating the role of the underlying risk factors for severe outcomes of the 2009 A/H1N1 influenza pandemic could be crucial to define priority risk groups in resource-limited settings in future pandemics. METHODS: We use individual-level clinical data on a large series of ARI (acute respiratory infection hospitalizations from a prospective surveillance system of the Mexican Social Security medical system to analyze clinical features at presentation, admission delays, selected comorbidities and receipt of seasonal vaccine on the risk of A/H1N1-related death. We considered ARI hospitalizations and inpatient-deaths, and recorded demographic, geographic, and medical information on individual patients during August-December, 2009. RESULTS: Seasonal influenza vaccination was associated with a reduced risk of death among A/H1N1 inpatients (OR = 0.43 (95% CI: 0.25, 0.74 after adjustment for age, gender, geography, antiviral treatment, admission delays, comorbidities and medical conditions. However, this result should be interpreted with caution as it could have been affected by factors not directly measured in our study. Moreover, the effect of antiviral treatment against A/H1N1 inpatient death did not reach statistical significance (OR = 0.56 (95% CI: 0.29, 1.10 probably because only 8.9% of A/H1N1 inpatients received antiviral treatment. Moreover, diabetes (OR = 1.6 and immune suppression (OR = 2.3 were statistically significant risk factors for death whereas asthmatic persons (OR = 0.3 or pregnant women (OR = 0.4 experienced a reduced fatality rate among A/H1N1 inpatients. We also observed an increased risk of death among A/H1N1 inpatients with admission delays >2 days after symptom onset (OR = 2.7. Similar associations were also observed for A/H1N1-negative inpatients. CONCLUSIONS: Geographical variation in identified medical risk factors including prevalence of diabetes and immune suppression may in part

  15. Antibody Response After a Single Dose of an AS03-Adjuvanted Split-Virion Influenza A (H1N1) Vaccine in Heart Transplant Recipients

    NARCIS (Netherlands)

    Meyer, Sven; Adam, Matti; Schweiger, Brunhilde; Ilchmann, Corina; Eulenburg, Christine; Sattinger, Edgar; Runte, Hendrik; Schlueter, Michael; Deuse, Tobias; Reichenspurner, Hermann; Costard-Jaeckle, Angelika

    2011-01-01

    Background. Influenza A (H1N1) has emerged as a considerable threat for recipients of organ transplants. Vaccination against the novel influenza A (H1N1) virus has generally been advocated. There is limited experience with AS03-adjuvanted A/H1N1 pandemic influenza vaccines in immunosuppressed patien

  16. Emerging influenza A/H1N1: challenges and development

    OpenAIRE

    Mishra N

    2011-01-01

    Human population suffered to four major influenza pandemics in the past by influenza virus in the form of either bird flu or swine flu. The virus has immense capability to diverse as it is capable in antigenic shift, antigenic drift and reassortment due to its fragmented RNA genome. The severity of previous pandemics suggests that severity in human population is directly proportional to the degree of divergence in hemagglutinin (HA) and neuraminidase (NA) genes and so the virus is named as Hn...

  17. Seroepidemiologic Effects of Influenza A(H1N1)pdm09 in Australia, New Zealand, and Singapore

    OpenAIRE

    Trauer, James M.; Bandaranayake, Don; Booy, Robert; Chen, Mark I; Cretikos, Michelle; Dowse, Gary K.; Dwyer, Dominic E; Greenberg, Michael E.; Huang, Q. Sue; Khandaker, Gulam; Kok, Jen; Laurie, Karen L.; Lee, Vernon J.; McVernon, Jodie; Walter, Scott

    2013-01-01

    To estimate population attack rates of influenza A(H1N1)pdm2009 in the Southern Hemisphere during June–August 2009, we conducted several serologic studies. We pooled individual-level data from studies using hemagglutination inhibition assays performed in Australia, New Zealand, and Singapore. We determined seropositive proportions (titer >40) for each study region by age-group and sex in pre- and postpandemic phases, as defined by jurisdictional notification data. After exclusions, the pooled...

  18. Epidemia de influenza A(H1N1 en la Argentina: Experiencia del Hospital Nacional Profesor Alejandro Posadas Influenza A(H1N1 epidemic in Argentina: Experience in a National General Hospital (Hospital Nacional Profesor Alejandro Posadas

    Directory of Open Access Journals (Sweden)

    2009-10-01

    Full Text Available Se describe la preparación y la atención médica durante la epidemia de influenza A(H1N1 (junio 2009 en un hospital general de agudos, público, de alta complejidad; con diagnóstico de laboratorio, internación general y cuidados intensivos (UCI. Se elaboró un plan para aumentar la capacidad asistencial, reasignar recursos y garantizar la bioseguridad. La consulta fue 7.1 ± 3.8 veces mayor que en 2006-2008. La detección de casos de A(H1N1 fue confirmada por PCR-RT en 186/486 (38.3% pacientes internados y en 56/176 (31.8% ambulatorios. Internados: mediana de edad 20 años; 75% menores de 45 y 32.3% menores de 15. Mortalidad global: 6.8%; 9.1% en los positivos. Adultos: recepción en un área de atención ambulatoria, internación (aislamiento y ventilación mecánica. Sala general: ingresaron 110 pacientes (5 veces más que 1999-2006 con saturación de oxígeno The preparation and medical care during the influenza A(H1N1 outbreak (June 2009 in a high complexity level, public, general hospital with laboratory diagnosis, general and intensive care (ICU hospitalization is described. A plan was designed to increase the hospital's surge capacity, reallocate resources and guarantee bio-safety. The number of consultations was 7.1 ± 3.8 times higher than during June 2006-2008. Detection of A(H1N1 cases were confirmed by PCR-RT in 186/486 (38.3% in-patients and 56/176 (31.8% out-patients. Median age among in-patients was 20 years; 75% < 45 and 32.3% < 15. Global mortality: 6.8%; 9.1% among confirmed cases. Adults were directed to a reception area of out-patient care, hospitalization (isolation and mechanical ventilation. General ward: 110 patients with oxygen saturation < 96% and/or risk factors (65.5% had asthma, chronic obstructive pulmonary disease, obesity, pregnancy or other were admitted (5 times more than in 1999-2006. Chest X-ray showed lung infiltrates and/or lung consolidation in 97.3%. Severe hypoxemia: 43.5%. There were no significant clinical or X-ray differences between 21/49 confirmed and non confirmed A(H1N1 cases. Treatment: oseltamivir, ampicillin-sulbactam, and clarithromycin. ICU: 28 severe pneumonia patients were admitted (21 with associated conditions; 24 with acute respiratory distress syndrome received mechanical ventilation, 21 of them had shock; 8/9 acute renal failure cases required hemodialysis. Mortality: 14/28; 7/14 with confirmed A(H1N1 infection. Seventy A(H1N1 infected children were hospitalized (27 required ICU, 6 of them died. The children's median age was 11 months; 61.8% presented comorbidities (prematurity, asthma, broncho-pulmonary dysplasia and congenital heart disease. Oseltamivir and antibiotics were administered. Children's mortality: 8.6%.

  19. A study of analysis PB1-F2 protein of Influenza Viruses A/H1N1pdm09, A/ H3N2, and A/H5N1

    Directory of Open Access Journals (Sweden)

    Hana Apsari Pawestri

    2016-07-01

    /H5N1 and A/H1N1pdm09 Methods. We conducted Gen Bank National Center for Biotechnology Information (NCBI for A/H5N1 and A/H1N1pdm09 Influenza virus sequences database search started from 1997 until 2015. Data pertinent to this study is PB1 gene of A/H5N1 and A/H1N1pdm09 Influenza viruses. We conducted the multiple alignments to determine the various length and important mutation.   Results. The PB1-F2 sequences from the 3262 Influenza A/H5N1 and 2472 Influenza A/H1N1pdm09 were studied. The analysis showed that all Influenza A/H5N1 carrying the full length 90 amino acids of PB2-F1 sequences, except the Influenza pandemic A/H1N1 2009, only 87 amino acids. In addition, the mutation indicates the presence of a significant correlation with the virulence shown by Serine at nucleotide number 66 which replaces Asparagines (N66S. The mutation occurs in 8.5% of Influenza A/H5N1 and 0.5% of Influenza A/H1N1pdm09. Conclusion. Several varying length and important mutation of PB2-F1 sequences from different subtype of A/H5N1 and A/H1N1pdm09 were obtained which are indicating the positively selected in specific subtype due to introduction and adaptation into different host. The further studies are required to understanding this variability and contribution of PB1-F2 proteins in virulence and pathogenesis of influenza viruses. Key Words : Pathogenesis, Influenza virus, PB-F2 Protein

  20. Theoretical studies on the susceptibility of oseltamivir against variants of 2009 A/H1N1 influenza neuraminidase.

    Science.gov (United States)

    Li, Lin; Li, Youyong; Zhang, Liling; Hou, Tingjun

    2012-10-22

    The outbreak and high speed global spread of the new strain of influenza A/H1N1 virus in 2009 posed a serious threat to global health. It is more likely that drug-resistant influenza strains will arise after the extensive use of anti-influenza drugs. Consequently, the identification of the potential resistant sites for drugs in advance and the understanding of the corresponding molecular mechanisms that cause drug resistance are quite important in the design of new drug candidates with better potency to combat drug resistance. Here, we performed molecular simulations to evaluate the potency of oseltamivir to combat drug resistance caused by the mutations in 2009 A/H1N1 neuraminidase (NA). We examined three representative drug-resistant mutations in NA, consisting of H274Y, N294S, and Y252H. First, a theoretical structure of A/H1N1 NA in complex with oseltamivir was constructed using homology modeling. Then, molecular dynamics (MD) simulations, molecular mechanics/Poisson-Boltzmann surface area (MM/PBSA) calculations, and MM/GBSA free energy decomposition were used to characterize the binding of oseltamivir with the wild type (WT) and three mutated NAs. Our predictions show that N294S and H274Y, two popular drug-resistant mutations in different variants of NA, still cause significant resistance to oseltamivir. However, the Y252H mutation does not impair the interactions between oseltamivir and A/H1N1 NA. An examination of individual energy components shows that the loss of polar interactions is the key source for the resistance of the studied mutations to oseltamivir. Moreover, free energy decomposition analysis and structural analysis reveal that the N294S or H274Y mutation triggers the large-scale conformational changes of the binding pocket and then impairs the affinity of oseltamivir. We expect that our results will be useful for the rational design of NA inhibitors with high potency against drug-resistant A/H1N1 mutants. PMID:22998323

  1. Nationwide surveillance of influenza during the pandemic (2009-10 and post-pandemic (2010-11 periods in Taiwan.

    Directory of Open Access Journals (Sweden)

    Jen-Hsiang Chuang

    Full Text Available INTRODUCTION: Although WHO declared the world moving into the post-pandemic period on August 10, 2010, influenza A(H1N1 2009 virus continued to circulate globally. Its impact was expected to continue during the 2010-11 influenza season. This study describes the nationwide surveillance findings of the pandemic and post-pandemic influenza periods in Taiwan and assesses the impact of influenza A(H1N1 2009 during the post-pandemic period. METHODS: The Influenza Laboratory Surveillance Network consisted of 12 contract laboratories for collecting and testing samples with acute respiratory tract infections. Surveillance of emergency room visits and outpatient department visits for influenza-like illness (ILI were conducted using the Real-Time Outbreak and Disease Surveillance system and the National Health Insurance program data, respectively. Hospitalized cases with severe complications and deaths were reported to the National Notifiable Disease Surveillance System. RESULTS: During the 2009-10 influenza season, pandemic A(H1N1 2009 was the predominant circulating strain and caused 44 deaths. However, the 2010-11 influenza season began with A(H3N2 being the predominant circulating strain, changing to A(H1N1 2009 in December 2010. Emergency room and outpatient department ILI surveillance displayed similar trends. By March 31, 2011, there were 1,751 cases of influenza with severe complications; 50.1% reported underlying diseases. Of the reported cases, 128 deaths were associated with influenza. Among these, 93 (72.6% were influenza A(H1N1 2009 and 30 (23.4% A(H3N2. Compared to the pandemic period, during the immediate post-pandemic period, increased number of hospitalizations and deaths were observed, and the patients were consistently older. CONCLUSIONS: Reemergence of influenza A(H1N1 2009 during the 2010-11 influenza season had an intense activity with age distribution shift. To further mitigate the impact of future influenza epidemics, Taiwan must

  2. Polymeric LabChip real-time PCR as a point-of-care-potential diagnostic tool for rapid detection of influenza A/H1N1 virus in human clinical specimens.

    Directory of Open Access Journals (Sweden)

    Hyun-Ok Song

    Full Text Available It is clinically important to be able to detect influenza A/H1N1 virus using a fast, portable, and accurate system that has high specificity and sensitivity. To achieve this goal, it is necessary to develop a highly specific primer set that recognizes only influenza A viral genes and a rapid real-time PCR system that can detect even a single copy of the viral gene. In this study, we developed and validated a novel fluidic chip-type real-time PCR (LabChip real-time PCR system that is sensitive and specific for the detection of influenza A/H1N1, including the pandemic influenza strain A/H1N1 of 2009. This LabChip real-time PCR system has several remarkable features: (1 It allows rapid quantitative analysis, requiring only 15 min to perform 30 cycles of real-time PCR. (2 It is portable, with a weight of only 5.5 kg. (3 The reaction cost is low, since it uses disposable plastic chips. (4 Its high efficiency is equivalent to that of commercially available tube-type real-time PCR systems. The developed disposable LabChip is an economic, heat-transferable, light-transparent, and easy-to-fabricate polymeric chip compared to conventional silicon- or glass-based labchip. In addition, our LabChip has large surface-to-volume ratios in micro channels that are required for overcoming time consumed for temperature control during real-time PCR. The efficiency of the LabChip real-time PCR system was confirmed using novel primer sets specifically targeted to the hemagglutinin (HA gene of influenza A/H1N1 and clinical specimens. Eighty-five human clinical swab samples were tested using the LabChip real-time PCR. The results demonstrated 100% sensitivity and specificity, showing 72 positive and 13 negative cases. These results were identical to those from a tube-type real-time PCR system. This indicates that the novel LabChip real-time PCR may be an ultra-fast, quantitative, point-of-care-potential diagnostic tool for influenza A/H1N1 with a high sensitivity and

  3. Protein profiling of nasopharyngeal aspirates of hospitalized and outpatients revealed cytokines associated with severe influenza A(H1N1)pdm09 virus infections: A pilot study.

    Science.gov (United States)

    Fu, Yu; Gaelings, Lana; Jalovaara, Petri; Kakkola, Laura; Kinnunen, Mervi T; Kallio-Kokko, Hannimari; Valkonen, Miia; Kantele, Anu; Kainov, Denis E

    2016-10-01

    Influenza A viruses (IAV) mutate rapidly and cause seasonal epidemics and occasional pandemics, which result in substantial number of patient visits to the doctors and even hospitalizations. We aimed here to identify inflammatory proteins, which levels correlated to clinical severity of the disease. For this we analysed 102 cytokines and growth factors in human nasopharyngeal aspirate (NPA) samples of 27 hospitalized and 27 outpatients diagnosed with influenza A(H1N1)pdm09 virus infection. We found that the relative levels of monocyte differentiation antigen CD14, lipocalin-2 (LCN2), C-C-motif chemokine 20 (CCL20), CD147, urokinase plasminogen activator surface receptor (uPAR), pro-epidermal growth factor (EGF), trefoil factor 3 (TFF3), and macrophage migration inhibitory factor (MIF) were significantly lower (padiponectin, and chitinase-3-like 1 (CHI3L1) were significantly higher (padiponectin and CHI3L1 levels have already been correlated with severity of IAV infection in mice and humans, our study is the first to describe association of CD147, RBP4, TFF3, and CFD with hospitalization of IAV-infected patients. Thus, we identified local innate immune profiles, which were associated with the clinical severity of influenza infections. PMID:27442005

  4. Predominance of influenza A(H1N1)pdm09 virus genetic subclade 6B.1 and influenza B/Victoria lineage viruses at the start of the 2015/16 influenza season in Europe

    OpenAIRE

    Broberg, E.; Melidou, A; Prosenc, Katarina; BRAGSTAD, K.; Hungnes, Olav; Schweiger, Brunhilde; Wedde, Marianne; Biere, Barbara; Buda, Silke

    2016-01-01

    Influenza A(H1N1)pdm09 viruses predominated in the European influenza 2015/16 season. Most analysed viruses clustered in a new genetic subclade 6B.1, antigenically similar to the northern hemisphere vaccine component A/California/7/2009. The predominant influenza B lineage was Victoria compared with Yamagata in the previous season. It remains to be evaluated at the end of the season if these changes affected the effectiveness of the vaccine for the 2015/16 season.

  5. Outcomes of influenza A(H1N1)pdm09 virus infection

    DEFF Research Database (Denmark)

    Lynfield, Ruth; Davey, Richard; Dwyer, Dominic E;

    2014-01-01

    initiated: FLU 002 in outpatients and FLU 003 in hospitalized patients. METHODS AND FINDINGS: Between October 2009 and December 2012, adults with influenza-like illness (ILI) were enrolled; outpatients were followed for 14 days and inpatients for 60 days. Disease progression was defined as hospitalization...... and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17...... data reinforce the need for international trials of novel treatment strategies for influenza infection and serve as a reminder of the need to monitor the severity of seasonal and pandemic influenza epidemics globally. TRIAL REGISTRATION: ClinicalTrials.gov Identifiers: FLU 002--NCT01056354, FLU 003...

  6. Identification of Low- and High-Impact Hemagglutinin Amino Acid Substitutions That Drive Antigenic Drift of Influenza A(H1N1) Viruses

    Science.gov (United States)

    Harvey, William T.; Benton, Donald J.; Gregory, Victoria; Hall, James P. J.; Daniels, Rodney S.; Bedford, Trevor; Haydon, Daniel T.; Hay, Alan J.; McCauley, John W.; Reeve, Richard

    2016-01-01

    Determining phenotype from genetic data is a fundamental challenge. Identification of emerging antigenic variants among circulating influenza viruses is critical to the vaccine virus selection process, with vaccine effectiveness maximized when constituents are antigenically similar to circulating viruses. Hemagglutination inhibition (HI) assay data are commonly used to assess influenza antigenicity. Here, sequence and 3-D structural information of hemagglutinin (HA) glycoproteins were analyzed together with corresponding HI assay data for former seasonal influenza A(H1N1) virus isolates (1997–2009) and reference viruses. The models developed identify and quantify the impact of eighteen amino acid substitutions on the antigenicity of HA, two of which were responsible for major transitions in antigenic phenotype. We used reverse genetics to demonstrate the causal effect on antigenicity for a subset of these substitutions. Information on the impact of substitutions allowed us to predict antigenic phenotypes of emerging viruses directly from HA gene sequence data and accuracy was doubled by including all substitutions causing antigenic changes over a model incorporating only the substitutions with the largest impact. The ability to quantify the phenotypic impact of specific amino acid substitutions should help refine emerging techniques that predict the evolution of virus populations from one year to the next, leading to stronger theoretical foundations for selection of candidate vaccine viruses. These techniques have great potential to be extended to other antigenically variable pathogens. PMID:27057693

  7. Vaccines and Antiviral Drugs in Pandemic Preparedness

    OpenAIRE

    Arnold S. Monto

    2006-01-01

    While measures such as closing schools and social distancing may slow the effects of pandemic influenza, only vaccines and antiviral drugs are clearly efficacious in preventing infection or treating illness. Unless the pandemic strain closely resembles one already recognized, vaccine will not be available early. However, studies can be conducted beforehand to address questions concerning vaccine dose, frequency of inoculation, and need for adjuvants. In contrast, antiviral drugs, particularly...

  8. Oseltamivir-resistant influenza A(H1N1pdm2009 strains found in Brazil are endowed with permissive mutations, which compensate the loss of fitness imposed by antiviral resistance

    Directory of Open Access Journals (Sweden)

    Thiago Moreno Lopes e Souza

    2015-02-01

    Full Text Available The 2009 pandemic influenza A virus outbreak led to the systematic use of the neuraminidase (NA inhibitor oseltamivir (OST. Consequently, OST-resistant strains, carrying the mutation H275Y, emerged in the years after the pandemics, with a prevalence of 1-2%. Currently, OST-resistant strains have been found in community settings, in untreated individuals. To spread in community settings, H275Y mutants must contain additional mutations, collectively called permissive mutations. We display the permissive mutations in NA of OST-resistant A(H1N1pdm09 virus found in Brazilian community settings. The NAs from 2013 are phylogenetically distinct from those of 2012, indicating a tendency of positive selection of NAs with better fitness. Some previously predicted permissive mutations, such as V241I and N369K, found in different countries, were also detected in Brazil. Importantly, the change D344N, also predicted to compensate loss of fitness imposed by H275Y mutation, was found in Brazil, but not in other countries in 2013. Our results reinforce the notion that OST-resistant A(H1N1pdm09 strains with compensatory mutations may arise in an independent fashion, with samples being identified in different states of Brazil and in different countries. Systematic circulation of these viral strains may jeopardise the use of the first line of anti-influenza drugs in the future.

  9. Comparison of epidemiological characteristics of type AH1N1 influenza and seasonal influenza in Luwan District,Shanghai%上海市卢湾区甲型H1N1流感与季节性流感流行特征比较分析

    Institute of Scientific and Technical Information of China (English)

    陆璐; 宋黎黎; 郦佳莹; 袁家麟; 贾晓东; 程华; 康来仪; 姜庆五

    2012-01-01

    Objective To compare the epidemicological characteristics of type AH1N1 influenza and seasonal influenza and to provide scientific basis on interventions. Methods The pathogen surveillance data of flu surveillance sentinel hospital of Luwan District from July 2009 to November 2011 was collected. We calculated 519 surveillance cases by age, year, month and week. In October 2011, we selected a probability sample of 200 residents of Luwan District. For each subject we measured HI antibody of influenza. Results In 2009, type AH1N1 accounted for the highest positive rate of 30%. In 2010, type AH3 accounted for the highest positive rate of 13% , followed by type BV with positive rate as 12%. In 2011, type AH1N1 accounted for the highest positive rate of 12% , followed by type BV with positive rate as 11%. Type AH1N1 became epidemic mainly in winter, type AH3 became epidemic mainly in summer, type BV mainly in spring. The whole population had relatively high antibody levels of type BY and AH1 with their geometric mean titer of antibody accounted for 1:918 and 1:897 respectively, while the antibody levels of type BV, AH3 and AH1N1 were relatively low with their geometric mean titer of antibody accounting for 1:625 , 1:599 and 1:120 respectively. The antibody level of type AH1N1 was significantly lower than that of other subtypes of influenza for the whole population. Conclusions Vaccine components should continue including type AH3, AH1N1 and BV strain components.%目的 比较甲型H1N1流感与季节性流感流行特征,为制定干预措施提供科学依据.方法 对卢湾区2009年7月~2011年11月流感监测病例进行分析,并于2011年10月对卢湾区200名居民进行流感HI抗体检测.结果 2009年,AH1N1阳性率最高,为30%;2010年,AH3、BV阳性率较高,分别为13%和12%;2011年,AH1N1、BV阳性率较高,分别为12%和11%.AH1N1流行季节主要为冬季,AH3主要为夏季,BV主要为春季.全人群BY和AH1抗体滴度较高,分别为1

  10. Analysis on the epidemiological and clinical characteristics of 190 cases with A(H1N1)influenza in Lhasa%拉萨190例甲型H1N1流感的流行病学特点及临床分析

    Institute of Scientific and Technical Information of China (English)

    龚学红; 王毅; 张小林; 索朗卓玛

    2010-01-01

    other anti-viral therapy to achieve better effect.184 cases were recovery,and there were no death cases.Conclusions The patients in this group are non-immune population,so it is imperative to vaccinate people during influenza pandemic.

  11. Pandemic Influenza Vaccines – The Challenges

    Directory of Open Access Journals (Sweden)

    Rebecca Cox

    2009-12-01

    Full Text Available Recent years’ enzootic spread of highly pathogenic H5N1 virus among poultry and the many lethal zoonoses in its wake has stimulated basic and applied pandemic vaccine research. The quest for an efficacious, affordable and timely accessible pandemic vaccine has been high on the agenda. When a variant H1N1 strain of swine origin emerged as a pandemic virus, it surprised many, as this subtype is well-known to man as a seasonal virus. This review will cover some difficult vaccine questions, such as the immunological challenges, the new production platforms, and the limited supply and global equity issues.

  12. Changes in heterosubtypic antibody responses during the first year of the 2009 A(H1N1) influenza pandemic

    OpenAIRE

    Freidl, Gudrun S; Henk-Jan van den Ham; Boni, Maciej F.; Erwin de Bruin; Koopmans, Marion P.G.

    2016-01-01

    textabstractSeropositivity to avian influenza (AI) via low-level antibody titers has been reported in the general population and poultry-exposed individuals, raising the question whether these findings reflect true infection with AI or cross-reactivity. Here we investigated serological profiles against human and avian influenza viruses in the general population using a protein microarray platform. We hypothesized that higher antibody diversity across recent H1 and H3 influenza viruses would b...

  13. Synthesising evidence to estimate pandemic (2009) A/H1N1 influenza severity in 2009-2011

    OpenAIRE

    Presanis, Anne M.; Pebody, Richard G.; Birrell, Paul J.; Tom, Brian D. M.; Helen K. Green; Durnall, Hayley; Fleming, Douglas; De Angelis, Daniela

    2014-01-01

    Knowledge of the severity of an influenza outbreak is crucial for informing and monitoring appropriate public health responses, both during and after an epidemic. However, case-fatality, case-intensive care admission and case-hospitalisation risks are difficult to measure directly. Bayesian evidence synthesis methods have previously been employed to combine fragmented, under-ascertained and biased surveillance data coherently and consistently, to estimate case-severity risks in the first two ...

  14. Acute respiratory distress syndrome (ARDS) complicating influenza A/H1N1v infection--a clinical approach.

    Science.gov (United States)

    Witczak, Agnieszka; Prystupa, Andrzej; Kurys-Denis, Ewa; Borys, Michał; Czuczwar, Mirosław; Niemcewicz, Marcin; Kocik, Janusz; Michalak, Anna; Pietrzak, Aldona; Chodorowska, Grażyna; Krupski, Witold; Mosiewicz, Jerzy; Tomasiewicz, Krzysztof

    2013-01-01

    ARDS is defined as an acute inflammatory syndrome characterized with bilateral parenchymal lung infiltrates on chest radiograph and PaO2/FiO2 ratiofat embolism, surface burn, massive blood transfusion. Influenza A/H1N1 infection seems to be responsible for the development of extremely severe type of ARDS with poor response to routine treatment. Despite great progress in the management of ARDS with novel agents and sophisticated techniques, including antimicrobial drugs, extracorporeal membrane oxygenation, prostaglandins, nitric oxide, prostacyclin, exogenous surfactant administration and activated protein C, supportive treatment based mostly on advanced mechanical ventilation in the intensive care units seems to be the most important for the prognosis. PMID:24364461

  15. Surveillance of influenza A(H_1N_1)in Hangzhou city in 2009%2009年杭州市甲型H_1N_1流感监测现状分析

    Institute of Scientific and Technical Information of China (English)

    刘社兰; 谢立; 杨旭辉; 孙昼; 王婧; 程瑾; 黄仁杰; 缪凡; 阮冰; 邓晶

    2010-01-01

    -like illness was comparatively flat during the first 28 weeks of 2009,then the percentage of patients with influenza-like illness increased and climbed to the peak at 35th week(7.47%,5 442/72 859).This number declined in the following weeks but rose again at 41st week.At 46th week,a second peak appeared and the percentage of Datients with influenza-1ike illness was 11.32%(11 034/97 436).Virological surveillance showed that the circulation of influenzz viruses before 38th week were mainly H_3N_2,B and seasonal influenza virus H_1N_1,while from 44th week on,the pandemic H_1N_1 influenza was the only predominated strain.Main snsceptible population in 2009 Hangzhou pandemic H_1N_1 influenza was people aged 11-25,and most of them were students.H_1N_1 strains of Hangzhou in 2009 were identical to strains in other parts of China,North American strains and vaccine candidate strain with 99%homology.but only 70%homology with seasonal inflnellZa virus.Conclusions The 2009 influenza A(H_1N_1)in Hangzhou has now entered a phase of rapid and susmined community transmission,susceptible populations are young adults.The predominated strain is the influenza A H_1N_1 type with high affinity and low pathogenicity to humans and no important variation.

  16. Determinants of non-vaccination against pandemic 2009 H1N1 influenza in pregnant women: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Romain Freund

    Full Text Available 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 randomly included between October 12, 2009 and February 3, 2010, with the aim to study characteristics of pandemic influenza during pregnancy. At inclusion, socio-demographic, medical, obstetrical factors and those associated with a higher risk of flu exposition and disease-spreading were systematically collected. Pandemic flu vaccine uptake was checked until delivery. 555 (62.9% women did not get vaccinated. Determinants associated with non-vaccination in a multivariate logistic regression were: geographic origin (Sub-Saharan African origin, adjusted Odd Ratio aOR = 5.4[2.3-12.7], North African origin, aOR = 2.5[1.3-4.7] and Asian origin, aOR = 2.1[1.7-2.6] compared to French and European origin and socio-professional categories (farmers, craftsmen and tradesmen, aOR = 2.3[2.0-2.6], intermediate professionals, aOR = 1.3[1.0-1.6], employees and manual workers, aOR = 2.5[1.4-4.4] compared to managers and intellectual professionals. The probability of not receiving pandemic flu vaccine was lower among women vaccinated against seasonal flu in the previous 5 years (aOR = 0.6[0.4-0.8] and among those who stopped smoking before or early during pregnancy (aOR = 0.6[0.4-0.8]. Number of children less than 18 years old living at home, work in contact with children or in healthcare area, or professional contact with the public, were not associated with a higher vaccine uptake. CONCLUSIONS/SIGNIFICANCE: In this cohort of pregnant women, vaccine coverage against pandemic

  17. Characteristic amino acid changes of influenza A(H1N1)pdm09 virus PA protein enhance A(H7N9) viral polymerase activity.

    Science.gov (United States)

    Liu, Jun; Huang, Feng; Zhang, Junsong; Tan, Likai; Lu, Gen; Zhang, Xu; Zhang, Hui

    2016-06-01

    Human coinfection with a novel H7N9 influenza virus and the 2009 pandemic A(H1N1) influenza virus, H1N1pdm09, has recently been reported in China. Because reassortment can occur during coinfection, it is necessary to clarify the effects of gene reassortment between these two viruses. Among the viral ribonucleoprotein complex (vRNP) genes, only the PA gene of H1N1pdm09 enhances the avian influenza viral polymerase activity. Based on a phylogenetic analysis, we show a special evolutionary feature of the H1N1pdm09 PA gene, which clustered with those of the novel H7N9 virus and related H9N2 viruses, rather than in the outgroup as the H1N1pdm09 genes do on the phylogenetic trees of other vRNP genes. Using a minigenome system of the novel H7N9 virus, we further demonstrate that replacement of its PA gene significantly enhanced its polymerase activity, whereas replacement of the other vRNP genes reduced its polymerase activity. We also show that the residues of PA evolutionarily conserved between H1N1pdm09 and the novel H7N9 virus are associated with attenuated or neutral polymerase activity. The mutations associated with the increased activity of the novel H7N9 polymerase are characteristic of the H1N1pdm09 gene, and are located almost adjacent to the surface of the PA protein. Our results suggest that the novel H7N9 virus has more effective PB1, PB2, and NP genes than H1N1pdm09, and that H1N1pdm09-like PA mutations enhance the novel H7N9 polymerase function. PMID:26980671

  18. Demand for care and nosocomial infection rate during the first influenza AH1N1 2009 virus outbreak at a referral hospital in Mexico City Demanda asistencial y tasa de infección nosocomial durante el primer brote de influenza AH1N1 2009 en un hospital de referencia en la Ciudad de México

    Directory of Open Access Journals (Sweden)

    Rogelio Pérez-Padilla

    2011-08-01

    Full Text Available OBJECTIVE: Comparison of routine hospital indicators (consults at the Emergency Room (ER and hospital admissions during the 2009 pandemic of the influenza AH1N1 virus at the national referral hospital for respiratory diseases in Mexico City. MATERIAL AND METHODS: The outbreak was from April to mid-May 2009 and two control periods were used:2009 (before and after the outbreak,and during April-May from 2007 and 2008. RESULTS: During the outbreak total consultation at the ER increased six times compared with the 2007-2008 control period and 11 times compared with the 2009 control period. Pneumonia- or influenza-related ER consultations increased 23.2 and 15.3%, respectively. The rate of nosocomial infection during the outbreak was 13.6 and that of nosocomial pneumonia was 6 per/100 hospital discharges, a two-fold and three-fold increase compared to the control periods respectively. CONCLUSIONS: During the outbreak,mean severity of admitted patients increased,with a rise in in-hospital mortality and nosocomial infections rate, including nosocomial pneumonia.OBJETIVO: Comparación de indicadores hospitalarios de rutina (consultas de urgencia, admisiones hospitalarias etc. durante la pandemia de influenzaAH1N1 2009 en un hospital de referencia para enfermedades respiratorias de la Ciudad de México. MATERIAL Y MÉTODOS: El brote se consideró de abril a la mitad de mayo de 2009 y se comparó con dos periodos control: el de 2009 (antes y después del brote, y durante abril y mayo de 2007 y 2008. RESULTADOS: Durante el brote las consultas de urgencia crecieron seis veces comparadas con el periodo control 2007-2008 y 11 veces contra el periodo control de 2009. Las consultas por neumonía o influenza incrementaron 23.2 y 15.3% comparadas contra los periodos control, respectivamente. La tasa de infección nosocomial durante el brote fue de 13.6 y la de neumonía nosocomial de 6.0 por 100 egresos hospitalarios, el doble y el triple de la documentada en los

  19. Continued emergence and changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus, United Kingdom, winter 2010/11.

    Science.gov (United States)

    Lackenby, A; Moran Gilad, J; Pebody, R; Miah, S; Calatayud, L; Bolotin, S; Vipond, I; Muir, P; Guiver, M; McMenamin, J; Reynolds, A; Moore, C; Gunson, R; Thompson, C; Galiano, M; Bermingham, A; Ellis, J; Zambon, M

    2011-01-01

    During the winter period 2010/11 27 epidemiologically unlinked, confirmed cases of oseltamivir-resistant influenza A(H1N1)2009 virus infection have been detected in multiple, geographically dispersed settings. Three of these cases were in community settings, with no known exposure to oseltamivir. This suggests possible onward transmission of resistant strains and could be an indication of a possibility of changing epidemiology of oseltamivir-resistant influenza A(H1N1)2009 virus. PMID:21315056

  20. ATTEMPTING TO PREDICT THE FATE OF AN ONGOING EPIDEMIC. LESSONS FROM A(H1N1 INFLUENZA IN USA.

    Directory of Open Access Journals (Sweden)

    Miguel Martín Martínez

    2009-01-01

    Full Text Available An attempt is made to estimate the main parameters of the 2009 Influenza type A(H1N1 outburst in USA based on public information provided by Centers for Disease Control (CDC during the early stage of the epidemic. Given the ill-posed nature of the statistical problem, a nonlinear fuction estimation method (Gauss-Newton and Hooke Jeeves was combined with linearization procedures that allowed to set adequate initial guess values for estimation. Based on data until May 13th, 2009, the following values are predicted for the USA outbreak: Tau (time to the peak of incidence 32 days; R0 (number of secondary infections per infected individual 1.7; K (total number of cases 20000(15000-35000. These results are in good agreement with the values reported by the WHO's Rapid Assessment Team for the outburst in Mexico. The method can be applied in any setting where cumulative number of cases are properly recorded.

  1. Profile of Brazilian scientific production on A/H1N1 pandemic influenza Perfil da produção científica brasileira sobre a gripe pandemica de influenza A/H1N1

    Directory of Open Access Journals (Sweden)

    Adriana Luchs

    2012-06-01

    Full Text Available In the last few years, bibliometric studies have proliferated, seeking to provide data on world research. This study analyzes the profile of the Brazilian scientific production in the A (H1N1 influenza field between 2009 and 2011. The research was conducted in MEDLINE, SciELO and LILACS databases, selecting papers in which the term "H1N1" and "Brazil" were defined as the main topics. The data were analyzed taking into consideration the Brazilian state and institution in which the articles were produced, the impact factor of the journal and the language. The research revealed 40 documents (27 from MEDLINE, 16 from SciELO and 24 from LILACS. The journal impact factor ranged from 0.0977 to 8.1230. A similar amount of articles were written in English and Portuguese and São Paulo was the most productive state in the country, with 95% of the Brazilian production originating from the Southern and Southeastern regions. Linguistic data indicate that previous efforts made in order to improve the scientific production of Brazilian researchers making their observations attain a broader scientific audience produced results. It is necessary to assess the scientific studies, especially those conducted with public funds, in order to ensure that the results will benefit society.Nos últimos anos, estudos bibliométricos proliferaram, procurando prover dados sobre a pesquisa mundial. O presente estudo analisou o perfil da produção científica brasileira no campo da influenza A (H1N1 durante o período de 2009 a 2011. A pesquisa foi conduzida através das bases de dados Medline, SciELO e Lilacs, selecionando artigos onde os termos "H1N1" e "Brazil" foram definidos como tópicos principais. Os dados foram analisados considerando-se: o estado brasileiro e a institutição onde o trabalho foi produzido, o fator de impacto de periódico e a língua. A pesquisa revelou 40 documentos (27 provenientes do Medline, 16 do SciELO e 24 do Lilacs. O fator de impacto do periódico variou de 0.0977 a 8.1230. Uma quantidade similar de artigos foi escrita em inglês e em português. São Paulo foi o estado mais produtivo no país e 95% da produção eram provenientes das regiões Sul e Sudeste. Os dados linguísticos indicam que esforços anteriores para melhorar a produção científica dos pesquisadores brasileiros, fazendo com que suas observações atingissem um público científico mais amplo, foram alcançados. É necessário avaliar os estudos científicos, especialmente os realizados com fundos públicos, a fim de assegurar que os resultados beneficiem a sociedade.

  2. Early assessment of anxiety and behavioral response to novel swine-origin influenza A(H1N1.

    Directory of Open Access Journals (Sweden)

    James Holland Jones

    Full Text Available BACKGROUND: Since late April, 2009, a novel influenza virus A (H1N1, generally referred to as the "swine flu," has spread around the globe and infected hundreds of thousands of people. During the first few days after the initial outbreak in Mexico, extensive media coverage together with a high degree of uncertainty about the transmissibility and mortality rate associated with the virus caused widespread concern in the population. The spread of an infectious disease can be strongly influenced by behavioral changes (e.g., social distancing during the early phase of an epidemic, but data on risk perception and behavioral response to a novel virus is usually collected with a substantial delay or after an epidemic has run its course. METHODOLOGY/PRINCIPAL FINDINGS: Here, we report the results from an online survey that gathered data (n = 6,249 about risk perception of the Influenza A(H1N1 outbreak during the first few days of widespread media coverage (April 28-May 5, 2009. We find that after an initially high level of concern, levels of anxiety waned along with the perception of the virus as an immediate threat. Overall, our data provide evidence that emotional status mediates behavioral response. Intriguingly, principal component analysis revealed strong clustering of anxiety about swine flu, bird flu and terrorism. All three of these threats receive a great deal of media attention and their fundamental uncertainty is likely to generate an inordinate amount of fear vis-a-vis their actual threat. CONCLUSIONS/SIGNIFICANCE: Our results suggest that respondents' behavior varies in predictable ways. Of particular interest, we find that affective variables, such as self-reported anxiety over the epidemic, mediate the likelihood that respondents will engage in protective behavior. Understanding how protective behavior such as social distancing varies and the specific factors that mediate it may help with the design of epidemic control strategies.

  3. Reproductive number and serial interval of the first wave of influenza A(H1N1pdm09 virus in South Africa.

    Directory of Open Access Journals (Sweden)

    Brett N Archer

    Full Text Available BACKGROUND/OBJECTIVE: Describing transmissibility parameters of past pandemics from diverse geographic sites remains critical to planning responses to future outbreaks. We characterize the transmissibility of influenza A(H1N1pdm09 (hereafter pH1N1 in South Africa during 2009 by estimating the serial interval (SI, the initial effective reproductive number (initial R(t and the temporal variation of R(t. METHODS: We make use of data from a central registry of all pH1N1 laboratory-confirmed cases detected throughout South Africa. Whenever date of symptom onset is missing, we estimate it from the date of specimen collection using a multiple imputation approach repeated 100 times for each missing value. We apply a likelihood-based method (method 1 for simultaneous estimation of initial R(t and the SI; estimate initial R(t from SI distributions established from prior field studies (method 2; and the Wallinga and Teunis method (method 3 to model the temporal variation of R(t. RESULTS: 12,360 confirmed pH1N1 cases were reported in the central registry. During the period of exponential growth of the epidemic (June 21 to August 3, 2009, we simultaneously estimate a mean R(t of 1.47 (95% CI: 1.30-1.72 and mean SI of 2.78 days (95% CI: 1.80-3.75 (method 1. Field studies found a mean SI of 2.3 days between primary cases and laboratory-confirmed secondary cases, and 2.7 days when considering both suspected and confirmed secondary cases. Incorporating the SI estimate from field studies using laboratory-confirmed cases, we found an initial R(t of 1.43 (95% CI: 1.38-1.49 (method 2. The mean R(t peaked at 2.91 (95% CI: 0.85-2.91 on June 21, as the epidemic commenced, and R(t>1 was sustained until August 22 (method 3. CONCLUSIONS: Transmissibility characteristics of pH1N1 in South Africa are similar to estimates reported by countries outside of Africa. Estimations using the likelihood-based method are in agreement with field findings.

  4. The Safety of Adjuvanted Vaccines Revisited: Vaccine-Induced Narcolepsy.

    Science.gov (United States)

    Ahmed, S Sohail; Montomoli, Emanuele; Pasini, Franco Laghi; Steinman, Lawrence

    2016-01-01

    Despite the very high benefit-to-risk ratio of vaccines, the fear of negative side effects has discouraged many people from getting vaccinated, resulting in the reemergence of previously controlled diseases such as measles, pertussis and diphtheria. This fear has been amplified more recently by multiple epidemiologic studies that confirmed the link of an AS03-adjuvanted pandemic influenza vaccine (Pandemrix, GlaxoSmithKline Biologicals, Germany) used in Europe during the 2009 H1N1 influenza pandemic [A(H1N1) pdm09] with the development of narcolepsy, a chronic sleep disorder, in children and adolescents. However, public misperceptions of what adjuvants are and why they are used in vaccines has created in some individuals a closed "black box" attitude towards all vaccines. The focus of this review article is to revisit this "black box" using the example of narcolepsy associated with the European AS03-adjuvanted pandemic influenza vaccine. PMID:27228647

  5. Rapid spread of influenza A(H1N1)pdm09 viruses with a new set of specific mutations in the internal genes in the beginning of 2015/2016 epidemic season in Moscow and Saint Petersburg (Russian Federation).

    Science.gov (United States)

    Komissarov, Andrey; Fadeev, Artem; Sergeeva, Maria; Petrov, Sergey; Sintsova, Kseniya; Egorova, Anna; Pisareva, Maria; Buzitskaya, Zhanna; Musaeva, Tamila; Danilenko, Daria; Konovalova, Nadezhda; Petrova, Polina; Stolyarov, Kirill; Smorodintseva, Elizaveta; Burtseva, Elena; Krasnoslobodtsev, Kirill; Kirillova, Elena; Karpova, Lyudmila; Eropkin, Mikhail; Sominina, Anna; Grudinin, Mikhail

    2016-07-01

    A dramatic increase of influenza activity in Russia since week 3 of 2016 significantly differs from previous seasons in terms of the incidence of influenza and acute respiratory infection (ARI) and in number of lethal cases. We performed antigenic analysis of 108 and whole-genome sequencing of 77 influenza A(H1N1)pdm09 viruses from Moscow and Saint Petersburg. Most of the viruses were antigenically related to the vaccine strain. Whole-genome analysis revealed a composition of specific mutations in the internal genes (D2E and M83I in NEP, E125D in NS1, M105T in NP, Q208K in M1, and N204S in PA-X) that probably emerged before the beginning of 2015/2016 epidemic season. PMID:26992820

  6. Incidence and epidemiology of hospitalized influenza cases in rural Thailand during the influenza A (H1N1pdm09 pandemic, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Henry C Baggett

    Full Text Available BACKGROUND: Data on the burden of the 2009 influenza pandemic in Asia are limited. Influenza A(H1N1pdm09 was first reported in Thailand in May 2009. We assessed incidence and epidemiology of influenza-associated hospitalizations during 2009-2010. METHODS: We conducted active, population-based surveillance for hospitalized cases of acute lower respiratory infection (ALRI in all 20 hospitals in two rural provinces. ALRI patients were sampled 1∶2 for participation in an etiology study in which nasopharyngeal swabs were collected for influenza virus testing by PCR. RESULTS: Of 7,207 patients tested, 902 (12.5% were influenza-positive, including 190 (7.8% of 2,436 children aged 75 years (407 per 100,000. The incidence of influenza A(H1N1pdm09 was 62 per 100,000 (214 per 100,000 in children <5 years. Eleven influenza-infected patients required mechanical ventilation, and four patients died, all adults with influenza A(H1N1pdm09 (1 or H3N2 (3. CONCLUSIONS: Influenza-associated hospitalization rates in Thailand during 2009-10 were substantial and exceeded rates described in western countries. Influenza A(H1N1pdm09 predominated, but H3N2 also caused notable morbidity. Expanded influenza vaccination coverage could have considerable public health impact, especially in young children.

  7. Molecular epidemiology of A/H3N2 and A/H1N1 influenza virus during a single epidemic season in the United States.

    Directory of Open Access Journals (Sweden)

    Martha I Nelson

    Full Text Available To determine the spatial and temporal dynamics of influenza A virus during a single epidemic, we examined whole-genome sequences of 284 A/H1N1 and 69 A/H3N2 viruses collected across the continental United States during the 2006-2007 influenza season, representing the largest study of its kind undertaken to date. A phylogenetic analysis revealed that multiple clades of both A/H1N1 and A/H3N2 entered and co-circulated in the United States during this season, even in localities that are distant from major metropolitan areas, and with no clear pattern of spatial spread. In addition, co-circulating clades of the same subtype exchanged genome segments through reassortment, producing both a minor clade of A/H3N2 viruses that appears to have re-acquired sensitivity to the adamantane class of antiviral drugs, as well as a likely antigenically distinct A/H1N1 clade that became globally dominant following this season. Overall, the co-circulation of multiple viral clades during the 2006-2007 epidemic season revealed patterns of spatial spread that are far more complex than observed previously, and suggests a major role for both migration and reassortment in shaping the epidemiological dynamics of human influenza A virus.

  8. Influenza update 2007-2008: vaccine advances, pandemic preparation.

    Science.gov (United States)

    Mossad, Sherif B

    2007-12-01

    Influenza vaccination remains our best measure to prevent epidemic and pandemic influenza. We must continue to improve vaccination rates for targeted populations. Antiviral options are currently limited to the neuraminidase inhibitors. PMID:18183839

  9. Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: results from a cohort study in general practice.

    Science.gov (United States)

    Hardelid, Pia; Fleming, Douglas M; Andrews, Nick; Barley, Michele; Durnall, Hayley; Mangtani, Punam; Pebody, Richard

    2012-02-01

    Estimation of influenza vaccine effectiveness (VE) is complicated by various degrees of mismatch between circulating and vaccine strains each season. We carried out a cohort study to estimate VE of trivalent (TIV) and pandemic influenza vaccines (PIV) in preventing various respiratory outcomes among general practice (GP) patients in England and Wales between 2008 and 2010. Dates of consultations for influenza-like illness (ILI), acute respiratory tract infection (ARTI), lower respiratory tract infection (LRTI) and nasopharyngeal swabs were obtained from the patient-level electronic records of the 100 practices enrolled in a national GP network. Dates of vaccination with TIV and PIV were also extracted. Confounders including age, time period and consultation frequency were adjusted for through Poisson regression models. In the winter of 2008/9, adjusted VE of TIV in preventing ILI was 22.3% (95% CI 13.5%, 30.2%). During the 2009/10 winter VE for PIV in preventing ILI was 21.0% (5.3%, 34.0%). The VE for PIV in preventing PCR-confirmed influenza A/H1N1 (2009) was 63.7% (-6.1%, 87.6%). TIV during the period of influenza circulation of 2008/9 and PIV in the winter of 2009/10 were effective in preventing GP consultations for ILI. The cohort study design could be used each season to estimate VE; however, residual confounding by indication could still present issues, despite adjustment for propensity to consult. PMID:22178524

  10. Host adaptive immunity deficiency in severe pandemic influenza

    OpenAIRE

    Bermejo-Martin, Jesus F; Martin-Loeches, Ignacio; Rello, Jordi; Antón, Andres; Almansa, Raquel; Xu, Luoling; Lopez-Campos, Guillermo; Pumarola, Tomás; Ran, Longsi; Ramirez, Paula; Banner, David; Cheuk Ng, Derek; Socias, Lorenzo; Loza, Ana; Andaluz, David

    2010-01-01

    Introduction Pandemic A/H1N1/2009 influenza causes severe lower respiratory complications in rare cases. The association between host immune responses and clinical outcome in severe cases is unknown. Methods We utilized gene expression, cytokine profiles and generation of antibody responses following hospitalization in 19 critically ill patients with primary pandemic A/H1N1/2009 influenza pneumonia for identifying host immune responses associated with clinical outcome. Ingenuity pathway analy...

  11. Pandemic influenza: overview of vaccines and antiviral drugs.

    OpenAIRE

    Cox, Manon M. J.

    2005-01-01

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

  12. Economic analysis of pandemic influenza vaccination strategies in Singapore.

    Directory of Open Access Journals (Sweden)

    Vernon J Lee

    Full Text Available BACKGROUND: All influenza pandemic plans advocate pandemic vaccination. However, few studies have evaluated the cost-effectiveness of different vaccination strategies. This paper compares the economic outcomes of vaccination compared with treatment with antiviral agents alone, in Singapore. METHODOLOGY: We analyzed the economic outcomes of pandemic vaccination (immediate vaccination and vaccine stockpiling compared with treatment-only in Singapore using a decision-based model to perform cost-benefit and cost-effectiveness analyses. We also explored the annual insurance premium (willingness to pay depending on the perceived risk of the next pandemic occurring. PRINCIPAL FINDINGS: The treatment-only strategy resulted in 690 deaths, 13,950 hospitalization days, and economic cost of USD$497 million. For immediate vaccination, at vaccine effectiveness of >55%, vaccination was cost-beneficial over treatment-only. Vaccine stockpiling is not cost-effective in most scenarios even with 100% vaccine effectiveness. The annual insurance premium was highest with immediate vaccination, and was lower with increased duration to the next pandemic. The premium was also higher with higher vaccine effectiveness, attack rates, and case-fatality rates. Stockpiling with case-fatality rates of 0.4-0.6% would be cost-beneficial if vaccine effectiveness was >80%; while at case-fatality of >5% stockpiling would be cost-beneficial even if vaccine effectiveness was 20%. High-risk sub-groups warrant higher premiums than low-risk sub-groups. CONCLUSIONS: The actual pandemic vaccine effectiveness and lead time is unknown. Vaccine strategy should be based on perception of severity. Immediate vaccination is most cost-effective, but requires vaccines to be available when required. Vaccine stockpiling as insurance against worst-case scenarios is also cost-effective. Research and development is therefore critical to develop and stockpile cheap, readily available effective vaccines.

  13. Mortality, Severe Acute Respiratory Infection, and Influenza-Like Illness Associated with Influenza A(H1N1)pdm09 in Argentina, 2009

    OpenAIRE

    Azziz-Baumgartner, Eduardo; Cabrera, Ana María; Chang, Loretta; Calli, Rogelio; Kusznierz, Gabriela; Baez, Clarisa; Yedlin, Pablo; Zamora, Ana María; Cuezzo, Romina; Sarrouf, Elena Beatriz; Uboldi, Andrea; Herrmann, Juan; Zerbini, Elsa; Uez, Osvaldo; Rico Cordeiro, Pedro Osvaldo

    2012-01-01

    Introduction While there is much information about the burden of influenza A(H1N1)pdm09 in North America, little data exist on its burden in South America. Methods During April to December 2009, we actively searched for persons with severe acute respiratory infection and influenza-like illness (ILI) in three sentinel cities. A proportion of case-patients provided swabs for influenza testing. We estimated the number of case-patients that would have tested positive for influenza by multiplying ...

  14. Usporedba pandemijskog virusa A/H1N1/ iz 1918. godine s potencijalnim pandemijskim virusom A/H5N1/ iz 2005. godine

    OpenAIRE

    Draženović, V.; Barišin, A.

    2006-01-01

    Jedna od tri velike pandemije 20. stoljeća je najveća epidemija svih vremena tzv. Španjolska gripa uzrokovana virusom tipa A/H1N1/, a 1918. godine usmrtila je oko 50 milijuna ljudi. Razlog tako velikog broja žrtava virusolozi nisu sa sigurnošću mogli odgonetnuti do u nazad par mjeseci. Na temelju zaostalog obdukcijskog materijala iz davne 1918. uspjelo je ponovno oživjeti pojedine komponente virusa i tako pojasniti nedoumice u vezi sa molekularnom osnovom patogenosti. Isto tako znanstvenici u...

  15. Modeling pandemic preparedness scenarios: health economic implications of enhanced pandemic vaccine supply.

    Science.gov (United States)

    Medema, Jeroen K; Zoellner, York F; Ryan, James; Palache, Abraham M

    2004-07-01

    Influenza pandemic planning is a complex, multifactorial process, which involves public health authorities, regulatory authorities, academia and industry. It is further complicated by the unpredictability of the time of emergence and severity of the next pandemic and the effectiveness of influenza epidemic interventions. The complexity and uncertainties surrounding pandemic preparedness have so far kept the various stakeholders from joining forces and tackling the problem from its roots. We developed a mathematical model, which shows the tangible consequences of conceptual plans by linking possible pandemic scenarios to health economic outcomes of possible intervention strategies. This model helps to structure the discussion on pandemic preparedness and facilitates the translation of pandemic planning concepts to concrete plans. The case study for which the model has been used shows the current level of global pandemic preparedness in an assumed pandemic scenario, the health economic implications of enhanced pandemic vaccine supply and the importance of cell culture-based influenza vaccine manufacturing technologies as a tool for pandemic control. PMID:15163482

  16. “Prepandemic” Immunization for Novel Influenza Viruses, “Swine Flu” Vaccine, Guillain-Barré Syndrome, and the Detection of Rare Severe Adverse Events

    OpenAIRE

    Evans, David; Cauchemez, Simon; Hayden, Frederick G.

    2009-01-01

    The availability of immunogenic, licensed H5N1 vaccines and the anticipated development of vaccines against “swine” influenza A(H1N1) have stimulated debate about the possible use of these vaccines for protection of those exposed to potential pandemic influenza viruses and for immunization or “priming” of populations in the so-called “prepandemic” (interpandemic) era. However, the safety of such vaccines is a critical issue in policy development for wide-scale application of vaccines in the i...

  17. 2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009–2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases

    OpenAIRE

    Barakat, Amal; Ihazmad, Hassan; El Falaki, Fatima; Tempia, Stefano; Cherkaoui, Imad; El Aouad, Rajae

    2012-01-01

    Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009–2010, including transmissibility and risk factors associated with fatal disease.

  18. Knowledge, Attitudes and Practices (KAP related to the Pandemic (H1N1 2009 among Chinese General Population: a Telephone Survey

    Directory of Open Access Journals (Sweden)

    Yan Weirong

    2011-05-01

    Full Text Available Abstract Background China is at greatest risk of the Pandemic (H1N1 2009 due to its huge population and high residential density. The unclear comprehension and negative attitudes towards the emerging infectious disease among general population may lead to unnecessary worry and even panic. The objective of this study was to investigate the Chinese public response to H1N1 pandemic and provide baseline data to develop public education campaigns in response to future outbreaks. Methods A close-ended questionnaire developed by the Chinese Center for Disease Control and Prevention was applied to assess the knowledge, attitudes and practices (KAP of pandemic (H1N1 2009 among 10,669 responders recruited from seven urban and two rural areas of China sampled by using the probability proportional to size (PPS method. Results 30.0% respondents were not clear whether food spread H1N1 virusand. 65.7% reported that the pandemic had no impact on their life. The immunization rates of the seasonal flu and H1N1vaccine were 7.5% and 10.8%, respectively. Farmers and those with lower education level were less likely to know the main transmission route (cough or talk face to face. Female and those with college and above education had higher perception of risk and more compliance with preventive behaviors. Relationships between knowledge and risk perception (OR = 1.69; 95%CI 1.54-1.86, and knowledge and practices (OR = 1.57; 95%CI 1.42-1.73 were found among the study subjects. With regard to the behavior of taking up A/H1N1 vaccination, there are several related factors found in the current study population, including the perception of life disturbed (OR = 1.29; 95%CI 1.11-1.50, the safety of A/H1N1 vaccine (OR = 0.07; 95%CI 0.04-0.11, the knowledge of free vaccination policy (OR = 7.20; 95%CI 5.91-8.78, the state's priority vaccination strategy(OR = 1.33; 95%CI 1.08-1.64, and taking up seasonal influenza vaccine behavior (OR = 4.69; 95%CI 3.53-6.23. Conclusions This A

  19. Analysis of oseltamivir-resistant H275Y mutation in a novel A/H1N1 influenza virus strain%一株新型甲型H1N1流感病毒H275Y的奥司他韦耐药变异分析

    Institute of Scientific and Technical Information of China (English)

    苏彤; 李淑华; 鹿文英; 韩磊; 韩一芳; 曹广文

    2009-01-01

    Objective To elucidate the genetic characteristics and variations of glycosylation sites of neuraminidase (NA) gene of the novel A/H1N1 influenza pandemic virus in 2009. Methods The sequences of NA gene of 110 A/H1N1 influenza virus strains isolated at different time and locations were downloaded from NCBI database. MEGA4.0 software and NJ method were used for nucleotide sequence alignment, coding protein sequence alignment and the phylogenetic tree construction. Results The NA gene of the novel A/H1N1 influenza virus strains isolated from different areas in 2009 shared an extremely high homology of 99. 5%-100%, but it was different from that of A/human/H1N1 influenza virus. The novel A/H1N1 influenza virus strains and Europe A/swine/HlNl influenza virus strains shared a high homology of 89. 6% - 92. 9%, with similar glycosylation sites at 50, 58, 63, 68, 88, 146, 235 and 386. Moreover, the homology of NA gene between the novel A/H1N1 influenza virus and A/chicken/H5N1 influenza virus amounted to 83. 6% -85. 3%. Amino acid residues at the enzyme active sites of the NA were strictly conservative in most novel A/H1N1 influenza virus strains, still manifesting as R118, D151, R152, R225, E277, R293, R368, Y402, E119, R156, W179, S180, D199, 1223, E228, H275, E278, N295 and E425. Four strains isolated from Denmark, Japan, and HongKong and Hunan province showed a H275Y mutatioa The NA gene of the novel A/H1N1 influenza virus might originate from Europe A/swine/HlNl influenza virus, and had genetic relationship with A/ chicken/H5N1 influenza virus. Conclusions The novel A/H1N1 influenza pandemic virus in 2009 might be a reassorted virus rather than the result of gradual evolution of A/human/HlNl influenza virus. A novel A/H1N1 influenza virus strain isolated from Hunan has a H275Y mutation which might be oseltamivir resistant.%目的 探讨2009年新型甲型H1N1流感病毒神经氨酸酶(NA)基因的进化规律,分析NA蛋白酶活性位点以及糖基

  20. The 2009 H1N1 Pandemic Influenza in Korea

    OpenAIRE

    Kim, Jae Yeol

    2016-01-01

    In late March of 2009, an outbreak of influenza in Mexico, was eventually identified as H1N1 influenza A. In June 2009, the World Health Organization raised a pandemic alert to the highest level. More than 214 countries have reported confirmed cases of pandemic H1N1 influenza A. In Korea, the first case of pandemic influenza A/H1N1 infection was reported on May 2, 2009. Between May 2009 and August 2010, 750,000 cases of pandemic influenza A/H1N1 were confirmed by laboratory test. The H1N1-rel...

  1. Functional balance between the hemagglutinin and neuraminidase of influenza A(H1N1pdm09 HA D222 variants.

    Directory of Open Access Journals (Sweden)

    Jean-Sébastien Casalegno

    Full Text Available D222G/N substitutions in A(H1N1pdm09 hemagglutinin may be associated with increased binding of viruses causing low respiratory tract infections and human pathogenesis. We assessed the impact of such substitutions on the balance between hemagglutinin binding and neuraminidase cleavage, viral growth and in vivo virulence.Seven viruses with differing polymorphisms at codon 222 (2 with D, 3 G, 1 N and 1 E were isolated from patients and characterized with regards hemagglutinin binding affinity (Kd to α-2,6 sialic acid (SAα-2,6 and SAα-2,3 and neuraminidase enzymatic properties (Km, Ki and Vmax. The hemagglutination assay was used to quantitatively assess the balance between hemagglutinin binding and neuraminidase cleavage. Viral growth properties were compared in vitro in MDCK-SIAT1 cells and in vivo in BALB/c mice. Compared with D222 variants, the binding affinity of G222 variants was greater for SAα-2,3 and lower for SAα-2,6, whereas that of both E222 and N222 variants was greater for both SAα-2,3 and SAα-2,6. Mean neuraminidase activity of D222 variants (16.0 nmol/h/10(6 was higher than that of G222 (1.7 nmol/h/10(6 viruses and E/N222 variants (4.4 nmol/h/10(6 viruses. The hemagglutination assay demonstrated a deviation from functional balance by E222 and N222 variants that displayed strong hemagglutinin binding but weak neuraminidase activity. This deviation impaired viral growth in MDCK-SIAT1 cells but not infectivity in mice. All strains but one exhibited low infectious dose in mice (MID50 and replicated to high titers in the lung; this D222 strain exhibited a ten-fold higher MID50 and replicated to low titers. Hemagglutinin-neuraminidase balance status had a greater impact on viral replication than hemagglutinin affinity strength, at least in vitro, thus emphasizing the importance of an optimal balance for influenza virus fitness. The mouse model is effective in assessing binding to SAα-2,3 but cannot differentiate SAα-2,3- from SAα-2,6- preference, nor estimate the hemagglutinin-neuraminidase balance in A(H1N1pdm09 strains.

  2. Determinants of adults' intention to vaccinate against pandemic swine flu

    Directory of Open Access Journals (Sweden)

    Goodwin Robin

    2011-01-01

    Full Text Available Abstract Background Vaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study. Methods Three hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306 or pen and paper (n = 56 questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions. Results The extended Theory of Planned Behaviour predicted 60% of adults' intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity, intention to have a seasonal vaccine this year, one perceived barrier: "I cannot be bothered to get a swine flu vaccination" and two perceived benefits: "vaccination decreases my chance of getting swine flu or its complications" and "if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor," being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents. Conclusions Theoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.

  3. ¿Cómo informaron los medios de comunicación sobre la influenza AH1N1 en Perú?

    Directory of Open Access Journals (Sweden)

    Ada Palpan-Guerra

    2015-06-01

    Full Text Available Se analiza las características de las noticias emitidas por los medios de comunicación del Perú (MC sobre influenza AH1N1 en el 2013, para lo cual se revisaron diariamente los MC escritos, radio, televisión e Internet. Las noticias se clasificaron según encuadre, valoración (educativa, informativa y con elevada percepción del riesgo de contagio y muerte -NEPRCM y alcance. Se realizó un análisis descriptivo de las principales variables del estudio. El encuadre de la noticias estuvo centrado en los casos de influenza (47,5% y las acciones del MINSA/otras instituciones (29,0%. El mayor porcentaje de noticias fueron de carácter informativo (73,7%, y solo el 7,5% fueron NEPRCM; estas últimas fueron más frecuentes en los diarios (9,0% y televisión (9,4%. Durante el 2013, los MC, en general, fueron responsables al momento de informar, aunque hubo algunos que difundieron noticias que podrían haber incrementado la percepción de riesgo en la población

  4. ¿Cómo informaron los medios de comunicación sobre la influenza AH1N1 en Perú?

    Directory of Open Access Journals (Sweden)

    Ada Palpan-Guerra

    2015-04-01

    Full Text Available Se analiza las características de las noticias emitidas por los medios de comunicación del Perú (MC sobre influenza AH1N1 en el 2013, para lo cual se revisaron diariamente los MC escritos, radio, televisión e Internet. Las noticias se clasificaron según encuadre, valoración (educativa, informativa y con elevada percepción del riesgo de contagio y muerte -NEPRCM y alcance. Se realizó un análisis descriptivo de las principales variables del estudio. El encuadre de la noticias estuvo centrado en los casos de influenza (47,5% y las acciones del MINSA/otras instituciones (29,0%. El mayor porcentaje de noticias fueron de carácter informativo (73,7%, y solo el 7,5% fueron NEPRCM; estas últimas fueron más frecuentes en los diarios (9,0% y televisión (9,4%. Durante el 2013, los MC, en general, fueron responsables al momento de informar, aunque hubo algunos que difundieron noticias que podrían haber incrementado la percepción de riesgo en la población

  5. Construyendo buenos ciudadanos con buenas prácticas en salud: dengue e influenza AH1N1 en Cali, Colombia

    Directory of Open Access Journals (Sweden)

    Alejandro Arango

    2013-06-01

    Full Text Available Este artículo discute la relación entre la dimensión biológica de las enfermedades y los hábitos de auto-cuidado o “conductas saludables”. Su pregunta central indaga por cómo un fenómeno aparentemente biológico genera ciertas “buenas prácticas” en torno a la salud, defendiendo la idea de la enfermedad como un asunto socio-cultura, más que un mero hecho biológico. El estudio aquí presentado se apoya en una investigación realizada en la ciudad de Cali y enfocada en dos enfermedades, dengue e influenza AH1N1, entre 2009 y 2010. El examen de la relevancia adquirida por estas dos dolencias, mostrará cómo la biología y las prácticas de auto-cuidado tienen una estrecha relación entre sí.

  6. “Prepandemic” Immunization for Novel Influenza Viruses, “Swine Flu” Vaccine, Guillain-Barré Syndrome, and the Detection of Rare Severe Adverse Events

    Science.gov (United States)

    Evans, David; Cauchemez, Simon; Hayden, Frederick G

    2010-01-01

    The availability of immunogenic, licensed H5N1 vaccines and the anticipated development of vaccines against “swine” influenza A(H1N1) have stimulated debate about the possible use of these vaccines for protection of those exposed to potential pandemic influenza viruses and for immunization or “priming” of populations in the so-called “prepandemic” (interpandemic) era. However, the safety of such vaccines is a critical issue in policy development for wide-scale application of vaccines in the interpandemic period. For example, wide-scale interpandemic use of H5N1 vaccines could lead to millions of persons receiving vaccines of uncertain efficacy potentially associated with rare severe adverse events and against a virus that may not cause a pandemic. Here, we first review aspects of the 1976 National Influenza Immunization Programme against “swine flu” and its well-documented association with Guillain-Barré syndrome as a case study illustration of a suspected vaccine-associated severe adverse event in a mass interpandemic immunization setting. This case study is especially timely, given the recent spread of a novel influenza A(H1N1) virus in humans in Mexico and beyond. Following this, we examine available safety data from clinical trials of H5N1 vaccines and briefly discuss how vaccine safety could be monitored in a postmarketing surveillance setting. PMID:19563262

  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. A(H1N1)流感病毒及抗病毒新药的筛选%A(H1N1) Influenza Virus and Screening of New Anti-influenza Virus Drugs

    Institute of Scientific and Technical Information of China (English)

    陈执中

    2009-01-01

    A(H1N1) influenza virus is a novel strain of influenza virus mutant,which was found in March to April 2009 in USA and Mexico. The spread of epidemic influenza brings about a serious attention by every country in the world and World Health Organization. In this paper, the A (H1N1) influenza virus and its symptom, virulence and spread are introduced. Meanwhile, the mutant' s resistance to anti-influenza drugs, the characterization of the 1918 pandemic influenza virus polymerase, the crystal structure of human and avian influenza virus polymerase and its action in influenza are also discussed. Accordingly, we put forward the screening ideas and research orientation for anti-influenza virus drugs, which will be a beneficial reference for the further design and development of new anti-influenza virus drugs.%A(H1N1)流感病毒是2009年3~4月在美国和墨西哥发现的一种流感病毒变异的新病毒株.这类流感疫情的蔓延引起了世界各国和世界卫生组织的严重关注.本文介绍了A(H1N1)流感新病毒株及感染这种病毒患者的症状,A(H1N1)流感病毒的致命力和传播,流感病毒变异对抗病毒药的抗药性,以及1918年流感大流行病毒聚合酶特性,人流感病毒和禽流感病毒聚合酶的结晶结构及其在感染中的作用.据此,提出了抗流感病毒药的筛选思路和研究方向,为抗流感病毒新药的设计和开发提供有益的参考.

  9. Ameaça e controle da gripe A(H1N1: uma análise discursiva de Veja, IstoÉ e Época Threat and control of influenza A (H1N1: a discursive analysis of Brazilian magazines Veja, IstoÉ and Época

    Directory of Open Access Journals (Sweden)

    Isaltina Maria de Azevedo Mello Gomes

    2012-06-01

    Full Text Available Em 2009, o aparecimento de casos da gripe A(H1N1 - a chamada gripe suína - em 207 países indicou o registro da primeira pandemia do século XXI, como já previam os informes dos órgãos sanitários há alguns anos. No Brasil, foram confirmados 27.850 casos de suína, dos quais 1.632 evoluíram a óbito, representando 18,6% das mortes mundiais e 27,7% no continente americano, segundo dados do Ministério da Saúde (2009. Os meios de comunicação brasileiros bem como os de outros países vincularam o surgimento da gripe suína como uma "reedição" diferenciada da gripe espanhola, devido à identificação de um novo subtipo de vírus da gripe que podia ser tão letal quanto a antiga. Um temor semelhante havia sido vivenciado também com a gripe aviária, em 1997, que levou autoridades a permanecerem em estado de alerta. Este artigo tem por objetivo avaliar a produção das notícias sobre a gripe A(H1N1 nas três principais revistas de circulação nacional do Brasil. Para tanto, escolhemos as oito capas de Veja, IstoÉ e Época em que a doença foi destaque nos primeiros meses da pandemia, em 2009. Tomando como base noções ligadas à Análise do Discurso e às Teorias do Jornalismo, as análises indicam que o noticiário se divide em duas fases, enfatizando, inicialmente, o alarme provocado pelo medo diante do novo vírus e das mortes registradas e, em seguida, o controle pela constatação de que a moléstia representava menos risco do que se imaginava, além das ações para combatê-la.In 2009, the emergence of cases of influenza A(H1N1 - the popular flu - in 207 countries indicated the registration of the first pandemic of the XXI century, as predicted in reports from health authorities some years ago. In Brazil, 27,850 cases of swine were confirmed, of which 1,632 died, representing 18,6% of deaths worldwide and 27,7% in the Americas, according to the Health Ministry of Brazil (2009. The media have linked the emergence of flu as a

  10. Permissible Variation in the 3′ Non-Coding Region of the Haemagglutinin Genome Segment of the H5N1 Candidate Influenza Vaccine Cirus NIBRG-14

    OpenAIRE

    Rachel E. Johnson; Hamill, Michelle; Harvey, Ruth; Nicolson, Carolyn; Robertson, James S.; Engelhardt, Othmar G.

    2012-01-01

    The candidate H5N1 vaccine virus NIBRG-14 was created in response to a call from the World Health Organisation in 2004 to prepare candidate vaccine viruses (CVVs) to combat the threat of an H5N1 pandemic. NIBRG-14 was created by reverse genetics and is composed of the neuraminidase (NA) and modified haemagglutinin (HA) genes from A/Vietnam/1194/2004 and the internal genes of PR8, a high growing laboratory adapted influenza A(H1N1) strain. Due to time constraints, the non-coding regions (NCRs)...

  11. [Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit].

    Science.gov (United States)

    Rodríguez, A; Alvarez-Rocha, L; Sirvent, J M; Zaragoza, R; Nieto, M; Arenzana, A; Luque, P; Socías, L; Martín, M; Navarro, D; Camarena, J; Lorente, L; Trefler, S; Vidaur, L; Solé-Violán, J; Barcenilla, F; Pobo, A; Vallés, J; Ferri, C; Martín-Loeches, I; Díaz, E; López, D; López-Pueyo, M J; Gordo, F; del Nogal, F; Marqués, A; Tormo, S; Fuset, M P; Pérez, F; Bonastre, J; Suberviola, B; Navas, E; León, C

    2012-03-01

    The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1. Immunochromatographic methods have low sensitivity; a negative result therefore does not rule out active infection. Classical culture is slow and has low sensitivity. Direct immunofluorescence offers a sensitivity of 90%, but requires a sample of high quality. Indirect methods for detecting antibodies are only of epidemiological interest. Patients with A/H1N1 flu may have relative leukopenia and elevated serum levels of LDH, CPK and CRP, but none of these variables are independently associated to the prognosis. However, plasma LDH> 1500 IU/L, and the presence of thrombocytopenia high suspicion of influenza A/H1N1 infection must continue with antiviral treatment, regardless of the negative results of initial tests, unless an alternative diagnosis can be established or clinical criteria suggest a low probability of influenza. In patients with influenza A/H1N1 pneumonia, empirical antibiotic therapy should be provided due to the possibility of bacterial coinfection. A beta-lactam plus a macrolide should be administered as soon as possible. The microbiological findings and clinical or laboratory test variables may decide withdrawal or not of antibiotic treatment. Pneumococcal vaccination is recommended as a preventive measure in the population at risk of suffering severe complications. Although the use of moderate- or low-dose corticosteroids has been proposed for the treatment of influenza A/H1N1 pneumonia, the existing scientific

  12. Autoantibodies against ganglioside GM3 are associated with narcolepsy-cataplexy developing after Pandemrix vaccination against 2009 pandemic H1N1 type influenza virus.

    Science.gov (United States)

    Saariaho, Anna-Helena; Vuorela, Arja; Freitag, Tobias L; Pizza, Fabio; Plazzi, Giuseppe; Partinen, Markku; Vaarala, Outi; Meri, Seppo

    2015-09-01

    Following the mass vaccinations against pandemic influenza A/H1N1 virus in 2009, a sudden increase in juvenile onset narcolepsy with cataplexy (NC) was detected in several European countries where AS03-adjuvanted Pandemrix vaccine had been used. NC is a chronic neurological disorder characterized by excessive daytime sleepiness and cataplexy. In human NC, the hypocretin-producing neurons in the hypothalamus or the hypocretin signaling pathway are destroyed by an autoimmune reaction. Both genetic (e.g. HLA-DQB1*0602) and environmental risk factors (e.g. Pandemrix) contribute to the disease development, but the underlying and the mediating immunological mechanisms are largely unknown. Influenza virus hemagglutinin is known to bind gangliosides, which serve as host cell virus receptors. Anti-ganglioside antibodies have previously been linked to various neurological disorders, like the Guillain-Barré syndrome which may develop after infection or vaccination. Because of these links we screened sera of NC patients and controls for IgG anti-ganglioside antibodies against 11 human brain gangliosides (GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1a, GT1b, GQ1b) and a sulfatide by using a line blot assay. Samples from 173 children and adolescents were analyzed: 48 with Pandemrix-associated NC, 20 with NC without Pandemrix association, 57 Pandemrix-vaccinated and 48 unvaccinated healthy children. We found that patients with Pandemrix-associated NC had more frequently (14.6%) anti-GM3 antibodies than vaccinated healthy controls (3.5%) (P = 0.047). Anti-GM3 antibodies were significantly associated with HLA-DQB1*0602 (P = 0.016) both in vaccinated NC patients and controls. In general, anti-ganglioside antibodies were more frequent in vaccinated (18.1%) than in unvaccinated (7.3%) individuals (P = 0.035). Our data suggest that autoimmunity against GM3 is a feature of Pandemrix-associated NC and that autoantibodies against gangliosides were induced by Pandemrix vaccination. PMID

  13. Seroprevalence of antibodies to influenza A/H1N1/2009 among transmission risk groups after the second wave in Mexico, by a virus-free ELISA method

    Science.gov (United States)

    Elizondo-Montemayor, Leticia; Alvarez, Mario M.; Hernández-Torre, Martín; Ugalde-Casas, Patricia A.; Lam-Franco, Lorena; Bustamante-Careaga, Humberto; Castilleja-Leal, Fernando; Contreras-Castillo, Julio; Moreno-Sánchez, Héctor; Tamargo-Barrera, Daniela; López-Pacheco, Felipe; Freiden, Pamela J.; Schultz-Cherry, Stacey

    2014-01-01

    Summary Objective No serological studies have been performed in Mexico to assess the seroprevalence of influenza A/H1N1/2009 in groups of people according to the potential risk of transmission. The aim of this study was to determine the seroprevalence of antibodies against influenza A/H1N1/2009 in subjects in Mexico grouped by risk of transmission. Methods Two thousand two hundred and twenty-two subjects were categorized into one of five occupation groups according to the potential risk of transmission: (1) students, (2) teachers, (3) healthcare workers, (4) institutional home residents aged >60 years, and (5) general population. Seroprevalence by potential transmission group and by age grouped into decades was determined by a virus-free ELISA method based on the recombinant receptor-binding domain of the hemagglutinin of influenza A/H1N1/2009 virus as antigen (85% sensitivity; 95% specificity). The Wilson score, Chi-square test, and logistic regression models were used for the statistical analyses. Results Seroprevalence for students was 47.3%, for teachers was 33.9%, for older adults was 36.5%, and for the general population was 33.0%, however it was only 24.6% for healthcare workers (p = 0.011). Of the students, 56.6% of those at middle school, 56.4% of those at high school, 52.7% of those at elementary school, and 31.1% of college students showed positive antibodies (p < 0.001). Seroprevalence was 44.6% for college teachers, 31.6% for middle school teachers, and 29.8% for elementary school teachers, but was only 20.3% for high school teachers (p = 0.002). Conclusions The student group was the group most affected by influenza A/H1N1/2009, while the healthcare worker group showed the lowest prevalence. Students represent a key target for preventive measures. PMID:21855383

  14. Market implementation of the MVA platform for pre-pandemic and pandemic influenza vaccines: A quantitative key opinion leader analysis

    NARCIS (Netherlands)

    B. Ramezanpour (Bahar); E.S. Pronker (Esther); J.H.C.M. Kreijtz (Joost); A.D.M.E. Osterhaus (Albert); H.J.H.M. Claassen (Eric)

    2015-01-01

    textabstractA quantitative method is presented to rank strengths, weaknesses, opportunities, and threats (SWOT) of modified vaccinia virus Ankara (MVA) as a platform for pre-pandemic and pandemic influenza vaccines. Analytic hierarchy process (AHP) was applied to achieve pairwise comparisons among S

  15. Study on the genomic sequences and molecular characteristics of influenza A(H1N1) virus%甲型H1N1流感病毒基因组序列分析及其特性研究

    Institute of Scientific and Technical Information of China (English)

    沃恩康; 吴海波; 王怡婷; 汪一帆; 王闻哲; 李颖; 郭潮潭

    2009-01-01

    目的 分析甲型H1N1流感病毒的基因组序列特征,阐明该毒株的遗传变异及分子特性.方法 GenBank中获取流感病毒全序列,对各段基因与已知序列进行分析比较,绘制进化树,并分析和预测甲型毒株的致病性、药物敏感性和现有疫苗的预防保护作用.结果 甲型H1N1病毒的HA、PB2、PB1、PA、NP、NS基因与美国本土的猪流感病毒序列具有高度同源性,NA和M基因具有典型的欧亚株系猪流感病毒特征.该病毒具有人传人的分子基础,HA上HA1和HA2裂解位点序列为PSIQSR↓+GLFGAI,尚不具备高致病性流感病毒的特征.病毒对金刚烷胺类药物耐药,而对达菲和扎那米韦敏感.HA片段5个抗原决定区氨基酸序列与人用流感疫苗具有较大差异,推测现有疫苗对预防本次疫情基本无效.结论 甲型H1N1是一种北美和欧亚两种猪流感病毒的混合体,开发针对本病毒的流感疫苗有助于进一步控制疫情蔓延.%Objective To analyse the genome of influenza A (H1N1) vires so as to elucidate its molecular characteristics and evolution status. Methods DNA sequences of the influenza viruses were collected from NCBI, and compared with the genomes of referenced intluenza viruses. The phylogenetic trees were constructed by the neighbor-joining method, and the pathogenicity, drug susceptibility and vaccine protection were analyzed. Results Phyiogenetic analysis showed that the genes encoding HA, PB2, PBI, PA, NP, and NS protein were most closely related to those influenza A viruses circulating in swine populations in North America. NA and M gene belonged to Eurasia lineages swine influenza vires. The amino acid sequence of the cleavage site between HA1 and HA2 was PARSSR ↓ GLFGAI with the typical characteristics of the low pathogenic influenza virus. Influenza A(H1N1) virus can spread from person-to-person. It is sensitive to oseltamivir and zanamivir but resistant to amantadine and remantadine. The current

  16. Influenza vaccine effectiveness in adults 65 years and older, Denmark, 2015/16 - a rapid epidemiological and virological assessment

    DEFF Research Database (Denmark)

    Emborg, Hanne Dorthe; Krause, Tyra Grove; Nielsen, Lene;

    2016-01-01

    In Denmark, both influenza A(H1N1)pdm09 and influenza B co-circulated in the 2015/16 season. We estimated the vaccine effectiveness (VE) of the trivalent influenza vaccine in patients 65 years and older using the test-negative case-control design. The adjusted VE against influenza A(H1N1)pdm09 wa...

  17. Hospitalized cases of influenza A(H1N1pdm09 in the French territories of the Americas, July 2009-March 2010 Casos hospitalizados de gripe A(H1N1pdm09 en los territorios franceses de las Américas entre julio de 2009 y marzo de 2010

    Directory of Open Access Journals (Sweden)

    Marie Barrau

    2012-08-01

    Full Text Available OBJECTIVE: To describe the methodology used for implementing a surveillance system specifically for influenza A(H1N1pdm09 in the French West Indies and French Guiana during an outbreak of this new virus in 2009-2010, and to report its main results. METHODS: This was an observational descriptive study of confirmed and probable cases of influenza A(H1N1pdm09 hospitalized for at least 24 hours in 23 July 2009-3 March 2010. Reverse transcription polymerase chain reaction was performed on nasopharyngeal swab samples according to the Centers for Disease Control and Prevention protocol. A probable case was defined as fever > 38ºC or aches or asthenia with respiratory symptoms (cough or dyspnea. All confirmed and probable hospitalized cases were reported, along with patient's age, sex, clinical condition at admission, place and length of hospitalization, antiviral treatment, underlying conditions, complications, and clinical evolution. A case was classified as severe if respiratory assistance or intensive care was required or if death resulted. RESULTS: A total of 331 confirmed and 16 probable cases were hospitalized, with a hospitalization rate ranging from 4.3 per 1 000 clinical cases in Saint Martin to 10.3 in French Guiana. Of these, 36 were severe, and subsequently, 10 were fatal. The median length of stay was 4 days for non-severe cases and 9 days for severe (P OBJETIVO: Describir la metodología usada para implementar un sistema de vigilancia específico para la gripe A(H1N1pdm09 en las Indias Occidentales Francesas y la Guayana Francesa durante un brote ocasionado por este virus nuevo ocurrido en 20092010 y presentar sus principales resultados. MÉTODOS: Se llevó a cabo un estudio de observación descriptivo de los casos confirmados y probables de gripe por A(H1N1pdm09 hospitalizados durante al menos 24 horas entre el 23 de julio de 2009 y el 3 de marzo de 2010. De conformidad con el protocolo de los Centros para el Control y la Prevención de Enfermedades se realizó la prueba de reacción en cadena de la polimerasa con transcripción inversa en muestras de hisopados nasofaríngeos. Se definió como caso probable la presencia de fiebre > 38 ºC o dolores o astenia junto con síntomas respiratorios (tos o disnea. Se comunicaron todos los casos hospitalizados confirmados y probables junto con la edad, el sexo, la situación clínica del paciente en el momento del ingreso, el lugar y la duración de la hospitalización, el tratamiento antivírico, las enfermedades subyacentes, las complicaciones y la evolución clínica. Se clasificaron como graves los casos que requirieron asistencia respiratoria o cuidados intensivos o provocaron la muerte. RESULTADOS: Fueron hospitalizados en total 331 casos confirmados y 16 probables, con una tasa de hospitalización que osciló entre 4,3 por cada 1 000 casos clínicos en San Martín y 10,3 por cada 1 000 en la Guayana Francesa. De ellos, 36 fueron graves y 10 llevaron posteriormente a la muerte del paciente. La mediana de la duración de las hospitalizaciones fue de 4 días para los casos no graves y de 9 días para los graves (P < 0,05. La edad media de los pacientes fue de 21 años, y los casos graves fueron significativamente de mayor edad que los no graves (media: 38 años frente a 19 años; P < 0,05. Las enfermedades subyacentes asociadas con un riesgo mayor de gravedad fueron edad de 65 años o más (RR = 7,5; IC de 95% = 4,213,3, diabetes (RR = 3,7; IC de 95% = 1,59,4, insuficiencia cardíaca (RR = 8,4; IC de 95% = 5,213,6 y obesidad mórbida (RR = 4,4; IC de 95% = 1,810,4. En los pacientes que recibieron tratamiento antivírico en el plazo de 2 días de la aparición de los síntomas las estancias hospitalarias fueron más breves (media: 4 días frente a 6,5 días; P < 0,05 y la enfermedad tendió a presentar menor gravedad (11,1% frente a 19,0%; P = 0,13. CONCLUSIONES: La investigación activa de los casos hospitalizados permitió una vigilancia casi exhaustiva. Las tasas de hospitalización y la letalidad de la pandemia fueron más moderadas que lo previsto. Durante este brote se confirmó la capacidad de algunas enfermedades subyacentes ya conocidas para aumentar la gravedad. Además, estos resultados demuestran la validez del tratamiento antivírico temprano.

  18. Age distribution of influenza like illness cases during post-pandemic A(H3N2: comparison with the twelve previous seasons, in France.

    Directory of Open Access Journals (Sweden)

    Clément Turbelin

    Full Text Available In France, the 2011-2012 influenza epidemic was characterized by the circulation of antigenically drifted influenza A(H3N2 viruses and by an increased disease severity and mortality among the elderly, with respect to the A(H1N1pdm09 pandemic and post-pandemic outbreaks. Whether the epidemiology of influenza in France differed between the 2011-2012 epidemic and the previous outbreaks is unclear. Here, we analyse the age distribution of influenza like illness (ILI cases attended in general practice during the 2011-2012 epidemic, and compare it with that of the twelve previous epidemic seasons. Influenza like illness data were obtained through a nationwide surveillance system based on sentinel general practitioners. Vaccine effectiveness was also estimated. The estimated number of ILI cases attended in general practice during the 2011-2012 was lower than that of the past twelve epidemics. The age distribution was characteristic of previous A(H3N2-dominated outbreaks: school-age children were relatively spared compared to epidemics (co-dominated by A(H1N1 and/or B viruses (including the 2009 pandemic and post-pandemic outbreaks, while the proportion of adults over 30 year-old was higher. The estimated vaccine effectiveness (54%, 95% CI (48, 60 was in the lower range for A(H3N2 epidemics. In conclusion, the age distribution of ILI cases attended in general practice seems to be not different between the A(H3N2 pre-pandemic and post-pandemic epidemics. Future researches including a more important number of ILI epidemics and confirmed virological data of influenza and other respiratory pathogens are necessary to confirm these results.

  19. A model-based economic analysis of pre-pandemic influenza vaccination cost-effectiveness

    OpenAIRE

    Halder, Nilimesh; Joel K Kelso; George J Milne

    2014-01-01

    Background A vaccine matched to a newly emerged pandemic influenza virus would require a production time of at least 6 months with current proven techniques, and so could only be used reactively after the peak of the pandemic. A pre-pandemic vaccine, although probably having lower efficacy, could be produced and used pre-emptively. While several previous studies have investigated the cost effectiveness of pre-emptive vaccination strategies, they have not been directly compared to realistic re...

  20. 许昌地区新型甲型H1N1流感合并细菌感染分析%Analyze on Novel A/H1N1 influenza infected by bacteria in Xuchang area

    Institute of Scientific and Technical Information of China (English)

    任丽娟; 艾根伟

    2011-01-01

    目的 研究新型甲型H1N1流感患者合并细菌感染情况.方法 收集咽拭子标本800份,检测其甲型H1N1流感病毒RNA,同时做咽拭子的细菌培养,根据结果 分析甲型H1N1流感患者合并细菌感染及致病菌的药敏情况.结果 800份样本中423例H1N1 RNA阳性;其中73例合并不同的细菌感染,占甲流患者的17%,多数细菌的耐药性较强.结论 许昌地区2009年的甲流疫情中,甲流患者合并细菌感染的情况值得关注,治疗中要注意细菌培养并合理用药.%Objective To research the patients with Novel A/H1N1 who had infected by bacteria.Methods To collect 800 examples of fauces swabs and incubat the swabs and detect the novel A( H1N1 ) influenza virus RNA,on the basis of the results,we could analyze whether the novel A/H1N1 influenza patients infected by bacteria.Results There were 423 patients who had infected by novel A/H1N1 influenza and 73( 17% ) of them had co-infected by bacteria,most of the bacteria were drug fast.Conclusions During the epidemic disease of novel A/H1N1 influenza in Xuchang area in 2009, the co-infected by bacteria and A/H1N1 should be payed more attention, furthermore, we should gave our attention to germicultue and prescribe medicines in reason.

  1. [Pandemic without drama. Influenza vaccination and Asian flu in Germany].

    Science.gov (United States)

    Witte, Wilfried

    2013-01-01

    The history of the 1957/58 Asian flu in Germany is systematically presented for the first time. The focus is on flu vaccination, which is discussed as a yardstick of the perception of the pandemic. International expertise on influenza virology was predominantly based in Anglo-Saxon countries. German microbiologists issued no clear recommendation for preventative vaccination until 1960. Instead, quinine was relied upon as the traditional medicinal prophylaxis. Antibiotics were more frequently administered. In East Germany, little fuss was made over the Asian flu. In line with the authorities' social hygiene orientation, vaccination was accepted as a matter of principle. In the Federal Republic and West Berlin, the population rejected the vaccination largely. It was seen as a scandal that many employees were on sick leave because of the flu, thus adversely affecting the economy. PMID:24844113

  2. Critical Clinical forms of influenza AH1N1: What we have learned from assisting the ill in Cienfuegos. Formas clínicas graves de la influenza AH1N1: Lo que hemos aprendido de la atención a estos enfermos en Cienfuegos

    Directory of Open Access Journals (Sweden)

    Grupo Operativo Provincial de Atención Médica a los enfermos adultos hospitalizados

    2009-11-01

    Full Text Available We currently possess a growing information level on the effects of the influenza AH1N1epidemics in a range of countries in the world. Much of that information refers to statistical data and recommendations for dealing with it. Concerning the clinics of the infected, the existence of groups presenting risks of complications has been repeatedly noted in the international literature, as well as critical clinical findings, with unusual manifestations in other epidemics caused by influenza viruses. To that effect, an approach to characterize various clinical-radiological forms of that entity, as well as serious complication risk groups, may help in the early diagnose and appropriate treatment, which, undoubtedly, along with keeping preventive measures, constitute the best form of assisting the ill in the epidemic phase.
    Actualmente se cuenta con una información cada vez más abundante sobre la afectación de la epidemia de influenza A H1N1, en diversas regiones del mundo. Mucha de ella, se refiere a datos estadísticos y a recomendaciones para su enfrentamiento. En relación con la clínica de los enfermos, se ha notificado reiteradamente, en la literatura internacional, la existencia de grupos de riesgo de complicaciones, así como la presentación de cuadros clínicos graves, con manifestaciones clínicas no habituales en otras epidemias ocasionadas por los virus de la influenza. En ese sentido, una aproximación a caracterizar varias formas clínico-radiológicas de presentación de esta entidad, así como los grupos de riesgo de complicaciones graves, puede ayudar en el diagnóstico precoz y el tratamiento oportuno, que, sin dudas, junto al mantenimiento de las importantes medidas preventivas, constituyen el mejor abordaje de la asistencia a los enfermos, en la fase de la epidemia.

  3. Compliance to oseltamivir among two populations in Oxfordshire, United Kingdom affected by influenza A(H1N1pdm09, November 2009--a waste water epidemiology study.

    Directory of Open Access Journals (Sweden)

    Andrew C Singer

    Full Text Available Antiviral provision remains the focus of many pandemic preparedness plans, however, there is considerable uncertainty regarding antiviral compliance rates. Here we employ a waste water epidemiology approach to estimate oseltamivir (Tamiflu® compliance. Oseltamivir carboxylate (oseltamivir's active metabolite was recovered from two waste water treatment plant (WWTP catchments within the United Kingdom at the peak of the autumnal wave of the 2009 Influenza A (H1N1pdm09 pandemic. Predictions of oseltamivir consumption from detected levels were compared with two sources of national government statistics to derive compliance rates. Scenario and sensitivity analysis indicated between 3-4 and 120-154 people were using oseltamivir during the study period in the two WWTP catchments and a compliance rate between 45-60%. With approximately half the collected antivirals going unused, there is a clear need to alter public health messages to improve compliance. We argue that a near real-time understanding of drug compliance at the scale of the waste water treatment plant (hundreds to millions of people can potentially help public health messages become more timely, targeted, and demographically sensitive, while potentially leading to less mis- and un-used antiviral, less wastage and ultimately a more robust and efficacious pandemic preparedness plan.

  4. Responding to Vaccine Safety Signals during Pandemic Influenza: A Modeling Study

    OpenAIRE

    Maro, Judith C.; Fryback, Dennis G.; Lieu, Tracy A; Lee, Grace M.; David B Martin

    2014-01-01

    Background: Managing emerging vaccine safety signals during an influenza pandemic is challenging. Federal regulators must balance vaccine risks against benefits while maintaining public confidence in the public health system. Methods: We developed a multi-criteria decision analysis model to explore regulatory decision-making in the context of emerging vaccine safety signals during a pandemic. We simulated vaccine safety surveillance system capabilities and used an age-structured compartmental...

  5. Influenza A(H1N1)pdm09 virus exhibiting enhanced cross-resistance to oseltamivir and peramivir due to a dual H275Y/G147R substitution, Japan, March 2016.

    Science.gov (United States)

    Takashita, Emi; Fujisaki, Seiichiro; Shirakura, Masayuki; Nakamura, Kazuya; Kishida, Noriko; Kuwahara, Tomoko; Shimazu, Yukie; Shimomura, Takeshi; Watanabe, Shinji; Odagiri, Takato

    2016-06-16

    An influenza A(H1N1)pdm09 virus carrying a G147R substitution in combination with an H275Y substitution in the neuraminidase protein, which confers cross-resistance to oseltamivir and peramivir, was detected from an immunocompromised inpatient in Japan, March 2016. This dual H275Y/G147R mutant virus exhibited enhanced cross-resistance to both drugs compared with the single H275Y mutant virus and reduced susceptibility to zanamivir, although it showed normal inhibition by laninamivir. PMID:27336226

  6. Report of two cases of influenza virus A/H1N1v and B co-infection during the 2010/2011 epidemics in the Italian Veneto Region

    OpenAIRE

    Calistri Arianna; Salata Cristiano; Cosentino Marina; Asnicar Samuele; Franchin Elisa; Cusinato Riccardo; Pacenti Monia; Donatelli Isabella; Palù Giorgio

    2011-01-01

    Abstract From October 2010 to April 2011, in the Italian Veneto Region, 1403 hospitalized patients were tested for influenza virus infection by specific real time RT-PCR. Overall, 327 samples were positive for either influenza A (75%) or B (25%) viruses. Among these positive patients two resulted co-infected by A/H1N1v and B viruses. Even though co-infection with both influenza A and B viruses appears to be a rare event, it occurs naturally and may play a role in epidemiology and pathogenicit...

  7. Comparison of Influenza Outbreaks in the Republic of Kazakhstan and Russia Induced by 2009 Yearly New Variant of A(H1N1)Influenza Virus

    Institute of Scientific and Technical Information of China (English)

    Karpova L S; Ospanov K S; Baiserkin B S; Boibosinov E U; Popovtseva N M; Stolyarova T P; Stolyarov K A; Mamadaliyev S M; Khairullin B M; Sandybayev N T; Kydyrbayev Zh K; Orynbayev M B

    2011-01-01

    The aim of the work is the comparison of the epidemiology of influenza and acute respiratory virus infections(ARVI)in the Republic of Kazakhstan with the corresponding influenza epidemic in Russia induced by influenza pandemic virus A/California/07/2009 in 2009. Data on influenza and ARVI from the Republic of Kazakhstan and Federal Center of influenza was collected and investigated over the course of several weeks from hospitalized patients with the same diagnosis among all population and in age groups on 16 territories of Kazakhstan and in 49 major cities of Russia. The epidemic in Kazakhstan resembled the Russian epidemic in terms of its abnormally early beginning,expression of monoaetiology,the spread of the epidemic into all territories and start of the epidemics among adult population. High percentage of hospitalized people and lethal outcome were registered in this epidemic. Similarity of epidemic process character in corresponding border-line territories of both countries was found out.

  8. 温州市首次甲型H1N1流感流行的特征分析%Characteristics analysis on the first epidemic of influenza A(H1N1)in Wenzhou

    Institute of Scientific and Technical Information of China (English)

    周祖木; 蔡圆圆; 魏晶娇; 陈晟; 潘琼娇; 马洪波

    2011-01-01

    Objective To analyse the epidemiological characteristics of the first influenza A (H1N1) epidemic in Wenzhou and provide a scientific basis for the measures on control and prevention of influenza. Methods A descriptive epidemiological method was used for analysis of influenza A (H1N1) case data in Wenzhou from May 2009 to July 2010. Results There were 4164 cases (accumulative incidence 53.94/100 000) of influenza A (H1N1) in Wenzhou between May 2009 and July 2010. The peak of incidence was from October 2009 to January 2010, there were 3825 cases, accounted for 91.86%. The patients occurred in eleven counties(districts) of Wenzhou. Most of the cases were found in Lucheng, Ruian and Yueqing counties (districts). Cases for groups aged 5-19 years accounted for 67.39% (2806 The influenza A (H1N1) is gradually transmitted from urbans to rural areas after first imported case is introduced to Wenzhou. The incidence rate is closely related to density of population and mobility of population. Schools are risk sellings for transmissions of influenza A (H1N1). It is very critical to strengthen the epidemiological surveillance for influenza in schools. The influenza A (H1N1) vaccination is specific measures for the prevention of influenza A(H1N1) and gained apparent effectiveness.%目的 分析温州市首次甲型H1N1流感流行特征,为防控措施提出建议.方法 用描述性流行病学方法,对温州市2009年5月至2010年7月甲型H1N1流感病例个案资料进行分析.结果 2009年5月至2010年7月共报告甲型H1N1流感病例4164例,累积发病率53.94/10万.2009年10月至2010年1月为发病高峰,共报告病例数3825例,占总病例数的91.86%.11个县(市、区)均有病例发生,病例数居前三位的是鹿城区、瑞安市和乐清市.5~19岁年龄组共2806例,占总病例数的67.39%,男女之比为1.25∶1;学生占总病例数的66.11%.213例重症与危重症病例中以散居儿童和学生最多,共91例,占42.72%.结论 输入性病

  9. Emerging antigenic variants at the antigenic site Sb in pandemic A(H1N12009 influenza virus in Japan detected by a human monoclonal antibody.

    Directory of Open Access Journals (Sweden)

    Mayo Yasugi

    Full Text Available The swine-origin pandemic A(H1N12009 virus, A(H1N1pdm09, is still circulating in parts of the human population. To monitor variants that may escape from vaccination specificity, antigenic characterization of circulating viruses is important. In this study, a hybridoma clone producing human monoclonal antibody against A(H1N1pdm09, designated 5E4, was prepared using peripheral lymphocytes from a vaccinated volunteer. The 5E4 showed viral neutralization activity and inhibited hemagglutination. 5E4 escape mutants harbored amino acid substitutions (A189T and D190E in the hemagglutinin (HA protein, suggesting that 5E4 recognized the antigenic site Sb in the HA protein. To study the diversity of Sb in A(H1N1pdm09, 58 viral isolates were obtained during the 2009/10 and 2010/11 winter seasons in Osaka, Japan. Hemagglutination-inhibition titers were significantly reduced against 5E4 in the 2010/11 compared with the 2009/10 samples. Viral neutralizing titers were also significantly decreased in the 2010/11 samples. By contrast, isolated samples reacted well to ferret anti-A(H1N1pdm09 serum from both seasons. Nonsynonymous substitution rates revealed that the variant Sb and Ca2 sequences were being positively selected between 2009/10 and 2010/11. In 7,415 HA protein sequences derived from GenBank, variants in the antigenic sites Sa and Sb increased significantly worldwide from 2009 to 2013. These results indicate that the antigenic variants in Sb are likely to be in global circulation currently.

  10. Critical care surveillance: insights into the impact of the 2010/11 influenza season relative to the 2009/10 pandemic season in England.

    Science.gov (United States)

    Green, H K; Ellis, J; Galiano, M; Watson, J M; Pebody, R G

    2013-01-01

    In 2010/11, the influenza season in England was marked by a relative increase in impact on the population compared to that seen during the 2009/10 pandemic, with the same influenza subtype, A(H1N1)pdm09, circulating. The peaks in critical care bed occupancy in both seasons coincided with peaks in influenza A(H1N1)pdm09 activity, but onset of influenza in 2010/11 additionally coincided with notably cold weather, a comparatively smaller peak in influenza B activity and increased reports of bacterial co-infection. A bigger impact on critical care services was seen across all regions in England in 2010/11, with, compared to 2009/10, a notable age shift in critical care admissions from children to young adults. The peak of respiratory syncytial virus (RSV) activity did not coincide with critical care admissions, and regression analysis suggested only a small proportion of critical care bed days might be attributed to the virus in either season. Differences in antiviral policy and improved overall vaccine uptake in 2010/11 with an influenza A(H1N1)pdm09 strain containing vaccine between seasons are unlikely to explain the change in impact observed between the two seasons. The reasons behind the relative high level of severe disease in the 2010/11 winter are likely to have resulted from a combination of factors, including an age shift in infection, accumulation of susceptible individuals through waning immunity, new susceptible individuals from new births and cold weather. The importance of further development of severe influenza disease surveillance schemes for future seasons is reinforced. PMID:23787130

  11. Market implementation of the MVA platform for pre-pandemic and pandemic influenza vaccines: A quantitative key opinion leader analysis

    Science.gov (United States)

    Ramezanpour, Bahar; Pronker, Esther S.; Kreijtz, Joost H.C.M.; Osterhaus, Albert D.M.E.; Claassen, E.

    2015-01-01

    A quantitative method is presented to rank strengths, weaknesses, opportunities, and threats (SWOT) of modified vaccinia virus Ankara (MVA) as a platform for pre-pandemic and pandemic influenza vaccines. Analytic hierarchy process (AHP) was applied to achieve pairwise comparisons among SWOT factors in order to prioritize them. Key opinion leaders (KOLs) in the influenza vaccine field were interviewed to collect a unique dataset to evaluate the market potential of this platform. The purpose of this study, to evaluate commercial potential of the MVA platform for the development of novel generation pandemic influenza vaccines, is accomplished by using a SWOT and AHP combined analytic method. Application of the SWOT–AHP model indicates that its strengths are considered more important by KOLs than its weaknesses, opportunities, and threats. Particularly, the inherent immunogenicity capability of MVA without the requirement of an adjuvant is the most important factor to increase commercial attractiveness of this platform. Concerns regarding vector vaccines and anti-vector immunity are considered its most important weakness, which might lower public health value of this platform. Furthermore, evaluation of the results of this study emphasizes equally important role that threats and opportunities of this platform play. This study further highlights unmet needs in the influenza vaccine market, which could be addressed by the implementation of the MVA platform. Broad use of MVA in clinical trials shows great promise for this vector as vaccine platform for pre-pandemic and pandemic influenza and threats by other respiratory viruses. Moreover, from the results of the clinical trials seem that MVA is particularly attractive for development of vaccines against pathogens for which no, or only insufficiently effective vaccines, are available. PMID:26048779

  12. Market implementation of the MVA platform for pre-pandemic and pandemic influenza vaccines: A quantitative key opinion leader analysis.

    Science.gov (United States)

    Ramezanpour, Bahar; Pronker, Esther S; Kreijtz, Joost H C M; Osterhaus, Albert D M E; Claassen, E

    2015-08-20

    A quantitative method is presented to rank strengths, weaknesses, opportunities, and threats (SWOT) of modified vaccinia virus Ankara (MVA) as a platform for pre-pandemic and pandemic influenza vaccines. Analytic hierarchy process (AHP) was applied to achieve pairwise comparisons among SWOT factors in order to prioritize them. Key opinion leaders (KOLs) in the influenza vaccine field were interviewed to collect a unique dataset to evaluate the market potential of this platform. The purpose of this study, to evaluate commercial potential of the MVA platform for the development of novel generation pandemic influenza vaccines, is accomplished by using a SWOT and AHP combined analytic method. Application of the SWOT-AHP model indicates that its strengths are considered more important by KOLs than its weaknesses, opportunities, and threats. Particularly, the inherent immunogenicity capability of MVA without the requirement of an adjuvant is the most important factor to increase commercial attractiveness of this platform. Concerns regarding vector vaccines and anti-vector immunity are considered its most important weakness, which might lower public health value of this platform. Furthermore, evaluation of the results of this study emphasizes equally important role that threats and opportunities of this platform play. This study further highlights unmet needs in the influenza vaccine market, which could be addressed by the implementation of the MVA platform. Broad use of MVA in clinical trials shows great promise for this vector as vaccine platform for pre-pandemic and pandemic influenza and threats by other respiratory viruses. Moreover, from the results of the clinical trials seem that MVA is particularly attractive for development of vaccines against pathogens for which no, or only insufficiently effective vaccines, are available. PMID:26048779

  13. 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.

  14. Real-time estimation of the hospitalization fatality risk of influenza A(H1N1)pdm09 in Hong Kong.

    Science.gov (United States)

    Wong, J Y; Wu, P; Lau, E H Y; Tsang, T K; Fang, V J; Ho, L-M; Cowling, B J

    2016-06-01

    During the early stage of an epidemic, timely and reliable estimation of the severity of infections are important for predicting the impact that the influenza viruses will have in the population. We obtained age-specific deaths and hospitalizations for patients with laboratory-confirmed H1N1pdm09 infections from June 2009 to December 2009 in Hong Kong. We retrospectively obtained the real-time estimates of the hospitalization fatality risk (HFR), using crude estimation or allowing for right-censoring for final status in some patients. Models accounting for right-censoring performed better than models without adjustments. The risk of deaths in hospitalized patients with confirmed H1N1pdm09 increased with age. Reliable estimates of the HFR could be obtained before the peak of the first wave of H1N1pdm09 in young and middle-aged adults but after the peak in the elderly. In the next influenza pandemic, timely estimation of the HFR will contribute to risk assessment and disease control. PMID:27125572

  15. Reconstructing a spatially heterogeneous epidemic: Characterising the geographic spread of 2009 A/H1N1pdm infection in England.

    Science.gov (United States)

    Birrell, Paul J; Zhang, Xu-Sheng; Pebody, Richard G; Gay, Nigel J; De Angelis, Daniela

    2016-01-01

    Understanding how the geographic distribution of and movements within a population influence the spatial spread of infections is crucial for the design of interventions to curb transmission. Existing knowledge is typically based on results from simulation studies whereas analyses of real data remain sparse. The main difficulty in quantifying the spatial pattern of disease spread is the paucity of available data together with the challenge of incorporating optimally the limited information into models of disease transmission. To address this challenge the role of routine migration on the spatial pattern of infection during the epidemic of 2009 pandemic influenza in England is investigated here through two modelling approaches: parallel-region models, where epidemics in different regions are assumed to occur in isolation with shared characteristics; and meta-region models where inter-region transmission is expressed as a function of the commuter flux between regions. Results highlight that the significantly less computationally demanding parallel-region approach is sufficiently flexible to capture the underlying dynamics. This suggests that inter-region movement is either inaccurately characterized by the available commuting data or insignificant once its initial impact on transmission has subsided. PMID:27404957

  16. Low-dose aspirin use does not diminish the immune response to monovalent H1N1 influenza vaccine in older adults.

    Science.gov (United States)

    Jackson, M L; Bellamy, A; Wolff, M; Hill, H; Jackson, L A

    2016-03-01

    Non-steroidal anti-inflammatory drugs (NSAIDs) may inhibit antibody production by peripheral blood mononuclear cells; one consequence of this could be decreased effectiveness of vaccines in NSAID users. Because many older adults use low-dose aspirin for primary or secondary prevention of coronary events, any inhibitory effect of aspirin on vaccine immune response could reduce the benefits of vaccination programmes in older adults. We tested whether immune response to vaccination differed between users vs. non-users of low-dose aspirin, using data from four randomized trials of monovalent 2009 pandemic influenza A(H1N1) vaccine. Geometric mean haemagglutination inhibition antibody titres were not significantly lower in low-dose aspirin users compared to non-users. Our results provide reassurance that influenza vaccination effectiveness is probably not reduced in older adults taking chronic low-dose aspirin. PMID:26330204

  17. 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

  18. Monitoring vaccine safety using the Vaccine Safety Datalink: utilizing immunization registries for pandemic influenza.

    Science.gov (United States)

    McCarthy, Natalie L; Gee, Julianne; Weintraub, Eric; Donahue, James G; Nordin, James D; Daley, Matthew F; Naleway, Allison; Henninger, Michelle; Baxter, Roger; Crane, Bradley; Aukes, Laurie; Wagner, Nicole; Fisher, Sarah; Jacobsen, Steven J; Sy, Lina; Baggs, James

    2011-07-12

    Mass vaccination campaigns during which new vaccines may be administered to many millions of people in a short period of time call for timely and accurate post-licensure surveillance to monitor vaccine safety. To address the need for timely H1N1 influenza vaccine safety information during the 2009-2010 H1N1 influenza pandemic, the Vaccine Safety Datalink (VSD) project assessed the feasibility and potential mechanisms for utilizing data from state and local immunization registries to capture vaccinations that would not otherwise be captured by the data systems of the participating VSD managed care organizations (MCOs). Three of the eight VSD sites were able to capture H1N1 immunization data electronically from the state and local registries, and one site was able to capture the immunizations through a paper-based system; however, the remaining four sites encountered various obstacles that prevented capture of such data. Additional work will be required at these sites to overcome the barriers, which included privacy and confidentiality laws, time constraints brought on by the pandemic, as well as data quality concerns. PMID:21596088

  19. Global patterns in seasonal activity of influenza A/H3N2, A/H1N1, and B from 1997 to 2005: viral coexistence and latitudinal gradients.

    Directory of Open Access Journals (Sweden)

    Brian S Finkelman

    Full Text Available Despite a mass of research on the epidemiology of seasonal influenza, overall patterns of infection have not been fully described on broad geographic scales and for specific types and subtypes of the influenza virus. Here we provide a descriptive analysis of laboratory-confirmed influenza surveillance data by type and subtype (A/H3N2, A/H1N1, and B for 19 temperate countries in the Northern and Southern hemispheres from 1997 to 2005, compiled from a public database maintained by WHO (FluNet. Key findings include patterns of large scale co-occurrence of influenza type A and B, interhemispheric synchrony for subtype A/H3N2, and latitudinal gradients in epidemic timing for type A. These findings highlight the need for more countries to conduct year-round viral surveillance and report reliable incidence data at the type and subtype level, especially in the Tropics.

  20. Cost effectiveness of vaccination against pandemic influenza in European countries : mathematical modelling analysis

    NARCIS (Netherlands)

    Lugner, A.K.; van Boven, Michiel; de Vries, Robin; Postma, M.J.; Wallinga, J.

    2012-01-01

    Objective To investigate whether a single optimal vaccination strategy exists across countries to deal with a future influenza pandemic by comparing the cost effectiveness of different strategies in various pandemic scenarios for three European countries. Design Economic and epidemic modelling study

  1. Production of polyclonal antibody against Tehran strain influenza virus (A/H1N1/2009 hemagglutinin conserved domain (HA2: brief report

    Directory of Open Access Journals (Sweden)

    Somayeh Zamani

    2015-10-01

    Full Text Available Background: The influenza virus is one of the most important factors for higher morbidity and mortality in the world. Recently, researchers have been focused on influenza conserved antigenic proteins such as hemagglutinin stalk domain (HA2 for vaccine production and serological studies. The HA2 plays a major role in the fusion of the virus with host cells membrane. The immunity system enables to produce antibody against HA2. The aim of this study is polyclonal antibody production against influenza HA2. Methods: This study was done in the Influenza Research Lab, Pasteur Institute of Iran, Tehran for one year from September 2013 to October 2014. In the present study, recombinant HA2 protein was produced in prokaryotic system and purified using Nickel affinity chromatography. The purified HA2 was mixed with Freund’s adjuvant (complete and incomplete and injected into two New Zealand white rabbits by intramuscularly and subcutaneously routes. Immunization was continued for several months with two weeks interval. Before each immunization, blood was drawn by venous puncture from the rabbit ear. Function of rabbit's sera was evaluated using radial immunodiffusion (RID in both forms, Single RID (SRID and Double RID (DRID. Finally, antiserum activity against HA2 was evaluated using western blotting as serological assay. Results: Sedimentary line and zone was observed in RID assays (SRID and DRID represent interaction between HA2 protein and anti- HA2 antibody. As well as, western blotting results was positive for HA2 protein. Therefore, these results showed that polyclonal antibody produced against HA2 protein can identify HA2 protein antigenic sites. Conclusion: These findings show that humoral immune responses have properly been stimulated in rabbits and these antibodies can identify HA2 protein and may be suitable for other serological methods.

  2. Responding to vaccine safety signals during pandemic influenza: a modeling study.

    Directory of Open Access Journals (Sweden)

    Judith C Maro

    Full Text Available Managing emerging vaccine safety signals during an influenza pandemic is challenging. Federal regulators must balance vaccine risks against benefits while maintaining public confidence in the public health system.We developed a multi-criteria decision analysis model to explore regulatory decision-making in the context of emerging vaccine safety signals during a pandemic. We simulated vaccine safety surveillance system capabilities and used an age-structured compartmental model to develop potential pandemic scenarios. We used an expert-derived multi-attribute utility function to evaluate potential regulatory responses by combining four outcome measures into a single measure of interest: 1 expected vaccination benefit from averted influenza; 2 expected vaccination risk from vaccine-associated febrile seizures; 3 expected vaccination risk from vaccine-associated Guillain-Barre Syndrome; and 4 expected change in vaccine-seeking behavior in future influenza seasons.Over multiple scenarios, risk communication, with or without suspension of vaccination of high-risk persons, were the consistently preferred regulatory responses over no action or general suspension when safety signals were detected during a pandemic influenza. On average, the expert panel valued near-term vaccine-related outcomes relative to long-term projected outcomes by 3:1. However, when decision-makers had minimal ability to influence near-term outcomes, the response was selected primarily by projected impacts on future vaccine-seeking behavior.The selected regulatory response depends on how quickly a vaccine safety signal is identified relative to the peak of the pandemic and the initiation of vaccination. Our analysis suggested two areas for future investment: efforts to improve the size and timeliness of the surveillance system and behavioral research to understand changes in vaccine-seeking behavior.

  3. 75 FR 55776 - Request for Comments on Vaccine Production and Additional Planning for Future Possible Pandemic...

    Science.gov (United States)

    2010-09-14

    ... International Trade Administration Request for Comments on Vaccine Production and Additional Planning for Future Possible Pandemic Influenza AGENCY: International Trade Administration, Department of Commerce. ACTION: Notice and request for comments. SUMMARY: The International Trade Administration invites submission...

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

    OpenAIRE

    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 C...

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

    OpenAIRE

    Jul-Larsen, Åsne; Madhun, Abdullah S.; Brokstad, Karl A.; Montomoli, Emanuele; Yusibov, Vidadi; Cox, Rebecca J.

    2012-01-01

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

  6. 北京市顺义区健康人群甲型H1N1流感抗体水平监测%Serologic survey on influenza A(H1N1) in Shunyi district of Beijing

    Institute of Scientific and Technical Information of China (English)

    冯冉; 王凤双; 肖雷; 吴殚; 唐莹; 高建华

    2012-01-01

    目的:了解北京市顺义区健康人群甲型H1N1流感抗体水平,为卫生部门制定预防控制措施和策略提供依据.方法:随机选取顺义区12个乡街的5岁以上健康人群采集免疫前静脉血检测抗体,评估健康人群抗体水平.结果:202份血清标本中甲流抗体水平阳性率46.53% (94/202),与北京市人群甲型H1N1流感抗体水平检测结果差异有统计学意义.抗体几何平均滴度倒数(GMRT)为32.78.不同性别人群之间甲型H1N1流感抗体阳性率无差别(P>0.05),不同年龄组之间抗体水平阳性率有差别(P<0.05),25岁~29岁、10岁~14岁组抗体水平阳性率高.结论:顺义区甲型H1N1流感实际感染数高于北京市甲型H1N1流感平均感染水平.甲型H1N1流感感染与性别无关,与年龄有关,感染主要集中在25岁~ 29岁、10岁~14岁组人群.%Objective:To know the antibody levels against influenza A(H1N1 ) in Shunyi district of Beiing, to provide a scientific evidence for related departments to make the prevention and control strategies of influenza A (H1N1). Methods: Venous blood was randomly collected from healthy population above 5 years old in 12 towns and streets of Shunyi district to analyze the antibody levels against A(H1N1 ). Results: Among 202 serum specimens, the positive rate of influenza A(H1N1 ) antibody was 46. 53% (94/202) , which had statistical significance with that of Beijing. The GMRT was 32. 78. The positive rate difference of influenza A( H1N1 ) antibody was not found between males and females(P>0.05) , while which was found among different groups(P <0. 05). Higher positive rate was found in population aged 25 ~29 and 10 ~ 14 years old. Conclusion-. Influenza A( H1N1) infection cases in Shunyi district were more than the average of Beijing, which was not related to sex but age, especially in people of 25 ~ 29 and 10 ~ 14 years old.

  7. Nosocomial Co-Transmission of Avian Influenza A(H7N9) and A(H1N1)pdm09 Viruses between 2 Patients with Hematologic Disorders.

    Science.gov (United States)

    Chen, Huazhong; Liu, Shelan; Liu, Jun; Chai, Chengliang; Mao, Haiyan; Yu, Zhao; Tang, Yuming; Zhu, Geqin; Chen, Haixiao X; Zhu, Chengchu; Shao, Hui; Tan, Shuguang; Wang, Qianli; Bi, Yuhai; Zou, Zhen; Liu, Guang; Jin, Tao; Jiang, Chengyu; Gao, George F; Peiris, Malik; Yu, Hongjie; Chen, Enfu

    2016-04-01

    A nosocomial cluster induced by co-infections with avian influenza A(H7N9) and A(H1N1)pdm09 (pH1N1) viruses occurred in 2 patients at a hospital in Zhejiang Province, China, in January 2014. The index case-patient was a 57-year-old man with chronic lymphocytic leukemia who had been occupationally exposed to poultry. He had co-infection with H7N9 and pH1N1 viruses. A 71-year-old man with polycythemia vera who was in the same ward as the index case-patient for 6 days acquired infection with H7N9 and pH1N1 viruses. The incubation period for the second case-patient was estimated to be <4 days. Both case-patients died of multiple organ failure. Virus genetic sequences from the 2 case-patients were identical. Of 103 close contacts, none had acute respiratory symptoms; all were negative for H7N9 virus. Serum samples from both case-patients demonstrated strong proinflammatory cytokine secretion but incompetent protective immune responses. These findings strongly suggest limited nosocomial co-transmission of H7N9 and pH1N1 viruses from 1 immunocompromised patient to another. PMID:26982379

  8. Nosocomial Co-Transmission of Avian Influenza A(H7N9) and A(H1N1)pdm09 Viruses between 2 Patients with Hematologic Disorders

    Science.gov (United States)

    Chen, Huazhong; Liu, Shelan; Liu, Jun; Chai, Chengliang; Mao, Haiyan; Yu, Zhao; Tang, Yuming; Zhu, Geqin; Chen, Haixiao X.; Zhu, Chengchu; Shao, Hui; Tan, Shuguang; Wang, Qianli; Bi, Yuhai; Zou, Zhen; Liu, Guang; Jin, Tao; Jiang, Chengyu; Gao, George F.; Peiris, Malik

    2016-01-01

    A nosocomial cluster induced by co-infections with avian influenza A(H7N9) and A(H1N1)pdm09 (pH1N1) viruses occurred in 2 patients at a hospital in Zhejiang Province, China, in January 2014. The index case-patient was a 57-year-old man with chronic lymphocytic leukemia who had been occupationally exposed to poultry. He had co-infection with H7N9 and pH1N1 viruses. A 71-year-old man with polycythemia vera who was in the same ward as the index case-patient for 6 days acquired infection with H7N9 and pH1N1 viruses. The incubation period for the second case-patient was estimated to be <4 days. Both case-patients died of multiple organ failure. Virus genetic sequences from the 2 case-patients were identical. Of 103 close contacts, none had acute respiratory symptoms; all were negative for H7N9 virus. Serum samples from both case-patients demonstrated strong proinflammatory cytokine secretion but incompetent protective immune responses. These findings strongly suggest limited nosocomial co-transmission of H7N9 and pH1N1 viruses from 1 immunocompromised patient to another. PMID:26982379

  9. Reasons for Low Pandemic H1N1 2009 Vaccine Acceptance within a College Sample

    Directory of Open Access Journals (Sweden)

    Russell D. Ravert

    2012-01-01

    Full Text Available This study examined health beliefs associated with novel influenza A (H1N1 immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% reported having received an H1N1 vaccine. In regression analysis, H1N1 immunization was associated with seasonal flu vaccine history, perceived vaccine effectiveness, perceived obstacles to vaccination, and vaccine safety concerns. Qualitative results illustrate the relationship of beliefs to vaccine decisions, particularly in demonstrating that students often held concerns that vaccine could cause H1N1 or side effects. Vaccine safety, efficacy, and obstacles to immunization were major considerations in deciding whether to accept the H1N1 pandemic vaccine. Therefore, focusing on those aspects might be especially useful in future vaccine efforts within the college population.

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

    Science.gov (United States)

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

    2013-05-15

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

  11. Cost effectiveness of vaccination against pandemic influenza in European countries: mathematical modelling analysis

    OpenAIRE

    Lugner, A.K.; van Boven, Michiel; de Vries, Robin; Postma, M. J.; Wallinga, J.

    2012-01-01

    Objective To investigate whether a single optimal vaccination strategy exists across countries to deal with a future influenza pandemic by comparing the cost effectiveness of different strategies in various pandemic scenarios for three European countries. Design Economic and epidemic modelling study. Settings General populations in Germany, the Netherlands, and the United Kingdom. Data sources Country specific patterns of social contact and demographic data. Model An age structured susceptibl...

  12. Public views of the uk media and government reaction to the 2009 swine flu pandemic

    Directory of Open Access Journals (Sweden)

    Smith Emily

    2010-11-01

    Full Text Available Abstract Background The first cases of influenza A/H1N1 (swine flu were confirmed in the UK on 27th April 2009, after a novel virus first identified in Mexico rapidly evolved into a pandemic. The swine flu outbreak was the first pandemic in more than 40 years and for many, their first encounter with a major influenza outbreak. This study examines public understandings of the pandemic, exploring how people deciphered the threat and perceived they could control the risks. Methods Purposive sampling was used to recruit seventy three people (61 women and 12 men to take part in 14 focus group discussions around the time of the second wave in swine flu cases. Results These discussions showed that there was little evidence of the public over-reacting, that people believed the threat of contracting swine flu was inevitable, and that they assessed their own self-efficacy for protecting against it to be low. Respondents assessed a greater risk to their health from the vaccine than from the disease. Such findings could have led to apathy about following the UK Governments recommended health protective behaviours, and a sub-optimal level of vaccine uptake. More generally, people were confused about the difference between seasonal influenza and swine flu and their vaccines. Conclusions This research suggests a gap in public understandings which could hinder attempts to communicate about novel flu viruses in the future. There was general support for the government's handling of the pandemic, although its public awareness campaign was deemed ineffectual as few people changed their current hand hygiene practices. There was less support for the media who were deemed to have over-reported the swine flu pandemic.

  13. Evaluation of healthcare providers’ approach towards pandemic influenza and their vaccination ratio

    Directory of Open Access Journals (Sweden)

    Ali Asan

    2015-11-01

    Full Text Available Objectives. Pandemic influenza is a contagious disease caused by the new pandemic influenza A H1N1 virus, originated from the genetic combination of human, pig and avian influenza viruses. Our research aimed to determine the level of pandemic influenza vaccination in healthcare providers and the factors influencing this level. Methods. Doctors, midwives and nurses working in primary, secondary and tertiary health institutions in Denizli established the universe of the research. Four nurses visited these health institutions on five workdays between the 4th and 8th of April 2011, informed the healthcare providers that participation to the research was voluntary and handed over data collection forms in the institutions visited. Then, these data collection forms were collected by the same nurses. Research data were analyzed with SPSS package program. Frequency, percentage, chi-square and logistic regression analyses were used in the evaluation. Results. 44.7% of the healthcare providers participating in the study stated that they had been vaccinated with pandemic influenza vaccine. When factors effecting the vaccination decision with pandemic influenza vaccine of the individuals participating the study was evaluated; statistically significant difference between vaccination and occupation (p=0.001, sex (p=0.001, and age (p=0.026 was detected. The proportion of doctors, males and individuals older than 40 years was higher among the vaccinated professionals. Conclusions. It is important to make announcements about vaccination with determination and by taking support from media and non-governmental organizations. Statements and explanations should be released with this in mind and media, and nongovernmental organizations should also take responsibility regarding this matter.

  14. Liver involvement during influenza infection: perspective on the 2009 influenza pandemic

    Science.gov (United States)

    Papic, Neven; Pangercic, Ana; Vargovic, Martina; Barsic, Bruno; Vince, Adriana; Kuzman, Ilija

    2011-01-01

    Please cite this paper as: Papic et al. (2011) Liver involvement during influenza infection: perspective on the 2009 influenza pandemic. Influenza and Other Respiratory Viruses 6(3), e2–e5. Elevation of liver transaminase levels is a frequent observation during systemic infections. The aim of our study was to investigate liver damage during pandemic 2009 influenza A/H1N1 infection in comparison with seasonal influenza. Serum levels of aspartate aminotransferase, alanine aminotransferase, and gamma‐glutamyl transpeptidase (GGT) were significantly higher in patients with pandemic influenza compared to seasonal influenza, which was strongly correlated with hypoxia. Moreover, a positive correlation between C‐reactive protein and serum GGT, alkaline phosphatase, and lactate dehydrogenase was noticed. Our findings support the hypothesis that the pandemic 2009 influenza A/H1N1 is an illness with a significant immune response to infection leading to hepatocellular injury. PMID:21951624

  15. Protection induced by early stage vaccination with pandemic influenza virus-like particles.

    Science.gov (United States)

    Lee, Gi-Ja; Quan, Fu-Shi

    2016-07-19

    The 2009 worldwide influenza pandemic emphasized the need for new approaches to develop emergency vaccines. In this study, a virus-like particle vaccine comprised of hemagglutinin (HA) and M1 from the pandemic influenza virus A/California/04/09 were used and its ability to induce protective immunity during the early stage of vaccination was assessed in a mouse model. A single intramuscular vaccination with virus-like particles (VLPs) provided protection on days 4 and 7 post-vaccination against lethal virus challenge with only moderate body weight loss. VLP vaccination induced significantly higher IgG antibody responses and high hemagglutinin inhibition (HAI) titers on day 4 post-vaccination. A predominant IgG2a antibody response and viral neutralizing antibodies were induced on day 7. These immune responses were closely correlated with protection. Lung virus titers decreased significantly on day 7 compared to those on day 4 post-vaccination. The lung virus titer on day 4 post-vaccination also decreased significantly compared to that of the naïve control. These results demonstrate that VLP vaccination confers effective protection during the early stage after vaccination in a mouse model. PMID:27317263

  16. Broadly protective adenovirus-based multivalent vaccines against highly pathogenic avian influenza viruses for pandemic preparedness.

    Science.gov (United States)

    Vemula, Sai V; Ahi, Yadvinder S; Swaim, Anne-Marie; Katz, Jacqueline M; Donis, Ruben; Sambhara, Suryaprakash; Mittal, Suresh K

    2013-01-01

    Recurrent outbreaks of H5, H7 and H9 avian influenza viruses in domestic poultry accompanied by their occasional transmission to humans have highlighted the public health threat posed by these viruses. Newer vaccine approaches for pandemic preparedness against these viruses are needed, given the limitations of vaccines currently approved for H5N1 viruses in terms of their production timelines and the ability to induce protective immune responses in the absence of adjuvants. In this study, we evaluated the feasibility of an adenovirus (AdV)-based multivalent vaccine approach for pandemic preparedness against H5, H7 and H9 avian influenza viruses in a mouse model. Replication-defective AdV vectors expressing hemagglutinin (HA) from different subtypes and nucleoprotein (NP) from one subtype induced high levels of humoral and cellular immune responses and conferred protection against virus replication following challenge with H5, H7 and H9 avian influenza virus subtypes. Inclusion of HA from the 2009 H1N1 pandemic virus in the vaccine formulation further broadened the vaccine coverage. Significantly high levels of HA stalk-specific antibodies were observed following immunization with the multivalent vaccine. Inclusion of NP into the multivalent HA vaccine formulation resulted in the induction of CD8 T cell responses. These results suggest that a multivalent vaccine strategy may provide reasonable protection in the event of a pandemic caused by H5, H7, or H9 avian influenza virus before a strain-matched vaccine can be produced. PMID:23638099

  17. One versus two doses: What is the best use of vaccine in an influenza pandemic?

    Directory of Open Access Journals (Sweden)

    Laura Matrajt

    2015-12-01

    Full Text Available Avian influenza A (H7N9, emerged in China in April 2013, sparking fears of a new, highly pathogenic, influenza pandemic. In addition, avian influenza A (H5N1 continues to circulate and remains a threat. Currently, influenza H7N9 vaccines are being tested to be stockpiled along with H5N1 vaccines. These vaccines require two doses, 21 days apart, for maximal protection. We developed a mathematical model to evaluate two possible strategies for allocating limited vaccine supplies: a one-dose strategy, where a larger number of people are vaccinated with a single dose, or a two-dose strategy, where half as many people are vaccinated with two doses. We prove that there is a threshold in the level of protection obtained after the first dose, below which vaccinating with two doses results in a lower illness attack rate than with the one-dose strategy; but above the threshold, the one-dose strategy would be better. For reactive vaccination, we show that the optimal use of vaccine depends on several parameters, with the most important one being the level of protection obtained after the first dose. We describe how these vaccine dosing strategies can be integrated into effective pandemic control plans.

  18. Learning from the 2009 H1N1 pandemic: prospects for more broadly effective influenza vaccines

    Institute of Scientific and Technical Information of China (English)

    Ethan C. Settembre; Philip R. Dormitzer; Rino Rappuoli

    2011-01-01

    Calls to develop a universal influenza vaccine have increased in the wake of the 2009 H1 N1 influenza pandemic. This demand comes at a time when analyses of the human antibody repertoire, informed by structures of complexes between broadly neutralizing antibodies and influenza hemagglutinin, have revealed the target of a class of broadly neutralizing antibodies. Recent studies suggest a path forward to more broadly protective influenza vaccines.%@@ Calls to develop a universal influenza vaccine have increased in the wake of the 2009 H1 N1 influenza pandemic.This demand comes at a time when analyses of the human antibody repertoire, informed by structures of complexes between broadly neutralizing antibodies and influenza hemagglutinin, have revealed the target of a class of broadly neutralizing antibodies.Recent studies suggest a path forward to more broadly protective influenza vaccines.

  19. Swedish nursing and medical students' high vaccination adherence during the influenza A (H1N1) pandemic 2009: insights for pandemic preparedness.

    Science.gov (United States)

    Faresjö, Tomas; Arvidsson, Lina; Boberg, Pontus; Hagert, Britt; Gursky, Elin A; Timpka, Toomas

    2012-03-01

    The aim of this study was to analyze Swedish health science student decision-making regarding vaccination against pandemic influenza during a national mass vaccination campaign. A questionnaire was distributed to 430 students during the influenza A (H1N1) pandemic in 2009. The data from medical and nursing students were compared and a multiple logistic regression model was applied to identify items independently associated with the decision to be vaccinated. The overall survey response rate was 90%. More medical (93.2%) than nursing students (84.8%) reported that they had received the vaccine (p perception that benefits can outweigh possible side effects was significantly (p students on objective risk communication. It should be taken into account that the pandemic information provided by authorities to the general public also affects health care students. PMID:22066650

  20. Immunity to seasonal and pandemic influenza A viruses

    OpenAIRE

    Valkenburg, Sophie A.; Rutigliano, John A.; Ellebedy, Ali H.; Doherty, Peter C.; THOMAS, PAUL G.; Kedzierska, Katherine

    2011-01-01

    The introduction of a new influenza strain into human circulation leads to rapid global spread. This review summarizes innate and adaptive immunity to influenza viruses, with an emphasis on T-cell responses that provide cross-protection between distinct subtypes and strains. We discuss antigenic variation within T-cell immunogenic peptides and our understanding of pre-existing immunity towards the pandemic A(H1N1) 2009 strain.

  1. Incorporating Research and Evaluation into Pandemic Influenza Vaccination Preparedness and Response

    Centers for Disease Control (CDC) Podcasts

    2014-03-27

    Dr. Tom Shimabukuro, a medical officer at CDC, discusses Pandemic Influenza Vaccination Preparedness and Response.  Created: 3/27/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/27/2014.

  2. 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…

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Adaptation of High-Growth Influenza H5N1 Vaccine Virus in Vero Cells: Implications for Pandemic Preparedness

    OpenAIRE

    Tseng, Yu-Fen; Hu, Alan Yung-Chih; Huang, Mei-Liang; Yeh, Wei-Zhou; Weng, Tsai-Chuan; Chen, Yu-Shuan; Chong, Pele; Lee, Min-Shi

    2011-01-01

    Current egg-based influenza vaccine production technology can't promptly meet the global demand during an influenza pandemic as shown in the 2009 H1N1 pandemic. Moreover, its manufacturing capacity would be vulnerable during pandemics caused by highly pathogenic avian influenza viruses. Therefore, vaccine production using mammalian cell technology is becoming attractive. Current influenza H5N1 vaccine strain (NIBRG-14), a reassortant virus between A/Vietnam/1194/2004 (H5N1) virus and egg-adap...

  5. 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

  6. Immunogenicity of Virus Like Particle Forming Baculoviral DNA Vaccine against Pandemic Influenza H1N1.

    Science.gov (United States)

    Gwon, Yong-Dae; Kim, Sehyun; Cho, Yeondong; Heo, Yoonki; Cho, Hansam; Park, Kihoon; Lee, Hee-Jung; Choi, Jiwon; Poo, Haryoung; Kim, Young Bong

    2016-01-01

    An outbreak of influenza H1N1 in 2009, representing the first influenza pandemic of the 21st century, was transmitted to over a million individuals and claimed 18,449 lives. The current status in many countries is to prepare influenza vaccine using cell-based or egg-based killed vaccine. However, traditional influenza vaccine platforms have several limitations. To overcome these limitations, many researchers have tried various approaches to develop alternative production platforms. One of the alternative approach, we reported the efficacy of influenza HA vaccination using a baculoviral DNA vaccine (AcHERV-HA). However, the immune response elicited by the AcHERV-HA vaccine, which only targets the HA antigen, was lower than that of the commercial killed vaccine. To overcome the limitations of this previous vaccine, we constructed a human endogenous retrovirus (HERV) envelope-coated, baculovirus-based, virus-like-particle (VLP)-forming DNA vaccine (termed AcHERV-VLP) against pandemic influenza A/California/04/2009 (pH1N1). BALB/c mice immunized with AcHERV-VLP (1×107 FFU AcHERV-VLP, i.m.) and compared with mice immunized with the killed vaccine or mice immunized with AcHERV-HA. As a result, AcHERV-VLP immunization produced a greater humoral immune response and exhibited neutralizing activity with an intrasubgroup H1 strain (PR8), elicited neutralizing antibody production, a high level of interferon-γ secretion in splenocytes, and diminished virus shedding in the lung after challenge with a lethal dose of influenza virus. In conclusion, VLP-forming baculovirus DNA vaccine could be a potential vaccine candidate capable of efficiently delivering DNA to the vaccinee and VLP forming DNA eliciting stronger immunogenicity than egg-based killed vaccines. PMID:27149064

  7. Immunogenicity of Virus Like Particle Forming Baculoviral DNA Vaccine against Pandemic Influenza H1N1.

    Directory of Open Access Journals (Sweden)

    Yong-Dae Gwon

    Full Text Available An outbreak of influenza H1N1 in 2009, representing the first influenza pandemic of the 21st century, was transmitted to over a million individuals and claimed 18,449 lives. The current status in many countries is to prepare influenza vaccine using cell-based or egg-based killed vaccine. However, traditional influenza vaccine platforms have several limitations. To overcome these limitations, many researchers have tried various approaches to develop alternative production platforms. One of the alternative approach, we reported the efficacy of influenza HA vaccination using a baculoviral DNA vaccine (AcHERV-HA. However, the immune response elicited by the AcHERV-HA vaccine, which only targets the HA antigen, was lower than that of the commercial killed vaccine. To overcome the limitations of this previous vaccine, we constructed a human endogenous retrovirus (HERV envelope-coated, baculovirus-based, virus-like-particle (VLP-forming DNA vaccine (termed AcHERV-VLP against pandemic influenza A/California/04/2009 (pH1N1. BALB/c mice immunized with AcHERV-VLP (1×107 FFU AcHERV-VLP, i.m. and compared with mice immunized with the killed vaccine or mice immunized with AcHERV-HA. As a result, AcHERV-VLP immunization produced a greater humoral immune response and exhibited neutralizing activity with an intrasubgroup H1 strain (PR8, elicited neutralizing antibody production, a high level of interferon-γ secretion in splenocytes, and diminished virus shedding in the lung after challenge with a lethal dose of influenza virus. In conclusion, VLP-forming baculovirus DNA vaccine could be a potential vaccine candidate capable of efficiently delivering DNA to the vaccinee and VLP forming DNA eliciting stronger immunogenicity than egg-based killed vaccines.

  8. Clinical analysis of 65 cases of A(H1N1)influenza complicated with pulmonary infection%甲型H1N1流感并发肺部感染65例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭云波; 马希涛; 杨志刚

    2013-01-01

    Objective To understand clinical features,chest-image characteristics and treatment of A(H1 N1)influenza complicated with pulmonary infection,improve the clinicians a better understanding of this disease.Methods A total of 65 patients with A(H1N1) referred to Henan,China were studied retrospectively.The reviewed data included clinical manifestations,Routine blood test,chest-image characteristics and treatment.Results The 65 patients were collected:31 men and 34 women.Of the 65 cases,19 cases were maternal.The main clinical manifestations of influenza-like symptoms included fever(65 cases),cough (64 cases),expectoration (53 cases),sore throat (40 cases),diarrhea (6 ca-ses).Routine blood test WBC revealed normal in 51 patients,and WBC count decreased in 16 patients and increased in 8 patients.Neutrophil count normal in 29 patients,decreased in 13 patients and increased in 23 patients.In the initial chest-image of 65 patients the main abnormal appearance was ground-glass opacification 65 cases,with consolidation in 32 cases,11 cases of malignant pleural effusion with.Bilateral lesions in 52 cases,right lung lesion in 8 cases,left lung lesions in 5 cases ; recovery stage lesions,except for 6 patient deaths,cord-like,reticular shadows in 46 cases,8 cases had no obvious changes,5 cases were completely absorbed.A total of 19 patients using ventilator assisted breathing.Application of oseltamivir in 65 cases,combined application of antibiotics in 65 cases,8 cases of immune serum virus.61 cases were cured,6 cases died,3 cases of maternal death cases.Conclusions ①A (H1 N1) influenza is highly infectious,easily complicated with pulmonary infection; ②Influenza a H1N1 influenza maternal is at-risk group,and the critical condition of the patient,severe morbidity and mortality significantly higher than other groups; ③Pulmonary disease spread to more than bilateral pulmonary lesions,radiological patch shadow,consolidation images and other manifestations of mixed,the slow absorption.%目的 了解甲型H1N1流感并发肺部感染的临床表现、影像学特征及诊疗经过,提高临床医师对该疾病的认识.方法 采用回顾性分析的方法对河南省65例实验室确诊甲型H1N1流感并发肺部感染的临床表现、血常规、影像学资料及治疗进行分析.结果 65例患者中共有男性31人,女性34人,孕产妇19例,临床表现包括发热(65例)、咳嗽(64例)、咳痰(53例)、咽痛(40例)、腹泻(6例)等.入院时外周血白细胞正常51例,降低16例,升高8例;中性粒细胞比例正常29例,降低13例,升高23例;急性期时65例出现磨玻璃状影,合并实变影32例,合并胸腔积液11例,双侧病变52例,右肺病变8例,左肺病变5例;恢复期病变,除6例患者死亡外,条索状、网状影46例,8例无明显变化,5例完全吸收.共有19例患者应用呼吸机辅助呼吸.应用奥司他韦65例,联合应用抗生素65例,免疫病毒血清8例.治愈61例,死亡6例,死亡病例中孕产妇3例.结论 ①甲型H1N1流感传染性强,易合并肺部感染;②孕产妇是甲型H1N1流感易感人群,且病情危重,重症发生率和死亡率明显高于其他人群;③肺部病变多波及双侧,影像学上斑片影、实变影等多种表现混合出现,吸收缓慢.

  9. High effectiveness of pandemic influenza A (H1N1) vaccination in healthcare workers from a Portuguese hospital

    OpenAIRE

    Costa, José Torres; Silva, Rui; Tavares, Margarida; Nienhaus, Albert

    2011-01-01

    Objectives Vaccination of healthcare workers (HCWs) was made a high priority during the phase six pandemic of the novel influenza A H1N1 (pH1N1) virus. We surveyed adherence to pH1N1 vaccination and the incidence of pH1N1 infection between vaccinated and unvaccinated HCWs. Methods Employees at the S. João Hospital in Porto, Portugal, were offered pH1N1 vaccinations free of charge. Pandemrix® was the vaccine administered. As part of the pandemic plan, employees with influenza-like symptoms (IL...

  10. Trends in influenza vaccination coverage in Portugal from 1998 to 2010: effect of major pandemic threats

    OpenAIRE

    Sousa Pinto, Cátia; Nunes, Baltazar; BRANCO, Maria João; Marinho Falcão, José

    2013-01-01

    BACKGROUND: Vaccination is the key measure available for prevention of the public health burden of annual influenza epidemics. This article describes national trends in seasonal influenza vaccine (IV) coverage in Portugal from 1998/99 to 2010/11, analyzes progress towards meeting WHO 2010 coverage goals, and addresses the effect of major public health threats of the last 12 years (SARS in 2003/04, influenza A (H5N1) in 2005/06, and the influenza A (H1N1)2009 pandemic) on vaccination trends. ...

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

    OpenAIRE

    Busquets, Núria; Segalés, Joaquim; Córdoba, Lorena; Mussá, Tufaria; Crisci, Elisa; Martín-Valls, Gerard E.; Simon-Grifé, Meritxell; Pérez-Simó, Marta; Pérez-Maíllo, Monica; Núñez, Jose I.; Abad, Francesc X.; Fraile, Lorenzo; Pina, Sonia; Majó, 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...

  12. Vaccination rates for pandemic influenza among pregnant women: An early observation from Chennai, South India

    Directory of Open Access Journals (Sweden)

    Emmanuel Bhaskar

    2012-01-01

    Full Text Available Context: World Health organization considers pregnancy as an important risk factor for severe illness due to pandemic influenza and recommends better vaccination coverage for them. Aims: This study was initiated to observe the vaccination rates among pregnant women in Chennai during 2 months following the availability of influenza vaccine in the region. Settings and Design: An urban community-based setting. Questionnaire-based observational study design. Materials and Methods: Pregnant women residing in Chennai selected by simple random sampling formed the study population. The study was conducted from 15 th to 30 th November 2010. Each pregnant woman was interviewed using a uniform questionnaire. Statistical Analysis Used: Characteristics between vaccinated and unvaccinated participants were compared using the Chi-square test or the Fisher exact test for categorical variables and Student′s t-test or Mann-Whitney U test for continuous variables. Results: 140 pregnant women were interviewed during the study period. The mean age of study participants was 25 years (range 21-35 years. 55% were less than 26 years of age and 65% were home makers. 32% had no basic school education. Of the 29 women with co-morbidities, 15 had gestational diabetes, 13 hypertension, 7 pre-eclampsia, and 7 had bronchial asthma. Fifty-eight had anemia diagnosed earlier or during current pregnancy. 32 (22.8% were given advice to get vaccinated for pandemic influenza of which 18 (12.8% received the vaccine. Conclusions: Observations on vaccination rates for pandemic influenza among pregnant women in Chennai, 2 months after the initiation of vaccination program is not encouraging.

  13. A coordinated cross-disciplinary research initiative to address an increased incidence of narcolepsy following the 2009-2010 Pandemrix vaccination programme in Sweden.

    Science.gov (United States)

    Feltelius, N; Persson, I; Ahlqvist-Rastad, J; Andersson, M; Arnheim-Dahlström, L; Bergman, P; Granath, F; Adori, C; Hökfelt, T; Kühlmann-Berenzon, S; Liljeström, P; Maeurer, M; Olsson, T; Örtqvist, Å; Partinen, M; Salmonson, T; Zethelius, B

    2015-10-01

    In response to the 2009-2010 influenza A(H1N1)pdm09 pandemic, a mass vaccination programme with the AS03-adjuvanted influenza A(H1N1) vaccine Pandemrix was initiated in Sweden. Unexpectedly, there were a number of narcolepsy cases amongst vaccinated children and adolescents reported. In this review, we summarize the results of a joint cross-disciplinary national research effort to investigate the adverse reaction signal from the spontaneous reporting system and to better understand possible causative mechanisms. A three- to fourfold increased risk of narcolepsy in vaccinated children and adolescents was verified by epidemiological studies. Of importance, no risk increase was observed for the other neurological and autoimmune diseases studied. Genetic studies confirmed the association with the allele HLA-DQB1*06:02, which is known to be related to sporadic narcolepsy. Furthermore, a number of studies using cellular and molecular experimental models investigated possible links between influenza vaccination and narcolepsy. Serum analysis, using a peptide microarray platform, showed that individuals who received Pandemrix exhibited a different epitope reactivity pattern to neuraminidase and haemagglutinin, as compared to individuals who were infected with H1N1. Patients with narcolepsy were also found to have increased levels of interferon-gamma production in response to streptococcus-associated antigens. The chain of patient-related events and the study results emerging over time were subjected to intense nationwide media attention. The importance of transparent communication and collaboration with patient representatives to maintain public trust in vaccination programmes is also discussed in the review. Organizational challenges due to this unexpected event delayed the initiation of some of the research projects, still the main objectives of this joint, cross-disciplinary research effort were reached, and important insights were acquired for future, similar

  14. Impact of cytokine in type 1 narcolepsy: Role of pandemic H1N1 vaccination ?

    Science.gov (United States)

    Lecendreux, Michel; Libri, Valentina; Jaussent, Isabelle; Mottez, Estelle; Lopez, Régis; Lavault, Sophie; Regnault, Armelle; Arnulf, Isabelle; Dauvilliers, Yves

    2015-06-01

    Recent advances in the identification of susceptibility genes and environmental exposures (pandemic influenza 2009 vaccination) provide strong support that narcolepsy type 1 is an immune-mediated disease. Considering the limited knowledge regarding the immune mechanisms involved in narcolepsy whether related to flu vaccination or not and the recent progresses in cytokine measurement technology, we assessed 30 cytokines, chemokines and growth factors using the Luminex technology in either peripheral (serum) or central (CSF) compartments in a large population of 90 children and adult patients with narcolepsy type 1 in comparison to 58 non-hypocretin deficient hypersomniacs and 41 healthy controls. Furthermore, we compared their levels in patients with narcolepsy whether exposed to pandemic flu vaccine or not, and analyzed the effect of age, duration of disease and symptom severity. Comparison for sera biomarkers between narcolepsy (n = 84, 54 males, median age: 15.5 years old) and healthy controls (n = 41, 13 males, median age: 20 years old) revealed an increased stimulation of the immune system with high release of several pro- and anti-inflammatory serum cytokines and growth factors with interferon-γ, CCL11, epidermal growth factor, and interleukin-2 receptor being independently associated with narcolepsy. Increased levels of interferon-γ, CCL11, and interleukin-12 were found when close to narcolepsy onset. After several adjustments, only one CSF biomarker differed between narcolepsy (n = 44, 26 males, median age: 15 years old) and non-hypocretin deficient hypersomnias (n = 57, 24 males, median age: 36 years old) with higher CCL 3 levels found in narcolepsy. Comparison for sera biomarkers between patients with narcolepsy who developed the disease post-pandemic flu vaccination (n = 36) to those without vaccination (n = 48) revealed an increased stimulation of the immune system with high release of three cytokines, regulated upon activation normal T-cell expressed

  15. 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...

  16. Reasons for Low Pandemic H1N1 2009 Vaccine Acceptance within a College Sample

    OpenAIRE

    Ravert, Russell D.; Fu, Linda Y.; Zimet, Gregory D.

    2012-01-01

    This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes asso...

  17. Nationwide molecular surveillance of pandemic H1N1 influenza A virus genomes: Canada, 2009.

    Directory of Open Access Journals (Sweden)

    Morag Graham

    Full Text Available BACKGROUND: In April 2009, a novel triple-reassortant swine influenza A H1N1 virus ("A/H1N1pdm"; also known as SOIV was detected and spread globally as the first influenza pandemic of the 21(st century. Sequencing has since been conducted at an unprecedented rate globally in order to monitor the diversification of this emergent virus and to track mutations that may affect virus behavior. METHODOLOGY/PRINCIPAL FINDINGS: By Sanger sequencing, we determined consensus whole-genome sequences for A/H1N1pdm viruses sampled nationwide in Canada over 33 weeks during the 2009 first and second pandemic waves. A total of 235 virus genomes sampled from unique subjects were analyzed, providing insight into the temporal and spatial trajectory of A/H1N1pdm lineages within Canada. Three clades (2, 3, and 7 were identifiable within the first two weeks of A/H1N1pdm appearance, with clades 5 and 6 appearing thereafter; further diversification was not apparent. Only two viral sites displayed evidence of adaptive evolution, located in hemagglutinin (HA corresponding to D222 in the HA receptor-binding site, and to E374 at HA2-subunit position 47. Among the Canadian sampled viruses, we observed notable genetic diversity (1.47 x 10⁻³ amino acid substitutions per site in the gene encoding PB1, particularly within the viral genomic RNA (vRNA-binding domain (residues 493-757. This genome data set supports the conclusion that A/H1N1pdm is evolving but not excessively relative to other H1N1 influenza A viruses. Entropy analysis was used to investigate whether any mutated A/H1N1pdm protein residues were associated with infection severity; however no virus genotypes were observed to trend with infection severity. One virus that harboured heterozygote coding mutations, including PB2 D567D/G, was attributed to a severe and potentially mixed infection; yet the functional significance of this PB2 mutation remains unknown. CONCLUSIONS/SIGNIFICANCE: These findings contribute to

  18. Mielitis transversa relacionada con vacunación anti-influenza A(H1N1) Transverse myelitis associated with anti-influenza A (H1N1) vaccination

    OpenAIRE

    María Florencia Arcondo; Adolfo Wachs; Marcelo Zylberman

    2011-01-01

    La mielitis transversa es una enfermedad inflamatoria que se caracteriza por disfunción de la médula espinal. Las causas reconocidas de mielitis transversa son autoinmunes, enfermedades desmielinizantes, post infecciosas y post vacunales, aunque hasta el 50% de los casos son idiopáticas. Las vacunas contra la rubéola, paperas, rabia y gripe estacional han sido asociadas a diversos trastornos neurológicos, como el Síndrome de Guillain Barré, la encefalomielitis diseminada aguda (ADEM) y la mie...

  19. FLU IN CHILDREN AFTER A PANDEMIC IN ST. PETERSBURG GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    E. A. Dondurey

    2014-01-01

    Full Text Available Flu monitoring was carried out in children’s general hospital in St. Petersburg within three epidemic seasons (2010–2011, 2011–2012 and 2012–2013. 1916 patients under the age of 18 years were examined with the complex of virologic tests . The natural decreasing of flu incidence and predominant diagnosing in etiologic structure one of the virus serotypes [in the first A(H1N1pdm09, in the second — A(H3N2] have been observed during the first two years after a pandemic. In the third season restoration of the main characteristics of epidemic flu situation were detected: polietiology with annual change of serotypes proportions, late start (winter and spring, majority of younger children among hospitalaized patients and a mild course of disease. The most probable candidates [viruses of a subtype A(H3N2] are revealed as a causal factor of significant increasing of disease incidence with the severe forms in the near future. Laboratory data were confirmed by increase in frequency of the complicated by pneumonia ARI at hospitalized patients during the periods of their maximum registration. All isolates received during the study were corresponded to the referens-strains included in vaccines. Thus, timely and appropriate vaccination during the studied period had to become an effective protection against a flu.

  20. The ethics of sharing preliminary research findings during public health emergencies: a case study from the 2009 influenza pandemic.

    Science.gov (United States)

    Crowcroft, N S; Rosella, L C; Pakes, B N

    2014-01-01

    During the 2009 A(H1N1) influenza pandemic, a suite of studies conducted in Canada showed an unexpected finding, that patients with medically attended laboratory-confirmed pandemic influenza were more likely to have received seasonal influenza vaccination than test-negative control patients. Different bodies, including scientific journals and government scientific advisory committees, reviewed the evidence simultaneously to determine its scientific validity and implications. Decision-making was complicated when the findings made their way into the media. The normal trajectory of non-urgent research includes peer-review publication after which decision-makers can process the information taking into account other evidence and logistic considerations. In the situation that arose, however, the congruence of an unexpected finding and the simultaneous review of the evidence both within and outside the traditional peer-review sphere raised several interesting issues about how to deal with emerging evidence during a public health emergency. These events are used in this article to aid discussion of the complex interrelationship between researchers, public health decision-makers and scientific journals, the trade-offs between sharing information early and maintaining the peer-review quality assurance process, and to emphasise the need for critical reflection on the practical and ethical norms that govern the way in which research is evaluated, published and communicated in public health emergencies. PMID:24970372

  1. Twitter influence on vaccination and antiviral uptake during the 2009 H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Andrew eMcNeill

    2016-02-01

    Full Text Available ObjectiveInformation exchange via Twitter and other forms of social media make public health communication more complex as citizens play an increasingly influential role in shaping acceptable or desired health behaviours. Taking the case of the 2009-10 H1N1 pandemic, we explore in detail the dissemination of H1N1-related advice in the UK through Twitter to see how it was used to discourage or encourage vaccine and antiviral uptake.MethodsIn three stages we conducted (1 an analysis of general content, retweeting patterns and URL sharing, (2 a discourse analysis of the public evaluation of press releases and (3 a template analysis of conversations around vaccine and antiviral uptake, using Protection Motivation Theory (PMT as a way of understanding how the public weighed the costs and benefits.ResultsNetwork analysis of retweets showed that information from official sources predominated. Analysing the spread of significant messages through Twitter showed that most content was descriptive but there was some criticism of health authorities. A detailed analysis of responses to press releases revealed some scepticism over the economic beneficiaries of vaccination, that served to undermine public trust. Finally, the conversational analysis showed the influence of peers when weighing up the risks and benefits of medication.ConclusionsMost tweets linked to reliable sources, however Twitter was used to discuss both individual and health authority motivations to vaccinate. The PMT framework describes the ways individuals assessed the threat of the H1N1 pandemic, weighing this against the perceived cost of taking medication. These findings offer some valuable insights for social media communication practices in future pandemics.

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

    Directory of Open Access Journals (Sweden)

    Lee Esther ST

    2011-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Petrović 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

  4. Natural T Cell–mediated Protection against Seasonal and Pandemic Influenza. Results of the Flu Watch Cohort Study

    Science.gov (United States)

    Wang, Lili; Goonetilleke, Nilu; Fragaszy, Ellen B.; Bermingham, Alison; Copas, Andrew; Dukes, Oliver; Millett, Elizabeth R. C.; Nazareth, Irwin; Nguyen-Van-Tam, Jonathan S.; Watson, John M.; Zambon, Maria; Johnson, Anne M.; McMichael, Andrew J.

    2015-01-01

    Rationale: A high proportion of influenza infections are asymptomatic. Animal and human challenge studies and observational studies suggest T cells protect against disease among those infected, but the impact of T-cell immunity at the population level is unknown. Objectives: To investigate whether naturally preexisting T-cell responses targeting highly conserved internal influenza proteins could provide cross-protective immunity against pandemic and seasonal influenza. Methods: We quantified influenza A(H3N2) virus–specific T cells in a population cohort during seasonal and pandemic periods between 2006 and 2010. Follow-up included paired serology, symptom reporting, and polymerase chain reaction (PCR) investigation of symptomatic cases. Measurements and Main Results: A total of 1,414 unvaccinated individuals had baseline T-cell measurements (1,703 participant observation sets). T-cell responses to A(H3N2) virus nucleoprotein (NP) dominated and strongly cross-reacted with A(H1N1)pdm09 NP (P < 0.001) in participants lacking antibody to A(H1N1)pdm09. Comparison of paired preseason and post-season sera (1,431 sets) showed 205 (14%) had evidence of infection based on fourfold influenza antibody titer rises. The presence of NP-specific T cells before exposure to virus correlated with less symptomatic, PCR-positive influenza A (overall adjusted odds ratio, 0.27; 95% confidence interval, 0.11–0.68; P = 0.005, during pandemic [P = 0.047] and seasonal [P = 0.049] periods). Protection was independent of baseline antibodies. Influenza-specific T-cell responses were detected in 43%, indicating a substantial population impact. Conclusions: Naturally occurring cross-protective T-cell immunity protects against symptomatic PCR-confirmed disease in those with evidence of infection and helps to explain why many infections do not cause symptoms. Vaccines stimulating T cells may provide important cross-protective immunity. PMID:25844934

  5. Responses to pandemic ASO3-adjuvanted A/California/07/09 H1N1 influenza vaccine in human immunodeficiency virus-infected individuals

    OpenAIRE

    Kelly Deborah; Burt Kimberley; Missaghi Bayan; Barrett Lisa; Keynan Yoav; Fowke Keith; Grant Michael

    2012-01-01

    Abstract Background Influenza infection may be more serious in human immunodeficiency virus (HIV)-infected individuals, therefore, vaccination against seasonal and pandemic strains is highly advised. Seasonal influenza vaccines have had no significant negative effects in well controlled HIV infection, but the impact of adjuvanted pandemic A/California/07/2009 H1N1 influenza hemaglutinin (HA) vaccine, which was used for the first time in the Canadian population as an authorized vaccine in autu...

  6. Efficacious recombinant influenza vaccines produced by high yield bacterial expression: a solution to global pandemic and seasonal needs.

    Directory of Open Access Journals (Sweden)

    Langzhou Song

    Full Text Available It is known that physical linkage of TLR ligands and vaccine antigens significantly enhances the immunopotency of the linked antigens. We have used this approach to generate novel influenza vaccines that fuse the globular head domain of the protective hemagglutinin (HA antigen with the potent TLR5 ligand, flagellin. These fusion proteins are efficiently expressed in standard E. coli fermentation systems and the HA moiety can be faithfully refolded to take on the native conformation of the globular head. In mouse models of influenza infection, the vaccines elicit robust antibody responses that mitigate disease and protect mice from lethal challenge. These immunologically potent vaccines can be efficiently manufactured to support pandemic response, pre-pandemic and seasonal vaccines.

  7. Adaptation of high-growth influenza H5N1 vaccine virus in Vero cells: implications for pandemic preparedness.

    Science.gov (United States)

    Tseng, Yu-Fen; Hu, Alan Yung-Chih; Huang, Mei-Liang; Yeh, Wei-Zhou; Weng, Tsai-Chuan; Chen, Yu-Shuan; Chong, Pele; Lee, Min-Shi

    2011-01-01

    Current egg-based influenza vaccine production technology can't promptly meet the global demand during an influenza pandemic as shown in the 2009 H1N1 pandemic. Moreover, its manufacturing capacity would be vulnerable during pandemics caused by highly pathogenic avian influenza viruses. Therefore, vaccine production using mammalian cell technology is becoming attractive. Current influenza H5N1 vaccine strain (NIBRG-14), a reassortant virus between A/Vietnam/1194/2004 (H5N1) virus and egg-adapted high-growth A/PR/8/1934 virus, could grow efficiently in eggs and MDCK cells but not Vero cells which is the most popular cell line for manufacturing human vaccines. After serial passages and plaque purifications of the NIBRG-14 vaccine virus in Vero cells, one high-growth virus strain (Vero-15) was generated and can grow over 10(8) TCID(50)/ml. In conclusion, one high-growth H5N1 vaccine virus was generated in Vero cells, which can be used to manufacture influenza H5N1 vaccines and prepare reassortant vaccine viruses for other influenza A subtypes. PMID:22022351

  8. Knowledge and attitudes of university students toward pandemic influenza: a cross-sectional study from Turkey

    Directory of Open Access Journals (Sweden)

    Hayran Osman

    2010-07-01

    Full Text Available Abstract Background During an influenza pandemic, higher education institutions with large populations of young adults can become serious outbreak centers. Since outbreak management is essential to disease control, we aimed to examine university students' knowledge of and attitudes toward the pandemic influenza A/H1N1 and vaccination and other preventive measures. Methods A cross-sectional study was conducted among 402 first year university students at Yeditepe University in Istanbul, Turkey between 1st and 30th of November 2009. Data regarding socio-demographic characteristics of the students, perceptions, level of knowledge and attitudes toward influenza pandemic and prevention measures were collected by means of a self-administered questionnaire. The questionnaire was distributed by the students affiliated with SANITAS, a university club of students in health related sciences. Results 25.1% (101/402 of the study group perceived their personal risk of influenza as "high", while 40.5% (163/402 perceived it as "moderate", 20.6% (107/402 viewed it as "low" and 7.7% (31/402 indicated that it was "unknown". The risk perception of males was significantly lower than that of females (p = 0.004 and the risk perception among the students of health sciences was significantly lower than that of students of other sciences (p = 0.037. Within the study group, 72.1% (290/402 indicated that their main information source regarding H1N1 was the mass media. Health sciences students tended to rely more on the internet as an information source than other students (p = 0.015. The vast majority (92.8%; 373/402 of those interviewed indicated that they would not be vaccinated. The major concerns regarding vaccination had to do with the safety and side effects of the vaccine. Most of the participants (343/402, 85.3% were carrying out one of prevention measures and the vast majority believed that hand washing, face mask and quarantina were effective measures for

  9. Estimates of pandemic influenza vaccine effectiveness in Europe, 2009-2010: results of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE multicentre case-control study.

    Directory of Open Access Journals (Sweden)

    Marta Valenciano

    2011-01-01

    Full Text Available BACKGROUND: A multicentre case-control study based on sentinel practitioner surveillance networks from seven European countries was undertaken to estimate the effectiveness of 2009-2010 pandemic and seasonal influenza vaccines against medically attended influenza-like illness (ILI laboratory-confirmed as pandemic influenza A (H1N1 (pH1N1. METHODS AND FINDINGS: Sentinel practitioners swabbed ILI patients using systematic sampling. We included in the study patients meeting the European ILI case definition with onset of symptoms >14 days after the start of national pandemic vaccination campaigns. We compared pH1N1 cases to influenza laboratory-negative controls. A valid vaccination corresponded to >14 days between receiving a dose of vaccine and symptom onset. We estimated pooled vaccine effectiveness (VE as 1 minus the odds ratio with the study site as a fixed effect. Using logistic regression, we adjusted VE for potential confounding factors (age group, sex, month of onset, chronic diseases and related hospitalizations, smoking history, seasonal influenza vaccinations, practitioner visits in previous year. We conducted a complete case analysis excluding individuals with missing values and a multiple multivariate imputation to estimate missing values. The multivariate imputation (n = 2902 adjusted pandemic VE (PIVE estimates were 71.9% (95% confidence interval [CI] 45.6-85.5 overall; 78.4% (95% CI 54.4-89.8 in patients <65 years; and 72.9% (95% CI 39.8-87.8 in individuals without chronic disease. The complete case (n = 1,502 adjusted PIVE were 66.0% (95% CI 23.9-84.8, 71.3% (95% CI 29.1-88.4, and 70.2% (95% CI 19.4-89.0, respectively. The adjusted PIVE was 66.0% (95% CI -69.9 to 93.2 if vaccinated 8-14 days before ILI onset. The adjusted 2009-2010 seasonal influenza VE was 9.9% (95% CI -65.2 to 50.9. CONCLUSIONS: Our results suggest good protection of the pandemic monovalent vaccine against medically attended pH1N1 and no effect of the

  10. Estimation of the burden of pandemic(H1N12009 in developing countries: experience from a tertiary care center in South India.

    Directory of Open Access Journals (Sweden)

    Mahesh Moorthy

    Full Text Available BACKGROUND: The burden of the pandemic (H1N1 2009 influenza might be underestimated if detection of the virus is mandated to diagnose infection. Using an alternate approach, we propose that a much higher pandemic burden was experienced in our institution. METHODOLOGY/PRINCIPAL FINDINGS: Consecutive patients (n = 2588 presenting to our hospital with influenza like illness (ILI or severe acute respiratory infection (SARI during a 1-year period (May 2009-April 2010 were prospectively recruited and tested for influenza A by real-time RT-PCR. Analysis of weekly trends showed an 11-fold increase in patients presenting with ILI/SARI during the peak pandemic period when compared with the pre-pandemic period and a significant (P<0.001 increase in SARI admissions during the pandemic period (30 ± 15.9 admissions/week when compared with pre-pandemic (7 ± 2.5 and post-pandemic periods (5 ± 3.8. However, Influenza A was detected in less than one-third of patients with ILI/SARI [699 (27.0%]; a majority of these (557/699, 79.7% were Pandemic (H1N12009 virus [A/H1N1/09]. An A/H1N1/09 positive test was correlated with shorter symptom duration prior to presentation (p = 0.03. More ILI cases tested positive for A/H1N1/09 when compared with SARI (27.4% vs. 14.6%, P = 0.037. When the entire study population was considered, A/H1N1/09 positivity was associated with lower risk of hospitalization (p<0.0001 and ICU admission (p = 0.013 suggesting mild self-limiting illness in a majority. CONCLUSION/SIGNIFICANCE: Analysis of weekly trends of ILI/SARI suggest a higher burden of the pandemic attributable to A/H1N1/09 than estimates assessed by a positive PCR test alone. The study highlights methodological consideration in the estimation of burden of pandemic influenza in developing countries using hospital-based data that may help assess the impact of future outbreaks of respiratory illnesses.

  11. Intent to receive pandemic influenza A (H1N1 vaccine, compliance with social distancing and sources of information in NC, 2009.

    Directory of Open Access Journals (Sweden)

    Jennifer A Horney

    Full Text Available BACKGROUND: Public adherence to influenza vaccination recommendations has been low, particularly among younger adults and children under 2, despite the availability of safe and effective seasonal vaccine. Intention to receive 2009 pandemic influenza A (H1N1 vaccine has been estimated to be 50% in select populations. This report measures knowledge of and intention to receive pandemic vaccine in a population-based setting, including target groups for seasonal and H1N1 influenza. METHODOLOGY AND PRINCIPAL FINDINGS: On August 28-29, 2009, we conducted a population-based survey in 2 counties in North Carolina. The survey used the 30x7 two-stage cluster sampling methodology to identify 210 target households. Prevalence ratios (PR and 95% confidence intervals (CI were estimated. Knowledge of pandemic influenza A (H1N1 vaccine was high, with 165 (80% aware that a vaccine was being prepared. A total of 133 (64% respondents intended to receive pandemic vaccine, 134 (64% intended to receive seasonal vaccine, and 109 (53% intended to receive both. Reporting great concern about H1N1 infection (PR 1.55; 95%CI: 1.30, 1.85, receiving seasonal influenza vaccine in 2008-09 (PR 1.47; 95%CI: 1.18, 1.82, and intending to receive seasonal influenza vaccine in 2009-10 (PR 1.27; 95%CI: 1.14, 1.42 were associated with intention to receive pandemic vaccine. Not associated were knowledge of vaccine, employment, having children under age 18, gender, race/ethnicity and age. Reasons cited for not intending to get vaccinated include not being at risk for infection, concerns about vaccine side effects and belief that illness caused by pandemic H1N1 would be mild. Forty-five percent of households with children under 18 and 65% of working adults reported ability to comply with self-isolation at home for 7-10 days if recommended by authorities. CONCLUSIONS AND SIGNIFICANCE: This is the first report of a population based rapid assessment used to assess knowledge and intent to

  12. H1N1 influenza pandemic in Italy revisited: has the willingness to get vaccinated suffered in the long run?

    Directory of Open Access Journals (Sweden)

    Ramona Ludolph

    2015-09-01

    Full Text Available Background. The aim of the study is to assess the long-term secondary effects of personal experience with the H1N1 pandemic of 2009/2010 and the perception of the institutional reaction to it on Italians’ willingness to get vaccinated in case of a novel influenza pandemic. Design and Methods. We conducted 140 face-to-face interviews in the Registry Office of the Municipality of Milan, Italy, from October to December 2012. Results. Willingness to get vaccinated during a novel influenza pandemic was best predicted by having been vaccinated against the seasonal flu in the past (OR=5.18; 95%CI: 1.40 to 19.13 and fear of losing one’s life in case of an infection with H1N1 (OR=4.09; 95%CI: 1.68 to 9.97. It was unaffected by the assessment of institutional performance. Conclusions. The findings of this study do not point to long-term secondary effects of the institutional handling of the H1N1 pandemic. The results highlight the fact that behavioural intention is not the same as behaviour, and that the former cannot simply be taken as an indicator of the latter.

  13. Effectiveness of seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 mid-season results.

    Science.gov (United States)

    Pebody, Richard; Warburton, Fiona; Ellis, Joanna; Andrews, Nick; Potts, Alison; Cottrell, Simon; Johnston, Jillian; Reynolds, Arlene; Gunson, Rory; Thompson, Catherine; Galiano, Monica; Robertson, Chris; Mullett, David; Gallagher, Naomh; Sinnathamby, Mary; Yonova, Ivelina; Moore, Catherine; McMenamin, Jim; de Lusignan, Simon; Zambon, Maria

    2016-03-31

    In 2015/16, the influenza season in the United Kingdom was dominated by influenza A(H1N1)pdm09 circulation. Virus characterisation indicated the emergence of genetic clusters, with the majority antigenically similar to the current influenza A(H1N1)pdm09 vaccine strain. Mid-season vaccine effectiveness (VE) estimates show an adjusted VE of 41.5% (95% confidence interval (CI): 3.0-64.7) against influenza-confirmed primary care consultations and of 49.1% (95% CI: 9.3-71.5) against influenza A(H1N1)pdm09. These estimates show levels of protection similar to the 2010/11 season, when this strain was first used in the seasonal vaccine. PMID:27074651

  14. THE POSSIBLE COLLISIONS IN VIRUS INFECTION IMMUNODIAGNOSTICS AND VACCINATION

    Directory of Open Access Journals (Sweden)

    E. P. Kharchenko

    2016-01-01

    Full Text Available Antibodies (Ab, especially natural, display multiple specificity not only due to intrinsic conformational dynamics. With computational analysis the distribution of identical and homologous peptides has been studied in surface proteins from RNA and DNA viruses of widely distributed infections. It was established that each virus protein shared the fragments homologous to other virus proteins that allowed to propose the existence of the peptide continuum of the protein relationship (PCPR. Possible manifestations of PCPR are multiple reactivity and autoreactivity in Ab and therefore it is not possible to consider the immune methods of virus identification as high reliable because of crossing interactions. The PCPR excludes the existence of 100% specificity in immune tests for virus identification. Immunodiagnostic collisions may occur either in identification of virus itself or identification of Ab to viruses. Also PCPR may be responsible for heterologous immunity and consequently the infection associated with severe pathology. The comparative analysis of peptide relationship of H1N1 influenza virus nucleoprotein and human proteins found out, beyond early described its common motif with human hypocretin receptor 2, peptides homologous to those in melanotonin and glutamate receptors and three ion channels. It allows to propose that the sleep disorder narcolepsy associated with Pandemrix vaccination (an adjuvanted, influenza pandemic vaccine and also with infection by influenza virus during the 2009 A(H1N1 influenza pandemic may be determined not only by Ab to the peptide motif common to influenza nucleoprotein and hypocretin receptor but also Ab to melanotonin and glutamate receptors and ion channels. Decreasing and even avoiding risks of complications from vaccination may be feasible by means of a computer analysis of vaccine proteins for the occurrence of epitopes homologous to the human protein those and particularly by an analysis of Ab profiles

  15. 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

  16. The decision to vaccinate or not during the H1N1 pandemic: selecting the lesser of two evils?

    Directory of Open Access Journals (Sweden)

    Andrea R Ashbaugh

    Full Text Available BACKGROUND: With the release of the H1N1 vaccine, there was much controversy surrounding its use despite strong encouragements to be vaccinated in the media. Though studies have examined factors influencing people's decision to be vaccinated, few have focused on how general beliefs about the world or where an individual gathers information might influence that decision. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional web-based survey (N = 817 was conducted during the H1N1 outbreak after the vaccine was available. Variables examined included sociodemographic information, health related behaviours, specific beliefs concerning the H1N1 virus and its vaccine, as well as general beliefs, such as fear of contamination, intolerance of uncertainty, emotional states, coping behaviour, and the source of information concerning the virus. Three converging statistical methods were used to examine the associations - analysis of variance, logistic regression, and recursive partition modelling. The most consistent and strongest association was that negative beliefs about the H1N1 vaccine (e.g. fear of its side effects was related to the decision not to be vaccinated, whereas beliefs about the dangers of the H1N1 virus was related to the decision to be vaccinated. Most notably, having very strong negative beliefs about the vaccine was a more powerful predictor than even strong beliefs about the dangers of the H1N1 virus. Furthermore, obtaining information from the Internet, as compared to more traditional sources of information (e.g., TV, newspapers was related to the decision not to be vaccinated. CONCLUSIONS/SIGNIFICANCE: These results are consistent with the Health Belief Model. Importantly they suggest that during future pandemics public health officials should not only discuss the dangers of the pandemic but also (i take additional steps to reassure the public about the safety of vaccines and (ii monitor the information disseminated over the Internet

  17. H1N1 Influenza Pandemic in Italy Revisited: Has the Willingness to Get Vaccinated Suffered in the Long Run?

    Science.gov (United States)

    Ludolph, Ramona; Nobile, Marta; Hartung, Uwe; Castaldi, Silvana; Schulz, Peter J.

    2015-01-01

    Background The aim of the study is to assess the long-term secondary effects of personal experience with the H1N1 pandemic of 2009/2010 and the perception of the institutional reaction to it on Italians’ willingness to get vaccinated in case of a novel influenza pandemic. Design and Methods We conducted 140 face-to-face interviews in the Registry Office of the Municipality of Milan, Italy, from October to December 2012. Results Willingness to get vaccinated during a novel influenza pandemic was best predicted by having been vaccinated against the seasonal flu in the past (OR=5.18; 95%CI: 1.40 to 19.13) and fear of losing one’s life in case of an infection with H1N1 (OR=4.09; 95%CI: 1.68 to 9.97). It was unaffected by the assessment of institutional performance. Conclusions The findings of this study do not point to long-term secondary effects of the institutional handling of the H1N1 pandemic. The results highlight the fact that behavioural intention is not the same as behaviour, and that the former cannot simply be taken as an indicator of the latter. Significance for public health Whereas influenza pandemics occurred rather rarely in the last centuries, their frequency can be expected to increase in the future due to the enhanced globalisation and still raising importance of air travelling. Recent examples (Ebola, H1N1, SARS, avian influenza) demonstrate that initially local disease outbreaks often become worldwide health threats of international concern. National and international health authorities are consequently urged to present preparedness plans on how to manage such health crises. However, their success highly depends on their acceptance by the public. To ensure the public compliance with recommended actions, effective communication is needed. Since communication is most successful when it meets the needs of the target audience, a full understanding of the audience is crucial. This study can help public health experts to better understand the

  18. Vaccination against 2009 pandemic H1N1 in a population dynamical model of Vancouver, Canada: timing is everything

    Directory of Open Access Journals (Sweden)

    Conway Jessica M

    2011-12-01

    Full Text Available Abstract Background Much remains unknown about the effect of timing and prioritization of vaccination against pandemic (pH1N1 2009 virus on health outcomes. We adapted a city-level contact network model to study different campaigns on influenza morbidity and mortality. Methods We modeled different distribution strategies initiated between July and November 2009 using a compartmental epidemic model that includes age structure and transmission network dynamics. The model represents the Greater Vancouver Regional District, a major North American city and surrounding suburbs with a population of 2 million, and is parameterized using data from the British Columbia Ministry of Health, published studies, and expert opinion. Outcomes are expressed as the number of infections and deaths averted due to vaccination. Results The model output was consistent with provincial surveillance data. Assuming a basic reproduction number = 1.4, an 8-week vaccination campaign initiated 2 weeks before the epidemic onset reduced morbidity and mortality by 79-91% and 80-87%, respectively, compared to no vaccination. Prioritizing children and parents for vaccination may have reduced transmission compared to actual practice, but the mortality benefit of this strategy appears highly sensitive to campaign timing. Modeling the actual late October start date resulted in modest reductions in morbidity and mortality (13-25% and 16-20%, respectively with little variation by prioritization scheme. Conclusion Delays in vaccine production due to technological or logistical barriers may reduce potential benefits of vaccination for pandemic influenza, and these temporal effects can outweigh any additional theoretical benefits from population targeting. Careful modeling may provide decision makers with estimates of these effects before the epidemic peak to guide production goals and inform policy. Integration of real-time surveillance data with mathematical models holds the promise of

  19. A cross-sectional survey to evaluate knowledge, attitudes and practices (KAP regarding seasonal influenza vaccination among European travellers to resource-limited destinations

    Directory of Open Access Journals (Sweden)

    Szucs Thomas D

    2010-07-01

    Full Text Available Abstract Background Influenza is one of the most common vaccine-preventable diseases in travellers. By performing two cross-sectional questionnaire surveys during winter 2009 and winter 2010 among European travellers to resource-limited destinations, we aimed to investigate knowledge, attitudes and practices (KAP regarding seasonal influenza vaccination. Methods Questionnaires were distributed in the waiting room to the visitors of the University of Zurich Centre for Travel' Health (CTH in January and February 2009 and January 2010 prior to travel health counselling (CTH09 and CTH10. Questions included demographic data, travel-related characteristics and KAP regarding influenza vaccination. Data were analysed by using SPSS® version 14.0 for Windows. Differences in proportions were compared using the Chi-square test and the significance level was set at p ≤ 0.05. Predictors for seasonal and pandemic influenza vaccination were determined by multiple logistic regression analyses. Results With a response rate of 96.6%, 906 individuals were enrolled and 868 (92.5% provided complete data. Seasonal influenza vaccination coverage was 13.7% (n = 119. Only 43 (14.2% participants were vaccinated against pandemic influenza A/H1N1, mostly having received both vaccines simultaneously, the seasonal and pandemic one. Job-related purposes (44, 37%, age > 64 yrs (25, 21% and recommendations of the family physician (27, 22.7% were the most often reported reasons for being vaccinated. In the multiple logistic regression analyses of the pooled data increasing age (OR = 1.03, 95% CI 1.01 - 1.04, a business trip (OR = 0.39, 95% CI 0.17 - 0.92 and seasonal influenza vaccination in the previous winter seasons (OR = 12.91, 95% CI 8.09 - 20.58 were independent predictors for seasonal influenza vaccination in 2009 or 2010. Influenza vaccination recommended by the family doctor (327, 37.7%, travel to regions with known high risk of influenza (305, 35.1%, and influenza

  20. Epidemiologic study of influenza A/H1N1 outbreak in a middle school in Haidian District, Beijing%北京市某中学聚集性甲型H1N1流感暴发疫情调查

    Institute of Scientific and Technical Information of China (English)

    韦懿芸; 郭菁; 华伟玉; 孙亚敏; 王江敏; 蔡润; 刘锋

    2011-01-01

    目的 了解北京市海淀区某中学聚集性甲型H1N1流感暴发的流行特征,为学校甲型H1N1流感疫情的控制提供科学依据.方法 收集该校甲型H1N1患者基本资料和疫情发生学校基本情况,采用描述性流行病学方法对该起疫情进行流行病学分析.结果 甲型H1N1流感暴发疫情历时17 d,累计确诊109名病例,学生罹息率为5.08%(104/2 048),教师罹患率为2.23%(5/224),隐性感染者比例为7.34%(8/109);与2008年同期比较,流感样病例比例差异有统计学意义;疫情初期发病学生以初二年级学生为主,中、后期扩散至初三及其他年级;不同性别人群罹患率差异有统计学意义;病例临床特征典型;甲型H1N1流感病例占流感样病例30.95%(104/336).结论 此次疫情为一起输入性甲型H1N1流感暴发疫情.严格执行校园内的晨午检和疫情报告制度,及时隔离病人及密切接触者,积极开展健康教育和对易感人群的免疫接种,可预防和控制甲型H1N1流感疫情的发生与流行.%Objective To study the epidemiological characters of an influerza A/H1N1 outbreak in a middle school in Haidian district, and to provide effective and scientific measures of respiratory diseases prevention and control in schools. Methods The data of every patient and basic information of school were collected, and epidemiological descriptive analysis was conducted in the study. Results The duration of the influenza A/H1N 1 outbreak was seventeen days. One hundred and nine patients were diagnosed and the attack rate of students was 5.08% ( 104/2 048 ), the attack rate of teachers was 2.23% ( 5/224 ) and the proportion of recessive infected patients was 7.34% ( 8/109 ). The incidence rate of influenza likely patient of 2009 was higher than that of 2008. In the early period, most patients were grade two of junior high school, while in the middle period and the later period, most patients were grade three of junior high school. There was no obvious sexual variation in the attack rate of A/H1N1 influenza;The clinical symptoms of patients were typical. The proportions of influenza A/H1N1 patient was 30.95% ( 104/336) in influenza likely patients.Conclusion The first patient in this A/H1N1 influenza outbreak is infected in community. Carrying out strict morning-noon health cheek-up and epidemic situation reporting system, timely isolation of patients and people around patients, implementation of health propaganda and inoculation are successfully utilized in control of epidemic influenza.

  1. 1918 pandemic H1N1 DNA vaccine protects ferrets against 2007 H1N1 virus infection

    DEFF Research Database (Denmark)

    Bragstad, Karoline; Martel, Cyril Jean-Marie; Aasted, Bent; Nielsen, Lars Peter; Fomsgaard, Anders

    of the H1N1 pandemic virus from 1918 induce protection in ferrets against infection with a H1N1 (A/New Caledonia/20/99(H1N1)) virus which was included in the conventional vaccine for the 2006-2007 season. The viruses are separated by a time interval of 89 years and differ by 21.2% in the HA1 protein...

  2. Pandemic Influenza A H1N1 2009 Infection versus Vaccination: A Cohort Study Comparing Immune Responses in Pregnancy

    OpenAIRE

    Fisher, Barbra M.; Van Bockern, Janice; Hart, Jan; Lynch, Anne M.; Winn, Virginia D.; Gibbs, Ronald S.; Weinberg, Adriana

    2012-01-01

    Background With the emergence of H1N1 pandemic (pH1N1) influenza, the CDC recommended that pregnant women be one of five initial target groups to receive the 2009 monovalent H1N1 vaccine, regardless of prior infection with this influenza strain. We sought to compare the immune response of pregnant women to H1N1 infection versus vaccination and to determine the extent of passive immunity conferred to the newborn. Methods/Findings During the 2009-2010 influenza season, we enrolled a cohort of w...

  3. A new sentinel surveillance system for severe influenza in England shows a shift in age distribution of hospitalised cases in the post-pandemic period.

    Directory of Open Access Journals (Sweden)

    Shelly Bolotin

    Full Text Available BACKGROUND: The World Health Organization and European Centre for Disease Prevention and Control have highlighted the importance of establishing systems to monitor severe influenza. Following the H1N1 (2009 influenza pandemic, a sentinel network of 23 Trusts, the UK Severe Influenza Surveillance System (USISS, was established to monitor hospitalisations due to confirmed seasonal influenza in England. This article presents the results of the first season of operation of USISS in 2010/11. METHODOLOGY/PRINCIPAL FINDINGS: A case was defined as a person hospitalised with confirmed influenza of any type. Weekly aggregate numbers of hospitalised influenza cases, broken down by flu type and level of care, were submitted by participating Trusts. Cases in 2010/11 were compared to cases during the 2009 pandemic in hospitals with available surveillance data for both time periods (n = 19. An unexpected resurgence in seasonal A/H1N1 (2009 influenza activity in England was observed in December 2010 with reports of severe disease. Reported cases over the period of 4 October 2010 to 13 February 2011 were mostly due to influenza A/H1N1 (2009. One thousand and seventy-one cases of influenza A/H1N1 (2009 occurred over this period compared to 409 at the same Trusts over the 2009/10 pandemic period (1 April 2009 to 6 January 2010. Median age of influenza A/H1N1 (2009 cases in 2010/11 was 35 years, compared with 20 years during the pandemic (p = <0.0001. CONCLUSIONS/SIGNIFICANCE: The Health Protection Agency successfully established a sentinel surveillance system for severe influenza in 2010/11, detecting a rise in influenza cases mirroring other surveillance indicators. The data indicate an upward shift in the age-distribution of influenza A/H1N1 (2009 during the 2010/11 influenza season as compared to the 2009/10 pandemic. Systems to enable the ongoing surveillance of severe influenza will be a key component in understanding and responding to the evolving

  4. Willingness to accept H1N1 pandemic influenza vaccine: A cross-sectional study of Hong Kong community nurses

    Directory of Open Access Journals (Sweden)

    Wong Carmen

    2010-10-01

    Full Text Available Abstract Background The 2009 pandemic of influenza A (H1N1 infection has alerted many governments to make preparedness plan to control the spread of influenza A (H1N1 infection. Vaccination for influenza is one of the most important primary preventative measures to reduce the disease burden. Our study aims to assess the willingness of nurses who work for the community nursing service (CNS in Hong Kong on their acceptance of influenza A (H1N1 influenza vaccination. Methods 401 questionnaires were posted from June 24, 2009 to June 30, 2009 to community nurses with 67% response rate. Results of the 267 respondents on their willingness to accept influenza A (H1N1 vaccine were analyzed. Results Twenty-seven percent of respondents were willing to accept influenza vaccination if vaccines were available. Having been vaccinated for seasonable influenza in the previous 12 months were significantly independently associated with their willingness to accept influenza A (H1N1 vaccination (OR = 4.03; 95% CI: 2.03-7.98. Conclusions Similar to previous findings conducted in hospital healthcare workers and nurses, we confirmed that the willingness of community nurses to accept influenza A (H1N1 vaccination is low. Future studies that evaluate interventions to address nurses' specific concerns or interventions that aim to raise the awareness among nurses on the importance of influenza A (H1N1 vaccination to protect vulnerable patient populations is needed.

  5. Respiratory virus laboratory pandemic planning an surveillance in central Viet Nam, 2008-2010

    Directory of Open Access Journals (Sweden)

    Trinh Xuan Mai

    2012-07-01

    Full Text Available Introduction: Laboratory capacity is needed in central Viet Nam to provide early warning to public health authorities of respiratory outbreaks of importance to human health, for example the outbreak of influenza A(H1N1 pandemic in 2009. Polymerase chain reaction (PCR procedures established as part of a capacity-building process were used to conduct prospective respiratory surveillance in a region where few previous studies have been undertaken.Methods: Between October 2008 and September 2010, nose and throat swabs from adults and children (approximately 20 per week presenting with an acute respiratory illness to the Ninh Hoa General Hospital were collected. Same-day PCR testing and result reporting for 13 respiratory viruses were carried out by locally trained scientists.Results: Of 2144 surveillance samples tested, 1235 (57.6% were positive for at least one virus. The most common were influenza A strains (17.9%, with pandemic influenza A(H1N1 2009 and seasonal H3N2 strain accounting for 52% and 43% of these, respectively. Other virus detections included: rhinovirus (12.4%, enterovirus (8.9%, influenza B (8.3%, adenovirus (5.3%, parainfluenza (4.7%, respiratory syncytial virus (RSV (3.9%, human coronavirus (3.0% and human metapneumovirus (0.3%. The detection rate was greatest in the 0–5 year age group. Viral co-infections were identified in 148 (6.9% cases.Discussion: The outbreak in 2009 of the influenza A(H1N1 pandemic strain provided a practical test of the laboratory’s pandemic plan. This study shows that the availability of appropriate equipment and molecular-based testing can contribute to important individual and public health outcomes in geographical locations susceptible to emerging infections.

  6. 不同专业大学生甲型H1N1流感知识及行为调查%Influenza A(H1N1)-related knowledge and behaviors among university students with different majors in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    顾菁; 陈培奋; 林羽媚; 刘德辉; 葛菲雪; 凌文华

    2011-01-01

    Objective To investigate influenza A( H1N1 )-related knowledge and behaviors among university students and to provide information for influenza A( H1N1 ) epidemic prevention in campus.Methods A total of 873 students from three different majors of two universities in Guangzhou were recruited.Anonymous self-administered questionnaire was used to collect data.Univariate and multivariate logistic regression model were used in the analysis.Results University students had some awareness of the transmission route and preventive measure of influenza A ( H1N1 ) (39.2% -96.8% ).But many of them did not have preventive behavior (23.9% -57.7% ).After adjusting for significant background factors, students majoring in public health knew more about influenza A( H1N1 )-related transmission route compared with those majoring in anthropology or social work( odds ratio = 2.5 - 5.2 ,P < 0.01 ).There was no significant difference in influenzaA( H1N1 ) related preventive behavior among students with different majors.Over 70% of the students reported that they had insufficient information to prevent influenza A(H1N1 ).Conclusion The condition of influenza A(H1N1 ) prevention in campus is far from requirment.Improvement in preventive perception and behavior is greatly needed among university students.%目的 了解不同专业大学生甲型H1N1流感相关知识和行为情况,为预防和控制校园内甲型H1N1流感疫情提供参考依据.方法 采用自行设计调查问卷,对广东省广州市2所高校3个不同专业共873名大学生进行问卷调查.结果 与公共卫生专业学生比较,人类学和社会工作专业学生对甲型H1NI流感的传播知识掌握较少(P0.05).结论 公共卫生专业大学生对甲型H1N1流感相关知识了解相对较多,但预防行为尚待提高.

  7. New pre-pandemic influenza vaccines: an egg- and adjuvant-independent human adenoviral vector strategy induces long-lasting protective immune responses in mice.

    Science.gov (United States)

    Hoelscher, M A; Jayashankar, L; Garg, S; Veguilla, V; Lu, X; Singh, N; Katz, J M; Mittal, S K; Sambhara, S

    2007-12-01

    Highly pathogenic avian H5N1 influenza viruses that are currently circulating in southeast Asia may acquire the potential to cause the next influenza pandemic. A number of alternate approaches are being pursued to generate cross-protective, dose-sparing, safe, and effective vaccines, as traditional vaccine approaches, i.e., embryonated egg-grown, are not immunogenic. We developed a replication-incompetent adenoviral vector-based, adjuvant- and egg-independent pandemic influenza vaccine strategy as a potential alternative to conventional egg-derived vaccines. In this paper, we address suboptimal dose and longevity of vaccine-induced protective immunity and demonstrate that a vaccine dose as little as 1 x 10(6) plaque-forming unit (PFU) is sufficient to induce protective immune responses against a highly pathogenic H5N1 virus. Furthermore, the vaccine-induced humoral and cellular immune responses and protective immunity persisted at least for a year. PMID:17957181

  8. Public preferences for vaccination programmes during pandemics caused by pathogens transmitted through respiratory droplets - a discrete choice experiment in four European countries, 2013.

    Science.gov (United States)

    Determann, Domino; Korfage, Ida J; Fagerlin, Angela; Steyerberg, Ewout W; Bliemer, Michiel C; Voeten, Helene A; Richardus, Jan Hendrik; Lambooij, Mattijs S; de Bekker-Grob, Esther W

    2016-06-01

    This study aims to quantify and compare preferences of citizens from different European countries for vaccination programme characteristics during pandemics, caused by pathogens which are transmitted through respiratory droplets. Internet panel members, nationally representative based on age, sex, educational level and region, of four European Union Member States (Netherlands, Poland, Spain, and Sweden, n = 2,068) completed an online discrete choice experiment. These countries, from different geographical areas of Europe, were chosen because of the availability of high-quality Internet panels and because of the cooperation between members of the project entitled Effective Communication in Outbreak Management: development of an evidence-based tool for Europe (ECOM). Data were analysed using panel latent class regression models. In the case of a severe pandemic scenario, vaccine effectiveness was the most important characteristic determining vaccination preference in all countries, followed by the body that advises on vaccination. In Sweden, the advice of family and/or friends and the advice of physicians strongly affected vaccine preferences, in contrast to Poland and Spain, where the advice of (international) health authorities was more decisive. Irrespective of pandemic scenario or vaccination programme characteristics, the predicted vaccination uptakes were lowest in Sweden, and highest in Poland. To increase vaccination uptake during future pandemics, the responsible authorities should align with other important stakeholders in the country and communicate in a coordinated manner. PMID:27277581

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 热毒宁注射液体外抑制甲型H1N1流感病毒的研究%In vitro inhibition of Reduning Injection on influenza A/H1N1 influenza virus

    Institute of Scientific and Technical Information of China (English)

    孙兰; 段书敏; 周军; 王振中; 毕宇安; 萧伟

    2014-01-01

    目的:研究热毒宁注射液体外抑制甲型H1N1流感病毒的作用。方法以奥司他韦为阳性对照,采用CPE和MTT法观察热毒宁注射液对甲型H1N1流感病毒的抑制作用。结果 CPE法结果表明热毒宁注射液最大无毒浓度(TC0)为16.2 mg/mL,半数中毒浓度为(TC50)为(24.5±8.1)mg/mL;MTT法测定结果表明热毒宁注射液TC0为16.2 mg/mL,TC50为(21.7±9.4)mg/mL。热毒宁注射液体外抑制甲型H1N1流感病毒结果显示,CPE法和MTT法热毒宁注射液作用感染细胞1次组半数有效浓度(IC50)为(900.0±173.2)、(933.3±57.7)μg/mL,治疗指数(TI)为27.2、23.2;热毒宁注射液作用感染细胞3次组IC50为(666.7±115.5)、(866.7±208.1)μg/mL,TI为36.7、25.0。结论热毒宁注射液具有明显体外抗甲型H1N1流感病毒的作用。%Objective To study the inhibitory effects of Reduning Injection on influenza A/H1N1 influenza virusin vitro.Methods With Oseltamivir as positive control, CPE and MTT methods were used to observe inhibitory effects of Reduning Injection on influenza A/H1N1 influenza virusin vitro.Results The CPE method results showed that maximum of no toxicity concentration (TC0) of Reduning Injection was 16.2 mg/mL, and median toxic concentration (TC50) was (24.5 ± 8.1) mg/mL. The MTT method results showed that maximum of no toxicity concentration (TC0) was (16.2 ± 0) mg/mL, and median toxic concentration (TC50) was (21.7 ± 9.4) mg/mL. Thein vitro inhibition of influenza A/H1N1 influenza virus of Reduning Injection showed the administration of Reduning Injection to infected cells once, median toxic concentration (TC50) of the CPE method and the MTT method were (900.0 ± 173.2)μg/mL, (933.3 ± 57.7)μg/mL, therapeutic indexes (TI) were 27.2 and 23.2, and administration of Reduning Injection to infected cells for three times, median toxic concentration (TC50) of the CPE method and the MTT method were (666.7 ± 115.5)μg/mL, (866.7 ± 208.1)μg/mL,TI were 36.7 and 25.0.Conclusion Reduning Injection has obvious resistance to the influenza A/H1N1 influenza virus in vitro. Administration of Reduning Injection to infected MDCK cells for three times is superior to the administration of Reduning Injection to infected MDCK cells once.

  11. 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; Nielsen, Lars; Thybo, Søren; Kronborg, Gitte

    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...... 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....

  12. Needle-Free Skin Patch Delivery of a Vaccine for a Potentially Pandemic Influenza Virus Provides Protection against Lethal Challenge in Mice▿

    OpenAIRE

    Garg, Sanjay; Hoelscher, Mary; Belser, Jessica A.; Wang, Chong; Jayashankar, Lakshmi; Guo, Zhu; Durland, Ross H.; Katz, Jacqueline M.; Sambhara, Suryaprakash

    2007-01-01

    In the event of another influenza virus pandemic, strategies for effective mass vaccination will urgently be needed. We used a novel transdermal patch delivery technology, known as the PassPort system, to vaccinate mice with recombinant H5 hemagglutinin with or without immunomodulators. This needle-free form of vaccine delivery induced robust serum antibody responses that were augmented by different immunomodulators that stimulated the innate immune system and protected mice against lethal ch...

  13. Aerosol Delivery of a Candidate Universal Influenza Vaccine Reduces Viral Load in Pigs Challenged with Pandemic H1N1 Virus

    OpenAIRE

    Morgan, Sophie B; Hemmink, Johanneke D.; Porter, Emily; Harley, Ross; Shelton, Holly; Aramouni, Mario; Everett, Helen E.; Brookes, Sharon M; Bailey, Michael; Townsend, Alain M.; Charleston, Bryan; Tchilian, Elma

    2016-01-01

    Influenza A viruses are a major health threat to livestock and humans, causing considerable mortality, morbidity, and economic loss. Current inactivated influenza vaccines are strain specific and new vaccines need to be produced at frequent intervals to combat newly arising influenza virus strains, so that a universal vaccine is highly desirable. We show that pandemic H1N1 influenza virus in which the hemagglutinin signal sequence has been suppressed (S-FLU), when administered to pigs by aero...

  14. Respiratory viral infections in institutions from late stage of the first and second waves of pandemic influenza A (H1N1) 2009, Ontario, Canada.

    Science.gov (United States)

    Asner, Sandra; Peci, Adriana; Marchand-Austin, Alex; Winter, Anne-Luise; Olsha, Romy; Kristjanson, Erik; Low, Donald E; Gubbay, Jonathan B

    2012-05-01

    We report the impact of respiratory viruses on various outbreak settings by using surveillance data from the late first and second wave periods of the 2009 pandemic. A total of 278/345(78·5%) outbreaks tested positive for at least one respiratory virus by multiplex PCR. We detected A(H1N1)pdm09 in 20·6% of all reported outbreaks of which 54·9% were reported by camps, schools, and day cares (CSDs) and 29·6% by long-term care facilities (LCFTs), whereas enterovirus/human rhinovirus (ENT/HRV) accounted for 62% outbreaks of which 83·7% were reported by long-term care facilities (LCTFs). ENT/HRV was frequently identified in LTCF outbreaks involving elderly residents, whereas in CSDs, A(H1N1)pdm09 was primarily detected. PMID:22353417

  15. 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

  16. Risk factors for influenza among health care workers during 2009 pandemic, Toronto, Ontario, Canada

    OpenAIRE

    Kuster, Stefan P; Coleman, Brenda L.; Raboud, Janet; McNeil, Shelly; De Serres, Gaston; Gubbay, Jonathan; Hatchette, Todd; Katz, Kevin C.; Loeb, Mark; Low, Donald; Mazzulli, Tony; Simor, Andrew; McGeer, Allison J.

    2013-01-01

    This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.1%) non-HCWs were posit...

  17. Risk Factors for Influenza among Health Care Workers during 2009 Pandemic, Toronto, Ontario, Canada

    OpenAIRE

    Kuster, Stefan P; Coleman, Brenda L.; Raboud, Janet; McNeil, Shelly; De Serres, Gaston; Gubbay, Jonathan; Hatchette, Todd; Katz, Kevin C.; Loeb, Mark; Low, Donald; Mazzulli, Tony; Simor, Andrew; McGeer, Allison J.; ,

    2013-01-01

    This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.1%) non-HCWs were posit...

  18. Is there an association between the H1N1 influenza pandemic vaccination and the manifestation of narcolepsy?

    OpenAIRE

    Masoudi, Sanita; Ploen, Daniela; Hildt, Eberhard

    2015-01-01

    After the mass-vaccination campaign during the influenza A (H1N1) 2009 pandemic, a significant increase in narcolepsy incidence was observed initially in Scandinavia, later in other European countries and recently also in Canada. Narcolepsy is a sleep disease caused by the loss of hypocretin-producing cells in the hypothalamus. Almost all narcolepsy patients carry the HLA-DQB1*0602 allele, giving a link to an autoimmune-mediated process. Most of the observed narcolepsy cases were correlate...

  19. No effect of 2008/09 seasonal influenza vaccination on the risk of pandemic H1N1 2009 influenza infection in England.

    Science.gov (United States)

    Pebody, Richard; Andrews, Nick; Waight, Pauline; Malkani, Rashmi; McCartney, Christine; Ellis, Joanna; Miller, Elizabeth

    2011-03-21

    This study reports effectiveness of trivalent influenza vaccine (TIV) against confirmed pandemic influenza infection in England using a retrospective test-negative case-control study. Cases and controls were frequency matched by age, swabbing-week and region. On univariable and multivariable analysis adjusted for underlying clinical risk factors, cases were no more or less likely than controls to be vaccinated with 2008-09 or 2007-08 season TIV. Adjusted vaccine effectiveness for the former was -6% (-43% to 22%). Vaccine effectiveness did not differ significantly by age-group or hospitalisation status. There was no evidence prior vaccination with TIV significantly altered subsequent risk of pandemic influenza H1N1 2009 infection. PMID:21292008

  20. Meta-analysis of the immunogenicity and tolerability of pandemic influenza A 2009 (H1N1 vaccines.

    Directory of Open Access Journals (Sweden)

    Lamberto Manzoli

    Full Text Available BACKGROUND: Although the 2009 (H1N1 influenza pandemic officially ended in August 2010, the virus will probably circulate in future years. Several types of H1N1 vaccines have been tested including various dosages and adjuvants, and meta-analysis is needed to identify the best formulation. METHODS: We searched MEDLINE, EMBASE, and nine clinical trial registries to April 2011, in any language for randomized clinical trials (RCTs on healthy children, adolescents, adults and the elderly. Primary outcome was the seroconversion rate according to hemagglutinination-inhibition (HI; secondary outcomes were adverse events. For the primary outcome, we used head-to-head meta-analysis and multiple-treatments meta-analysis. RESULTS: Eighteen RCTs could be included in all primary analyses, for a total of 76 arms (16,725 subjects. After 2 doses, all 2009 H1N1 split/subunit inactivated vaccines were highly immunogenic and overcome CPMP seroconversion criteria. After 1 dose only, all split/subunit vaccines induced a satisfactory immunogenicity (> = 70% in adults and adolescents, while only some formulations showed acceptable results for children and elderly (non-adjuvanted at high-doses and oil-in-water adjuvanted vaccines. Vaccines with oil-in-water adjuvants were more immunogenic than both nonadjuvanted and aluminum-adjuvanted vaccines at equal doses and their immunogenicity at doses < = 6 µg (even with as little as 1.875 µg of hemagglutinin antigen was not significantly lower than that achieved after higher doses. Finally, the rate of serious vaccine-related adverse events was low for all 2009 H1N1 vaccines (3 cases, resolved in 10 days, out of 22826 vaccinated subjects. However, mild to moderate adverse reactions were more (and very frequent for oil-in-water adjuvanted vaccines. CONCLUSIONS: Several one-dose formulations might be valid for future vaccines, but 2 doses may be needed for children, especially if a low-dose non-adjuvanted vaccine is

  1. Immunogenicity and tolerability after two doses of non-adjuvanted, whole-virion pandemic influenza A (H1N1 vaccine in HIV-infected individuals.

    Directory of Open Access Journals (Sweden)

    Heimo Lagler

    Full Text Available BACKGROUND: During the influenza pandemic of 2009/10, the whole-virion, Vero-cell-derived, inactivated, pandemic influenza A (H1N1 vaccine Celvapan® (Baxter was used in Austria. Celvapan® is adjuvant-free and was the only such vaccine at that time in Europe. The objective of this observational, non-interventional, prospective single-center study was to evaluate the immunogenicity and tolerability of two intramuscular doses of this novel vaccine in HIV-positive individuals. METHODS AND FINDINGS: A standard hemagglutination inhibition (HAI assay was used for evaluation of the seroconversion rate and seroprotection against the pandemic H1N1 strain. In addition, H1N1-specific IgG antibodies were measured using a recently developed ELISA and compared with the HAI results. Tolerability of vaccination was evaluated up to one month after the second dose. A total of 79 HIV-infected adults with an indication for H1N1 vaccination were evaluated. At baseline, 55 of the 79 participants had an HAI titer ≥1:40 and two patients showed a positive IgG ELISA. The seroconversion rate was 31% after the first vaccination, increasing to 41% after the second; the corresponding seroprotection rates were 92% and 83% respectively. ELISA IgG levels were positive in 25% after the first vaccination and in 37% after the second. Among the participants with baseline HAI titers 60 years of age had a baseline HAI titer <1:40 or seroconverted after vaccination. The vaccine was well tolerated. CONCLUSION: The non-adjuvanted pandemic influenza A (H1N1 vaccine was well tolerated and induced a measurable immune response in a sample of HIV-infected individuals.

  2. Permissible variation in the 3' non-coding region of the haemagglutinin genome segment of the H5N1 candidate influenza vaccine virus NIBRG-14 [corrected].

    Science.gov (United States)

    Johnson, Rachel E; Hamill, Michelle; Harvey, Ruth; Nicolson, Carolyn; Robertson, James S; Engelhardt, Othmar G

    2012-01-01

    The candidate H5N1 vaccine virus NIBRG-14 was created in response to a call from the World Health Organisation in 2004 to prepare candidate vaccine viruses (CVVs) to combat the threat of an H5N1 pandemic. NIBRG-14 was created by reverse genetics and is composed of the neuraminidase (NA) and modified haemagglutinin (HA) genes from A/Vietnam/1194/2004 and the internal genes of PR8, a high growing laboratory adapted influenza A(H1N1) strain. Due to time constraints, the non-coding regions (NCRs) of A/Vietnam/1194/2004 HA were not determined prior to creating NIBRG-14. Consequently, the sequence of the primers used to clone the modified A/Vietnam/1194/2004 HA was based upon previous experience of cloning H5N1 viruses. We report here that the HA 3' NCR sequence of NIBRG-14 is different to that of the parental wild type virus A/Vietnam/1194/2004; however this does not appear to impact on its growth or antigen yield. We introduced additional small changes into the 3'NCR of NIBRG-14; these had only minor effects on viral growth and antigen content. These findings may serve to assure the influenza vaccine community that generation of CVVs using best-guess NCR sequences, based on sequence alignments, are likely to produce robust viruses. PMID:22606247

  3. 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

  4. Alternative Live-Attenuated Influenza Vaccines Based on Modifications in the Polymerase Genes Protect against Epidemic and Pandemic Flu▿

    Science.gov (United States)

    Solórzano, Alicia; Ye, Jianqiang; Pérez, Daniel R.

    2010-01-01

    Human influenza is a seasonal disease associated with significant morbidity and mortality. Influenza vaccination is the most effective means for disease prevention. We have previously shown that mutations in the PB1 and PB2 genes of the live-attenuated influenza vaccine (LAIV) from the cold-adapted (ca) influenza virus A/Ann Arbor/6/60 (H2N2) could be transferred to avian influenza viruses and produce partially attenuated viruses. We also demonstrated that avian influenza viruses carrying the PB1 and PB2 mutations could be further attenuated by stably introducing a hemagglutinin (HA) epitope tag in the PB1 gene. In this work, we wanted to determine whether these modifications would also result in attenuation of a so-called triple reassortant (TR) swine influenza virus (SIV). Thus, the TR influenza A/swine/Wisconsin/14094/99 (H3N2) virus was generated by reverse genetics and subsequently mutated in the PB1 and PB2 genes. Here we show that a combination of mutations in this TR backbone results in an attenuated virus in vitro and in vivo. Furthermore, we show the potential of our TR backbone as a vaccine that provides protection against the 2009 swine-origin pandemic influenza H1N1 virus (S-OIV) when carrying the surface of a classical swine strain. We propose that the availability of alternative backbones to the conventional ca A/Ann Arbor/6/60 LAIV strain could also be useful in epidemic and pandemic influenza and should be considered for influenza vaccine development. In addition, our data provide evidence that the use of these alternative backbones could potentially circumvent the effects of original antigenic sin (OAS) in certain circumstances. PMID:20181702

  5. A whole virus pandemic influenza H1N1 vaccine is highly immunogenic and protective in active immunization and passive protection mouse models.

    Directory of Open Access Journals (Sweden)

    Otfried Kistner

    Full Text Available The recent emergence and rapid spread of a novel swine-derived H1N1 influenza virus has resulted in the first influenza pandemic of this century. Monovalent vaccines have undergone preclinical and clinical development prior to initiation of mass immunization campaigns. We have carried out a series of immunogenicity and protection studies following active immunization of mice, which indicate that a whole virus, nonadjuvanted vaccine is immunogenic at low doses and protects against live virus challenge. The immunogenicity in this model was comparable to that of a whole virus H5N1 vaccine, which had previously been demonstrated to induce high levels of seroprotection in clinical studies. The efficacy of the H1N1 pandemic vaccine in protecting against live virus challenge was also seen to be equivalent to that of the H5N1 vaccine. The protective efficacy of the H1N1 vaccine was also confirmed using a severe combined immunodeficient (SCID mouse model. It was demonstrated that mouse and guinea pig immune sera elicited following active H1N1 vaccination resulted in 100% protection of SCID mice following passive transfer of immune sera and lethal challenge. The immune responses to a whole virus pandemic H1N1 and a split seasonal H1N1 vaccine were also compared in this study. It was demonstrated that the whole virus vaccine induced a balanced Th-1 and Th-2 response in mice, whereas the split vaccine induced mainly a Th-2 response and only minimal levels of Th-1 responses. These data supported the initiation of clinical studies with the same low doses of whole virus vaccine that had previously been demonstrated to be immunogenic in clinical studies with a whole virus H5N1 vaccine.

  6. Factors Affecting Intention to Receive and Self-Reported Receipt of 2009 Pandemic (H1N1) Vaccine in Hong Kong: A Longitudinal Study

    OpenAIRE

    Liao, Qiuyan; Cowling, Benjamin J.; Lam, Wendy Wing Tak; Fielding, Richard

    2011-01-01

    Background Vaccination was a core component for mitigating the 2009 influenza pandemic (pH1N1). However, a vaccination program's efficacy largely depends on population compliance. We examined general population decision-making for pH1N1 vaccination using a modified Theory of Planned Behaviour (TBP). Methodology We conducted a longitudinal study, collecting data before and after the introduction of pH1N1 vaccine in Hong Kong. Structural equation modeling (SEM) tested if a modified TPB had expl...

  7. Situational awareness and health protective responses to pandemic influenza A (H1N1 in Hong Kong: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Qiuyan Liao

    Full Text Available BACKGROUND: Whether information sources influence health protective behaviours during influenza pandemics or other emerging infectious disease epidemics is uncertain. METHODOLOGY: Data from cross-sectional telephone interviews of 1,001 Hong Kong adults in June, 2009 were tested against theory and data-derived hypothesized associations between trust in (formal/informal information, understanding, self-efficacy, perceived susceptibility and worry, and hand hygiene and social distancing using Structural Equation Modelling with multigroup comparisons. PRINCIPAL FINDINGS: Trust in formal (government/media information about influenza was associated with greater reported understanding of A/H1N1 cause (β = 0.36 and A/H1N1 prevention self-efficacy (β = 0.25, which in turn were associated with more hand hygiene (β = 0.19 and β = 0.23, respectively. Trust in informal (interpersonal information was negatively associated with perceived personal A/H1N1 susceptibility (β = -0.21, which was negatively associated with perceived self-efficacy (β = -0.42 but positively associated with influenza worry (β = 0.44. Trust in informal information was positively associated with influenza worry (β = 0.16 which was in turn associated with greater social distancing (β = 0.36. Multigroup comparisons showed gender differences regarding paths from trust in formal information to understanding of A/H1N1 cause, trust in informal information to understanding of A/H1N1 cause, and understanding of A/H1N1 cause to perceived self-efficacy. CONCLUSIONS/SIGNIFICANCE: Trust in government/media information was more strongly associated with greater self-efficacy and handwashing, whereas trust in informal information was strongly associated with perceived health threat and avoidance behaviour. Risk communication should consider the effect of gender differences.

  8. Predictors of influenza vaccine uptake during the 2009/10 influenza A H1N1v ('swine flu') pandemic: Results from five national surveys in the United Kingdom

    OpenAIRE

    Han, Y. K.; Michie, S.; Potts, H. W.; Rubin, G.J.

    2016-01-01

    OBJECTIVES: To investigate reasons underlying the low uptake of the influenza A H1N1v vaccination in the UK during the 2009/10 pandemic. METHODS: We analysed data from five national telephone surveys conducted in the UK during the latter stages of the pandemic to identify predictors of uptake amongst members of the public offered the vaccine by their primary care physician (n=1320). In addition to demographic variables, participants reported: reasons for declining the vaccination, levels of w...

  9. Predictors of influenza vaccine uptake during the 2009/10 influenza A H1N1v ('swine flu') pandemic:Results from five national surveys in the United Kingdom

    OpenAIRE

    Han, You Kyung Julia; Michie, Susan; Potts, Henry W.W.; Rubin, G. James

    2016-01-01

    Objectives: To investigate reasons underlying the low uptake of the influenza A H1N1v vaccination in the UK during the 2009/10 pandemic. Methods: We analysed data from five national telephone surveys conducted in the UK during the latter stages of the pandemic to identify predictors of uptake amongst members of the public offered the vaccine by their primary care physician (n=1320). In addition to demographic variables, participants reported: reasons for declining the vaccination, levels of w...

  10. Mortality attributable to influenza in England and Wales prior to, during and after the 2009 pandemic.

    Science.gov (United States)

    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 proportion of samples positive for influenza A or B. To adjust for confounding factors, a similar activity indicator was calculated for Respiratory Syncytial Virus. Extreme temperature and seasonal trend were controlled for. Following a severe influenza season in 2008/09 in 65+yr olds (estimated excess of 13,058 influenza A all-cause deaths), attributed all-cause mortality was not significant during the 2009 pandemic in this age group and comparatively low levels of influenza A mortality were seen in post-pandemic seasons. The age shift of the burden of seasonal influenza from the elderly to young adults during the pandemic continued into 2010/11; a comparatively larger impact was seen with the same circulating A(H1N1)pdm09 strain, with the burden of influenza A all-cause excess mortality in 15-64 yr olds the largest reported during 2008/09-2011/12 (436 deaths in 15-44 yr olds and 1,274 in 45-64 yr olds). On average, 76% of seasonal influenza A all-age attributable deaths had a cardiovascular or respiratory cause recorded (average of 5,849 influenza A deaths per season), with nearly a quarter reported for other causes (average of 1,770 influenza A deaths per season), highlighting the importance of all-cause as well as cause-specific estimates. No significant influenza B attributable mortality was detected by season, cause or age group. This analysis forms part of the preparatory work to establish a routine mortality monitoring system ahead of introduction of the UK universal

  11. Mortality attributable to influenza in England and Wales prior to, during and after the 2009 pandemic.

    Directory of Open Access Journals (Sweden)

    Helen K Green

    Full Text Available 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 proportion of samples positive for influenza A or B. To adjust for confounding factors, a similar activity indicator was calculated for Respiratory Syncytial Virus. Extreme temperature and seasonal trend were controlled for. Following a severe influenza season in 2008/09 in 65+yr olds (estimated excess of 13,058 influenza A all-cause deaths, attributed all-cause mortality was not significant during the 2009 pandemic in this age group and comparatively low levels of influenza A mortality were seen in post-pandemic seasons. The age shift of the burden of seasonal influenza from the elderly to young adults during the pandemic continued into 2010/11; a comparatively larger impact was seen with the same circulating A(H1N1pdm09 strain, with the burden of influenza A all-cause excess mortality in 15-64 yr olds the largest reported during 2008/09-2011/12 (436 deaths in 15-44 yr olds and 1,274 in 45-64 yr olds. On average, 76% of seasonal influenza A all-age attributable deaths had a cardiovascular or respiratory cause recorded (average of 5,849 influenza A deaths per season, with nearly a quarter reported for other causes (average of 1,770 influenza A deaths per season, highlighting the importance of all-cause as well as cause-specific estimates. No significant influenza B attributable mortality was detected by season, cause or age group. This analysis forms part of the preparatory work to establish a routine mortality monitoring system ahead of introduction of the UK

  12. 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).

  13. GLA-AF, an Emulsion-Free Vaccine Adjuvant for Pandemic Influenza

    OpenAIRE

    Clegg, Christopher H.; Roque, Richard; Perrone, Lucy A.; Rininger, Joseph A.; Bowen, Richard; Reed, Steven G.

    2014-01-01

    The ongoing threat from Influenza necessitates the development of new vaccine and adjuvant technologies that can maximize vaccine immunogenicity, shorten production cycles, and increase global vaccine supply. Currently, the most successful adjuvants for Influenza vaccines are squalene-based oil-in-water emulsions. These adjuvants enhance seroprotective antibody titers to homologous and heterologous strains of virus, and augment a significant dose sparing activity that could improve vaccine ma...

  14. Predictors of influenza vaccine uptake during the 2009/10 influenza A H1N1v (‘swine flu’) pandemic: Results from five national surveys in the United Kingdom

    Science.gov (United States)

    Han, You Kyung Julia; Michie, Susan; Potts, Henry W.W.; Rubin, G. James

    2016-01-01

    Objectives To investigate reasons underlying the low uptake of the influenza A H1N1v vaccination in the UK during the 2009/10 pandemic. Methods We analysed data from five national telephone surveys conducted in the UK during the latter stages of the pandemic to identify predictors of uptake amongst members of the public offered the vaccine by their primary care physician (n = 1320). In addition to demographic variables, participants reported: reasons for declining the vaccination, levels of worry about the risk of catching swine flu, whether too much fuss was being made about the pandemic, whether they or a close friend or relative had had swine flu, how effective they felt the vaccine was, whether they had previously had a seasonal flu vaccination, how well prepared they felt the government was for a pandemic and how satisfied they were with information available about the pandemic. Most participants (n = 734, 55.6%) reported being vaccinated against swine flu, compared to 396 who had not been vaccinated and were unlikely to be vaccinated in the future. Results The main reasons given for declining vaccination were concerns over the vaccine's safety, and being generally healthy. Controlling for demographic variables, risk factors for not being vaccinated were: being female, not having a long-standing infirmity or illness, not having been vaccinated against seasonal flu in previous years, feeling that too much fuss had been made about the pandemic and believing that the vaccine was ineffective. Conclusions Interventions that target these factors may be effective in improving uptake in a future pandemic. PMID:26757401

  15. DNA vaccination elicits protective immune responses against pandemic and classic swine influenza viruses in pigs

    Science.gov (United States)

    Swine influenza is a highly contagious viral infection in pigs that significantly impacts the pork industry due to weight loss and secondary infections. There is also the potential of a significant public health threat, highlighted by the possibility that the 2009 H1N1 pandemic strain emerged from r...

  16. Responses to pandemic ASO3-adjuvanted A/California/07/09 H1N1 influenza vaccine in human immunodeficiency virus-infected individuals

    Directory of Open Access Journals (Sweden)

    Kelly Deborah

    2012-08-01

    Full Text Available Abstract Background Influenza infection may be more serious in human immunodeficiency virus (HIV-infected individuals, therefore, vaccination against seasonal and pandemic strains is highly advised. Seasonal influenza vaccines have had no significant negative effects in well controlled HIV infection, but the impact of adjuvanted pandemic A/California/07/2009 H1N1 influenza hemaglutinin (HA vaccine, which was used for the first time in the Canadian population as an authorized vaccine in autumn 2009, has not been extensively studied. Objective Assess vaccine-related effects on CD4+ T cell counts and humoral responses to the vaccine in individuals attending the Newfoundland and Labrador Provincial HIV clinic. Methods A single dose of ArepanrixTM split vaccine including 3.75 μg A/California/07/2009 H1N1 HA antigen and ASO3 adjuvant was administered to 81 HIV-infected individuals by intramuscular injection. Plasma samples from shortly before, and 1–5 months after vaccination were collected from 80/81 individuals to assess humoral anti-H1N1 HA responses using a sensitive microbead-based array assay. Data on CD4+ T cell counts, plasma viral load, antiretroviral therapy and patient age were collected from clinical records of 81 individuals. Results Overall, 36/80 responded to vaccination either by seroconversion to H1N1 HA or with a clear increase in anti-H1N1 HA antibody levels. Approximately 1/3 (28/80 had pre-existing anti-H1N1 HA antibodies and were more likely to respond to vaccination (22/28. Responders had higher baseline CD4+ T cell counts and responders without pre-existing antibodies against H1N1 HA were younger than either non-responders or responders with pre-existing antibodies. Compared to changes in their CD4+ T cell counts observed over a similar time period one year later, vaccine recipients displayed a minor, transient fall in CD4+ T cell numbers, which was greater amongst responders. Conclusions We observed low response rates

  17. Description of a large urban school-located 2009 pandemic H1N1 vaccination campaign, New York City 2009-2010.

    Science.gov (United States)

    Narciso, Heather E; Pathela, Preeti; Morgenthau, Beth Maldin; Kansagra, Susan M; May, Linda; Scaccia, Allison; Zucker, Jane R

    2012-04-01

    In the spring of 2009, New York City (NYC) experienced the emergence and rapid spread of pandemic influenza A H1N1 virus (pH1N1), which had a high attack rate in children and caused many school closures. During the 2009 fall wave of pH1N1, a school-located vaccination campaign for elementary schoolchildren was conducted in order to reduce infection and transmission in the school setting, thereby reducing the impact of pH1N1 that was observed earlier in the year. In this paper, we describe the planning and outcomes of the NYC school-located vaccination campaign. We compared consent and vaccination data for three vaccination models (school nurse alone, school nurse plus contract nurse, team). Overall, >1,200 of almost 1,600 eligible schools participated, achieving 26.8% consent and 21.5% first-dose vaccination rates, which did not vary significantly by vaccination model. A total of 189,902 doses were administered during two vaccination rounds to 115,668 students at 998 schools included in the analysis; vaccination rates varied by borough, school type, and poverty level. The team model achieved vaccination of more children per day and required fewer vaccination days per school. NYC's campaign is the largest described school-located influenza vaccination campaign to date. Despite substantial challenges, school-located vaccination is feasible in large, urban settings, and during a public health emergency. PMID:22318374

  18. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Weibin [Molecular Virus Unit, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200025 (China); Chen, Aizhong [Key Laboratory of Molecular Cell Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031 (China); Miao, Yi [Shanghai Xuhui Central Hospital, Shanghai 200031 (China); Xia, Shengli [Center for Disease Control and Prevention of Henan Province, Zhengzhou 450016 (China); Ling, Zhiyang; Xu, Ke; Wang, Tongyan [Molecular Virus Unit, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200025 (China); Xu, Ying; Cui, Jun; Wu, Hongqiang; Hu, Guiyu; Tian, Lin; Wang, Lingling [Key Laboratory of Molecular Cell Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031 (China); Shu, Yuelong [Chinese Center for Disease Control and Prevention, Beijing 102206 (China); Ma, Xiaowei [Hualan Biological Bacterin Company, Xinxiang 453003 (China); Xu, Bianli; Zhang, Jin [Center for Disease Control and Prevention of Henan Province, Zhengzhou 450016 (China); Lin, Xiaojun, E-mail: linxiaojun@hualan.com [Hualan Biological Bacterin Company, Xinxiang 453003 (China); Bian, Chao, E-mail: cbian@sibs.ac.cn [Key Laboratory of Molecular Cell Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031 (China); Sun, Bing, E-mail: bsun@sibs.ac.cn [Molecular Virus Unit, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200025 (China); Key Laboratory of Molecular Cell Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031 (China)

    2013-01-20

    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.

  20. Economics of Employer-Sponsored Workplace Vaccination to Prevent Pandemic and Seasonal Influenza

    OpenAIRE

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

    2010-01-01

    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 determined the cost-benefit of employer-sponsored workplace vaccination from the employer's perspective. Implementing such programs was relatively inexpensive (

  1. Outbreak of H3N2 influenza at a US military base in Djibouti during the H1N1 pandemic of 2009.

    Directory of Open Access Journals (Sweden)

    Michael T Cosby

    Full Text Available BACKGROUND: Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. OBJECTIVE: We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1pdm09]. METHODS: Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR methodology and sequenced genetic material was phylogenetically compared to other published strains. RESULTS: rt-RT-PCR and DNA sequencing revealed that 25 (78% of the 32 clinical samples collected were seasonal H3N2 and only 2 (6% were A(H1N1pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. CONCLUSIONS: This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.

  2. Outbreak of H3N2 Influenza at a US Military Base in Djibouti during the H1N1 Pandemic of 2009

    Science.gov (United States)

    Cosby, Michael T.; Pimentel, Guillermo; Nevin, Remington L.; Fouad Ahmed, Salwa; Klena, John D.; Amir, Ehab; Younan, Mary; Browning, Robert; Sebeny, Peter J.

    2013-01-01

    Background Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. Objective We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. Methods Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. Results rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. Conclusions This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed. PMID:24339995

  3. Influenza gain-of-function experiments: their role in vaccine virus recommendation and pandemic preparedness.

    Science.gov (United States)

    Schultz-Cherry, S; Webby, R J; Webster, R G; Kelso, A; Barr, I G; McCauley, J W; Daniels, R S; Wang, D; Shu, Y; Nobusawa, E; Itamura, S; Tashiro, M; Harada, Y; Watanabe, S; Odagiri, T; Ye, Z; Grohmann, G; Harvey, R; Engelhardt, O; Smith, D; Hamilton, K; Claes, F; Dauphin, G

    2014-01-01

    In recent years, controversy has arisen regarding the risks and benefits of certain types of gain-of-function (GOF) studies involving avian influenza viruses. In this article, we provide specific examples of how different types of data, including information garnered from GOF studies, have helped to shape the influenza vaccine production process-from selection of candidate vaccine viruses (CVVs) to the manufacture and stockpiling of safe, high-yield prepandemic vaccines for the global community. The article is not written to support a specific pro- or anti-GOF stance but rather to inform the scientific community about factors involved in vaccine virus selection and the preparation of prepandemic influenza vaccines and the impact that some GOF information has had on this process. PMID:25505124

  4. Seroprevalence of pandemic H1N1 antibody among health care workers in Hong Kong following receipt of monovalent 2009 H1N1 influenza vaccine.

    Directory of Open Access Journals (Sweden)

    Ying Zhou

    Full Text Available BACKGROUND: Healthcare workers in many countries are recommended to receive influenza vaccine to protect themselves as well as patients. A monovalent H1N1 vaccine became available in Hong Kong in December 2009 and around 10% of local healthcare workers had received the vaccine by February 2010. METHODS: We conducted a cross-sectional study of the prevalence of antibody to pandemic (H1N1 2009 among HCWs in Hong Kong in February-March 2010 following the first pandemic wave and the pH1N1 vaccination campaign. In this study we focus on the subset of healthcare workers who reported receipt of non-adjuvanted monovalent 2009 H1N1 vaccine (Panenza, Sanofi Pasteur. Sera collected from HCWs were tested for antibody against the pH1N1 virus by hemagglutination inhibition (HI and viral neutralization (VN assays. RESULTS: We enrolled 703 HCWs. Among 104 HCWs who reported receipt of pH1N1 vaccine, 54% (95% confidence interval (CI: 44%-63% had antibody titer ≥1∶40 by HI and 42% (95% CI: 33%-52% had antibody titer ≥1∶40 by VN. The proportion of HCWs with antibody titer ≥1∶40 by HI and VN significantly decreased with age, and the proportion with antibody titer ≥1∶40 by VN was marginally significantly lower among HCWs who reported prior receipt of 2007-08 seasonal influenza vaccine (odds ratio: 0.43; 95% CI: 0.19-1.00. After adjustment for age, the effect of prior seasonal vaccine receipt was not statistically significant. CONCLUSIONS: Our findings suggest that monovalent H1N1 vaccine may have had suboptimal immunogenicity in HCWs in Hong Kong. Larger studies are required to confirm whether influenza vaccine maintains high efficacy and effectiveness in HCWs.

  5. Pandemic influenza planning, United States, 1978-2008.

    Science.gov (United States)

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

    2013-06-01

    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 2003 reemergence of influenza A(H5N1) virus infection in humans. We outline the evolution of US pandemic planning since the late 1970s, summarize planning accomplishments, and explain their ongoing importance. The public health community's response to the 2009 influenza A(H1N1)pdm09 pandemic demonstrated the value of planning and provided insights into improving future plans and response efforts. Preparedness planning will enhance the collective, multilevel response to future public health crises. PMID:23731839

  6. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    Energy Technology Data Exchange (ETDEWEB)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis [General Hospital, PET/CT Unit, Athens (Greece)

    2010-05-15

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed{sup 18}F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  7. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    International Nuclear Information System (INIS)

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed18F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  8. Determinants of vaccine immunogenicity in HIV-infected pregnant women: analysis of B and T cell responses to pandemic H1N1 monovalent vaccine.

    Directory of Open Access Journals (Sweden)

    Adriana Weinberg

    Full Text Available Influenza infections have high frequency and morbidity in HIV-infected pregnant women, underscoring the importance of vaccine-conferred protection. To identify the factors that determine vaccine immunogenicity in this group, we characterized the relationship of B- and T-cell responses to pandemic H1N1 (pH1N1 vaccine with HIV-associated immunologic and virologic characteristics. pH1N1 and seasonal-H1N1 (sH1N1 antibodies were measured in 119 HIV-infected pregnant women after two double-strength pH1N1 vaccine doses. pH1N1-IgG and IgA B-cell FluoroSpot, pH1N1- and sH1N1-interferon γ (IFNγ and granzyme B (GrB T-cell FluoroSpot, and flow cytometric characterization of B- and T-cell subsets were performed in 57 subjects. pH1N1-antibodies increased after vaccination, but less than previously described in healthy adults. pH1N1-IgG memory B cells (Bmem increased, IFNγ-effector T-cells (Teff decreased, and IgA Bmem and GrB Teff did not change. pH1N1-antibodies and Teff were significantly correlated with each other and with sH1N1-HAI and Teff, respectively, before and after vaccination. pH1N1-antibody responses to the vaccine significantly increased with high proportions of CD4+, low CD8+ and low CD8+HLADR+CD38+ activated (Tact cells. pH1N1-IgG Bmem responses increased with high proportions of CD19+CD27+CD21- activated B cells (Bact, high CD8+CD39+ regulatory T cells (Treg, and low CD19+CD27-CD21- exhausted B cells (Bexhaust. IFNγ-Teff responses increased with low HIV plasma RNA, CD8+HLADR+CD38+ Tact, CD4+FoxP3+ Treg and CD19+IL10+ Breg. In conclusion, pre-existing antibody and Teff responses to sH1N1 were associated with increased responses to pH1N1 vaccination in HIV-infected pregnant women suggesting an important role for heterosubtypic immunologic memory. High CD4+% T cells were associated with increased, whereas high HIV replication, Tact and Bexhaust were associated with decreased vaccine immunogenicity. High Treg increased antibody responses but

  9. Pandemic influenza 1918 H1N1 and 1968 H3N2 DNA vaccines induce cross‐reactive immunity in ferrets against infection with viruses drifted for decades

    Science.gov (United States)

    Bragstad, Karoline; Martel, Cyril J.; Thomsen, Joakim S.; Jensen, Kim L.; Nielsen, Lars P.; Aasted, Bent; Fomsgaard, Anders

    2010-01-01

    Please cite this paper as: Bragstad et al. (2010) Pandemic influenza 1918 H1N1 and 1968 H3N2 DNA vaccines induce cross‐reactive immunity in ferrets against infection with viruses drifted for decades. Influenza and Other Respiratory Viruses 5(1), 13–23. Background  Alternative influenza vaccines and vaccine production forms are needed as the conventional protein vaccines do not induce broad cross‐reactivity against drifted strains. Furthermore, fast vaccine production is especially important in a pandemic situation, and broader vaccine reactivity would diminish the need for frequent change in the vaccine formulations. Objective  In this study, we compared the ability of pandemic influenza DNA vaccines to induce immunity against distantly related strains within a subtype with the immunity induced by conventional trivalent protein vaccines against homologous virus challenge. Methods  Ferrets were immunised by particle‐mediated epidermal delivery (gene gun) with DNA vaccines based on the haemagglutinin (HA) and neuraminidase (NA) and/or the matrix (M) and nucleoprotein genes of the 1918 H1N1 Spanish influenza pandemic virus or the 1968 H3N2 Hong Kong influenza pandemic virus. The animals were challenged with contemporary H1N1 or H3N2 viruses. Results  We demonstrated that DNA vaccines encoding proteins of the original 1918 H1N1 pandemic virus induced protective cross‐reactive immune responses in ferrets against infection with a 1947 H1N1 virus and a recent 1999 H1N1 virus. Similarly, a DNA vaccine, based on the HA and NA of the 1968 H3N2 pandemic virus, induced cross‐reactive immune responses against a recent 2005 H3N2 virus challenge. Conclusions  DNA vaccines based on pandemic or recent seasonal influenza genes induced cross‐reactive immunity against contemporary virus challenge as good as or superior to contemporary conventional trivalent protein vaccines. This suggests a unique ability of influenza DNA to induce cross‐protective immunity

  10. Aerosol Delivery of a Candidate Universal Influenza Vaccine Reduces Viral Load in Pigs Challenged with Pandemic H1N1 Virus.

    Science.gov (United States)

    Morgan, Sophie B; Hemmink, Johanneke D; Porter, Emily; Harley, Ross; Shelton, Holly; Aramouni, Mario; Everett, Helen E; Brookes, Sharon M; Bailey, Michael; Townsend, Alain M; Charleston, Bryan; Tchilian, Elma

    2016-06-15

    Influenza A viruses are a major health threat to livestock and humans, causing considerable mortality, morbidity, and economic loss. Current inactivated influenza vaccines are strain specific and new vaccines need to be produced at frequent intervals to combat newly arising influenza virus strains, so that a universal vaccine is highly desirable. We show that pandemic H1N1 influenza virus in which the hemagglutinin signal sequence has been suppressed (S-FLU), when administered to pigs by aerosol can induce CD4 and CD8 T cell immune responses in blood, bronchoalveolar lavage (BAL), and tracheobronchial lymph nodes. Neutralizing Ab was not produced. Detection of a BAL response correlated with a reduction in viral titer in nasal swabs and lungs, following challenge with H1N1 pandemic virus. Intratracheal immunization with a higher dose of a heterologous H5N1 S-FLU vaccine induced weaker BAL and stronger tracheobronchial lymph node responses and a lesser reduction in viral titer. We conclude that local cellular immune responses are important for protection against influenza A virus infection, that these can be most efficiently induced by aerosol immunization targeting the lower respiratory tract, and that S-FLU is a promising universal influenza vaccine candidate. PMID:27183611

  11. The pandemic influenza A (H1N1 2009 vaccine does not increase the mortality rate of idiopathic interstitial pneumonia: a matched case-control study.

    Directory of Open Access Journals (Sweden)

    Hiroshi Yokomichi

    Full Text Available BACKGROUND: Evidence regarding the mortality rate after administration of the pandemic influenza A (H1N1 2009 vaccine on patients with underlying diseases is currently scarce. We conducted a case-control study in Japan to compare the mortality rates of patients with idiopathic interstitial pneumonia after the vaccines were administered and were not administered. METHODS: Between October 2009 and March 2010, we collected clinical records in Japan and conducted a 1:1 matched case-control study. Patients with idiopathic interstitial pneumonia who died during this period were considered case patients, and those who survived were considered control patients. We determined and compared the proportion of each group that received the pandemic influenza A (H1N1 2009 vaccine and estimated the odds ratio. Finally, we conducted simulations that compensated for the shortcomings of the study associated with adjusted severity of idiopathic interstitial pneumonia. RESULTS: The case and control groups each comprised of 75 patients with idiopathic interstitial pneumonia. The proportion of patients who received the pandemic influenza A (H1N1 2009 vaccine was 30.7% and 38.7% for the case and control groups, respectively. During that winter, the crude conditional odds ratio of mortality was 0.63 (95% confidence interval, 0.25-1.47 and the adjusted conditional odds ratio was 1.18 (95% confidence interval, 0.33-4.49; neither was significant. The simulation study showed more accurate conditional odds ratios of 0.63-0.71. CONCLUSIONS: In our study, we detected no evidence that the influenza A (H1N1 2009 vaccine increased the mortality rate of patients with idiopathic interstitial pneumonia. The results, however, are limited by the small sample size and low statistical power. A larger-scale study is required.

  12. On the random distribution of scarce doses of vaccine in response to the threat of an influenza pandemic: a response to Wardrope.

    Science.gov (United States)

    McLachlan, Hugh V

    2015-02-01

    Wardrope argues against my proposed non-consequentialist policy for the distribution of scarce influenza vaccine in the face of a pandemic. According to him, even if one accepts what he calls my deontological ethical theory, it does not follow that we are required to agree with my proposed randomised allocation of doses of vaccine by means of a lottery. He argues in particular that I fail to consider fully the prophylactic role of vaccination whereby it serves to protect from infection more people than are vaccinated. He concludes that: 'The benefits and burdens of vaccination are provided impartially and far more effectively by targeted vaccination than impartial lotteries.' He has shown convincingly that this conclusion can be established in the case of his particular envisaged scenario. However, Wardrope gives no reason to suppose that, in the circumstances that we actually face, targeted vaccination would constitute impartial treatment of citizens in the UK. I readily agree with Wardrope that if it should treat its citizens justly and impartially, it does not necessarily follow that the state should distribute vaccinations of the basis of a lottery. That will be a reasonable thing to do only if certain assumptions are made. These assumptions will not always be reasonable. However, they are reasonable ones to make in the actual circumstances that currently apply. PMID:24143004

  13. Predictors of influenza vaccine uptake during the 2009/10 influenza A H1N1v (‘swine flu’) pandemic: Results from five national surveys in the United Kingdom

    OpenAIRE

    Han, You Kyung Julia; Michie, Susan; Potts, Henry W.W.; Rubin, G. James

    2016-01-01

    Objectives To investigate reasons underlying the low uptake of the influenza A H1N1v vaccination in the UK during the 2009/10 pandemic. Methods We analysed data from five national telephone surveys conducted in the UK during the latter stages of the pandemic to identify predictors of uptake amongst members of the public offered the vaccine by their primary care physician (n = 1320). In addition to demographic variables, participants reported: reasons for declining the vaccination, levels of w...

  14. Evaluation of the efficacy and cross-protectivity of recent human and swine vaccines against the pandemic (H1N1 2009 virus infection.

    Directory of Open Access Journals (Sweden)

    Philippe Noriel Q Pascua

    Full Text Available The current pandemic (H1N1 2009 virus remains transmissible among humans worldwide with cases of reverse zoonosis, providing opportunities to produce more pathogenic variants which could pose greater human health concerns. To investigate whether recent seasonal human or swine H1N1 vaccines could induce cross-reactive immune responses against infection with the pandemic (H1N1 2009 virus, mice, ferrets or mini-pigs were administered with various regimens (once or twice and antigen content (1.77, 3.5 or 7.5 microg HA of a-Brsibane/59/07, a-CAN01/04 or RgCA/04/09xPR8 vaccine. Receipt of a-CAN01/04 (2-doses but not a-Brisbane/59/07 induced detectable but modest (20-40 units cross-reactive serum antibody against CA/04/09 by hemagglutinin inhibition (HI assays in mice. Only double administration (7.5 microg HA of both vaccine in ferrets could elicit cross-reactivity (30-60 HI titers. Similar antigen content of a-CAN01/04 in mini-pigs also caused a modest approximately 30 HI titers (twice vaccinated. However, vaccine-induced antibody titers could not suppress active virus replication in the lungs (mice or virus shedding (ferrets and pigs of immunized hosts intranasally challenged with CA/04/09. Furthermore, neither ferrets nor swine could abrogate aerosol transmission of the virus into naïve contact animals. Altogether, these results suggest that neither recent human nor animal H1N1 vaccine could provide complete protectivity in all animal models. Thus, this study warrants the need for strain-specific vaccines that could yield the optimal protection desired for humans and/or animals.

  15. Memory immune responses against pandemic (H1N1 2009 influenza virus induced by a whole particle vaccine in cynomolgus monkeys carrying Mafa-A1*052:02.

    Directory of Open Access Journals (Sweden)

    Masahiko Arikata

    Full Text Available We made an H1N1 vaccine candidate from a virus library consisting of 144 ( = 16 HA×9 NA non-pathogenic influenza A viruses and examined its protective effects against a pandemic (2009 H1N1 strain using immunologically naïve cynomolgus macaques to exclude preexisting immunity and to employ a preclinical study since preexisting immunity in humans previously vaccinated or infected with influenza virus might make comparison of vaccine efficacy difficult. Furthermore, macaques carrying a major histocompatibility complex class I molecule, Mafa-A1*052:02, were used to analyze peptide-specific CD8(+ T cell responses. Sera of macaques immunized with an inactivated whole particle formulation without addition of an adjuvant showed higher neutralization titers against the vaccine strain A/Hokkaido/2/1981 (H1N1 than did sera of macaques immunized with a split formulation. Neutralization activities against the pandemic strain A/Narita/1/2009 (H1N1 in sera of macaques immunized twice with the split vaccine reached levels similar to those in sera of macaques immunized once with the whole particle vaccine. After inoculation with the pandemic virus, the virus was detected in nasal samples of unvaccinated macaques for 6 days after infection and for 2.67 days and 5.33 days on average in macaques vaccinated with the whole particle vaccine and the split vaccine, respectively. After the challenge infection, recall neutralizing antibody responses against the pandemic virus and CD8(+ T cell responses specific for nucleoprotein peptide NP262-270 bound to Mafa-A1*052:02 in macaques vaccinated with the whole particle vaccine were observed more promptly or more vigorously than those in macaques vaccinated with the split vaccine. These findings demonstrated that the vaccine derived from our virus library was effective for pandemic virus infection in macaques and that the whole particle vaccine conferred more effective memory and broader cross-reactive immune responses

  16. Development of a candidate influenza vaccine based on virus-like particles displaying influenza M2e peptide into the immunodominant region of hepatitis B core antigen: Broad protective efficacy of particles carrying four copies of M2e.

    Science.gov (United States)

    Tsybalova, Liudmila M; Stepanova, Liudmila A; Kuprianov, Victor V; Blokhina, Elena A; Potapchuk, Marina V; Korotkov, Alexander V; Gorshkov, Andrey N; Kasyanenko, Marina A; Ravin, Nikolai V; Kiselev, Oleg I

    2015-06-26

    A long-term objective when designing influenza vaccines is to create one with broad cross-reactivity that will provide effective control over influenza, no matter which strain has caused the disease. Here we summarize the results from an investigation into the immunogenic and protective capacities inherent in variations of a recombinant protein, HBc/4M2e. This protein contains four copies of the ectodomain from the influenza virus protein M2 (M2e) fused within the immunodominant loop of the hepatitis B virus core antigen (HBc). Variations of this basic design include preparations containing M2e from the consensus human influenza virus; the M2e from the highly pathogenic avian A/H5N1 virus and a combination of two copies from human and two copies from avian influenza viruses. Intramuscular delivery in mice with preparations containing four identical copies of M2e induced high IgG titers in blood sera and bronchoalveolar lavages. It also provoked the formation of memory T-cells and antibodies were retained in the blood sera for a significant period of time post immunization. Furthermore, these preparations prevented the death of 75-100% of animals, which were challenged with lethal doses of virus. This resulted in a 1.2-3.5 log10 decrease in viral replication within the lungs. Moreover, HBc particles carrying only "human" or "avian" M2e displayed cross-reactivity in relation to human (A/H1N1, A/H2N2 and A/H3N2) or A/H5N1 and A(H1N1)pdm09 viruses, respectively; however, with the particles carrying both "human" and "avian" M2e this effect was much weaker, especially in relation to influenza virus A/H5N1. It is apparent from this work that to quickly produce vaccine for a pandemic it would be necessary to have several variations of a recombinant protein, containing four copies of M2e (each one against a group of likely influenza virus strains) with these relevant constructs housed within a comprehensive collection Escherichia coli-producers and maintained ready for use

  17. Duration of {sup 18}F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination

    Energy Technology Data Exchange (ETDEWEB)

    Thomassen, Anders; Lerberg Nielsen, Anne; Gerke, Oke; Johansen, Allan; Petersen, Henrik [OUH, Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark)

    2011-05-15

    The aim of our study was to investigate the occurrence of fluorodeoxyglucose (FDG) avidity in draining axillary lymph nodes after vaccination against influenza (H1N1v pandemic and seasonal) and to determine the period of increased FDG uptake. During December 2009, patients referred for {sup 18}F-FDG positron emission tomography (PET)/CT scans (n = 293) filled in a questionnaire concerning vaccination type (seasonal and/or H1N1v), time and anatomical localization of vaccination. Only injections in deltoid regions were evaluated, thus ensuring that draining lymph nodes were axillary. If more vaccinations had been given, only the latest vaccination was evaluated in each deltoid region. Of all patients who underwent PET/CT scans during December 2009, 26% had been vaccinated with at least one influenza vaccination in the deltoid region. A total of 92 'draining' and 60 'reference' (i.e. contralateral, non-vaccinated) axillary lymph nodes were evaluated in 61 patients (19 of 61 patients were scanned twice). The maximal intensity in FDG uptake (SUV{sub max}) in draining lymph nodes was 5 g/ml body weight (BW), whereas the maximal intensity in reference lymph nodes was 1.9 g/ml BW. The SUV{sub max} was normalized approximately 40 days after vaccination. No significant enlargement of metabolically active draining lymph nodes could be demonstrated on CT scan. Chemotherapy or immunosuppressive drugs given within 2 weeks from vaccination did not affect SUV{sub max} in the axillary lymph nodes. Influenza vaccination may lead to FDG-avid draining lymph nodes beyond 1 month. (orig.)

  18. Duration of 18F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination

    International Nuclear Information System (INIS)

    The aim of our study was to investigate the occurrence of fluorodeoxyglucose (FDG) avidity in draining axillary lymph nodes after vaccination against influenza (H1N1v pandemic and seasonal) and to determine the period of increased FDG uptake. During December 2009, patients referred for 18F-FDG positron emission tomography (PET)/CT scans (n = 293) filled in a questionnaire concerning vaccination type (seasonal and/or H1N1v), time and anatomical localization of vaccination. Only injections in deltoid regions were evaluated, thus ensuring that draining lymph nodes were axillary. If more vaccinations had been given, only the latest vaccination was evaluated in each deltoid region. Of all patients who underwent PET/CT scans during December 2009, 26% had been vaccinated with at least one influenza vaccination in the deltoid region. A total of 92 'draining' and 60 'reference' (i.e. contralateral, non-vaccinated) axillary lymph nodes were evaluated in 61 patients (19 of 61 patients were scanned twice). The maximal intensity in FDG uptake (SUVmax) in draining lymph nodes was 5 g/ml body weight (BW), whereas the maximal intensity in reference lymph nodes was 1.9 g/ml BW. The SUVmax was normalized approximately 40 days after vaccination. No significant enlargement of metabolically active draining lymph nodes could be demonstrated on CT scan. Chemotherapy or immunosuppressive drugs given within 2 weeks from vaccination did not affect SUVmax in the axillary lymph nodes. Influenza vaccination may lead to FDG-avid draining lymph nodes beyond 1 month. (orig.)

  19. Properly folded bacterially expressed H1N1 hemagglutinin globular head and ectodomain vaccines protect ferrets against H1N1 pandemic influenza virus.

    Directory of Open Access Journals (Sweden)

    Surender Khurana

    Full Text Available BACKGROUND: In the face of impending influenza pandemic, a rapid vaccine production and mass vaccination is the most effective approach to prevent the large scale mortality and morbidity that was associated with the 1918 "Spanish Flu". The traditional process of influenza vaccine production in eggs is time consuming and may not meet the demands of rapid global vaccination required to curtail influenza pandemic. METHODOLOGY/PRINCIPAL FINDINGS: Recombinant technology can be used to express the hemagglutinin (HA of the emerging new influenza strain in a variety of systems including mammalian, insect, and bacterial cells. In this study, two forms of HA proteins derived from the currently circulating novel H1N1 A/California/07/2009 virus, HA1 (1-330 and HA (1-480, were expressed and purified from E. coli under controlled redox refolding conditions that favoured proper protein folding. However, only the recombinant HA1 (1-330 protein formed oligomers, including functional trimers that bound receptor and caused agglutination of human red blood cells. These proteins were used to vaccinate ferrets prior to challenge with the A/California/07/2009 virus. Both proteins induced neutralizing antibodies, and reduced viral loads in nasal washes. However, the HA1 (1-330 protein that had higher content of multimeric forms provided better protection from fever and weight loss at a lower vaccine dose compared with HA (1-480. Protein yield for the HA1 (1-330 ranged around 40 mg/Liter, while the HA (1-480 yield was 0.4-0.8 mg/Liter. CONCLUSIONS/SIGNIFICANCE: This is the first study that describes production in bacterial system of properly folded functional globular HA1 domain trimers, lacking the HA2 transmembrane protein, that elicit potent neutralizing antibody responses following vaccination and protect ferrets from in vivo challenge. The combination of bacterial expression system with established quality control methods could provide a mechanism for rapid large

  20. Prevalence of influenza-like illness and seasonal and pandemic H1N1 influenza vaccination coverage among workers--United States, 2009-10 influenza season.

    Science.gov (United States)

    Luckhaupt, Sara E; Calvert, Geoffrey M; Li, Jia; Sweeney, Marie; Santibanez, Tammy A

    2014-03-14

    During an influenza pandemic, information about the industry and occupation (I&O) of persons likely to be infected with influenza virus is important to guide key policy decisions regarding vaccine prioritization and exposure-control measures. Health-care personnel (HCP) might have increased opportunity for exposure to influenza infection, and they have been prioritized for influenza vaccination because of their own risk and the risk that infected HCP pose to patients. To identify other groups of workers that might be at increased risk for pandemic influenza infection, influenza-like illness (ILI) and vaccination coverage data from the 2009 National H1N1 Flu Survey (NHFS), which was conducted during October 2009 through June 2010, were analyzed. In a representative sample of 28,710 employed adults, 5.5% reported ILI symptoms in the month before the interview, and 23.7% received the 2009 pandemic H1N1 (pH1N1) influenza vaccine. Among employed adults, the highest prevalence of ILI was reported by those employed in the industry groups "Real estate and rental and leasing" (10.5%) and "Accommodation and food services" (10.2%), and in the occupation groups "Food preparation and serving related" (11.0%) and "Community and social services" (8.3%). Both seasonal influenza and pH1N1 vaccination coverage were relatively low in all of these groups of workers. Adults not in the labor force (i.e., homemakers, students, retired persons, and persons unable to work) had ILI prevalence and pH1N1 vaccination coverage similar to those found in all employed adults combined; in contrast, ILI prevalence was higher and pH1N1 vaccination coverage was lower among unemployed adults (i.e., those looking for work). These results suggest that adults employed in certain industries and occupations might have increased risk for influenza infection, and that the majority of these workers did not receive seasonal or pH1N1 influenza vaccine. Unemployed adults might also be considered a high risk group

  1. Safety and efficacy of a novel live attenuated influenza vaccine against pandemic H1N1 in swine

    Science.gov (United States)

    On June 11, 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) is the predominant influenza strain in the human population. It has also crossed the species barriers a...

  2. Humoral and Cell-Mediated Immunity to Pandemic H1N1 Influenza in a Canadian Cohort One Year Post-Pandemic: Implications for Vaccination

    OpenAIRE

    Wagar, Lisa E.; Rosella, Laura; Crowcroft, Natasha; Lowcock, Beth; Drohomyrecky, Paulina C.; Foisy, Julie; Gubbay, Jonathan; Rebbapragada, Anu; Winter, Anne-Luise; Achonu, Camille; Brian J Ward; Watts, Tania H

    2011-01-01

    We evaluated a cohort of Canadian donors for T cell and antibody responses against influenza A/California/7/2009 (pH1N1) at 8-10 months after the 2nd pandemic wave by flow cytometry and microneutralization assays. Memory CD8 T cell responses to pH1N1 were detectable in 58% (61/105) of donors. These responses were largely due to cross-reactive CD8 T cell epitopes as, for those donors tested, similar recall responses were obtained to A/California 2009 and A/PR8 1934 H1N1 Hviruses. Longitudinal ...

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

    Directory of Open Access Journals (Sweden)

    Okamatsu Masatoshi

    2013-02-01

    Full Text Available 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 (H1N1 pandemic strain. Each of the vaccines was injected subcutaneously into mice and their potencies were evaluated by challenge with A/Narita/1/2009 (H1N1 virus strain in mice. Results A/swine/Hokkaido/2/81 (H1N1, which was isolated from the lung of a diseased piglet, was selected on the basis of their antigenicity and growth capacity in embryonated chicken eggs. Two injections of the WV vaccine induced an immune response in mice, decreasing the impact of disease caused by the challenge with A/Narita/1/2009 (H1N1, as did the vaccine prepared from the homologous strain. Conclusion The WV vaccine prepared from an influenza virus in the library is useful as an emergency vaccine in the early phase of pandemic influenza.

  4. Origins of the 2009 H1N1 influenza pandemic in swine in Mexico

    Science.gov (United States)

    Mena, Ignacio; Nelson, Martha I; Quezada-Monroy, Francisco; Dutta, Jayeeta; Cortes-Fernández, Refugio; Lara-Puente, J Horacio; Castro-Peralta, Felipa; Cunha, Luis F; Trovão, Nídia S; Lozano-Dubernard, Bernardo; Rambaut, Andrew; van Bakel, Harm; García-Sastre, Adolfo

    2016-01-01

    Asia is considered an important source of influenza A virus (IAV) pandemics, owing to large, diverse viral reservoirs in poultry and swine. However, the zoonotic origins of the 2009 A/H1N1 influenza pandemic virus (pdmH1N1) remain unclear, due to conflicting evidence from swine and humans. There is strong evidence that the first human outbreak of pdmH1N1 occurred in Mexico in early 2009. However, no related swine viruses have been detected in Mexico or any part of the Americas, and to date the most closely related ancestor viruses were identified in Asian swine. Here, we use 58 new whole-genome sequences from IAVs collected in Mexican swine to establish that the swine virus responsible for the 2009 pandemic evolved in central Mexico. This finding highlights how the 2009 pandemic arose from a region not considered a pandemic risk, owing to an expansion of IAV diversity in swine resulting from long-distance live swine trade. DOI: http://dx.doi.org/10.7554/eLife.16777.001 PMID:27350259

  5. 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...

  6. Epidemiological aspects of influenza A related to climatic conditions during and after a pandemic period in the city of Salvador, northeastern Brazil

    Science.gov (United States)

    Silva, Rosangela de Castro; Siqueira, Marilda Agudo Mendonça; Netto, Eduardo Martins; Bastos, Jacione Silva; Nascimento-Carvalho, Cristiana Maria; Vilas-Boas, Ana Luisa; Bouzas, Maiara Lana; Motta, Fernando do Couto; Brites, Carlos

    2014-01-01

    During the influenza pandemic of 2009, the A(H1N1)pdm09, A/H3N2 seasonal and influenza B viruses were observed to be co-circulating with other respiratory viruses. To observe the epidemiological pattern of the influenza virus between May 2009-August 2011, 467 nasopharyngeal aspirates were collected from children less than five years of age in the city of Salvador. In addition, data on weather conditions were obtained. Indirect immunofluorescence, real-time transcription reverse polymerase chain reaction (RT-PCR), and sequencing assays were performed for influenza virus detection. Of all 467 samples, 34 (7%) specimens were positive for influenza A and of these, viral characterisation identified Flu A/H3N2 in 25/34 (74%) and A(H1N1)pdm09 in 9/34 (26%). Influenza B accounted for a small proportion (0.8%) and the other respiratory viruses for 27.2% (127/467). No deaths were registered and no pattern of seasonality or expected climatic conditions could be established. These observations are important for predicting the evolution of epidemics and in implementing future anti-pandemic measures. PMID:24714967

  7. Epidemiological aspects of influenza A related to climatic conditions during and after a pandemic period in the city of Salvador, northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Rosangela de Castro Silva

    2014-04-01

    Full Text Available During the influenza pandemic of 2009, the A(H1N1pdm09, A/H3N2 seasonal and influenza B viruses were observed to be co-circulating with other respiratory viruses. To observe the epidemiological pattern of the influenza virus between May 2009-August 2011, 467 nasopharyngeal aspirates were collected from children less than five years of age in the city of Salvador. In addition, data on weather conditions were obtained. Indirect immunofluorescence, real-time transcription reverse polymerase chain reaction (RT-PCR, and sequencing assays were performed for influenza virus detection. Of all 467 samples, 34 (7% specimens were positive for influenza A and of these, viral characterisation identified Flu A/H3N2 in 25/34 (74% and A(H1N1pdm09 in 9/34 (26%. Influenza B accounted for a small proportion (0.8% and the other respiratory viruses for 27.2% (127/467. No deaths were registered and no pattern of seasonality or expected climatic conditions could be established. These observations are important for predicting the evolution of epidemics and in implementing future anti-pandemic measures.

  8. Immunogenic and Protective Properties of the First Kazakhstan Vaccine against Pandemic Influenza A (H1N1) pdm09 in Ferrets

    Institute of Scientific and Technical Information of China (English)

    Kaissar Tabynov; Zhailaubai Kydyrbayev; Abylai Sansyzbay; Berik Khairullin; Sholpan Ryskeldinova; Nurika Assanzhanova; Yerken Kozhamkulov; Dulat Inkarbekov

    2012-01-01

    This paper presents the results of a pre-clinical study of the immunogenicity and efficacy of an egg-derived,inactivated,whole-virion adjuvanted vaccine (Refluvac(R)) on ferret models.For this purpose,groups of eight ferrets (6 to 7 months old) were injected with 0.5 mL of vaccine specimens containing 3.75,7.5 or 15.0 μg of virus hemagglutinin.Administration was intramuscular and given either as a single dose or as two doses 14 days apart.All vaccine specimens manifested immunogenicity in ferrets for single (HI titer,from 51 ± 7 to 160 ± 23) and double (HI titer,from 697 ± 120 to 829 ± 117) administrations.To assess the protective effects of the vaccine,ferrets from the vaccinated and control groups were infected intranasally with pandemic virus A/California/7/09 (H1N1) pdm09 at a dose of 106 EID50/0.5 mL.Fourteen days post-infection,the ferrets inoculated with single or double vaccines containing 3.75,7.5 or 15.0 μg of hemagglutinin per dose showed no signs of influenza infection,weight loss,or body temperature rise,and no premature deaths occurred.The number of vaccinated ferrets shedding the virus via the upper airway,as well as the amount of virus shed after infection,was significantly reduced in comparison with animals from the control group.Based on our results,we suggest that a single vaccination at a dose of 3.75 or 7.5 μg hemagglutinin be used for Phase I clinical trials.

  9. Pandemic influenza 1918 H1N1 and 1968 H3N2 DNA vaccines induce cross-reactive immunity in ferrets against infection with viruses drifted for decades

    DEFF Research Database (Denmark)

    Bragstad, Karoline; Martel, Cyril; Thomsen, Joakim S.; Jensen, Kim Lynge; Nielsen, Lars P.; Aasted, Bent; Fomsgaard, Anders

    2011-01-01

    Please cite this paper as: Bragstad et al. (2010) Pandemic influenza 1918 H1N1 and 1968 H3N2 DNA vaccines induce cross-reactive immunity in ferrets against infection with viruses drifted for decades. Influenza and Other Respiratory Viruses 5(1), 13-23. Background Alternative influenza vaccines and...... immunised by particle-mediated epidermal delivery (gene gun) with DNA vaccines based on the haemagglutinin (HA) and neuraminidase (NA) and/or the matrix (M) and nucleoprotein genes of the 1918 H1N1 Spanish influenza pandemic virus or the 1968 H3N2 Hong Kong influenza pandemic virus. The animals were...... challenged with contemporary H1N1 or H3N2 viruses. Results We demonstrated that DNA vaccines encoding proteins of the original 1918 H1N1 pandemic virus induced protective cross-reactive immune responses in ferrets against infection with a 1947 H1N1 virus and a recent 1999 H1N1 virus. Similarly, a DNA vaccine...

  10. Deployable laboratory response to influenza pandemic; PCR assay field trials and comparison with reference methods.

    Directory of Open Access Journals (Sweden)

    Timothy J J Inglis

    Full Text Available BACKGROUND: The influenza A/H1N1/09 pandemic spread quickly during the Southern Hemisphere winter in 2009 and reached epidemic proportions within weeks of the official WHO alert. Vulnerable population groups included indigenous Australians and remote northern population centres visited by international travellers. At the height of the Australian epidemic a large number of troops converged on a training area in northern Australia for an international exercise, raising concerns about their potential exposure to the emerging influenza threat before, during and immediately after their arrival in the area. Influenza A/H1N1/09 became the dominant seasonal variant and returned to Australia during the Southern winter the following year. METHODS: A duplex nucleic acid amplification assay was developed within weeks of the first WHO influenza pandemic alert, demonstrated in northwestern Australia shortly afterwards and deployed as part of the pathology support for a field hospital during a military exercise during the initial epidemic surge in June 2009. RESULTS: The nucleic acid amplification assay was twice as sensitive as a point of care influenza immunoassay, as specific but a little less sensitive than the reference laboratory nucleic acid amplification assay. Repetition of the field assay with blinded clinical samples obtained during the 2010 winter influenza season demonstrated a 91.7% congruence with the reference laboratory method. CONCLUSIONS: Rapid in-house development of a deployable epidemic influenza assay allowed a flexible laboratory response, effective targeting of limited disease control resources in an austere military environment, and provided the public health laboratory service with a set of verification tools for resource-limited settings. The assay method was suitable for rapid deployment in time for the 2010 Northern winter.

  11. Community-based measures for mitigating the 2009 H1N1 pandemic in China.

    Directory of Open Access Journals (Sweden)

    Sanyi Tang

    Full Text Available Since the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45-1.92 and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of

  12. 某国际学校学生家长对甲型H1N1流感暴发后关闭学校的认可度调查%INVESTIGATION ON THE ACCEPTANCE OF HOUSEHOLD TO SCHOOL CLOSURE RESULTING FROM INFLUENZA A(H1N1)OUTBREAK

    Institute of Scientific and Technical Information of China (English)

    李琳; 徐文体; 董晓春; 张颖; 谢娟

    2011-01-01

    [目的]了解学生家长对甲型 H1N1 流感暴发后关闭学校这一措施的认可度.[方法]采用统一的问卷对发生甲流暴发疫情的某国际学校 460 名家长进行调查.[结果]回收有效问卷368份,问卷有效率为80%.53.80%家长赞成关闭学校,理由主要是认为关闭学校能保护其他健康学生避免感染(52.53%);46.20%家长反对关闭学校,理由主要是认为仅需膈离病例就能阻止疫情(31.76%).非病例学生家长赞成关闭学校的比例明显高于病例组家长(X2=6.88,P=0·009).年级与赞成关闭学校的比例之间呈负相关,随着年级增高,非病例学生家长赞成关闭学校的比例随之降低(rs=-0.595,P=0.032).[结论]家长对关闭学校的措施存在分歧.提示卫生和教育部分应采取措施,加强健康教育并保障防控措施落实,防止疫情向社区的扩散.%[Objective] To explore the household responses to school closure resulting from influenza A (H1N1) out break. [Methods] We surveyed 460 families affected by pandemic (H1N1) related school closures with uniform questionnaire. [Results] Valid questionnaires were returned for 368 (80%). Closure was considered appropriate by 53.8% of the parents, and the main reason was to protect the healthy students (52.53%); 46.20% of the parents who thought the school closures were not appropriate, and the main reason was enough case-quarantined (31.76%). The percentage of parents who indicated the closure was appropriate was higher among the parents of non-case than the parents of cases (x2 = 6.88, P = 0.009). Parental opinion about the appropriateness of the school closure was negatively correlated with grades (rs =-0.622, P= 0.031). [Con Clusion] Parental opinion on the school closure is different. It is indicated that the departments of health and education should take measures to assure the control measures implemented.

  13. 上海地区甲型H1N1流行性感冒流行病学调查和临床特征分析%Epidemiological survey and clinical analysis of patients with influenza A(H1N1)in Shanghai

    Institute of Scientific and Technical Information of China (English)

    欧强; 殷科珊; 陆云飞; 黄琴; 张志勇; 卢洪洲

    2009-01-01

    included throat congestion,swelling of tonsil,etc.The number of leukocytes in the peripheral blood was normal or low.CD4+ T lymphocyte count was lower than normal in some eases.Abnormal appearance of chest computerized tomography(CT)included increased bronchovascular shadows,pneumonia,pleural thickening and pleurisy.Oseltamivir was the first choice for treatment of A HIN1 influenza and its side effects were little.The prognosis was good and all patients recovered.Conclusions The infectivity of the new influenza is high.It can influence the cellular immunity.The symptoms are slight.The therapeutic effect is good by taking oseltamivir in early stage.Center for Disease Control and Prevention(CDC)should strengthen monitoring and take some measures to cope with the influenza pandemic.

  14. Pandemic Risk

    OpenAIRE

    Jonas, Olga B.

    2013-01-01

    This study examines pandemic risk, what it means for development, and how management could be improved, both in countries and internationally. Widely held beliefs—the inevitability of pandemics, which makes them not worth worrying about, health sector exclusive management of the risks, and the nondevelopmental nature of pandemic risk—lead to underestimation, scant preparedness, and inadequate prevention. Examining the reasons why these myths persist could help governments and international or...

  15. 4Flu - an individual based simulation tool to study the effects of quadrivalent vaccination on seasonal influenza in Germany

    OpenAIRE

    Eichner, Martin; Schwehm, Markus; Hain, Johannes; Uphoff, Helmut; Salzberger, Bernd; Knuf, Markus; Schmidt-Ott, Ruprecht

    2014-01-01

    Background Influenza vaccines contain Influenza A and B antigens and are adjusted annually to match the characteristics of circulating viruses. In Germany, Influenza B viruses belonged to the B/Yamagata lineage, but since 2001, the antigenically distinct B/Victoria lineage has been co-circulating. Trivalent influenza vaccines (TIV) contain antigens of the two A subtypes A(H3N2) and A(H1N1), yet of only one B lineage, resulting in frequent vaccine mismatches. Since 2012, the WHO has been recom...

  16. A clinical trial to assess the immunogenicity and safety of Inactivated Influenza Vaccine (Whole Virion IP (Pandemic Influenza (H1N1 2009 Monovalent Vaccine; VaxiFlu-S ™ in healthy Indian adult population

    Directory of Open Access Journals (Sweden)

    A H Kubavat

    2011-01-01

    Full Text Available Background : The pandemic of H1N1 2009 influenza has spread world over and low degree of virus transmission has continued in several regions of India. Aims : To assess the immunogenicity and safety of Pandemic Influenza (H1N1 2009 Monovalent Vaccine in healthy adult Indian population. Settings and Design : Prospective, open label, multicentric, phase 2/3 clinical trial. Materials and Methods : Healthy adult Indian subjects belonging to either 18-59 years or ≥60 years age groups were enrolled and administered a single 0.5 ml (≥15 mcg of hemagglutinin antigen dose of vaccine in the deltoid muscle. Anti-hemagglutinin antibody titer was assessed at baseline and 21 (±2 days after vaccination by Hemagglutination Inhibition (HI test. Safety assessments were done for a period of 42 days. Statistical Analysis Used : Percentages of appropriate population with 95% confidence intervals calculated, log transformation of the data to calculate Geometric Mean Titers (GMTs and chi-square test and student′s t-test applied for significance testing. Results : 182/198 and 53/63 volunteers in age groups of 18-59 years and ≥60 years, respectively, achieved an HI titer ≥1 : 40 at Day 21 (91.9% [95% confidence interval: 88.1-95.7%] and 84.1% [75.1-93.2%]; P=0.072. Further, 171/198 and 50/63 volunteers in the respective age groups achieved seroconversion/four-fold increase in titer at Day 21 (86.4% [81.6-91.1%] and 79.4% [69.4-89.4%]; P=0.179. A significant rise of 22.6-fold [18.0-28.4] and 10.5-fold [7.4-15.0] was noted in GMT in the respective age groups (P<0.001 for both groups as compared to baseline. Nine vaccine-related adverse events were reported (3.4% incidence [1.2-5.6%], which were of low severity only. Conclusions : Pandemic Influenza (H1N1 2009 Monovalent Vaccine produces excellent immunogenic response with a good tolerability profile in adult Indian population.

  17. Influenza pandemic (H1N1 2009 activity during summer 2009: Effectiveness of the 2008-9 trivalent vaccine against pandemic influenza in Spain Actividad de la gripe pandémica (H1N1 2009 durante el verano de 2009: Efectividad de la vacuna trivalente 2008-9 frente a la gripe pandémica en España

    Directory of Open Access Journals (Sweden)

    Amparo Larrauri

    2011-02-01

    Full Text Available Introduction: The Spanish influenza surveillance system (SISS maintained its activity during the summer of 2009 to monitor the influenza pandemic. Objectives: To describe pandemic influenza activity from May to September 2009 and to estimate the effectiveness of the 2008-9 seasonal influenza vaccine against laboratory-confirmed pandemic (H1N1 2009 influenza. Methods: Data from the SISS were used to identify the trend of pandemic (H1N1 2009 influenza outside the influenza season. For the effectiveness study, we compared the vaccination status of notified cases [influenza-like illnesses (ILI laboratory confirmed as pandemic influenza] with that of the test-negative controls. Results: The first laboratory-confirmed case of the pandemic virus was notified in the system in week 20/2009. The ILI rate increased gradually in the study period, exceeding basic activity in week 38. The proportion of pandemic (H1N1 2009 influenza viruses detected by the system represented 14% in week 20/2009 and rapidly increased to 90% in week 34. The adjusted vaccine effectiveness of the 2008-9 seasonal vaccine against laboratory-confirmed pandemic influenza was 12% (-30; 41. Conclusions: The SISS became an essential tool for pandemic monitoring in Spain. The improved SISS will provide more accurate information on influenza activity in future seasonal or pandemic waves. Using surveillance data, we could not demonstrate the effectiveness of the seasonal 2008-9 vaccine against laboratory-confirmed pandemic influenza.Introducción: El Sistema de Vigilancia de Gripe en España (SVGE continuó y reforzó su actividad durante el verano de 2009 con el objetivo de vigilar la evolución de la pandemia en España. Objetivos: Describir la actividad de la gripe pandémica en España de mayo a septiembre de 2009 y estimar la efectividad de la vacuna antigripal estacional 2008-2009 frente a casos confirmados de gripe pandémica (H1N1 2009. Métodos: Se utilizaron datos del SVGE para

  18. Avian influenza: an emerging pandemic threat.

    Science.gov (United States)

    Jin, Xian Wen; Mossad, Sherif B

    2005-12-01

    While we are facing the threat of an emerging pandemic from the current avian flu outbreak in Asia, we have learned important traits of the virus responsible for the 1918 Spanish influenza pandemic that made it so deadly. By using stockpiled antiviral drugs effectively and developing an effective vaccine, we can be in a better position than ever to mitigate the global impact of an avian influenza pandemic. PMID:16392727

  19. Safety of pandemic (H1N1 2009 monovalent vaccines in taiwan: a self-controlled case series study.

    Directory of Open Access Journals (Sweden)

    Wan-Ting Huang

    Full Text Available In Taiwan, new H1N1 monovalent vaccines without adjuvant and with MF59® adjuvant were used in the nationwide vaccination campaign beginning on November 1, 2009. From November 2009 through February 2010, the authors identified recipients of H1N1 vaccines who were diagnosed with adverse events of special interest (AESIs in a large-linked safety database, and used the self-controlled case series (SCCS method to examine the risk of each AESI in the 0-42 days after H1N1 vaccination. Of the 3.5 million doses of H1N1 vaccines administered and captured in the linked database, the SCCS analysis of Guillain-Barré syndrome (GBS found an incidence rate ratio of 3.81 (95% confidence interval 0.43-33.85 within 0-42 days after nonadjuvanted H1N1 vaccination and no cases after MF59®-adjuvanted H1N1 vaccination. The risks of other AESIs were, in general, not increased in any of the predefined postvaccination risk periods and age groups. The databases and infrastructure created for H1N1 vaccine safety evaluation may serve as a model for safety, effectiveness and coverage studies of licensed vaccines in Taiwan.

  20. Safety of Pandemic (H1N1) 2009 Monovalent Vaccines in Taiwan: A Self-Controlled Case Series Study

    OpenAIRE

    Wan-Ting Huang; Hsu-Wen Yang; Tzu-Lin Liao; Wan-Jen Wu; Shu-Er Yang; Yi-Chien Chih; Jen-Hsiang Chuang

    2013-01-01

    In Taiwan, new H1N1 monovalent vaccines without adjuvant and with MF59® adjuvant were used in the nationwide vaccination campaign beginning on November 1, 2009. From November 2009 through February 2010, the authors identified recipients of H1N1 vaccines who were diagnosed with adverse events of special interest (AESIs) in a large-linked safety database, and used the self-controlled case series (SCCS) method to examine the risk of each AESI in the 0-42 days after H1N1 vaccination. Of the 3.5 m...

  1. Los virus Influenza y la nueva pandemia A/H1N1

    Directory of Open Access Journals (Sweden)

    Miguel Talledo

    2011-07-01

    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 Neuraminidasa, 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.

  2. [How did the media report on the AH1N1 Influenza in Peru?].

    Science.gov (United States)

    Palpan-Guerra, Ada; Munayco, César V

    2015-01-01

    We analyzed the characteristics of news issued by communication media (CM) in Peru on H1N1 influenza in 2013, for which written, radio, television and internet CM were reviewed daily. The news were classified according to framing, estimation (educational, informative and with high perception of risk of contagion and death) and scope. A descriptive analysis of the main variables of the study was made. The framing of the news was focused on influenza cases (47.5%) and actions of the Ministry of Health and other institutions (29.0%). The highest percentage of news was informative (73.7%), and only 7.5% were news with high perception of risk of contagion and death; the latter was more frequent in newspapers (9.0%) and television (9.4%). During 2013, the CM, in general, was responsible at the time of reporting, although there were some that spread news that could have increased the perception of risk in the population. PMID:26338390

  3. A(H1N1)Influenza Pneumonia with Acute Disseminated Encephalomyelitis: A Case Report

    Institute of Scientific and Technical Information of China (English)

    JUN YANG; YU-GUANG WANG; YUN-LIANG XU; XIAN-LING REN; YU MAO; XING-WANG LI

    2010-01-01

    @@ INTRODUCTION A 56-year-old Chinese female patient with A (H1N1) influenza pneumonia accompanied by acute disseminated encephalomyelitis (ADEM) of the Central Nervous System (CNS) is described in this article. The patient had typical clinical manifestation,and the diagnosis was reached after MRI and other examinations. From this case, we can conclude that the virus ofA (H1N1) influenza can infect CNS, and we should pay more attention to patients of A (H1N1)influenza pneumonia with neurological complications.

  4. Origin and fate of A/H1N1 influenza in Scotland during 2009

    OpenAIRE

    Lycett, S.; McLeish, N.J.; Robertson, C.; Carman, W; Baillie, G.; McMenamin, J.; Rambaut, A; Simmonds, P.; Woolhouse, M.; Leigh Brown, A.J.

    2012-01-01

    The spread of influenza has usually been described by a ‘density’ model, where the largest centres of population drive the epidemic within a country. An alternative model emphasizing the role of air travel has recently been developed. We have examined the relative importance of the two in the context of the 2009 H1N1 influenza epidemic in Scotland. We obtained genome sequences of 70 strains representative of the geographical and temporal distribution of H1N1 influenza during the summer and wi...

  5. Los virus Influenza y la nueva pandemia A/H1N1

    OpenAIRE

    Miguel Talledo; Kattya Zumaeta

    2011-01-01

    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 Neuraminidasa, 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 ...

  6. Impact of School Cycles and Environmental Forcing on the Timing of Pandemic Influenza Activity in Mexican States, May-December 2009.

    Science.gov (United States)

    Tamerius, James; Viboud, Cécile; Shaman, Jeffrey; Chowell, Gerardo

    2015-08-01

    While a relationship between environmental forcing and influenza transmission has been established in inter-pandemic seasons, the drivers of pandemic influenza remain debated. In particular, school effects may predominate in pandemic seasons marked by an atypical concentration of cases among children. For the 2009 A/H1N1 pandemic, Mexico is a particularly interesting case study due to its broad geographic extent encompassing temperate and tropical regions, well-documented regional variation in the occurrence of pandemic outbreaks, and coincidence of several school breaks during the pandemic period. Here we fit a series of transmission models to daily laboratory-confirmed influenza data in 32 Mexican states using MCMC approaches, considering a meta-population framework or the absence of spatial coupling between states. We use these models to explore the effect of environmental, school-related and travel factors on the generation of spatially-heterogeneous pandemic waves. We find that the spatial structure of the pandemic is best understood by the interplay between regional differences in specific humidity (explaining the occurrence of pandemic activity towards the end of the school term in late May-June 2009 in more humid southeastern states), school vacations (preventing influenza transmission during July-August in all states), and regional differences in residual susceptibility (resulting in large outbreaks in early fall 2009 in central and northern Mexico that had yet to experience fully-developed outbreaks). Our results are in line with the concept that very high levels of specific humidity, as present during summer in southeastern Mexico, favor influenza transmission, and that school cycles are a strong determinant of pandemic wave timing. PMID:26291446

  7. Debate Regarding Oseltamivir Use for Seasonal and Pandemic Influenza

    Science.gov (United States)

    Kelly, Heath

    2016-01-01

    A debate about the market-leading influenza antiviral medication, oseltamivir, which initially focused on treatment for generally mild illness, has been expanded to question the wisdom of stockpiling for use in future influenza pandemics. Although randomized controlled trial evidence confirms that oseltamivir will reduce symptom duration by 17–25 hours among otherwise healthy adolescents and adults with community-managed disease, no randomized controlled trials have examined the effectiveness of oseltamivir against more serious outcomes. Observational studies, although criticized on methodologic grounds, suggest that oseltamivir given early can reduce the risk for death by half among persons hospitalized with confirmed infection caused by influenza A(H1N1)pdm09 and influenza A(H5N1) viruses. However, available randomized controlled trial data may not be able to capture the effect of oseltamivir use among hospitalized patients with severe disease. We assert that data on outpatients with relatively mild disease should not form the basis for policies on the management of more severe disease. PMID:27191818

  8. The Decision to Vaccinate or Not during the H1N1 Pandemic: Selecting the Lesser of Two Evils?

    OpenAIRE

    Andrea R Ashbaugh; Herbert, Christophe F.; Saimon, Elena; Azoulay, Nelson; Olivera-Figueroa, Lening; Brunet, Alain

    2013-01-01

    Background With the release of the H1N1 vaccine, there was much controversy surrounding its use despite strong encouragements to be vaccinated in the media. Though studies have examined factors influencing people's decision to be vaccinated, few have focused on how general beliefs about the world or where an individual gathers information might influence that decision. Methodology/Principal Findings A cross-sectional web-based survey (N = 817) was conducted during the H1N1 outbreak after the ...

  9. 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...

  10. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2014: the Influenza Complications Alert Network (FluCAN).

    Science.gov (United States)

    Blyth, Christopher C; Macartney, Kristine K; Hewagama, Saliya; Senenayake, Sanjaya; Friedman, N Deborah; Simpson, Graham; Upham, John; Kotsimbos, Tom; Kelly, Paul; Cheng, Allen C

    2016-07-28

    The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance programme operating in all states and territories in Australia. We summarise the epidemiology of children hospitalised with laboratory-confirmed influenza in 2014 and reports on the effectiveness of inactivated trivalent inactivated vaccine (TIV) in children. In this observational study, cases were defined as children admitted with acute respiratory illness (ARI) with influenza confirmed by PCR. Controls were hospitalised children with ARI testing negative for influenza. Vaccine effectiveness (VE) was estimated as 1 minus the odds ratio of vaccination in influenza positive cases compared with test-negative controls using conditional logistic regression models. From April until October 2014, 402 children were admitted with PCR-confirmed influenza. Of these, 28% were aged < 1 year, 16% were Indigenous, and 39% had underlying conditions predisposing to severe influenza. Influenza A was detected in 90% of cases of influenza; influenza A(H1N1)pdm09 was the most frequent subtype (109/141 of subtyped cases) followed by A(H3N2) (32/141). Only 15% of children with influenza received antiviral therapy. The adjusted VE of one or more doses of TIV for preventing hospitalised influenza was estimated at 55.5% (95% confidence intervals (CI): 11.6-77.6%). Effectiveness against influenza A(H1N1)pdm09 was high (91.6% , 95% CI: 36.0-98.9%) yet appeared poor against H3N2. In summary, the 2014 southern hemisphere TIV was moderately effective against severe influenza in children. Significant VE was observed against influenza A(H1N1)pdm09. PMID:27494798

  11. Status of pandemic influenza vaccination and factors affecting it in pregnant women in Kahramanmaras, an eastern Mediterranean city of Turkey.

    Directory of Open Access Journals (Sweden)

    Ali Ozer

    Full Text Available BACKGROUND: Pregnant women are a target group for receipt of influenza vaccine because there appears to be an elevated mortality and morbidity rate associated with influenza virus infection in pregnant women. The goal of this study is to determine the factors affecting the decisions of pregnant women in Turkey to be vaccinated or not for 2009 H1N1 influenza. METHODOLOGY: We enrolled 314 of 522 (60.2% pregnant women who attended to the antenatal clinics of the Medical Faculty of Kahramanmaras Sutcuimam University's Department of Gynecology and Obstetrics between December 23, 2009, and February 1, 2010. We developed a 48-question survey which was completed in a face-to-face interview at the clinic with each pregnant woman. PRINCIPAL FINDINGS: Of the 314 pregnant women, 27.4% were in the first trimester, 33.8% were in the second trimester, and 38.8% were in the third trimester. Twenty-eight pregnant women (8.9% got vaccinated. Of all the women interviewed, 68.5% stated that they were comfortable with their decisions about the vaccine, 7.3% stated they were not comfortable, and 24.2% stated that they were hesitant about their decisions. The probability of receiving the 2009 H1N1 vaccine was 3.46 times higher among working women than housewives, 1.85 times higher among women who have a child than those who do not, and 1.29 times higher among women with a high-school education or higher than those with only a secondary-school education and below. Correct knowledge about the minimal risks associated with receipt of influenza vaccine were associated with a significant increase in the probability of receiving the 2009 H1N1 vaccine. CONCLUSIONS/SIGNIFICANCE: The number of pregnant women in the study group who received the 2009 H1N1 vaccine was very low (8.9% and two-thirds of them stated that they were comfortable with their decisions concerning the vaccine. Our results may have implications for public health measures to increase the currently low

  12. Influenza epidemiology and vaccine effectiveness among patients with influenza-like illness, viral watch sentinel sites, South Africa, 2005-2009.

    Directory of Open Access Journals (Sweden)

    Genevie M Ntshoe

    Full Text Available BACKGROUND: There is limited data on the epidemiology of influenza and few published estimates of influenza vaccine effectiveness (VE from Africa. In April 2009, a new influenza virus strain infecting humans was identified and rapidly spread globally. We compared the characteristics of patients ill with influenza A(H1N1pdm09 virus to those ill with seasonal influenza and estimated influenza vaccine effectiveness during five influenza seasons (2005-2009 in South Africa. METHODS: Epidemiological data and throat and/or nasal swabs were collected from patients with influenza-like illness (ILI at sentinel sites. Samples were tested for seasonal influenza viruses using culture, haemagglutination inhibition tests and/or polymerase chain reaction (PCR and for influenza A(H1N1pdm09 by real-time PCR. For the vaccine effectiveness (VE analysis we considered patients testing positive for influenza A and/or B as cases and those testing negative for influenza as controls. Age-adjusted VE was calculated as 1-odds ratio for influenza in vaccinated and non-vaccinated individuals. RESULTS: From 2005 through 2009 we identified 3,717 influenza case-patients. The median age was significantly lower among patients infected with influenza A(H1N1pdm09 virus than those with seasonal influenza, 17 and 27 years respectively (p<0.001. The vaccine coverage during the influenza season ranged from 3.4% in 2009 to 5.1% in 2006 and was higher in the ≥50 years (range 6.9% in 2008 to 13.2% in 2006 than in the <50 years age group (range 2.2% in 2007 to 3.7% in 2006. The age-adjusted VE estimates for seasonal influenza were 48.6% (4.9%, 73.2%; -14.2% (-9.7%, 34.8%; 12.0% (-70.4%, 55.4%; 67.4% (12.4%, 90.3% and 29.6% (-21.5%, 60.1% from 2005 to 2009 respectively. For the A(H1N1pdm09 season, the efficacy of seasonal vaccine was -6.4% (-93.5%, 43.3%. CONCLUSION: Influenza vaccine demonstrated a significant protective effect in two of the five years evaluated. Low vaccine coverage may

  13. Why Pandemic Response is Unique

    DEFF Research Database (Denmark)

    Bækkeskov, Erik; Rubin, Olivier

    2014-01-01

    , the case studies of media coverage in the USA and Denmark demonstrate that the response was bureaucratized in the public health agencies (CDC and DMHA, respectively). Hence, while natural disaster responses appear to follow a political logic, the response to pandemics appears to be more strongly...... attention and coverage in two deviant cases, the USA and Denmark. Findings – Theories linking political survival to disaster responses find little empirical support in the substantial cross-country variations of vaccination responses during the 2009 H1N1 pandemic. Rather than following a political logic...... instituted in the hands of bureaucratic experts. Research limitations/implications – There is an added value of encompassing bureaucratic dynamics in political theories of disaster response; bureaucratized expertise proved to constitute a strong plausible explanation of the 2009 pandemic vaccination response...

  14. A new method of exercising pandemic preparedness through an interactive simulation and visualization.

    Science.gov (United States)

    Araz, Ozgur M; Jehn, Megan; Lant, Timothy; Fowler, John W

    2012-06-01

    As seen in the spring 2009 A/H1N1 influenza outbreak, influenza pandemics can have profound social, legal and economic effects. This experience has also made the importance of public health preparedness exercises more evident. Universities face unique challenges with respect to pandemic preparedness due to their dense student populations, location within the larger community and frequent student/faculty international travel. Depending on the social structure of the community, different mitigation strategies should be applied for decreasing the severity and transmissibility of the disease. To this end, Arizona State University has developed a simulation model and tabletop exercise that facilitates decision-maker interactions around emergency-response scenarios. This simulation gives policy makers the ability to see the real-time impact of their decisions. Therefore, tabletop exercises with computer simulations are developed to practice these decisions, which can possibly give opportunities for practicing better policy implementations. This paper introduces a new method of designing and performing table-top exercises for pandemic influenza via state-of-the-art technologies including system visualization and group decision making with a supporting simulation model. The presented exercise methodology can increase readiness for a pandemic through the support of computer and information technologies and the survey results that we include in this paper certainly support this result. The video scenarios and the computer simulation model make the exercise appear very compelling and real, which makes this presented method of exercising different than the other table-top exercises in the literature. Finally, designing a pandemic preparedness exercise with supporting technologies can help identifying the communication gaps between responsible authorities and advance the table-top exercising methodology. PMID:20960052

  15. The incidence of narcolepsy in Europe

    DEFF Research Database (Denmark)

    Wijnans, Leonoor; Lecomte, Coralie; de Vries, Corinne; Weibel, Daniel; Sammon, Cormac; Hviid, Anders; Svanström, Henrik; Mølgaard-Nielsen, Ditte; Heijbel, Harald; Dahlström, Lisen Arnheim; Hallgren, Jonas; Sparen, Par; Jennum, Poul; Mosseveld, Mees; Schuemie, Martijn; van der Maas, Nicoline; Partinen, Markku; Romio, Silvana; Trotta, Francesco; Santuccio, Carmela; Menna, Angelo; Plazzi, Giuseppe; Moghadam, Keivan Kaveh; Ferro, Salvatore; Lammers, Gert Jan; Overeem, Sebastiaan; Johansen, Kari; Kramarz, Piotr; Bonhoeffer, Jan; Sturkenboom, Miriam C J M

    2013-01-01

    In August 2010 reports of a possible association between exposure to AS03 adjuvanted pandemic A(H1N1)pdm09 vaccine and occurrence of narcolepsy in children and adolescents emerged in Sweden and Finland. In response to this signal, the background rates of narcolepsy in Europe were assessed to...

  16. Alternative Live-Attenuated Influenza Vaccines Based on Modifications in the Polymerase Genes Protect against Epidemic and Pandemic Flu▿

    OpenAIRE

    Solórzano, Alicia; Ye, Jianqiang; Pérez, Daniel R.

    2010-01-01

    Human influenza is a seasonal disease associated with significant morbidity and mortality. Influenza vaccination is the most effective means for disease prevention. We have previously shown that mutations in the PB1 and PB2 genes of the live-attenuated influenza vaccine (LAIV) from the cold-adapted (ca) influenza virus A/Ann Arbor/6/60 (H2N2) could be transferred to avian influenza viruses and produce partially attenuated viruses. We also demonstrated that avian influenza viruses carrying the...

  17. Glycosylation on Hemagglutinin Affects the Virulence and Pathogenicity of Pandemic H1N1/2009 Influenza A Virus in Mice

    OpenAIRE

    Yan ZHANG; Zhu, Jiping; Li, Yongtao; Bradley, Konrad C.; Cao, Jiyue; Chen, Huanchun; Jin, Meilin; Zhou, Hongbo

    2013-01-01

    The two glycosylation sites (Asn142 and Asn177) were observed in the HA of most human seasonal influenza A/H1N1 viruses, while none in pandemic H1N1/2009 influenza A (pH1N1) viruses. We investigated the effect of the two glycosylation sites on viral virulence and pathogenicity in mice using recombinant pH1N1. The H1N1/144 and H1N1/177 mutants which gained potential glycosylation sites Asn142 and Asn177 on HA respectively were generated from A/Mexico/4486/2009(H1N1) by site-directed mutagenesi...

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

    DEFF Research Database (Denmark)

    Fordyce, Sarah L; Bragstad, Karoline; Pedersen, Svend Stenvang; Jensen, Thøger Gorm; Gahrn-Hansen, Bente; Daniels, Rod; Hay, Alan; Kampmann, Marie-Louise; Bruhn, Christian Aw; Moreno-Mayar, J Victor; Avila Arcos, Maria del Carmen; Gilbert, M Thomas P; Nielsen, Lars P

    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...

  19. Correlates of 2009 Pandemic H1N1 Influenza Vaccine Acceptance among Middle and High School Teachers in Rural Georgia

    Science.gov (United States)

    Gargano, Lisa M.; Painter, Julia E.; Sales, Jessica M.; Morfaw, Christopher; Jones, LaDawna M.; Weiss, Paul; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.

    2011-01-01

    Background: Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study…

  20. Costs of School-Located Influenza Vaccination Clinics in Maine during the 2009-2010 H1N1 Pandemic

    Science.gov (United States)

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

    2012-01-01

    This study retrospectively estimated costs for a convenience sample of school-located vaccination (SLV) clinics conducted in Maine during the 2009-2010 influenza season. Surveys were developed to capture the cost of labor including unpaid volunteers as well as supplies and materials used in SLV clinics. Six nurses from different school districts…

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

    Directory of Open Access Journals (Sweden)

    Chowell Gerardo

    2012-10-01

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

  2. ПРОТИВОВИРУСНАЯ АКТИВНОСТЬ ПРОИЗВОДНЫХ АДАМАНТА-НА В ОТНОШЕНИИ ВИРУСА ГРИППА A(H1N1)PDM09 НА МОДЕЛИ IN VIVO

    OpenAIRE

    Щелканов, Михаил; Шибнев, Владимир; Финогенова, Марина; Федякина, Ирина; Гараев, Тимур; Маркова, Наталья; Кириллов, Илья

    2014-01-01

    Впервые in vivo на модели вирусной пневмонии мышей исследована противовирусная активность в отношении вируса гриппа A(H1N1)pdm09 синтетических производных адамантанового ряда, включающих остатки аминокислот и липоевую кислоту. Установлено, что производные адамантана с остатками гистидина, серина и липоевой кислоты способны ингибировать резистентный к ремантадину штамм вируса гриппа A(H1N1)pdm09. В результате продолжительность жизни мышей, зараженных вирусом, увеличилась в 1,6 раза относительн...

  3. Effectiveness of Trivalent Inactivated Influenza Vaccine in Children Estimated by a Test-Negative Case-Control Design Study Based on Influenza Rapid Diagnostic Test Results

    Science.gov (United States)

    Yamaguchi, Yoshio; Tomidokoro, Yuka; Sekiguchi, Shinichiro; Mitamura, Keiko; Fujino, Motoko; Shiro, Hiroyuki; Komiyama, Osamu; Taguchi, Nobuhiko; Nakata, Yuji; Yoshida, Naoko; Narabayashi, Atsushi; Myokai, Michiko; Sato, Masanori; Furuichi, Munehiro; Baba, Hiroaki; Fujita, Hisayo; Sato, Akihiro; Ookawara, Ichiro; Tsunematsu, Kenichiro; Yoshida, Makoto; Kono, Mio; Tanaka, Fumie; Kawakami, Chiharu; Kimiya, Takahisa; Takahashi, Takao; Iwata, Satoshi

    2015-01-01

    We assessed vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in children 6 months to 15 years of age in 22 hospitals in Japan during the 2013–14 season. Our study was conducted according to a test-negative case-control design based on influenza rapid diagnostic test (IRDT) results. Outpatients who came to our clinics with a fever of 38°C or over and had undergone an IRDT were enrolled in this study. Patients with positive IRDT results were recorded as cases, and patients with negative results were recorded as controls. Between November 2013 and March 2014, a total of 4727 pediatric patients (6 months to 15 years of age) were enrolled: 876 were positive for influenza A, 66 for A(H1N1)pdm09 and in the other 810 the subtype was unknown; 1405 were positive for influenza B; and 2445 were negative for influenza. Overall VE was 46% (95% confidence interval [CI], 39–52). Adjusted VE against influenza A, influenza A(H1N1)pdm09, and influenza B was 63% (95% CI, 56–69), 77% (95% CI, 59–87), and 26% (95% CI, 14–36), respectively. Influenza vaccine was not effective against either influenza A or influenza B in infants 6 to 11 months of age. Two doses of influenza vaccine provided better protection against influenza A infection than a single dose did. VE against hospitalization influenza A infection was 76%. Influenza vaccine was effective against influenza A, especially against influenza A(H1N1)pdm09, but was much less effective against influenza B. PMID:26317334

  4. The Evaluations of Swine Flu Magnitudes in TV News: A Comparative Analysis of Paired Influenza Pandemics.

    Science.gov (United States)

    Pan, Po-Lin; Meng, Juan

    2015-01-01

    This study examined how major TV news networks covered two flu pandemics in 1976 and 2009 in terms of news frames, mortality exemplars, mortality subject attributes, vaccination, evaluation approaches, and news sources. Results showed that the first pandemic was frequently framed with the medical/scientific and political/legal issues, while the second pandemic was emphasized with the health risk issue in TV news. Both flu pandemics were regularly reported with mortality exemplars, but the focus in the first pandemic was on the flu virus threat and vaccination side effects, while the vaccination shortage was frequently revealed in the second outbreak. PMID:26075542

  5. Immunogenicity and tolerability of inactivated flu vaccine In high risk and healthy children Inmunogenicidad y tolerancia de la vacuna inactivada anti-influenza en niños en alto riesgo y en controles sanos

    OpenAIRE

    Maria Luisa Avila Aguero; Alejandra Soriano-Fallas; María De Los Angeles Umaña-Sauma; Rolando Ulloa-Gutiérrez; Sabine Arnoux

    2007-01-01

    We conducted this open study to evaluate the immunogenicity and safety of the inactivated influenza vaccine, Imovax Gripe® in 154 children between 6 and 36 months of age at high risk of influenza- related complications, and in a reference group of 64 healthy children. The study was conducted over two flu seasons, in which the vaccine contained the same A strains but different B strains. The results for the A/H3N2 and A/H1N1 strains from the two flu seasons were pooled, but those for the B str...

  6. 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

  7. Hemagglutinin 222D/G polymorphism facilitates fast intra-host evolution of pandemic (H1N1 2009 influenza A viruses.

    Directory of Open Access Journals (Sweden)

    Nora Seidel

    Full Text Available The amino acid substitution of aspartic acid to glycine in hemagglutinin (HA in position 222 (HA-D222G as well as HA-222D/G polymorphism of pandemic (H1N1 2009 influenza viruses (A(H1N1pdm09 were frequently reported in severe influenza in humans and mice. Their impact on viral pathogenicity and the course of influenza has been discussed controversially and the underlying mechanism remained unclarified. In the present study, BALB/c mice, infected with the once mouse lung- and cell-passaged A(H1N1pdm09 isolate A/Jena/5258/09 (mpJena/5258, developed severe pneumonia. From day 2 to 3 or 4 post infection (p.i. symptoms (body weight loss and clinical score continuously worsened. After a short disease stagnation or even recovery phase in most mice, severity of disease further increased on days 6 and 7 p.i. Thereafter, surviving mice recovered. A 45 times higher virus titer maximum in the lung than in the trachea on day 2 p.i. and significantly higher tracheal virus titers compared to lung on day 6 p.i. indicated changes in the organ tropism during infection. Sequence analysis revealed an HA-222D/G polymorphism. HA-D222 and HA-G222 variants co-circulated in lung and trachea. Whereas, HA-D222 variant predominated in the lung, HA-G222 became the major variant in the trachea after day 4 p.i. This was accompanied by lower neutralizing antibody titers and broader receptor recognition including terminal sialic acid α-2,3-linked galactose, which is abundant on mouse trachea epithelial cells. Plaque-purified HA-G222-mpJena/5258 virus induced severe influenza with maximum symptom on day 6 p.i. These results demonstrated for the first time that HA-222D/G quasispecies of A(H1N1pdm09 caused severe biphasic influenza because of fast viral intra-host evolution, which enabled partial antibody escape and minor changes in receptor binding.

  8. Planning for the Pandemic

    Directory of Open Access Journals (Sweden)

    Joanne Embree

    2006-01-01

    Full Text Available Over the past year, many of us have become involved in the development of strategic plans for the hospitals, health authorities and clinical practices in which we work in case an influenza pandemic occurs in the very near future. Planning for this on the front lines is difficult, due in large part to the uncertainties involved. How will the pandemic evolve? Is the current H5N1 strain of bird flu going to be 'the' one? How closely will the pandemic resemble that of 1918? Will it have the same transmission characteristics as the yearly endemic influenza strains or will it be so different that our routine infection prevention precautions for influenza will be ineffective? Will there be a useful vaccine that is widely available and safe? That the current death rate associated with H5N1 strain infections in humans is approximately 60% is quite frightening; an influenza pandemic with such a high death rate is almost incomprehensible. Therefore, it is a relief to hear that the upper estimates are at a much lower rate of approximately 5% in most suggested epidemiological models. Will the use of oseltamivir really work to prevent infection, illness, morbidity or death? If so, will there be sufficient supplies available in Canada? How are we supposed to make plans so that our medical system, which is already quite stressed, will be functional under the extreme conditions that are anticipated? One major difficulty is that we do not actually know how soon, if at all, the pandemic will occur. Specific, highly detailed plans made today may not be applicable in the future. As a result, most contingency plans are being made for a generic situation based on the general assumption that some percentage of the workforce will be absent from work for some specified period of time. In general, the plans tend to be impersonal because they concentrate on essential functions that need to be undertaken in an institution and assume that, with training, all personnel can

  9. Pooled influenza vaccine effectiveness estimates for Australia, 2012-2014.

    Science.gov (United States)

    Sullivan, S G; Carville, K S; Chilver, M; Fielding, J E; Grant, K A; Kelly, H; Levy, A; Stocks, N P; Tempone, S S; Regan, A K

    2016-08-01

    Data were pooled from three Australian sentinel general practice influenza surveillance networks to estimate Australia-wide influenza vaccine coverage and effectiveness against community presentations for laboratory-confirmed influenza for the 2012, 2013 and 2014 seasons. Patients presenting with influenza-like illness at participating GP practices were swabbed and tested for influenza. The vaccination odds of patients testing positive were compared with patients testing negative to estimate influenza vaccine effectiveness (VE) by logistic regression, adjusting for age group, week of presentation and network. Pooling of data across Australia increased the sample size for estimation from a minimum of 684 to 3,683 in 2012, from 314 to 2,042 in 2013 and from 497 to 3,074 in 2014. Overall VE was 38% [95% confidence interval (CI) 24-49] in 2012, 60% (95% CI 45-70) in 2013 and 44% (95% CI 31-55) in 2014. For A(H1N1)pdm09 VE was 54% (95% CI-28 to 83) in 2012, 59% (95% CI 33-74) in 2013 and 55% (95% CI 39-67) in 2014. For A(H3N2), VE was 30% (95% CI 14-44) in 2012, 67% (95% CI 39-82) in 2013 and 26% (95% CI 1-45) in 2014. For influenza B, VE was stable across years at 56% (95% CI 37-70) in 2012, 57% (95% CI 30-73) in 2013 and 54% (95% CI 21-73) in 2014. Overall VE against influenza was low in 2012 and 2014 when A(H3N2) was the dominant strain and the vaccine was poorly matched. In contrast, overall VE was higher in 2013 when A(H1N1)pdm09 dominated and the vaccine was a better match. Pooling data can increase the sample available and enable more precise subtype- and age group-specific estimates, but limitations remain. PMID:27125368

  10. Deaths from Bacterial Pneumonia during 1918–19 Influenza Pandemic

    OpenAIRE

    Brundage, John F.; Shanks, G. Dennis

    2008-01-01

    Deaths during the 1918–19 influenza pandemic have been attributed to a hypervirulent influenza strain. Hence, preparations for the next pandemic focus almost exclusively on vaccine prevention and antiviral treatment for infections with a novel influenza strain. However, we hypothesize that infections with the pandemic strain generally caused self-limited (rarely fatal) illnesses that enabled colonizing strains of bacteria to produce highly lethal pneumonias. This sequential-infection hypothes...

  11. 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-γ, the chemotactic factors MIP-1β, 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.

  12. National Pandemic Influenza Plan

    OpenAIRE

    Department of Health

    2007-01-01

    National Pandemic Influenza Plan The purpose of this document is to tell you about pandemic influenza (flu), to explain what the Government and the health services are doing to prepare for a possible pandemic and most importantly, to advise you what you need to do if there is a pandemic. Click here to download PDF 614kb

  13. Serologic Status for Pandemic (H1N1) 2009 Virus, Taiwan

    OpenAIRE

    Huang, Daniel Tsung-Ning; Shao, Pei-Lan; Huang, Kuo-Chin; Lu, Chun-Yi; Wang, Jen-Ren; Shih, Shin-Ru; Chi, Hsin; Lai, Mei-Ru; Lee, Chin-Yun; Chang, Luan-Yin; Huang, Li-Min

    2011-01-01

    We studied preexisting immunity to pandemic (H1N1) 2009 virus in persons in Taiwan. A total of 18 (36%) of 50 elderly adults in Taiwan born before 1935 had protective antibodies against currently circulating pandemic (H1N1) 2009 virus. Seasonal influenza vaccines induced antibodies that did not protect against pandemic (H1N1) 2009 virus.

  14. WEEKLY WATCH

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    SOCIETY A/H1N1 Vaccine Recipients The first batch of people to receive A/H1N1 flu vaccinations in Beijing had no ab- normal reactions, a local health official said on September 22. The nation’s capital took the lead to start an A/H1N1 flu vaccination program

  15. Does the effectiveness of control measures depend on the influenza pandemic profile?

    Directory of Open Access Journals (Sweden)

    Solen Kernéis

    Full Text Available BACKGROUND: Although strategies to contain influenza pandemics are well studied, the characterization and the implications of different geographical and temporal diffusion patterns of the pandemic have been given less attention. METHODOLOGY/MAIN FINDINGS: Using a well-documented metapopulation model incorporating air travel between 52 major world cities, we identified potential influenza pandemic diffusion profiles and examined how the impact of interventions might be affected by this heterogeneity. Clustering methods applied to a set of pandemic simulations, characterized by seven parameters related to the conditions of emergence that were varied following Latin hypercube sampling, were used to identify six pandemic profiles exhibiting different characteristics notably in terms of global burden (from 415 to >160 million of cases and duration (from 26 to 360 days. A multivariate sensitivity analysis showed that the transmission rate and proportion of susceptibles have a strong impact on the pandemic diffusion. The correlation between interventions and pandemic outcomes were analyzed for two specific profiles: a fast, massive pandemic and a slow building, long-lasting one. In both cases, the date of introduction for five control measures (masks, isolation, prophylactic or therapeutic use of antivirals, vaccination correlated strongly with pandemic outcomes. Conversely, the coverage and efficacy of these interventions only moderately correlated with pandemic outcomes in the case of a massive pandemic. Pre-pandemic vaccination influenced pandemic outcomes in both profiles, while travel restriction was the only measure without any measurable effect in either. CONCLUSIONS: our study highlights: (i the great heterogeneity in possible profiles of a future influenza pandemic; (ii the value of being well prepared in every country since a pandemic may have heavy consequences wherever and whenever it starts; (iii the need to quickly implement control

  16. Antiviral Strategies for Pandemic and Seasonal Influenza

    OpenAIRE

    Fang Fang; Maria Hedlund; Larson, Jeffrey L.

    2010-01-01

    While vaccines are the primary public health response to seasonal and pandemic flu, short of a universal vaccine there are inherent limitations to this approach. Antiviral drugs provide valuable alternative options for treatment and prophylaxis of influenza. Here, we will review drugs and drug candidates against influenza with an emphasis on the recent progress of a host-targeting entry-blocker drug candidate, DAS181, a sialidase fusion protein.

  17. Pandemic H1N1 influenza infections in 2009

    Directory of Open Access Journals (Sweden)

    Mustafa Hacımustafaoğlu

    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

  18. Immunogenicity and tolerability of inactivated flu vaccine in high risk and healthy children.

    Science.gov (United States)

    Avila Aguero, María Luisa; Soriano-Fallas, Alejandra; Umaña-Sauma, María de los Angeles; Ulloa-Gutierrez, Rolando; Arnoux, Sabine

    2007-01-01

    We conducted this open study to evaluate the immunogenicity and safety of the inactivated influenza vaccine, Imovax Gripe in 154 children between 6 and 36 months of age at high risk of influenza-related complications, and in a reference group of 64 healthy children. The study was conducted over two flu seasons, in which the vaccine contained the same A strains but different B strains. The results for the A/H3N2 and A/H1N1 strains from the two flu seasons were pooled, but those for the B strains were not. Anti-hemagglutinin (HA) antibody titers were determined before, and one month after each vaccination, and safety was evaluated based on diary card reporting any adverse event observed, either included or not in the list of "solicited events". Within each group of vaccines, the seroconversion rates, seroprotection rates, and ratio of post- to prevaccination geometric mean titers (GMTR) for the A/H3N2 and the A/H1N1 strains fulfilled all requirements of the criteria of the European Union Committee for Proprietary Medicinal Products (CPMP). The immune responses in high-risk and in healthy children were similar, and consistent with those observed in previous studies conducted in healthy children. The vaccine was equally well tolerated by all study groups. Reactogenicity was low and similar in both high-risk and healthy children. Overall from 9.5% to 15.4% of at-risk children and 12% of healthy children reported a solicited local reaction; 23.0 to 28.8% of high-risk and 25.3% of healthy children reported a solicited systemic reaction. The study results provide support for vaccination of children at high-risk of influenza related complications. PMID:17891930

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

    Directory of Open Access Journals (Sweden)

    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

  20. Learning to Trust Flu Shots: Quasi-Experimental Evidence from the 2009 Swine Flu Pandemic.

    Science.gov (United States)

    Maurer, Jürgen; Harris, Katherine M

    2016-09-01

    This paper studies consumer learning in influenza vaccination decisions. We examine consumer learning in influenza vaccine demand within a reduced form instrumental variable framework that exploits differences in risk characteristics of different influenza viruses as a natural experiment to distinguish the effects of learning based on previous influenza vaccination experiences from unobserved heterogeneity. The emergence of a new virus strain (influenza A H1N1/09) during the 2009 'Swine flu' pandemic resulted in two different vaccines being recommended for distinct population subgroups with some people, who were not usually targeted by seasonal vaccination programs, being specifically recommended for the new Swine flu vaccine. We use these differences in vaccination targeting to construct instrumental variables for estimating the effect of past influenza vaccination experiences on the demand for pandemic vaccine. We find large causal effects of previous seasonal vaccination on pandemic vaccination. Causal effects of past influenza vaccination experiences on perceived vaccination safety are likely to be an important pathway linking past vaccination experiences with future vaccine uptake. Our results suggest a significant role of learning in vaccination decisions. Current efforts to expand seasonal vaccination may thus have potentially important long-term effects on future influenza vaccination levels and pandemic preparedness. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27381724

  1. Comparison of serum hemagglutinin and neuraminidase inhibition antibodies after 2010-2011 trivalent inactivated influenza vaccination in healthcare personnel.

    Science.gov (United States)

    Laguio-Vila, Maryrose R; Thompson, Mark G; Reynolds, Sue; Spencer, Sarah M; Gaglani, Manjusha; Naleway, Allison; Ball, Sarah; Bozeman, Sam; Baker, Steven; Martínez-Sobrido, Luis; Levine, Min; Katz, Jackie; Fry, Alicia M; Treanor, John J

    2015-01-01

    Background.  Most inactivated influenza vaccines contain purified and standardized hemagglutinin (HA) and residual neuraminidase (NA) antigens. Vaccine-associated HA antibody responses (hemagglutination inhibition [HAI]) are well described, but less is known about the immune response to the NA. Methods.  Serum of 1349 healthcare personnel (HCP) electing or declining the 2010-2011 trivalent-inactivated influenza vaccine ([IIV3], containing A/California/7/2009 p(H1N1), A/Perth/16/2009 [H3N2], B/Brisbane/60/2008 strains) were tested for NA-inhibiting (NAI) antibody by a modified lectin-based assay using pseudotyped N1 and N2 influenza A viruses with an irrelevant (H5) HA. Neuraminidase-inhibiting and HAI antibody titers were evaluated approximately 30 days after vaccination and end-of-season for those with polymerase chain reaction (PCR)-confirmed influenza infection. Results.  In 916 HCP (68%) receiving IIV3, a 2-fold increase in N1 and N2 NAI antibody occurred in 63.7% and 47.3%, respectively. Smaller responses occurred in HCP age >50 years and those without prior 2009-2010 IIV3 nor monovalent A(H1N1)pdm09 influenza vaccinations. Forty-four PCR-confirmed influenza infections were observed, primarily affecting those with lower pre-exposure HAI and NAI antibodies. Higher pre-NAI titers correlated with shorter duration of illness for A(H1N1)pdm09 virus infections. Conclusions.  Trivalent-inactivated influenza vaccine is modestly immunogenic for N1 and N2 antigens in HCP. Vaccines eliciting robust NA immune responses may improve efficacy and reduce influenza-associated morbidity. PMID:25884004

  2. Intra- and inter-pandemic variations of antiviral, antibiotics and decongestants in wastewater treatment plants and receiving rivers.

    Directory of Open Access Journals (Sweden)

    Andrew C Singer

    Full Text Available The concentration of eleven antibiotics (trimethoprim, oxytetracycline, ciprofloxacin, azithromycin, cefotaxime, doxycycline, sulfamethoxazole, erythromycin, clarithromycin, ofloxacin, norfloxacin, three decongestants (naphazoline, oxymetazoline, xylometazoline and the antiviral drug oseltamivir's active metabolite, oseltamivir carboxylate (OC, were measured weekly at 21 locations within the River Thames catchment in England during the month of November 2009, the autumnal peak of the influenza A[H1N1]pdm09 pandemic. The aim was to quantify the pharmaceutical response to the pandemic and compare this to drug use during the late pandemic (March 2010 and the inter-pandemic periods (May 2011. A large and small wastewater treatment plant (WWTP were sampled in November 2009 to understand the differential fate of the analytes in the two WWTPs prior to their entry in the receiving river and to estimate drug users using a wastewater epidemiology approach. Mean hourly OC concentrations in the small and large WWTP's influent were 208 and 350 ng/L (max, 2070 and 550 ng/L, respectively. Erythromycin was the most concentrated antibiotic measured in Benson and Oxford WWTPs influent (max=6,870 and 2,930 ng/L, respectively. Napthazoline and oxymetazoline were the most frequently detected and concentrated decongestant in the Benson WWTP influent (1650 and 67 ng/L and effluent (696 and 307 ng/L, respectively, but were below detection in the Oxford WWTP. OC was found in 73% of November 2009's weekly river samples (max=193 ng/L, but only in 5% and 0% of the late- and inter-pandemic river samples, respectively. The mean river concentration of each antibiotic during the pandemic largely fell between 17-74 ng/L, with clarithromycin (max=292 ng/L and erythromycin (max=448 ng/L yielding the highest single measure. In general, the concentration and frequency of detecting antibiotics in the river increased during the pandemic. OC was uniquely well-suited for the wastewater

  3. Vaccinations

    Science.gov (United States)

    ... vaccinated? For many years, a set of annual vaccinations was considered normal and necessary for dogs and ... to protect for a full year. Consequently, one vaccination schedule will not work well for all pets. ...

  4. Reassessing Google Flu Trends data for detection of seasonal and pandemic influenza: a comparative epidemiological study at three geographic scales.

    Directory of Open Access Journals (Sweden)

    Donald R Olson

    Full Text Available The goal of influenza-like illness (ILI surveillance is to determine the timing, location and magnitude of outbreaks by monitoring the frequency and progression of clinical case incidence. Advances in computational and information technology have allowed for automated collection of higher volumes of electronic data and more timely analyses than previously possible. Novel surveillance systems, including those based on internet search query data like Google Flu Trends (GFT, are being used as surrogates for clinically-based reporting of influenza-like-illness (ILI. We investigated the reliability of GFT during the last decade (2003 to 2013, and compared weekly public health surveillance with search query data to characterize the timing and intensity of seasonal and pandemic influenza at the national (United States, regional (Mid-Atlantic and local (New York City levels. We identified substantial flaws in the original and updated GFT models at all three geographic scales, including completely missing the first wave of the 2009 influenza A/H1N1 pandemic, and greatly overestimating the intensity of the A/H3N2 epidemic during the 2012/2013 season. These results were obtained for both the original (2008 and the updated (2009 GFT algorithms. The performance of both models was problematic, perhaps because of changes in internet search behavior and differences in the seasonality, geographical heterogeneity and age-distribution of the epidemics between the periods of GFT model-fitting and prospective use. We conclude that GFT data may not provide reliable surveillance for seasonal or pandemic influenza and should be interpreted with caution until the algorithm can be improved and evaluated. Current internet search query data are no substitute for timely local clinical and laboratory surveillance, or national surveillance based on local data collection. New generation surveillance systems such as GFT should incorporate the use of near-real time electronic

  5. Reassessing Google Flu Trends data for detection of seasonal and pandemic influenza: a comparative epidemiological study at three geographic scales.

    Science.gov (United States)

    Olson, Donald R; Konty, Kevin J; Paladini, Marc; Viboud, Cecile; Simonsen, Lone

    2013-01-01

    The goal of influenza-like illness (ILI) surveillance is to determine the timing, location and magnitude of outbreaks by monitoring the frequency and progression of clinical case incidence. Advances in computational and information technology have allowed for automated collection of higher volumes of electronic data and more timely analyses than previously possible. Novel surveillance systems, including those based on internet search query data like Google Flu Trends (GFT), are being used as surrogates for clinically-based reporting of influenza-like-illness (ILI). We investigated the reliability of GFT during the last decade (2003 to 2013), and compared weekly public health surveillance with search query data to characterize the timing and intensity of seasonal and pandemic influenza at the national (United States), regional (Mid-Atlantic) and local (New York City) levels. We identified substantial flaws in the original and updated GFT models at all three geographic scales, including completely missing the first wave of the 2009 influenza A/H1N1 pandemic, and greatly overestimating the intensity of the A/H3N2 epidemic during the 2012/2013 season. These results were obtained for both the original (2008) and the updated (2009) GFT algorithms. The performance of both models was problematic, perhaps because of changes in internet search behavior and differences in the seasonality, geographical heterogeneity and age-distribution of the epidemics between the periods of GFT model-fitting and prospective use. We conclude that GFT data may not provide reliable surveillance for seasonal or pandemic influenza and should be interpreted with caution until the algorithm can be improved and evaluated. Current internet search query data are no substitute for timely local clinical and laboratory surveillance, or national surveillance based on local data collection. New generation surveillance systems such as GFT should incorporate the use of near-real time electronic health data

  6. Reassessing Google Flu Trends Data for Detection of Seasonal and Pandemic Influenza: A Comparative Epidemiological Study at Three Geographic Scales

    Science.gov (United States)

    Olson, Donald R.; Konty, Kevin J.; Paladini, Marc; Viboud, Cecile; Simonsen, Lone

    2013-01-01

    The goal of influenza-like illness (ILI) surveillance is to determine the timing, location and magnitude of outbreaks by monitoring the frequency and progression of clinical case incidence. Advances in computational and information technology have allowed for automated collection of higher volumes of electronic data and more timely analyses than previously possible. Novel surveillance systems, including those based on internet search query data like Google Flu Trends (GFT), are being used as surrogates for clinically-based reporting of influenza-like-illness (ILI). We investigated the reliability of GFT during the last decade (2003 to 2013), and compared weekly public health surveillance with search query data to characterize the timing and intensity of seasonal and pandemic influenza at the national (United States), regional (Mid-Atlantic) and local (New York City) levels. We identified substantial flaws in the original and updated GFT models at all three geographic scales, including completely missing the first wave of the 2009 influenza A/H1N1 pandemic, and greatly overestimating the intensity of the A/H3N2 epidemic during the 2012/2013 season. These results were obtained for both the original (2008) and the updated (2009) GFT algorithms. The performance of both models was problematic, perhaps because of changes in internet search behavior and differences in the seasonality, geographical heterogeneity and age-distribution of the epidemics between the periods of GFT model-fitting and prospective use. We conclude that GFT data may not provide reliable surveillance for seasonal or pandemic influenza and should be interpreted with caution until the algorithm can be improved and evaluated. Current internet search query data are no substitute for timely local clinical and laboratory surveillance, or national surveillance based on local data collection. New generation surveillance systems such as GFT should incorporate the use of near-real time electronic health data

  7. 甲型H1N1流行性感冒疫苗接种人群的血清抗体分析%Analysis of serum antibody level in population vaccinated with H1N1 pandemic influenza vaccine

    Institute of Scientific and Technical Information of China (English)

    陈艺韵; 鲁恩洁; 李铁钢; 蒋力云; 狄飚; 吴新伟

    2012-01-01

    目的:了解接种甲型H1N1流行性感冒(流感)疫苗后,人群中血清抗体的变化情况,为甲型H1N1流感疫苗的接种提供依据.方法:随机采集不同年龄已接种甲型H1N1流感疫苗人群的血清,采用血凝抑制实验检测血清中甲型H1N1流感抗体的血凝抑制滴度(HI滴度),HI滴度≥1:40判定为阳性,同时调查采样对象的甲型H1N1流感疫苗与季节性流感疫苗的接种史.结果:甲型H1N1流感抗体阳性率为57.4%(402份/700份),抗体几何平均滴度(GMT)为1:35.6;甲型H1N1流感抗体阳性率与GMT较高的是10~30岁组人群,较低的是60岁以上的人群;接种甲型H1N1流感疫苗后30~90天,GMT水平达到高峰(1:56);随着季节性流感疫苗接种次数的增多,人群血清中甲型H1N1流感抗体的阳性率与GMT值反而降低.结论:青少年与成人接种甲型H1N1流感疫苗的免疫效果比儿童和老年人的好;甲型H1N1流感疫苗对人群的保护作用能持续90天左右;甲型H1N1流感抗体在0~10岁组,10~30岁组人群中持续的时间比30~60岁,>60岁组人群长;多次接种季节性流感疫苗可能会影响甲型H1N1流感抗体的产生.建议对儿童和老年人开展双倍剂量甲型H1N1流感疫苗接种;甲型H1N1流感疫苗的接种时间最好在流行期前1~3月内,并且应每年接种一次.%Objective:To investigate the change of antibody level in people who were vaccinated with H1N1 pandemic influenza vaccine, and to provide advices for the vaccination project. Methods:The serum specimens were collected randomly from people who were vaccinated with H1N1 pandemic influenza vaccine and antibody levels were examined by Hemagglutination inhibition (HI) test. Samples with HI titer≥40 was considered as positive. The information of the vaccination history of H1N1 pandemic influenza and seasonal influenza vaccine was collected. Results:700 serum specimens were collected, 402(57. 4% ) of those were positive, the geometric mean titer(GMT) was 1

  8. Mitigation approaches to combat the flu pandemic

    Directory of Open Access Journals (Sweden)

    Raman Chawla

    2009-01-01

    The National Disaster Management Authority (NDMA, Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies, nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its effective implementation at national, state and local levels.

  9. Mielitis transversa relacionada con vacunación anti-influenza A(H1N1

    Directory of Open Access Journals (Sweden)

    María Florencia Arcondo

    2011-04-01

    Full Text Available La mielitis transversa es una enfermedad inflamatoria que se caracteriza por disfunción de la médula espinal. Las causas reconocidas de mielitis transversa son autoinmunes, enfermedades desmielinizantes, post infecciosas y post vacunales, aunque hasta el 50% de los casos son idiopáticas. Las vacunas contra la rubéola, paperas, rabia y gripe estacional han sido asociadas a diversos trastornos neurológicos, como el Síndrome de Guillain Barré, la encefalomielitis diseminada aguda (ADEM y la mielitis transversa. Como mecanismo preventivo luego de la pandemia de 2009, en febrero del año 2010 se inició en nuestro país la campaña de vacunación contra la Influenza A (H1N1. Se presenta el caso de una paciente con hipoestesias que aparecieron cuatro días después de haber recibido la vacuna monovalente anti-influenza A (H1N1 y progresaron con evidente nivel sensitivo. La paciente cumplía criterios diagnósticos de mielitis transversa, según el Transverse Myelitis Consortium Working Group. Tuvo remisión de las imágenes de la resonancia magnética y estabilidad clínica sin tratamiento con corticoides. Se discuten aspectos diagnósticos, pronósticos y terapéuticos de esta entidad clínica.

  10. Dependence of the results of ecological-epidemic investigation of influenza A(H1N1) on immunity

    Science.gov (United States)

    Fathudinova, Mohinav; Alimova, Barno; Rahimova, Halima

    2016-07-01

    This report presents the results of ecology-epidemical and immunological researches influ-enza virus A (H1 N1) and acute respiratory infection in Dushanbe from 2011 till 2015. The received results epidemiological and immunological analysis showed us, that last years has been changed not only characteristics of influenza epidemic, but it can not be notice the low-er of intensively of the collective immunity to actual versions influenza viruses A and B

  11. Mielitis transversa relacionada con vacunación anti-influenza A(H1N1)

    OpenAIRE

    2011-01-01

    La mielitis transversa es una enfermedad inflamatoria que se caracteriza por disfunción de la médula espinal. Las causas reconocidas de mielitis transversa son autoinmunes, enfermedades desmielinizantes, post infecciosas y post vacunales, aunque hasta el 50% de los casos son idiopáticas. Las vacunas contra la rubéola, paperas, rabia y gripe estacional han sido asociadas a diversos trastornos neurológicos, como el Síndrome de Guillain Barré, la encefalomielitis diseminada aguda (ADEM) y la mie...

  12. Unusual posterior reversible encephalopathy syndrome in a case of influenza A/H1N1 infection.

    Science.gov (United States)

    Locuratolo, Nicoletta; Mannarelli, Daniela; Colonnese, Claudio; Pauletti, Caterina; Antonaci, Laura; Ferretti, Giancarlo; Fattapposta, Francesco

    2012-10-15

    Central nervous system involvement is an uncommon though potentially a severe complication during influenza infection; the pathogenic mechanisms of the neurological syndromes described in humans are largely unknown. We describe a case of a 51-year-old man who presented with fever and behavioral changes but no focal neurological deficits. The next day, the condition rapidly evolved into a severe neurological syndrome with recurrent focal motor seizures with secondary generalization. At the brain MRI, FLAIR disclosed a slight area of increased signal in the left mesial frontal cortex extending to the frontopolar area and insula. At DWI, a mild hyperintensity was evident in the mesial-frontopolar cortex, with normal ADC values. MR perfusion was indicative of severe hypoperfusion. Fungal, bacterial and viral cultures in CSF, blood and urine were negative. The nasopharyngeal swab PCR was positive for the H1N1-influenza A virus. The patient was thus treated and by day five the neurological examination results had returned to normal. A follow-up MRI, performed two weeks later, only revealed a residual slight hyperintensity in the left medial frontal cortex. The onset of a rapidly evolving encephalopathy syndrome, its close association with a MRI brain pattern of acute vasogenic edema and favorable outcome support a diagnosis of PRES during influenza A infection. However, the topographic characteristics of the cerebral lesion seem to define a PRES with an atypical pattern. PMID:22910147

  13. Early assessment of anxiety and behavioral response to novel swine-origin influenza A(H1N1)

    OpenAIRE

    James Holland Jones; Marcel Salathé

    2009-01-01

    BACKGROUND: Since late April, 2009, a novel influenza virus A (H1N1), generally referred to as the "swine flu," has spread around the globe and infected hundreds of thousands of people. During the first few days after the initial outbreak in Mexico, extensive media coverage together with a high degree of uncertainty about the transmissibility and mortality rate associated with the virus caused widespread concern in the population. The spread of an infectious disease can be strongly influenced...

  14. Sequence-based identification and characterization of nosocomial influenza A(H1N1)pdm09 virus infections

    NARCIS (Netherlands)

    Jonges, M.; Rahamat-Langendoen, J.; Meijer, A.; Niesters, H. G.; Koopmans, M.

    2012-01-01

    Background: Highly transmissible viruses such as influenza are a potential source of nosocomial infections and thereby cause increased patient morbidity and mortality. Aim: To assess whether influenza virus sequence data can be used to link nosocomial influenza transmission between individuals. Meth

  15. Model Selection and Evaluation Based on Emerging Infectious Disease Data Sets including A/H1N1 and Ebola

    Directory of Open Access Journals (Sweden)

    Wendi Liu

    2015-01-01

    Full Text Available The aim of the present study is to apply simple ODE models in the area of modeling the spread of emerging infectious diseases and show the importance of model selection in estimating parameters, the basic reproduction number, turning point, and final size. To quantify the plausibility of each model, given the data and the set of four models including Logistic, Gompertz, Rosenzweg, and Richards models, the Bayes factors are calculated and the precise estimates of the best fitted model parameters and key epidemic characteristics have been obtained. In particular, for Ebola the basic reproduction numbers are 1.3522 (95% CI (1.3506, 1.3537, 1.2101 (95% CI (1.2084, 1.2119, 3.0234 (95% CI (2.6063, 3.4881, and 1.9018 (95% CI (1.8565, 1.9478, the turning points are November 7,November 17, October 2, and November 3, 2014, and the final sizes until December 2015 are 25794 (95% CI (25630, 25958, 3916 (95% CI (3865, 3967, 9886 (95% CI (9740, 10031, and 12633 (95% CI (12515, 12750 for West Africa, Guinea, Liberia, and Sierra Leone, respectively. The main results confirm that model selection is crucial in evaluating and predicting the important quantities describing the emerging infectious diseases, and arbitrarily picking a model without any consideration of alternatives is problematic.

  16. Influence of Statins on Influenza Vaccine Response in Elderly Individuals.

    Science.gov (United States)

    Black, Steven; Nicolay, Uwe; Del Giudice, Giuseppe; Rappuoli, Rino

    2016-04-15

    Influenza vaccination strategies have targeted elderly individuals because they are at high risk of disease complications and mortality. Statins are a class of drugs used to treat hypercholesterolemia and are frequently used in the elderly population to reduce the risk of cardiovascular disease. However, statins are also known to have immunomodulatory effects that could impact influenza vaccine response. In a post hoc analysis, we performed a cross-sectional observational study nested within a comparative immunogenicity clinical trial of adjuvanted versus unadjuvanted influenza vaccine in elderly persons to evaluate the influence of statin therapy on the immune response to vaccination. Overall, data on >5000 trial participants were available for analysis. Comparison of hemagglutination-inhibiting geometric mean titers to influenza A(H1N1), A(H3N2), and B strains revealed that titers were 38% (95% confidence interval [CI], 27%-50%), 67% (95% CI, 54%-80%), and 38% (95% CI, 28%-29%) lower, respectively, in subjects receiving chronic statin therapy, compared with those not receiving chronic statin therapy. This apparent immunosuppressive effect of statins on the vaccine immune response was most dramatic in individuals receiving synthetic statins. These effects were seen in both the adjuvanted and unadjuvanted vaccine groups in the clinical trial. These results, if confirmed, could have implications both for future clinical trials design, as well as for vaccine use recommendations for elderly individuals. PMID:26516142

  17. Towards universal influenza vaccines?

    OpenAIRE

    Osterhaus, Ab; Fouchier, Ron; Rimmelzwaan, Guus

    2011-01-01

    Vaccination is the most cost-effective way to reduce the considerable disease burden of seasonal influenza. Although seasonal influenza vaccines are effective, their performance in the elderly and immunocompromised individuals would benefit from improvement. Major problems related to the development and production of pandemic influenza vaccines are response time and production capacity as well as vaccine efficacy and safety. Several improvements can be envisaged. Vaccine production technologi...

  18. 2009 pandemic influenza A (H1N1 virus outbreak and response--Rwanda, October, 2009-May, 2010.

    Directory of Open Access Journals (Sweden)

    Justin Wane

    Full Text Available BACKGROUND: In October 2009, the first case of pandemic influenza A(H1N1pdm09 (pH1N1 was confirmed in Kigali, Rwanda and countrywide dissemination occurred within several weeks. We describe clinical and epidemiological characteristics of this epidemic. METHODS: From October 2009 through May 2010, we undertook epidemiologic investigations and response to pH1N1. Respiratory specimens were collected from all patients meeting the WHO case definition for pH1N1, which were tested using CDC's real time RT-PCR protocol at the Rwandan National Reference Laboratory (NRL. Following documented viral transmission in the community, testing focused on clinically severe and high-risk group suspect cases. RESULTS: From October 9, 2009 through May 31, 2010, NRL tested 2,045 specimens. In total, 26% (n = 532 of specimens tested influenza positive; of these 96% (n = 510 were influenza A and 4% (n = 22 were influenza B. Of cases testing influenza A positive, 96.8% (n = 494, 3% (n = 15, and 0.2% (n = 1 were A(H1N1pdm09, Seasonal A(H3 and Seasonal A(non-subtyped, respectively. Among laboratory-confirmed cases, 263 (53.2% were children <15 years and 275 (52% were female. In total, 58 (12% cases were hospitalized with mean duration of hospitalization of 5 days (Range: 2-15 days. All cases recovered and there were no deaths. Overall, 339 (68% confirmed cases received oseltamivir in any setting. Among all positive cases, 26.9% (143/532 were among groups known to be at high risk of influenza-associated complications, including age <5 years 23% (122/532, asthma 0.8% (4/532, cardiac disease 1.5% (8/532, pregnancy 0.6% (3/532, diabetes mellitus 0.4% (2/532, and chronic malnutrition 0.8% (4/532. CONCLUSIONS: Rwanda experienced a PH1N1 outbreak which was epidemiologically similar to PH1N1 outbreaks in the region. Unlike seasonal influenza, children <15 years were the most affected by pH1N1. Lessons learned from the outbreak response included the need to

  19. STUDY ON THE EFFECT EVALUATION OF INFLUENZA VACCINE IN CONTROLLING PANDEMIC INFLUENZA BY USING SEIR MODEL%动力模型在评价流感疫苗控制大流行疫情效果中的研究

    Institute of Scientific and Technical Information of China (English)

    倪莉红; Dr Joseph Wu

    2011-01-01

    [Objective] To simulate the attack rate of pandemic influenza in people, understand the effect of influenza vaccination in controlling the pandemic and anticipate the time at which vaccination begins (TL) , and take vaccinate the entire population (Dv) in order for the vaccination to be worthwhile. [Methods] The dynamic of influenza was simulated using SEIR model based on the natural history of illness and, the attack rate (AR) was defined as the evaluating indicator. [Results] For pandemic influenza strains with Ro being around 2, all infected individuals presented symptomatic, and the influence of the time at which vaccination begins (TL) on the AR was greater than the time of vaccinate the entire population (Dv). If the worthwhile of vaccine was defined as the AR being kept below 50%, the largest combination of TL and Dv was the 30th day and 80 days or the 40th day and 30 days. [Conclusion] To mitigate the damage of pandemic, the vaccination program should focus on how to shorten the time at which vaccination begins (TL).%[目的]模拟流感大流行对人类的影响,了解流感疫苗对控制流感大流行的作用,并预测为使疫苗物有所值,疫苗计划的滞后时间(TL)和完成时间(Dv). [方法]基于传染病的自然规律,在传统SEIR模型的基础上建立对人群免疫的传染病模型,采用感染率(AR)作为判断指标. [结果]对于R0在2左右的流感大流行,感染者均表现临床症状的情况下,疫苗计划滞后时间对感染率的影响大于疫苗计划完成时间,当感染率控制在50%以下则被认为疫苗计划有价值时,最大的TL和Dv组合为30和80或40和30d. [结论]为最大程度地减少大流行期间的损失,防病重点应放在尽早地开发和使用疫苗上.

  20. Duration of (18)F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination

    DEFF Research Database (Denmark)

    Thomassen, Anders; Lerberg Nielsen, Anne; Gerke, Oke;

    2011-01-01

    'reference' (i.e. contralateral, non-vaccinated) axillary lymph nodes were evaluated in 61 patients (19 of 61 patients were scanned twice). The maximal intensity in FDG uptake (SUV(max)) in draining lymph nodes was 5 g/ml body weight (BW), whereas the maximal intensity in reference lymph nodes was 1.9 g....../ml BW. The SUV(max) was normalized approximately 40 days after vaccination. No significant enlargement of metabolically active draining lymph nodes could be demonstrated on CT scan. Chemotherapy or immunosuppressive drugs given within 2 weeks from vaccination did not affect SUV(max) in the axillary...

  1. Abnormal humoral immune response to influenza vaccination in pediatric type-1 human immunodeficiency virus infected patients receiving highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Carlos J Montoya

    2007-06-01

    Full Text Available Given that highly active antiretroviral therapy (HAART has been demonstrated useful to restore immune competence in type-1 human immunodeficiency virus (HIV-1-infected subjects, we evaluated the specific antibody response to influenza vaccine in a cohort of HIV-1-infected children on HAART so as to analyze the quality of this immune response in patients under antiretroviral therapy. Sixteen HIV-1-infected children and 10 HIV-1 seronegative controls were immunized with a commercially available trivalent inactivated influenza vaccine containing the strains A/H1N1, A/H3N2, and B. Serum hemagglutinin inhibition (HI antibody titers were determined for the three viral strains at the time of vaccination and 1 month later. Immunization induced a significantly increased humoral response against the three influenza virus strains in controls, and only against A/H3N2 in HIV-1-infected children. The comparison of post-vaccination HI titers between HIV-1+ patients and HIV-1 negative controls showed significantly higher HI titers against the three strains in controls. In addition, post vaccination protective HI titers (defined as equal to or higher than 1:40 against the strains A/H3N2 and B were observed in a lower proportion of HIV-1+ children than in controls, while a similar proportion of individuals from each group achieved protective HI titers against the A/H1N1 strain. The CD4+ T cell count, CD4/CD8 T cells ratio, and serum viral load were not affected by influenza virus vaccination when pre- vs post-vaccination values were compared. These findings suggest that despite the fact that HAART is efficient in controlling HIV-1 replication and in increasing CD4+ T cell count in HIV-1-infected children, restoration of immune competence and response to cognate antigens remain incomplete, indicating that additional therapeutic strategies are required to achieve a full reconstitution of immune functions.

  2. The effect of age and recent influenza vaccination history on the immunogenicity and efficacy of 2009-10 seasonal trivalent inactivated influenza vaccination in children.

    Directory of Open Access Journals (Sweden)

    Sophia Ng

    Full Text Available BACKGROUND: There is some evidence that annual vaccination of trivalent inactivated influenza vaccine (TIV may lead to reduced vaccine immunogenicity but evidence is lacking on whether vaccine efficacy is affected by prior vaccination history. The efficacy of one dose of TIV in children 6-8 y of age against influenza B is uncertain. We examined whether immunogenicity and efficacy of influenza vaccination in school-age children varied by age and past vaccination history. METHODS AND FINDINGS: We conducted a randomized controlled trial of 2009-10 TIV. Influenza vaccination history in the two preceding years was recorded. Immunogenicity was assessed by comparison of HI titers before and one month after receipt of TIV/placebo. Subjects were followed up for 11 months with symptom diaries, and respiratory specimens were collected during acute respiratory illnesses to permit confirmation of influenza virus infections. We found that previous vaccination was associated with reduced antibody responses to TIV against seasonal A(H1N1 and A(H3N2 particularly in children 9-17 y of age, but increased antibody responses to the same lineage of influenza B virus in children 6-8 y of age. Serological responses to the influenza A vaccine viruses were high regardless of vaccination history. One dose of TIV appeared to be efficacious against confirmed influenza B in children 6-8 y of age regardless of vaccination history. CONCLUSIONS: Prior vaccination was associated with lower antibody titer rises following vaccination against seasonal influenza A vaccine viruses, but higher responses to influenza B among individuals primed with viruses from the same lineage in preceding years. In a year in which influenza B virus predominated, no impact of prior vaccination history was observed on vaccine efficacy against influenza B. The strains that circulated in the year of study did not allow us to study the effect of prior vaccination on vaccine efficacy against influenza A.

  3. Protective efficacy of a human endogenous retrovirus envelope-coated, nonreplicable, baculovirus-based hemagglutin vaccine against pandemic influenza H1N1 2009.

    Science.gov (United States)

    Choi, Jae-Yoo; Gwon, Yong-Dae; Kim, Jeong-Ki; Cho, Yeon-Dong; Heo, Yoon-Ki; Cho, Han-Sam; Choi, Tae-Jin; Poo, Ha-Ryoung; Oh, Yu-Kyoung; Kim, Young Bong

    2013-01-01

    Despite the advantages of DNA vaccines, overcoming their lower efficacy relative to that of conventional vaccines remains a challenge. Here, we constructed a human endogenous retrovirus (HERV) envelope-coated, nonreplicable, baculovirus-based HA vaccine against swine influenza A/California/04/2009(H1N1) hemagglutin (HA) (AcHERV-sH1N1-HA) as an alternative to conventional vaccines and evaluated its efficacy in two strains of mice, BALB/c and C57BL/6. A commercially available, killed virus vaccine was used as a positive control. Mice were intramuscularly administered AcHERV-sH1N1-HA or the commercial vaccine and subsequently given two booster injections. Compared with the commercial vaccine, AcHERV-sH1N1-HA induced significantly higher levels of cellular immune responses in both BALB/c and C57BL/6 mice. Unlike cellular immune responses, humoral immune responses depended on the strain of mice. Following immunization with AcHERV-sH1N1-HA, C57BL/6 mice showed HA-specific IgG titers 10- to 100-fold lower than those of BALB/c mice. In line with the different levels of humoral immune responses, the survival of immunized mice after intranasal challenge with sH1N1 virus (A/California/04/2009) depended on the strain. After challenge with 10-times the median lethal dose (MLD50) of sH1N1 virus, 100% of BALB/c mice immunized with the commercial vaccine or AcHERV-sH1N1-HA survived. In contrast, C57BL/6 mice immunized with AcHERV-sH1N1-HA or the commercial vaccine showed 60% and 70% survival respectively, after challenge with sH1N1 virus. In all mice, virus titers and results of histological analyses of lung tissues were consistent with the survival data. Our results indicate the importance of humoral immune response as a major defense system against influenza viral infection. Moreover, the complete survival of BALB/c mice immunized with AcHERV-sH1N1-HA after challenge with sH1N1 virus suggests the potential of baculoviral vector-based vaccines to achieve an efficacy comparable to

  4. Protective efficacy of a human endogenous retrovirus envelope-coated, nonreplicable, baculovirus-based hemagglutin vaccine against pandemic influenza H1N1 2009.

    Directory of Open Access Journals (Sweden)

    Jae-Yoo Choi

    Full Text Available Despite the advantages of DNA vaccines, overcoming their lower efficacy relative to that of conventional vaccines remains a challenge. Here, we constructed a human endogenous retrovirus (HERV envelope-coated, nonreplicable, baculovirus-based HA vaccine against swine influenza A/California/04/2009(H1N1 hemagglutin (HA (AcHERV-sH1N1-HA as an alternative to conventional vaccines and evaluated its efficacy in two strains of mice, BALB/c and C57BL/6. A commercially available, killed virus vaccine was used as a positive control. Mice were intramuscularly administered AcHERV-sH1N1-HA or the commercial vaccine and subsequently given two booster injections. Compared with the commercial vaccine, AcHERV-sH1N1-HA induced significantly higher levels of cellular immune responses in both BALB/c and C57BL/6 mice. Unlike cellular immune responses, humoral immune responses depended on the strain of mice. Following immunization with AcHERV-sH1N1-HA, C57BL/6 mice showed HA-specific IgG titers 10- to 100-fold lower than those of BALB/c mice. In line with the different levels of humoral immune responses, the survival of immunized mice after intranasal challenge with sH1N1 virus (A/California/04/2009 depended on the strain. After challenge with 10-times the median lethal dose (MLD50 of sH1N1 virus, 100% of BALB/c mice immunized with the commercial vaccine or AcHERV-sH1N1-HA survived. In contrast, C57BL/6 mice immunized with AcHERV-sH1N1-HA or the commercial vaccine showed 60% and 70% survival respectively, after challenge with sH1N1 virus. In all mice, virus titers and results of histological analyses of lung tissues were consistent with the survival data. Our results indicate the importance of humoral immune response as a major defense system against influenza viral infection. Moreover, the complete survival of BALB/c mice immunized with AcHERV-sH1N1-HA after challenge with sH1N1 virus suggests the potential of baculoviral vector-based vaccines to achieve an efficacy

  5. Pandemic influenza: certain uncertainties

    OpenAIRE

    Morens, David M.; Taubenberger, Jeffery K.

    2011-01-01

    For at least five centuries, major epidemics and pandemics of influenza have occurred unexpectedly and at irregular intervals. Despite the modern notion that pandemic influenza is a distinct phenomenon obeying such constant (if incompletely understood) rules such as dramatic genetic change, cyclicity, “wave” patterning, virus replacement, and predictable epidemic behavior, much evidence suggests the opposite. Although there is much that we know about pandemic influenza, there appears to be mu...

  6. Strategies for Fighting Pandemic Flu in Developing Countries

    Centers for Disease Control (CDC) Podcasts

    2009-03-04

    Countries throughout the world are preparing for the next influenza pandemic. Developing countries face special challenges because they don't have antiviral drugs or vaccines that more developed countries have. In this podcast, CDC's Dr. Dan Jernigan discusses new and innovative approaches that may help developing countries fight pandemic flu when it emerges.  Created: 3/4/2009 by Emerging Infectious Diseases.   Date Released: 3/4/2009.

  7. Effects of a Formula Containing Two Types of Prebiotics, Bifidogenic Growth Stimulator and Galacto-oligosaccharide, and Fermented Milk Products on Intestinal Microbiota and Antibody Response to Influenza Vaccine in Elderly Patients: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Shinya Nagafuchi

    2015-06-01

    Full Text Available We investigated the effect of a formula containing two different prebiotics (bifidogenic growth stimulator and galacto-oligosaccharide and fermented milk products on intestinal microbiota and antibody responses to an influenza vaccine in enterally fed elderly in-patients. Patients were administered either formula containing prebiotics and fermented milk products (group F: n = 12, 79.9 ± 9.5 years old or standard formula (group C: n = 12, 80.7 ± 10.1 years old via percutaneous endoscopic gastrostomy during a 14-week intervention period. Subjects were immunized with an influenza vaccine (A/H1N1, A/H3N2, and B at week 4 of the intervention. Blood biochemical indices, intestinal bacteria populations and antibody titers were analyzed. Bifidobacterium counts increased significantly in group F compared with group C. The enhanced antibody titers against A/H1N1 were maintained in group F for a longer period compared with group C. The titers against A/H3N2 were unchanged between both groups, and those against B were significantly lower in group F than in group C, although few subjects had seroprotective titers against A/H3N2 and B. These results suggest that administration of the formula containing prebiotics and fermented milk products may maintain antibody titers for longer periods through the improvement of intestinal microbiota.

  8. Including the public in pandemic planning: a deliberative approach

    Directory of Open Access Journals (Sweden)

    Braunack-Mayer Annette J

    2010-08-01

    Full Text Available Abstract Background Against a background of pandemic threat posed by SARS and avian H5N1 influenza, this study used deliberative forums to elucidate informed community perspectives on aspects of pandemic planning. Methods Two deliberative forums were carried out with members of the South Australian community. The forums were supported by a qualitative study with adults and youths, systematic reviews of the literature and the involvement of an extended group of academic experts and policy makers. The forum discussions were recorded with simultaneous transcription and analysed thematically. Results Participants allocated scarce resources of antiviral drugs and pandemic vaccine based on a desire to preserve society function in a time of crisis. Participants were divided on the acceptability of social distancing and quarantine measures. However, should such measures be adopted, they thought that reasonable financial, household and psychological support was essential. In addition, provided such support was present, the participants, in general, were willing to impose strict sanctions on those who violated quarantine and social distancing measures. Conclusions The recommendations from the forums suggest that the implementation of pandemic plans in a severe pandemic will be challenging, but not impossible. Implementation may be more successful if the public is engaged in pandemic planning before a pandemic, effective communication of key points is practiced before and during a pandemic and if judicious use is made of supportive measures to assist those in quarantine or affected by social isolation measures.

  9. Antiviral resistance and the control of pandemic influenza.

    Directory of Open Access Journals (Sweden)

    Marc Lipsitch

    2007-01-01

    Full Text Available BACKGROUND: The response to the next influenza pandemic will likely include extensive use of antiviral drugs (mainly oseltamivir, combined with other transmission-reducing measures. Animal and in vitro studies suggest that some strains of influenza may become resistant to oseltamivir while maintaining infectiousness (fitness. Use of antiviral agents on the scale anticipated for the control of pandemic influenza will create an unprecedented selective pressure for the emergence and spread of these strains. Nonetheless, antiviral resistance has received little attention when evaluating these plans. METHODS AND FINDINGS: We designed and analyzed a deterministic compartmental model of the transmission of oseltamivir-sensitive and -resistant influenza infections during a pandemic. The model predicts that even if antiviral treatment or prophylaxis leads to the emergence of a transmissible resistant strain in as few as 1 in 50,000 treated persons and 1 in 500,000 prophylaxed persons, widespread use of antivirals may strongly promote the spread of resistant strains at the population level, leading to a prevalence of tens of percent by the end of a pandemic. On the other hand, even in circumstances in which a resistant strain spreads widely, the use of antivirals may significantly delay and/or reduce the total size of the pandemic. If resistant strains carry some fitness cost, then, despite widespread emergence of resistance, antivirals could slow pandemic spread by months or more, and buy time for vaccine development; this delay would be prolonged by nondrug control measures (e.g., social distancing that reduce transmission, or use of a stockpiled suboptimal vaccine. Surprisingly, the model suggests that such nondrug control measures would increase the proportion of the epidemic caused by resistant strains. CONCLUSIONS: The benefits of antiviral drug use to control an influenza pandemic may be reduced, although not completely offset, by drug resistance

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

    Directory of Open Access Journals (Sweden)

    Yu-Hsiang Hsieh

    2013-03-01

    Full Text Available Introduction: Little is known regarding compliance with management guidelines for epidemicinfluenza in adult emergency department (ED settings during the 2009 novel influenza A(H1N1 epidemic, especially in relation to the Centers for Disease Control and Prevention (CDCguidance.Methods: We investigated all patients with a clinical diagnosis of influenza at an inner-citytertiary academic adult ED with an annual census of approximately 60,000 visits from May 2008to December 2009. We aimed to determine patterns of presentation and management for adultpatients with an ED diagnosis of influenza during the H1N1 pandemic, using seasonal influenza(pre-H1N1 as reference and to determine the ED provider’s adherence to American College ofEmergency Physicians and CDC guidance during the 2009 H1N1 influenza pandemic. Adherenceto key elements of CDC 2009 H1N1 guidance was defined as (1 the proportion of admittedpatients who were recommended to receive testing or treatment who actually received testingfor influenza or treatment with antivirals; and (2 the proportion of high-risk patients who weresupposed to be treated who actually were treated with antivirals.Results: Among 339 patients with clinically diagnosed influenza, 88% occurred during the H1N1pandemic. Patients were similarly managed during both phases. Median length of visit (pre-H1N1:385 min, H1N1: 355 min, P > 0.05 and admission rates (pre-H1N1: 8%, H1N1: 11%, P > 0.05were similar between the 2 groups. 28% of patients in the pre-H1N1 group and 16% of patientsin the H1N1 group were prescribed antibiotics during their ED visits (P > 0.05. There were 34admitted patients during the pandemic;, 30 (88% of them received influenza testing in the ED,and 22 (65% were prescribed antivirals in the ED. Noticeably, 19 (56% of the 34 admittedpatients, including 6 with a positive influenza test, received antibiotic treatment during their ED stay.Conclusion: During the recent H1N1 pandemic, most admitted patients

  11. Immunogenicity and safety of a trivalent inactivated 2010-2011 influenza vaccine in Taiwan infants aged 6-12 months.

    Science.gov (United States)

    Hwang, Kao-Pin; Hsu, Yu-Lung; Hsieh, Tsung-Hsueh; Lin, Hsiao-Chuan; Yen, Ting-Yu; Wei, Hsiu-Mei; Lin, Hung-Chih; Chen, An-Chyi; Chow, Julie Chi; Huang, Li-Min

    2014-05-01

    This prospective study aimed to investigate the immune responses and safety of an influenza vaccine in vaccine-naïve infants aged 6-12 months, and was conducted from November 2010 to May 2011. Fifty-nine infants aged 6-12 months received two doses of trivalent inactivated influenza vaccine 4 weeks apart. Hemagglutination inhibition titers were measured 4 weeks after the two doses of study vaccine. Based on the assumption that a hemagglutination inhibition titer of 1:40 or greater against the antigen would be protective in adults, two doses of the study vaccine generated a protective immune response of 63.2% against influenza A(H1N1), 82.5% against influenza A(H3N2) and 38.6% against influenza B viruses in infants aged 6-12 months. The geometric mean fold rises against influenza type A and B viruses also met the European Medicines Agency criteria for flu vaccines. The solicited events within 7 days after vaccination were mild in intensity. No deaths or adverse events such as optic neuritis, cranial neuropathy, and brachial neuropathy or Guillain-Barre syndrome were reported. Two doses of inactivated influenza vaccine were well tolerated and induced a protective immune response against influenza in infants aged 6-12 months. PMID:24625341

  12. Pandemic H1N1 influenza virus infection in a Canadian cat.

    Science.gov (United States)

    Knight, Cameron G; Davies, Jennifer L; Joseph, Tomy; Ondrich, Sarah; Rosa, Brielle V

    2016-05-01

    A cat was presented for necropsy after being found dead at home. Histologic findings suggested viral pneumonia. Polymerase chain reaction and viral typing revealed influenza A(H1N1)pdm09. This is the first report of influenza in a Canadian cat and highlights the importance of considering influenza virus in the differential diagnosis for feline respiratory distress. PMID:27152036

  13. Can antiviral drugs contain pandemic influenza transmission?

    Directory of Open Access Journals (Sweden)

    Niels G Becker

    Full Text Available Antiviral drugs dispensed during the 2009 influenza pandemic generally failed to contain transmission. This poses the question of whether preparedness for a future pandemic should include plans to use antiviral drugs to mitigate transmission.Simulations using a standard transmission model that allows for infected arrivals and delayed vaccination show that attempts to contain transmission require relatively few antiviral doses. In contrast, persistent use of antiviral drugs when the reproduction number remains above 1 use very many doses and are unlikely to reduce the eventual attack rate appreciably unless the stockpile is very large. A second model, in which the community has a household structure, shows that the effectiveness of a strategy of dispensing antiviral drugs to infected households decreases rapidly with time delays in dispensing the antivirals. Using characteristics of past pandemics it is estimated that at least 80% of primary household cases must present upon show of symptoms to have a chance of containing transmission by dispensing antiviral drugs to households. To determine data needs, household outbreaks were simulated with 50% receiving antiviral drugs early and 50% receiving antiviral drugs late. A test to compare the size of household outbreaks indicates that at least 100-200 household outbreaks need to be monitored to find evidence that antiviral drugs can mitigate transmission of the newly emerged virus.Use of antiviral drugs in an early attempt to contain transmission should be part of preparedness plans for a future influenza pandemic. Data on the incidence of the first 350 cases and the eventual attack rates of the first 200 hundred household outbreaks should be used to estimate the initial reproduction number R and the effectiveness of antiviral drugs to mitigate transmission. Use of antiviral drugs to mitigate general transmission should cease if these estimates indicate that containment of transmission is unlikely.

  14. Influenza: Epidemics and Pandemics

    OpenAIRE

    Markovski, Velo

    2013-01-01

    Influenza is a viral, pandemic and respiratory disease with high morbidity particular and significant mortality rate amongst humans. WHO has counted that each outbreak of epidemic is costing between 10-60 million dollars to one million citizens and each year there are between 250.000 to 500.000 deaths caused by flu. Eight RNA segments of influenza A and B viruses and seven segments of the C viruses are independently encapsulated by viral nucleoprotein. The heamagglutinin is the most important...

  15. Prevention and Control of Seasonal Influenza with Vaccines.

    Science.gov (United States)

    Grohskopf, Lisa A; Sokolow, Leslie Z; Broder, Karen R; Olsen, Sonja J; Karron, Ruth A; Jernigan, Daniel B; Bresee, Joseph S

    2016-01-01

    This report updates the 2015-16 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines (Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 influenza season. MMWR Morb Mortal Wkly Rep 2015;64:818-25). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For the 2016-17 influenza season, inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will be available in a trivalent formulation (RIV3). In light of concerns regarding low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, for the 2016-17 season, ACIP makes the interim recommendation that live attenuated influenza vaccine (LAIV4) should not be used. Vaccine virus strains included in the 2016-17 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines will include an additional influenza B virus strain, a B/Phuket/3073/2013-like virus (Yamagata lineage).Recommendations for use of different vaccine types and specific populations are discussed. A licensed, age-appropriate vaccine should be used. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended product is otherwise appropriate. This information is intended for vaccination providers, immunization program personnel, and public health personnel. Information in this report reflects discussions during public meetings of ACIP held on October 21, 2015; February 24, 2016; and June 22, 2016

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

    OpenAIRE

    Wasserman Jeffrey; Lurie Nicole; Aledort Julia E; Bozzette Samuel A

    2007-01-01

    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 pan...

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

    OpenAIRE

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

    2012-01-01

    Please cite this paper as: Starbuck et al (2012) Are we prepared to help low‐resource communities cope with a severe influenza pandemic? Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12040. 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 ina...

  18. Selecting Viruses for the Seasonal Influenza Vaccine

    Science.gov (United States)

    ... Japan (National Institute for Infectious Diseases); and Beijing, China (National Institute for Viral Disease Control and Prevention). ... Influenza (Flu) Vaccines Are Made . Top of Page Influenza Types Seasonal Avian Swine Variant Pandemic Other Get Email Updates To ...

  19. Advances in influenza vaccination

    OpenAIRE

    Reperant, Leslie A.; Rimmelzwaan, Guus F.; Osterhaus, Albert D. M. E.

    2014-01-01

    Influenza virus infections yearly cause high morbidity and mortality burdens in humans, and the development of a new influenza pandemic continues to threaten mankind as a Damoclean sword. Influenza vaccines have been produced by using egg-based virus growth and passaging techniques that were developed more than 60 years ago, following the identification of influenza A virus as an etiological agent of seasonal influenza. These vaccines aimed mainly at eliciting neutralizing antibodies targetin...

  20. Antiviral Prophylaxis and Isolation for the Control of Pandemic Influenza

    OpenAIRE

    Qingxia Zhang; Dingcheng Wang

    2014-01-01

    Before effective vaccines become available, antiviral drugs are considered as the major control strategies for a pandemic influenza. However, perhaps such control strategies can be severely hindered by the low-efficacy of antiviral drugs. For this reason, using antiviral drugs and an isolation strategy is included in our study. A compartmental model that allows for imported exposed individuals and asymptomatic cases is used to evaluate the effectiveness of control strategies via antiviral pro...

  1. Vaccines for allergy.

    Science.gov (United States)

    Linhart, Birgit; Valenta, Rudolf

    2012-06-01

    Vaccines aim to establish or strengthen immune responses but are also effective for the treatment of allergy. The latter is surprising because allergy represents a hyper-immune response based on immunoglobulin E production against harmless environmental antigens, i.e., allergens. Nevertheless, vaccination with allergens, termed allergen-specific immunotherapy is the only disease-modifying therapy of allergy with long-lasting effects. New forms of allergy diagnosis and allergy vaccines based on recombinant allergen-derivatives, peptides and allergen genes have emerged through molecular allergen characterization. The molecular allergy vaccines allow sophisticated targeting of the immune system and may eliminate side effects which so far have limited the use of traditional allergen extract-based vaccines. Successful clinical trials performed with the new vaccines indicate that broad allergy vaccination is on the horizon and may help to control the allergy pandemic. PMID:22521141

  2. Epidemiology of influenza viruses from 2009-2013-A sentinel surveillance report from Union territory of Puducherry, India

    Institute of Scientific and Technical Information of China (English)

    Ganesh; Nandhini; Sistla; Sujatha

    2015-01-01

    Objective: To report the i ndings of inl uenza surveillance programme from Union territory of Puducherry and to document the clinical and epidemiological data of inl uenza viruses over a i ve year period from 2009-2013. Methods: Respiratory samples were collected from patients with influenza-like illness from 2009-2013 as part of routine diagnostic and surveillance activity. Detection of pandemic inl uenza A(H1N1) 2009, inl uenza A(H3N2) and inl uenza B was done using Real-time PCR. Results: Of the total 2 247 samples collected from patients with inl uenza-like illness during the study period 287(12.7%) and 92(4.0%) were positive for inl uenza A(H1N1) 2009 and inl uenza A(H3N2) respectively. A subset of 557 of these samples were also tested for inl uenza B and 24(4.3%) were positive. Signii cantly higher positivity rate for both viruses was observed in adults when compared with children. The peak positivity of influenza A(H1N1) 2009 was observed in 2009 followed by 2012, while that of inl uenza A(H3N2) was more uniformly distributed with the exception of 2012. Overall mortality rate due to influenza A(H1N1) 2009 was 7.6% while it was 1% for influenza A(H3N2). Each year influenza-like illness and influenza virus activity coincided with period of high rainfall and low temperature except in the first half of 2012. Conclusions: As the sole referral laboratory in this region, the data provides a comprehensive picture of inl uenza activity. This information will be useful in future planning of the vaccine schedule and inl uenza pandemic preparedness.

  3. Caso Anatomopatológico influenza AH1N1 en una paciente embarazada: características clínicas y patológicas

    Directory of Open Access Journals (Sweden)

    José Luis Quirós Alpízar

    2010-03-01

    Full Text Available Se decriben los hallazgos clínicos y patológicos de la infección por influenza A (H1 N1, basados en un caso de autopsia. La paciente, una mujer de 25 años embarazada de gemelos, con 33 semanas de gestación y síntomas similares a influenza, quien fue admitida en el hospital y murió 13 días después. En la autopsia, el principal hallazgo fue daño alveolar difuso en fase proliferativa.We describe the pathologic and clinical changes over a case of Influenza A (H1N1 infection based in autopsy findings. The patient was a 25 year-old female pregnant of 33 weeks gestation twins, who had flu-like symptoms. She was hospitalized, but died 13 days after admitting. Autopsy findings included a diffuse alveolar damage in a proliferative phase.

  4. Multidrug resistant 2009 a/h1n1 influenza clinical isolate with a neuraminidase i223r mutation retains its virulence and transmissibility in ferrets

    NARCIS (Netherlands)

    E. van der Vries (Erhard); E.J.B.V. Kroeze; K.J. Stittelaar (Koert); M. Linster (Martin); A. van der Linden; E.J.A. Schrauwen (Eefje); L.M.E. Leijten (Lonneke); G. van Amerongen (Geert); M. Schutten (Martin); T. Kuiken (Thijs); A.D.M.E. Osterhaus (Albert); R.A.M. Fouchier (Ron); C.A.B. Boucher (Charles); S. Herfst (Sander)

    2011-01-01

    textabstractOnly two classes of antiviral drugs, neuraminidase inhibitors and adamantanes, are approved for prophylaxis and therapy against influenza virus infections. A major concern is that influenza virus becomes resistant to these antiviral drugs and spreads in the human population. The 2009 pan

  5. Language Generation of A/H1N1 Flu%"甲型H1N1流感"之语言生成

    Institute of Scientific and Technical Information of China (English)

    周筱娟

    2010-01-01

    语言静态是相对的,动态是绝对的.当下"猪流感"到"甲型H1N1流感"术语变更的实际情形表明,语言生成会经过"基础、修正、生成"的直线过程,经受从言语到语言的心理认知过程.

  6. Antibodies to influenza nucleoprotein cross-react with human hypocretin receptor 2.

    Science.gov (United States)

    Ahmed, Syed Sohail; Volkmuth, Wayne; Duca, José; Corti, Lorenzo; Pallaoro, Michele; Pezzicoli, Alfredo; Karle, Anette; Rigat, Fabio; Rappuoli, Rino; Narasimhan, Vas; Julkunen, Ilkka; Vuorela, Arja; Vaarala, Outi; Nohynek, Hanna; Pasini, Franco Laghi; Montomoli, Emanuele; Trombetta, Claudia; Adams, Christopher M; Rothbard, Jonathan; Steinman, Lawrence

    2015-07-01

    The sleep disorder narcolepsy is linked to the HLA-DQB1*0602 haplotype and dysregulation of the hypocretin ligand-hypocretin receptor pathway. Narcolepsy was associated with Pandemrix vaccination (an adjuvanted, influenza pandemic vaccine) and also with infection by influenza virus during the 2009 A(H1N1) influenza pandemic. In contrast, very few cases were reported after Focetria vaccination (a differently manufactured adjuvanted influenza pandemic vaccine). We hypothesized that differences between these vaccines (which are derived from inactivated influenza viral proteins) explain the association of narcolepsy with Pandemrix-vaccinated subjects. A mimic peptide was identified from a surface-exposed region of influenza nucleoprotein A that shared protein residues in common with a fragment of the first extracellular domain of hypocretin receptor 2. A significant proportion of sera from HLA-DQB1*0602 haplotype-positive narcoleptic Finnish patients with a history of Pandemrix vaccination (vaccine-associated narcolepsy) contained antibodies to hypocretin receptor 2 compared to sera from nonnarcoleptic individuals with either 2009 A(H1N1) pandemic influenza infection or history of Focetria vaccination. Antibodies from vaccine-associated narcolepsy sera cross-reacted with both influenza nucleoprotein and hypocretin receptor 2, which was demonstrated by competitive binding using 21-mer peptide (containing the identified nucleoprotein mimic) and 55-mer recombinant peptide (first extracellular domain of hypocretin receptor 2) on cell lines expressing human hypocretin receptor 2. Mass spectrometry indicated that relative to Pandemrix, Focetria contained 72.7% less influenza nucleoprotein. In accord, no durable antibody responses to nucleoprotein were detected in sera from Focetria-vaccinated nonnarcoleptic subjects. Thus, differences in vaccine nucleoprotein content and respective immune response may explain the narcolepsy association with Pandemrix. PMID:26136476

  7. Cross-protection by conventional influenza vaccines

    OpenAIRE

    Roos, A.L.E.

    2016-01-01

    In this thesis, we explore whether the protective efficacy of a trivalent virosomal seasonal influenza vaccine (TVV) can be broadened and thereby increase pandemic preparedness until more broadly protective influenza vaccines may become available. Chapter 2 examines the ability of a vaccination regimen comprising multiple immunizations to improve the cross-protective efficacy of TVV in mice. Chapter 3 explores whether priming a TVV with vaccine homologous HA DNA can improve its efficacy of in...

  8. INFLUENZA SURVEILLANCE IN RUSSIA BASED ON EPIDEMIOLOGICAL AND LABORATORY DATA FOR THE PERIOD FROM 2005 TO 2012

    Directory of Open Access Journals (Sweden)

    Sominina Anna

    2013-01-01

    Full Text Available Exchange of information on and sharing of influenza viruses through the GISRS network has great significance for understanding influenza virus evolution, recognition of a new pandemic virus emergence and for preparing annual WHO recommendations on influenza vaccine strain composition. Influenza surveillance in Russia is based on collaboration of two NICs with 59 Regional Bases. Most epidemiological and laboratory data are entered through the internet into the electronic database at the Research Institute of Influenza (RII, where they are analyzed and then reported to the Ministry of Public Health of Russia. Simultaneously, data are introduced into WHO’s Flu Net and Euro Flu, both electronic databases. Annual influenza epidemics of moderate intensity were registered during four pre-pandemic seasons. Children aged 0-2 and 3-6 years were the most affected groups of the population. Influenza registered clinically among hospitalized patients with respiratory infections for the whole epidemic period varied between 1.3 and 5.4% and up but to 18.5-23.0% during the peak of the two pandemic waves caused by influenza A(H1N1 pdm 09 virus and to lesser extent (2.9 to 8.5% during usual seasonal epidemics. Most epidemics were associated with influenza A(H1N1, A(H3N2 and B co-circulation. During the two pandemic waves (in 2009-2010 and 2010-2011 influenza A(H1N1 pdm 09 predominated. It was accompanied by a rapid growth of influenza morbidity with a significant increase of both hospitalization and mortality. The new pandemic virus displaced the previous seasonal A(H1N1 virus completely. As a rule, most of the influenza viruses circulating in Russia were antigenic ally related to the strains recommended by WHO for vaccine composition for the Northern hemisphere with the exception of two seasons when an unexpected replacement of the influenza B Victoria lineage by Yamagata lineage (2007-2008 and the following return of Victoria lineage viruses (2008-2009 was

  9. Pandemic influenza planning by videoconference.

    Science.gov (United States)

    Kimball, Ann Marie; Arima, Yuzo; French, H Matthew; Osaki, Carl S; Hoff, Rodney; Lee, Soo-Sim; Schafer, Lisa; Nabae, Koji; Chen, Chang-Hsun; Hsun, Chang; Hishamuddin, Pengiran; Nelson, Rodney; Woody, Karalee; Brown, Jacqueline; Fox, Louis

    2009-01-01

    Collaboration between nations and sectors is crucial to improve regional preparedness against pandemic influenza. In 2008, a Virtual Symposium was organized in the Asia-Pacific region by the Asia-Pacific Economic Cooperation Emerging Infections Network (APEC EINet) to discuss pandemic preparedness. The multipoint videoconference lasted approximately 4.5 hours and was attended by 16 APEC members who shared best practices in public-private partnerships for pandemic influenza preparedness planning. Twelve of the 16 APEC members who participated responded to a post-event survey. The overall experience of the event was rated highly. Partnering public health, technology and business communities to discuss best practices in preparedness using videoconferencing may be an effective way to improve regional preparedness. Utilization of videoconferencing on a routine basis should be considered to improve preparedness among APEC members and enhance its usability during a pandemic. PMID:19815907

  10. 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

  11. Zika - A Pandemic in Progress?

    Science.gov (United States)

    Mohamad Idris, Fauziah

    2016-03-01

    The emerging threat of Zika virus outbreak with associated neurological abnormalities needs to be assessed in perspective in terms of its ability to cause a pandemic. This article attempts to throw some light on the issue. PMID:27547117

  12. Drug: D09725 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D09725 Drug Emulsified influenza HA vaccine (A/H1N1 ); Arepanrix (H1N1 ) (TN) H1N1 ... influenza vacci ... antigen D09725 Emulsified influenza HA vaccine (A/H1N1 ) PubChem: 124490465 ...

  13. The first pandemic of the 21st century: a review of the 2009 pandemic variant influenza A (H1N1) virus.

    Science.gov (United States)

    Scalera, Nikole M; Mossad, Sherif B

    2009-09-01

    Swine influenza was first described in the 1918 pandemic and made a resurgence in April 2009 in the form of a triple-reassortant influenza A virus, which is composed of a combination of human, swine, and Eurasian avian strains. As evidenced with previous influenza pandemics, young adults and children aged < 24 years are the population most affected. Definitive diagnosis has largely been limited by the inability of conventional influenza testing to distinguish among influenza A subtypes; however, the surge in pandemic cases clearly emerged at the end of the annual influenza season in the northern hemisphere. The pandemic variant influenza A (H1N1) strain is typically susceptible to oseltamivir and resistant to adamantanes, unlike the 2008 to 2009 seasonal influenza A (H1N1). However, 2 cases of oseltamivir-resistant pandemic-variant influenza A (H1N1) were reported in late August 2009. The full impact of the current pandemic is not yet clear, and further reassortment with the circulating seasonal influenza strains in the upcoming 2009 fall season could potentially lead to acquisition of widespread oseltamivir resistance. Vaccination will become paramount in importance for prevention and public health safety. PMID:19820273

  14. Influenza Activity - United States, 2015-16 Season and Composition of the 2016-17 Influenza Vaccine.

    Science.gov (United States)

    Davlin, Stacy L; Blanton, Lenee; Kniss, Krista; Mustaquim, Desiree; Smith, Sophie; Kramer, Natalie; Cohen, Jessica; Cummings, Charisse Nitura; Garg, Shikha; Flannery, Brendan; Fry, Alicia M; Grohskopf, Lisa A; Bresee, Joseph; Wallis, Teresa; Sessions, Wendy; Garten, Rebecca; Xu, Xiyan; Elal, Anwar Isa Abd; Gubareva, Larisa; Barnes, John; Wentworth, David E; Burns, Erin; Katz, Jacqueline; Jernigan, Daniel; Brammer, Lynnette

    2016-01-01

    During the 2015-16 influenza season (October 4, 2015-May 21, 2016) in the United States, influenza activity* was lower and peaked later compared with the previous three seasons (2012-13, 2013-14, and 2014-15). Activity remained low from October 2015 until late December 2015 and peaked in mid-March 2016. During the most recent 18 influenza seasons (including this season), only two other seasons have peaked in March (2011-12 and 2005-06). Overall influenza activity was moderate this season, with a lower percentage of outpatient visits for influenza-like illness (ILI),(†) lower hospitalization rates, and a lower percentage of deaths attributed to pneumonia and influenza (P&I) compared with the preceding three seasons. Influenza A(H1N1)pdm09 viruses predominated overall, but influenza A(H3N2) viruses were more commonly identified from October to early December, and influenza B viruses were more commonly identified from mid-April through mid-May. The majority of viruses characterized this season were antigenically similar to the reference viruses representing the recommended components of the 2015-16 Northern Hemisphere influenza vaccine (1). This report summarizes influenza activity in the United States during the 2015-16 influenza season (October 4, 2015-May 21, 2016)(§) and reports the vaccine virus components recommended for the 2016-17 Northern Hemisphere influenza vaccines. PMID:27281364

  15. Scientific lessons from the first influenza pandemic of the 20th century.

    Science.gov (United States)

    Oxford, J S; Lambkin, R; Elliot, A; Daniels, R; Sefton, A; Gill, D

    2006-11-10

    Re-analysis of the influenza pandemic of 1918 has given reassurance about a rather low reproductive number (R(o)), a prolonged herald wave of virus and that the skewed mortality towards the young adult could be a singularly unique event dependent upon previous infection history, perhaps not to be repeated in a future pandemic. Over 99% of those who contracted the virus survived, in spite of the absence of antivirals, vaccine and antibiotics for the secondary bacteria infections which probably accounted for one-third of the 50 million deaths. Therefore, in spite of a three-fold population increase since 1918 and 100 thousand plane journeys daily, judicious and careful planning together with a stockpile of antiviral drugs, oseltamivir, zanamivir and M2 blockers and a generic H5N1 vaccine, and application of hygiene would be expected to reduce mortality in a new pandemic, to figures significantly less than 1918. PMID:17069939

  16. Flu vaccination in pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Siettou

    2012-04-01

    Full Text Available In periods of seasonal influenza, during pandemic flu in the past and from recent experience that we have the emergence of influenza A (H1N1, pregnant compared with non-pregnant women are at increased risk to get sick and to develop serious complications up to mortality. Purpose: This paper examines the risks that arise for pregnant from contamination with the flu virus and the safety of influenza vaccination in pregnancy. Method: The method involves searching review and research studies in Pubmed data base mainly of the 2000 until 2009 and the words were used is pregnancy, flu vaccination, complications of the flu vaccination at the period of pregnancy. Results: Morbidity during periods of seasonal influenza in pregnant women is increased, while in times of pandemic are recorded fatalities. Based on this, specific recommendations have been made for a flu vaccination in pregnant women, both from the CDC, the American College of Obstetricians and Gynecologists in the U.S. and other official bodies like the World Health Organization, according to that the constitution of influenza vaccine in the pregnancy is necessary, given that the probability of morbidity in this period is increased at 10%. Conclusions: The studies so far to influenza vaccination in pregnancy, do not record serious complications for pregnant women and infants. However more research needs to be done on the safety of influenza vaccination in pregnancy.

  17. DNA Vaccine Initiates Replication of Live Attenuated Chikungunya Virus In Vitro and Elicits Protective Immune Response in Mice

    OpenAIRE

    Tretyakova, Irina; Hearn, Jason; Wang, Eryu; Weaver, Scott; Pushko, Peter

    2014-01-01

    Background. Chikungunya virus (CHIKV) causes outbreaks of chikungunya fever worldwide and represents an emerging pandemic threat. Vaccine development against CHIKV has proved challenging. Currently there is no approved vaccine or specific therapy for the disease.

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

    OpenAIRE

    Arinaminpathy, N.; McLean, A. R.

    2007-01-01

    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.

  19. Influenza A (H1N1) 2009: a pandemic alarm

    Indian Academy of Sciences (India)

    Madhu Khanna; Neha Gupta; Ankit Gupta; V K Vijayan

    2009-09-01

    At this critical juncture when the world has not yet recovered from the threat of avian influenza, the virus has returned in the disguise of swine influenza, a lesser known illness common in pigs. It has reached pandemic proportions in a short time span with health personnel still devising ways to identify the novel H1N1 virus and develop vaccines against it. The H1N1 virus has caused a considerable number of deaths within the short duration since its emergence. Presently, there are no effective methods to contain this newly emerged virus. Therefore, a proper and clear insight is urgently required to prevent an outbreak in the future and make preparations that may be planned well in advance. This review is an attempt to discuss the historical perspective of the swine flu virus, its epidemiology and route of transmission to better understand the various control measures that may be taken to fight the danger of a global pandemic.

  20. Developing pandemic preparedness in Europe in the 21st century: experience, evolution and next steps

    Directory of Open Access Journals (Sweden)

    Angus Nicoll

    2012-04-01

    Full Text Available PROBLEM: Improving pandemic planning and preparedness is a challenge in Europe, a diverse region whose regional bodies (the Regional Office for Europe of the World Health Organization [WHO], the European Commission and the European Centre for Disease Prevention and Control have overlapping roles and responsibilities. APPROACH: European pandemic preparedness indicators were used to develop an assessment tool and procedure based on the 2005 global WHO checklist for pandemic preparedness. These were then applied to Member States of WHO's European Region, initially as part of structured national assessments conducted during short visits by external teams. LOCAL SETTING: Countries in WHO's European Region. RELEVANT CHANGES: From 2005 to 2008, 43 countries underwent a pandemic preparedness assessment that included a short external assessment visit by an expert team. These short visits developed into a longer self-assessment procedure involving an external team but "owned" by the countries, which identified gaps and developed plans for improving preparedness. The assessment tool and procedure became more sophisticated as national and local pandemic preparedness became more complex. The 2009 pandemic revealed new gaps in planning, surveillance communications and immunization. LESSONS LEARNT: Structured national self-assessments with support from external teams allow individual countries to identify gaps in their pandemic preparedness plans and enable regional bodies to assess the regional and global resources that such plans require. The 2009 pandemic revealed additional problems with surveillance, pandemic severity estimates, the flexibility of the response, vaccination, involvement of health-care workers and communication. European national plans are being upgraded and global leadership is required to ensure that these plans are uniformly applied across the region.

  1. Controlling pandemic flu: the value of international air travel restrictions.

    Directory of Open Access Journals (Sweden)

    Joshua M Epstein

    Full Text Available BACKGROUND: Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration. METHODS AND FINDINGS: A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product. CONCLUSIONS: International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of

  2. Planning for the Next Global Pandemic

    OpenAIRE

    Allen G.P. Ross; Crowe, Suzanne M.; Tyndall, Mark W.

    2015-01-01

    In order to mitigate human and financial losses as a result of future global pandemics, we must plan now. As the Ebola virus pandemic declines, we must reflect on how we have mismanaged this recent international crisis and how we can better prepare for the next global pandemic. Of great concern is the increasing frequency of pandemics occurring over the last few decades. Clearly, the window of opportunity to act is closing. This editorial discusses many issues including priority emerging and ...

  3. Canadian survey on pandemic flu preparations

    OpenAIRE

    Tracy CS; Guglietti C; Gibson JL; Wilson Kumanan; Ritvo Paul; Nie JX; Jadad AR; Upshur REG

    2010-01-01

    Abstract Background The management of pandemic influenza creates public health challenges. An ethical framework, 'Stand on Guard for Thee: ethical considerations in pandemic influenza preparedness' that served as a template for the World Health Organization's global consultation on pandemic planning, was transformed into a survey administered to a random sample of 500 Canadians to obtain opinions on key ethical issues in pandemic preparedness planning. Methods All framework authors and additi...

  4. The evolutionary emergence of pandemic influenza

    OpenAIRE

    Day, Troy; André, 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. Preparing for a Pandemic Flu Outbreak

    Science.gov (United States)

    Dittbenner, Richard

    2009-01-01

    This article discusses the things college leaders should know and do in case of a pandemic influenza outbreak. The author talks about four principles that will guide college leaders in developing a pandemic influenza plan and presents the 10 elements of an effective college pandemic planning process.

  6. Slowing the Next Pandemic: Survey of Community Mitigation Strategies

    Centers for Disease Control (CDC) Podcasts

    2008-04-15

    During the next influenza pandemic, it will take time to develop a vaccine and there may be limited medication to treat or prevent illness. To slow the spread of disease, CDC and other public health officials will likely ask Americans to decrease contact with others through altering work schedules, school dismissals and other measures. Researchers recently surveyed the public to see whether people could follow those recommendations and what kind of impact they might have.  Created: 4/15/2008 by Emerging Infectious Diseases.   Date Released: 4/29/2008.

  7. Flu vaccination in pregnancy

    OpenAIRE

    Maria Siettou; Maria Saridi

    2012-01-01

    In periods of seasonal influenza, during pandemic flu in the past and from recent experience that we have the emergence of influenza A (H1N1), pregnant compared with non-pregnant women are at increased risk to get sick and to develop serious complications up to mortality. Purpose: This paper examines the risks that arise for pregnant from contamination with the flu virus and the safety of influenza vaccination in pregnancy. Method: The method involves searching review and research studies in ...

  8. Fugleinfluenza og perspektiverne for vaccination mod pandemisk influenza

    DEFF Research Database (Denmark)

    Holst, Peter Johannes; Christensen, Jan Pravsgaard; Thomsen, Allan Randrup

    2008-01-01

    We may expect that the next influenza pandemic will affect about half the world's population within a year and that it will cause unpredictable mortality rates. In this perspective, we review the molecular mechanisms underlying the development of new pandemic influenza strains and a discussion on...... existing and future vaccination strategies directed towards prevention of pandemic influenza is presented. There is an urgent need to develop paninfluenza-specific vaccines and invest substantially in new technologies in order to better meet this threat. Udgivelsesdato: 2008-Nov-24...

  9. 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

  10. Universal influenza vaccines: Shifting to better vaccines.

    Science.gov (United States)

    Berlanda Scorza, Francesco; Tsvetnitsky, Vadim; Donnelly, John J

    2016-06-01

    Influenza virus causes acute upper and lower respiratory infections and is the most likely, among known pathogens, to cause a large epidemic in humans. Influenza virus mutates rapidly, enabling it to evade natural and vaccine-induced immunity. Furthermore, influenza viruses can cross from animals to humans, generating novel, potentially pandemic strains. Currently available influenza vaccines induce a strain specific response and may be ineffective against new influenza viruses. The difficulty in predicting circulating strains has frequently resulted in mismatch between the annual vaccine and circulating viruses. Low-resource countries remain mostly unprotected against seasonal influenza and are particularly vulnerable to future pandemics, in part, because investments in vaccine manufacturing and stockpiling are concentrated in high-resource countries. Antibodies that target conserved sites in the hemagglutinin stalk have been isolated from humans and shown to confer protection in animal models, suggesting that broadly protective immunity may be possible. Several innovative influenza vaccine candidates are currently in preclinical or early clinical development. New technologies include adjuvants, synthetic peptides, virus-like particles (VLPs), DNA vectors, messenger RNA, viral vectors, and attenuated or inactivated influenza viruses. Other approaches target the conserved exposed epitope of the surface exposed membrane matrix protein M2e. Well-conserved influenza proteins, such as nucleoprotein and matrix protein, are mainly targeted for developing strong cross-protective T cell responses. With multiple vaccine candidates moving along the testing and development pipeline, the field is steadily moving toward a product that is more potent, durable, and broadly protective than previously licensed vaccines. PMID:27038130

  11. Effectiveness of trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2012/13 end of season results.

    Science.gov (United States)

    Andrews, N; McMenamin, J; Durnall, H; Ellis, J; Lackenby, A; Robertson, C; von Wissmann, B; Cottrell, S; Smyth, B; Moore, C; Gunson, R; Zambon, M; Fleming, D; Pebody, R

    2014-01-01

    The effectiveness of the 2012/13 trivalent seasonal influenza vaccine (TIV) was assessed using a test-negative case-control study of patients consulting primary care with influenza-like illness in the United Kingdom. Strain characterisation was undertaken on selected isolates. Vaccine effectiveness (VE) against confirmed influenza A(H3N2), A(H1N1) and B virus infection, adjusted for age, sex, surveillance scheme (i.e. setting) and month of sample collection was 26% (95% confidence interval (CI): -4 to 48), 73% (95% CI: 37 to 89) and 51% (95% CI: 34 to 63) respectively. There was an indication, although not significant, that VE declined by time since vaccination for influenza A(H3N2) (VE 50% within three months, 2% after three months, p=0.25). For influenza A(H3N2) this is the second season of low VE, contributing to the World Health Organization (WHO) recommendation that the 2013/14 influenza vaccine strain composition be changed to an A(H3N2) virus antigenically like cell-propagated prototype 2012/13 vaccine strain (A/Victoria/361/2011). The lower VE seen for type B is consistent with antigenic drift away from the 2012/13 vaccine strain. The majority of influenza B viruses analysed belong to the genetic clade 2 and were antigenically distinguishable from the 2012/13 vaccine virus B/Wisconsin/1/2010 clade 3. These findings supported the change to the WHO recommended influenza B vaccine component for 2013/14. PMID:25033051

  12. 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

  13. 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

  14. Human immunodeficiency virus vaccine an update

    Directory of Open Access Journals (Sweden)

    V T Beena

    2013-01-01

    Full Text Available Since the discovery of acquired immuno deficiency syndrome (AIDS in late1980s, the spread of human immunodeficiency virus (HIV has reached pandemic proportions, representing a global developmental and public health threat. Finding of a safe, globally effective and affordable HIV vaccine offers the best hope for the future control of the disease pandemic. Significant progress has been made over the past years in the areas of basic virology, immunology, and pathogenesis of HIV/AIDS and the development of anti-retroviral drugs. However, the search for an HIV vaccine faces formidable scientific challenges related to the high genetic variability of the virus, the lack of immune correlates of protection, limitations with the existing animal models and logistical problems associated with the conduct of multiple clinical trials. Most of the vaccine approaches developed so far aim at inducing cell-mediated immune responses. Multiple vaccine concepts and vaccination strategies have been tested, including DNA vaccines, subunit vaccines, live vectored recombinant vaccines, various prime-boost vaccine combinations and vaccine based on broadly neutralizing human anti-HIV Antibody 2G12. This article reviews the state of the art in HIV vaccine research, summarizes the results obtained so far and discusses the challenges to be met in the development of a successful HIV vaccine.

  15. [Influenza vaccine and adjuvant].

    Science.gov (United States)

    Nakayama, Tetsuo

    2011-01-01

    Adjuvant is originated from the Latin word "adjuvare" which means "help" in English to enhance the immunological responses when given together with antigens. The beginning of adjuvant was mineral oil which enhanced the immune response when it was given with inactivated Salmonella typhimurium. Aluminium salt was used to precipitate diphtheria toxoid and increased level of antibody response was demonstrated when administered with alum-precipitated antigens. Since 1930, aluminium salt has been used as DTaP (diphtheria-tetanus-acellular pertussis vaccine) adjuvant. Many candidates were tested for adjuvant activity but only aluminum salt is allowed to use for human vaccines. New adjuvant MF59, oil-in-water emulsion type, was developed for influenza vaccine for elderly (Fluad) and series of AS adjuvant are used for hepatitis B, pandemic flue, and human papiloma virus vaccines. Oil-adjuvanted influenza pandemic vaccines induced higher antibody response than alum-adjuvanted vaccine with higher incidence of adverse events, especially for local reactions. Alum-adjuvanted whole virion inactivated H5N1 vaccine was developed in Japan, and it induced relatively well immune responses in adults. When it applied for children, febrile reaction was noted in approximately 60% of the subjects, with higher antibodies. Recent investigation on innate immunity demonstrates that adjuvant activity is initiated from the stimulation on innate immunity and/or inflammasome, resulting in cytokine induction and antigen uptake by monocytes and macrophages. The probable reason for high incidence of feb